首页 > 最新文献

Aesthetic Surgery Journal最新文献

英文 中文
Twenty Years of Macromastia Research: A Comprehensive Analysis of Diagnostic Standardization, Surgical Technique Optimization, and Exploration of Molecular Mechanisms. 巨乳症研究二十年:诊断标准化、手术技术优化和分子机制探索的综合分析。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-30 DOI: 10.1093/asj/sjag030
Ke-Jun Wu, Xia Yang, Rong-Quan He, Di-Yuan Qin, Ming-Jie Li, Qi Li, Jian-Di Li, Yu-Qing Liu, Gang Chen, Zhi-Qiang Han

Macromastia, characterized by excessive breast tissue growth, causes physical symptoms, psychosocial distress, and diminished quality of life. Despite the effectiveness of reduction mammaplasty, progress remains limited by inconsistent diagnostic criteria and incomplete mechanistic understanding. We combined bibliometric analysis with transcriptomic profiling to map research evolution and identify candidate molecular pathways. Bibliometric analysis of 499 macromastia publications from the Web of Science Core Collection (Clarivate Analytics, Philadelphia, PA, USA) employed keyword co-occurrence, thematic clustering, and temporal trend analysis. Complementarily, transcriptomic sequencing was performed on breast tissue from 3 severe macromastia patients (unilateral specimen >500 g) and 4 controls undergoing mammoplasty for benign conditions, with standardized preprocessing, differential expression analysis, and functional enrichment. Bibliometric mapping revealed a paradigm shift from subjective assessments toward quantitative evaluation in diagnosis, surgical planning, and quality-of-life measurement. Emerging terms (2021-2025) including 3D imaging, digital modeling, and inframammary fold measurements reflected growing emphasis on objective standards. Core themes centered on surgical outcomes, complications, and patient satisfaction. Mechanistic keywords increasingly highlighted hormonal regulation-particularly estrogen metabolism (aromatase/CYP19A1) and prolactin-related dysfunction-alongside emerging interest in cell communication and stem cells. Transcriptomic profiling identified differential expression patterns consistent with endocrine and growth signaling, with pathway enrichment implicating immune regulation, extracellular matrix remodeling, and oxidative stress. Downregulated pathways were enriched for DNA repair and transcriptional regulation.By integrating bibliometrics with transcriptomics, this study synthesizes two decades of macromastia research, documents the transition toward quantitative standards, and nominates molecular pathways warranting further validation.

巨乳症以乳房组织过度生长为特征,可引起身体症状、心理社会困扰和生活质量下降。尽管乳房缩小成形术是有效的,但由于诊断标准不一致和不完整的机制理解,进展仍然受到限制。我们将文献计量学分析与转录组学分析相结合,绘制研究进化图并确定候选分子途径。文献计量学分析采用关键词共现、主题聚类和时间趋势分析对Web of Science核心馆藏(Clarivate Analytics, Philadelphia, PA, USA) 499篇大乳房症出版物进行分析。此外,对3例重度巨乳症患者(单侧标本>500 g)和4例对照组的乳腺组织进行转录组测序,并进行标准化预处理、差异表达分析和功能富集。文献计量测绘揭示了在诊断、手术计划和生活质量测量方面从主观评估向定量评估的范式转变。新兴术语(2021-2025)包括3D成像、数字建模和乳腺下褶测量,反映了对客观标准的日益重视。核心主题集中于手术结果、并发症和患者满意度。机械关键词越来越多地强调激素调节-特别是雌激素代谢(芳香化酶/CYP19A1)和催乳素相关功能障碍-以及对细胞通讯和干细胞的新兴兴趣。转录组学分析确定了与内分泌和生长信号一致的差异表达模式,途径富集涉及免疫调节、细胞外基质重塑和氧化应激。下调通路被富集用于DNA修复和转录调控。通过整合文献计量学和转录组学,本研究综合了二十年来的巨乳症研究,记录了向定量标准的转变,并提名了需要进一步验证的分子途径。
{"title":"Twenty Years of Macromastia Research: A Comprehensive Analysis of Diagnostic Standardization, Surgical Technique Optimization, and Exploration of Molecular Mechanisms.","authors":"Ke-Jun Wu, Xia Yang, Rong-Quan He, Di-Yuan Qin, Ming-Jie Li, Qi Li, Jian-Di Li, Yu-Qing Liu, Gang Chen, Zhi-Qiang Han","doi":"10.1093/asj/sjag030","DOIUrl":"https://doi.org/10.1093/asj/sjag030","url":null,"abstract":"<p><p>Macromastia, characterized by excessive breast tissue growth, causes physical symptoms, psychosocial distress, and diminished quality of life. Despite the effectiveness of reduction mammaplasty, progress remains limited by inconsistent diagnostic criteria and incomplete mechanistic understanding. We combined bibliometric analysis with transcriptomic profiling to map research evolution and identify candidate molecular pathways. Bibliometric analysis of 499 macromastia publications from the Web of Science Core Collection (Clarivate Analytics, Philadelphia, PA, USA) employed keyword co-occurrence, thematic clustering, and temporal trend analysis. Complementarily, transcriptomic sequencing was performed on breast tissue from 3 severe macromastia patients (unilateral specimen >500 g) and 4 controls undergoing mammoplasty for benign conditions, with standardized preprocessing, differential expression analysis, and functional enrichment. Bibliometric mapping revealed a paradigm shift from subjective assessments toward quantitative evaluation in diagnosis, surgical planning, and quality-of-life measurement. Emerging terms (2021-2025) including 3D imaging, digital modeling, and inframammary fold measurements reflected growing emphasis on objective standards. Core themes centered on surgical outcomes, complications, and patient satisfaction. Mechanistic keywords increasingly highlighted hormonal regulation-particularly estrogen metabolism (aromatase/CYP19A1) and prolactin-related dysfunction-alongside emerging interest in cell communication and stem cells. Transcriptomic profiling identified differential expression patterns consistent with endocrine and growth signaling, with pathway enrichment implicating immune regulation, extracellular matrix remodeling, and oxidative stress. Downregulated pathways were enriched for DNA repair and transcriptional regulation.By integrating bibliometrics with transcriptomics, this study synthesizes two decades of macromastia research, documents the transition toward quantitative standards, and nominates molecular pathways warranting further validation.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deep Learning-Based Model for Breast Implant Classification in Ultrasonography: A Multi-Institutional Model Development and Validation Study. 基于深度学习的超声乳房植入物分类模型:多机构模型开发与验证研究。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjaf220
Hyokyung Yoo, Seoi Jeong, Hyoun-Joong Kong, Jeongmok Cho, Hak Chang, Sungwan Kim, Ki Yong Hong

Background: The increasing prevalence of implant-based breast surgeries highlights a critical gap in patient knowledge regarding implant information, exacerbated by inadequate record-keeping and emerging safety concerns.

Objectives: The authors of this study address the need for reliable implant identification methods by developing a deep learning model capable of classifying breast implants using ultrasound images.

Methods: Retrospective data of 28,712 breast ultrasound PNG files from 4136 breast implants in 2580 patients obtained from multiple institutions were utilized to train and validate this model.

Results: The findings demonstrate that the deep learning model achieved high diagnostic accuracy, with a balanced accuracy of 0.893 for manufacturer classification and 0.971 for implant texture classification in external test datasets. The model's performance was enhanced by employing Gradient-Weighted Class Activation Mapping (Grad-CAM) for interpretability.

Conclusions: By automating the identification process, this tool alleviates the reliance on specialized training among plastic surgeons regarding breast ultrasound, streamlining patient care. Despite limitations, the model shows promise for improving clinical workflows and patient outcomes.

背景:基于假体的乳房手术越来越普遍,这凸显了患者对假体信息知识的严重差距,而记录保存不足和新出现的安全问题加剧了这一差距。目的:本研究通过开发一种能够使用超声图像对乳房植入物进行分类的深度学习模型,解决了对可靠的植入物识别方法的需求。方法:利用多机构2580例患者4136例乳房植入物28712份乳腺超声PNG文件的回顾性数据,对该模型进行训练和验证。结果:我们的研究结果表明,深度学习模型获得了较高的诊断准确率,在外部测试数据集上,制造商分类的平衡准确率为0.893,植入物纹理分类的平衡准确率为0.971。采用Grad-CAM提高模型的可解释性,提高了模型的性能。结论:通过自动化识别过程,该工具减轻了整形外科医生在乳房超声方面对专业培训的依赖,简化了患者护理。尽管存在局限性,但该模型显示出改善临床工作流程和患者预后的希望。
{"title":"Deep Learning-Based Model for Breast Implant Classification in Ultrasonography: A Multi-Institutional Model Development and Validation Study.","authors":"Hyokyung Yoo, Seoi Jeong, Hyoun-Joong Kong, Jeongmok Cho, Hak Chang, Sungwan Kim, Ki Yong Hong","doi":"10.1093/asj/sjaf220","DOIUrl":"10.1093/asj/sjaf220","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of implant-based breast surgeries highlights a critical gap in patient knowledge regarding implant information, exacerbated by inadequate record-keeping and emerging safety concerns.</p><p><strong>Objectives: </strong>The authors of this study address the need for reliable implant identification methods by developing a deep learning model capable of classifying breast implants using ultrasound images.</p><p><strong>Methods: </strong>Retrospective data of 28,712 breast ultrasound PNG files from 4136 breast implants in 2580 patients obtained from multiple institutions were utilized to train and validate this model.</p><p><strong>Results: </strong>The findings demonstrate that the deep learning model achieved high diagnostic accuracy, with a balanced accuracy of 0.893 for manufacturer classification and 0.971 for implant texture classification in external test datasets. The model's performance was enhanced by employing Gradient-Weighted Class Activation Mapping (Grad-CAM) for interpretability.</p><p><strong>Conclusions: </strong>By automating the identification process, this tool alleviates the reliance on specialized training among plastic surgeons regarding breast ultrasound, streamlining patient care. Despite limitations, the model shows promise for improving clinical workflows and patient outcomes.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"137-149"},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Efficacy and Recurrence Risk of Intralesional Therapies for Hypertrophic Scars and Keloids: A Network Meta-Analysis. 增生性疤痕和瘢痕疙瘩病灶内治疗的比较疗效和复发风险:网络荟萃分析。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjaf182
I Chang Lai, Guan-Lun Huang, Kuan-Chun Lee, Po-Yuan Wu

Hypertrophic scars and keloids are fibroproliferative disorders arising from aberrant wound healing, often leading to aesthetic disfigurement, functional impairment, and psychosocial burden. Intralesional therapies remain a mainstay of treatment, yet the comparative efficacy and recurrence profiles of different agents have not been definitively established. We conducted a systematic search of PubMed (National Institutes of Health, Bethesda, MD), Cochrane Library (Wiley, Hoboken, NJ), US National Institutes of Health Ongoing Trials Register, EMBASE (Elsevier, Amsterdam, the Netherlands), and Google Scholar (Alphabet, Inc., Mountain View, CA) from inception through May 2025, restricted to English-language publications, to identify randomized controlled trials comparing 2 or more intralesional treatments for hypertrophic scars or keloids. Twenty-four eligible trials were included in a frequentist random-effects network meta-analysis integrating direct and indirect comparisons. Pooled estimates demonstrated that triamcinolone acetonide combined with 5-fluorouracil (TAC + 5-FU) achieved the most consistent improvements in treatment efficacy and recurrence control. Botulinum toxin A (BTA) ranked highest in treatment response but did not significantly reduce recurrence risk. Verapamil was associated with significantly lower efficacy compared with TAC, whereas bleomycin and 5-FU monotherapies provided intermediate outcomes without statistical superiority. Overall, TAC + 5-FU offered the most favorable balance between efficacy and recurrence reduction, whereas BTA showed strong response efficacy. These findings provide a comprehensive synthesis of intralesional therapies for hypertrophic scars and keloids, support the consideration of combination regimens in scar management, and underscore the need for further well-designed head-to-head trials with standardized endpoints to refine individualized treatment strategies. Level of Evidence: 3 (Therapeutic).

增生性疤痕和瘢痕疙瘩是由异常伤口愈合引起的纤维增生性疾病,通常导致美观毁容、功能损伤和社会心理负担。病灶内治疗仍然是主要的治疗方法,但不同药物的比较疗效和复发情况尚未明确确定。我们对PubMed(美国国立卫生研究院,Bethesda, MD)、Cochrane图书馆(Wiley, Hoboken, NJ)、美国国立卫生研究院正在进行的试验注册、EMBASE(爱思唯尔,阿姆斯特丹,荷兰)和谷歌Scholar (Alphabet, Inc., Mountain View, CA)进行了系统检索,从一开始到2025年5月,仅限于英语出版物,以确定比较两种或两种以上的增生性疤痕或瘢痕瘤病灶内治疗的随机对照试验。24项符合条件的试验被纳入频率随机效应网络荟萃分析,整合了直接和间接比较。综合估计显示曲安奈德联合5-氟尿嘧啶(TAC+5-FU)在治疗疗效和复发控制方面的改善最为一致。肉毒毒素A (BTA)在治疗反应中排名最高,但没有显著降低复发风险。与TAC相比,维拉帕米(VER)的疗效明显较低,而博来霉素(BLM)和5-FU单药治疗提供了中间结果,没有统计学优势。总体而言,TAC+5-FU在疗效和减少复发之间提供了最有利的平衡,而BTA表现出较强的缓解疗效。这些发现为增生性疤痕和瘢痕疙瘩的病灶内治疗提供了全面的综合,支持在疤痕管理中考虑联合治疗方案,并强调需要进一步设计良好的头对头试验,标准化终点,以完善个体化治疗策略。
{"title":"Comparative Efficacy and Recurrence Risk of Intralesional Therapies for Hypertrophic Scars and Keloids: A Network Meta-Analysis.","authors":"I Chang Lai, Guan-Lun Huang, Kuan-Chun Lee, Po-Yuan Wu","doi":"10.1093/asj/sjaf182","DOIUrl":"10.1093/asj/sjaf182","url":null,"abstract":"<p><p>Hypertrophic scars and keloids are fibroproliferative disorders arising from aberrant wound healing, often leading to aesthetic disfigurement, functional impairment, and psychosocial burden. Intralesional therapies remain a mainstay of treatment, yet the comparative efficacy and recurrence profiles of different agents have not been definitively established. We conducted a systematic search of PubMed (National Institutes of Health, Bethesda, MD), Cochrane Library (Wiley, Hoboken, NJ), US National Institutes of Health Ongoing Trials Register, EMBASE (Elsevier, Amsterdam, the Netherlands), and Google Scholar (Alphabet, Inc., Mountain View, CA) from inception through May 2025, restricted to English-language publications, to identify randomized controlled trials comparing 2 or more intralesional treatments for hypertrophic scars or keloids. Twenty-four eligible trials were included in a frequentist random-effects network meta-analysis integrating direct and indirect comparisons. Pooled estimates demonstrated that triamcinolone acetonide combined with 5-fluorouracil (TAC + 5-FU) achieved the most consistent improvements in treatment efficacy and recurrence control. Botulinum toxin A (BTA) ranked highest in treatment response but did not significantly reduce recurrence risk. Verapamil was associated with significantly lower efficacy compared with TAC, whereas bleomycin and 5-FU monotherapies provided intermediate outcomes without statistical superiority. Overall, TAC + 5-FU offered the most favorable balance between efficacy and recurrence reduction, whereas BTA showed strong response efficacy. These findings provide a comprehensive synthesis of intralesional therapies for hypertrophic scars and keloids, support the consideration of combination regimens in scar management, and underscore the need for further well-designed head-to-head trials with standardized endpoints to refine individualized treatment strategies. Level of Evidence: 3 (Therapeutic).</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"202-212"},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perfusion of the Superficial Musculoaponeurotic System and the Superficial Temporal Fascia During Facelift, as Assessed by Indocyanine Green Angiography. 用吲哚菁绿血管造影评估面部拉皮术中浅表肌筋膜系统和颞浅筋膜的灌注。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjag021
Chenzhi Lai, Xinhang Dong, Fangning Zhao, Xiaoshuang Guo, Xiaolei Jin

Background: A clear understanding of the superficial musculoaponeurotic system (SMAS) perfusion during extended SMAS rhytidectomy is helpful for surgical planning and for elucidating the structural characteristics of the SMAS.

Objectives: To determine the vascularity of the SMAS during extended SMAS rhytidectomy, as assessed using indocyanine green angiography (ICGA), and to discuss the clinical relevance of the SMAS perfusion pattern for surgical practice.

Methods: A total of 20 patients who underwent extended SMAS rhytidectomy were evaluated intraoperatively. The perfusion patterns of the buccal-mandibular area SMAS and the superficial temporal fascia before and immediately after dissection were assessed by means of ICGA.

Results: Perfusion of the buccal-mandibular area SMAS originated from a transverse facial artery perforator in the deep layer before dissection, but was absent after dissection. No perfusion was observed after elevation of the buccal-mandibular area SMAS. In contrast, a prominent axial vessel was visible within the superficial temporal fascia. When this fascia was dissected, it was predominantly perfused by the parietal branch of the superficial temporal artery, which was present bilaterally in all patients. The superficial temporal fascia showed a marked peak in blood perfusion after dissection.

Conclusions: Perfusion of the buccal-mandibular area SMAS originated from a transverse facial artery perforator in the deep layer and remained poor during extended SMAS rhytidectomy. Because of the poor perfusion of the buccal-mandibular area SMAS after elevation, high-risk patients may benefit from composite facelifts, less extensive skin dissection, or preservation of the transverse facial artery perforator. The superficial temporal fascia can be harvested as an inferior-pedicled flap down to the zygomatic arch, whereas the buccal-mandibular area SMAS cannot be reliably harvested in this manner.

背景:了解浅表肌腱神经系统(SMAS)在大范围除皱术中的灌注情况有助于手术计划和阐明SMAS的结构特征。目的:利用吲哚菁绿血管造影(ICGA)评估扩展SMAS除皱术期间SMAS血管的血管性,并讨论SMAS灌注模式与外科实践的临床相关性。方法:对20例接受扩展SMAS除皱术的患者进行术中评价。采用ICGA法观察颊下颌区SMAS及颞浅筋膜剥离前后的灌注情况。结果:颊下颌区SMAS在剥离前灌注来源于面横动脉深层穿支,剥离后无灌注。颊下颌区SMAS抬高后未见灌注。相反,颞浅筋膜内可见明显的轴向血管。当这个筋膜被切开时,它主要是由颞浅动脉的顶支灌注的,这在所有患者中都是双侧存在的。颞浅筋膜解剖后血流灌注明显增高。结论:颊下颌区SMAS的灌注起源于深层面横动脉穿支,在扩展SMAS除皱术中仍然很差。由于提升后颊下颌区域SMAS灌注不良,高危患者可选择复合拉皮术、较少的皮肤剥离或保留面横动脉穿支。颞浅筋膜可以作为下蒂皮瓣切除至颧弓,而颊下颌区域的SMAS不能以这种方式可靠地切除。
{"title":"Perfusion of the Superficial Musculoaponeurotic System and the Superficial Temporal Fascia During Facelift, as Assessed by Indocyanine Green Angiography.","authors":"Chenzhi Lai, Xinhang Dong, Fangning Zhao, Xiaoshuang Guo, Xiaolei Jin","doi":"10.1093/asj/sjag021","DOIUrl":"https://doi.org/10.1093/asj/sjag021","url":null,"abstract":"<p><strong>Background: </strong>A clear understanding of the superficial musculoaponeurotic system (SMAS) perfusion during extended SMAS rhytidectomy is helpful for surgical planning and for elucidating the structural characteristics of the SMAS.</p><p><strong>Objectives: </strong>To determine the vascularity of the SMAS during extended SMAS rhytidectomy, as assessed using indocyanine green angiography (ICGA), and to discuss the clinical relevance of the SMAS perfusion pattern for surgical practice.</p><p><strong>Methods: </strong>A total of 20 patients who underwent extended SMAS rhytidectomy were evaluated intraoperatively. The perfusion patterns of the buccal-mandibular area SMAS and the superficial temporal fascia before and immediately after dissection were assessed by means of ICGA.</p><p><strong>Results: </strong>Perfusion of the buccal-mandibular area SMAS originated from a transverse facial artery perforator in the deep layer before dissection, but was absent after dissection. No perfusion was observed after elevation of the buccal-mandibular area SMAS. In contrast, a prominent axial vessel was visible within the superficial temporal fascia. When this fascia was dissected, it was predominantly perfused by the parietal branch of the superficial temporal artery, which was present bilaterally in all patients. The superficial temporal fascia showed a marked peak in blood perfusion after dissection.</p><p><strong>Conclusions: </strong>Perfusion of the buccal-mandibular area SMAS originated from a transverse facial artery perforator in the deep layer and remained poor during extended SMAS rhytidectomy. Because of the poor perfusion of the buccal-mandibular area SMAS after elevation, high-risk patients may benefit from composite facelifts, less extensive skin dissection, or preservation of the transverse facial artery perforator. The superficial temporal fascia can be harvested as an inferior-pedicled flap down to the zygomatic arch, whereas the buccal-mandibular area SMAS cannot be reliably harvested in this manner.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improvement of Mild Nasal Contour Imperfections With Autologous Fat Grafting in East Asian Females: Techniques and Anatomy. 自体脂肪移植术改善东亚女性轻度鼻轮廓缺陷:技术与解剖学。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjaf199
Zonglin Huang, Xinyu Zhang, Chanyuan Jiang, Xiangyu Liu, Bo Yin, Facheng Li, Xuefeng Han

Background: East Asian women often present with mild nasal contour imperfections for which they are unwilling to undergo open rhinoplasty because the potential risks outweigh the modest severity. Autologous fat grafting is a mature technique for soft-tissue augmentation and has been applied in rhinoplasty; however, when solely used, its efficacy in this demographic remains obscure.

Objectives: The authors of this study aim to evaluate the clinical effectiveness of autologous fat grafting for mild nasal contour imperfections in East Asian women.

Methods: Cadaveric head dissection was performed to verify the anatomical accuracy of fat placement using the described techniques. A retrospective examination was conducted on 130 East Asian female patients (median age, 31 years; median follow-up, 18 months) that underwent rhinoplasty with autologous fat grafting between May 2013 and April 2024. Preoperative and postoperative profile photographs were measured for objective results. Patient satisfaction was assessed using FACE-Q questionnaires, and the results were also evaluated by 3-party ratings.

Results: Cadaveric dissections confirmed precise and predictable fat placement within targeted anatomical planes. Clinically, significant postoperative changes were observed in nasofrontal angle (mean change, +0.99°), nasolabial angle (+1.41°), nasal base convexity (+0.73%), and dorsal inclination angle (-0.38°; all P < .05); subgroup analyses identified nasal spine augmentation driving nasolabial angle increases. Both FACE-Q scores and 3-party ratings reflected high postoperative satisfaction. No severe complications were reported; minor complications included nodule formation and fat migration.

Conclusions: Autologous fat grafting is effective for correcting mild nasal contour imperfections in East Asian women. As corroborated by clinical results and dissection, the described techniques ensure precise fat placement in different nasal esthetic units.

Level of evidence: 3 (therapeutic):

背景:东亚女性经常出现轻微的鼻轮廓不完美,她们不愿意接受开放式鼻整形术,因为潜在的风险超过了适度的严重程度。自体脂肪移植是一种成熟的软组织隆胸技术,已广泛应用于鼻整形术;然而,当单独使用时,其在这一人口统计中的功效仍然模糊不清。目的:探讨自体脂肪移植术治疗东亚女性轻度鼻轮廓缺损的临床效果。方法:解剖尸体头部,验证所述技术脂肪放置的解剖学准确性。回顾性研究了2013年5月至2024年4月期间接受自体脂肪移植术鼻整形的130例东亚女性患者(中位年龄31岁,中位随访18个月)。测量术前和术后的侧面照片以获得客观结果。采用FACE-Q问卷对患者满意度进行评估,并通过三方评分对结果进行评估。结果:尸体解剖证实了在目标解剖平面内精确和可预测的脂肪放置。临床观察,术后鼻额角(平均变化+0.99°)、鼻唇角(+1.41°)、鼻底凸度(+0.73%)、鼻背倾角(-0.38°,均p < 0.05)发生显著变化;亚组分析表明鼻棘增大可导致鼻唇角增大。FACE-Q评分和三方评分均反映出较高的术后满意度。无严重并发症报告;轻微并发症包括结节形成和脂肪迁移。结论:自体脂肪移植术可有效矫正东亚女性轻度鼻轮廓缺损。临床结果和解剖证实,所描述的技术可确保在不同的鼻美容单位中精确地放置脂肪。
{"title":"Improvement of Mild Nasal Contour Imperfections With Autologous Fat Grafting in East Asian Females: Techniques and Anatomy.","authors":"Zonglin Huang, Xinyu Zhang, Chanyuan Jiang, Xiangyu Liu, Bo Yin, Facheng Li, Xuefeng Han","doi":"10.1093/asj/sjaf199","DOIUrl":"10.1093/asj/sjaf199","url":null,"abstract":"<p><strong>Background: </strong>East Asian women often present with mild nasal contour imperfections for which they are unwilling to undergo open rhinoplasty because the potential risks outweigh the modest severity. Autologous fat grafting is a mature technique for soft-tissue augmentation and has been applied in rhinoplasty; however, when solely used, its efficacy in this demographic remains obscure.</p><p><strong>Objectives: </strong>The authors of this study aim to evaluate the clinical effectiveness of autologous fat grafting for mild nasal contour imperfections in East Asian women.</p><p><strong>Methods: </strong>Cadaveric head dissection was performed to verify the anatomical accuracy of fat placement using the described techniques. A retrospective examination was conducted on 130 East Asian female patients (median age, 31 years; median follow-up, 18 months) that underwent rhinoplasty with autologous fat grafting between May 2013 and April 2024. Preoperative and postoperative profile photographs were measured for objective results. Patient satisfaction was assessed using FACE-Q questionnaires, and the results were also evaluated by 3-party ratings.</p><p><strong>Results: </strong>Cadaveric dissections confirmed precise and predictable fat placement within targeted anatomical planes. Clinically, significant postoperative changes were observed in nasofrontal angle (mean change, +0.99°), nasolabial angle (+1.41°), nasal base convexity (+0.73%), and dorsal inclination angle (-0.38°; all P < .05); subgroup analyses identified nasal spine augmentation driving nasolabial angle increases. Both FACE-Q scores and 3-party ratings reflected high postoperative satisfaction. No severe complications were reported; minor complications included nodule formation and fat migration.</p><p><strong>Conclusions: </strong>Autologous fat grafting is effective for correcting mild nasal contour imperfections in East Asian women. As corroborated by clinical results and dissection, the described techniques ensure precise fat placement in different nasal esthetic units.</p><p><strong>Level of evidence: 3 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"185-194"},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the Use of 5-Factor Modified Frailty Index to Predict Wound Healing Complications in Reduction Mammoplasty. 评价5因素修正脆性指数预测缩乳术中创面愈合并发症的应用。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjag026
Brittany Lala, Amy Yao, Fei Wang, Katie E Weichman

Background: Reduction mammoplasty is an established treatment for symptomatic macromastia. Understanding risk factors associated with complications is essential for counseling and patient selection. The modified frailty index (mFI-5) has been proposed as a simple tool to assess risk in surgical candidates.

Objectives: We sought to determine if the mFI-5 can accurately predict wound healing complications following reduction mammoplasty.

Methods: A retrospective review was performed of primary bilateral reduction mammoplasty cases between 2017 and 2019 at one institution. MFI-5 scores were calculated for each patient. 30-day wound healing complications were defined as incisional dehiscence, T-point breakdown, nipple-areolar complex necrosis, and fat necrosis. Univariate and multivariate logistic regression were used to evaluate predictive value.

Results: 474 patients were stratified into three age groups: 15-30, 31-50, and over 51. Twenty-six percent of patients developed 1 wound healing problem. On univariate analysis, ages 31-50 and 51+ (OR 2.75 and 3.16) and mFI score of 1 (OR 2.07) were associated with an increased risk of wound healing complications. Adjusted multivariate analysis indicated that age greater than 51 years significantly predicted wound healing issues (OR 2.89; p=0.001) when controlled for American Society of Anesthesiologists (ASA) score, smoking, and body mass index (BMI). The mFI-5 did not significantly predict wound healing issues when controlled for age, ASA, BMI, or smoking.

Conclusions: In our population, the mFI-5 was not a statistically significant predictor of wound healing complications following reduction mammoplasty. When controlling for confounders, advanced age alone seems to place patients at higher risk for wound healing complications.

背景:缩小乳房成形术是治疗症状性巨乳症的常用方法。了解与并发症相关的危险因素对咨询和患者选择至关重要。改良后的衰弱指数(mFI-5)已被提议作为评估外科候选人风险的简单工具。目的:我们试图确定mFI-5是否能准确预测乳房缩小成形术后的伤口愈合并发症。方法:回顾性分析某医院2017 - 2019年一期双侧缩乳术病例。计算每位患者的MFI-5评分。30天创面愈合并发症定义为切口裂开、t点破裂、乳头-乳晕复合体坏死、脂肪坏死。采用单因素和多因素logistic回归对预测值进行评价。结果:474例患者分为15-30岁、31-50岁和51岁以上三个年龄组。26%的患者出现了伤口愈合问题。在单因素分析中,31-50岁和51岁以上(OR为2.75和3.16)以及mFI评分为1 (OR为2.07)与伤口愈合并发症的风险增加相关。调整后的多变量分析表明,在控制美国麻醉医师协会(ASA)评分、吸烟和体重指数(BMI)的情况下,年龄大于51岁显著预测伤口愈合问题(OR 2.89; p=0.001)。在控制年龄、ASA、BMI或吸烟的情况下,mFI-5不能显著预测伤口愈合问题。结论:在我们的人群中,mFI-5不是缩小乳房成形术后伤口愈合并发症的统计学显著预测因子。当控制混杂因素时,仅高龄似乎就使患者有更高的伤口愈合并发症风险。
{"title":"Evaluating the Use of 5-Factor Modified Frailty Index to Predict Wound Healing Complications in Reduction Mammoplasty.","authors":"Brittany Lala, Amy Yao, Fei Wang, Katie E Weichman","doi":"10.1093/asj/sjag026","DOIUrl":"https://doi.org/10.1093/asj/sjag026","url":null,"abstract":"<p><strong>Background: </strong>Reduction mammoplasty is an established treatment for symptomatic macromastia. Understanding risk factors associated with complications is essential for counseling and patient selection. The modified frailty index (mFI-5) has been proposed as a simple tool to assess risk in surgical candidates.</p><p><strong>Objectives: </strong>We sought to determine if the mFI-5 can accurately predict wound healing complications following reduction mammoplasty.</p><p><strong>Methods: </strong>A retrospective review was performed of primary bilateral reduction mammoplasty cases between 2017 and 2019 at one institution. MFI-5 scores were calculated for each patient. 30-day wound healing complications were defined as incisional dehiscence, T-point breakdown, nipple-areolar complex necrosis, and fat necrosis. Univariate and multivariate logistic regression were used to evaluate predictive value.</p><p><strong>Results: </strong>474 patients were stratified into three age groups: 15-30, 31-50, and over 51. Twenty-six percent of patients developed 1 wound healing problem. On univariate analysis, ages 31-50 and 51+ (OR 2.75 and 3.16) and mFI score of 1 (OR 2.07) were associated with an increased risk of wound healing complications. Adjusted multivariate analysis indicated that age greater than 51 years significantly predicted wound healing issues (OR 2.89; p=0.001) when controlled for American Society of Anesthesiologists (ASA) score, smoking, and body mass index (BMI). The mFI-5 did not significantly predict wound healing issues when controlled for age, ASA, BMI, or smoking.</p><p><strong>Conclusions: </strong>In our population, the mFI-5 was not a statistically significant predictor of wound healing complications following reduction mammoplasty. When controlling for confounders, advanced age alone seems to place patients at higher risk for wound healing complications.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ergonomics in Careers Dedicated to Rhinoplasty: Prevalence and Prevention of Work-Related Musculoskeletal Disorders. 致力于鼻整形的职业人体工程学:与工作相关的肌肉骨骼疾病的流行和预防。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjaf228
Mariline Santos, Olcay Cem Bulut, Ralph Hohenberger, Rob Vergeer, Miguel Gonçalves Ferreira, Frank R Datema

Background: Rhinoplasty is an ergonomically demanding procedure that subjects surgeons to prolonged unfavorable postures and repetitive fine motor movements, increasing the risk of work-related musculoskeletal disorders (WRMDs). Nevertheless, ergonomic awareness and training in rhinoplasty remain limited.

Objectives: The aim of the authors of this study is to evaluate the prevalence of WRMDs among rhinoplasty surgeons and to assess ergonomic factors, training, and attitudes toward strategies to improve well-being and career longevity.

Methods: A 36-item electronic survey was distributed to members of the Evidence-Based Rhinoplasty Research Group (Feb-May 2025) to gather demographic, professional, and ergonomic data, including Likert-scale assessments of comfort and strain during rhinoplasty.

Results: A total of 109 consultant surgeons completed the survey. Mean comfort and strain scores were 6.7 ± 1.7 and 5.2 ± 2.3, respectively; 72% experienced discomfort (mainly neck, shoulders, and lower back), with greater experience correlating with better scores (P < .05). No significant differences were observed with gender, BMI, height, average duration of each rhinoplasty, weekly time spent on rhinoplasty, or the use of headlights or loupes. Only 5.3% had received formal ergonomics training; however, 81.4% expressed interest in ergonomic assessments, and 93.8% believed exercise benefits career longevity.

Conclusions: WRMDs are highly prevalent among rhinoplasty surgeons. Comfort and strain appear more related to posture, case volume, and cumulative experience than to specific instruments or techniques. Despite the prevalence and impact of these symptoms, ergonomic training remains rare, although interest is high. Targeted interventions-such as optimizing operating room setup, promoting intraoperative microbreaks, and encouraging physical exercise-are essential to reduce discomfort and support long-term career sustainability.

Level of evidence: 4 (therapeutic):

背景:鼻整形术是一项对人体工程学要求很高的手术,外科医生需要长时间的不良姿势和重复的精细运动,增加了与工作相关的肌肉骨骼疾病(wrmd)的风险。然而,人体工程学的认识和培训在鼻整形仍然有限。目的:评估鼻整形外科医生中wrmd的患病率,并评估人体工程学因素、培训和对改善健康和职业寿命策略的态度。方法:向循证鼻整形研究小组(2025年2 - 5月)的成员分发了一份36项的电子调查,以收集人口统计、专业和人体工程学数据,包括鼻整形过程中舒适度和应变的李克特量表评估。结果:109名会诊外科医生完成了调查。平均舒适和应变评分分别为6.7 ± 1.7和5.2 ± 2.3。72%的患者感到不适(主要是颈部、肩部、下背部),经验越丰富,得分越高(p < 0.05)。性别、身体质量指数、身高、每次隆鼻手术的平均持续时间、每周隆鼻手术花费的时间、使用前灯或放大镜等因素均无显著差异。只有5.3%的人接受过正式的人体工程学培训;然而,81.4%的人对人体工程学评估感兴趣,93.8%的人认为锻炼有利于职业寿命。结论:wrmd在鼻整形外科中非常普遍。舒适和劳损似乎与姿势、病例量和累积经验有关,而与特定的器械或技术无关。尽管这些症状的流行和影响,人体工程学训练仍然很少,尽管兴趣很高。有针对性的干预措施——如优化手术室设置、促进术中微休息和鼓励体育锻炼——对于减少不适和支持长期职业可持续性至关重要。
{"title":"Ergonomics in Careers Dedicated to Rhinoplasty: Prevalence and Prevention of Work-Related Musculoskeletal Disorders.","authors":"Mariline Santos, Olcay Cem Bulut, Ralph Hohenberger, Rob Vergeer, Miguel Gonçalves Ferreira, Frank R Datema","doi":"10.1093/asj/sjaf228","DOIUrl":"10.1093/asj/sjaf228","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty is an ergonomically demanding procedure that subjects surgeons to prolonged unfavorable postures and repetitive fine motor movements, increasing the risk of work-related musculoskeletal disorders (WRMDs). Nevertheless, ergonomic awareness and training in rhinoplasty remain limited.</p><p><strong>Objectives: </strong>The aim of the authors of this study is to evaluate the prevalence of WRMDs among rhinoplasty surgeons and to assess ergonomic factors, training, and attitudes toward strategies to improve well-being and career longevity.</p><p><strong>Methods: </strong>A 36-item electronic survey was distributed to members of the Evidence-Based Rhinoplasty Research Group (Feb-May 2025) to gather demographic, professional, and ergonomic data, including Likert-scale assessments of comfort and strain during rhinoplasty.</p><p><strong>Results: </strong>A total of 109 consultant surgeons completed the survey. Mean comfort and strain scores were 6.7 ± 1.7 and 5.2 ± 2.3, respectively; 72% experienced discomfort (mainly neck, shoulders, and lower back), with greater experience correlating with better scores (P < .05). No significant differences were observed with gender, BMI, height, average duration of each rhinoplasty, weekly time spent on rhinoplasty, or the use of headlights or loupes. Only 5.3% had received formal ergonomics training; however, 81.4% expressed interest in ergonomic assessments, and 93.8% believed exercise benefits career longevity.</p><p><strong>Conclusions: </strong>WRMDs are highly prevalent among rhinoplasty surgeons. Comfort and strain appear more related to posture, case volume, and cumulative experience than to specific instruments or techniques. Despite the prevalence and impact of these symptoms, ergonomic training remains rare, although interest is high. Targeted interventions-such as optimizing operating room setup, promoting intraoperative microbreaks, and encouraging physical exercise-are essential to reduce discomfort and support long-term career sustainability.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"174-184"},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Southern and Rural U.S. Markets Exhibit the Highest Unmet Demand for Aesthetic Surgery: Insights from Google Search Data and Plastic Surgeon Distribution Across Designated Market Areas. 美国南部和农村市场对美容手术的需求最高:来自谷歌搜索数据和整形外科医生在指定市场区域分布的见解。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjag028
Scott R Levin, Nina Yu, Granger B Wong

Background: Optimizing plastic surgeon distribution is essential to meeting rising consumer demand for aesthetic operations.

Objectives: This study aimed to identify aesthetic surgery demand-supply mismatches across U.S. Designated Market Areas (DMAs) and quantify regional demand changes from pre- to post-COVID periods.

Methods: This cross-sectional ecological analysis used Google Trends (Google LLC, Mountain View, CA, USA) Relative Search Volume (RSV) averaged for nine aesthetic operations as a proxy for demand across 210 DMAs from August 2024-2025. Surgeon concentration was calculated as board-certified plastic surgeons per 10,000 residents. Demand-Supply Ratio (DSR) was defined as RSV divided by surgeon concentration. DMAs were grouped into quintiles (Tiers 1-5, highest to lowest DSR).

Results: Median RSV was 45.03 (Interquartile Range [IQR] 39.52-54.90) and median surgeon density was 0.10 (IQR 0.06-0.17). Seventeen DMAs (8.1%) were "plastic surgery deserts," with search activity but no surgeons, clustering in the South, Midwest, and West. Median DSR was 426.16 (IQR 307.35-565.08), with highest DSRs concentrated in Southern and rural/interior DMAs, whereas coastal hubs were saturated. While surgeon concentration increased across DSR Tiers 1-5, RSV did not significantly differ. Nationally, median RSV increased 22.54% (IQR 16.65%-32.34%) from 2018-2019 to 2024-2025, with rising RSV in 95.2% of DMAs and highest growth in the Midwest (+32.58%, IQR 24.90%-47.55%).

Conclusions: Southern and rural DMAs are disproportionately represented among underserved aesthetic markets and plastic surgery deserts. Aesthetic demand is rising nationwide, particularly in the American interior, underscoring high-growth regions where strategic expansion of aesthetic services by board-certified plastic surgeons may improve patient access and safety.

背景:优化整形外科医生的分布是必不可少的,以满足日益增长的消费者对美容手术的需求。目的:本研究旨在确定美国指定市场区域(dma)的美容手术供需不匹配,并量化从疫情前到后的区域需求变化。方法:采用谷歌Trends(谷歌LLC, Mountain View, CA, USA)的相对搜索量(RSV)作为2024年8月至2025年8月210个dma需求的代表,对9个美学操作的平均相对搜索量(RSV)进行横断面生态分析。外科医生的集中度是按每1万名住院医师中有外科医师资格计算的。需求供给比(DSR)定义为RSV除以外科医生浓度。dma分为五分位数(1-5级,DSR最高至最低)。结果:RSV中位数为45.03(四分位间距[IQR] 39.52 ~ 54.90),外科医生密度中位数为0.10 (IQR为0.06 ~ 0.17)。17个dma(8.1%)是“整形手术沙漠”,有搜索活动但没有外科医生,集中在南部、中西部和西部。平均DSR为426.16 (IQR 307.35-565.08),最高的DSR集中在南部和农村/内陆地区,而沿海枢纽则饱和。虽然外科医生浓度在DSR 1-5级之间增加,但RSV没有显著差异。在全国范围内,从2018-2019年到2024-2025年,RSV中位数增长了22.54% (IQR 16.65%-32.34%),其中95.2%的dma RSV增长,中西部地区增长最快(+32.58%,IQR 24.90%-47.55%)。结论:南方和农村的dma不成比例地代表了服务不足的美容市场和整形手术沙漠。美容需求在全国范围内不断上升,尤其是在美国内陆地区,在高增长地区,通过委员会认证的整形外科医生战略性地扩大美容服务,可能会改善患者的就诊和安全。
{"title":"Southern and Rural U.S. Markets Exhibit the Highest Unmet Demand for Aesthetic Surgery: Insights from Google Search Data and Plastic Surgeon Distribution Across Designated Market Areas.","authors":"Scott R Levin, Nina Yu, Granger B Wong","doi":"10.1093/asj/sjag028","DOIUrl":"https://doi.org/10.1093/asj/sjag028","url":null,"abstract":"<p><strong>Background: </strong>Optimizing plastic surgeon distribution is essential to meeting rising consumer demand for aesthetic operations.</p><p><strong>Objectives: </strong>This study aimed to identify aesthetic surgery demand-supply mismatches across U.S. Designated Market Areas (DMAs) and quantify regional demand changes from pre- to post-COVID periods.</p><p><strong>Methods: </strong>This cross-sectional ecological analysis used Google Trends (Google LLC, Mountain View, CA, USA) Relative Search Volume (RSV) averaged for nine aesthetic operations as a proxy for demand across 210 DMAs from August 2024-2025. Surgeon concentration was calculated as board-certified plastic surgeons per 10,000 residents. Demand-Supply Ratio (DSR) was defined as RSV divided by surgeon concentration. DMAs were grouped into quintiles (Tiers 1-5, highest to lowest DSR).</p><p><strong>Results: </strong>Median RSV was 45.03 (Interquartile Range [IQR] 39.52-54.90) and median surgeon density was 0.10 (IQR 0.06-0.17). Seventeen DMAs (8.1%) were \"plastic surgery deserts,\" with search activity but no surgeons, clustering in the South, Midwest, and West. Median DSR was 426.16 (IQR 307.35-565.08), with highest DSRs concentrated in Southern and rural/interior DMAs, whereas coastal hubs were saturated. While surgeon concentration increased across DSR Tiers 1-5, RSV did not significantly differ. Nationally, median RSV increased 22.54% (IQR 16.65%-32.34%) from 2018-2019 to 2024-2025, with rising RSV in 95.2% of DMAs and highest growth in the Midwest (+32.58%, IQR 24.90%-47.55%).</p><p><strong>Conclusions: </strong>Southern and rural DMAs are disproportionately represented among underserved aesthetic markets and plastic surgery deserts. Aesthetic demand is rising nationwide, particularly in the American interior, underscoring high-growth regions where strategic expansion of aesthetic services by board-certified plastic surgeons may improve patient access and safety.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the Time of Maximal Vasoconstrictive Effect of Epinephrine in Facelift Surgery. 拉皮术中肾上腺素最大血管收缩作用时间的评价。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjaf141
Sami Tarabishy, Abigail Meyers, Marjorie C Kragel, Pierce L Janssen, James E Zins

Background: It remains unclear how long a plastic surgeon should wait for the optimal vasoconstrictive effect of epinephrine as local anesthetic before incision for aesthetic facial surgery.

Objectives: In this study we investigate the optimal timing for epinephrine-induced vasoconstriction in facelift procedures by measuring cheek skin temperature changes with forward-looking infrared thermography (FLIR).

Methods: A retrospective chart review was conducted on all patients who underwent facelift surgery by J.E.Z. between July 2023 and June 2024. Skin surface temperature was recorded at baseline and at predetermined time points up to 15 minutes following injection of the standardized epinephrine-containing local anesthetic solution. Additional patient data were obtained from electronic medical record review.

Results: Twenty-seven patients were included in the study. The median time for each patient to reach the lowest recorded cheek temperature was 5 minutes postinjection (mean 5.1 ± 2.9 minutes). Injected cheeks exhibited the largest median temperature decrease of 2.3°C at 7 minutes, followed by gradual rewarming to baseline. Uninjected nasal skin warmed steadily throughout the observation period. Of the 27 patients, 15 (55.6%) reached their minimum cheek temperature by 5 minutes, 23 (85.2%) by 7 minutes, and all 27 (100%) by 11 minutes.

Conclusions: These findings demonstrate that the maximal vasoconstrictive effect of epinephrine in facelift surgery occurs approximately 5 to 7 minutes after injection. We recommend that facelift surgeons wait 5 to 7 minutes before initiating incisions and dissection to balance optimal hemostasis with procedural efficiency.

Level of evidence: 4 (therapeutic):

背景:目前尚不清楚整形外科医生在进行面部美容手术切口前,局部麻醉肾上腺素收缩血管的最佳效果应该等待多长时间。目的:本研究通过前视红外热像仪(FLIR)测量面部皮肤温度的变化,探讨在面部拉皮术中肾上腺素诱导血管收缩的最佳时机。方法:对资深作者于2023年7月至2024年6月期间进行的所有面部拉皮手术患者进行回顾性图表分析。在注射标准的含肾上腺素的局部麻醉溶液后15分钟,在基线和预定时间点记录皮肤表面温度。从电子病历审查中获得其他患者数据。结果:27例患者纳入研究。每位患者达到最低记录颊温的中位时间为注射后5分钟(平均5.1±2.9分钟)。注射后的脸颊在7分钟内表现出最大的中位温度下降2.3°C,随后逐渐恢复到基线温度。在整个观察期间,未注射的鼻腔皮肤稳定升温。27例患者中,15例(55.6%)在5分钟内达到最低颊温,23例(85.2%)在7分钟内达到最低颊温,27例(100%)在11分钟内达到最低颊温。结论:这些结果表明,在拉皮手术中,肾上腺素的最大血管收缩作用发生在注射后约5-7分钟。我们建议整容外科医生在开始切口和剥离之前等待5-7分钟,以平衡最佳止血和手术效率。
{"title":"Evaluating the Time of Maximal Vasoconstrictive Effect of Epinephrine in Facelift Surgery.","authors":"Sami Tarabishy, Abigail Meyers, Marjorie C Kragel, Pierce L Janssen, James E Zins","doi":"10.1093/asj/sjaf141","DOIUrl":"10.1093/asj/sjaf141","url":null,"abstract":"<p><strong>Background: </strong>It remains unclear how long a plastic surgeon should wait for the optimal vasoconstrictive effect of epinephrine as local anesthetic before incision for aesthetic facial surgery.</p><p><strong>Objectives: </strong>In this study we investigate the optimal timing for epinephrine-induced vasoconstriction in facelift procedures by measuring cheek skin temperature changes with forward-looking infrared thermography (FLIR).</p><p><strong>Methods: </strong>A retrospective chart review was conducted on all patients who underwent facelift surgery by J.E.Z. between July 2023 and June 2024. Skin surface temperature was recorded at baseline and at predetermined time points up to 15 minutes following injection of the standardized epinephrine-containing local anesthetic solution. Additional patient data were obtained from electronic medical record review.</p><p><strong>Results: </strong>Twenty-seven patients were included in the study. The median time for each patient to reach the lowest recorded cheek temperature was 5 minutes postinjection (mean 5.1 ± 2.9 minutes). Injected cheeks exhibited the largest median temperature decrease of 2.3°C at 7 minutes, followed by gradual rewarming to baseline. Uninjected nasal skin warmed steadily throughout the observation period. Of the 27 patients, 15 (55.6%) reached their minimum cheek temperature by 5 minutes, 23 (85.2%) by 7 minutes, and all 27 (100%) by 11 minutes.</p><p><strong>Conclusions: </strong>These findings demonstrate that the maximal vasoconstrictive effect of epinephrine in facelift surgery occurs approximately 5 to 7 minutes after injection. We recommend that facelift surgeons wait 5 to 7 minutes before initiating incisions and dissection to balance optimal hemostasis with procedural efficiency.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"168-173"},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical Considerations on Polyurethane-Coated Implants in Breast Reconstruction. 聚氨酯涂层假体在乳房重建中的关键考虑。
IF 3 2区 医学 Q1 SURGERY Pub Date : 2026-01-29 DOI: 10.1093/asj/sjaf171
Manuel Cabrera Charleston, Daniela Guadalupe Oscura Paredes
{"title":"Critical Considerations on Polyurethane-Coated Implants in Breast Reconstruction.","authors":"Manuel Cabrera Charleston, Daniela Guadalupe Oscura Paredes","doi":"10.1093/asj/sjaf171","DOIUrl":"10.1093/asj/sjaf171","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP12-NP13"},"PeriodicalIF":3.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Aesthetic Surgery Journal
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1