Aesthetic Surgery Journal最新文献

Background: Snapchat dysmorphia (SD) is an emerging phenomenon that characterizes individuals seeking aesthetic procedures to replicate the appearance of their digitally altered selfies. This phenomenon has been hypothesized to be linked to body dysmorphic disorder (BDD) symptoms. Additionally, body trust (ie, perceiving the body as safe and trustworthy, relying on its signals and sensations), which could contrast excessive focus on physical appearance, may moderate this relationship. Current literature on SD reveals a notable lack of comprehensive empirical investigations.

Objectives: In this study, the authors examine the factorial structure and internal consistency of a newly developed measure: the SD Questionnaire (SDQ). Additionally, it explored the relationship between SD and BDD symptoms, with a focus on the potential moderating role of body trust.

Methods: Data were collected from a sample of 163 women seeking aesthetic medicine treatments. The factorial structure and internal consistency of the SDQ were examined. Its association with BDD symptoms was explored within a hierarchical regression model, after controlling for other variables (eg, motivations to pursue cosmetic procedures). Finally, the potential moderating role of body trust was tested.

Results: Findings supported a unidimensional factor structure for the SDQ, which also demonstrated a significant association with BDD symptoms. Body trust did not moderate this relationship.

Conclusions: Findings provide preliminary support for the validity of the SDQ in women seeking aesthetic medicine procedures and lend empirical weight to anecdotal claims that SD is distinct yet related to BDD. Finally, although body trust was negatively associated with BDD symptoms, it did not show a moderation effect.

Level of evidence: 4 (diagnostic):

Background: Nontobacco nicotine dependence has been recently linked to the obese population. Although abdominoplasty and panniculectomy are mainly indicated for patients with a history of obesity, no studies have yet investigated whether non-tobacco nicotine dependence poses a risk for abdominoplasty and panniculectomy complications.

Objectives: To evaluate the association between preoperative nontobacco nicotine dependence and the incidence of postoperative complications following abdominoplasty and panniculectomy procedures.

Methods: A retrospective cohort analysis was conducted using the TriNetX Global Collaborative Network. Patients > 18 years who underwent abdominoplasty or panniculectomy were divided into two groups: those who had documented nontobacco nicotine dependence (NTND) and those who had no documented nicotine dependence. Two sub-analyses were furtherly conducted, one of patients who underwent abdominoplasty and another of patients who underwent panniculectomy. Propensity score matching (PSM) was applied to balance demographic and clinical variables. Primary outcomes included postoperative complications at three-time intervals: 30 days, 60 days, and 90 days.

Results: After 1:1 PSM, each cohort consisted of 1,116 patients. Within 90 days following abdominoplasty or panniculectomy, patients with NTND exhibited significantly higher risks of surgical site infection (Relative Risk [RR] 1.458, 95% CI: 1.093,1.945), readmission (RR 1.632, 95% CI: 1.099,2.422), Inpatient hospitalization (RR 1.333, 95% CI: 1.028,1.73), post-operative opioid use (RR 1.281, 95% CI: 1.204,1.363), and any surgical site complications (RR 1.549, 95% CI: 1.287,1.865) compared to patients without nicotine dependence.

Conclusions: Non-tobacco nicotine dependence is associated with increased risk of surgical site complications, readmission and opioid consumption within 90 days post-operatively. Screening for NTND is required during pre-operative consultations and strategies aimed at mitigating the negative effect must be considered.

Background: The internet and social media have become dominant platforms for health information dissemination. Aesthetic plastic surgery and dermatology are particularly vulnerable to the rapid spread of misinformation, which can influence individual decision-making, professional credibility, and ultimately public health.

Objectives: This systematic review aims to synthesize current evidence on the impact of internet and social media misinformation related to aesthetic plastic surgery and dermatology, and to assess its implications for patient safety, professional practice, and public health.

Methods: A systematic search of PubMed (National Library of Medicine, Bethesda, MD, USA) and Scopus (Elsevier, Amsterdam, The Netherlands) was conducted for reviews and systematic reviews published between January 2014 and March 2024. The review followed PRISMA guidelines and applied PICOS criteria. Eligible studies addressed misinformation, fake news, or misleading communication in the context of aesthetic plastic surgery and dermatology. Data were extracted on study characteristics, key findings, and recommendations.

Results: From an initial yield of 935 articles, 15 reviews met inclusion criteria. The analysis revealed recurring themes: (a) prevalence and drivers of misinformation, (b) risks posed by unlicensed practitioners and non-medical influencers, (c) threats to patient privacy and data protection, (d) psychological harms linked to distorted body image expectations, and (e) lack of adequate regulatory frameworks. Several studies highlighted the critical role of physicians in countering misinformation by engaging actively on digital platforms.

Conclusions: Misinformation about aesthetic and dermatological procedures constitutes a significant public health risk, with implications ranging from unsafe treatments to erosion of trust in healthcare systems. Regulatory oversight, patient education, and proactive professional engagement on social media are urgently needed to mitigate harms and strengthen public health protection.

Background: Polydioxanone (PDO) mesh offers a more cost-effective option for soft-tissue support for two-stage breast reconstruction with tissue expansion compared to biologic mesh, but differences in complication rates have not been well established.

Objectives: The purpose of this study was to present a single centers' early postoperative complications following immediate tissue expander (TE) insertion for breast reconstruction using PDO mesh, biologic mesh, or no mesh.

Methods: This is a retrospective cohort study of patients undergoing immediate TE insertion following mastectomy between July 2021 to 2024 at a single academic center. Patients were grouped by mesh type. Univariate and multivariate regression analyses were performed.

Results: A total of 919 TEs in 524 patients were analyzed, with 27.7% with PDO mesh, 52.9% with biologic mesh, and 19.5% with no mesh. TE infection occurred in 70 breasts (7.6%) in 55 patients (10.5%), with infection rates of 10.6% in the PDO mesh group, 6.6% in the biologic mesh group, and 6.2% in the no mesh group (p=NS). Ipsilateral radiation exposure was the only factor significantly associated with infection (OR 7.2, p=0.008). Among prepectoral reconstructions, infection rates were higher compared to subpectoral cases, but mesh type was not independently associated with infection. Explantation occurred in 120 breasts (13.0%) with no difference between mesh types.

Conclusions: Short-term outcomes following TE placement were comparable among patients receiving PDO mesh, biologic mesh, or no mesh. These findings suggest that mastectomy flap quality and patient factors may have a greater impact on complications than mesh type, especially with prepectoral placement.

Regenerative peptides are gaining attention in regenerative medicine and plastic surgery for their potential to enhance surgical recovery and tissue regeneration. This review synthesizes evidence on four key peptides-focusing on their potential applications in wound healing, scar optimization, and aesthetic plastic surgery. Preclinical studies show promise, safety profiles appear favorable, but rigorous clinical trials are lacking. The paucity of human studies highlights an urgent need for high-quality research. Plastic surgeons are well-positioned to lead investigations, integrating regenerative peptides into perioperative care and evaluating their ability to optimize outcomes in aesthetic procedures.

Subfascial placement has been reported to reduce capsular contracture (CC) in primary breast augmentation. Given the shift toward smooth implants, it is unclear whether the perceived advantage reflects the surgical plane or historical implant selection. This study compares CC rates between subfascial and subglandular breast augmentation stratified by implant surface. A systematic review and meta-analysis were conducted. PubMed (National Institutes of Health, Bethesda, MD), Embase (Elsevier, Amsterdam, the Netherlands), Scopus (Elsevier), Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Library, London, UK), and Google Scholar (Alphabet, Inc., Mountain View, CA) were searched through April 2025. Studies reporting CC in primary augmentation with specified implant surface and plane were included. Random-effects models generated pooled incidences and odds ratios. Subgroup analyses evaluated studies published in the last decade and with a mean follow up duration greater than 24 months. Thirty-three studies met inclusion criteria. Across all years, studies comparing subfascial versus subglandular placement for smooth implants demonstrated no statistically significant difference in capsular contracture rates (7.2% vs 17.1%, p=0.13). Studies evaluating textured implants similarly showed no significant difference between planes (0.9% vs 3.7%, p=0.08). In studies published since 2015, smooth implants demonstrated comparable capsular contracture rates between subglandular and subfascial placement (8.2% vs 10.3%, p=0.54). In studies with mean follow-up greater than 24 months, no significant differences were observed for smooth implants, while textured implants demonstrated lower rates with subfascial placement. Microtextured implants demonstrated the lowest CC rates. When controlling for implant surface, CC rates do not differ significantly between subfascial and subglandular placement. Previously reported reductions in CC with subfascial augmentation appear driven by textured-implant cohorts. In contemporary smooth-implant practice, CC rates are similar across prepectoral planes.

Background: RibXcar is a minimally invasive technique for waistline contouring that uses ultrasound-guided monocortical rib fractures to achieve controlled angulation while preserving thoracic stability. Although its safety profile is favorable, bicorticalization fracture extension through both cortices remains a potential complication requiring systematic evaluation.

Objectives: This study aimed to assess the incidence, clinical evolution, and radiologic characteristics of bicorticality in a prospective cohort of RibXcar patients.

Methods: A prospective cohort of 328 female patients (mean age 28.3 ± 6.7 years; BMI 25.3 ± 1.8 kg/m²) underwent RibXcar between January and December 2023, performed by a single surgeon. Eligible patients were women aged 18-40 years with BMI < 30 kg/m² and visceral fat < 13%. All completed one-year clinical and radiologic follow-up. Postoperative pain, complications, and imaging findings were analyzed using Wilcoxon tests (p < 0.05).

Results: Bicorticality occurred in 15 patients (4.6%), mostly within the first 20 postoperative days. Pain was reported by 41 patients (12.5%), but in 7.9% was related to corset misuse rather than fracture status. Bicorticality correlated with higher visceral fat (12.7% ± 0.5 vs. 8.0% ± 0.3; p < 0.001) and longer operative time (48.9 ± 6.3 vs. 43.3 ± 8.3 min; p = 0.01). No hemothorax or pneumothorax occurred. At one year, 98.2% demonstrated satisfactory healing; 1.5% showed callus irregularity; and only one patient (0.3%) had persistent bicorticality.

Conclusions: RibXcar achieves controlled monocortical fractures with a low bicorticalization rate and predictable consolidation. Visceral fat and operative duration appear more influential than BMI in complication risk, supporting the technique's safety and reproducibility.

Background: Although transconjunctival orbital fat removal (TOFR)-a minimally invasive procedure-is increasingly performed to correct lower eyelid bulging, multicenter prospective studies evaluating patient satisfaction across multiple dimensions-bulging, pigmentation, and skin laxity-remain scarce.

Objectives: To evaluate post-TOFR satisfaction and identify factors influencing patient-reported outcomes.

Methods: This prospective observational study included 920 consecutive patients undergoing standardized TOFR between July and August 2025 across 60 aesthetic surgery clinics in Japan. A 5-point Likert scale assessed satisfaction with bulging, pigmentation, and skin laxity; scores of ≥4 indicated high satisfaction. Adjunctive treatments-hyaluronic acid (HA), collagen filler, and extracellular matrix (ECM) products-were analyzed.

Results: Satisfaction with skin laxity-but not bulging and pigmentation-significantly declined with age (ρ=-0.093, p=0.005). Total removal yielded higher satisfaction than partial removal, but without statistical significance. HA adjunctive treatment significantly improved satisfaction with pigmentation (65.4 vs 75.9%, p=0.002) and skin laxity (76.2 vs 82.9%, p=0.026). In multivariate analysis, HA (odds ratio, 1.56, p=0.026) and HA+ECM (odds ratio 1.76, p=0.013) were independent predictors of higher pigmentation-related satisfaction. Age cutoffs identified via Youden's index indicated significant declines in satisfaction beyond 38-48 years, particularly for skin laxity. Overall satisfaction (high satisfaction across all three domains) ranged from 64% to 73%, with trends toward improvement in groups receiving HA and multiple adjunctive procedures.

Conclusions: TOFR yielded high satisfaction regarding lower eyelid bulging. However, satisfaction with skin laxity declined with age. Adjunctive HA treatment improved pigmentation and skin laxity outcomes, underscoring the importance of individualized multimodal treatment, particularly in older patients.