Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Amyloidosis Screening by Biopsy During Carpal Tunnel Release: A Systematic Review and Meta-analysis.","authors":"Peter C Ferrin, Gwendolyn Daly, Angelo B Lipira, Ravi F Sood","doi":"10.1097/GOX.0000000000006816","DOIUrl":"10.1097/GOX.0000000000006816","url":null,"abstract":"<p><strong>Background: </strong>Cardiac amyloidosis (CA) is an underdiagnosed cause of heart failure with newly available effective therapies. Carpal tunnel syndrome is a common early manifestation of amyloidosis, and tissue obtained during carpal tunnel release (CTR) can be screened for amyloid, allowing for early CA diagnosis and treatment. However, neither screening criteria nor diagnostic yield are well defined. We estimated the prevalence of amyloid within the tenosynovium or transverse carpal ligament and occult CA among patients undergoing screening biopsy during CTR based on the results of published studies.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of studies that analyzed screening biopsies obtained at the time of CTR for the presence of amyloid.</p><p><strong>Results: </strong>Of 21 articles meeting inclusion criteria, 14 included biopsies from a general population undergoing CTR, 5 reported biopsies from a prescreened population at elevated risk for amyloidosis undergoing CTR, and 2 included patients undergoing CTR with suspected amyloidosis. The pooled prevalence of amyloid within the tenosynovium/transverse carpal ligament was 11% (95% confidence interval: 5%-18%) in American and European studies without prescreening, 20% (95% confidence interval: 13%-29%) in studies of screened patients, and 88%-100% in studies of patients suspected of having amyloidosis preoperatively. Overall, 5%-20% of patients with amyloid-positive biopsies who underwent cardiac screening were eventually diagnosed with CA, of whom 33% were started on transthyretin tetramer stabilizers.</p><p><strong>Conclusions: </strong>Biopsies for amyloid during CTR demonstrate a high rate of positivity among at-risk populations and an opportunity for early detection of occult CA. Future studies should further refine diagnostic criteria to optimize cost-effectiveness of widespread screening.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6816"},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Preoperative Septal Patch Test Helpful for Determining the Effects After Nasal Septal Perforation Closure?","authors":"Yu Hosokawa, Masafumi Sawada, Tetsuo Ikezono","doi":"10.1097/GOX.0000000000006813","DOIUrl":"10.1097/GOX.0000000000006813","url":null,"abstract":"<p><p>Nasal septal perforation (NSP) closure is a challenging procedure. In the case of a large NSP, it may be necessary to use tissue from outside the nose; therefore, the decision to perform NSP closure should be made carefully. The indication for NSP closure is whether the patient has nasal symptoms due to the NSP; however, the causes of nasal obstruction are diverse and can be difficult to determine. We performed the septal patch test (SPT) as a simple examination to determine if NSP closure will improve nasal symptoms. The septal patch is created by cutting a piece of filter paper slightly larger than the NSP and adjusting it for a proper fit. Two septal patches are prepared and used to cover the NSP from both the left and right nasal cavities. Nasal breathing symptoms are evaluated using a visual analog scale (N-VAS) before and 3 minutes after SPT. We evaluated 6 cases of NSP. The average N-VAS score was 1.5 preoperatively, 8.16 after SPT, and 8.16 postoperatively. The maximum and minimum NSP sizes were 35 and 5 mm, respectively. Nasal symptoms after SPT were similar to those after NSP closure. We believe that SPT is useful for evaluating the symptom-relieving effects of NSP closure procedures. If a patient with nasal obstruction also has an NSP, performing SPT alongside other assessments may help identify the cause of the nasal obstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6813"},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Assessment, Strategy, and Treatment Protocol: Nasolabial Fold Assessment, Strategy, and Treatment With Hyaluronic Acid Fillers in Chinese Patients.","authors":"Qin Li, Haiyan Cui, Fang-Wen Tseng, Qingyang Liu, Zhiqiang Xue, Jani van Loghem, Kai-Chih Hung, Lijun Zhou, Wen Xie, Jingjing Zhao","doi":"10.1097/GOX.0000000000006792","DOIUrl":"10.1097/GOX.0000000000006792","url":null,"abstract":"<p><strong>Background: </strong>Causes contributing to nasolabial fold (NLF) appearance can be multifactorial, hence requiring distinct dermal filler strategies. We devised 4 assessment, strategy, and treatment (AST) injection protocols, incorporating NLF etiology and severity, patient expectations, and the selection of Belotero Balance Lidocaine (BBL) and Belotero Volume Lidocaine (BVL) hyaluronic acid fillers.</p><p><strong>Methods: </strong>The underlying etiology and photonumeric assessments of NLF severity guided protocol selection. In protocol 1, the NLF was injected directly with BBL into the mid-to-deep dermis and/or immediate subdermal plane. In protocol 2, BVL was injected using dual-plane sandwich technique into the canine fossa and subcutaneous layers. Protocol 3 combined indirect injections of BVL into the deep medial cheek fat compartment and preauricular hollows to lift ptotic soft tissue, followed by direct NLF injections with protocols 1 and 2. In protocol 4, BVL was injected into the temple and/or jawline, in combination with midface augmentation (AST protocol 3) and direct NLF injections (AST protocols 1 and 2) to fully address all underlying etiologies contributing to NLF appearance.</p><p><strong>Results: </strong>AST protocols facilitate treatment customization to each patient's NLF etiology and severity through direct and indirect approaches. At 30 days, NLF severity improved visibly and satisfactorily. Improvements varied from effacement of superficial nasolabial wrinkles to shallower NLF depth, improvement in cheek projection and nasojugal groove appearance, and smoother submalar contours.</p><p><strong>Conclusions: </strong>The AST protocols provide a strategic reference for combining BBL and BVL in a personalized patient-centric approach for effective, holistic, and balanced NLF corrections and pan-facial aesthetic improvements.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6792"},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Study: Thread Rhinoplasty With Different Methods of Barbed Thread Implantation.","authors":"Takahiko Tamura, Yoshimasa Furuichi, Taichi Tamura, Takashi Fuse, Miku Toma, Kohki Okumura, Hiroo Teranishi","doi":"10.1097/GOX.0000000000006807","DOIUrl":"10.1097/GOX.0000000000006807","url":null,"abstract":"<p><strong>Background: </strong>Thread rhinoplasty is a minimally invasive procedure with short downtime and high patient satisfaction. Although it is known that the effectiveness of rhinoplasty varies depending on the method of thread placement, there have been no studies quantifying these differences. In this study, we analyzed the differences in the effectiveness of rhinoplasty depending on the method of thread implantation using a 3-dimensional imaging analyzer (VECTRA H2, Canfield Scientific).</p><p><strong>Methods: </strong>This study was a prospective observation study. Six patients who underwent rhinoplasty using threads from February to May 2024 were divided into 2 groups according to the method of thread placement: nasal septum implantation group (group S) and nasal septum + nasal dorsum implantation group (group SD). The pre- and postoperative changes analyzed by VECTRAH2 were compared between the 2 groups.</p><p><strong>Results: </strong>Nasal dorsal length change, nasal wing length change, and nasal wing length/nasal dorsal length ratio change were not significantly different between the two groups. The angular changes were as follows: nasolabial angle change (15 [8-23], -1 [-7 to 6], <i>P</i> < 0.05), nasal frontal angle change (-3 [-4 to -2], 1.67 [1-3], <i>P</i> < 0.05), nasal face angle change (4 [3-5], 1 [0-2], <i>P</i> < 0.05), and nasal jaw angle change (-4.3 [-5 to -3], -4.3 [-5 to -4], <i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Thread rhinoplasty was found to have different postoperative effects depending on the method of thread implantation. It was suggested that it is possible to provide a procedure that meets the patient's wishes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6807"},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Microgravity Experiments in Plastic Surgery: A Literature Review.","authors":"Jonathan Cornacchini, Yanis Berkane, Vlad Tereshenko, Olivier Camuzard, Alexandre G Lellouch, Elise Lupon","doi":"10.1097/GOX.0000000000006802","DOIUrl":"10.1097/GOX.0000000000006802","url":null,"abstract":"<p><strong>Background: </strong>Interest in microgravity is growing in the medical and surgical fields. This literature review aims to synthesize existing evidence on microgravity applications in plastic surgery, focusing on experimental methods, outcomes, and prospects.</p><p><strong>Methods: </strong>All reported articles up to October 2023, including publications and news reports, were screened for inclusion using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The PubMed keywords and Boolean operators were \"plastic surgery AND microgravity,\" \"plastic surgery AND spaceflight,\" \"wound healing AND microgravity,\" \"skin aging AND microgravity,\" \"skin cancer AND microgravity,\" and \"melanoma AND microgravity.\"</p><p><strong>Results: </strong>A total of 201 articles were identified, and 14 studies were included. Plastic surgery procedures can be performed under microgravity, resulting in a delayed wound healing process. Four studies demonstrated that microgravity could reduce skin thickness and modify cell metabolism. In 2 studies, neoplastic melanoma cells have shown behavioral modifications under microgravity with induced apoptosis but increased potential for metastasis.</p><p><strong>Conclusions: </strong>Microgravity represents a unique environment with potential implications in plastic surgery, although further rigorous studies need to be conducted in humans. The anticipated rise and development of spaceflights render the study of biological changes in space an impactful and significant topic.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6802"},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12114005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Method for Precisely Designing the Form of Double Eyelid in Double Eyelid Plasty.","authors":"Hongyu Yin, Huan Yang","doi":"10.1097/GOX.0000000000006723","DOIUrl":"10.1097/GOX.0000000000006723","url":null,"abstract":"<p><strong>Background: </strong>Given the high prevalence of monolids in Asians and challenges in achieving natural-looking symmetrical folds in blepharoplasty, this study introduces a precise double eyelid design method to improve surgical outcomes. This study aimed to introduce a method of precise designing of double eyelid shape in double eyelid blepharoplasty.</p><p><strong>Methods: </strong>After removing the orbicularis oculi muscle and orbital septum fat properly in the operation, the same double eyelid marker line was drawn on the anterior tarsal tissue as that designed before operation, and then the skin-anterior tarsal tissue skin was sutured along the marker line.</p><p><strong>Results: </strong>We followed up 160 patients who had this method applied for 6-12 months, using a questionnaire named self-evaluation of the postoperative form of double eyelid. The satisfaction rate of double eyelid morphology was 92.5%.</p><p><strong>Conclusions: </strong>This method simplifies the repeated adjustment of suture operation, enables precise surgical operations, and has high satisfaction with the shape of double eyelids after operation, thus deserving popularization.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6723"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Autologous Fat Grafting in Delayed Breast Reconstruction Using Tissue Expanders.","authors":"Jasem Alshemeili, Bruce Lelala, Donald A Hudson","doi":"10.1097/GOX.0000000000006771","DOIUrl":"10.1097/GOX.0000000000006771","url":null,"abstract":"<p><strong>Background: </strong>Delayed prosthetic breast reconstruction is commonly undertaken, but after radiotherapy it carries a higher risk of complications. Autologous fat grafting (AFG) improves the quality of the tissue, particularly after radiotherapy. The aim of this study was to assess the role of AFG in patients undergoing delayed breast reconstruction with tissue expanders as the first stage.</p><p><strong>Methods: </strong>This is a retrospective study of 58 patients (mean age 45 y, range 26-62 y) having delayed prosthetic breast reconstruction by tissue expansion as the first stage, at a tertiary hospital between January 2016 and November 2019. History of radiotherapy postmastectomy was recorded. Fifty-eight patients were divided into those who received fat grafting before tissue expander insertion and those who did not. Complications of both groups were analyzed.</p><p><strong>Results: </strong>Forty-one patients had tissue expanders inserted without fat grafting, whereas 17 patients had fat grafting before tissue expander insertion. Of these 17 patients (10 of whom also had postoperative radiotherapy) who had fat grafting before expander insertion, only 2 developed extrusion; both patients had radiation. Of 41 patients having tissue expansion insertion without fat grafting, 19 patients developed extrusion, and 14 of these 19 patients had radiation therapy.</p><p><strong>Conclusions: </strong>Clinical assessment of the mastectomy flaps is required before tissue expander insertion, and, if atrophic and scarred from previous infection, or, if the patient has undergone radiotherapy, AFG should be considered. Fat grafting reduced tissue expander extrusion in patients having delayed breast reconstruction, especially in patients who had radiation.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6771"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital Melanocytic Nevus of the Nose: Clinical Experience and Reconstructive Approaches.","authors":"Alexander Margulis, Allan Billig, Neta Adler","doi":"10.1097/GOX.0000000000006784","DOIUrl":"10.1097/GOX.0000000000006784","url":null,"abstract":"<p><strong>Background: </strong>Congenital melanocytic nevi (CMNs) of the nose are uncommon. These nevi present an aesthetic reconstructive challenge. This study presented our experience in surgical management of the varying presentations of these lesions.</p><p><strong>Methods: </strong>Seventeen patients with medium and large nasal CMNs were operated on between the years 2010 and 2020. Children with small congenital nevi amenable to excision and primary closure were excluded from this study. Data were collected regarding patient characteristics, surgical management, and postoperative outcomes and complications. Medium-sized nasal nevi isolated to the upper two-thirds of the nose were reconstructed with serial excision, whereas lower third nevi were reconstructed with full-thickness skin grafts or composite grafts. Larger nevi, with an extension into an additional facial unit, were reconstructed with expanded flaps from the forehead or cheek regions.</p><p><strong>Results: </strong>Children with nevi isolated to the nose had between 1 and 3 procedures including serial excision, skin grafts, or composite grafts. Children with extensive facial CMNs had between 2 and 8 procedures (for treatment of the whole facial nevus). Two patients were reconstructed with expanded cheek flaps, 1 with an expanded forehead flap, and 2 with both. Reconstructions were achieved with minimal complication rates and good surgical outcomes.</p><p><strong>Conclusions: </strong>Congenital nevi of the nose present a reconstructive challenge. The authors developed a treatment algorithm with the aim of offering an optimal surgical management plan. Longer follow-up is still needed given many of the patients will reach mature facial growth in the near future.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6784"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Study: Lymphatic Brain Decongestion: A New Surgical Technique in Alzheimer Disease.","authors":"Anastasios Topalis, Chrysanthi Bekiari, Efterpi Demiri, Dimitrios Dionyssiou","doi":"10.1097/GOX.0000000000006806","DOIUrl":"10.1097/GOX.0000000000006806","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer disease (AD) is characterized by progressive cognitive function decline and neurodegeneration. Accumulation of amyloid-beta peptides forms plaques leading to brain inflammation and neuronal death. Glymphatic and meningeal lymphatic systems regulate brain fluid homeostasis and affect neurodegeneration by transferring amyloid-beta peptides from the brain to the cervical lymph nodes. We aimed to assess the feasibility of a novel operation in a rat model, to enhance the meningeal lymphatic system and consequently increase the clearance of amyloid-beta peptide.</p><p><strong>Methods: </strong>Ten 12-month-old rats were divided into 2 groups. Group A (control) had no intervention. Group B underwent collagen scaffold implantation between the subdural space above the hippocampus and the right submandibular lymph node, to achieve guided lymphangiogenesis. Animals were weighed and examined for neurological, behavioral and cognitive tests preoperatively and 6 and 12 weeks postoperatively, including NeuroScale, modified open field, and novel object location recognition tests.</p><p><strong>Results: </strong>One animal of group B died 2 days postoperatively. The remaining rats had no complications, maintained or increased their weight, and showed no signs of infection or neurological impairment. Behavioral tests were in favor of group B at 12 weeks postoperative. Animals of group A had statistically significant decline in cognitive function over time. Animals of group B demonstrated the same or better cognitive function.</p><p><strong>Conclusions: </strong>In this pilot study, we demonstrated the feasibility of the proposed surgical procedure, which resulted in positive cognitive function for the animals. We are now utilizing an AD rat model to evaluate the possible therapeutic effect of the procedure.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6806"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonsurgical Rhinoplasty: A Modified Rino-4-Puntos Technique With Hyaluronic Acid Improves the Appearance of Nasal Septal Deviation.","authors":"Fernando Silikovich, George Kroumpouzos","doi":"10.1097/GOX.0000000000006801","DOIUrl":"10.1097/GOX.0000000000006801","url":null,"abstract":"<p><strong>Background: </strong>Recently, we introduced the Rino-4-Puntos (R4P) nonsurgical rhinoplasty technique using hyaluronic acid (HA), which effectively addresses nose shape issues. However, no nonsurgical rhinoplasty procedure has been explicitly tested for improving the appearance of nasal septal deviation (NSD). This study aimed to evaluate the aesthetic outcome, longevity of results, safety, and patient satisfaction of the modified R4P (mR4P) technique, designed to address nose shape issues related to NSD.</p><p><strong>Methods: </strong>This was a retrospective study of consecutive patients treated with mR4P. NSD is the leading cause of unpleasing aesthetics. The R4P technique involves targeted injections with an intermediate <i>G</i> prime (<i>G</i>') HA at the radix (point 1), supratip (point 2), and tip (point 3), and high <i>G</i>' HA at the columella (point 4). To specifically address nose shape issues caused by NSD, modifications were made to points 4.2 and 4.3 of the technique. At these points, the needle insertion point was repositioned to the side of deviation. Then, the needle was directed diagonally opposite the deviation toward the nasal tip.</p><p><strong>Results: </strong>Eighty individuals (68.7% women) were included. The procedure is suitable for mild-to-moderate caudal NSD, including I- and C-shaped NSDs. Notably, 87.5% of the participants were very satisfied and 12.5% were satisfied with the aesthetic outcome. Most (81.2%) patients reported respiratory improvements after mR4P. The treatment effect lasted for a median of 11 months. No vascular complications occurred.</p><p><strong>Conclusions: </strong>The mR4P technique improves the appearance of caudal NSD and provides good longevity of the aesthetic outcomes and safety.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 5","pages":"e6801"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}