Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Corrigendum to “A clinician survey of skin substitute use in burns care in the UK and Ireland: The CASSIUS study” [J Plast Reconstr Aesthet Surg 102 (2025) 238–246]","authors":"Alice Lee , Andrew R. McKean , Justin C.R. Wormald , Ian C.C. King , Declan P. Collins , Baljit Dheansa , on behalf of the CASSIUS Collaborative","doi":"10.1016/j.bjps.2025.09.024","DOIUrl":"10.1016/j.bjps.2025.09.024","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Page 1"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of antibiotics-impregnated mesh in preventing capsular contracture recurrence: A single-surgeon experience","authors":"Xinfei C. Miao ,&nbsp;Eric S. Ruff ,&nbsp;Malcolm J. Rude","doi":"10.1016/j.bjps.2025.09.018","DOIUrl":"10.1016/j.bjps.2025.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Capsular contracture remains the leading cause of revision surgery following implant-based breast augmentation, with growing evidence suggesting that biofilm may play a key role in its formation. This study aimed to evaluate the effectiveness of using an antibacterial envelope in reducing the recurrence of capsular contracture.</div></div><div><h3>Methods</h3><div>This retrospective case series included patients presented with capsular contracture. All patients underwent capsulectomy with implant replacement and placement of an antibiotic absorbable mesh placed anterior to the implant. Demographic information, implant data, and postoperative outcomes were collected. Patients with less than 24 months of follow-up were excluded from the study. Descriptive analysis was performed using Microsoft Excel.</div></div><div><h3>Results</h3><div>A total of 18 patients (31 breasts) were included in this study. The mean age at the presentation of capsular contracture was 50.9 ± 9.0 years, and the mean duration since the placement of the original implant was 166.1 months. Mean postoperative follow-up was 54.7 months. All patients had Baker grade III or IV capsular contracture at presentation. Following capsulectomy with mesh placement, recurrence of capsular contracture occurred in five breasts (16.1%). Immediate postoperative complications included one hematoma that was treated with reoperation.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the safe profile and potential use of antibiotic-impregnated mesh in reducing the capsular contracture recurrence. Further investigation is warranted to assess the outcomes and validate this technique for managing capsular contracture.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 144-146"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stratified dorsal augmentation – A novel technique for dorsal reconstruction","authors":"Erkan Soylu ,&nbsp;Alper Yenigun ,&nbsp;Fadlullah Aksoy ,&nbsp;Orhan Ozturan","doi":"10.1016/j.bjps.2025.09.012","DOIUrl":"10.1016/j.bjps.2025.09.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Dorsal augmentation enhances nasal dorsum height and contour. Existing techniques face challenges like resorption, infection, and migration. This study introduces Stratified Dorsal Augmentation, a multi-layered cartilage grafting approach to improve stability and aesthetics.</div></div><div><h3>Methods</h3><div>A total of 68 patients (19 males, 49 females) underwent open structural rhinoplasty (2020–2023). Autologous costal cartilage was harvested (7th rib in females, 8th in males) using U-shape technique. Grafting involved: (1) diced cartilage for surface smoothing, (2) a solid 2 mm obliquely split costal cartilage graft for structure, (3) an additional diced cartilage layer for contouring, and (4) a perichondrium overlay for stability. The average follow-up was 29 months.</div></div><div><h3>Results</h3><div>All patients achieved the desired dorsum height. No cases of graft rejection, migration, or warping occurred. Two vestibular infections resolved with antibiotics, and two minor bleeding cases were managed conservatively. Three patients required minor secondary revisions.</div></div><div><h3>Conclusion</h3><div>The Stratified Dorsal Augmentation technique minimizes warping, migration, and resorption, while ensuring both long-term stability and a natural appearance, making it a safe and effective alternative for dorsal augmentation.</div></div><div><h3>Level of evidence</h3><div>IV</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 2-6"},"PeriodicalIF":2.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subpectoral to prepectoral pocket change in implant-based breast reconstruction: A retrospective cohort study at a single institution","authors":"Sam Fallon ,&nbsp;Scott K. Odorico ,&nbsp;Aidin Gharavi ,&nbsp;Eilene Yang ,&nbsp;Christin Harless ,&nbsp;Aparna Vijayasekaran","doi":"10.1016/j.bjps.2025.09.005","DOIUrl":"10.1016/j.bjps.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Patients who underwent breast reconstruction with submuscular implants frequently experience animation deformity (AD), pain, and cosmetic issues, warranting consideration of implant removal, exchange, pocket change, or autologous reconstruction. Advances in prepectoral reconstruction have prompted several patients to undergo transfer of their implants from a submuscular to prepectoral pocket (“pocket change”).</div></div><div><h3>Methods</h3><div>We conducted a single-center, retrospective review analyzing all patients with post-mastectomy submuscular implant-based reconstruction who underwent pocket change procedures from 2014 to 2023.</div></div><div><h3>Results</h3><div>Procedures on 275 breasts in 153 patients met the inclusion criteria. Reasons for pursuing surgery included pain or discomfort (173 procedures, 63%), AD (158, 57%), non-AD cosmetic issues (92, 33%), muscle spasm (84, 31%), capsular contracture (68, 25%), and implant rupture (44, 16%). In 45 cases (16%), the procedure was staged using prepectoral tissue expanders. Mesh was used in 194 procedures (71%). Mean length of postoperative follow-up was 2.54 years. Complications included 7 seromas (2.5%), 1 hematoma (0.4%), 10 infections (3.6%), and 7 hospitalizations within 30 days of surgery (2.5%). In 6 patients (2.2%), the prepectoral implant was removed within 1 year of surgery—due to 5 infections and 1 capsular contracture. Ten cases (3.6%) of capsular contracture were reported. AD was resolved in all affected patients. Finally, 82 patients reported pain outcomes within 60 days of their unilateral or bilateral procedure, with 75 (91%) experiencing resolved or significantly improved pain.</div></div><div><h3>Conclusions</h3><div>A pocket change procedure is an effective intervention to treat complications associated with submuscular implant reconstruction. Further study is warranted to evaluate long-term aesthetic and patient satisfaction outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 54-59"},"PeriodicalIF":2.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From concept to clinical practice-Unraveling the adoption of regenerative peripheral nerve interface (RPNI) surgery","authors":"Melanie J. Wang ,&nbsp;Theodore A. Kung ,&nbsp;Stephen W.P. Kemp ,&nbsp;Paul S. Cederna","doi":"10.1016/j.bjps.2025.08.040","DOIUrl":"10.1016/j.bjps.2025.08.040","url":null,"abstract":"<div><h3>Purpose</h3><div>Postamputation pain affects up to 95% of the 2.3 million individuals with amputations in the US. Regenerative Peripheral Nerve Interface (RPNI) surgery is a promising new approach for managing postamputation pain and enhancing prosthetic control. The purpose of this study was to determine the adoption of this surgical intervention over time to provide insight for future research direction and clinical applications.</div></div><div><h3>Methods</h3><div>This study was designed as a trend analysis to evaluate the adoption of RPNI surgery. A comprehensive search of the PubMed and Embase databases was conducted from 2011 to 2024, with publications categorized into basic science, clinical science, and review articles. Data were extracted and analyzed for temporal and thematic patterns. To complement academic output, a pilot analysis of Google Search trends was performed using the terms “RPNI” and “Regenerative Peripheral Nerve Interface,” to assess global search volume and average annual growth rates. Statististical analysis was performed using SPSS.</div></div><div><h3>Results</h3><div>The search identified 233 publications, among which 106 met the inclusion criteria: 26 (24.5%) basic science articles, 40 (37.7%) clinical science articles, and 40 (37.7%) reviews. Publication output demonstrated a significant upward trajectory (p &lt; 0.001). Overall, 82% of the publications were from the last 5 years. Thematic analysis revealed a progression from early animal model and proof-of-concept studies (2011–2015) to translational and early clinical reports (2016–2018), followed by randomized trials, case series, and comparative studies with targeted muscle reinnervation (2019–2021). The most recent years (2022–2024) were characterized by systematic reviews, multi-institutional trials, and refinements in surgical technique (e.g., vascularized and muscle cuff RPNI). Google Search data corroborated these findings, with the search volume for “RPNI” increasing by 16,307% from 2011 to 2024, demonstrating academic and public momentum.</div></div><div><h3>Conclusions</h3><div>RPNI surgery has gained significant traction over the past 14 years. Long-term clinical outcomes and patient-reported experiences should be further investigated to support the already promising basic science and clinical outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 123-129"},"PeriodicalIF":2.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal shockwave therapy improves post-breast reconstruction fibrosis: A randomized controlled blinded clinical trial","authors":"Antoinette T. Nguyen ,&nbsp;Jeewon Chon ,&nbsp;Rena A. Li ,&nbsp;Bradley A. Melnick ,&nbsp;Anmar Abu-Romman ,&nbsp;Rahim Laiwalla ,&nbsp;Tarifa H. Adam ,&nbsp;Robert D. Galiano","doi":"10.1016/j.bjps.2025.08.045","DOIUrl":"10.1016/j.bjps.2025.08.045","url":null,"abstract":"<div><h3>Background</h3><div>Fibrosis following breast reconstruction is a debilitating syndrome characterized by (1) restricted shoulder and upper extremity mobility, (2) chronic pain and discomfort, (3) poor tissue pliability, and (4) suboptimal aesthetic outcomes. This condition significantly impairs the quality of life and functional recovery. Currently, no therapeutics directly target fibrotic remodeling. Extracorporeal shockwave therapy (ESWT) uses targeted acoustic pulses to stimulate cellular regeneration, collagen remodeling, and tissue softening, and may offer a novel non-invasive intervention.</div></div><div><h3>Methods</h3><div>A single-blinded randomized controlled clinical trial was conducted in 40 adult women with clinically diagnosed postoperative fibrosis following breast reconstruction. Participants were randomized to receive either ESWT or sham treatment, delivered in eight biweekly sessions over four weeks, with follow-up at three months. The primary outcome was patient-reported breast softness. Secondary outcomes included pain, fibrosis size, shoulder mobility, observer assessments, and ultrasound-based tissue quality.</div></div><div><h3>Results</h3><div>Compared to the placebo group, the ESWT group demonstrated significantly greater improvements in breast softness (mean change: 4.92 ± 1.86 vs. 0.9 ± 1.48; <em>p</em> = 0.00003), pain (−2.00 ± 2.28 vs. +0.43 ± 2.16; <em>p</em> = 0.0052), and fibrosis size (3.88 ± 1.82 vs. 0.86 ± 1.59; <em>p</em> = 0.0015). Observer-rated outcomes also favored the treatment, including breast firmness (−2.12 ± 1.55 vs. −0.14 ± 1.77; <em>p</em> = 0.0013) and overall opinion (−2.04 ± 1.78 vs. −0.43 ± 1.74; <em>p</em> = 0.0003). Ultrasound scores improved across all metrics, including fibrosis depth (1.08 ± 0.74 vs. 0.57 ± 0.51; <em>p</em> = 1.57 × 10⁻⁵) and boundary definition (1.23 ± 0.65 vs. 0.29 ± 0.47; <em>p</em> = 5.30 × 10⁻⁵).</div></div><div><h3>Conclusion</h3><div>ESWT significantly improved pain, softness, lesion size, and sonographic fibrosis features in patients with post-reconstruction fibrosis, demonstrating strong and sustained therapeutic benefit.</div></div><div><h3>Clinical trial registration</h3><div>NCT06919042</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 7-17"},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retro-orbicularis oculi fat reduction via sub-brow incision in thyroid eye disease","authors":"Muhammad Abumanhal,&nbsp;Chrisha Faye Habaluyas,&nbsp;Yasuhiro Takahashi","doi":"10.1016/j.bjps.2025.09.006","DOIUrl":"10.1016/j.bjps.2025.09.006","url":null,"abstract":"<div><div>The retro-orbicularis oculi fat (ROOF) hypertrophy contributes to upper eyelid fullness in patients with thyroid eye disease (TED). This report describes the surgical technique and evaluates the aesthetic and clinical outcomes of ROOF reduction via a sub-brow incision in patients with TED. This retrospective observational study included 60 patients (118 eyelids; 2 males and 58 females; mean age, 46.2 ± 13.2 years) who underwent ROOF excision between October 2019 and January 2025. Data collected included patient demographics, surgical details, ROOF thickness (measured by imaging studies), volume of excised fat, margin reflex distance-1 (MRD-1), and postoperative complications. Patient satisfaction was assessed at the 3-month follow-up. Consequently, the mean volume of ROOF excised was 0.69 ± 0.51 mL. Concurrent fat removal included excision of the preaponeurotic fat pad in 77 eyelids (mean volume excised: 0.59 ± 0.23 mL) and the medial fat pad in 45 eyelids (mean volume excised: 0.17 ± 0.10 mL). ROOF thickness correlated moderately with the volume excised (<em>r</em> = 0.395, <em>p</em> &lt; 0.001). MRD-1 did not significantly change postoperatively (preoperative: 4.4 ± 1.1 mm; postoperative: 4.5 ± 1.0 mm; <em>p</em> = 0.626). A high patient satisfaction rate of 93.3% was achieved. No major complications were reported. This report indicates that ROOF excision via a sub-brow incision is a safe and effective adjunct to aesthetic eyelid surgery, offering improved cosmetic outcomes with a low complication rate. This technique may be considered in patients with TED presenting with prominent upper eyelid fullness.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 69-75"},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast reduction and mastopexy procedures on previously irradiated breasts: A retrospective study","authors":"Jad Bissar ,&nbsp;Kevin Serror ,&nbsp;Yannick Sprunger ,&nbsp;Jeremy Kaplan ,&nbsp;Marc Chaouat ,&nbsp;David Boccara","doi":"10.1016/j.bjps.2025.08.042","DOIUrl":"10.1016/j.bjps.2025.08.042","url":null,"abstract":"<div><h3>Background</h3><div>Post-radiation fibrosis and vascular compromise significantly complicate elective breast surgeries in previously irradiated patients, despite a high incidence of post-treatment asymmetry and macromastia. This study evaluates complication profiles across surgical techniques to provide evidence-based guidance for breast reduction and mastopexy in irradiated breasts.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 41 patients with prior breast irradiation undergoing bilateral breast reduction (n=30), mastopexy (n=7), or mixed procedures (n=4) between 2015–2023 was analyzed. Reduction techniques included superior pedicle (n=4), supero-medial pedicle (n=12), and Thorek free nipple graft (n=14); mastopexies employed Wise-pattern superior pedicle techniques. Outcomes were compared with 1442 non-irradiated breast reductions. Complications were classified as major (reoperation required) or minor (conservatively managed). Statistical analysis utilized Fisher’s exact tests and odds ratios (SPSS v26).</div></div><div><h3>Results</h3><div>Irradiated breasts had significantly higher overall complication rates compared to non-irradiated controls (44% vs. 21%; OR 3.017; p=0.0014), with seromas occurring exclusively in irradiated cases (15% vs. 0%; p&lt;0.001). Mastopexies showed higher dehiscence rates than reductions (29% vs. 0%; p=0.01). Among reduction techniques, the supero-medial pedicle had the highest complication rate (67%), while Thorek procedures showed no seromas (p=0.04). No major complications occurred; revisions (15%) addressed asymmetry only.</div></div><div><h3>Conclusions</h3><div>Breast surgery in irradiated fields remains viable when guided by technique-specific risk profiles and conservative tissue handling. Mastopexy carries elevated dehiscence risks, while the Thorek technique may reduce seroma formation in high-risk patients. Because subgroup analyses were under-powered, all technique-related recommendations should be regarded as preliminary and hypothesis-generating, pending validation in larger multicentre cohorts.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 45-53"},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning can aid in the differential diagnosis of neurogenic thoracic outlet syndrome and carpal tunnel syndrome","authors":"Syeda Hoorulain Ahmed ,&nbsp;David C. Hall ,&nbsp;Bassam M. Smadi ,&nbsp;Ramin Shekouhi ,&nbsp;Harvey Chim","doi":"10.1016/j.bjps.2025.09.004","DOIUrl":"10.1016/j.bjps.2025.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Symptoms related to neurogenic thoracic outlet syndrome (nTOS) and carpal tunnel syndrome (CTS) may overlap, leading to diagnostic uncertainty. In this study, we used a machine learning model to identify key predictors of nTOS by comparing it with CTS.</div></div><div><h3>Methods</h3><div>We reviewed records of patients who underwent surgical intervention for nTOS (n = 68) or CTS (n = 65). The machine learning model was developed using the scikit-learn library in Python, and a binary logistic regression model incorporating patient history and physical exam findings was developed to differentiate nTOS from CTS. Positivity rates of Tinel’s sign and the scratch collapse test (SCT) were compared using Agresti-Coull confidence intervals, chi-squared goodness-of-fit, and binomial tests.</div></div><div><h3>Results</h3><div>For diagnosis of nTOS, the baseline random forest model achieved 80.0% accuracy (F1-score: 0.76, area under the receiver operating characteristic curve: 0.91). After hyperparameter tuning, accuracy improved to 85.0% and precision reached 1.0, yielding a 7.7% gain in overall performance. Both Tinel’s sign and SCT in isolation were diagnostic of nTOS and CTS but could not differentiate between the 2 conditions. In both the baseline and optimized random forest model, the Roos/Elevated Arm Stress Test, body mass index, and duration of symptoms prior to surgery emerged as the most influential predictors of nTOS<em>.</em></div></div><div><h3>Conclusions</h3><div>The random forest model predicted nTOS with up to 85% accuracy. SCT and Tinel’s tests in isolation could not distinguish between nTOS and CTS. Combining multiple clinical and demographic variables within a machine learning model yielded superior diagnostic accuracy for distinguishing nTOS from CTS.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 106-114"},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking filler strategy for the aging face","authors":"Aaron L. Wiegmann ,&nbsp;Tara M. Chadab,&nbsp;Rod J. Rohrich","doi":"10.1016/j.bjps.2025.08.043","DOIUrl":"10.1016/j.bjps.2025.08.043","url":null,"abstract":"<div><div>Filler injections have seen considerable growth in the United States as social media increases awareness and educates the masses on the role they play in facial rejuvenation. To optimize facial rejuvenation using fillers, an understanding of predictable aging patterns of the face is essential. Facial aging is significantly influenced by volume loss, and knowledge of the facial fat compartments guides volume restoration. This manuscript is conceptually based on the senior author’s expertise and 25-year experience and current philosophy in using fat and filler for facial volumization and rejuvenation. A standardized, top-down approach to rejuvenating the aged face with filler is described. Moreover, an algorithm has been provided to prioritize treatment of the highest impact facial areas in terms of human perception and rejuvenation with pure volume enhancement. The top-down sequence also allows for stepwise evaluation of downstream rejuvenation effects and judicious use of the product.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 115-122"},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}