Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Evaluation of prepectoral reconstruction surgical outcomes: Main operating room vs ambulatory surgery center","authors":"","doi":"10.1016/j.bjps.2024.09.038","DOIUrl":"10.1016/j.bjps.2024.09.038","url":null,"abstract":"<div><h3>Introduction</h3><div>During the height of the recent Coronavirus (COVID-19) pandemic, several surgeries were transitioned to ambulatory surgery centers to reserve inpatient resources and reduce transmission risks. Our study evaluated the surgical outcomes of patients who underwent prepectoral breast reconstruction in the operating rooms of two full-service main hospitals versus their associated surgery centers.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted of patients who underwent immediate prepectoral breast reconstruction at a single hospital between 2018 and 2022. Eligible patients had at least 3 months of post-expander follow-up, with the majority also having 3 months of post-implant follow-up. Patient demographics, reconstructive characteristics, post-expander outcomes, and post-implant outcomes were evaluated between the surgery center and main operating room using the chi-squared (or Fisher’s exact) and Wilcoxon ranked-sum tests.</div></div><div><h3>Results</h3><div>This study included 301 patients, outcomes of 509 post-expander breasts, and outcomes of 410 post-implant breasts. The patient characteristics were similar with the only significant difference being the hospital length of stay (increased stay at the main hospital). There were no statistically significant differences in any of the surgical outcomes between the two groups in the post-expander or post-implant period.</div></div><div><h3>Conclusion</h3><div>The COVID-19 pandemic disrupted elective procedures, prompting a shift toward outpatient surgery to optimize hospital resources and reduce inpatient exposure risks. Although breast reconstruction is elective, delays can pose risks for patients with cancer. Our results show that surgical outcomes for prepectoral prosthetic breast reconstruction remain consistent whether performed in outpatient surgical centers or main hospitals.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402456","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":"Trends in advanced practice providers in plastic and reconstructive surgery, 2013–2021","authors":"","doi":"10.1016/j.bjps.2024.09.034","DOIUrl":"10.1016/j.bjps.2024.09.034","url":null,"abstract":"<div><p>This restrospective cohort study of Medicare payment data found increases in the number of advanced practice providers who bill for plastic and reconstructive surgery care. The growth in advanced practice providers is expected to continue in plastic surgery, and further investigation is needed to effectively integrate these providers into academic centers.</p></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1748681524005916/pdfft?md5=a4e3ca9e1bb6ffc4313288fb9b325804&pid=1-s2.0-S1748681524005916-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-image, self-esteem, anxiety, and functional capacity in patients undergoing open-structure rhinoplasty","authors":"","doi":"10.1016/j.bjps.2024.09.023","DOIUrl":"10.1016/j.bjps.2024.09.023","url":null,"abstract":"<div><h3>Background</h3><div>Rhinoplasty may improve negative psychological aspects, such as mild to moderate body dysmorphic disorder; however, the repercussions on the self-image and quality of life of patients after the procedure are unknown.</div></div><div><h3>Objective</h3><div>To evaluate self-image, self-esteem, anxiety, and functional capacity of patients undergoing open-structure rhinoplasty.</div></div><div><h3>Methods</h3><div>A primary, analytical, clinical, longitudinal, and prospective study was conducted, which included 30 female patients, aged between 18 and 50 years with elongated nose and nasal hump, who underwent open and structured rhinoplasty. All procedures were performed by a team from the Rhinology DCP/Unifesp. The Rosenberg Self-Esteem Scale - EPM, BDSS, BDD-YBOCS, SF-36, SRQ-20, and STAI (T/E) questionnaires were administered before the surgery and at 6, 12, and 18 months after surgery.</div></div><div><h3>Results</h3><div>The results showed statistically significant differences in the Rosenberg scale - EPM (p = 0.017), BDSS (p &lt; 0.001), BDD (p = 0.006), SF-36 (p = 0.041), SRQ-20 (p = 0.012), and STAI-T (p = 0.001) scores in general analyses. Additionally, the statistically significant changes persisted in various stratified postoperative periods. In the qualitative analysis, there was only statistical significance for the classification of the BDSS score, where the “Absent” (absence of body dysmorphism) index increased from 70.0% in the preoperative state to 96.7% in 18 months postoperatively. The “Present” (presence of body dysmorphism) index fell from 30.0% to 3.3% in the same period (p = 0.001).</div></div><div><h3>Conclusion</h3><div>Open-structure rhinoplasty improved the patients’ self-image, self-esteem, anxiety, and mental health.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368064","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":"Periauricular hair transplantation enhances the cosmetic results of eyebrow transplantation: A retrospective study in Chinese recipients","authors":"","doi":"10.1016/j.bjps.2024.09.008","DOIUrl":"10.1016/j.bjps.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Eyebrow transplant surgeries have become increasingly popular in recent years. Periauricular hair, with its slow growth rate and fine caliber similar to eyebrow hair, has been strategically used in eyebrow transplants to achieve enhanced and authentically natural aesthetic results.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the postoperative clinical outcomes of using periauricular hair for eyebrow transplantation.</div></div><div><h3>Methods</h3><div>Data from 81 patients (72 women and 9 men) who underwent eyebrow transplantation with periauricular hair between October 2020 and September 2022 were analyzed. They were followed up for 15 months’ post-surgery to evaluate recovery and complications. Patient satisfaction and quality of postoperative life were assessed using a 5-point Likert scale.</div></div><div><h3>Results</h3><div>For female patients, the average total number of transplanted hair grafts and surgery duration were 402.33 ± 158.48 FU (follicular unit) and 193.86 ± 66.69 min, respectively. Contrastingly, male patients exhibited slightly higher values, with an average of 481.78 ± 126.43 FU and 229.00 ± 96.80 min, respectively. No significant complications were reported during the postoperative follow-up. Patients expressed general satisfaction with immediate and 15-month postoperative outcomes, reflected in a mean overall satisfaction score of 4.90. The overall satisfaction of the subjects at 15 months postoperative was significantly higher than the preoperative satisfaction (<em>Z</em> = −8.483, <em>p</em> &lt; 0.001). The eyebrow/forehead surgery did not have a significant impact on postoperative satisfaction (<em>H</em> = 5.355, <em>p</em> = 0.374 &gt; 0.05); however, patients without tattoos tended to report higher levels of postoperative satisfaction (<em>Z</em> = 8.056, <em>p</em> = 0.004 &lt; 0.05). Patient satisfaction ratings for physical function, psychological function, social function, and quality of life post-operation were 5, 4.95, and 4.94, respectively.</div></div><div><h3>Conclusions</h3><div>Eyebrow transplant using periauricular hair can improve cosmetic outcomes and is a viable option in clinical practice.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1748681524005588/pdfft?md5=a95372093fd952cb5a86426ea6ecb4d0&pid=1-s2.0-S1748681524005588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and postoperative complications after plastic surgery procedures: More than just hypercoagulability","authors":"","doi":"10.1016/j.bjps.2024.09.024","DOIUrl":"10.1016/j.bjps.2024.09.024","url":null,"abstract":"<div><h3>Background</h3><div>Although plastic surgery procedures generally demonstrate less than 2% incidence of venous thromboembolism (VTE) outcomes, the post-COVID era data remain elusive. This study sought to elucidate the relationship between COVID-19 infection and the risk of VTE outcomes across plastic surgery procedures.</div></div><div><h3>Methods</h3><div>Plastic surgery procedures were identified in the 2012–2022 National Surgical Quality Improvement Program databases. The outcomes of interest were the postoperative occurrence of VTE, defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), and postoperative complication. Propensity score matching was used to 1) compare overall rates of VTE between the pre-pandemic era and pandemic era cohorts and 2) compare rates of VTE and overall postoperative complications in cases with and without COVID-19 diagnosis in the years 2021–2022 (<em>p</em> &lt; 0.05).</div></div><div><h3>Results</h3><div>Overall, 269,006 plastic surgery cases were identified, comprising general breast (76%) and trunk (9.4%) procedures. Non-breast free tissue transfer cases were associated with the highest rates of DVT (1.3%) and trunk procedures with the highest rates of PE (0.7%). After propensity score matching, the overall rate of VTE after the onset of the COVID-19 pandemic was not significantly different from the pre-pandemic era (<em>p</em> = 0.40). In a separately matched cohort, COVID-19 diagnosis did not significantly predict the risk for VTE (<em>p</em> = 0.48) but did significantly predict the risk for overall postoperative complications (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Although COVID-19 diagnosis itself did not predict the risk of VTE in matched analysis, it significantly predicted the overall postoperative complications. Future studies may further investigate the effects of COVID-19 infection over longer periods of follow-up.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315320","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":"Reporting of patient-reported outcomes amongst randomized clinical trials in plastic surgery: a systematic review using CONSORT-PRO","authors":"","doi":"10.1016/j.bjps.2024.09.022","DOIUrl":"10.1016/j.bjps.2024.09.022","url":null,"abstract":"<div><h3>Background</h3><div>Patient-reported outcomes (PROs) are key to investigating patient perspectives in randomized controlled trials (RCTs). Standardization of PRO reporting is critical for trial generalizability and the application of findings to clinical practice. This systematic review aimed to evaluate the reporting quality of RCTs published in the top plastic surgery journals according to the consolidated standards of reporting trials (CONSORT)-PRO extension.</div></div><div><h3>Methods</h3><div>We completed a comprehensive search of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. All RCTs with a validated PRO endpoint published in the top 10 plastic surgery journals (based on the 2021 Web of Science Impact Factor) from 2014 to 2023 were included. Two reviewers independently extracted data and scored the included studies using the CONSORT-PRO checklist. Univariate regression was applied to assess factors associated with reporting adherence. Studies were assessed for their risk of bias using the Cochrane Risk of Bias 2.0 tool.</div></div><div><h3>Results</h3><div>A total of 88 RCTs were included. PROs were the primary endpoint in 50 (57%) and the secondary endpoint of 38 (43%) studies. Mean overall reporting adherence was poor (39% (±12) and 36% (±13) in studies with PRO as primary and secondary endpoints, respectively). The presence of industry support was significantly associated with greater adherence.</div></div><div><h3>Conclusions</h3><div>There is low adherence to the CONSORT-PRO extension among plastic surgery RCTs published in the top 10 plastic surgery journals. We encourage journals and authors to endorse and apply the CONSORT-PRO extension. This may optimize the dissemination of clinical findings from RCTs and assist patient-centered care.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378743","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":"Dynamic anatomical study of the posterior brachial artery perforator flap: Aesthetic refinement and clinical results","authors":"","doi":"10.1016/j.bjps.2024.08.079","DOIUrl":"10.1016/j.bjps.2024.08.079","url":null,"abstract":"<div><h3>Background</h3><div>Reconstruction of the axillary fossa represents a surgical challenge given the functional implications for mobility of the upper limb. The posterior brachial flap is a solution of choice for this indication, providing fine and functional local reconstruction, but little is known about its perforasome. This study aimed to identify the location of the perforator, analyze perfusion flow, and link vessel distribution, and propose an aesthetic refinement to the surgical technique by medializing the skin paddle to conceal aesthetic scarring at the donor site.</div></div><div><h3>Methods</h3><div>Fifteen fresh cadavers were harvested and dissected. Twenty-six arms were injected with methylene blue. Two arms were injected with radiopaque dye. A dynamic (4-dimensional) computed tomographic angiography was performed to complete the analysis.</div></div><div><h3>Results</h3><div>The perforasome was centered on the posterior axis of the arm with a perfusion area ranging from 82.2 to 142.9 cm², with a median of 112.7 (96.7–125.6) cm². The median length of the pedicle was 83 mm on an average (65–91 mm). Its caliber at the emergence of the source vessel had a mean diameter of 1.43 mm (1.27–1.61 mm). The distal limit of the paddle was located on an average 10.7 cm from the olecranon (7.8–12.2 cm). The scans showed direct linking vessels toward the perforasomes on the medial side of the arm, suggesting that it is possible to medialize the cutaneous paddle.</div></div><div><h3>Conclusion</h3><div>The posterior brachial flap presents with a constant perforasome. It can be harvested more medially than previously described to improve the aesthetic results, while maintaining reproducibility and satisfactory vascular reliability.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging appearance of regenerative peripheral nerve interface","authors":"","doi":"10.1016/j.bjps.2024.09.017","DOIUrl":"10.1016/j.bjps.2024.09.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the MRI appearance of regenerative peripheral nerve interface (RPNI) and the potential association between the MRI appearance and RPNI revision.</div></div><div><h3>Material and methods</h3><div>A retrospective assessment was undertaken of the MRI appearance of RPNIs performed at our institution between 1/1/2010 and 7/29/2023 with clinical correlation.</div></div><div><h3>Results</h3><div>Fourteen patients (8 men and 6 women, age range 31–80 years, median age 51 years) with technically adequate MRI of RPNIs were included in this study including 5 patients with below knee amputation with 5 tibial and 4 common peroneal nerves RPNI, 8 patients with above knee amputations (AKA) with sciatic RPNIs, and 1 patient following forequarter amputation with a brachial plexus RPNI. Two patients underwent revision RPNI surgery thrice (AKA-sciatic nerve) for a total of 6 RPNI revisions. On T1 weighted sequences, all RPNIs were isointense to the muscle and blended with the surrounding scar and muscle tissues whereas on T2 weighted sequences, all RPNIs were hyperintense in signal compared to the muscle. All but 1 RPNI underwent post contrast enhancement in variable patterns. No statistically significant difference in MRI appearance was found between RPNIs with or without a following RPNI revision surgery.</div></div><div><h3>Conclusion</h3><div>RPNI on MRI typically have a bright and intermediate signal on T2 and T1 weighted sequences, respectively, and typically undergo postcontrast enhancement in variable patterns without a statistically significant difference between the cases with and without follow-up RPNI revision. However, enhancement of RPNI should not be misconstrued as pathological.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357998","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":"Management of thoracic aortic graft infections with combined omental and bilateral pectoralis major flaps","authors":"","doi":"10.1016/j.bjps.2024.09.016","DOIUrl":"10.1016/j.bjps.2024.09.016","url":null,"abstract":"<div><h3>Background</h3><div>Aortic vascular graft/endograft infection (VGEI) has historically been managed through graft removal and re-replacement, but new approaches suggest vascularized tissue transfer is an effective adjunctive treatment. We describe our experience with treating thoracic aortic vascular graft infection with combined omental and bilateral pectoralis major myocutaneous (PMM) advancement flaps.</div></div><div><h3>Methods</h3><div>Data from all patients undergoing combined flap closure by the senior author at a high-acuity cardiac surgery center from 1995–2023 were reviewed. Patients with clinical and radiographic signs of thoracic aortic vascular graft infection were included.</div></div><div><h3>Results</h3><div>Complete data were available for 598 patients with sternal and mediastinal wounds. Combined PMM and omental flaps were mobilized in 11 thoracic aortic vascular graft infection patients. Indications for flap management included culture-positive infection (8/11; 72.7%), dehiscence (5/11; 45.5%), drainage (7/11; 63.6%), and inability to close the sternotomy due to hemodynamic instability (5/11; 45.5%). During chest exploration, 6/11 (54.5%) underwent complete removal of the infected graft, compared to 5/11 (45.5%) who underwent graft-preserving washout and debridement. Immediate flap closure was performed in 6/11 (54.5%). Postoperative complications included dehiscence (2/11; 18.2%), seroma (1/11; 9.1%), hematoma (1/11, 9.1%), abdominal hernia (1/11; 9.1%), and recurrent infection (1/11; 9.1%). One patient (9.1%) died within 30 days of sternal reconstruction from mitral valve failure tachyarrhythmia. None of the patients underwent reoperation for flap-related complications.</div></div><div><h3>Conclusions</h3><div>Despite significant comorbidities, low postoperative morbidity and mortality indicate that combined omental and pectoralis major flaps are a safe and effective adjunctive treatment to the antimicrobial and surgical management of select thoracic aortic vascular graft infections.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315321","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":"A novel lower eyelid reconstruction using a skin-tarsoligamentous sling to prevent postoperative drooping deformity: Quantitative analyses using drooping index and angular difference in canthal tilt","authors":"","doi":"10.1016/j.bjps.2024.09.021","DOIUrl":"10.1016/j.bjps.2024.09.021","url":null,"abstract":"<div><p>Lower eyelid reconstruction using skin flaps sometimes results in undesirable deformities due to postoperative flap drooping. We aimed to examine the effectiveness of a novel procedure for reconstructing the skin-tarsoligamentous sling of the lower eyelid. We included 37 patients who underwent anterior lamellar reconstruction with a cheek rotation flap for full-thickness lower eyelid defect. They were divided into two groups: Group A included 19 patients who underwent tarsoligamentous sling reconstruction with a fascia lata strip and buccal mucosa grafting, and Group B comprised 18 patients who underwent skin-tarsoligamentous sling reconstruction using an additional combination of a periosteal flap and de-epithelialized triangular flap at the lateral canthal region, representing our novel approach. To evaluate the severity of postoperative deformities, we used the drooping index, the ratio of drooping compared to the healthy side, along with the angular difference in canthal tilt, obtained between the reconstructed and healthy sides, using photographs taken ≥6 months post-reconstruction. Group B demonstrated superior outcomes, with mean drooping indices of 1.13 compared to 1.33 in Group A (P = 0.031) and mean angular differences in canthal tilt of −0.73° compared to −2.45° in Group A (P = 0.021). Patient satisfaction was significantly higher in Group B than in Group A (P = 0.042). Furthermore, patients with drooping index &lt;1.2 and an angular difference in canthal tilt ≥−1.0° exhibited higher satisfaction scores. Our novel approach to lower eyelid reconstruction using a skin-tarsoligamentous sling yielded improved aesthetic outcomes, fewer complications, and higher patient satisfaction.</p></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272558","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}