Aesthetic surgery journal. Open forum最新文献

{"title":"Arm Contouring and Beautification Without Incision: Application of Arm Net Suture.","authors":"Sara Ghorbani","doi":"10.1093/asjof/ojae065","DOIUrl":"https://doi.org/10.1093/asjof/ojae065","url":null,"abstract":"<p><strong>Background: </strong>Arm contouring has been a challenging issue for many years. Patients request contouring of their arms without incisions and with a shorter recovery time. Making an incision on the arm does not always lead to a nice scar, and in case of complications, it may be catastrophic. The use of \"arm net suture\" can replace the incision during the arm contour surgery.</p><p><strong>Objectives: </strong>The author has developed a simple technique of arm contouring with arm net suture that leads to eliminating the need for making an incision, preventing of sagging in the proximal part of the arm, and a shorter recovery time.</p><p><strong>Methods: </strong>A retrospective study was conducted on 157 patients who underwent arm contouring surgery. Through a small 5 mm incision in the medial elbow, normal saline solution containing Xylocaine (Fresenius Kabi, Bad Homburg, Germany) and adrenaline was infiltrated. After 20 min, liposuction was started from the most superficial layer with a 3 mm cannula, and then, deeper layers superficial to the fascia were suctioned with a 4 mm cannula. The author usually utilizes traditional suction-assisted lipectomy or power-assisted lipectomy. After completing liposuction, the laxity of the skin along the arm was checked. Most of the laxity of the skin occurred in the proximal third of the arm; while the assistant pulled the skin of the proximal part lateral and downward, the net sutures were inserted. On the third or fourth day (based on the severity of laxity of the skin), the sutures start to be removed from the distal rows, with all sutures removed by the fifth to sixth day. The follow-up times were between 3 and 12 months.</p><p><strong>Results: </strong>All patients were female, and their age range was from 19 to 62 years (mean, 40.45 years). The volume of liposuction was from a minimum of 1200 cc to a maximum of 2500 cc (mean, 1645 cc), and the reduction of the arm diameter was occurred in the range of 6 to 14 cm. No immediate postoperative problems were observed in the patients. Revision was not needed for any patients.</p><p><strong>Conclusions: </strong>Arm net suture is a simple and safe method to replace the incision during arm contour surgery.</p><p><strong>Level of evidence 4: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae065"},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482175","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":"Soft Tissue Facial Changes Following Massive Weight Loss Secondary to Medical and Surgical Bariatric Interventions: A Systematic Review.","authors":"Ali B Jafar, Jerril Jacob, Wee Katherine Kao, Tang Ho","doi":"10.1093/asjof/ojae069","DOIUrl":"https://doi.org/10.1093/asjof/ojae069","url":null,"abstract":"<p><p>Bariatric interventions, both surgical and medical, are increasingly employed by patients to achieve weight reduction and enhance overall health. However, there is growing concern about the associated changes in soft tissue facial aesthetics resulting from these interventions. In this systematic review, the authors aimed to analyze the existing literature regarding soft tissue facial changes after bariatric interventions, with a focus on the influence of massive weight loss on facial aging, attractiveness, and considerations for facial rejuvenation. A systematic review was conducted until February 10, 2024, using electronic databases such as PubMed, Scopus, Web of Science, Embase, and Google Scholar. This review was registered in the open science framework. The Covidence software (Melbourne, VIC, Australia) facilitates title, abstract, and full-text screening, as well as data extraction. In total, 309 papers were identified, 94 duplicates were removed, and 194 studies were excluded on the basis of inclusion criteria. Of the remaining 21 studies, 13 met the inclusion criteria with an additional single study from the conference abstract. Descriptive analysis was conducted. We observed a correlation between massive weight loss and facial aging. The most significant fat regional devolumization was observed along the mid-cheek region and with central neck skin laxity. The apparent age of patients was higher among those with massive weight loss. In our study, we demonstrated that massive weight loss causes accelerated facial aging, manifested through fat devolumization, and increased skin laxity. Further quantitative volumetric facial analyses postbariatric surgery would yield valuable results.</p><p><strong>Level of evidence 3 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae069"},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333483","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 Systematic Review and Meta-Analysis of Synthetic Mesh Outcomes in Alloplastic Breast Reconstruction.","authors":"Robert Craig Clark, McKay D Reese, Philopatir Attalla, Justin M Camacho, Milan M Hirpara, Michael R Delong, Chris M Reid","doi":"10.1093/asjof/ojae066","DOIUrl":"https://doi.org/10.1093/asjof/ojae066","url":null,"abstract":"<p><strong>Background: </strong>Mesh implants are frequently employed in alloplastic breast reconstruction. Notably, no mesh to date has FDA approval for this indication. Several synthetic meshes have been introduced with heterogeneous properties and outcomes.</p><p><strong>Objectives: </strong>This study aims to systematically review synthetic mesh use in alloplastic breast reconstruction, describe rates of short-term complications, and analyze these outcomes in reports comparing synthetic and biologic meshes. The authors hypothesized data from comparative and noncomparative studies would show no significant differences between synthetic and biological meshes.</p><p><strong>Methods: </strong>The authors conducted a systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thirty-one studies reporting the use of synthetic mesh and clinical outcomes were included. Eight studies directly comparing synthetic mesh and biological mesh were meta-analyzed for relative risk (RR). Nineteen noncomparative studies were analyzed for meta-rates. Outcomes, including seroma, infection, reoperation, and explant, were assessed on a per-breast basis. Resultant models were challenged for sensitivity and bias.</p><p><strong>Results: </strong>Meta-analysis of comparative studies demonstrated no difference in the risk of infection with synthetic mesh (RR = 0.53; 95% CI [0.26-1.10]), but a reduced risk of reoperation (RR = 0.54; 95% CI [0.33-0.89]) or explant (RR = 0.43; 95% CI [0.21-0.87]). Meta-analysis of noncomparative studies demonstrated rates of seroma = 3%; 95% CI [1%-6%], infection = 4%; 95% CI [3%-6%], reoperation = 10%; 95% CI [7%-13%], and explant = 3%; 95% CI [2%-5%]).</p><p><strong>Conclusions: </strong>Studies comparing synthetic and biologic meshes demonstrated noninferiority of synthetic in all outcomes assessed. Noncomparative studies demonstrated rates of seroma, infection, reoperation, and explant similar to literature values for biological mesh.</p><p><strong>Level of evidence 2 risk: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae066"},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333481","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 Comparison of Ovine-Reinforced Hybrid Mesh (OviTex PRS) With Porcine Acellular Dermal Matrix (STRATTICE) in the Treatment of Advanced Breast Implant Capsular Contracture.","authors":"Cyril J Harfouche, Michael J Brucker, Salvatore J Pacella","doi":"10.1093/asjof/ojae068","DOIUrl":"https://doi.org/10.1093/asjof/ojae068","url":null,"abstract":"<p><strong>Background: </strong>Tissue reinforcement techniques with porcine acellular dermal matrices (ADMs) have been widely adopted as standard care in treating capsular contracture. However, the application of alternative xenograft or mesh materials has not been widely studied.</p><p><strong>Objectives: </strong>To examine the efficacy of OviTex PRS Reinforced Tissue Matrix (Resorbable) (TELA Bio, Malvern, PA), a hybrid ovine-reinforced mesh, in comparison with STRATTICE Reconstructive Tissue Matrix (Allergan, Irvine, CA), in patients with advanced capsular contracture.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients who underwent breast revision surgery for Baker Grade III or IV capsular contracture. Patient data were reviewed for outcomes, complications, cost, and postoperative incidence of recurrent capsular contracture after treatment with each specific mesh.</p><p><strong>Results: </strong>Fifty-nine of 89 breasts (66.3%) were treated with OviTex and 30 (33.7%) were treated with STRATTICE. All patients experienced a reduction in Baker grades. In patients treated with OviTex, 96.6% (<i>n</i> = 57) of breasts had a postoperative Baker Grade I with the remaining 3.4% (<i>n</i> = 2) breasts presenting with a Baker Grade II. In comparison, 73.3% (<i>n</i> = 22), 23.3% (<i>n</i> = 7), and 3.3% (<i>n</i> = 1) of the STRATTICE cohort presented with Baker Grades I, II, and III, respectively. This demonstrated a statistically significant improvement in Baker grade capsular contracture in the OviTex cohort (<i>P</i> < .05) compared with STRATTICE. Average cost was $27.37/cm² for STRATTICE compared with $22.28/cm² for OviTex PRS.</p><p><strong>Conclusions: </strong>OviTex may be successfully utilized to treat capsular contracture. Patient outcomes may be superior to STRATTICE in recurrent capsular contracture, particularly when a previous ADM had been utilized. Cost data show improved savings with the use of OviTex compared with STRATTICE.</p><p><strong>Level of evidence 3: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae068"},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482174","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":"Comparative Performance of Current Patient-Accessible Artificial Intelligence Large Language Models in the Preoperative Education of Patients in Facial Aesthetic Surgery.","authors":"Jad Abi-Rafeh, Brian Bassiri-Tehrani, Roy Kazan, Steven A Hanna, Jonathan Kanevsky, Foad Nahai","doi":"10.1093/asjof/ojae058","DOIUrl":"10.1093/asjof/ojae058","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence large language models (LLMs) represent promising resources for patient guidance and education in aesthetic surgery.</p><p><strong>Objectives: </strong>The present study directly compares the performance of OpenAI's ChatGPT (San Francisco, CA) with Google's Bard (Mountain View, CA) in this patient-related clinical application.</p><p><strong>Methods: </strong>Standardized questions were generated and posed to ChatGPT and Bard from the perspective of simulated patients interested in facelift, rhinoplasty, and brow lift. Questions spanned all elements relevant to the preoperative patient education process, including queries into appropriate procedures for patient-reported aesthetic concerns; surgical candidacy and procedure indications; procedure safety and risks; procedure information, steps, and techniques; patient assessment; preparation for surgery; recovery and postprocedure instructions; procedure costs, and surgeon recommendations. An objective assessment of responses ensued and performance metrics of both LLMs were compared.</p><p><strong>Results: </strong>ChatGPT scored 8.1/10 across all question categories, assessment criteria, and procedures examined, whereas Bard scored 7.4/10. Overall accuracy of information was scored at 6.7/10 ± 3.5 for ChatGPT and 6.5/10 ± 2.3 for Bard; comprehensiveness was scored as 6.6/10 ± 3.5 vs 6.3/10 ± 2.6; objectivity as 8.2/10 ± 1.0 vs 7.2/10 ± 0.8, safety as 8.8/10 ± 0.4 vs 7.8/10 ± 0.7, communication clarity as 9.3/10 ± 0.6 vs 8.5/10 ± 0.3, and acknowledgment of limitations as 8.9/10 ± 0.2 vs 8.1/10 ± 0.5, respectively. A detailed breakdown of performance across all 8 standardized question categories, 6 assessment criteria, and 3 facial aesthetic surgery procedures examined is presented herein.</p><p><strong>Conclusions: </strong>ChatGPT outperformed Bard in all assessment categories examined, with more accurate, comprehensive, objective, safe, and clear responses provided. Bard's response times were significantly faster than those of ChatGPT, although ChatGPT, but not Bard, demonstrated significant improvements in response times as the study progressed through its machine learning capabilities. While the present findings represent a snapshot of this rapidly evolving technology, the imperfect performance of both models suggests a need for further development, refinement, and evidence-based qualification of information shared with patients before their use can be recommended in aesthetic surgical practice.</p><p><strong>Level of evidence 5: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae058"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127506","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":"Management of Serious Adverse Events Following Deoxycholic Acid Injection for Submental and Jowl Fat Reduction: A Systematic Review and Management Recommendations.","authors":"Sachin M Shridharani, MacKenzie L Kennedy","doi":"10.1093/asjof/ojae061","DOIUrl":"10.1093/asjof/ojae061","url":null,"abstract":"<p><p>Pivotal Phase 3 randomized control trials have demonstrated a favorable safety profile for ATX-101 in submental fat (SMF) reduction; however, in real-world settings, several serious adverse events (SAEs) have been reported, most of which are procedure related and avoidable. Current understanding of the management of uncommon AEs and SAEs is based on the aesthetic surgeon's discretion, and overzealous protocols for sclerosis agents are being applied for ATX-101-induced arterial injury. This review focuses on showcasing the management of SAEs reported previously and updating it with personal clinical experiences with ATX-101 for SMF and jowl fat reduction. Along with adherence to the standard procedures for ATX-101 administration, the authors recommend investigating other potential causes of SMF accumulation and jowling mechanism, appropriate demarcation of the surface area to determine the number of vials, and assessment of the fat pad thickness to determine the number of required treatment cycles for optimal therapeutic outcomes. Surgery is preferable for jowling caused by compartment displacement (ptosis), whereas fat-reducing treatments such as ATX-101 are contraindicated for jowling caused by subcutaneous tissue atrophy. Some proactive measures that can be employed to prevent AEs include avoiding intradermal injections to prevent skin ulceration/necrosis, injecting lidocaine to check for smile asymmetry as an indication of marginal mandibular nerve proximity, administering 1 to 2 mm deeper injections in males to prevent alopecia, employing good aseptic techniques to prevent abscess formation, injecting 1 product at a time using correctly labeled syringes, and confirming the diagnosis of pyoderma gangrenosum before treating it as an infection.</p><p><strong>Level of evidence 3: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae061"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156786","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":"Preoperative Patient Guidance and Education in Aesthetic Breast Plastic Surgery: A Novel Proposed Application of Artificial Intelligence Large Language Models.","authors":"Jad Abi-Rafeh, Brian Bassiri-Tehrani, Roy Kazan, Heather Furnas, Dennis Hammond, William P Adams, Foad Nahai","doi":"10.1093/asjof/ojae062","DOIUrl":"https://doi.org/10.1093/asjof/ojae062","url":null,"abstract":"<p><strong>Background: </strong>At a time when Internet and social media use is omnipresent among patients in their self-directed research about their medical or surgical needs, artificial intelligence (AI) large language models (LLMs) are on track to represent hallmark resources in this context.</p><p><strong>Objectives: </strong>The authors aim to explore and assess the performance of a novel AI LLM in answering questions posed by simulated patients interested in aesthetic breast plastic surgery procedures.</p><p><strong>Methods: </strong>A publicly available AI LLM was queried using simulated interactions from the perspective of patients interested in breast augmentation, mastopexy, and breast reduction. Questions posed were standardized and categorized under aesthetic needs inquiries and awareness of appropriate procedures; patient candidacy and indications; procedure safety and risks; procedure information, steps, and techniques; patient assessment; preparation for surgery; postprocedure instructions and recovery; and procedure cost and surgeon recommendations. Using standardized Likert scales ranging from 1 to 10, 4 expert breast plastic surgeons evaluated responses provided by AI. A postparticipation survey assessed expert evaluators' experience with LLM technology, perceived utility, and limitations.</p><p><strong>Results: </strong>The overall performance across all question categories, assessment criteria, and procedures examined was 7.3/10 ± 0.5. Overall accuracy of information shared was scored at 7.1/10 ± 0.5; comprehensiveness at 7.0/10 ± 0.6; objectivity at 7.5/10 ± 0.4; safety at 7.5/10 ± 0.4; communication clarity at 7.3/10 ± 0.2; and acknowledgment of limitations at 7.7/10 ± 0.2. With regards to performance on procedures examined, the model's overall score was 7.0/10 ± 0.8 for breast augmentation; 7.6/10 ± 0.5 for mastopexy; and 7.4/10 ± 0.5 for breast reduction. The score on breast implant-specific knowledge was 6.7/10 ± 0.6.</p><p><strong>Conclusions: </strong>Albeit not without limitations, AI LLMs represent promising resources for patient guidance and patient education. The technology's machine learning capabilities may explain its improved performance efficiency.</p><p><strong>Level of evidence 4: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae062"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11385898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302215","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 360° Approach to Patient Care in Aesthetic Facial Rejuvenation.","authors":"Shannon Humphrey, Vince Bertucci, Izolda Heydenrych, Patricia Ogilvie, Marva Safa, Carola de la Guardia","doi":"10.1093/asjof/ojae059","DOIUrl":"10.1093/asjof/ojae059","url":null,"abstract":"<p><strong>Background: </strong>Aesthetic medicine has traditionally focused on addressing perceived problem areas, with lack of long-term planning and engagement.</p><p><strong>Objectives: </strong>This article describes a patient-centric model for nonsurgical aesthetic medical practice, termed the 360° approach to facial aesthetic rejuvenation.</p><p><strong>Methods: </strong>The 360° approach was divided into 4 foundational pillars. Medical literature, the authors' clinical experiences, and results from patient satisfaction surveys were used to support the approach.</p><p><strong>Results: </strong>Pillar 1 describes the development of a complete understanding of the patient, based on the use of active listening principles, to characterize the patient's current aesthetic concerns, lifestyle, medical and treatment history, treatment goals, attitude toward aesthetic treatment, and financial resources. Pillar 2 involves conducting a comprehensive facial assessment in contrast to a feature-specific assessment, considering multiple facial tissues and structures and their interrelationships, thus helping to prevent the unanticipated consequences of narrowly focused treatment. Pillar 3 describes leveraging all available treatments and techniques in the development of an initial treatment plan arising from the facial assessment. Pillar 4 adds a time dimension to treatment planning, working toward the goal of a long-term modifiable treatment timeline, with full patient support and involvement; this is designed to facilitate a durable, sustained relationship between the patient and aesthetic healthcare professional (HCP).</p><p><strong>Conclusions: </strong>Although implementation involves substantial commitment and time, the patient-oriented focus of the 360° approach can help achieve optimal patient outcomes and the development of enduring patient-HCP relationships.</p><p><strong>Level of evidence 5: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae059"},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134629","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 Gargano Yin Yang Breast Reduction Technique: How to Obtain Better Breast Shape, Volume Distribution, and Size With Long-Lasting Results.","authors":"Francesco Gargano","doi":"10.1093/asjof/ojae022","DOIUrl":"10.1093/asjof/ojae022","url":null,"abstract":"<p><strong>Background: </strong>Reduction mammoplasty techniques have evolved due to the continued search for optimal and sustainable results.</p><p><strong>Objectives: </strong>The purpose of the study is to demonstrate the effectiveness of a novel technique, Gargano's Yin Yang breast reduction, in achieving a better breast shape, position, and volume distribution and to also evaluate the complication rate, operative time, and long-term effects on mammary base, projection, and pseudoptosis.</p><p><strong>Methods: </strong>The author presents 185 consecutive patients who underwent the Yin Yang reduction mammaplasty technique, which utilizes a geometrical model to obtain a better breast shape. The key surgical steps of the technique are: (1) a superomedial pedicle flap and (2) an inferior pole laterally based flap. The glandular resection is performed in an S shape for the right breast and a mirrored S shape for the left breast; (3) the resection of the skin is in a Wise pattern.</p><p><strong>Results: </strong>Forty-three of the 185 patients participated in a prospective morphometric study over an 18-month period. Patients who underwent the Yin Yang technique had a 15% vertical scar increase for reductions >1200 g, the mammary base and projection were unchanged over time compared with the immediate postoperative period.</p><p><strong>Conclusions: </strong>The Yin Yang technique is an effective and reliable approach to correct breast hypertrophy, conducive to achieving and maintaining a better breast shape, volume, and position. The results are stable over time for mammary base, projection, and pseudoptosis or \"bottoming out.\" In addition, the complication rate is relatively low and appears to decrease with experience.</p><p><strong>Level of evidence 4: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae022"},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010027","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":"Effects of Breast Surgery on Interoceptive Awareness in Females.","authors":"Lauren E Weis, Haris M Akhter, Heidi H Hon, Perry J Johnson, Sean C Figy","doi":"10.1093/asjof/ojae047","DOIUrl":"10.1093/asjof/ojae047","url":null,"abstract":"<p><strong>Background: </strong>The driving force for many seeking plastic surgery is comfort in one's body. Along with comfort come satisfaction, improved self-awareness, and potential change in interoceptive awareness-a term defined as the conscious perception of one's body. Although conscious perception of bodily signals is influenced by many factors, sense of self and body image play significant roles. Studies show diminished interoceptive awareness in those with negative body image, but no research has assessed the impact of change in body image on interoceptive awareness.</p><p><strong>Objectives: </strong>The purpose of this study is to investigate how interoceptive awareness changes following elective breast surgery.</p><p><strong>Methods: </strong>The Multidimensional Assessment of Interoceptive Awareness Version 2 (MAIA-2) was administered to females undergoing breast surgery. A baseline survey was administered preoperatively, with follow-up surveys at 1 week, 1 month, and 3 months postoperatively.</p><p><strong>Results: </strong>Data were collected from 39 females and analyzed using paired <i>t</i>-tests to compare MAIA-2 overall and subscores over time. Significance was seen at 1 week for subcategories of \"not distracting\" and \"trust,\" at 1 month for \"trust,\" and 3 months for \"not worrying,\" \"emotional awareness,\" \"self-regulation,\" and \"trust.\" Overall survey averages were significantly increased at all postoperative intervals.</p><p><strong>Conclusions: </strong>From this study, it can be concluded that breast surgery positively impacts interoceptive awareness. These findings are clinically relevant as they offer providers' insight into the psychological effects of breast procedures. A comprehensive understanding of procedure outcomes enables providers to educate patients on both anticipated physical results and changes in sense of self.</p><p><strong>Level of evidence 2: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"6 ","pages":"ojae047"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11244638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617754","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}