Aesthetic Plastic Surgery最新文献

{"title":"Embodied Affirmation: Experiences with Gender-Affirming Top Surgery.","authors":"Ethan D Paliwoda, Elma Dema, Kiersten Hamilton, Shivani Modi, Melia Wakeman, Hanaa Shihadeh, Benjamin J Schalet, Dzifa S Kpodzo","doi":"10.1007/s00266-025-05047-9","DOIUrl":"https://doi.org/10.1007/s00266-025-05047-9","url":null,"abstract":"<p><strong>Background: </strong>Gender-affirming top surgery is an increasingly requested procedure by individuals to address gender dysphoria. On Instagram and TikTok, \"#TopSurgery\" is currently the most common gender-affirming surgery hashtag, with most content being shared by patients. This study aims to analyze online posts to elucidate patient perceptions and information dissemination related to gender-affirming top surgery.</p><p><strong>Methods: </strong>Instagram and TikTok were queried under \"#TopSurgery.\" Public patient posts discussing their gender-affirming top surgery experiences were collected. Across 808 posts made after 2020, forty-two subthemes were identified reflecting gender-Q foci and were grouped into five central motifs.</p><p><strong>Results: </strong>The five central motifs were Psychosocial and Emotional Well-being (31%), Empowerment and Identity Formation (30%), Navigating the Medical Journey (17%), Physical Health and Body Image (16%), and Allies and Stigma (6%). The most common subthemes were Appearance & Body Image (587, 73%), Satisfaction and Relief (576, 71%), Empowerment & Confidence (554, 69%), Positivity & Inspiration (535, 66%), Quality of Life & Mental Health (496, 61%), Self-Esteem & Identity Affirmation (470, 58%), Milestones & Achievements (404, 50%), and Outreach & Health Literacy (306, 38%).</p><p><strong>Conclusion: </strong>Significant differences existed between social media posts shared on Instagram and TikTok, those made before and after surgery, and by those of different identities. Patients use social media to share experiences with gender-affirming top surgery, including emotional, physical, and lifestyle changes. Themes of these posts vary by platform, surgical stage, and gender identity. These insights can enhance the physician-patient relationship, improving counseling, setting patient expectations, and navigating the pre/postoperative period.</p><p><strong>Level v: </strong>OBSERVATIONAL STUDY: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635888","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 Rise of Intelligent Plastic Surgery: A 10-Year Bibliometric Journey Through AI Applications, Challenges, and Transformative Potential.","authors":"Yi Liu, Kexin Deng, Chengwu Zhang, Zhigen Yuan, Jianda Zhou, Can Liu","doi":"10.1007/s00266-025-05068-4","DOIUrl":"https://doi.org/10.1007/s00266-025-05068-4","url":null,"abstract":"<p><strong>Background: </strong>Driven by advancements in deep learning, surgical robots, and predictive modeling technologies, the integration of artificial intelligence (AI) and plastic surgery has expanded rapidly. Although AI shows the potential to enhance precision and efficiency, its clinical integration faces challenges, including ethical concerns and interdisciplinary complexity, which require a systematic analysis of research trends.</p><p><strong>Methods: </strong>The CiteSpace and VOSviewer software were used to conduct a quantitative analysis of 235 documents in the core collection of Web of Science from 2016 to 2024. Co-citation networks, keyword co-occurrence, burst detection, and cluster analysis were employed to map the research trajectories. The inclusion criteria gave priority to studies that explicitly incorporated artificial intelligence into surgical designs or outcomes. The contributions of countries, institutions, and authors were evaluated through centrality indicators.</p><p><strong>Result: </strong>Publications related to artificial intelligence have grown exponentially, with the USA, Germany, and Canada leading research output. Harvard and Stanford Universities dominate in terms of institutional contributions, but cross-institutional collaboration remains limited. The keyword cluster highlights the innovations of artificial intelligence in breast reconstruction, facial analysis, and automated grading systems. Burst terms such as \"deep learning,\" \"risk assessment,\" and \"attractiveness\" underscore AI's role in optimizing surgical outcomes, but they also expose biases against Western-centric beauty standards. Ethical concerns, dataset diversity gaps, and overreliance on AI-driven decisions have become key obstacles.</p><p><strong>Conclusion: </strong>The integration of artificial intelligence in plastic surgery goes beyond the utility based on tools and into data-informed surgical engineering. The persistent gap in collaboration and dataset diversity highlights the need for global, interdisciplinary efforts to address technical and ethical challenges while advancing AI's clinical utility. Future research must prioritize transparency, inclusivity, and collaborative innovation to realize AI's transformative potential while mitigating risks.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635910","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 Allures and the Alarms of the Hair Transplant Tourism Industry.","authors":"Syed Ali Haider, Sabina Hasanzade, Sahar Borna, Cesar Abraham Gomez-Cabello, Sophia M Pressman, Ariana Genovese, Maissa Trabilsy, Srinivasagam Prabha, Bernardo G Collaco, Antonio Jorge Forte","doi":"10.1007/s00266-025-05018-0","DOIUrl":"https://doi.org/10.1007/s00266-025-05018-0","url":null,"abstract":"<p><strong>Background: </strong>Hair transplant tourism has surged globally, with Turkey, especially Istanbul, becoming the epicenter, generating about US$1 billion annually. This growth is fueled by substantially lower costs and appealing all-inclusive packages, leading patients to prioritize perceived value despite associated risks abroad.</p><p><strong>Objectives: </strong>This review critically examines the multifaceted international hair transplant industry, using Turkey as a case study. We aim to analyze economic drivers and the perception that high surgical volume equates to expertise, against significant patient safety concerns.</p><p><strong>Methods: </strong>A comprehensive review of existing literature and reports was conducted. We documented trends including aggressive digital marketing, the expanded role of unsupervised technicians, bait and switch practices, and alarming complication rates reported by regulatory bodies, which burden patients' home healthcare systems.</p><p><strong>Results: </strong>While the hair transplant tourism industry can offer effective solutions and high graft survival in some centers, it primarily operates within a permissive regulatory environment, lacking standardization, oversight, and consistent reporting, creating a \"data black hole.\" This, combined with the psychological distress of hair loss and the false perception of transplantation as minor, creates profound patient vulnerability, intensified by marketing campaigns that downplay risks.</p><p><strong>Conclusions: </strong>While the industry offers affordable pathways, regulatory gaps and quality variability introduce substantial risks. Prospective patients should recognize that significant price variations may correlate with differences in resources, surgeon experience, technology, and safety protocols. Urgent development of international standards, robust verification, transparent reporting, and comprehensive patient education are imperative for patient safety and the ethical growth of this rapidly expanding medical tourism sector.</p><p><strong>Level of evidence v: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635909","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":"Qualitative Terms Used In Rhinoplasty: A Scoping Review -Toward Establishing a Bridge Between Qualitative Terminology and Quantifiability.","authors":"Mazhar Çelikoyar, Aidan Beeching, Esther M Sarino, Eric Dobratz, Oguzhan Topsakal","doi":"10.1007/s00266-025-05072-8","DOIUrl":"https://doi.org/10.1007/s00266-025-05072-8","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty is one of the most commonly performed aesthetic surgical procedures. Both patients and surgeons rely on qualitative descriptors such as \"plunging nose,\" \"bulbous tip,\" or \"twisted nose\" to describe nasal features. Despite their frequent use, there is limited standardization of these terms and their correlation with objective measurements.</p><p><strong>Methods: </strong>A scoping review was conducted following the PRISMA-ScR guidelines. The study searched three electronic databases (PubMed/MEDLINE, Ovid/MEDLINE, and Web of Science) for English language articles published between 1949 and 2021. Qualitative descriptors and semi-quantitative and quantitative measures were extracted and categorized.</p><p><strong>Results: </strong>A total of 459 studies were included, comprising retrospective studies (272), prospective studies (38), technical descriptive articles and literature reviews (180), and letters to the editor (5). Qualitative terms were recorded 23.5% (237/1007) of the time, semi-quantitative terms 16% (162/1007), and quantitative descriptions 57% (578/1007). The most commonly described nasal features were the tip (20.8%), dorsum (13.2%), and alar base (12.3%). Measurement techniques varied, with photography being the most common (60%), followed by surgeon assessment (20.3%) and 3D imaging (5.4%).</p><p><strong>Conclusions: </strong>This review highlights a gap in the correlation between qualitative rhinoplasty descriptors and quantitative analysis. Standardization and integration of objective measurement tools may enhance clinical communication and surgical planning.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635908","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":"Comparison of Non-liposuction and Liposuction Techniques in Single-port Endoscopic Subcutaneous Mastectomy for Gynecomastia: A Retrospective Analysis.","authors":"Yuming Shao, Jie Zhang, Huanyu Lu, Shoukun Xue, Chao Fang, Yuyang Li, Kunbing Zhu","doi":"10.1007/s00266-025-05050-0","DOIUrl":"https://doi.org/10.1007/s00266-025-05050-0","url":null,"abstract":"<p><strong>Background: </strong>Gynecomastia (GM) is a common benign proliferation of male breast tissue that can significantly impact patients' physical and mental health. Endoscopic subcutaneous mastectomy (ESCM) has emerged as a promising minimally invasive approach for treating GM. However, the relative efficacy of different techniques for creating operative space during ESCM remains unclear. This study aims to compare the clinical outcomes of non-liposuction and liposuction techniques in single-port ESCM for GM treatment.</p><p><strong>Methods: </strong>This retrospective study included 41 GM patients who underwent single-port ESCM via bilateral axillary approach at Shandong Maternal and Child Health Hospital between September 2022 and September 2023. Patients were divided into non-liposuction (n=20) and liposuction (n=21) groups. Operative time, blood loss, postoperative drainage volume, complication rates, and patient satisfaction were compared between the two groups.</p><p><strong>Results: </strong>All procedures were successfully completed without conversion to open surgery. The non-liposuction group had significantly shorter mean operative time compared to the liposuction group (124.30 vs 168.81 minutes, P<0.001). Postoperative day 1 drainage volume was also significantly lower in the non-liposuction group (43.40 vs 107.05 mL, P<0.001). No significant differences were observed in intraoperative blood loss, complication rates, or patient satisfaction between the two groups. The overall complication rate was 7.3% (3/41), with two cases in the liposuction group and one in the non-liposuction group. No recurrences were reported during the 12-month follow-up period.</p><p><strong>Conclusion: </strong>Single-port ESCM is a safe and effective method for treating GM. Compared to the liposuction technique, the non-liposuction approach demonstrates significant advantages in reducing operative time and postoperative drainage volume while maintaining comparable safety and patient satisfaction. These findings provide new insights for optimizing GM treatment strategies and potentially improving patient outcomes.</p><p><strong>Level of evidence iv: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615834","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 Columellar Auto-Strut Technique: A Refined Approach to Nasal Tip Stabilization in Septorhinoplasty.","authors":"Mehmet Çelik, Said Sönmez, Deniz Kanlıada","doi":"10.1007/s00266-025-05067-5","DOIUrl":"https://doi.org/10.1007/s00266-025-05067-5","url":null,"abstract":"<p><strong>Background: </strong>The Columellar Auto-Strut Technique (CAST) is a refined modification of the Tongue-in-Groove (TIG) method, designed to provide stable nasal tip support while maintaining aesthetic flexibility. This study evaluates the clinical outcomes of CAST in septorhinoplasty (SRP).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 78 patients who underwent SRP using CAST. Nasal tip projection (Goode ratio), nasolabial angle (NLA), and subjective tip stiffness were assessed preoperatively and postoperatively.</p><p><strong>Results: </strong>The mean NLA increased from 84.3° ± 5.2° to 99.8° ± 4.8° (p < 0.001). The Goode ratio improved from 0.58 ± 0.06 to 0.63 ± 0.01 p = 0.003). The mean VAS score for nasal tip stiffness was 7.1 ± 1.1. No significant cases of nasal tip deviation or nostril asymmetry were reported.</p><p><strong>Conclusions: </strong>The CAST technique offers stable nasal tip support with predictable outcomes, preserving both function and aesthetics. Further studies with larger sample sizes and long-term follow-up are needed to validate its effectiveness in routine SRP.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607158","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":"Modified Ishida-Ferreira Type B Technique Combined with Polygon Tipplasty and Sliding Alar Cartilage Flaps: A Versatile Solution for Primary Caucasian Rhinoplasty.","authors":"Metin Kerem, Burak Ergün Tatar, Nilüfer Bahadırlı","doi":"10.1007/s00266-025-04996-5","DOIUrl":"https://doi.org/10.1007/s00266-025-04996-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Dorsal cartilage preservation techniques have gained significant popularity among rhinoplasty surgeons recently, as they present natural dorsal aesthetic lines, and avoid dorsal reconstruction procedures for the cartilage dorsum. With correct patient selection criteria, cartilage preservation techniques give good results, while on the wrong patients, this may not always be possible. Also, blending these dorsal preservation techniques with different approaches in other subunits of the nose (tip complex and alar cartilages) may offer a variety of options in today's rhinoplasty world. This study presents a modified version of the Ishida-Ferreira cartilage push-down technique combined with polygon tipplasty and sliding alar cartilage flaps.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis of 110 patients who underwent primary rhinoplasty (June 2021-August 2023) was conducted. The inclusion criteria were primary rhinoplasty cases with no history of any surgical/non-surgical nose treatments and have a nasal index (NI) of 75 or less (leptorrhine or mesorrhine). Cases requiring augmentation, S-shaped humps, wide dorsum, (NI greater than 75), and severe axis/septum deviations have been excluded from the study. The surgical steps included Cottle low septal strip resection, triangular osteotomies from the dorsal aspect of the nasal bones, push-down, lateral osteotomies, polygon tipplasty, and sliding alar cartilage flaps. Postoperative satisfaction was evaluated using a 5-point Likert scale. Statistical analysis was performed to examine correlations between age, operative time, and satisfaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the patients was 27.7 years, and 76.4% were female. The mean operative time was 107 minutes (75-160). Patient satisfaction scores were high, with a mean of 4.51 points: 63.6% scored \"very good\" and 26.4% scored \"good.\" Early complications included prolonged bleeding in 1.8% of the cases. Late complications occurred in 3.6% of patients (dorsal widening, bony cap malposition, and nostril asymmetry), with four patients (3.6%) requiring revision surgery. No significant correlation was found between satisfaction and age or operative time (P &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The modified technique demonstrated several advantages thanks to the modified Ishida-Ferreira technique, where the dorsal cartilage integrity is preserved. Unlike the original high strip technique, the low strip modification lets us to remove the septal base cartilage where deviations are very common. Also, the stronger septal base cartilage provides a better material to be used as a columellar strut. Combining modified cartilage and bony cap preservation, polygon tipplasty, and sliding alar cartilage flaps improves dorsal and tip stability while preserving external nasal integrity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This approach offers a fast, effective, and modular solution for primary rhinoplasty, y","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615835","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":"Sub-nipple Incision for Gland Resection in Gynecomastia, Combined with High-Definition Liposculpture Principles: Technical Refinements and a Step-by-Step Video Guide.","authors":"Tamara A Garsten, Toon Sels, Steven D M Colpaert, Marc van Cleemput","doi":"10.1007/s00266-025-05076-4","DOIUrl":"https://doi.org/10.1007/s00266-025-05076-4","url":null,"abstract":"<p><p>Gynecomastia correction often requires removal of both a glandular and fat component. Aggressive tissue removal bears the risk of causing irregularities, areolar scars, or a flat chest. Insufficient removal, on the other hand, causes recurrence. We present a new minimally invasive technique combining adequate gland removal with minimal scarring and improved contour. Our technique is based on the observation that we can make the retroareolar fibroglandular tissue extremely moldable if we first remove all the fat from between the periareolar fibrous strands. This fat removal requires a 3-mm or smaller power-assisted liposuction canula. Next, glandular resection is possible through a 7-mm incision at the base of the nipple. Combined with principles from high-definition liposculpture, superior esthetic results can be obtained.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599127","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":"Comparison of Clinical Associations and Outcomes Between Superomedial and Inferior Pedicle Breast Reduction Surgery: A Retrospective Study.","authors":"Thomas Ren, Andre Galenchik-Chan, Katherine Wang, Duc T Bui","doi":"10.1007/s00266-025-05041-1","DOIUrl":"https://doi.org/10.1007/s00266-025-05041-1","url":null,"abstract":"<p><strong>Introduction: </strong>Historically, the inferior pedicle (IFP) procedure has been the dominant technique for the treatment of macromastia; however, the superomedial pedicle (SMP) approach allows for decreased operative times, reduced incision tension, and improved and longer lasting superior pole fullness. The goal of this study is to investigate and compare the clinical outcomes and complications associated with the inferior pedicle and superomedial pedicle approaches to reduction mammoplasty.</p><p><strong>Materials and methods: </strong>This retrospective study was conducted through a single surgeon's experience with a total of 444 patients from 2005-2024. Patients were divided into two cohorts based on their breast reduction pedicle type. Chi-square tests and linear regression analysis were utilized to compare patient characteristics and surgical outcomes of the two pedicle types.</p><p><strong>Results: </strong>Of the total 444 reduction mammoplasty patients, 114 (25.7%) underwent the IFP technique and 330 (74.3%) underwent the SMP reduction. Patients in the IFP cohort had a significantly higher total complication rate of 57.0%, while the SMP cohort had a total complication rate of 46.1%. The prevalence of cellulitis was the only statistically significant difference between the two groups. 21.9% of IFP patients developed cellulitis post-operatively compared to 7.0% of SMP patients.</p><p><strong>Conclusion: </strong>This study supports the notion that superior pedicle reduction mammoplasty is as safe and may result in fewer complications than the current inferior pedicle standard. The overall complication rate, and specifically prevalence of cellulitis within the IFP technique may be attributed to four main factors: operative time, weight of breast resected, BMI, and drain status. Given the lack of similar findings in the literature, we believe our results may reflect differences in preoperative patient characteristics and postoperative management. Both techniques appear to have comparable complication rates and should remain essential skills for surgeons.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599125","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":"Treatment of Trapdoor Deformity After Facial Skin Flap Reconstruction.","authors":"Gianmarco Polverino, Francesca Russo, Francesca Mosella, Francesco Mazzarone, Francesco D'Andrea","doi":"10.1007/s00266-025-05008-2","DOIUrl":"https://doi.org/10.1007/s00266-025-05008-2","url":null,"abstract":"<p><strong>Background: </strong>The trapdoor deformity is a common postoperative complication characterized by bulging tissue within a depressed, semicircular scar, often seen after reconstructive procedures with curved flaps. It results from complex physiomechanical forces, including scar contraction vectors, tissue bunching, lymphatic or venous obstruction, and excess subcutaneous fat. Despite various theories, its exact pathophysiology remains unclear. Traditional treatments like Z-plasties and peripheral undermining aim to redirect contraction forces, though recurrence is frequent. Emerging research explores lymphatic dysfunction as a contributing factor. This study systematically reviews all flap types associated with trapdoor deformity and evaluates both current and emerging management strategies.</p><p><strong>Materials and methods: </strong>A systematic literature review on trapdoor deformity was conducted following PRISMA guidelines, using PubMed, Scopus, and Web of Science. Inclusion criteria covered original clinical studies on trapdoor deformity treatment and prevention in facial flaps, while reviews, unclear reports, and animal studies were excluded. Two investigators independently extracted data, with a third reviewer resolving discrepancies. Both English and select non-English articles were analyzed.</p><p><strong>Results: </strong>Out of 1864 screened citations, 867 duplicates and 898 irrelevant articles were excluded, leaving 99 for full-text review. Fifty met inclusion criteria, reporting 521 trapdoor deformity cases from 1982 to 2024. The bilobed and nasolabial flaps were most associated with TD, especially in nasal reconstruction. Only 12 of the included studies focused on treatment as the primary endpoint.</p><p><strong>Conclusion: </strong>Triamcinolone injections are an effective first-line treatment. Laser therapy shows potential and warrants further research, whereas super shaving lacks robust data on long-term outcomes and complication.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599128","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}