Jacob G Mabey, Alexander J Kammien, Vikram G Mookerjee, J Grant Thomson
{"title":"A Biomechanical Analysis of Barbed and Monofilament Suture in an Ex Vivo Skin Closure Model.","authors":"Jacob G Mabey, Alexander J Kammien, Vikram G Mookerjee, J Grant Thomson","doi":"10.1007/s00266-025-04947-0","DOIUrl":"https://doi.org/10.1007/s00266-025-04947-0","url":null,"abstract":"<p><strong>Background: </strong>Previous studies propose that barbed suture may have equivalent tensile strength and reduced suturing time compared to traditional suture materials, but this has not been tested in skin closure using tissue from living human donors.</p><p><strong>Methods: </strong>Twenty-four 5 cm by 2.5 cm samples were cut from twelve skin and subcutaneous tissue specimens that were obtained from abdominal wall procedures. Each sample was sectioned in half, and the skin was then closed using one of two techniques: knotless (running subcuticular with 3-0 barbed suture and skin glue) or layered closure (deep dermal sutures with 3-0 poliglecaprone, running subcuticular with 4-0 poliglecaprone and skin glue). Closure time and load to failure were recorded and compared using t-tests.</p><p><strong>Results: </strong>Mean closure time was significantly shorter for the knotless technique (2.2 ± 0.6 minutes) compared to layered closure (5.6 ± 0.5 minutes). Regarding tensile strength, mean load to failure for the knotless closure (46.5 ± 22.2 N) was significantly lower than the layered closure (79.3 ± 39.1 N). All techniques failed due to suture rupture.</p><p><strong>Conclusions: </strong>Knotless closures significantly reduced closure time but were weaker than layered closures. All closures exceeded estimates of clinical tension in wound closure, suggesting that knotless skin closures may be a viable option in some scenarios to reduce closure time and suture material.</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":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172374","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}
Muhammad Ashhad Noor, Ahmad Abul, Mohammad Saleki, Ali Alkhabbaz, Ali Abel, Mohammad Karam, Sarah Al-Youha
{"title":"Botulinum Toxin Injection for Hemifacial Spasm and Benign Essential Blepharospasm: A Systematic Review and Meta-Analysis Comparing Pretarsal and Preseptal Injection Techniques.","authors":"Muhammad Ashhad Noor, Ahmad Abul, Mohammad Saleki, Ali Alkhabbaz, Ali Abel, Mohammad Karam, Sarah Al-Youha","doi":"10.1007/s00266-025-04913-w","DOIUrl":"https://doi.org/10.1007/s00266-025-04913-w","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcomes of pretarsal versus preseptal botulinum toxin injection techniques for patients with benign essential blepharospasm (BEB) and hemifacial spasm (HFS).</p><p><strong>Methods: </strong>The study was pre-registered on PROSPERO (CRD42023479251). A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, and an electronic search was conducted to identify all studies comparing outcomes between the two techniques. Change in Jankovic Rating Scale (JRS) was the primary outcome. Adverse events, duration to maximum response, and latency to first response were secondary outcomes.</p><p><strong>Results: </strong>A total of 384 patients with 2657 injections for HFS patients and 1033 injections for BEB patients were reported across six studies. The mean difference analysis for the change in JRS scores in HFS patients reveals a statistically significant difference favouring the pretarsal group for improved JRS ratings (MD=0.47, CI= 0.19 to 0.75, P = 0.001) and change in JRS scores in BEB patients favouring the pretarsal group (MD=0.92, CI= 0.48 to 1.36, P 0.001). There was a significant difference favouring the pretarsal group in duration of maximum response in HFS (P= 0.0005) and fewer occurrences of ptosis (P=0.0009). Other secondary outcomes including post-procedure tearing, irritation, and lagophthalmos had similar results.</p><p><strong>Conclusion: </strong>Pretarsal botulinum toxin injection is a preferable alternative for BEB and HFS compared to the preseptal approach, because it minimizes the extent and frequency of spasms, has less occurrences of ptosis, and has a greater duration of maximal response. More clinical trials are needed to validate the findings of this meta-analysis.</p><p><strong>Level of evidence i: </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":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180357","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}
Tahera Bhojani-Lynch, Sabrina Shah-Desai, Jean-Christophe Bichet, Bárbara Magalhães, Kevin Poupard
{"title":"Real-World Evidence on the Routine Use, Efficacy, and Safety of a Hyaluronic Acid-Based Dermal Filler in the Periorbital Region.","authors":"Tahera Bhojani-Lynch, Sabrina Shah-Desai, Jean-Christophe Bichet, Bárbara Magalhães, Kevin Poupard","doi":"10.1007/s00266-025-04809-9","DOIUrl":"https://doi.org/10.1007/s00266-025-04809-9","url":null,"abstract":"<p><strong>Background: </strong>The appearance of the periorbital region is essential in facial aesthetic perception and is a frequent concern of patients seeking rejuvenation. TEOSYAL® PureSense Redensity 2 (R2) has a 10-year track record of effectively and safely treating the under-eye area, specifically the tear trough.</p><p><strong>Methods: </strong>A prospective, observational study aimed to investigate the efficacy and safety of R2 in a real-world setting for aesthetic indications. Participants received at least one treatment injection with R2, and investigators followed their routine injection techniques and indications. The primary endpoint was the Global Aesthetic Improvement Scale (GAIS) score recorded 3 months post-injection. Secondary efficacy outcomes included subject and investigator satisfaction, as well as GAIS scores at later timepoints. Safety was monitored by documenting common treatment responses (CTRs) and adverse events (AEs).</p><p><strong>Results: </strong>The 136 subjects enrolled in EYELIGHT received 958 initial injections, of which 451 (47.1%) were performed with R2: 89 (35.3%) tear trough, 61 (24.2%) palpebromalar groove, 45 (17.9%) outer canthus, 38 (15.1%) crow's feet, and 19 (7.5%) brow. A GAIS improvement of more than 70% was achieved for the tear trough and remaining periorbital indications, with most subjects reporting satisfaction with treatment (84.3%). Treatment effect was observed up to 12 months post-injection. All CTRs were mild or moderate and resolved within a month. No severe AEs were reported.</p><p><strong>Conclusion: </strong>Real-world evidence confirmed the 10-year long success of R2 as an effective and safe treatment of the tear trough. Based on this evidence, its use extends beyond the tear trough, showing effectiveness and safety in the whole periorbital area.</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":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179700","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":"Writing an Abstract: Humans or ChatGPT?","authors":"Shigeki Matsubara","doi":"10.1007/s00266-025-04983-w","DOIUrl":"https://doi.org/10.1007/s00266-025-04983-w","url":null,"abstract":"<p><p>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":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180590","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}
Giulia Lo Russo, Leonardo Scortecci, Francesca Ruccia, Ankur Khajuria, Leonardo Gada
{"title":"A New Algorithm for Masculine Chest-Wall Contouring in 560 Trans-AFAB (Assigned Female at Birth) Patients: Clinical Outcomes and Patient-Reported Satisfaction Using the TRANS-Q Questionnaire.","authors":"Giulia Lo Russo, Leonardo Scortecci, Francesca Ruccia, Ankur Khajuria, Leonardo Gada","doi":"10.1007/s00266-025-04942-5","DOIUrl":"https://doi.org/10.1007/s00266-025-04942-5","url":null,"abstract":"<p><strong>Introduction: </strong>The preoperative plan is crucial in chest-wall contouring surgery. Choosing the right surgical technique may be challenging, especially when there are many variables to consider. Therefore, the senior author (GLR) described a novel and simpler preoperative algorithm which we used in our group of 560 trans-AFAB patients.</p><p><strong>Methods: </strong>From 2016 to 2024, 560 consecutive trans-AFAB patients underwent top surgery with the new algorithm that uses the inferior border of pectoralis major muscle as a landmark to decide between three techniques: (1) Periareolar incision (PA), when the NAC is on the landmark, (2) hemi-periareolar incision (HP), when the NAC is above the landmark, and (3) double-incision technique with free nipple graft (DI) when the NAC is below the landmark. Complications, need for a touch-up, scar quality (through the Vancouver Scar Scale) and patient-reported outcomes (through TRANS-Q questionnaire) were analyzed.</p><p><strong>Results: </strong>The most used technique was DI (82.4%) followed by HP (11.4%) and PA (6.2%). Hematoma occurred in 10.8% of the patients but only 1.7% needed a reintervention in the operating room. We performed a touch-up procedure in 9% of the patients. The most prevalent VSS score was 1 registered in 38.4% of patients. The TRANS-Q questionnaire revealed that the large majority of patients showed an improvement after surgery (p value: 1.41 × 10<sup>-16</sup>).</p><p><strong>Conclusion: </strong>This simple but effective new algorithm can support surgical choices and maximize the aesthetic outcomes in trans-AFAB patients' chest-wall contouring. High patient satisfaction and good surgical outcomes evidence the efficacy of this algorithm.</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":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172376","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":"Effect of Depressor Septi Transposition on Preventing Tip Droop During Smiling in Tongue-in-Groove Tip Plasty: A Randomized Controlled Trial.","authors":"Shayan Dasdar, Nika Kianfar, Mosleh Kadkhoda-Mohammadi, Babak Saedi","doi":"10.1007/s00266-025-04966-x","DOIUrl":"https://doi.org/10.1007/s00266-025-04966-x","url":null,"abstract":"<p><strong>Background and aims: </strong>Plunging tips caused by overactivity of the depressor septi nasi (DSN) muscle present common challenges in rhinoplasty. The tongue-in-groove (TIG) surgical technique has proven effective in correcting static tip drooping.</p><p><strong>Objective: </strong>This study aims to assess the effect of DSN transposition on preventing tip drooping during smiling in TIG tip plasty.</p><p><strong>Methods: </strong>This clinical trial was conducted at a tertiary academic hospital from April 2022 to July 2024. Fifty patients with plunging tips who were undergoing septorhinoplasty were randomly assigned to two groups: TIG alone (n = 25) and TIG with DSN transposition (n = 25). The primary outcome measured was the percentage change in the tip angle between relaxed and smiling poses, evaluated through preoperative and one-year postoperative assessments. Secondary outcomes included the position of the tip, the position of the alar, tip projection, rotation, and patient satisfaction measured by the Standardized Cosmesis and Health Nasal Outcomes Survey.</p><p><strong>Results: </strong>The reduction in tip angle was significantly greater in both groups (TIG alone: from - 9.38 to - 5.80%, p < 0.001; TIG with DSN transposition: from - 11.57 to - 8.65%, p = 0.001). There were no significant differences between the groups in terms of tip angle (p = 0.518), tip position (p = 0.363), alar position (p = 0.239), or nasolabial angle (p = 0.287). Improvements in patient satisfaction scores were also similar between the groups (TIG alone: 15.62 ± 8.44; TIG with DSN transposition: 18.50 ± 8.64, p = 0.286).</p><p><strong>Conclusion: </strong>Both TIG and TIG combined with DSN transposition effectively reduce dynamic nasal tip drooping during smiling. DSN transposition may not lead to a significant improvement in outcomes compared to TIG alone.</p><p><strong>Level of evidence i: </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":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172377","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":"Letter to Editor: The Impact of Body Mass Index on Breast Reduction Outcomes: A Multi-Institutional Data Analysis of 45,000 Cases over 15 Years.","authors":"Syed Israr, Ruba Javed, Zauha Fawad","doi":"10.1007/s00266-025-04990-x","DOIUrl":"https://doi.org/10.1007/s00266-025-04990-x","url":null,"abstract":"<p><p>We commend Knoedler et al. for their comprehensive study, \"The impact of body mass index on breast reduction outcomes,\" which leverages a robust sample size and a reputable dataset to address an important topic in plastic surgery. While the study successfully highlights the relevance of BMI in breast reduction outcomes, we identify several methodological limitations that could affect the generalizability and depth of its findings. Crucially, the omission of confounding variables such as smoking, diabetes, immunologic and mental health status may limit the accuracy of the reported outcomes. Unlike previous work by the same authors on gynecomastia surgery, which incorporated more comprehensive factors, this study does not fully explore the relationship between BMI, reoperation, and complication rates. Moreover, the limited 30-day post-operative follow-up may overlook long-term complications such as fat necrosis and scarring, which are critical to patient satisfaction. The exclusion of male, non-binary patients, and those undergoing simultaneous procedures, while controlling variability, restricts the study's applicability to broader populations. Additionally, reliance on NSQIP, though valuable, omits nuances like surgical techniques and patient compliance. We suggest future studies incorporate a broader range of variables and follow-up periods to enhance the scope and precision of surgical outcome research.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":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155462","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":"Digitally Guided Precision Fat Grafting for Progressive Hemifacial Atrophy.","authors":"Guojie Chen, Qiang Fu, Xiao Xu, Lili Xu, Peixuan Zhang, Tianran Li, Minliang Chen","doi":"10.1007/s00266-025-04923-8","DOIUrl":"https://doi.org/10.1007/s00266-025-04923-8","url":null,"abstract":"<p><strong>Background: </strong>Autologous fat grafting (AFG) is widely used to treat progressive hemifacial atrophy (PHA), but accurate measurement of tissue defects in PHA patients remains a challenge due to varied facial defects and complex anatomy.</p><p><strong>Methods: </strong>This retrospective study monitored patients undergoing AFG over 12-16 months. Using 3D computed tomography (CT), the midsagittal plane of the face was scanned, mirror-image analysis (MIA) was carried out, and soft tissue volume loss was predicted across facial regions. The patients were evaluated at four intervals (preoperatively and at 3, 6, and 12 months postoperatively) by calculating the asymmetry index (AI), asymmetry rate (AR), preoperative soft tissue volume deficiency (Preop STVD), volume deficiency rate (VDR), and percentage volume maintenance (PVM). Patient characteristics, satisfaction, and outcomes were also analyzed.</p><p><strong>Results: </strong>Fifteen patients (mean age 22) underwent an average of 1.9 AFG surgeries. Preoperative soft tissue defect volume was measured at 101.96 ± 82.52 cm<sup>3</sup>, with an average fat injection volume of 93.38 ± 73.71 cm<sup>3</sup>. Tissue defect rates ranged from 1.43 to 10.16% (mean 4.42 ± 3.47%), and volume maintenance varied from 35.60 to 79.16% (average 56.64 ± 13.48%). Postoperatively, defect rates ranged from 0.78 to 4.86% (mean 2.11 ± 1.66%), with volume maintenance between 52.36 and 71.74% (average 63.50 ± 8.09%). Significant improvements in facial symmetry and patient satisfaction were noted, with no complications reported.</p><p><strong>Conclusion: </strong>Digitally guided precision fat grafting is a promising method for predicting soft tissue loss and improving facial symmetry in patients with progressive hemifacial atrophy.</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":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155446","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":"Comment on: Internal Bra: A literature Review and Sub-classification of Definitions.","authors":"Mohammadhossein Hesamirostami","doi":"10.1007/s00266-025-04988-5","DOIUrl":"https://doi.org/10.1007/s00266-025-04988-5","url":null,"abstract":"","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155445","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}
Xiaoshuang Guo, Mengle Yan, Minghao Zhao, Panxi Yu, Jianjian Lu
{"title":"Temporary Orbicular Oculi Palsy After Radio-Frequency Assisted Liposuction (RFAL) Combined with Transconjunctival Lower Blepharoplasty: Case Report and Systematic Review of Complication.","authors":"Xiaoshuang Guo, Mengle Yan, Minghao Zhao, Panxi Yu, Jianjian Lu","doi":"10.1007/s00266-025-04901-0","DOIUrl":"https://doi.org/10.1007/s00266-025-04901-0","url":null,"abstract":"<p><strong>Background: </strong>Radio-frequency assisted liposuction (RFAL) is a minimally invasive procedure that harnesses the subcutaneous fat and fascia for thermal skin tightening and subcutaneous tissue remodeling. It has gradually become an ancillary procedure to excisional facial surgeries, such as facelift, liposuction, and blepharoplasty. This study aims to report and summarize the complications of RFAL combination therapy.</p><p><strong>Methods: </strong>We reported two unusual cases of temporary orbicular oculi muscle palsy, asymmetry of blinking, and opthalmospasm after transconjunctival lower blepharoplasty combined with RFAL. In addition, we performed a systematic review of the English literature on complications of RFAL combination therapy.</p><p><strong>Results: </strong>The bibliographic search retrieved 16 studies involving 1181 cases conducting ancillary RFAL in the face and neck and retrieved 27 studies involving 2522 cases conducting RFAL in body contouring. The overall complication rate for the RFAL procedure is 5% (range 2-10%) in the face and neck and 9% (range 5-15%) in body contouring. Periocular nerve injury has not been reported before; however, marginal mandibular neuropraxia is around 0.9% (range from 0 to 4.6%), and deep burn has been reported independently as case series. No complication of RFAL/transconjunctival lower blepharoplasty combination therapy has been reported due to a lack of relevant studies.</p><p><strong>Conclusions: </strong>RFAL is an ancillary procedure for mild to moderate skin laxity with an acceptable complication rate. However, the protection of motor nerves during RFAL and transconjunctival lower blepharoplasty should always be considered. The suitable energy delivered and rational access incision ports are all necessary for a safe outcome.</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":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155465","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}