Aesthetic Plastic Surgery最新文献

{"title":"Robot-Assisted Breast Augmentation.","authors":"So Min Oh, Sang Cheon Park, Hyung Bae Kim, Hyun Ho Han, Jin Sup Eom","doi":"10.1007/s00266-026-06007-7","DOIUrl":"https://doi.org/10.1007/s00266-026-06007-7","url":null,"abstract":"<p><strong>Background: </strong>Robotic systems are increasingly employed across various surgical fields and are now expanding into breast surgery. However, few studies have explored robotic surgery in aesthetic breast augmentation. Traditional breast augmentation with axillary approach relies on endoscopic assistance but is limited by restricted visualization, operational inflexibility, surgeon fatigue, and a long learning curve.</p><p><strong>Objectives: </strong>This study introduces robot-assisted transaxillary breast augmentation using the da Vinci single-port (SP) surgical system (Intuitive Surgical, Sunnyvale, CA), which offers high-resolution imaging with adjustable magnification, flexible robotic arms, and gas insufflation to reduce surgeon fatigue.</p><p><strong>Methods: </strong>From January 2023 to July 2024, a total of 12 breasts from eight female patients underwent robot-assisted augmentation using the da Vinci SP surgical system. Four patients received bilateral augmentation for aesthetic purposes, while the remaining four underwent direct-to-implant reconstruction after robot-assisted mastectomy, combined with contralateral augmentation.</p><p><strong>Results: </strong>The mean total operative time was 89.8 min (range, 74-100 min), including a mean robotic docking time of 67.7 min (range, 51-78 min). Intraoperative bleeding was minimal, and no early postoperative complications occurred. One patient developed lateral implant displacement and bottoming out, requiring revision surgery, presumably linked to mechanical stress from pectoralis muscle contraction by upper extremity strength training in the early postoperative period. All other patients recovered uneventfully without late complications.</p><p><strong>Conclusions: </strong>Robotic surgery addresses the limitations of endoscopic techniques, achieving favorable cosmetic outcomes with minimal, concealed scarring while enhancing surgical precision and safety. This study demonstrates the technical feasibility of a single-port robotic system for mammoplasty and highlights its potential for broader applications in aesthetic surgery.</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":2.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023758","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":"Does History of Reduction Mammoplasty Predispose to Lactation Complications? A Multicenter Retrospective Cohort.","authors":"Yoram Wolf, Ron Skorochod, Nir Zontag","doi":"10.1007/s00266-026-06262-8","DOIUrl":"https://doi.org/10.1007/s00266-026-06262-8","url":null,"abstract":"<p><strong>Background: </strong>Reduction mammoplasty is a prevalent procedure, primarily done to treat macromastia. While it is known for its positive clinical and quality of life benefits, there are still concerns regarding long-term complications it may carry, especially during pregnancy and lactation.</p><p><strong>Purpose: </strong>Our primary objective is to evaluate whether reduction mammoplasty increased the risk for breastfeeding complications compared with matched control patients who did not undergo prior aesthetic breast surgery.</p><p><strong>Methods: </strong>A retrospective study using TriNetX platform was queried for female patients aged 18 years and older. Patients who underwent reduction mammoplasty and subsequently delivered were compared with patients who delivered without a history of aesthetic breast surgery. The primary outcome were breastfeeding complications within a year after delivery, including lactation disorders, breast infections, mastitis, antibiotic prescriptions, and emergency department (ED) visits.</p><p><strong>Results: </strong>1103 patients who had reduction mammoplasty and delivery were propensity-matched to 1103 control patients who had delivery. Within 1 year of delivery, patients who had reduction mammoplasty had a comparable risk for disorders of lactations [hazard ratio (HR) = 1.41; CI (0.87-2.27); p = 0.16], infections of breast [HR = 0.67; CI (0.39-1.16); p = 0.15], and mastitis [HR = 0.60; CI (0.31-1.15); p = 0.12]. However, an increased risk for antibiotic prescription [HR = 1.20; CI (1.05-1.37); p = 0.005] and ED visits [HR = 1.38; CI (1.13-1.67); p = 0.0011] were observed.</p><p><strong>Conclusions: </strong>Reduction mammoplasty was not associated with a significant increase in breastfeeding disorders or breast infections after delivery, but was associated with higher antibiotic prescriptions and ED visits. These findings suggest that the procedure may not be linked to major adverse lactation outcomes.</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":2.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015342","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":"Cephalic Alar Base Malposition: Recognition and Correction with an Advancement Flap.","authors":"Helena Hotz Arroyo Ramos, Rebeca Silva Chiabai Loureiro, Julia Carvalho Kozelinski, Heloisa Nardi Koerner, Leila Freire, Dean M Toriumi","doi":"10.1007/s00266-026-06226-y","DOIUrl":"https://doi.org/10.1007/s00266-026-06226-y","url":null,"abstract":"<p><strong>Background: </strong>Cephalic alar base malposition (CABM) represents an underrecognized cause of nasal base disharmony and is frequently misdiagnosed as alar rim retraction. In this condition, the alar base is vertically displaced in a cephalic direction, creating imbalance in the alar-columellar relationship and often exaggerating the appearance of nasal tip ptosis. This study describes a reproducible surgical technique using a full-thickness advancement flap to reposition the alar base inferiorly while preserving the natural contour of the alar-facial groove.</p><p><strong>Methods: </strong>A retrospective study was performed including patients who underwent primary or revision rhinoplasty between January 2023 and January 2025. Patients diagnosed with CABM were treated using a standardized surgical protocol based on full-thickness alar base release and inferior advancement of both cutaneous and vestibular components. Preoperative and postoperative outcomes were assessed through standardized photography and patient-reported satisfaction using the Utrecht Questionnaire.</p><p><strong>Results: </strong>During the study period, 101 patients were diagnosed with CABM and underwent correction using the described technique. Follow-up ranged from 12 to 24 months. Patients who completed postoperative Utrecht assessments demonstrated significant improvement in satisfaction scores (P < 0.0001). Complication rates were low and included increased nasal hair visibility (5%), minor unfavorable scarring (4%), and revision for asymmetry in two cases.</p><p><strong>Conclusions: </strong>The advancement flap technique effectively corrects cephalic alar base malposition by restoring the vertical height of the alar insertion rather than relying on excisional methods. Nasal base harmony depends not only on width but also on the vertical position of the alar insertion.</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":2.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015347","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":"Beyond Proportion: A Neuroaesthetic and Body-Image Perspective on \"Ideal\" Breast Proportionality.","authors":"Mohammad Amir Beigi Habibabadi","doi":"10.1007/s00266-026-06278-0","DOIUrl":"https://doi.org/10.1007/s00266-026-06278-0","url":null,"abstract":"","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015396","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":"Intramuscular Fat Grafting for Pectoralis Volumization in Transmasculine Patients. Combining Chest Masculinization and Chest Contouring in One Surgery.","authors":"C V Brasó, C Corrao, R Elia, M Maruccia, G Giudice","doi":"10.1007/s00266-026-06271-7","DOIUrl":"https://doi.org/10.1007/s00266-026-06271-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Chest masculinization surgery represents a key component of gender-affirming care for transgender men and has been associated with significant improvements in psychological well-being and reduction of gender dysphoria. Although established techniques such as double-incision mastectomy with nipple-areola complex grafting and periareolar approaches effectively remove breast tissue, postoperative chest contour may remain flat and lack pectoral definition in some patients. Autologous fat grafting has been widely used in cisgender male aesthetic surgery to enhance pectoral projection and muscular definition. However, its application during masculinizing mastectomy in transgender patients remains poorly described. This study evaluates the outcomes and safety of intramuscular pectoralis major fat grafting performed concurrently with chest masculinization surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis of prospectively collected data was conducted on transgender patients who underwent chest masculinization surgery with simultaneous pectoralis major fat grafting between January 2022 and January 2025 at a single institution. Patients underwent either double-incision mastectomy with free nipple-areola complex grafting or ultrasonic-assisted subcutaneous mastectomy depending on breast characteristics. Autologous fat was harvested from the flanks, axillary pillar, or back and injected into the pectoralis major muscle in intramuscular and sub-muscular planes. Primary outcomes included patient satisfaction assessed at 12 months using the validated TRANS-Q questionnaire. Secondary outcomes included postoperative complications and revision procedures classified according to the Clavien-Dindo system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty transgender patients (120 mastectomies) were included. The mean age was 32.5 years, and the mean body mass index was 22.5 kg/m&lt;sup&gt;2&lt;/sup&gt;. Forty patients underwent double-incision mastectomy and twenty ultrasonic-assisted subcutaneous mastectomy. The mean fat graft volume was approximately 150-200 cc per side. High satisfaction scores were reported across all TRANS-Q domains, with the highest values observed in gender congruence (mean &gt; 93). Overall complications included fat necrosis (16.7%), seroma (13.3%), and partial nipple-areola complex necrosis (3.3%). Secondary aesthetic revisions were required in 16.7% of patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Intramuscular pectoralis major fat grafting combined with chest masculinization surgery appears to be a safe and effective strategy to enhance thoracic contour and improve masculine chest definition in transgender men. This integrated approach may optimize aesthetic outcomes and contribute to high levels of patient satisfaction and gender congruence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Level of evidence iv: &lt;/strong&gt;This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medic","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015362","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":"Chemical Decompensation for Frontalis-Driven Multiple Eyelid Folds After Revision Double-Eyelid Surgery.","authors":"Hao Gong, Jiayu Qiang, Xiaolei Jin, Xiaoshuang Guo","doi":"10.1007/s00266-026-06221-3","DOIUrl":"https://doi.org/10.1007/s00266-026-06221-3","url":null,"abstract":"<p><strong>Background: </strong>Multiple eyelid folds after revision double-eyelid surgery are commonly attributed to structural factors. This single-patient report describes a possible contribution of acquired compensatory frontalis activation and a temporary intervention termed chemical decompensation.</p><p><strong>Methods: </strong>AA 28-year-old woman with unilateral multiple eyelid folds after revision surgery underwent brow-eyelid continuum assessment. After manual confirmation of adequate independent levator function, unilateral low-dose onabotulinumtoxinA (5 U) was administered above the affected brow. Evaluation included paired photographs, perceived-improvement ratings from five evaluators, and eyelid-opening measurements. Follow-up ultrasonography was performed 116 days after injection.</p><p><strong>Results: </strong>At one week, paired photographic review showed reduced multiple folding, with a mean visual analog scale perceived-improvement score of 7.3 ± 0.67 and no observed functional compromise. Follow-up ultrasonography showed findings consistent with a local adhesion/fixation point. The improvement suggests that dynamic frontalis traction contributed to the visible deformity, but does not independently confirm adhesion or quantify the relative dynamic and structural contributions.</p><p><strong>Conclusion: </strong>Chemical decompensation may provide temporary improvement during recovery while scar maturation and later reassessment proceed. The post-injection response offers supportive, case-specific information rather than a validated diagnostic test. This approach does not replace definitive revision when indicated. Prospective validation in larger cohorts is warranted.</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":2.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001142","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 Hybrid Auricular Cartilage-ePTFE Technique for Limited Nasal Lengthening and Augmentation in Selected Primary Han Chinese Rhinoplasty.","authors":"Caiyue Liu, Xiaoxiao Zhang, Feng Zhou, Chen Cheng, Nuo Chen, Jiao Wei, Qingfeng Li, Chen Wang, Charles Yuen Yung Loh, Jian Lin, Yingfan Zhang","doi":"10.1007/s00266-026-06264-6","DOIUrl":"https://doi.org/10.1007/s00266-026-06264-6","url":null,"abstract":"<p><strong>Background: </strong>Augmentation rhinoplasty is commonly performed in Han Chinese patients. Although costal cartilage provides abundant graft material, its harvest increases operative complexity and donor-site morbidity. This study evaluated a selective hybrid technique combining autologous auricular cartilage with an expanded polytetrafluoroethylene (ePTFE) implant for dorsal augmentation, limited nasal lengthening, and tip refinement in carefully selected primary patients.</p><p><strong>Objectives: </strong>To evaluate postoperative anthropometric outcomes and implant-related complications associated with a hybrid technique using an ePTFE implant for dorsal augmentation and limited nasal lengthening, combined with auricular cartilage grafting for tip support, contour refinement, and distal implant shielding.</p><p><strong>Methods: </strong>This retrospective case series included 137 female Han Chinese patients with mildly short or near-normal noses who underwent primary rhinoplasty between December 2016 and July 2022. Only patients with a minimum follow-up of 24 months were included in the clinical analysis. All patients received a custom-carved I-shaped ePTFE implant for dorsal augmentation and limited nasal lengthening support, together with unilateral auricular cartilage grafting for tip modification. Standardized preoperative and postoperative anthropometric measurements were compared using paired t tests.</p><p><strong>Results: </strong>Follow-up ranged from 24 to 60 months, with a mean duration of 36.2 months. Complications included implant deviation requiring revision in 3 patients, 2.2%, early postoperative infection in 2, 1.5%, late infection in 1, 0.7%, and inadequate dorsal height or tip projection in 6, 4.3%. Mean nasal length increased from 43.0 ± 1.9 mm preoperatively to 45.0 ± 1.8 mm postoperatively, P < 0.05. Mean nasal tip projection increased from 19.0 ± 1.6 mm to 23.0 ± 1.7 mm, P < 0.001. Mean nasolabial angle changed from 100.7 ± 5.33° to 98.2 ± 3.43°, P < 0.05. No implant extrusion was observed during the available follow-up period.</p><p><strong>Conclusions: </strong>In selected primary Han Chinese patients, this hybrid ePTFE-auricular cartilage technique may be a useful option for dorsal augmentation, limited nasal lengthening, and tip refinement. The approach may help achieve aesthetic goals in mild cases without routine costal cartilage harvest. However, the findings should be interpreted within the context of a retrospective case series with a minimum 24-month follow-up, and longer follow-up is required to further evaluate delayed implant-related complications and the durability of aesthetic 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":2.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001114","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 Modified Eyebrow Lift Technique Based on New Anatomy Findings of Muscular-deep Fascial System.","authors":"Wenfang Dong, Xin Qi, Bing Wen, Zhenmin Zhao","doi":"10.1007/s00266-026-06152-z","DOIUrl":"https://doi.org/10.1007/s00266-026-06152-z","url":null,"abstract":"<p><strong>Background: </strong>Eyebrow lift surgery addresses periorbital aging in Asian women, yet achieving durable eyebrow stability and adequate projection remains challenging. Leveraging recent anatomical insights into the muscular-multilayered deep fascial system, we developed an enhanced deep-plane eyebrow lift technique and evaluated its safety and efficacy.</p><p><strong>Methods: </strong>A retrospective review of demographic data, surgical complications, and satisfaction rates was conducted for consecutive patients who underwent this modified eyebrow lift, in which the deep fascial system served as anchoring points for suspending periorbital soft tissue. Outcomes were evaluated through surgeon- and patient-reported satisfaction scores (categorized as poor, fair, satisfactory, or totally satisfactory) and by comparing preoperative and postoperative measurements of upper eyelid and eyebrow height.</p><p><strong>Results: </strong>Thirty-seven patients (aged 32-73 years) were included. Mean satisfaction scores were 3.87 ± 0.41 (surgeon) and 3.71 ± 0.60 (patient). Upper eyelid height increased significantly from 4.54±0.58 mm to 5.39±0.47 mm (p < 0.001) at medial limbus point, from 4.87±0.61 mm to 6.21±0.59 mm (p < 0.001) at mid-pupil point, from 3.62±0.73 mm to 5.68±0.75 mm (p < 0.001) at lateral canthus point. Eyebrow height also improved, though not statistically significantly. No surgical complications were observed during a mean follow-up of 12.0 months.</p><p><strong>Conclusion: </strong>Based on recent anatomy findings regarding muscular-multilayered deep fascial system, this study explored surgical strategies for favorable and sustained periorbital rejuvenation in Asian women, with high satisfaction and no major complications.</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":2.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001175","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":"Postoperative Analgesic Efficacy of a Novel Surgical Modified Serratus Anterior Plane Block in Reduction Mammaplasty: A Prospective Randomized Controlled Trial.","authors":"Ayhan Sonmez, Alperen Can Kokten, Ebru Kayikci, Ismail Bulbuloglu, Hatice Selcuk Kusderci, Serkan Tulgar","doi":"10.1007/s00266-026-06269-1","DOIUrl":"https://doi.org/10.1007/s00266-026-06269-1","url":null,"abstract":"<p><strong>Background: </strong>Postoperative analgesia after reduction mammaplasty remains challenging, particularly given the extent and distribution of surgical dissection. While ultrasound-guided interfascial plane blocks are commonly used, their timing and reliability may be influenced by surgical duration and tissue manipulation. We investigated whether a surgically administered serratus anterior plane block, applied under direct visualization immediately before wound closure, could enhance postoperative analgesia.</p><p><strong>Methods: </strong>In this prospective randomized controlled trial, patients undergoing reduction mammaplasty were assigned to receive either a bilateral surgical serratus anterior plane block in addition to standardized multimodal analgesia or standard analgesia alone. The block was performed intraoperatively by the surgeon without ultrasound guidance. The primary endpoint was cumulative tramadol consumption within the first 24 postoperative hours. Secondary outcomes included postoperative pain intensity, time to first analgesic request, and opioid-related adverse effects.</p><p><strong>Results: </strong>Fifty-six patients completed the study. Patients receiving the surgical serratus anterior plane block demonstrated lower pain scores in the early postoperative period, while pain intensity became comparable between groups later during follow-up. Despite this convergence, opioid consumption remained consistently lower in the block group throughout the first 24 hours, with a 43% reduction in cumulative tramadol use at 24 hours. In addition, the time to first postoperative analgesic demand was significantly prolonged in the block group. No block-related complications were observed.</p><p><strong>Conclusion: </strong>A surgically performed serratus anterior plane block applied immediately before wound closure was associated with a sustained opioid-sparing effect after reduction mammaplasty. This intraoperative approach may offer a practical alternative to ultrasound-guided techniques; however, further studies are required to refine the technique and define its role within enhanced recovery pathways.</p><p><strong>Level of evidence ii: </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":2.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001155","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":"Impact of Preoperative Condylar Volume on Postoperative Displacement in Asymmetric Mandibular Setback Surgery: A Retrospective Cohort Study.","authors":"Shunchao Yan, Chongxu Qiao, Junyan Miao, Junru Li, Zai Shi, Jingyi Xu, Yuming Qu, Guoping Wu","doi":"10.1007/s00266-026-06263-7","DOIUrl":"https://doi.org/10.1007/s00266-026-06263-7","url":null,"abstract":"<p><strong>Background: </strong>Predicting postoperative condylar displacement remains a significant challenge in bilateral sagittal split ramus osteotomy (BSSO). The influence of preoperative condylar volume on such displacements is not well understood. This study aims to investigate the association between preoperative condylar and ramal volumetric parameters and postoperative condylar displacement following BSSO.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective cohort study of patients with skeletal Class III malocclusion who underwent BSSO between January 2018 and December 2023. The primary predictor variables were the volumetric parameters of the mandibular condyle and ramus, while the primary outcome was condylar displacement, quantified using cone-beam computed tomography (CBCT) scans at three time points: T0 (preoperative), T1 (immediate postoperative) and T2 (≥ 6 months postoperative). Covariates included age, sex and the magnitude of mandibular asymmetry.</p><p><strong>Results: </strong>The study cohort comprised 37 subjects: 17 in the symmetric group (SG, mean age: 24.5 ± 6.3 years, 47.1% female) and 20 in the asymmetric group (AG, mean age: 27.4 ± 6.7 years, 55.0% female). No statistically significant differences in intraoperative or postoperative condylar movements were observed between the groups. Key correlations identified included a negative association between ramus volume and transverse displacement during surgical correction in AG (r = - 0.345, P = 0.029), as well as a negative correlation with roll rotation in SG (r = - 0.340, P = 0.049). Postoperatively, in the AG, larger condylar volume was associated with reduced vertical translation (r = - 0.381, P = 0.015), and a higher condyle-ramus index (CRI) was associated with less roll rotation (r = - 0.406, P = 0.009). No significant correlations were identified in SG during the postoperative phase.</p><p><strong>Conclusions: </strong>This study identified an association between preoperative condylar/ramus volume and postoperative displacement patterns in asymmetric mandibular setback surgery, involving both translational and rotational components. However, the correlations observed were weak-to-moderate, indicating that volumetric parameters alone are not sufficient for reliable prediction at individual patient level. Further research employing larger, prospective cohorts is needed to validate these associations and to investigate whether specific anatomical subunits of the condyle demonstrate stronger correlations with postoperative stability.</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":2.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987680","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}