Aesthetic Plastic Surgery最新文献

{"title":"Determinants of Artificial Intelligence Adoption in Aesthetic Practice: A Cross-Sectional Study.","authors":"Gökhan Öcel, Dilaver Tengilimoğlu, Elif Eşiyok Barut, Mehmet Sönmez","doi":"10.1007/s00266-026-06321-0","DOIUrl":"https://doi.org/10.1007/s00266-026-06321-0","url":null,"abstract":"<p><strong>Background: </strong>The integration of artificial intelligence (AI) into plastic and aesthetic surgery is advancing rapidly, with applications in preoperative image analysis, outcome simulation, and complication prediction. However, the adoption of AI-based systems in clinical practice remains limited, and the psychological and structural determinants of adoption among plastic surgery physicians are not fully understood. This study examines the cognitive, emotional, and structural factors influencing AI adoption intentions within an extended Unified Theory of Acceptance and Use of Technology (UTAUT) framework.</p><p><strong>Methods: </strong>A quantitative cross-sectional survey was conducted among 102 physicians, including specialists, senior residents, and certified cosmetic medicine practitioners. The extended UTAUT model incorporates performance expectancy, effort expectancy, AI anxiety, and perceived barriers as determinants of behavioural intention. Data were analysed using exploratory factor analysis, Pearson's correlation, and multiple linear regression.</p><p><strong>Results: </strong>Performance expectancy (β = 0.431, p < 0.001) and effort expectancy (β = 0.287, p < 0.001) significantly and positively predicted AI adoption intention, together explaining 52% of the variance (R² = 0.52). Conversely, AI anxiety (β = - 0.251, p < 0.001) and perceived barriers (β = - 0.189, p = 0.004) had significant negative effects. Demographic variables, including age and professional experience, showed no statistically significant influence on adoption intention.</p><p><strong>Conclusions: </strong>In plastic and aesthetic surgery, perceived clinical utility and ease of use are the primary drivers of AI adoption, whereas emotional concerns and structural barriers act as significant impediments. Targeted educational programmes, transparent AI systems, and ethically grounded regulatory frameworks are essential for fostering sustainable AI integration into aesthetic surgical practice.</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":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206434","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":"Endoscopic Subcutaneous Mastectomy with Cold-Knife Flap Dissection Through a Single Axillary Incision for Gynaecomastia.","authors":"Jinqiu Xue, Hua Zhu, Qiang Ding","doi":"10.1007/s00266-026-06274-4","DOIUrl":"https://doi.org/10.1007/s00266-026-06274-4","url":null,"abstract":"<p><strong>Background: </strong>Gynaecomastia (GNY) is the most common benign proliferation of glandular breast tissues in males and is frequently associated with psychosocial distress and aesthetic concerns. Traditional open surgical approaches are associated with visible scarring and prolonged postoperative recovery. Minimally invasive techniques, including liposuction-assisted endoscopic procedures, may still result in visible scars and residual glandular tissue. In this study, we evaluated the safety, efficacy, and aesthetic outcomes of endoscopic subcutaneous mastectomy combined with cold-knife flap dissection through a single axillary incision for the treatment of GNY.</p><p><strong>Methods: </strong>A total of 51 male patients with GNY involving 102 breasts who underwent surgical treatment between August 2023 and October 2024 were enrolled. Patient demographics, operative data, postoperative complications, and satisfaction outcomes were systematically recorded. Four independent observers evaluated preoperative and postoperative photographs using a 1-15 scoring system based on six major aesthetic parameters.</p><p><strong>Results: </strong>Endoscopic subcutaneous mastectomy combined with cold-knife flap dissection through a single axillary incision was successfully completed in all patients. The mean operative time was 46.84 ± 15.04 per side (range 14-87) min. The mean thickness of the resected glandular tissues was 2.80 ± 0.88 (range 1-5) cm. The mean postoperative drainage volume was 48.72 ± 34.74 (range 10-170) mL, and the mean hospital stay was 4.31 ± 1.57 (range 2-8) days. Postoperative complications included hematoma in two breasts, seromas in one breast, and effusion in two breasts, whereas skin redundancy occurred in two patients with bilateral GNY. No patient developed severe pain, infection, nipple-areolar complex necrosis, nipple retraction, or skin flap necrosis. All patients reported satisfaction with postoperative quality of life (100%), and no recurrence was observed during follow-up.</p><p><strong>Conclusions: </strong>Endoscopic subcutaneous mastectomy combined with cold-knife flap dissection through a single axillary incision appears to be a safe and effective approach for GNY, offering minimal invasiveness, rapid postoperative recovery, and favourable aesthetic outcomes. This technique may improve patient satisfaction and may represent a promising treatment option owing to its favourable safety profile and cosmetic 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 Table of Contents or online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206437","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":"Capsulectomy Following Breast Implant Removal: Evidence-Based Indications and a Framework for Clinical Decision-Making.","authors":"Tim Brown MChir","doi":"10.1007/s00266-026-06365-2","DOIUrl":"https://doi.org/10.1007/s00266-026-06365-2","url":null,"abstract":"<p><p>The question of when capsulectomy is genuinely indicated at the time of breast implant removal has important implications for clinical practice, surgical risk, and patient counselling. This review defines the evidence-based indications for capsulectomy, evaluates the evidence for each of the additional contexts in which it is commonly proposed, and provides a clinical decision framework to assist surgeons in counselling patients and documenting clinical reasoning. No published study directly compares outcomes of explantation with capsulectomy versus explantation alone; the most rigorous prospective data show that explantation without capsulectomy produces symptom improvement statistically indistinguishable from partial or total capsulectomy. The only pre-registered controlled cohort study (n = 9590) found no difference in BII symptom prevalence between women with and without implants, and silicone particle migration to lymph nodes is not reduced by capsulectomy in controlled analyses. The proposed capsular contaminants (biofilm, fungal elements, and heavy metals) have each been examined in controlled tissue analyses; none differentiates symptomatic from asymptomatic patients. A 2024 European expert consensus recommending capsulectomy for macrotextured implants constitutes Level V consensus from a panel composed exclusively of surgeons who perform the procedure. Capsulectomy carries a higher complication rate than explantation alone, and no published evidence documents harm from leaving a capsule in situ after benign explantation. Four indications are supported by the available evidence: confirmed BIA-ALCL, confirmed capsular malignancy, symptomatic capsular calcification with demonstrable mammographic impairment, and Grade III-IV contracture where capsulotomy is insufficient. A clinical decision framework is provided to facilitate evidence-based practice and structured informed consent. 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":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190633","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 the Editor on \"Preoperative GLP-1 Receptor Agonists and Thromboinflammatory Markers in Patients Undergoing Abdominoplasty: A Prospective Monocentric Study\".","authors":"Mahin Nosratzehi, Shahin Nosratzehi, Mehdi Rostami","doi":"10.1007/s00266-026-06399-6","DOIUrl":"https://doi.org/10.1007/s00266-026-06399-6","url":null,"abstract":"","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190665","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 Distal U-Shaped Capsule Sparing Technique (DUS-CS) for Revision Breast Augmentation: A Consecutive Clinical Series of 223 Patients.","authors":"Annabelle M Bromba, Marc Daniels, Sonia M Fertsch, Katrin Seidenstücker, Beatrix Munder, Mazen Hagouan, Dirk Janku, Birgit Aufmesser-Freyhardt, Nour Abu Abdallah, Robert J Musmann, Nora Stockhausen, Sogol Rajabpour, Benedetta Vasselli, Laura Wohlthat, Andreas Wolter, Christoph Andree","doi":"10.1007/s00266-026-06351-8","DOIUrl":"https://doi.org/10.1007/s00266-026-06351-8","url":null,"abstract":"<p><strong>Background: </strong>Capsular contracture is a common complication following breast augmentation with silicone implants, which often requires surgical revision, especially in advanced stages. A surgical gold standard for the treatment of capsular contracture is still under discussion. This article presents a novel capsule-sparing method for implant exchange in patients with capsular contracture.</p><p><strong>Methods: </strong>This is a retrospective, descriptive, single-center technical study focusing on the detailed presentation, surgical rationale, and standardized execution of a novel capsule-sparing revision technique. The technique combines a U-shaped selective capsulectomy with the Double-Unit Superomedio-Central (DUS-CS) approach to preserve structurally intact capsule segments, minimize surgical trauma, and maintain implant position during revision surgery. The central and cranial parts of the capsule are removed, while the medial, lateral, and caudal parts are left in place. The newly inserted breast implant is limited and stabilized by the remaining capsule remnants. Possible implant dislocation is reduced, and soft tissue coverage is improved.</p><p><strong>Results: </strong>A total of 223 patients have already undergone surgery using the DUS-CS technique between January 1, 2023, and November 21, 2025. Within the available follow-up period, no recurrence of capsular contracture, symmastia, or bottoming out were observed in the treated cohort.</p><p><strong>Conclusions: </strong>This technique allows effective treatment of capsular contracture while avoiding the morbidity of total capsulectomy. Preliminary clinical experience demonstrates feasibility and safety, particularly in revision cases where maintenance of pocket geometry is essential. Larger studies are required to evaluate long-term outcomes and recurrence rates.</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":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190652","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":"Indocyanine Green Angiography Reduces Ischemic Complications in Immediate Implant-Based Breast Reconstruction: A Systematic Review and Meta-analysis.","authors":"Seung-Ho Choi, Sang-Oh Lee, Du-Hyong Cho, Sung-Eun Kim, Il-Kug Kim","doi":"10.1007/s00266-026-06339-4","DOIUrl":"https://doi.org/10.1007/s00266-026-06339-4","url":null,"abstract":"<p><strong>Background: </strong>Skin- and nipple-sparing mastectomy followed by immediate implant-based breast reconstruction (IBBR) has grown substantially in clinical practice, yet mastectomy skin flap necrosis (MSFN) persists as a clinically significant source of morbidity. Intraoperative indocyanine green angiography (ICGA) enables real-time, objective quantification of skin flap perfusion, but its specific effect on IBBR outcomes has yet to be established through dedicated meta-analytic synthesis. This study aimed to evaluate whether intraoperative ICGA-guided decision-making lowers the incidence of MSFN and related surgical complications relative to conventional clinical appraisal in immediate IBBR.</p><p><strong>Methods: </strong>Four databases-PubMed, Embase, Scopus, and the Cochrane Library-were searched through March 2026 for comparative studies of immediate IBBR. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel method.</p><p><strong>Results: </strong>Nine studies comprising 1,356 reconstructed breasts (655 ICGA; 701 clinical assessment) met inclusion criteria. ICGA was associated with significantly lower risks of overall MSFN (RR 0.57, 95% CI 0.44-0.73) and severe MSFN (RR 0.35, 95% CI 0.22-0.55), as well as reduced return to the operating room, surgical-site infection, and flap salvage procedures. Overall complication rates, hematoma/seroma, and implant loss were not significantly different between groups.</p><p><strong>Conclusions: </strong>Intraoperative ICGA significantly reduced the risk of overall MSFN by approximately 43% and severe MSFN by approximately 65%, with fewer unplanned reoperations and flap salvage procedures, without affecting non-ischemic outcomes. The evidence supports selective incorporation of ICGA into IBBR surgical protocols, with particular emphasis on patients carrying elevated perfusion-related risk.</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":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190621","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":"Comparative Evaluation of Large Language Models in the Recognition of Postoperative Complications Following Aesthetic Surgery.","authors":"Koray Temiz","doi":"10.1007/s00266-026-06352-7","DOIUrl":"https://doi.org/10.1007/s00266-026-06352-7","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) are increasingly being explored as supportive tools in postoperative patient communication. However, their ability to recognize and appropriately manage postoperative surgical complications remains unclear. This study comparatively evaluated ChatGPT, Gemini, and Claude in postoperative complication assessment following aesthetic surgical procedures.</p><p><strong>Methods: </strong>Thirty standardized postoperative clinical scenarios representing low-, moderate-, and high-risk complications were independently submitted to the three AI systems using a standardized prompt. Responses were evaluated for diagnostic accuracy, management appropriateness, triage accuracy, patient safety, and completeness using 5-point Likert scales. Critical management errors and dangerous reassurance were additionally recorded.</p><p><strong>Results: </strong>ChatGPT demonstrated the highest overall performance across most domains. Mean diagnostic accuracy scores were 3.99 ± 0.57 for ChatGPT, 3.61 ± 0.62 for Gemini, and 3.90 ± 0.62 for Claude (p < 0.001). Critical management errors were uncommon overall but occurred most frequently with Gemini. In high-risk scenarios, appropriate emergency referral recommendations were identified in 93.3% of ChatGPT evaluations, 76.7% of Gemini evaluations, and 96.7% of Claude evaluations (p = 0.018).</p><p><strong>Conclusion: </strong>The evaluated AI systems demonstrated moderate-to-high capability in recognizing common postoperative complications; however, variability became more apparent in clinically urgent scenarios. Current LLMs may serve as supportive informational tools in postoperative care but should not replace physician assessment in potentially serious complications.</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":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179133","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":"Implant Pocket Plane Selection in Breast Augmentation: Methodological Pitfalls in Meta-Analytic Comparisons.","authors":"Felipe Giraldo Alvarez Gonçalves, Emily Caroline da Fonseca Sampaio, Miguel Rodrigues Moreira, Rolf Gemperli, Cristina Pires Camargo","doi":"10.1007/s00266-026-06317-w","DOIUrl":"https://doi.org/10.1007/s00266-026-06317-w","url":null,"abstract":"","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178492","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":"Abstracts of the ISAPS World Congress 2026, Cancún : October 27-31, 2026.","authors":"","doi":"10.1007/s00266-026-06170-x","DOIUrl":"https://doi.org/10.1007/s00266-026-06170-x","url":null,"abstract":"","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179163","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":"Critical Appraisal: Anesthetic Management and Perioperative Predictors of Outcomes in Combined Body Contouring Procedures.","authors":"Iqra Akhtar, Shehreyar Ahmad","doi":"10.1007/s00266-026-06401-1","DOIUrl":"https://doi.org/10.1007/s00266-026-06401-1","url":null,"abstract":"<p><p>This letter discusses the paper authored by Sahin et al. titled \"Anesthetic Management and Perioperative Risk Factors in Combined Body Contouring Procedures: Brazilian Butt Lift, Liposuction and Abdominoplasty.\" Notable strengths include the large cohort (n = 1120) and the standardized protocols, as well as the low complication rate (0.8%). Noteworthy weaknesses include methodological concerns, which limit the conclusions. The selection bias of the retrospective design and ASA I-II classification compared with data from national datasets reporting higher morbidity are limitations. Because of its multiplicity of predictors and the few number of events, there are concerns of overfitting in the multivariable model. There is also residual confounding between groups, and the binary \"prior surgery\" variable does not differentiate high-risk post-bariatric patients. There was no uniformity in outcomes reported, no follow-up, and no patient-reported outcomes. Claims that combined procedures seem safe should be cautious; findings are hypothesis generating. Future studies should focus on prospective multicenter study, bariatric surgery subgroups analysis, validated prediction modeling, and patient-centered outcomes.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":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178253","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}