Aesthetic Plastic Surgery最新文献

{"title":"Evaluating the Efficacy of Dermabrasion, Fat Grafting, and Fibrous Septa Release: A Clinical Study.","authors":"Faysal Saud Shaeer","doi":"10.1007/s00266-026-05860-w","DOIUrl":"https://doi.org/10.1007/s00266-026-05860-w","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive cosmetic procedures such as dermabrasion, fat grafting, and fibrous septa release have gained popularity for addressing various aesthetic concerns, including skin texture irregularities, volume loss, and cellulite. This study aimed to evaluate the efficacy, safety, and patient satisfaction associated with these procedures.</p><p><strong>Methods: </strong>A retrospective study was conducted on 150 patients who underwent dermabrasion, fat grafting, or fibrous septa release between January 2021 and December 2022. Patient data were obtained from hospital records and included demographic details, pre- and post-procedure photographs, complication rates, and patient satisfaction scores measured using the FACE-Q Satisfaction with Appearance Scale. Comparative statistical analyses were performed to evaluate outcomes.</p><p><strong>Results: </strong>Dermabrasion led to improvement in 86% (n = 43) of patients, primarily in skin texture and acne scars, with mild erythema observed in 12% (n = 6). Fat grafting yielded successful volume restoration in 90% (n = 45), with minor fat absorption in 8% (n = 4). Fibrous septa release improved cellulite appearance in 80% (n = 40) of patients, though 24% (n = 12) experienced transient bruising. Patient satisfaction scores were highest for fat grafting (mean = 8.9 ± 0.6), followed by dermabrasion (8.3 ± 0.9) and fibrous septa release (7.8 ± 1.1) (p = 0.03).</p><p><strong>Conclusion: </strong>Each procedure demonstrated efficacy in treating specific aesthetic conditions. Dermabrasion is most effective for surface-level skin imperfections, fat grafting for volume enhancement, and fibrous septa release for cellulite reduction. All showed acceptable safety profiles and high patient satisfaction. Future prospective studies with larger cohorts and long-term follow-up are recommended to validate these findings.</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":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759756","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":"L-shaped Reduction Malarplasty: Its Geometric Consideration.","authors":"Yuanrong You, Lai Gui","doi":"10.1007/s00266-026-05844-w","DOIUrl":"https://doi.org/10.1007/s00266-026-05844-w","url":null,"abstract":"<p><strong>Background: </strong>L-shaped reduction malarplasty is a popular surgery in Oriental population. None of the previews studies investigated the relationship between bone moving and the orientation of the osteotomy lines. This study aimed to illustrate the relationship between zygomatic complex bone moving and the orientation of the osteotomy lines, and to propose a geometric model for surgical planning.</p><p><strong>Methods: </strong>Osteotomy lines of L-shaped reduction malarplasty were projected to the coronal plane. Four geometric models were made to analyze the relationship between zygomatic complex bone moving and the orientation of the osteotomy lines. A retrospective study of bone move in L-shaped reduction malarplasty was made. Differences of the data gained by measurement on CT images and the results calculated by the geometric equations were analyzed with a paired t test. Differences were considered statistically significant at a P value less than 0.05. Results consistency was assessed with the Bland-Altman plot.</p><p><strong>Results: </strong>Equations analyzing the relationship between zygomatic complex bone moving and the orientation of the osteotomy lines were proposed. The oblique osteomy line affects the downward bone moving, and the direction of the vertical osteotomy lines affects the inward bone moving along with the width of bone removed. A retrospective clinical study included 20 sides of zygoma on ten consecutive patients who underwent L-shaped reduction malarplasty from 2023 to 2024 was made. Statistical analysis shown no statistical significance (P = 0.891) between the data gained by measurement and calculated by the equations. A great accordance was shown by the Bland-Altman plot analyses.</p><p><strong>Conclusions: </strong>Orientation of the osteotomy lines affects the zygomatic complex bone moving. Less slant of the oblique osteotomy line is recommended to minimize the downward moving. The two parallel osteotomy lines on the anterior part of the zygomatic bone are recommended to be vertical to achieve precisely operation.</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":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728132","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 Efficacy Study of Facial Biomechanical A-Type Botox Injection in Reshaping the Jawline.","authors":"Jie Jin, Yixiang Han, Li Tian, Da Geng, Yan Ma, Banghong Jiang, Xiuyu Ge, Ziyue Ye, Jing Xu","doi":"10.1007/s00266-026-05725-2","DOIUrl":"https://doi.org/10.1007/s00266-026-05725-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Aging-related changes of the mandibular margin are common, and with increasing aesthetic awareness, the demand for non-surgical jawline rejuvenation is growing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To compare the efficacy and safety of a facial biomechanical injection technique versus a microdroplet injection technique for botulinum toxin type A jawline rejuvenation, using ultrasound and three-dimensional (3D) imaging for anatomical assessment rather than real-time injection guidance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From September 2023 to February 2024, 36 individuals (4 males, 32 females) seeking improvement in jawline laxity were enrolled at the First Affiliated Hospital of Bengbu Medical University. In a split-face, self-controlled design, the left hemiface received the facial biomechanical injection technique (observation group) and the right hemiface received the microdroplet injection technique (control group), yielding 72 treated hemifaces (36 per group). Each hemiface received a total of 20 U of botulinum toxin type A: four 5-U boluses in the facial biomechanical group and twenty 1-U microdroplets in the control group. Ultrasound imaging and 3D deviation color maps were used to evaluate soft-tissue changes at baseline and 30 days, 60 days, and 90 days after treatment. Outcome measures included Cervicomental Angle Severity (CAS, primary endpoint), Global Aesthetic Improvement Scale (GAIS), Visual Analogue Scale (VAS) scores for pain, ultrasound-based soft-tissue thickness at a standardized mandibular point, and qualitative 3D color-map changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both techniques improved CAS grades over time; however, the facial biomechanical injection technique produced greater improvement in CAS at 60 and 90 days compared with the microdroplet technique (P &lt; 0.001). GAIS scores favored the facial biomechanical group at 30 days (P &lt; 0.05). VAS scores during injection were significantly lower with the facial biomechanical technique (P &lt; 0.001), reflecting better procedural comfort. Qualitative 3D deviation color maps and ultrasound measurements suggested a relative reduction in subcutaneous soft-tissue thickness along the mandibular margin in the facial biomechanical group, consistent with enhanced jawline definition. No serious adverse events occurred, and all treatment-related effects were transient and self-limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this pilot split-face study, the facial biomechanical botulinum toxin type A injection technique provided greater medium-term improvement in jawline contour and patient-reported comfort than the microdroplet technique, with a similar short-term safety profile.&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 Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .&lt;","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727887","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":"Medial Limited Midface-Lift-16-Year Experience.","authors":"Vitaly Zholtikov, Natalya Korableva, Yulia Lebedeva","doi":"10.1007/s00266-026-05775-6","DOIUrl":"https://doi.org/10.1007/s00266-026-05775-6","url":null,"abstract":"<p><strong>Basic data: </strong>Lifting the soft tissues from the midface is a necessary component in many cases in complex facial rejuvenation. Despite the widespread use of these surgeries, technical difficulties and a significant number of complications persist.</p><p><strong>Objectives: </strong>This paper details the technique of medial limited mid-facelift with the main purpose of correcting age-related changes of the lower eyelids and the middle third of the face.</p><p><strong>Methods: </strong>In all clinical cases, the surgery was performed through the subciliary approach. A limited subperiosteal dissection of the midface soft tissues was used, which in all cases was not performed medial to the lateral edge of the infraorbital neurovascular bundle. The flap was carried out by cutting the periosteum, then was elevated in the vertical direction and was fixed to the bony part of the orbit through several holes drilled in the lower edge of the orbit.</p><p><strong>Results: </strong>The study is based on 569 clinical cases over a period of 16 years from 2007 to 2023. The evaluation of the appearance of the lower eyelid area and the middle zone of the face was made, as well as changes in the length of the lower eyelid before and after surgery.</p><p><strong>Conclusions: </strong>Medial limited subperiosteal mid-facelift makes it possible to obtain a harmonious and stable result of rejuvenation of this area. Limited tissue mobilization and reliable fixation of the tissue flap to the orbital margin, made it possible to achieve a short-term rehabilitation period and a minimum number of complications requiring repeated treatment.</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":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728115","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":"Rethinking Skin Preparation: Is Hypochlorous Acid (Clinisept+) a Safe Alternative Skin Preparation in Aesthetic Surgery?","authors":"Ali Arnaout, Mohammad R Goodarzi, Nora F Nugent, Marc D Pacifico, Fulvio Urso-Baiarda, Charles A T Durrant, Simon Heppell, Ahmed S Ali-Khan","doi":"10.1007/s00266-026-05806-2","DOIUrl":"https://doi.org/10.1007/s00266-026-05806-2","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) in aesthetic surgery, though rare (~1%), can compromise outcomes. Standard preoperative antiseptics such as chlorhexidine gluconate (CHG) and povidone-iodine are effective but may cause irritation or toxicity. Clinisept+ is a stabilised hypochlorous acid (HOCl) solution with broad antimicrobial activity and excellent tissue compatibility, yet evidence for its surgical use is limited.</p><p><strong>Methods: </strong>A prospective, multicentre audit was conducted in four UK private aesthetic surgery clinics (January-August 2024). All patients received Clinisept+ as the sole preoperative skin preparation. Demographics, smoking status, procedure type, antibiotic prophylaxis, SSIs, wound complications, and skin reactions were recorded. SSIs were defined as infections requiring treatment. Associations with smoking and antibiotic use were analysed with Fisher's exact test.</p><p><strong>Results: </strong>A total of 157 patients (median age 45 years; 78% female) underwent diverse aesthetic procedures. The SSI rate was 1.27% (2/157), both minor and resolving with oral antibiotics. All SSIs occurred in smokers without prophylactic antibiotics (p = 0.04 vs non-smokers). Wound-healing complications occurred in 5.1% (8/157), none infected. No skin sensitivity or allergic reactions were reported.</p><p><strong>Conclusions: </strong>Clinisept+ yielded SSI rates comparable to historical data for CHG and povidone-iodine, with excellent tolerability and no observed skin irritation. HOCl-based preparation may be advantageous in patients with sensitive skin or when operating near mucosal or delicate regions. These findings support its safe use in aesthetic surgery, though randomised controlled trials are warranted to confirm non-inferiority.</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":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728082","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 Outcome of the Reconstructive Procedure Using Buccal Pad of Fat Flap and Deep Plane Facelift after Permanent Filler Removal.","authors":"Samir Ghoraba, Maram Ismail","doi":"10.1007/s00266-026-05836-w","DOIUrl":"https://doi.org/10.1007/s00266-026-05836-w","url":null,"abstract":"<p><strong>Background: </strong>Deep plane facelift in patients with prior permanent filler injection is a formidable reconstructive and aesthetic procedure. Various reconstructive techniques have been previously described in the literature to address the defects after permanent fillers removal. This study investigates the effectiveness and complication rate of reconstruction of these soft tissue defects using the buccal pad of fat flap.</p><p><strong>Materials and methods: </strong>This prospective cohort study was conducted at Opal Aesthetic Center in Cairo from 2016 to 2022. Patients underwent removal of the permanent fillers, followed by a deep plane facelift and reconstruction of the resulting defect using a buccal pad of fat flap. Follow up was done for a minimum period of six months to a maximum of five years to assess contour and complications.</p><p><strong>Results: </strong>A study of 151 patients, comprising 92.7% females with a mean age of 47.8 years, examined the outcomes of reconstruction using buccal pad of fat flap following permanent filler removal in conjunction with a deep plane facelift procedure. Patient satisfaction was high, with 80.7% rating their outcomes as \"very good\" or \"excellent\". Primary surgeries had an 88.5% satisfaction rate, whereas revision surgeries had only a 33.4% satisfaction rate. Contour irregularities were reported in 10.6% of cases and were linked to the occurrence of complications (p < 0.001).</p><p><strong>Conclusion: </strong>The buccal fat pad flap combined with a deep plane facelift after permanent filler removal is a safe and effective reconstructive method with high patient satisfaction. Primary surgeries generally have better outcomes than secondary revisions. The outcome of the buccal fat pad procedure has shown to be negatively affected by smoking, previous surgeries and the presence of post-operative complications. Future research should refine techniques for secondary cases and investigate treatments to improve tissue quality.</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":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727904","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":"ADM-Assisted Breast Reconstruction vs Micro-Polyurethane Foam-Covered Implants in the Prepectoral Space: A Monocentric Study.","authors":"Sergio Miranda, Luca Mazzocconi, Giulio Tarantino, Samuele Frassoni, Vincenzo Bagnardi, Gaia Ghiringhelli, Pietro Caldarella, Francesca De Lorenzi","doi":"10.1007/s00266-026-05675-9","DOIUrl":"https://doi.org/10.1007/s00266-026-05675-9","url":null,"abstract":"<p><strong>Background: </strong>Prepectoral breast reconstruction using acellular dermal matrices (ADMs) or micro-polyurethane foam-covered breast implants have emerged as commonly used surgical techniques. Although the use of both ADMs and micro-polyurethane foam-covered implants in prepectoral breast reconstruction are widely described in literature, comparative data remains limited.</p><p><strong>Objectives: </strong>Our goal was to compare the short-term and medium-term clinical outcomes as well as the patient-reported outcomes in patients undergoing direct-to-implant (DTI) prepectoral breast reconstruction using ADM versus micro-polyurethane foam-covered implants.</p><p><strong>Methods: </strong>A retrospective matched cohort study was conducted on 64 patients (32 ADM-wrapped and 32 micro-polyurethane foam-covered breast implants). Patients were matched based on prior surgery, adjuvant radiotherapy, and implant volume. Demographic and oncological characteristics, surgical variables, short- and medium-term outcomes, and patient-reported outcomes were compared between the two groups.</p><p><strong>Results: </strong>The micro-polyurethane group had significantly older patients (median age 53 vs. 47 years; p = 0.036). Periprosthetic fluid collection (31% vs. 3%; p = 0.006) and need for percutaneous fluid aspiration (38% vs. 9%; p = 0.016) occurred significantly more often in the ADM group. The indication for further surgery was also higher with ADM (47% vs. 19%; p = 0.031). Patient satisfaction showed a non-significant trend favoring micro-polyurethane implants in satisfaction with outcome domain (mean: 89 vs. 82; p = 0.060).</p><p><strong>Conclusions: </strong>Both ADM-assisted reconstructions and micro-polyurethane implants demonstrated high performance in the short and medium term, and they were associated to high patient satisfaction with reconstruction. However, micro-polyurethane implants were associated with fewer periprosthetic fluid collections and a lower need for percutaneous fluid aspirations compared to the ADM group. These findings suggest a potential advantage in terms of reduced postoperative complications.</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":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728110","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 Prospective Comparison of Inverted V Mid-columellar and V-Shaped Columellar-Labial Incisions in Reconstructive Rhinoplasty.","authors":"Amir Arvin Sazgar, Ali Aalizade, Mohammadhossein Zeyfoalzam, Saeed Golparvaran, Mehr Ava Sazgar","doi":"10.1007/s00266-026-05848-6","DOIUrl":"https://doi.org/10.1007/s00266-026-05848-6","url":null,"abstract":"<p><strong>Background: </strong>Reconstructive rhinoplasty for severely deformed noses requires meticulous technique. While reusing mid-columellar incisions is a common practice, a V-shaped columella-labial incision with V-Y closure may provide superior results. We conducted a prospective study to compare the outcomes of these two approaches.</p><p><strong>Methods: </strong>This study included 52 patients (n = 26 per group) who underwent reconstructive rhinoplasty. Group A received a V-shaped columella-labial incision, while Group B received a mid-columellar incision. All surgeries were performed by the same surgeon. Standardized pre- and one-year postoperative photographs were analyzed for changes in nasal projection, columellar height, and scar quality (Stony Brook Scar Evaluation Scale) by independent evaluators.</p><p><strong>Results: </strong>The V-shaped incision group demonstrated significantly greater improvement in nasal projection after adjustment for baseline differences (adjusted p = 0.002) and greater columellar height gain (p < 0.001) compared with the mid-columellar group. Linear regression analysis confirmed that columellar incision type remained an independent predictor of projection change after controlling for preoperative projection. Scar assessments showed no significant difference between groups (p = 0.557).</p><p><strong>Conclusion: </strong>The V-shaped columella-labial incision provides significantly greater improvement in nasal projection and columellar height without increasing scar-related concerns. This technique demonstrates reliability as an initial approach for managing severely compromised nasal structures, though further studies are warranted.</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":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715579","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":"Single-Stage Total Alar Reconstruction Using an Integrated Lining Nasolabial Flap.","authors":"Bilgen Can, Tahir Aziz Eser","doi":"10.1007/s00266-026-05854-8","DOIUrl":"https://doi.org/10.1007/s00266-026-05854-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Total alar reconstruction is challenging because it requires recreating a unique, multilayered anatomy with dynamic characteristics. Conventional techniques are often multistage and require additional donor sites for internal lining and cartilage grafting, thereby increasing donor-site morbidity. Secondary thinning procedures are often required, and long-term alar stability outcomes remain variable. We present the Integrated Lining Nasolabial Flap, a single-stage technique in which the internal lining is derived from dermal and epidermal layers of the flap itself, thereby eliminating additional donor-site morbidity. We report functional and aesthetic outcomes and assess postoperative alar stability, focusing on the potential role of sustained nasal dilator use as a non-cartilage-based supportive strategy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;Twenty patients who underwent single-stage total alar reconstruction with the Integrated Lining Nasolabial Flap were retrospectively reviewed. Patients with at least 6 months of follow-up were included in the analysis. Early and late postoperative complications were recorded. Postoperative alar collapse was assessed and analyzed in relation to nasal dilator compliance. Cosmetic outcomes were evaluated using a visual analog scale and the FACE-Q \"Satisfaction with Nostrils\" module, and the association with patient age was examined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty patients (mean age, 60.2 ± 7.9 years) underwent single-stage reconstruction with this technique and were included in the analysis, with a median follow-up of 12.5 months (range, 6-32 months). Early complications occurred in 2 patients (10%) and were limited to superficial wound dehiscence, which was managed conservatively. No flap loss, vascular compromise, or internal lining necrosis was observed. Late complications were observed in 8 patients (40%), including alar retraction in 2 (10%), isolated alar collapse in 1 (5%), combined alar collapse with retraction in 2 (10%), and alar asymmetry in 3 (15%). No patient required a secondary thinning procedure. Alar collapse (isolated or combined) occurred in three patients (15%), all of whom were noncompliant with nasal dilator use; no collapse was observed among compliant patients (P = 0.004). The median cosmetic VAS score was 60 (range, 50-90), and the median FACE-Q \"Satisfaction with Nostrils\" score was 72 (range, 44-91). No significant correlation was found between age and aesthetic outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The Integrated Lining Nasolabial Flap allows single-stage total alar reconstruction by creating the internal lining from the flap itself, avoiding additional donor sites and secondary thinning procedures. In this Level IV study, sustained postoperative nasal dilator use was significantly associated with improved alar stability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance statement: &lt;/strong&gt;This technique offers a single-stage solution for total","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715529","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":"Clinical Implications of Pitanguy Ligament Management for Nasal Tip Contouring in Open versus Closed Rhinoplasty.","authors":"Etkin Boynuyogun, Tunahan Kilic, Suleyman Yildizdal, Melih Cakaroglu, Ugur Kocer","doi":"10.1007/s00266-026-05851-x","DOIUrl":"https://doi.org/10.1007/s00266-026-05851-x","url":null,"abstract":"<p><strong>Background: </strong>Several modalities have been developed to achieve precise tip contouring and address postsurgical edema. This comparative study aimed to analyze the short- and long-term effects of the Pitanguy ligament management on nasal tip aesthetics and postsurgical edema in open versus closed rhinoplasty.</p><p><strong>Methods: </strong>Patients were divided into three groups, each comprising 40 individuals. Group I (open rhinoplasty without ligament repair), Group II (open rhinoplasty with ligament repair), and Group III (closed rhinoplasty with ligament preservation). All patients included in the study were evaluated for the depth of the supratip area, nasal tip edema, rotations, projections and completed the Rhinoplasty Outcome Evaluation questionnaire.</p><p><strong>Results: </strong>The depth of the supratip area and tip edema were significantly different in group I than in groups II and III in early postoperative follow-ups (p<0.001). The Goode score and nasolabial angle were significantly different between groups I and III in the early postoperative period (p<0.05). However, there were no statistically significant differences in the depth of the supratip area, tip edema, and Goode score at 12 months postoperatively among the groups.</p><p><strong>Conclusions: </strong>Precise control of the cartilaginous framework and soft-tissue covering combines the concepts that provide control of the projection, position, and rotation of the nasal tip in the long-term. Although subsiding initial edema and improved supratip definition were achieved in the early postoperative follow-up, there were no differences between the results of the surgeries in all groups in the long-term.</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":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715607","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}