Aesthetic Plastic Surgery最新文献

{"title":"Buccal Fat Pad Excision: Incidence, Management, and Clinical Observations of Postoperative Hematoma and Seroma in 302 Patients.","authors":"Kai-Yi Shu, Yu-Qi Zhao, Jiu-Li Zhao, Yan Zheng, Xiao Qin","doi":"10.1007/s00266-026-06305-0","DOIUrl":"https://doi.org/10.1007/s00266-026-06305-0","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence, clinical characteristics, management, and outcomes of postoperative hematoma and seroma after buccal fat pad (BFP) excision, and to evaluate the association between resection completeness and early complications using both side-level and patient-level analytical approaches.</p><p><strong>Methods: </strong>This single-centre retrospective study included 302 patients (90 males, 212 females) who underwent BFP excision under local anaesthesia from November 2023 to September 2025. A standardised intraoral protocol was applied, comprising epinephrine-containing tumescent anaesthesia, gentle blunt dissection, syringe-based volume measurement, and postoperative compression. Follow-up was scheduled at 1 week, 1, 3, and 6 months. Hematoma and seroma were defined by clinical and ultrasound findings. Incidence was reported with 95% confidence intervals, and side-level associations were analysed via Fisher's exact test.</p><p><strong>Results: </strong>The overall complication rate was 1.99% (6/302, 95% CI 0.73-4.29%), with all events occurring on partial removal sides. No complications were noted after complete resection (0/302 sides). The complication rate was 2.1% for partial versus 0% for complete removal (p = 0.003). All complications resolved with aspiration or drainage plus antibiotics if indicated, without reoperation or permanent nerve injury. Six-month satisfaction reached 96%.</p><p><strong>Conclusion: </strong>Standardised BFP excision is safe with a low complication rate. Hematoma/seroma is limited to partial resection. Incomplete buccal process excision requires enhanced clinical vigilance and close postoperative monitoring.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163504","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":"Assessing the Effectiveness of Bupivacaine for Managing Pain Post-rhinoplasty: A Triple-blinded Controlled Clinical Trial.","authors":"Reza Kaboodkhani, Tahere Babaei, Tayebeh Kazemi, Amirhossein Babaei","doi":"10.1007/s00266-026-06349-2","DOIUrl":"https://doi.org/10.1007/s00266-026-06349-2","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty is often accompanied by significant postoperative pain, making effective pain management crucial for enhancing patient satisfaction and facilitating recovery. This study evaluates the effectiveness of bupivacaine, a long-acting local anesthetic, in managing postoperative pain for patients undergoing rhinoplasty.</p><p><strong>Methods: </strong>A randomized triple-blind controlled clinical trial was conducted involving 220 participants aged 17 to 50 years, classified as ASA I. Participants were randomly assigned to one of four groups: control (no bupivacaine), injection (4 ml of bupivacaine via nerve block), topical (bupivacaine-soaked mesh placed in the nostrils), and combination (both topical and injection). Pain levels were assessed at 1, 6, 24, 48, and 72 h post-surgery. Secondary outcomes included analgesic consumption, the incidence of postoperative nausea and vomiting, and patient complications.</p><p><strong>Results: </strong>A total of 212 patients completed the study. At 1, 6, 24, and 72 h post-surgery, the topical group reported significantly lower pain levels compared to other groups. Analgesic consumption was significantly lower in both the injection and combination groups. Additionally, the combination group had lower rates of postoperative nausea and vomiting and reported higher overall satisfaction, with 79.2% rating their experience as \"better than they expected\" (p = 0.020).</p><p><strong>Conclusion: </strong>The use of bupivacaine, especially when applied combined, through both topical and injection methods, greatly improves pain management after rhinoplasty. This technique not only decreases pain and the need for analgesics but also enhances patient satisfaction and reduces side effects.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163964","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":"Philtral Ridge Repair with Nasolabial Muscle Reconstruction in Unilateral Microform Cleft Lip: Evaluation Based on Three-Dimensional Anthropometry.","authors":"Liwen Zhu, Yilue Zheng, Di Wu, Tao Song, Yongqian Wang, Ningbei Yin","doi":"10.1007/s00266-026-06334-9","DOIUrl":"https://doi.org/10.1007/s00266-026-06334-9","url":null,"abstract":"<p><strong>Background: </strong>Unilateral microform cleft lip presents with subtle but characteristic philtral deformities. Conventional repair techniques often yield conspicuous scarring or inadequate reconstruction of the underlying musculature and philtral contour. This study aimed to evaluate the outcomes of philtral ridge repair with small-incision nasolabial muscle reconstruction.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with unilateral microform cleft lip who underwent primary repair at our institute between September 2020 and October 2023. The procedure involved a small incision at the vermilion-cutaneous junction, release of abnormal muscle attachments, and reconstruction of the musculocutaneous framework to simulate physiological tension lines. Outcomes were assessed at a minimum of 12 months postoperatively using (1) expert evaluation using a modified visual analog scale (VAS) assessing philtral ridge prominence, groove, and scar and (2) objective three-dimensional anthropometric measurement of philtral ridge projection.</p><p><strong>Results: </strong>The 14 included patients had a mean age at surgery of 4.41 years (range: 9 months-9 years) and a mean follow-up duration of 27.21 months. The mean total VAS score was 4.24, indicating a good result. Preoperatively, the cleft-side philtral ridge projection was significantly lower than that of the noncleft side at the mid-philtrum and below the columella (p < 0.05). Following surgery, the cleft-side projection increased significantly at all three planes (p < 0.05). Postoperatively, no statistically significant differences between the cleft and noncleft sides were detected at the midlevel of the philtrum or below the nasal columella (p > 0.05).</p><p><strong>Conclusions: </strong>The nasolabial muscle tension line group reconstruction technique was associated with improved philtral ridge projection and favorable aesthetic outcomes in patients with unilateral microform cleft lip.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164373","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":"Extended Autologous Fat Grafting for Temporal Contour Restoration.","authors":"Yong-Sheng Su, Shu-Rong Lu, Juan Zhou, Li-Li He, Ke Hu, Meng Liu","doi":"10.1007/s00266-026-06267-3","DOIUrl":"https://doi.org/10.1007/s00266-026-06267-3","url":null,"abstract":"<p><strong>Background: </strong>Continuity of the temporal contour is essential for maintaining a smooth transition from the lateral forehead to the zygomatic arch. Although autologous fat grafting is commonly used to correct temporal hollowing, conventional temple-focused augmentation may be insufficient to restore overall temporal contour continuity. This study presents an extended temporal fat grafting approach to address this limitation.</p><p><strong>Methods: </strong>Extended temporal fat grafting was performed, with deep grafting in the loose areolar plane overlying the temporalis muscle. Selective superficial refinement was performed in the anterior temporal region when necessary. Outcomes were assessed using standardized patient-reported satisfaction measures.</p><p><strong>Results: </strong>The mean satisfaction score was 2.32 ± 0.48. Secondary touch-up grafting was required in 3.6% of cases. No major complications or perceived posterior temporal hairline changes were observed during follow-up.</p><p><strong>Conclusions: </strong>Extended autologous fat grafting involving both the anterior and posterior temporal regions, combined with a dual-entry cross-tunneling technique within the loose areolar space, provided satisfactory temporal contour restoration in this case series. No perceived posterior temporal hairline changes were observed during follow-up. This approach may represent a safe and practical strategy for addressing temporal contour deficiency, although comparative studies are required to further evaluate its potential advantages over conventional techniques.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163462","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":"Influence of Cannula Design on Lipoaspirate Architecture: A Double-Blind, Split-Body Trial Comparing Basket, Accelerator, and Candy Cane Cannulas.","authors":"Yanko Castro-Govea, Roberto Martínez-Mejorada, Cynthia M Gonzalez-Cantu, Luis Rodrigo Gomez-Alvarez, Pedro Emiliano Ramos-Morales, Luis Adrian Alvarez-Lozada, Everardo Valdés-Flores","doi":"10.1007/s00266-026-06294-0","DOIUrl":"https://doi.org/10.1007/s00266-026-06294-0","url":null,"abstract":"<p><strong>Background: </strong>Autologous fat grafting is widely used in reconstructive and esthetic surgery; however, variability in graft retention remains a major limitation. Cannula design may influence the mechanical trauma inflicted during fat harvesting, potentially affecting adipocyte architecture and tissue integrity. This study aimed to evaluate the macroscopic and histologic characteristics of adipose tissue harvested using three different suction cannulas.</p><p><strong>Materials and methods: </strong>A double-blind, non-randomized, split-body clinical trial was conducted. Adipose tissue was harvested from the abdominal region of sixteen patients undergoing elective liposuction using three 4-mm diameter cannulas (Basket, Accelerator [ACC], and Candy Cane). Lipoaspirate samples were processed to separate aqueous, adipose, and oily phases. Macroscopic parcel area was measured using stereoscopic imaging, and histologic evaluation assessed adipocyte alterations, septal connective tissue disorganization, and debris presence. Statistical analysis aimed to determine differences from each characteristic per cannula design.</p><p><strong>Results: </strong>A total of 48 adipose tissue samples were analyzed. The ACC cannula produced the largest adipose parcels and exhibited greater parcel size heterogeneity, whereas the Candy Cane and Basket cannulas generated smaller and more uniform parcels. No significant differences were observed among cannula types in the proportions of aqueous, adipose, or oily phases. Histologic analysis showed no significant association between cannula type and adipocyte alterations, septal disorganization, or debris presence. Patient age demonstrated significant correlations with adipose-phase volume and parcel size across cannula types.</p><p><strong>Conclusion: </strong>Cannula geometry influences the macroscopic architecture of harvested adipose tissue but does not appear to significantly affect histologic integrity or phase distribution when standardized harvesting conditions are applied. Patient-related factors, particularly age, may contribute to variability in adipose tissue characteristics at the time of harvest.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163505","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":"Pretarsal Orbicularis Oculi Preservation with Palpebral Margin Incision and Internal Fixation for Double Eyelid Blepharoplasty in East Asian Patients: A Retrospective Multicenter Cohort Study.","authors":"Yang Hu, Xiangyu Chen, Chengwu Zhang, Shiyi Wen, Huiling Ma, Ping Li","doi":"10.1007/s00266-026-06382-1","DOIUrl":"https://doi.org/10.1007/s00266-026-06382-1","url":null,"abstract":"<p><strong>Background: </strong>Natural double eyelid blepharoplasty in East Asian patients requires stable crease formation, rapid recovery, inconspicuous scarring, and coordinated eyelid movement. This study evaluated the clinical outcomes of pretarsal orbicularis oculi preservation with palpebral margin incision and internal fixation.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study included 238 East Asian patients who underwent bilateral double eyelid blepharoplasty between June 2019 and April 2023. Patients were divided into a pretarsal orbicularis preservation group with palpebral margin incision and internal fixation (n = 121) and a conventional incisional blepharoplasty group (n = 117). Postoperative morphology, swelling, dynamic eyelid function, scar outcomes, FACE-Q scores, and adverse events were compared. Multivariable linear or logistic regression was used to adjust postoperative comparisons for age, sex, participating center, mild ptosis correction, and epicanthoplasty.</p><p><strong>Results: </strong>Baseline characteristics and the frequencies of concurrent mild ptosis correction and epicanthoplasty did not differ significantly between groups. Adjusted analyses showed similar natural curvature and bilateral symmetry, whereas the preservation group had lower early swelling scores, better blinking coordination and eye-closure naturalness, lower Vancouver Scar Scale scores, and higher scar satisfaction scores. FACE-Q Satisfaction with Eyes was higher at 6, 12, and 24 months; Psychological Well-being was higher at 6 and 12 months; and Satisfaction with Facial Appearance was higher at all postoperative time points. Total adverse events were less frequent in the preservation group (9.9% vs. 19.7%; adjusted OR, 0.42; 95% CI, 0.19-0.92; P = 0.030).</p><p><strong>Conclusions: </strong>Pretarsal orbicularis oculi preservation with palpebral margin incision and internal fixation was associated with reduced early swelling, better dynamic eyelid function, improved scar quality, favorable patient-reported outcomes, and fewer overall adverse events compared with conventional incisional blepharoplasty.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164130","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 Weight Loss: Facial Remodeling Associated with GLP-1 Receptor Agonists-A Systematic Review and Therapeutic Framework.","authors":"Fabio Maglitto, Giovanni Salzano, Serena Trotta, Eutilia Manzo, Luigi Vaira, Marzia Petrocelli, Giovanni Dell'Aversana Orabona","doi":"10.1007/s00266-026-06331-y","DOIUrl":"https://doi.org/10.1007/s00266-026-06331-y","url":null,"abstract":"<p><strong>Background: </strong>Facial volume depletion and skin laxity have increasingly been reported during weight loss associated with glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment. However, these changes are not recognized as a distinct clinical entity and may overlap with those occurring after other forms of rapid or massive weight loss. Evidence regarding their treatment remains limited.</p><p><strong>Methods: </strong>This systematic review was conducted according to PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261415797). PubMed/MEDLINE, Embase, and Scopus were searched from inception to June 5, 2026. Clinical studies evaluating interventions for facial changes associated with GLP-1RA-related weight loss were included. Study characteristics, interventions, outcomes, safety, and methodological limitations were synthesized narratively. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools.</p><p><strong>Results: </strong>Four uncontrolled observational studies involving 98 treated participants met the eligibility criteria. Two studies enrolled exclusively patients receiving GLP-1RAs or related incretin-based medications, whereas two included mixed weight-loss etiologies. Investigated interventions included injectable biostimulators and fillers, endotissutal bipolar radiofrequency, and a topical formulation. All studies reported favorable within-group findings; however, heterogeneous populations, weight-loss trajectories, interventions, outcomes, and follow-up durations, together with the absence of comparator groups, precluded conclusions regarding treatment effectiveness or superiority.</p><p><strong>Conclusions: </strong>The available evidence is preliminary and insufficient to support a validated therapeutic algorithm. The proposed framework is hypothesis-generating and integrates limited review findings with established principles of post-weight-loss facial rejuvenation. Comparative studies evaluating surgical and nonsurgical interventions are required.</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 . Trial registration number PROSPERO Registration CRD420261415797.</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164105","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":"Efficacy Analysis of Transconjunctival Blepharoplasty Combined with Nanofat Grafting in Correcting Tear Trough Deformity.","authors":"Lu Wang, Zexin Chen, Zixin Chai, Yuchen Fan, Xiang Li, Dachun Chen, Fengqin Miao, Fangfang Guo","doi":"10.1007/s00266-026-06303-2","DOIUrl":"https://doi.org/10.1007/s00266-026-06303-2","url":null,"abstract":"<p><strong>Background: </strong>Tear trough deformity often coexists with lower eyelid bags. While transconjunctival blepharoplasty combined with autologous fat grafting is effective, the optimal preparation method-conventional fat versus nanofat-remains unclear. This study compares the efficacy and safety of these two techniques.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 87 patients who underwent transconjunctival blepharoplasty combined with either granular fat (Group A, n = 41) or nanofat grafting (Group B, n = 46). Outcomes were assessed at 6 months postoperatively using patient satisfaction scores, Barton grade improvement, tear trough height-to-palpebral fissure width (TTDH/PFW) ratio, lower eyelid pigmentation scores, and complication rates.</p><p><strong>Results: </strong>Both groups showed significant improvement. However, for mild-to-moderate deformity, Group B demonstrated superior outcomes: higher patient satisfaction (P < 0.001), greater reduction in TTDH/PFW (P < 0.05), and significant improvement in lower eyelid pigmentation (P < 0.001). Group B also had a significantly lower complication rate. No significant difference was found for severe deformity.</p><p><strong>Conclusion: </strong>For mild-to-moderate tear trough deformity, nanofat grafting combined with transconjunctival blepharoplasty provides more effective and comprehensive correction-improving contour, reducing pigmentation, and resulting in fewer complications-compared to conventional macrofat grafting.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164981","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 CAD-Based Workflow for Structured Mid-Sagittal Plane Definition in Contralateral Mandibular Mirroring: A Technical Note.","authors":"Sombir Singh, Shagun Sharma, Amanurrahman Zubair Ahemad, Vidya Rattan, Sabah Zaheer","doi":"10.1007/s00266-026-06322-z","DOIUrl":"https://doi.org/10.1007/s00266-026-06322-z","url":null,"abstract":"<p><strong>Objectives: </strong>To describe a structured CAD-based workflow for defining the mandibular mid-sagittal plane during contralateral mirroring for unilateral mandibular defects and to demonstrate its clinical applicability in reconstructive planning.</p><p><strong>Methods: </strong>DICOM data were segmented to generate a mandibular STL model. In CAD software, a mid-sagittal splitting plane was constructed using convergent geometric references, including a best-fit plane, principal inertia axis, and centre-of-gravity point, combined with pogonion as the anterior midline reference. The unaffected hemimandible was mirrored across this plane, exported as an STL file, and used for biomodel fabrication, guide planning, and reconstruction plate pre-contouring. A representative ameloblastoma case was used to illustrate the workflow.</p><p><strong>Results: </strong>The workflow produced a mirrored mandibular template suitable for digital-to-physical transfer. In the representative case, the template supported preoperative reconstruction plate adaptation and intraoperative contour planning. At 12-month follow-up, facial contour and occlusion were clinically acceptable on qualitative assessment.</p><p><strong>Conclusions: </strong>A convergent reference CAD workflow offers a practical method for standardising mid-sagittal plane definition in mandibular contralateral mirroring. The workflow may reduce reliance on subjective landmark selection in unilateral pathology; however, quantitative validation against established midplane methods is required.</p><p><strong>Clinical significance: </strong>This technique provides a stepwise digital planning workflow for unilateral mandibular reconstruction, helping surgeons define the mid-sagittal plane, create mirrored templates, fabricate biomodels, and pre-contour reconstruction plates when tumour-related distortion limits reliable anatomical reference points.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163894","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 Impact of Tranexamic Acid Administration Route on Outcomes in Reduction Mammaplasty.","authors":"Joni Ilmanen, Salvatore Giordano","doi":"10.1007/s00266-026-06385-y","DOIUrl":"https://doi.org/10.1007/s00266-026-06385-y","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hematoma requiring unplanned intervention remains a clinically significant complication following reduction mammaplasty. Tranexamic acid (TXA) is increasingly used to reduce its occurrence and perioperative bleeding, but the optimal route of administration in breast reduction surgery remains unclear.</p><p><strong>Objectives: </strong>This study aimed to evaluate the effects of different TXA administration routes on hematoma incidence and perioperative outcomes in patients undergoing reduction mammaplasty.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of consecutive patients who underwent bilateral reduction mammaplasty at a single institution between 2020 and 2024. Patients were stratified into three groups according to the route of TXA administration: intravenous, topical, or combined intravenous plus topical. Group differences were evaluated using univariate analyses and multivariable logistic regression.</p><p><strong>Results: </strong>A total of 272 patients were included. The incidence of postoperative hematoma requiring intervention was low (0.0-2.4%) and did not differ significantly between groups. Estimated intraoperative blood loss was significantly higher in the intravenous TXA group (p  =  0.004). Partial or total nipple-areolar complex necrosis occurred more frequently in the combined TXA group (7.7%; p  =  0.056 overall, with pairwise p  =  0.013 compared to other groups). In multivariable analysis, comorbidity burden showed a trend toward predicting postoperative hematoma.</p><p><strong>Conclusions: </strong>The route of TXA administration did not significantly affect hematoma rates. Although a higher incidence of nipple-areolar complex necrosis was observed in the combined TXA group, this finding is based on a small number of events and should be interpreted with caution. Prospective studies are needed to further evaluate the optimal TXA administration strategy in reduction mammaplasty.</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":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164145","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}