Aesthetic Plastic Surgery最新文献

{"title":"TRAM Flap Plus Fat Grafting: A Hybrid Solution for Natural Breast Augmentation.","authors":"Tung Dinh Nguyen","doi":"10.1007/s00266-025-05292-y","DOIUrl":"https://doi.org/10.1007/s00266-025-05292-y","url":null,"abstract":"<p><strong>Background: </strong>Implant-based breast augmentation remains widely practiced but is increasingly scrutinized due to complications such as rupture, capsular contracture, and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Fat grafting provides a natural alternative but is limited by variable resorption. To overcome these limitations, we investigated a hybrid autologous approach combining bilateral pedicled transverse rectus abdominis myocutaneous (TRAM) flaps with supplementary fat grafting.</p><p><strong>Methods: </strong>This prospective, single-center case series included 55 female patients treated between June 2022 and September 2024 for indications including implant removal, free silicone injection complications, and post-pregnancy hypoplasia. Bilateral pedicled TRAM flaps were inset in the subglandular plane, and autologous fat grafting was performed for volume refinement. Outcomes were evaluated using 3 Tesla MRI and BREAST-Q (Version 2.0) questionnaire over a 6-12 month follow-up. Fat retention was calculated by subtracting known flap volume from total postoperative breast volume. Complications were graded using the Clavien-Dindo classification. A post hoc power analysis was performed.</p><p><strong>Results: </strong>All flaps were viable with no partial or total loss. The mean TRAM flap volume was 227 cc; mean fat graft volume was 53.9 cc per breast. MRI confirmed a mean fat retention rate of 83.0%, exceeding published benchmarks. No Grade II or higher complications occurred. Patient satisfaction was high: 98.2% agreed that surgical outcomes met expectations. The mean BREAST-Q score was 64.5 (Rasch scale), with a positive correlation between graft volume and satisfaction (r = 0.288). A moderate inverse correlation was noted between ideal breast size and perceived life impact (r = - 0.375, p = 0.005). Post hoc analysis confirmed > 80% power to detect medium effect sizes.</p><p><strong>Conclusions: </strong>The TRAM flap plus fat grafting technique provides a durable, safe, and highly satisfying autologous solution for complex breast revision cases. It offers robust volume restoration and aesthetic refinement with minimal morbidity. MRI and validated patient-reported outcomes support its efficacy as a targeted alternative in selected patients.</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":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278822","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":"Pocket Conversion from Prepectoral to Retropectoral Implant Placement in Breast Reconstruction: A Cost-effective Solution for High-Grade Rippling and Implant Visibility.","authors":"Maria Lucia Mangialardi, Veronica Vietti Michelina, Giovanni Zoccali, Marcello Pozzi, Roy De Vita","doi":"10.1007/s00266-025-05234-8","DOIUrl":"https://doi.org/10.1007/s00266-025-05234-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Immediate prepectoral breast reconstruction (PBR) after conservative mastectomy has gained widespread adoption in recent years, demonstrating excellent outcomes in terms of function, aesthetics, and patient-reported satisfaction. However, as with all surgical advancements, the increasing use of prepectoral techniques has also introduced new limitations and complications. Among these, implant rippling and implant visibility are the most common reasons for revision surgery after PBR. While autologous fat grafting is the most frequently employed technique for revision-aimed at enhancing skin flap thickness and contour-this solution is not viable for all patients. In particular, patients with limited donor sites or those exhibiting high-grade rippling may require alternative surgical approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aims to describe our management of patients who previously underwent PBR and presented with high-grade rippling or a \"flying saucer effect,\" where autologous fat grafting was not feasible. In these cases, we performed a pocket conversion from prepectoral to retropectoral implant placement. Our surgical technique reuses the existing periprosthetic capsule of the prepectoral implant, avoiding the use of acellular dermal matrices and thereby eliminating additional costs. This article details our technique and evaluates the resulting aesthetic and patient-reported outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a prospective observational study from November 2022 to October 2024, enrolling all patients with prior PBR who presented with unsatisfactory aesthetic outcomes (high-grade rippling or implant visibility) for whom fat grafting was not a viable option. Collected data included patient age, side of surgery, indication for mastectomy, eventual radiation therapy or previous fat graft, reasons for implant revision, and postoperative complications. Aesthetic outcomes were assessed using a 5-point Likert scale, evaluating breast shape, symmetry, and overall satisfaction. Patient satisfaction was measured using the BREAST-Q Reconstruction Module, evaluating the domains \"Satisfaction with Breasts\" and \"Satisfaction with Outcome,\" both preoperatively and at 1-year follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fourteen breasts from seven patients (mean age 46.2 years, range 34-65) underwent pocket conversion. All patients had undergone bilateral nipple-sparing mastectomy and immediate PBR. Mean follow-up was 15.2 months (range 12-25). One minor complication (7.1%) was recorded: a seroma requiring office drainage. No implant removals, infections, or deformities were reported. All cases showed complete resolution of rippling and/or implant visibility. No animation deformity was observed. Mean aesthetic scores (Likert scale) were 4.4 for breast shape, 4.3 for symmetry, and 4.4 for global satisfaction. BREAST-Q analysis showed significant improvement: the \"Satisfaction with Breasts\" domain increase","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278869","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":"'Your Face, Their Stage': A Global, AI-Enhanced, Mixed-Methods Survey on Public Perceptions of Live Educational Cosmetic Procedures.","authors":"Eqram Rahman, Alain Michon, Parinitha Rao, Patricia E Garcia, Hany Niamey Abu-Farsakh, Mobasheratul Jannat, Syed Nazim Hussain, Nanze Yu, Elias Tam, Sotirios Ioannidis, Zakia Rahman, Greg J Goodman, Woffles T L Wu, William Richard Webb, Jean D A Carruthers","doi":"10.1007/s00266-025-05297-7","DOIUrl":"https://doi.org/10.1007/s00266-025-05297-7","url":null,"abstract":"<p><strong>Background: </strong>The global rise of live cosmetic procedure demonstrations particularly in non-surgical aesthetic medicine has prompted growing ethical concern. While often framed as educational, these public displays risk conflating clinical care with commercial performance.</p><p><strong>Methods: </strong>A multilingual cross-sectional survey of 16,950 participants from 43 countries captured public perceptions of live aesthetic procedures using both structured and open-ended items. AI-enhanced methodologies including natural language processing (NLP), sentiment analysis, and machine learning (ML) were applied to assess attitudes, emotional responses, and predictors of negative sentiment.</p><p><strong>Results: </strong>Respondents exhibited high levels of ethical discomfort: 76.5% believed live procedures served self-promotional aims, while 69.7% perceived them as compromising patient privacy. Narrative analysis showed that 49.8% of open-text responses expressed negative sentiment, with dominant emotional tones being disgust (24.3%) and concern (22.8%). Topic modelling identified six core public concerns: commercial exploitation (22.5%), power imbalance in consent (19.3%), and surveillance culture (14.2%) among them. Predictive modelling using logistic regression and random forest classifiers (AUC = 0.82, F1 = 0.765) revealed narrative polarity, region, emotional tone, and prior cosmetic experience as significant predictors of negative sentiment. Respondents with no prior procedural history were more likely to describe feelings of exposure, shame, and loss of autonomy. Notably, nearly half of respondents expressed concern about the future of cosmetic medicine, citing risks of performance-driven care and ethical erosion. In response, we propose the INFORM-A checklist, an evidence-based ethical framework to guide the conduct of live or recorded procedural broadcasts.</p><p><strong>Conclusion: </strong>Public perception of live cosmetic procedures is characterised by scepticism and emotional discomfort, particularly when transparency and ethical safeguards are absent. The educational value of these practices is widely contested, with findings suggesting a misalignment between professional intent and public trust. Regulators, practitioners, and conference organisers must reevaluate the ethics of live procedural demonstrations in favour of consent-driven, accountable, and psychologically safe educational alternatives.</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":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285371","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":"How Does the Buccal Fat Pad Age and How Can it Be Managed in Facelift Surgery? A Scoping Review of the Literature and Our Proposed Algorithm.","authors":"Philippe Bellity, Lolita Pechevy, Raphael Carloni","doi":"10.1007/s00266-025-05300-1","DOIUrl":"https://doi.org/10.1007/s00266-025-05300-1","url":null,"abstract":"<p><strong>Background: </strong>The buccal fat pad tends to sag and herniate with age, creating an unnatural bulge in the perioral area. Failure to address this during a facelift can be a source of postoperative dissatisfaction.</p><p><strong>Objectives: </strong>To perform a scoping review of the literature on the aging of the buccal fat pad, to summarize published studies on its management during facelift surgery and to propose an algorithm for the diagnosis and management of the buccal fat pad during facelift surgery.</p><p><strong>Methods: </strong>PubMed, Cochrane Library and Google Scholar databases were searched for published studies that included anatomic data on the aging of the buccal fat pad and surgical procedures involving the buccal fat pad during associated facelift surgery.</p><p><strong>Results: </strong>Of the 188 articles initially identified by the search, 23 were finally selected. 10 were anatomic studies addressing buccal fat pad aging and 13 studies were therapeutic studies addressing buccal fat pad management during facelift surgery. BFP is likely to increase between childhood and adulthood and may not begin to decrease until after the age of 60 or 70. Vertical descent of the BFP and pseudo-herniation of the buccal extension is the natural progression of aging, making BFP reduction the most common procedure performed during facelift surgery.</p><p><strong>Conclusion: </strong>Depending on the surgeon's preference, BFP reduction can be performed through a facelift or an intraoral approach. The facelift approach should be preferred when a transposition is indicated. Patients should be informed of the risks of buccal branch injury and hematoma in the buccal space.</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":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285409","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":"Evaluating the Homing Potential of Adipose-Derived Stromal Cells Following Dorsal Subcutaneous Injection in a Rat Fat Graft Model.","authors":"Chun-Yee Ho, Tzu-Hsun Tsai, Dun-Hao Chang, Yo-Shen Chen, Shinn-Chih Wu, Feng-Huei Lin","doi":"10.1007/s00266-025-05275-z","DOIUrl":"https://doi.org/10.1007/s00266-025-05275-z","url":null,"abstract":"<p><strong>Background: </strong>Cell-assisted lipotransfer is a fat-grafting technique that uses adipose tissue from lipoaspirates mixed with adipose-derived stromal cells (ASCs) to enhance fat graft survival. Intravenously injected ASCs migrate to the fat graft site via circulatory system; however, a large portion of circulatory ASCs can get trapped in the lungs, reducing the amount of available ASCs for fat graft. The molecular and cellular mechanisms modulating ASC homing remain unclear. We aimed to investigate the migration and infiltration of ASCs to adjacent fat graft when injected subcutaneously.</p><p><strong>Methods: </strong>A fat graft was implanted on the dorsal side of Sprague-Dawley rats without genetic modification. Green fluorescent protein (GFP)-ASCs were harvested from genetically engineered Sprague-Dawley rats and injected subcutaneously cephalically away from the fat graft at 0, 1, and 2 cm. The migration and fate of the injected GFP-ASCs in relation to fat grafts were monitored using an in vivo imaging system for 4 weeks, and GFP fluorescence in fat graft was examined under a microscope.</p><p><strong>Results: </strong>Cell migration was observed at both 1 and 2 cm from the fat graft. However, ASC infiltration to the fat graft was greater at a distance of 1 cm away from the graft than at 0 and 2 cm.</p><p><strong>Conclusion: </strong>ASC migration into fat grafts was observed after subcutaneous injection. ASCs injected at a distance of 1 cm showed positive retention rates ASCs those mixed directly with the fat graft or those injected at a greater distance (2 cm) from the fat graft. ASCs successfully migrated to fat grafts, with greater infiltration observed when the injection site was closer This migration capacity underscores the importance of injection site proximity in optimizing ASC delivery We provide a novel approach to enhance fat graft survival NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273576","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":"Minimally Invasive Removal of Frontal Lipoma with Endoscope.","authors":"Yimou Sun, Qifei Wang, Hongbin Xie","doi":"10.1007/s00266-025-05293-x","DOIUrl":"https://doi.org/10.1007/s00266-025-05293-x","url":null,"abstract":"<p><strong>Background: </strong>Frontal lipomas are commonly excised through an overlying incision. Endoscopic techniques can be used to remove the lesions for a cosmetic outcome.</p><p><strong>Objectives: </strong>This study aimed to evaluate the outcomes of endoscopic removal of frontal lipomas and summarize the associated experiences.</p><p><strong>Methods: </strong>Eighty-three patients with forehead lipomas were included in the retrospective study. Fifty-six patients underwent endoscopic surgery (endoscopic excision group), while twenty-seven patients underwent direct excision (direct excision group). Patients characteristics including age, gender, tumor locations and sizes were collected. Additionally, surgery duration, surgery costs, hospital costs, satisfaction with the procedure, complications and follow-up were also evaluated.</p><p><strong>Results: </strong>Patients in endoscopic excision group were younger than those in direct excision group. Additionally, the average surgery duration in endoscopic excision group was longer compared to that in direct excision group. Patients in endoscopic excision group were more satisfied with smoothness of appearance and were more than willing to recommend endoscopic surgery to others. There was no significant difference in satisfaction regarding pain or discomfort control and hospitalization costs between the two groups. No complications such as wound infection, poor wound healing, forehead scars and recurrence were observed in endoscopic excision group. No noticeable scars were left on the forehead in the endoscopic excision group compared to the direct excision group.</p><p><strong>Conclusions: </strong>Endoscopic excision is a safe and minimally invasive approach for forehead lipomas.</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":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273626","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":"Ideal Eyebrows in East Asians: Based on Morphological Measurements and Questionnaire Survey.","authors":"Haoyang Li, Jinfeng Yuan, Ping Xue, Jiaxian Zhang, Muhan Wu, Botian Jiang, Wenzhen Li, Hailin Wang, Cheng Zheng, Wangzehao He, Zhiqi Hu, Nanze Yu, Wei Wu, Yong Miao","doi":"10.1007/s00266-025-05236-6","DOIUrl":"https://doi.org/10.1007/s00266-025-05236-6","url":null,"abstract":"<p><strong>Background: </strong>Eyebrows play a crucial role in facial aesthetics and emotional expression. Although eyebrow transplantation and reconstruction have gained popularity, a standardized classification system and ideal aesthetic parameters for East Asian eyebrows remain undefined.</p><p><strong>Methods: </strong>A retrospective image analysis was conducted on 1,482 East Asian participants (1,043 males, 439 females) from multiple medical institutions. Eyebrow morphology was measured using Photoshop-assisted digital analysis. Independently, a novel eyebrow classification system was developed, categorizing eyebrows into 12 distinct types. Additionally, a cross-sectional study of 513 participants (146 males, 367 females) was conducted using AI-generated facial images to assess preferences for eyebrow shape and characteristics using a 5-point Likert scale.</p><p><strong>Results: </strong>Among males, the triangular straight eyebrow was the most preferred, whereas females favored the smooth arched eyebrow. The ideal eyebrow peak was positioned on or outside the lateral canthus, with an optimal eyebrow peak height-to-intercanthal distance (HBP/ICD) ratio of 1.2. Males exhibited significantly greater eyebrow width-to-intercanthal distance (EW/ICD) ratios (0.4-0.5) and denser eyebrow hair, whereas females had a preferred EW/ICD ratio of 0.25-0.35 (p < 0.001).</p><p><strong>Conclusions: </strong>This study provides quantitative morphological data and a standardized eyebrow classification system for East Asians, offering clinical guidance for eyebrow transplantation and reconstruction. These findings enhance the understanding of East Asian eyebrow aesthetics and provide a valuable reference for personalized surgical design.</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":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257042","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":"Three-Dimensional Magnetic Resonance Imaging-Guided Localization of Hyaluronic Acid Hydrogel for Precision in Hyaluronidase Injection: A Retrospective Case-Control Study.","authors":"Ya-Hong Chen, Chu-Hsin Chen, Jia-Rong Zhang, Shuang-Bai Zhou, Kai Liu","doi":"10.1007/s00266-025-05197-w","DOIUrl":"https://doi.org/10.1007/s00266-025-05197-w","url":null,"abstract":"<p><strong>Background: </strong>Facial overfilled syndrome (FOS), a complication of excessive hyaluronic acid (HA) filler use, poses challenges in aesthetic medicine due to its gradual onset and impact on facial contours. Traditional hyaluronidase injections to dissolve excess HA often lack precision, risking suboptimal outcomes. This study evaluates the efficacy of three-dimensional magnetic resonance imaging (3D-MRI)-guided HA localization in guiding precise hyaluronidase administration.</p><p><strong>Methods: </strong>In this retrospective case-control study (January 2019-December 2024), 50 patients with FOS were divided into two groups: 3D-MRI-guided hyaluronidase injection (M+ group, n=25) and non-guided injection (M- group, n=25). Outcomes were assessed via 2D/3D photography, 3D images and 3D-MRI volumetric analysis, the Global Aesthetic Improvement Scale (GAIS), patient satisfaction surveys, and safety evaluations at 1 and 2 months posttreatment.</p><p><strong>Results: </strong>Both groups showed improved facial contours posttreatment, with no significant difference in GAIS scores (M+: 1.62 ± 0.32 vs. M-: 1.68 ± 0.53, p > 0.05) or adverse events (e.g., mild swelling, bruising). The M+ group demonstrated precise HA localization, with notable volume reductions (e.g., forehead: 31.6-7.9 mL at 2 months). Patient satisfaction was high in both groups (M+: 1.62 ± 0.31 vs. M-: 1.74 ± 0.58 at 1 month, p > 0.05). The average number of treatments (M+: 1.12 ± 0.33 vs. M-: 1.61 ± 0.67) and average treatment duration (M+: 12.64 ± 2.02 vs. M-: 19.27 ± 5.34) in the M+ group were significantly lower than those in the M- group (p < 0.05).</p><p><strong>Conclusion: </strong>3D-MRI guidance enhances the precision of hyaluronidase injections for FOS, offering objective insights into HA distribution. While clinical outcomes were comparable between groups, 3D-MRI provides a promising tool for tailored treatment, warranting further exploration in aesthetic 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":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249348","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":"Concentrated Micronized Fat Ameliorates Skin Fibrosis in Bleomycin-Induced Murine Model and Enhances Fat Graft Survival.","authors":"Xuan Ma, Miao Dong, Ningbei Yin, Facheng Li","doi":"10.1007/s00266-025-05278-w","DOIUrl":"https://doi.org/10.1007/s00266-025-05278-w","url":null,"abstract":"<p><strong>Background: </strong>Scleroderma is characterized by fibrosis of the skin and internal organs, vascular abnormalities, and immune dysregulation. Fat grafting has emerged as a promising therapeutic approach for improving soft tissue deficits and alleviating fibrosis in scleroderma patients. However, low fat graft survival and unresolved fibrosis in fibrotic tissues limit its efficacy. This study aims to evaluate the efficacy of Concentrated Micronized Fat (CMF), a mechanically processed fat product enriched with stromal vascular fraction (SVF) cells and intact adipocytes, in mitigating bleomycin-induced skin fibrosis and enhancing fat graft survival.</p><p><strong>Method: </strong>CMF was prepared using a mechanical micronization and filtration-adsorption method to enrich stromal vascular fraction cells while retaining intact adipocytes. In vitro experiments assessed the effects of CMF on fibroblast proliferation and migration. A murine model of bleomycin (BLM)-induced skin fibrosis was established, and the therapeutic effects of CMF and Coleman fat were compared through in vivo transplantation.</p><p><strong>Result: </strong>In vitro experiments showed that CMF significantly inhibited fibroblast proliferation and migration. In vivo, CMF transplantation effectively mitigated bleomycin-induced dermal thickening and collagen deposition while promoting adipocyte survival.</p><p><strong>Conclusion: </strong>CMF effectively alleviates skin fibrosis. It improves fat graft retention under fibrotic conditions. These results suggest that CMF is a promising therapeutic approach for treating scleroderma-related fibrosis.</p><p><strong>No level assigned: </strong>This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249354","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":"Anatomical-Functional-Aesthetic Classification of Cervical Aging: Development of the S-F-M Score and Visual Mandala Model.","authors":"Gladstone Eustaquio de Lima Faria, Shannon Humphrey","doi":"10.1007/s00266-025-05243-7","DOIUrl":"https://doi.org/10.1007/s00266-025-05243-7","url":null,"abstract":"<p><strong>Background: </strong>Cervical aging is a multifactorial process affecting skin quality, fat distribution, and platysmal activity, yet existing assessment tools typically address these elements in isolation. A need remains for a comprehensive, intuitive, and clinically applicable classification model to guide diagnosis and treatment planning.</p><p><strong>Objectives: </strong>To propose a unified anatomical-functional classification system for cervical aging that integrates three independent axes-Skin (S), Fat (F), and Muscle (M)-into a visual mandala model, allowing for personalized treatment strategies.</p><p><strong>Methods: </strong>A structured literature review was performed to evaluate existing cervical classification scales and their anatomical foundations. Based on the synthesis of validated criteria, the S-F-M Score was developed, with each axis graded from 0 (normal) to 3 (severe alteration). These scores are combined into a cervical phenotype (e.g., S2-F1-M3) and plotted on a radial diagram to visually guide diagnosis and therapeutic focus.</p><p><strong>Results: </strong>The S-F-M Score enables a modular and reproducible assessment of cervical aging. The visual mandala representation enhances communication and decision-making by highlighting the dominant aging vector. Practical examples demonstrate its application in selecting tailored treatments, such as biostimulators for skin laxity, lipolytic approaches for submental fat, and botulinum toxin for platysmal hypertonia.</p><p><strong>Conclusions: </strong>The S-F-M classification and mandala model offer an integrative and scalable tool for cervical aesthetic evaluation. By aligning clinical diagnosis with anatomical targets, this system supports individualized, layer-specific treatment planning and provides a foundation for standardization in both clinical practice and future research.</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":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249338","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}