Aesthetic Plastic Surgery最新文献

{"title":"Comparative Analysis of Nasal Tip Stability: Columellar Strut Graft Alone vs. Combination with Flexible Tongue-in-Groove.","authors":"Ağah Yeniceri, Melih Cayonu","doi":"10.1007/s00266-025-05290-0","DOIUrl":"https://doi.org/10.1007/s00266-025-05290-0","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the effects of the flexible tongue-in-groove (TIG) technique on nasal tip stability in patients undergoing columellar strut graft (CSG) placement. Nasal tip rotation and projection changes were compared between patients who underwent CSG with the flexible TIG technique and those who received CSG alone.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 88 patients who underwent primary open approach septorhinoplasty with CSG placement between January 2022 and June 2024. Patients were divided into two groups: CSG with flexible TIG (n = 44) and CSG alone (n = 44). Nasal tip rotation was assessed using the nasolabial angle (NLA), and nasal tip projection was evaluated using the Goode ratio. Measurements were obtained preoperatively, at 1 week postoperatively, and at 12 months postoperatively. Statistical analysis was performed.</p><p><strong>Results: </strong>Patients who underwent CSG with flexible TIG had significantly less nasal tip rotation loss (5.18 ± 3.01) compared to those with CSG alone (11.95 ± 5.59, p <0.0001). Similarly, the flexible TIG group demonstrated significantly lower nasal tip projection loss over time (0.03 ± 0.018 vs. 0.04 ± 0.024, p =0.004). Pearson correlation analysis demonstrated a statistically significant positive association between the degree of intraoperative change in the NLA and the amount of NLA loss observed at long-term follow-up (r = 0.356, p = 0.001).</p><p><strong>Conclusion: </strong>CSG combined with the flexible TIG technique has been shown to provide better long-term nasal tip rotation and projection stability compared to the use of CSG alone. Our findings suggest that the flexible TIG technique overcomes some of the limitations associated with the use of CSG alone.</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":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Rosiglitazone on Subdermal Adipose Tissue Growth and Lipid Droplet Formation: An In Vitro and In Vivo Study.","authors":"Yunkang Wang, Zhihan Yang, Yan Li, Ju Li, Yong Zhao, Hao Cheng","doi":"10.1007/s00266-025-05274-0","DOIUrl":"https://doi.org/10.1007/s00266-025-05274-0","url":null,"abstract":"<p><strong>Background: </strong>Adipose tissue regeneration plays a crucial role in tissue repair and aesthetic medicine. The PPARγ pathway is pivotal in lipid metabolism and adipogenesis. As a PPARγ agonist, rosiglitazone has shown potential in promoting adipocyte differentiation and lipid droplet formation. However, its localized effects on adipose tissue regeneration and underlying mechanisms remain unclear.</p><p><strong>Objective: </strong>This study aimed to investigate the role of rosiglitazone in adipocyte growth and lipid accumulation through both in vitro and in vivo experiments, analyzing its effects under different concentrations and administration frequencies.</p><p><strong>Methods: </strong>3T3-L1 preadipocytes were differentiated and treated with varying concentrations of rosiglitazone (1, 10, 50, 100, 200 µmol/L). In parallel, a murine model was established with localized injections of rosiglitazone into inguinal fat pads, with the contralateral fat pad injected with physiological saline as a control. The study examined five rosiglitazone concentrations and three injection frequencies (once every 1, 3, or 7 days). Adipose tissue weight, lipid droplet formation, and the expression of adipogenesis-related genes (PPARγ and CEBPα) were assessed using Oil Red O staining, CCK-8 assays, and qPCR. Histological analysis (H&E staining, perilipin immunofluorescence) was performed on adipose tissues to evaluate morphological changes.</p><p><strong>Results: </strong>Rosiglitazone significantly promoted preadipocyte differentiation and lipid accumulation both in vitro and in vivo. The most effective concentration was 100 µmol/L, which maximally increased preadipocyte numbers, lipid droplet size, and PPARγ/CEBPα expression. In the murine model, localized administration of rosiglitazone led to enhanced adipose tissue growth, particularly with injections every 3 to 7 days, whereas higher doses (200 µmol/L) showed no additional benefit and exhibited signs of metabolic adaptation.</p><p><strong>Conclusion: </strong>Rosiglitazone, as a PPARγ agonist, effectively promotes adipocyte proliferation and lipid accumulation, presenting potential applications in soft tissue augmentation and tissue engineering. Future studies should optimize its administration regimen and investigate its long-term clinical feasibility.</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":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211393","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":"Recommendations on Ensuring Safety in Lower Limb Fat Grafting: Physiological Insights, Risk Assessment, and Advanced Surgical Techniques.","authors":"Katarina Andjelkov, Michel R Rouif, Ali M Ghanem, Andre Cervantes, Kai Uwe Schlaudraff","doi":"10.1007/s00266-025-05202-2","DOIUrl":"https://doi.org/10.1007/s00266-025-05202-2","url":null,"abstract":"<p><strong>Background: </strong>Calf fat grafting has grown with body contouring advances, but robust safety and long-term outcomes data remain limited. This review synthesizes current evidence to guide safe practice.</p><p><strong>Methods: </strong>Narrative review of recent studies and cadaveric data focused on injection plane (subcutaneous vs intramuscular), graft volume, complications (fat embolism, vascular events, compartment syndrome), and the role of ultrasound guidance.</p><p><strong>Results: </strong>Intramuscular fat grafting markedly increases intramuscular pressures and carries higher risks of embolism and thrombosis. Subcutaneous/suprafascial grafting shows lower pressure changes and fewer serious events, though volume retention may require staged procedures. Cadaveric and in vivo pressure studies corroborate compartment-salient concerns with intramuscular approaches, emphasizing cautious technique and volume limits.Ultrasound aids anatomy but does not negate deeper-plane risks.</p><p><strong>Conclusion: </strong>To minimize thromboembolic and ischemic complications, calf fat grafting should prioritize subcutaneous/suprafascial deposition, conservative graft volumes, and careful patient selection. Intramuscular fat grafting warrants extreme caution or avoidance due to elevated compartment pressures and embolic risk. Ultrasound guidance, while helpful for anatomy, does not mitigate deeper-plane risks and should not justify intramuscular injections. Consider staging extensive augmentation and educate patients about realistic outcomes. These guidelines aim to enhance safety and inform evidence-based practice in calf fat grafting.</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.</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211367","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":"Augmentation Mastopexy: A Personalized Technique on 200 Patients.","authors":"Agostino Bruno, Mauro Barbera, Matteo Cilluffo, Marco Schirosi","doi":"10.1007/s00266-025-05287-9","DOIUrl":"https://doi.org/10.1007/s00266-025-05287-9","url":null,"abstract":"<p><strong>Background: </strong>Augmentation mastopexy is a complex and technically demanding procedure that addresses breast ptosis and volume deficiency simultaneously. It requires careful planning, precise surgical techniques, and customization to each patient's anatomical and esthetic characteristics. Consistent outcomes remain a challenge due to the interplay between implant placement, tissue reshaping, and long-term stability.</p><p><strong>Methods: </strong>This study describes a tailored mastopexy technique implemented in 200 patients. Preoperative planning included comprehensive clinical assessments and precise skin markings. Implant selection was individualized based on patient morphology and esthetic goals. A dual-plane pocket dissection was employed to optimize implant positioning and achieve natural outcomes. Advanced tissue management strategies were used to maintain vascular integrity and ensure long-term stability. Emphasis was placed on achieving symmetry and minimizing complications such as capsular contracture, implant malposition, or the \"waterfall effect.\"</p><p><strong>Results: </strong>Outcomes were evaluated in terms of esthetic results, complication rates, and patient satisfaction over a follow-up period of 12 to 36 months. High satisfaction (92%) was reported, with consistently natural and harmonious outcomes. The complication rate was low: Implant malposition occurred in 3% of cases and capsular contracture in 2.5%. No significant vascular compromise or severe wound healing issues were observed.</p><p><strong>Conclusion: </strong>The personalized mastopexy technique demonstrates efficacy in achieving esthetically pleasing and durable outcomes with a low rate of complications. By integrating individualized planning, precise surgical execution, and advanced tissue management, this method offers a reliable framework for ptosis correction and volume enhancement in esthetic breast surgery.</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":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211436","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":"Increasing Implant Size During Implant Exchange Surgery Decreases the Risk for Post-Operative Seroma: Our Experience With 689 Patients.","authors":"Yoram Wolf, Eran Hadad, Shaked Menashe, Ron Skorochod","doi":"10.1007/s00266-025-05285-x","DOIUrl":"https://doi.org/10.1007/s00266-025-05285-x","url":null,"abstract":"<p><strong>Background: </strong>Augmentation mammaplasty is the second most common aesthetic procedure in the USA, with over 300,000 surgeries performed in 2023. Although the procedure is typically regarded as safe and effective, revision surgeries, frequently prompted by aesthetic considerations or complications, present distinctive risks, including seroma formation. There is a paucity of data concerning the factors that influence the development of seromas in implant exchange surgeries.</p><p><strong>Aim: </strong>Examine the relationship between implant size alterations and likelihood of seroma development in secondary breast augmentation.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted with a total of 689 patients who underwent implant exchange. Demographic, surgical, and post-operative information was collected. To ascertain the risk factors for seroma development, univariate and multivariate logistic regression models were employed.</p><p><strong>Results: </strong>Patients who developed post-operative seromas were younger (p < 0.001), non-smokers (p = 0.015), and opted for a decrease in implant size (p = 0.007). Utilization of suction drains and prolonged antibiotic treatment were also associated with seroma development. Multivariate analysis demonstrated that an increase in implant size (OR 0.98, 95% CI 0.96-0.99) and older age (OR 0.93, 95% CI 0.83-0.99) were protective factors against the formation of seromas.</p><p><strong>Conclusion: </strong>Findings of this study indicate a correlation between implant size reduction and an elevated risk of seroma formation in implant exchange surgeries.</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":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Desmopressin, Tranexamic Acid, and Phenylephrine in Reducing Bleeding and Improving Surgical Field Quality during Rhinoplasty: A Triple-Blind Randomized Controlled Trial.","authors":"Mohammad Reza Zamani, Rohollah Abbasi, Behzad Imani, Ashkan Karimi, Roya Najafi Vosough","doi":"10.1007/s00266-025-05277-x","DOIUrl":"https://doi.org/10.1007/s00266-025-05277-x","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty, a popular cosmetic surgery, often faces intraoperative bleeding, which reduces surgical visibility and increases postoperative periorbital edema and ecchymosis. This study compared the effects of desmopressin, tranexamic acid, and phenylephrine on reducing bleeding and improving surgical field quality in rhinoplasty.</p><p><strong>Methods: </strong>In this triple-blind clinical trial, 80 patients aged 18-50 undergoing rhinoplasty were randomly divided into four groups: tranexamic acid, phenylephrine, desmopressin, and control. Surgical field quality was assessed using the Boezaart scale, and bleeding volume was measured by weighing blood-soaked gauze and suction fluid. Data were recorded at 15, 30, 45, and 90-minute intervals and analyzed using SPSS 24.</p><p><strong>Results: </strong>There were no significant differences in demographic or laboratory characteristics among the groups (p > 0.05). The desmopressin and tranexamic acid groups had less bleeding than the control group at 30, 45, and 90 min (p < 0.05), while phenylephrine was effective only at 30 and 45 min (p < 0.05). The quality of the surgical field was better in the desmopressin and tranexamic acid groups at all time points (p < 0.05), but phenylephrine showed improvement only at 15 and 30 min (p < 0.05). Additionally, all intervention groups had a shorter operative time duration compared to the control group (p < 0.05).</p><p><strong>Conclusion: </strong>Desmopressin, tranexamic acid, and phenylephrine, in that order, were the most effective in reducing bleeding and improving surgical field quality. Additionally, these drugs reduced operative time, highlighting their potential to benefit patients and facilitate surgical procedures for surgeons.</p><p><strong>Trial registration: </strong>IRCT20240712062409N1 LEVEL OF EVIDENCE I: 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":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197795","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":"Cell Salvage in Liposuction, a Safety Tool in a New Surgical Scenario.","authors":"Luiz Felipe Duarte Fernandes Vieira, Carlos Lacerda Andrade Almeida, João Paulo Siqueira, Leonardo Campelo Almeida, Raphael Carvalho Sodre Duarte, Flavio Kreimer","doi":"10.1007/s00266-025-05283-z","DOIUrl":"https://doi.org/10.1007/s00266-025-05283-z","url":null,"abstract":"<p><strong>Background: </strong>The improvement in liposuction and associated procedures seen in recent years has led to an increase in complications, particularly related to significant blood loss. This study aims to evaluate the intraoperative use of cell salvage to recover red blood cells from liposuction aspirate and reinfuse them into the patient.</p><p><strong>Methods: </strong>A prospective, randomized, blinded and controlled trial was conducted with 63 patients.</p><p><strong>Results: </strong>Postoperative hematocrit (HT) was significantly higher in the intervention group (34.8 ± 3.3) compared to the control group (31.1 ± 2.7, p < 0.001). Similarly, hemoglobin (Hb) levels were greater 24 hours after surgery (11.7 ± 1.1 vs 10.4 ± 0.8, p < 0.001). On average, 198.5 mL (198.50 ± 136.60) of red blood cells were recovered and reinfused.</p><p><strong>Conclusion: </strong>Patient blood management is a key strategy to enhance surgical outcomes globally. The use of cell salvage during liposuction helps preserve hemoglobin levels close to normal ranges and prevent acute anemia, contributing to faster and safer recovery. Cell salvage should be considered a standard tool and routinely used in extensive liposuction procedures.</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":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197831","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":"Injection of the Concentrate Derived from Nanofat Graft Promotes Hair Growth in Patients of Male Androgenetic Alopecia: A Clinical Pilot Study.","authors":"Zhidan Zhang, Nan Chen, Liling Xiao, Kecheng Li, Hongwei Liu","doi":"10.1007/s00266-025-05291-z","DOIUrl":"https://doi.org/10.1007/s00266-025-05291-z","url":null,"abstract":"<p><strong>Background: </strong>Androgenetic alopecia (AGA) is the most common hair loss disorder in men. Adipose-derived stem cells (ADSCs) have shown regenerative potential, but their clinical application is hindered by complex processing. Concentrate derived from nanofat graft (CDNF), rich in ADSCs, promotes hair growth in mice, suggesting its potential clinical efficacy.</p><p><strong>Objective: </strong>This study aimed to assess the efficacy of intradermal CDNF injection as a novel autologous therapeutic approach for AGA.</p><p><strong>Methods: </strong>Ten male AGA patients (Norwood-Hamilton III-VI, aged 22-38) received three CDNF injections (0.25ml/cm²) into the scalp subdermis at 4-week intervals. Changes in hair density, diameter, and pigmentation were evaluated via ultra-high-resolution photography at baseline, 3, 6, and 12 months post-treatment.</p><p><strong>Results: </strong>All patients exhibited hair regeneration at all follow-ups. Significant improvements were observed not only in total hair count but also in hair diameter and pigmentation. Quantitative analysis revealed a significant increase in the number of hairs with a diameter >0.03 mm at all follow-up time points. Conversely, the number of hairs with a diameter ≤0.03 mm demonstrated a notable decrease at the 3- and 6-month assessments. Peak efficacy was observed at 12 months post-injection, with total hair counts significantly exceeding baseline levels. No severe adverse events were reported. Furthermore, treatment outcomes showed no significant variation with patient age.</p><p><strong>Conclusions: </strong>Intradermal CDNF injection is an efficacious and safe regenerative therapy for male AGA, suggesting that this regenerative therapy may serve as a promising alternative treatment option for hair loss.</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":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197894","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":"Free Jejunal Graft Vaginoplasty in Gender Affirmation Surgery: A Novel Technique.","authors":"Eunhae Cho, Jihyun Kim, Eul-Sik Yoon, Sanguan Kunaporn, Na-Hyun Hwang","doi":"10.1007/s00266-025-05201-3","DOIUrl":"https://doi.org/10.1007/s00266-025-05201-3","url":null,"abstract":"<p><strong>Backgrounds: </strong>Many techniques have been described for reconstruction of the vaginal canal in gender affirmation surgery. However, none of the existing methods is known to be ideal. To overcome disadvantages of previous methods, we developed a method of vaginoplasty using a free jejunal graft. In this study, we describe the new method in detail and report postoperative results of our case series.</p><p><strong>Methods: </strong>Between May 2022 and July 2023, 10 transfeminine patients underwent two-stage gender-affirming vaginoplasty at Korea University Anam Hospital. The first stage involved orchiectomy, urethroplasty, and neovaginal canal dissection. In the second stage, an average of 14.3 cm of jejunum was harvested via single-port laparoscopy, remodeled, and placed in the neovaginal canal. Patient characteristics, along with intra- and perioperative outcomes, were recorded.</p><p><strong>Results: </strong>The median patient age was 27 years (range 21-52). The median BMI was 20.1 kg/m², having received 50.6 months of hormonal replacement therapy, in average. No patient had history of gender-affirming surgery. The first surgery took 654 minutes (range 330-920 minutes) and the second surgery 283 minutes (range 150-441 minutes), in average. No major complication was noted. All patients were followed up for 6-18 months. In the donor site, two patients experienced paralytic ileus, which resolved within a week. No patient complained of persistent gastrointestinal discomfort.</p><p><strong>Conclusions: </strong>A two-staged free jejunal graft for neovagina construction is a safe and effective method of gender-affirming surgery for transfeminine individuals. This paper presents a novel approach of using a free jejunal graft to line the neovagina. The new technique comprises two stages of surgery to ensure hemostasis and minimize swelling of the neovaginal canal. No major complication was noted in the donor or the recipient site after follow-up of at least 6 months on 10 patients.</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":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197809","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":"Utilization of Serratus Muscle-Fascia Flap to Ensure Implant Stability in Prepectoral Direct-to-Implant Reconstruction.","authors":"Mehmet Sağır, Erdem Güven, Onur Saylik, Emir Çapkınoğlu, Cihan Uras","doi":"10.1007/s00266-025-05238-4","DOIUrl":"https://doi.org/10.1007/s00266-025-05238-4","url":null,"abstract":"<p><strong>Background: </strong>In prosthetic breast reconstruction, the thought on the placement of the implant has changed over the years. The aim of this study was to use the serratus muscle-fascia flap for prepectoral breast reconstruction with a permanent implant, performed simultaneously with mastectomy, in cases where mesh was not used. Essentially, the serratus muscle-fascia flap was used in prepectoral repairs to ensuring the implant is positioned where it should be. The goal here is to keep the prosthesis stable in the mastectomy pocket until the capsule forms.</p><p><strong>Methods: </strong>This retrospective study included all patients who underwent prepectoral reconstruction using the serratus muscle-fascia flap between January 2023 and September 2024. This study consists only of patients who underwent surgery at the Acıbadem University Senology Institute. Two-stage reconstruction, delayed reconstruction, and breast reconstruction with autologous tissue were excluded from the study. The surgery was performed by Güven E and Sağır M from the plastic surgery team, and the mastectomy was performed by Uras C from the general surgery team. In the mastectomy pouch, the prosthesis was supported from the lateral and superolateral regions with serratus muscle-fascia flaps. The patients were evaluated for implant position at the end of the eighth week. They were also evaluated for early and late complications.</p><p><strong>Results: </strong>This study includes 57 patients and 70 breasts. Early complications were observed in 3 breasts, while late complications were observed in 9 breasts. At the 8-week postoperative follow-up, no lateral displacement of the implant was observed in any of the breasts, and all breast quadrants were formed. No full-thickness necrosis of the areola or skin flaps was observed in any of the breasts. In the late period, two breasts developed seroma. The most common complication was rippling with fat injection.</p><p><strong>Conclusion: </strong>Prepectoral permanent implant reconstruction was performed without the use of mesh, reducing costs. In lateral incisions, in prepectoral reconstruction, the entire or part of the incision line is supported by vascularized tissue. The indication for prepectoral breast reconstruction has been expanded. LEVEL OF EVIDENCE IV: 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":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190606","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}