Aesthetic Surgery Journal最新文献

{"title":"Ultrasound-Assisted Facial Autologous Fat Grafting: A Systematic Review of Perioperative Safety and Volumetric Outcomes.","authors":"Ronghao Ouyang, Ximeng Jia, Ziming Zhang, Yutong Liang, Benjie Li, Mengzhe Qing, Jintian Hu","doi":"10.1093/asj/sjag091","DOIUrl":"https://doi.org/10.1093/asj/sjag091","url":null,"abstract":"<p><p>High-frequency ultrasound (HFUS) is increasingly used to map facial vasculature and tissue planes, identify prior fillers, and objectively assess volume after autologous facial fat grafting (AFG), but its perioperative benefit has not been systematically synthesized. We performed a PRISMA-compliant systematic review (PROSPERO registration: CRD420251242117), searching PubMed, Embase, Web of Science Core Collection, and the Cochrane Library from inception to November 1, 2025, without language restrictions. We included human clinical studies using B-mode and/or Doppler ultrasound preoperatively, intraoperatively, or postoperatively and reporting safety and/or volumetric outcomes. Methodological quality was assessed using National Institutes of Health tools; due to heterogeneity, findings were narratively synthesized. Twelve studies (885 patients; 2017-2024) were included, predominantly single-center observational designs. Across studies, HFUS supported vascular mapping and filler characterization, real-time confirmation of cannula location within intended planes (\"safe layers\"), and postoperative monitoring of retention and complications. In a comparative temple augmentation cohort, ultrasound guidance enabled higher injection volumes (22.32±5.19 vs 10.55±2.25 mL) and higher satisfaction (92% vs 74%) without increased complications. Ultrasound-measured retention typically declined during the first 3-6 months and then stabilized, with ∼50-70% retention at 1 year and higher retention after supplementary grafting (49.4% vs 71.7% in one cohort). No study reported blindness, stroke, or skin necrosis; adverse events were generally mild and transient. Overall, HFUS-assisted facial AFG appears promising for risk stratification and objective monitoring, but higher-quality comparative studies with standardized ultrasound protocols and core outcome sets are needed.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of High-Frequency Ultrasound, Computed Tomography, and Magnetic Resonance Imaging in Detecting Ruptured Silicone Breast Implants.","authors":"Xiaoying Mao, Ziming Zhang, Ying Jia, Li Yuan, Hongli Chai, Jintian Hu","doi":"10.1093/asj/sjag093","DOIUrl":"https://doi.org/10.1093/asj/sjag093","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Complications Associated With Rib Remodeling: A Multinational Patient-safety Case Series.","authors":"Mauricio E Perez Pachon, Jesus Cuenca Pardo, Martin Lira, Luis Alberto Cantero, Carlos Oñate, Daniel Oñate, Rodrigo Dominguez-Millan, Minyor Avellaneda, Lázaro Cárdenas-Camarena, Alfredo E Hoyos","doi":"10.1093/asj/sjag089","DOIUrl":"https://doi.org/10.1093/asj/sjag089","url":null,"abstract":"<p><strong>Background: </strong>Rib remodeling techniques designed to reduce the waistline have gained popularity in aesthetic surgery. Among them, rib remodeling performed by punctures using a piezotome has been promoted as a minimally invasive alternative to rib contouring. Published literature describing the technique has suggested a low incidence of complications based primarily on surgeon-reported surveys.</p><p><strong>Objectives: </strong>Report a multinational series of fatal complications associated with RibXcar technique and to analyze potential mechanisms contributing to mortality.</p><p><strong>Methods: </strong>A retrospective patient-safety case series was compiled from adverse event reports and medico-legal documentation identified across Latin America between 2023 and 2025. Cases were independently reviewed and validated by scientific committees from the Mexican Association of Plastic, Aesthetic and Reconstructive Surgery (AMCPER), the Colombian Society of Plastic Surgery (SCCP), and a designated expert witness involved in the medico-legal review of the Peruvian cases. Available clinical records, forensic reports, and institutional documentation were reviewed.</p><p><strong>Results: </strong>Six deaths associated with rib remodeling performed by puncture technique (RibXcar) were identified across three countries (Peru, Ecuador, and Mexico). Patients ranged from 23 to 42 years old. Procedures were commonly performed in combination with body contouring surgeries such as lipoabdominoplasty. Documented causes of death included pulmonary thromboembolism, visceral injury with peritonitis, and acute respiratory failure. Most cases occurred within 4 hours to 70 days after surgery.</p><p><strong>Conclusions: </strong>Although RibXcar technique has been described as safe in low-level literature, this multinational patient-safety report documents fatal complications associated with the procedure. Our findings raise concerns regarding the biomechanical safety of perpendicular rib puncture approach for corticotomy that rely on tactile feedback rather than direct visualization. Greater scrutiny, standardized training, and anatomical risk assessment are required before broader adoption.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Reassessment of the Mandibular Septum: Relationship with The Marginal Mandibular Nerve and Deep Structures of Lower Face.","authors":"Cansu Yalçın, Ahmet Safa Doğan, Selçuk Tunalı, Sebat Karamürsel","doi":"10.1093/asj/sjag090","DOIUrl":"https://doi.org/10.1093/asj/sjag090","url":null,"abstract":"<p><strong>Background: </strong>The mandibular septum is not a well-defined anatomical structure and mostly known as a ligamentous formation which separates the jowl and submandibular fat compartments.</p><p><strong>Objectives: </strong>This study aimed to investigate the anatomical relationships between the mandibular septum(MS), the platysma-mandibular ligament (PML), together with the mandibular osteocutaneous ligament(MOCL), and the marginal mandibular nerve(MMN), with a focus on their potential relevance in facelift surgery.</p><p><strong>Methods: </strong>The MS, PML, MOCL, and the MMN were identified in 14 cadavers(28 hemifaces). Layer-by-layer dissection techniques were carried out in the subcutaneous and subplatysmal planes using 3.5 magnifying surgical loupes.</p><p><strong>Results: </strong>The MS and PML were observed to be continuous with one another, functioning as a supportive structure that limits inferior migration of jowl fat toward the neck. The MOCL was located superiorly 5.79±0.80 mm on the right side, whereas 5.43±0.94mm on the left side to the PML and MS(p>0.05). The MMN was identified inferiorly 8.43±1.91mm on the right side and 8.71±1.94 mm on the left side, to the MS at the gonial angle(p>0.05). At the junction point of the MS and PML, MMN crossed the mandible and continued in the preperiosteally to the mental foramen.</p><p><strong>Conclusions: </strong>The MMN courses inferior to the MS along the masseter muscle and becomes deeper at the anterior margin of the masseter, where it may be at increased risk of injury. These findings may improve surgical awareness during facelift procedures and aid in nerve preservation.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ethical Landscape of Plastic Surgeons Prescribing Weight Loss Medications.","authors":"Rohun Gupta, Jason Lin, Herluf Lund, Sumesh Kaswan","doi":"10.1093/asj/sjag015","DOIUrl":"https://doi.org/10.1093/asj/sjag015","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Technique for Nipple-Areola Reconstruction in Gender Affirming Mastectomies Using Nipple Punch Grafts and Areola Tattooing (NPAT) - A Pilot Study.","authors":"Bardia Amirlak, Tristan Amini, Lauren Kim, Vidhya Nadarajan, Dominic Henn","doi":"10.1093/asj/sjag087","DOIUrl":"https://doi.org/10.1093/asj/sjag087","url":null,"abstract":"<p><strong>Background: </strong>Free nipple-areola grafting (FNAG) is the most common approach for nipple-areola complex (NAC) reconstruction in transgender patients and is often performed in conjunction with double incision mastectomy for chest masculinization. Unwanted consequences of FNAG include graft failure, hypopigmentation as well as circular scarring around the areola.</p><p><strong>Methods: </strong>We developed a novel technique for NAC reconstruction using nipple punch grafts in conjunction with 3D areola tattooing (NPAT). Patient demographics and postoperative complications were reviewed. To compare aesthetic outcomes of NPAT with FNAG, postoperative images of both groups were distributed among public raters using the crowdsourcing platform Amazon MTurk. Raters were asked to rank the aesthetic appearance of each NAC on a 1-7 Likert scale.</p><p><strong>Results: </strong>Eighteen patients (mean age 30 ± 10.74, mean BMI 27 ± 7.36) underwent double incision mastectomy together with NPAT for NAC reconstruction. Mean follow-up was 100 days after surgery. Postoperative complications such as graft loss, partial graft necrosis, hypertrophic/distended scarring were not observed. One patient demonstrated a loss of graft projection, and one patient developed partial graft depigmentation. Across the full sample of 895 public raters, NPAT received significantly higher aesthetic ratings than FNAG (NPAT 5.0 ± 1.5 vs FNAG 4.5 ± 1.8, p < 0.001), a pattern that persisted across different genders and age groups.</p><p><strong>Conclusion: </strong>The NPAT technique is a simple and effective approach to NAC reconstruction in transgender patients, combining the advantages of traditional FNAG and 3D tattooing. Our findings suggest that NPAT may provide an aesthetically superior NAC and potentially reduce complications associated with traditional FNAG.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Age on Complications in Facelift Surgery.","authors":"Neel Vishwanath, Max Mandelbaum, Eduardo Williams-Medina, Osama Darras, Elad Fraiman, Viren Patel, Nicholas R Sinclair, James E Zins","doi":"10.1093/asj/sjag084","DOIUrl":"https://doi.org/10.1093/asj/sjag084","url":null,"abstract":"<p><strong>Background: </strong>Facelift surgery is increasingly performed in older adults, yet data on age-stratified risk remain limited.</p><p><strong>Objectives: </strong>This study updates a prior 2011 single-surgeon series and evaluates whether advancing age, including age greater than 75 years, is associated with complications after facelift surgery.</p><p><strong>Methods: </strong>We retrospectively reviewed 10 years of consecutive primary or secondary facelifts by a single surgeon using extended SMAS or SMAS plication. Demographics, comorbidities, and operative details were recorded. Complications were classified as major (unplanned admission, reoperation, persistent motor nerve injury) or minor (outpatient-managed). Age was analyzed in five strata (less than 60, 60-65, 66-70, 71-75, and 76 or older) and at dichotomous cutoffs (66 years or greater, 71 years or greater, 76 years or greater). Multivariable logistic regression evaluated age-complication associations.</p><p><strong>Results: </strong>541 patients underwent facelift: less than 60 years (28%), 60-65 (24%), 66-70 (24%), 71-75 (17%), and 76 or older (7%). Major complications were rare (0.4%) and did not differ by age (p=0.08). Minor complications occurred in 7.6% of patients and were not associated with age on univariate (p=0.4) or multivariable analysis. On subanalysis, age was not associated with any complication (major or minor) after adjustment, including among patients older than 75 (OR 1.82 [0.51-5.19], p=0.3).</p><p><strong>Conclusions: </strong>In this single-surgeon cohort with strict preoperative screening and standardized management, facelift surgery remained safe across all age groups, including age greater than 75 years. Chronological age alone is therefore not an independent predictor of adverse events after rhytidectomy.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MedSpas: Patient Safety and Accreditation.","authors":"Robert Singer, Mark Jewell, Renato Saltz, Thomas Fiala","doi":"10.1093/asj/sjag085","DOIUrl":"https://doi.org/10.1093/asj/sjag085","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Computed Tomographic Evaluation of Mandibular Bone Morphology Following OnabotulinumtoxinA Treatment of Masseter Muscle Prominence: Results of a 12-Month, Repeat-Treatment, Placebo-Controlled Study in Healthy Adults.","authors":"Sanjay M Mallya, Paul Kostenuik, René Hopfinger, Mansur Ahmad, James Mah, Shawneen Gonzalez, Donna Faletto, Elisabeth Lee, Beta Bowen, Reva Mccaskill, Mitchell F Brin","doi":"10.1093/asj/sjag080","DOIUrl":"https://doi.org/10.1093/asj/sjag080","url":null,"abstract":"<p><strong>Background: </strong>Botulinum neurotoxins (eg, onabotulinumtoxinA) are used off-label to treat masseter muscle prominence (MMP), a benign enlargement of the masseter muscles that may be aesthetically undesirable. Limited evidence suggests botulinum neurotoxin injections into masticatory muscles may adversely affect mandibular morphology, but this has not been rigorously investigated in context of MMP.</p><p><strong>Objective: </strong>To evaluate whether mandibular morphology changes occur in individuals with MMP following bilateral masseter treatment with onabotulinumtoxinA.</p><p><strong>Methods: </strong>In a 12-month, double-blind, placebo-controlled, Phase 2 study, 187 healthy adults with bilateral MMP received 1 or 2 onabotulinumtoxinA treatments (24, 48, 72, or 96 U) or placebo. Multidetector computed tomography (MDCT) scans (baseline, days 90 and 360) were evaluated using quantitative and qualitative mandibular morphology indicators. Adverse events (AEs) were monitored throughout.</p><p><strong>Results: </strong>Quantitative assessments of bigonial width, cortical thickness, mandibular flare, and gonial angles found no differences between onabotulinumtoxinA (n=150) and placebo (n=37). Most participants (94%) showed no qualitative changes to mandibular condylar head (shape, position, cortical surface, and cortical thickness), glenoid fossa, or articular eminence (appearance, cortical surface). No clinically significant changes were identified after repeated qualitative assessments in 12 participants with findings suggestive of post-baseline osteopathic change. The most reported treatment-related AE, mastication disorder (6.0%), was consistent with prior reports following onabotulinumtoxinA masseter treatment for MMP.</p><p><strong>Conclusion: </strong>Quantitative and qualitative MDCT evaluations showed no detectable differences in predefined mandibular morphometric measures versus placebo after 1 or 2 onabotulinumtoxinA treatments for MMP over 1 year. Safety events were localized and consistent with drug mechanism. Late-emerging effects beyond 12 months cannot be excluded.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Optimizing Cannula Selection for Filler Injection in Accordance With Vascular Anatomy, Injection Technique, and Cannula Design.","authors":"Kyuho Yi","doi":"10.1093/asj/sjag086","DOIUrl":"https://doi.org/10.1093/asj/sjag086","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}