Aesthetic Surgery Journal最新文献

{"title":"Preservation Breast Augmentation Under Sedation Is a Low-Pain Procedure: A Randomized Controlled Trial of Serratus Anterior Plane Block as an Adjunct.","authors":"Burak Ergün Tatar, Ezgi Polat, Emirhan Kahraman, Ferhat Şimşek, Mehmet Aydın, Burak Özkan","doi":"10.1093/asj/sjag188","DOIUrl":"https://doi.org/10.1093/asj/sjag188","url":null,"abstract":"<p><strong>Background: </strong>Preservation breast augmentation (PBA) is an intralamellar technique preserving the pectoralis major muscle, circummammary ligament, and Cooper's suspensory ligaments. Its perioperative pain profile and the value of regional anesthesia adjuncts remain uncharacterized.</p><p><strong>Objectives: </strong>To characterize the perioperative pain profile of PBA under local anesthesia and sedation, and to determine whether a preoperative deep SAP block reduces intraoperative analgesic requirements and early postoperative pain.</p><p><strong>Methods: </strong>This prospective, randomized, single-blind trial enrolled 40 women undergoing PBA. Patients were randomized 1:1 to a preoperative deep SAP block (20 mL of 0.25% bupivacaine bilaterally) or standard care; all procedures used tumescent local anesthesia and propofol sedation. Endpoints included 24-hour NRS score, rescue propofol and fentanyl consumption, hemodynamic response, and postoperative analgesic use.</p><p><strong>Results: </strong>Baseline characteristics were comparable. The SAP group required less rescue propofol (45 ± 3 vs. 55 ± 4 mg; p < 0.001; d = 2.83) and fentanyl (12 ± 5 vs. 22 ± 9 µg; p < 0.001; d = 1.37). NRS scores favored the SAP group at 60 min (3.4 vs. 4.5; p = 0.011) and 6 h (3.8 vs. 4.7; p = 0.035), converging by 24 h (3.4 vs. 3.2; p = 0.377); both groups remained within a low pain range (NRS ≤ 3.5). No major complications occurred.</p><p><strong>Conclusions: </strong>PBA under local anesthesia and sedation is associated with a consistently low perioperative pain profile. The SAP block provides a clinically meaningful intraoperative analgesic advantage and improves early postoperative comfort, supporting selective rather than routine use.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896344","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":"Autologous Fat Grafting for Breast Augmentation and Breast Remodeling: A Systematic Review and Meta-analysis of Complications, Radiologic Outcomes, Graft Retention, and Patient-Reported Satisfaction.","authors":"Pietro Gentile, Aris Sterodimas","doi":"10.1093/asj/sjag187","DOIUrl":"https://doi.org/10.1093/asj/sjag187","url":null,"abstract":"<p><p>Autologous fat grafting (AFG) is increasingly used for aesthetic breast augmentation and remodeling because it provides natural tissue augmentation without permanent implants. This systematic review and meta-analysis evaluated complications, radiologic outcomes, graft retention, and patient satisfaction following AFG. A PRISMA 2020-compliant search identified 40 primary clinical studies including 5,684 patients. The risk of bias was assessed using the RoB2, ROBINS-I, and Newcastle-Ottawa Scale. Random-effects meta-analysis used restricted maximum likelihood estimation as the primary model, with Hartung-Knapp adjustment and DerSimonian-Laird and Paule-Mandel estimators in sensitivity analyses. Mean follow-up exceeded 6 months. The pooled complication rate was 25.9% (95% CI, 22.4-29.6), mainly consisting of minor radiologic or palpable findings; fat necrosis was the most common adverse event. Benign radiologic findings included fat necrosis (8.8%) and calcifications (1.1%), without evidence of impaired cancer detection. Mean injected fat volume was 310 mL per breast. Twelve-month volume retention was 61.3% (95% CI, 57.1-65.4), with higher retention in SVF/PRP-enriched grafts (68.9% vs 56.1%; p<0.01), although evidence remained heterogeneous. Patient satisfaction was 93.1% (95% CI, 90.4-95.8), despite heterogeneous PROMs. Heterogeneity was substantial for complications (I2=78%; τ2=0.021; Q=177.6; p<0.001) and volume retention (I2=82%; τ2=0.067; Q=216.4; p<0.001), and moderate for radiologic outcomes (I2=52%; τ2=0.008; Q=81.3; p<0.001), reflecting variability in techniques, imaging, processing, enrichment, assessment methods, and follow-up. Current observational evidence supports favorable safety profiles; however, oncologic outcomes were not quantitatively pooled, and prospective comparative studies with standardized reporting are required.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890871","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 Science of Modern Breast Implants: A Qualitative and Quantitative Comparison of Silicone Breast Devices.","authors":"Khaled Alameddine, Shikhar Tomur, William P Adams","doi":"10.1093/asj/sjag185","DOIUrl":"https://doi.org/10.1093/asj/sjag185","url":null,"abstract":"<p><strong>Background: </strong>Breast implants remain the cornerstone of aesthetic and reconstructive breast surgery, yet surgeon device selection is frequently driven by manufacturer marketing, social media, and brand loyalty rather than objective scientific data.</p><p><strong>Objectives: </strong>To provide a comprehensive, side-by-side qualitative and quantitative comparison of current-generation silicone gel breast implants from the four major United States manufacturers, characterizing each device's gel, shell, and gel-shell interface properties.</p><p><strong>Methods: </strong>Two unopened, current-generation implants were obtained from each of Allergan (Inspira Responsive, Inspira SoftTouch), Mentor (MemoryGel BOOST, MemoryGel Xtra), Motiva (Ergonomix, Round), and Sientra (106/HSC, 107/HSC+). Eight assessment methods were applied: still-photo tilt-table analysis, time-in-motion video analysis, gel-shell pinch-roll testing, BTC 2000 biomechanical gel evaluation, tensiometer gel-shell peel testing, in vivo high-resolution ultrasound imaging, blinded patient tactile assessment, and matrix usability scoring.</p><p><strong>Results: </strong>Mentor MemoryGel BOOST demonstrated the most form-stable gel across all five BTC 2000 parameters, the longest pinch-roll endpoint, and the longest tensiometer peel time with significant retained gel, indicating the strongest gel-shell interaction. Despite this form stability, BOOST was the third-highest-rated implant on blinded patient tactile assessment, with MemoryGel Xtra ranked first. Sientra 106 was consistently the least form-stable. Allergan implants demonstrated the highest ultrasound shell visualization clarity. Allergan also achieved the highest matrix usability score, reflecting broad profile diversity across aesthetic and reconstructive applications.</p><p><strong>Conclusions: </strong>Current silicone gel breast implants demonstrate measurable, manufacturer-specific differences in gel behavior, shell properties, gel-shell interaction, sonographic appearance, and clinical applicability. These findings support a paradigm shift toward science-driven implant selection and provide objective data to guide surgeon decision-making.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890929","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":"Tranexamic Acid Concentration and Flap Survival in Rats.","authors":"Ertuğrul Karanfil, Metin Görgü, Berkalp Berker, Ümit Ozan Özlen, Süleyman Mert Kılıç, Yasin Burak Bozdemir","doi":"10.1093/asj/sjag183","DOIUrl":"https://doi.org/10.1093/asj/sjag183","url":null,"abstract":"<p><strong>Background: </strong>Random-pattern skin flaps are prone to distal necrosis, a major challenge in reconstructive surgery. Tranexamic acid (TXA) reduces perioperative bleeding, but its impact on flap viability remains controversial.</p><p><strong>Objectives: </strong>To investigate the concentration-dependent effects of local TXA application on random-pattern flap survival, with and without surgical delay, in the McFarlane dorsal rat flap model.</p><p><strong>Methods: </strong>Sixty-four female Wistar albino rats were randomized into eight groups (n=8): control, TXA 10, 30, and 100 mg/mL, delayed control, and delayed TXA at the same concentrations. A 3×9 cm caudal-based dorsal flap was elevated and 1 mL of saline or TXA was administered locally before closure. Flap necrosis was quantified using ImageJ software. Two-way ANOVA assessed the independent effects of delay and TXA concentration; subgroup analyses used one-way ANOVA with Tukey HSD (non-delayed) and Kruskal-Wallis with Dunn's test (delayed).</p><p><strong>Results: </strong>High-concentration TXA (100 mg/mL) significantly increased necrosis in non-delayed flaps (40.39% ± 7.41%, p = 0.016 vs. control). Delayed flaps showed markedly reduced necrosis across all groups (delayed control: 1.00% ± 1.45%, p < 0.001). No significant differences were observed among delayed subgroups regardless of TXA concentration. Two-way ANOVA identified the delay procedure as the dominant main effect (F(1,56) = 665.97, p < 0.001, partial η2 = 0.922).</p><p><strong>Conclusions: </strong>High-concentration local TXA impairs random-pattern flap survival, while low-concentration TXA (10 mg/mL) appears well tolerated. The surgical delay procedure markedly reduces TXA-associated necrosis risk across all concentrations. Careful concentration selection is recommended when TXA is used in cutaneous flap surgery.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886018","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":"Effectiveness, Patient Satisfaction, and Safety of a Next-generation PLLA Collagen Biostimulator for Nasolabial Fold Augmentation: 12-month Results of a Prospective Multicenter Study.","authors":"Adriana Ribe, Ulrika Erhardt, Karina De Almeida Caramico, Émilie Souton-Al Gburi, Franco Grimolizzi, Per Hedén","doi":"10.1093/asj/sjag180","DOIUrl":"https://doi.org/10.1093/asj/sjag180","url":null,"abstract":"<p><strong>Background: </strong>Poly-L-lactic acid (PLLA) dermal fillers induce neocollagenesis through a bioinductive mechanism rather than facial tissue volumization. The next-generation PLLA-LASYNPRO formulation (LASYNPRO, Lactic Acid Induced Synthesis of Collagen Protein), a biomaterial-microsphere technology developed for regenerative aesthetic biostimulation, composed of uniform, non-porous microspheres, has been proposed as an evolution of earlier PLLA products, offering a more controlled, lower-inflammatory regenerative pathway. Efficacy data for nasolabial fold (NLF) correction are emerging, but patient-reported outcomes remain underreported.</p><p><strong>Objectives: </strong>To evaluate patient-reported outcomes, aesthetic self-perception, and treatment satisfaction over 12 months following JULÄINE (PLLA-LASYNPRO) treatment for NLF correction.</p><p><strong>Methods: </strong>Prospective, single-arm, multicenter post-market clinical follow-up (PMCF) investigation enrolling 60 subjects. Subjects received up to 3 bilateral NLF injections of JULÄINE™ at 2- to 4-week intervals. Patient-reported outcomes included FACE-Q Appraisal of Lines (Nasolabial Folds), FACE-Q Satisfaction with Outcome, the Global Aesthetic Improvement Scale (GAIS), and a 12-item subject satisfaction questionnaire, assessed at 6 and 12 months after the final injection.</p><p><strong>Results: </strong>At 12 months, the FACE-Q Appraisal of Lines score improved by a mean of 20.7 points (P<.0001; d=1.14), a large effect that continued to grow between 6 and 12 months. Subject GAIS responder rate was 83.3% at both timepoints. More than 90% of subjects reported natural-looking results; 83%-85% would repeat the treatment; 90%-94% would recommend it. Overall satisfaction was 88.9% at 6 months and 77.8% at 12 months. No serious adverse events or device deficiencies were reported.</p><p><strong>Conclusions: </strong>JULÄINE produced sustained, clinically meaningful improvements in patient-perceived aesthetic outcomes with high treatment satisfaction over 12 months. The consistent perception of natural-looking results is in line with the progressive, collagen-building mechanism of PLLA-LASYNPRO.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872717","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":"Long-term Clinical Outcomes of Autologous Non-activated Platelet-rich Plasma (A-PRP) Delivered Through Mechanical and Controlled Infiltration in Male and Female Androgenetic Alopecia: A 10-year Prospective Randomized Evaluator-blinded Study.","authors":"Pietro Gentile","doi":"10.1093/asj/sjag181","DOIUrl":"https://doi.org/10.1093/asj/sjag181","url":null,"abstract":"<p><strong>Background: </strong>Androgenetic alopecia (AGA) is the most common cause of progressive hair loss in men and women and is associated with significant psychosocial distress. Platelet-rich plasma (PRP) is a regenerative therapy that stimulates follicular activity, angiogenesis, and dermal papilla activation through growth factor release.</p><p><strong>Objectives: </strong>This prospective randomized evaluator-blinded clinical trial evaluated the long-term efficacy and safety of autologous non-activated PRP (A-PRP) delivered through a standardized mechanical and controlled infiltration protocol.</p><p><strong>Methods: </strong>Between January 2015 and January 2025, 234 patients with AGA were enrolled, including 135 men (Norwood-Hamilton I-IV) and 99 women (Ludwig I-II); 25 patients had previous confirmed COVID-19 infection. Patients received three A-PRP sessions at 30-day intervals with intradermal administration of 0.2 mL/cm2. Hair density (HD), hair thickness (HT), and total hair count (HC) were assessed by computerized trichoscopy and phototrichogram analysis at baseline, 12, 36, 60, and 120 months.</p><p><strong>Results: </strong>At 12 months, HD increased by 31.4%, HT by 26.8%, and HC by 29.7% compared with baseline (p < 0.001). HD remained above baseline at 36 months (+24.1%) and 60 months (+17.3%). At 120 months, patients receiving maintenance treatment showed an 11.2% improvement. Female patients demonstrated greater preservation of hair shaft diameter. No significant differences were observed according to previous COVID-19 infection, and no severe adverse events occurred.</p><p><strong>Conclusions: </strong>Standardized A-PRP infiltration provides a safe and effective regenerative approach for AGA, with maintained clinical improvement during long-term follow-up. These findings support the role of standardized delivery protocols in improving reproducibility and therapeutic consistency in regenerative hair restoration.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872715","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 Modified Delphi Study on the Ethics and Governance of Live Injecting at Aesthetic Conferences. Is There a Better and Safer Alternative?","authors":"Greg J Goodman, Mark R Magnusson, Eqram Rahman, Sarah G Boxley, Narendra Kumar, Andrew Clark, Hema A Sundaram, Frank Lin, Michael Clague, Niamh Corduff, Sarah Hart, Peter Callan, Stefania Roberts, Cara B McDonald, Alice Rudd, Katy Wallace, Antoinette Ciconte, Anita Patel, Sean Arendse, Aakriti Gupta, Terence Poon, Catherine E Porter, Philip Bekhor, Lee-Mei Yap, Firas Al-Niaimi, Adrian Lim, Howard M Studniberg, Maeve A Ahern, Angelo Tsirbas, Richard Webb William, Zallmann Michaela, Somia Naveen","doi":"10.1093/asj/sjag179","DOIUrl":"https://doi.org/10.1093/asj/sjag179","url":null,"abstract":"<p><strong>Background: </strong>Live clinical demonstrations at aesthetic medicine conferences is common, yet concerns regarding patient safety, commercial influence, and ethical governance. This study established a consensus-based governance framework for live injecting and compared expert and attendee perspectives.</p><p><strong>Methods: </strong>A two-stage modified Delphi process involved an international expert panel (n=31) alongside a cross-sectional attendee survey of conference (n=218). Round 1 included 46 statements addressing clinical safety, ethics, educational value, commercial influence, and governance, with consensus predefined as ≥70% agreement. Unresolved statements were refined in Round 2. A 23-item modified survey assessed attendee views on live injecting and alternative educational formats.</p><p><strong>Results: </strong>Experts demonstrated strong consensus on key governance requirements. A voluntary code of conduct was supported by 96.6% of experts and that formal tripartite agreements between injector, host clinician, and organiser be required (93.1%) and that the practitioner assuming medico-legal responsibility must be physically present during demonstrations (89.7%). Experts identified performance pressure (95.7%) and unsafe modelling for less experienced practitioners (91.3%) as significant risks. Attendees favoured alternatives: 74% preferred small-group teaching over auditorium demonstrations, and 82% would still attend conferences if live injecting were replaced by high-quality recorded demonstrations.</p><p><strong>Conclusion: </strong>Live injecting demonstrations retain conditional support but require stronger clinical governance to ensure patient safety and ethical practice. Findings support standardised oversight mechanisms, including in-person clinical supervision, defined medico-legal accountability, and a formal code of conduct. Small-group teaching and high-definition recorded demonstrations, may offer safer, equally effective alternatives for procedural education.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872674","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":"Establishing Normative Data on Satisfaction with Nasal Appearance: a Dutch Population-Based Study Using Aesthetic Rhinoplasty Outcome Instruments.","authors":"Melody Kasapov, Pedro M Afonso, Frank R Datema, Floris V W J van Zijl","doi":"10.1093/asj/sjag177","DOIUrl":"https://doi.org/10.1093/asj/sjag177","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of aesthetic rhinoplasty increasingly relies on patient-reported outcome measures (PROMs). However, the absence of population-based normative data limits accurate interpretation of these outcomes.</p><p><strong>Objectives: </strong>This study aimed to establish population-based normative scores for aesthetic rhinoplasty PROMs in a representative Dutch sample, thereby enhancing their interpretability. A secondary objective was to evaluate the influence of demographic factors on nasal appearance satisfaction.</p><p><strong>Methods: </strong>A sample representative of the Dutch general population was obtained via an online panel. Participants completed 4 frequently used aesthetic rhinoplasty PROMs: the Utrecht Questionnaire (UQ), the SCHNOS cosmetic subscale, the FACE-Q rhinoplasty module, and the Numeric Rating Scale (NRS). Average scores were calculated for each PROM, and ordinal regression was employed to evaluate associations between nasal satisfaction and demographic variables, including age, gender, migration background, education, income, and residence.</p><p><strong>Results: </strong>The weighted sample (n=1,134) showed high overall satisfaction with nasal appearance (mean UQ=6.28, SCHNOS-C=11.38, FQnose=75.2, FQnostrils=80.09, NRS=7.67). Aesthetic satisfaction significantly increased with age for all PROMs, with this shift occurring more rapidly in males. Individuals with a non-Western background reported significantly lower satisfaction in FQnose (OR 1.819, p=0.004), FQnostrils (OR 1.586, p=0.031), and SCHNOS-C (OR 0.417, p<0.001). Gender, education, income, and residence did not significantly affect satisfaction.</p><p><strong>Conclusions: </strong>This study provides normative benchmarks for aesthetic rhinoplasty PROMs, filling a critical literature gap. The general population exhibits high nasal appearance satisfaction. The significant influence of age and migration background highlights the complexity of aesthetic perception and underlines the necessity of patient-centered benchmarks to interpret aesthetic rhinoplasty outcomes.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863558","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":"Vision Loss Following Nonsurgical Rhinoplasty Injections: Systematic Review of Cases and Management.","authors":"Evan S Pistone, Manav M Patel, Kimberley Brondeel, Philong Nguyen, J Micheal Smith","doi":"10.1093/asj/sjag174","DOIUrl":"https://doi.org/10.1093/asj/sjag174","url":null,"abstract":"<p><p>Vision loss following nonsurgical rhinoplasty with dermal fillers is a rare but catastrophic complication. This systematic review synthesizes reported cases of visual impairment after nasal filler injection, focusing on mechanisms of injury, risk factors, management strategies, and outcomes. A systematic search of Scopus, Ovid Medline, and CINAHL was performed using terms related to visual changes, dermal fillers, and nonsurgical rhinoplasty. After duplicate removal, 1,498 unique articles were screened using predefined inclusion and exclusion criteria. Data were extracted independently by three reviewers, and descriptive statistics summarized patient demographics, injection sites, filler types, treatments, and outcomes. Twenty-one articles met inclusion criteria, comprising 22 cases of vision loss. The mean patient age was 33.4 years, and 90.9% of patients were female. Hyaluronic acid was the most commonly used filler (50%). Vision loss occurred immediately after injection in 82% of cases. Injection site was reported for 18 patients (86%), with 5 patients (24%) receiving injections in multiple locations. The nasal bridge or dorsum was the most frequent injection site (12 patients, 57%), followed by the glabellar region (6 patients, 29%). Full visual recovery occurred in only 27% of cases, requiring an average of 5.3 months. Vision loss was often immediate and irreversible despite treatment with hyaluronidase, corticosteroids, and antibiotics. Hyperbaric oxygen therapy showed promise and warrants further study. Prevention through careful technique, detailed anatomical knowledge, and prompt intervention remains essential.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838636","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: Unnecessary Roughness: Why Surface Topography and Host Response Interpretation Matter.","authors":"Ronika S Leang, Nathan R Chan, Sally M Winkler, Taylor M Levee, Allen Gabriel","doi":"10.1093/asj/sjag171","DOIUrl":"https://doi.org/10.1093/asj/sjag171","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811776","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}