Aesthetic Surgery Journal最新文献

{"title":"Feasibility of an AI-driven Classification of Tuberous Breast Deformity: A Siamese Network Approach with a Continuous Tuberosity Score.","authors":"Stefano Vaccari, Alberto Paderno, Simone Furlan, Mattia Federico Cavallero, Alessandro Marco Lupacchini, Riccardo Di Giuli, Marco Klinger, Francesco Klinger, Valeriano Vinci","doi":"10.1093/asj/sjaf090","DOIUrl":"https://doi.org/10.1093/asj/sjaf090","url":null,"abstract":"<p><strong>Background: </strong>Tuberous breast deformity (TBD) is a congenital condition characterized by constriction of the breast base, parenchymal hypoplasia, and areolar herniation. The absence of a universally accepted classification system complicates diagnosis and surgical planning, leading to variability in clinical outcomes. Artificial intelligence (AI) has emerged as a powerful adjunct in medical imaging, enabling objective, reproducible, and data-driven diagnostic assessments.</p><p><strong>Objectives: </strong>This study introduces an AI-driven diagnostic tool for tuberous breast deformity (TBD) classification using a Siamese Network trained on paired frontal and lateral images. Additionally, the model generates a continuous Tuberosity Score (ranging from 0 to 1) based on embedding vector distances, offering an objective measure to enhance surgical planning and improved clinical outcomes.</p><p><strong>Methods: </strong>A dataset of 200 expertly classified frontal and lateral breast images (100 tuberous, 100 non-tuberous) was used to train a Siamese Network with contrastive loss. The model extracted high-dimensional feature embeddings to differentiate tuberous from non-tuberous breasts. Five-fold cross-validation ensured robust performance evaluation. Performance metrics included accuracy, precision, recall, and F1-score. Visualization techniques, such as t-SNE clustering and occlusion sensitivity mapping, were employed to interpret model decisions.</p><p><strong>Results: </strong>The model achieved an average accuracy of 96.2% ± 5.5%, with balanced precision and recall. The Tuberosity Score, derived from the Euclidean distance between embeddings, provided a continuous measure of deformity severity, correlating well with clinical assessments.</p><p><strong>Conclusions: </strong>This AI-based framework offers an objective, high-accuracy classification system for TBD. The Tuberosity Score enhances diagnostic precision, potentially aiding in surgical planning and improving patient outcomes.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101316","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":"Measuring Satisfaction With Minimally Invasive Aesthetic Treatments With the SKIN-Q Treatment Outcome Scale.","authors":"Anne F Klassen, Charlene Rae, Lucas Gallo, Stefan Cano, Manraj Kaur, Steven Dayan, Katie Armstrong, Lotte Poulsen, Elena Tsangaris, Katherine B Santosa, Andrea L Pusic","doi":"10.1093/asj/sjaf075","DOIUrl":"https://doi.org/10.1093/asj/sjaf075","url":null,"abstract":"<p><strong>Background: </strong>A key outcome in aesthetic treatments is the patient's view of how their skin looks and feels after a treatment.</p><p><strong>Objectives: </strong>To add a Treatment Outcome scale to the SKIN-Q patient-reported outcome measure.</p><p><strong>Methods: </strong>Concept elicitation interviews were performed with patients recruited from clinics in Canada and the USA. Data were coded, analyzed, and used to draft a Treatment Outcome scale. The scale was refined with patient and expert feedback and field tested in an online sample (i.e., Prolific). Rasch measurement and classical test theory psychometric analyses were performed to examine scale reliability and validity.</p><p><strong>Results: </strong>The concept elicitation interviews included 26 participants. The first draft of the Treatment Outcome scale included 32 items that assessed changes in appearance (e.g., look better) and wellbeing (e.g., feel more confident). Items were revised with input from 12 experts, 11 patients, and 174 online participants who had aesthetic face and/or body treatments and provided 180 survey responses, resulting in 36 items. Prolific data were collected from 499 participants who provided 542 assessments. The sample comprised 80.6% women; 78.8% had a facial treatment, 11.4% had a body treatment, and 9.8% had both a facial and body treatment. Data for a final 10-item Treatment Outcome scale fit the Rasch model (Chi-square = 50.46, df=40, p=0.124). The scale evidenced high reliability, with a person separation index and Cronbach alpha values >0.87. A total of 20/22 (91%) pre-defined construct validation hypotheses were accepted. A total of 136 participants completed the Treatment Outcome scale a second time within 7-14 days. The intraclass correlation coefficient for the test-retest was 0.89 (95% CI 0.85, 0.92).</p><p><strong>Conclusions: </strong>This new SKIN-Q scale can be used alongside other patient-centered outcome tools to measure how patients look and feel after minimally invasive aesthetic treatments for the body and/or face.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109405","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 Effect of Patient Involvement in Implant Size Selection on Satisfaction With Breast Size: An Analysis of 1,840 Primary Augmentations.","authors":"Jerzy Kolasinski, Malgorzata Kolenda, Szymon Kolacz, Anna Kasielska-Trojan","doi":"10.1093/asj/sjaf085","DOIUrl":"https://doi.org/10.1093/asj/sjaf085","url":null,"abstract":"<p><strong>Background: </strong>Aesthetic breast surgery is a specific field, in which the aim is not to achieve any universally defined standard, but to meet the patient's expectations.</p><p><strong>Objectives: </strong>The aim of the study was to determine the proportion of women who were dissatisfied with breast size following primary breast augmentation and decided for revision. The study presents and verifies an algorithm for breast implant selection which involves the patient in the decision-making process.</p><p><strong>Methods: </strong>A retrospective analysis was performed of medical charts from January 2012 to December 2022 from one private center. The final analysis included 1840 patients. All had implants chosen according to the Patient Decision-Making Process on Implant Size Selection (PIS).</p><p><strong>Results: </strong>Of the studied cases, 18 decided for implant exchange due to dissatisfaction with breast size (0.98%). This group differed significantly from the controls (n=1822) in the following aspects: lower BMI during primary procedure, lower mean implant volume and shorter follow-up. In all but two women, mean BMI increased by 1 unit before revisional surgery (from 19.7 to 20.6).</p><p><strong>Conclusions: </strong>Dissatisfaction with breast implant size is a rare cause of revision in breast augmentation surgery when the patient is involved in the final decision on the volume of the implants. The presented algorithm (PIS) yielded less than 1% dissatisfaction with breast size in a long-term follow-up.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075458","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":"Utilizing Generative Text-to-Image AI Models to Explore Race, Gender, and Age in Plastic and Aesthetic Surgery.","authors":"Maissa Trabilsy, Arianna Genovese, Srinivasagam Prabha, Sahar Borna, Cesar A Gomez-Cabello, Syed Ali Haider, Cui Tao, Antonio J Forte","doi":"10.1093/asj/sjaf084","DOIUrl":"10.1093/asj/sjaf084","url":null,"abstract":"<p><strong>Background: </strong>It is unclear how representative and inclusive of various patient populations generative text-to-image AI models are.</p><p><strong>Objectives: </strong>This project explores the diversity of race, gender, and age in the images generated by AI models: DALL-E3, Midjourney, and Adobe Firefly, in response to prompts focused on liposuction, blepharoplasty, and rhinoplasty.</p><p><strong>Methods: </strong>Prompts were designed to prompt the AI model to generate images of surgical outcomes for liposuction, blepharoplasty, and rhinoplasty for each gender, race and age combination: male vs. female, Caucasian or white, Black or African American, Latino or Hispanic, and age groups: 20-30 years, 31-45 years, and 46+ years. Each generated image was evaluated for representation of skin color by Fitzpatrick and Monk scales, sex parity using a 4-item questionnaire, and the incorporation of Westernized beauty standards. Analysis was then conducted, utilizing the Kruskal-Walis test or the Fischer's exact test between the 3 models (p<0.05).</p><p><strong>Results: </strong>There was no significant difference between the representation of light skin color (Fitzpatrick I-III & Monk 1-5) vs. dark skin color (Fitzpatrick IV-VI & Monk 6-10) between the models (p=0.26 & p=0.31). A significant difference was found between the models and between females vs. males regarding aging (p<0.0001 & p=0.0009). There were also significant differences found for the depiction of clear skin (p <0.0001), large and/or light-colored eyes (p=0.0010), and narrow noses (p<0.0001).</p><p><strong>Conclusions: </strong>Although there is fair representation of light skin colors and dark skin colors across the models, the depiction of gender bias and Westernized beauty standards can be improved.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075464","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 Medicolegal Challenges of Facial Plastic Surgery: A Systematic Review.","authors":"Saule A Mussabekova, Yuliya Menchisheva, Álvaro Varela Morillas","doi":"10.1093/asj/sjaf082","DOIUrl":"10.1093/asj/sjaf082","url":null,"abstract":"<p><p>Facial plastic surgery is associated with a growing number of medico-legal challenges, particularly due to postoperative complications and patient dissatisfaction. This systematic review aimed to examine the medico-legal challenges associated with facial plastic surgery, focusing on postoperative complications, patient dissatisfaction, litigation cases, and medico-legal risk factors. A comprehensive literature search was conducted in MEDLINE (National Library of Medicine; Bethesda, MD), EMBASE (Elsevier; Amsterdam, the Netherlands), Cochrane Library (Wiley; Hoboken, NJ), PubMed (National Library of Medicine), Web of Science (Clarivate Analytics; Philadelphia, PA), SCOPUS (Elsevier), and Google Scholar (Alphabet Inc., Mountain View, CA) from 2020 to 2024. Medico-legal cases related to facial aesthetic surgeries were included. In total, 27 studies met the inclusion criteria. The leading causes of litigation included unsatisfactory aesthetic outcomes, failure of informed consent, technical surgical errors, and inadequate postoperative follow-up. The highest litigation rates were reported in countries with high volumes of plastic surgery cases and stringent regulations. This review highlights the increasing medico-legal burden in aesthetic surgery. Informed consent, postoperative monitoring, and technical precision are crucial for mitigating risks and preventing malpractice claims. The study synthesized medico-legal trends across all major facial aesthetic surgeries. It incorporated a global perspective, analyzing litigation data from over 10 countries, which is uncommon in most similar studies.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075460","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":"Intrathecal Morphine vs Paravertebral Nerve Blocks for Analgesia After Breast Reconstruction With Abdominally Based Free Flaps.","authors":"Matthew W Swisher, Austin T Nguyen, Miriam Becker, Jacklynn F Sztain, Wendy B Abramson, Paige S Tsuda, Brenton S Alexander, Chris M Reid, Engy T Said","doi":"10.1093/asj/sjaf043","DOIUrl":"10.1093/asj/sjaf043","url":null,"abstract":"<p><strong>Background: </strong>Breast reconstruction with abdominally based free flaps can be associated with more significant acute pain and longer hospital stays than implant-based techniques. As new pain management strategies are developed, there have not been any studies conducted to analyze the analgesic effects of intrathecal morphine (ITM) for patients undergoing abdominally based free flap reconstruction.</p><p><strong>Objectives: </strong>The primary outcome analyzed in this retrospective study was opioid consumption, which was measured from the postoperative anesthesia care unit (PACU) through postoperative day (POD) 2. Secondary outcomes of the study analyzed included factors such as pain scores, hospital length of stay (LOS), and adverse effects.</p><p><strong>Methods: </strong>Fifty-one patients presented for breast reconstruction with abdominally based free flaps and received ITM for postoperative analgesia. Results obtained were compared with a cohort that included an equal number of patients who received paravertebral nerve blocks (PVBs).</p><p><strong>Results: </strong>Results showed that patients who received ITM displayed a lower median consumption in the PACU (0 mg vs 12.5 mg MEQ; P = .009), from PACU to POD 1 (0 mg vs 7.5 mg MEQ; P = .046), and POD 1 to POD 2 (7.5 mg vs 30 mg MEQ; P = .002) when compared with those who received PVBs. Those who received ITM also had lower median pain scores in the PACU and from PACU to POD 1 and a decreased LOS. There were similar rates of adverse events.</p><p><strong>Conclusions: </strong>ITM improves postoperative analgesia after abdominally based free flaps when compared to PVBs and may facilitate recovery and earlier discharge.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"605-610"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on: Patient Factors That Impact FACE-Q Aesthetics Outcomes: An Exploratory Cross-sectional Regression Analysis.","authors":"Aaron Lee Wiegmann, Sammy Sinno","doi":"10.1093/asj/sjaf046","DOIUrl":"10.1093/asj/sjaf046","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"552-553"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662076","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":"Efficacy and Safety of CBL-514 Injection in Reducing Abdominal Subcutaneous Fat: A Randomized, Single-Blind, Placebo-Controlled Phase II Study.","authors":"Michael Gold, Joel Schlessinger, Greg J Goodman, Steven Dayan, Janet DuBois, Yu-Fang Ling, An-Yi Sheu, Wilson W S Ho, Yin-Chia Chou","doi":"10.1093/asj/sjaf032","DOIUrl":"10.1093/asj/sjaf032","url":null,"abstract":"<p><strong>Background: </strong>A small-molecule injectable drug, CBL-514, has shown promising efficacy and safety for subcutaneous fat reduction.</p><p><strong>Objectives: </strong>To further evaluate the efficacy and safety of CBL-514 for abdominal subcutaneous fat reduction.</p><p><strong>Methods: </strong>In this single-blind, randomized, parallel-group, placebo-controlled Phase 2 trial, 76 participants were randomized (2:1) to receive up to 4 CBL-514 treatments (2 mg/cm2, maximum 600 mg/treatment) or placebo, administered subcutaneously to the abdomen every 4 weeks. Two follow-up visits were conducted at 4 and 8 weeks following final treatment. Changes in abdominal subcutaneous fat thickness and volume were measured by ultrasound. The primary endpoint was the proportion of participants with subcutaneous fat volume loss of ≥150 mL from baseline compared with placebo.</p><p><strong>Results: </strong>In the intention-to-treat population, a significantly higher proportion of CBL-514-treated participants achieved ≥150 mL subcutaneous fat volume reduction from baseline compared with placebo-treated participants at both follow-up visits. At 8 weeks post final treatment, 69.6% of CBL-514-treated participants lost ≥150 mL subcutaneous fat, compared with none in the placebo group (P < .001). Moreover, 60.9% of participants in the CBL-514 group further achieved the ≥200 mL subcutaneous fat loss threshold. Of the 28 participants in CBL-514 group (n = 50) who lost ≥150 mL subcutaneous fat, 42.9% (12/28 participants) achieved this target after a single treatment. The most common treatment-emergent adverse events were injection site reactions and were of mild-to-moderate severity.</p><p><strong>Conclusions: </strong>CBL-514 treatment significantly reduced abdominal subcutaneous fat volume with a favorable safety profile. As a noninvasive treatment, CBL-514 could be a new, promising alternative therapy for effective targeted subcutaneous fat reduction.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"611-620"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closed Preservation Rhinoplasty in the Mestizo Patient: Challenges and Techniques for Nasal Tip Support.","authors":"Cesar Valdivia, Paul D Durand, Baris Çakir","doi":"10.1093/asj/sjaf017","DOIUrl":"10.1093/asj/sjaf017","url":null,"abstract":"<p><strong>Background: </strong>Closed preservation rhinoplasty continues to grow in popularity. Nevertheless, many surgeons remain wary of performing closed preservation rhinoplasty in certain patient populations. Mestizo noses have a thick soft-tissue envelope and weak nasal tip support. These inherent characteristics have led many surgeons to favor open structural techniques when addressing the tip in the mestizo patient.</p><p><strong>Objectives: </strong>The aim of this article was to describe a set of techniques that have been successfully utilized by the authors to maximize tip support and definition when performing closed preservation rhinoplasty in a patient population for which structural techniques were once thought to be the only viable option.</p><p><strong>Methods: </strong>A total of 417 primary rhinoplasty cases were studied retrospectively between January 2022 and December 2023. All the cases were performed by a closed approach and with dorsal preservation of the soft-tissue envelope. All patients underwent 1 of 4 types of surgical technique for the tip area: Type I, 105 patients; Type II, 124 patients; Type III, 181 patients; Type IV, 7 patients.</p><p><strong>Results: </strong>Of the 417 patients, 331 (79.3%) were female and 86 (20.6%) were male. Patient age ranged from 15 to 66 years, with a median age of 23 years. Patients were followed for a period of 6 months to 1 year postoperatively. Seven patients underwent revision surgery (1.7%).</p><p><strong>Conclusions: </strong>Even with its various potential benefits, there is still apprehension about performing closed preservation rhinoplasty in certain patient populations. The authors present several techniques that have been successfully utilized to maximize tip support and definition when performing closed preservation rhinoplasty in the mestizo patient.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"568-573"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057647","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":"Commentary on: Aesthetic Efficacy and Safety of Combined Microfocused Ultrasound With Visualization and Calcium Hydroxylapatite Treatment: A Systematic Review of Human Evidence.","authors":"Lawrence S Bass","doi":"10.1093/asj/sjaf020","DOIUrl":"10.1093/asj/sjaf020","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"643-644"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253984","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}