Aesthetic Surgery Journal最新文献

{"title":"Correction to: Decoding the Implications of Glucagon-like Peptide-1 Receptor Agonists on Accelerated Facial and Skin Aging.","authors":"","doi":"10.1093/asj/sjaf039","DOIUrl":"https://doi.org/10.1093/asj/sjaf039","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673131","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":"Treatment of the High Iliac Crest with Iliac Crest Reduction (XCREST).","authors":"Raúl Martín Manzaneda Cipriani","doi":"10.1093/asj/sjaf044","DOIUrl":"https://doi.org/10.1093/asj/sjaf044","url":null,"abstract":"<p><strong>Background: </strong>The iliac crest is defined as the superior border of the ilium or iliac bone and serves as an insertion point for various muscles, ligaments, and fasciae. The iliac crest should be prioritized if a more harmonious body is sought, since, by performing a fat transfer above the gluteus medius muscle area, the gluteus medius is volumized and a high and large buttock is obtained, which is not always aesthetically beautiful.</p><p><strong>Objectives: </strong>Describe a safe, crest-treating technique (XCREST) oriented to decrease the iliac crest to achieve a more harmonious transition from the waist to the hip.</p><p><strong>Methods: </strong>In this study, the sample consisted of 200 female patients. Measurements were taken of the waist, the distance between the iliac crest and the trochanter and the distance between the last palpable rib and the iliac crest in the preoperative stage, in the immediate postoperative stage and six months later.</p><p><strong>Results: </strong>A reduction in the mean waist measurement was found, being 83.11 cm preoperatively, 72.31 cm in the immediate postoperative period and 72.06 six months after the operation. Of the 200 cases, the average distance between the last palpable rib and the iliac crest increased by 3.8 cm. Ten percent of the patients presented complications related to pain for less than two months, which were duly treated.</p><p><strong>Conclusions: </strong>The XCREST technique effectively reduces the waist diameter and improves the aesthetic appearance at the sixth postoperative month, evidencing a better transition between the waist, hip, and buttocks.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673134","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: 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":"https://doi.org/10.1093/asj/sjaf046","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","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":"A Controlled Phase 2b Trial to Assess the Efficacy and Safety of a Single Intervention of OnabotulinumtoxinA for Treating Masseter Muscle Prominence.","authors":"Steven Liew, Derek Jones, Steven Dayan, Sabrina Fabi, Alexander Rivkin, Brian Biesman, Tanya Brandstetter, Grace Pan, Julia K Garcia, Elisabeth Lee, Beta Bowen, Mitchell F Brin","doi":"10.1093/asj/sjaf042","DOIUrl":"https://doi.org/10.1093/asj/sjaf042","url":null,"abstract":"<p><strong>Background: </strong>Masseter muscle prominence (MMP) is a benign condition characterized by a wide, square, or trapezoidal lower facial shape, which may be considered undesirable.</p><p><strong>Objectives: </strong>To evaluate onabotulinumtoxinA (onabotA) efficacy and safety for MMP treatment.</p><p><strong>Methods: </strong>In a phase 2b study, adults with investigator- and participant-assessed bilateral grade 4/5 MMP on the 5-grade MMP Scale (MMPS) and MMPS-Participant, respectively, were randomized 1:1:1 to receive a single intramuscular injection of onabotA 48 U, 72 U, or placebo in the masseter muscles. The primary endpoint was the proportion of subjects achieving investigator-assessed MMPS grade ≤3 at day 90. Adverse events were monitored throughout.</p><p><strong>Results: </strong>Subjects received onabotA 48 U (n=53), 72 U (n=46), or placebo (n=46). Significantly greater proportions achieved MMPS grade ≤3 with onabotA vs placebo (90.6%, 91.3%, and 21.7% for onabotA 48 U, 72 U, and placebo, respectively, at day 90; P<0.0001). Improvements in lower facial volume, width, and angle were significantly greater for onabotA vs placebo at all timepoints. At day 90, the proportion of subjects perceiving improvements was significantly greater with onabotA treatment vs placebo. Significantly more subjects were \"satisfied/very satisfied\" with onabotA vs placebo through day 180. Treatment was well tolerated; both onabotA groups had a similar incidence of treatment-emergent adverse events (TEAEs). Nasopharyngitis (onabotA, 3.9% vs placebo, 0%) and upper respiratory infection (2.9% vs 0%, respectively) were the most common TEAEs.</p><p><strong>Conclusions: </strong>One injection of onabotA 48 U or 72 U was well tolerated and effective in reducing MMP severity as assessed by investigators and subjects.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662074","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 Versus 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":"https://doi.org/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 intrathecal morphine's (ITM) analgesic effects for patients undergoing abdominally based free flap reconstruction.</p><p><strong>Objectives: </strong>The primary outcome analyzed from this retrospective study was opioid consumption, which was measured from postoperative anesthesia care unit (PACU) through postoperative day (POD) 2. In addition, the secondary outcomes analyzed from the study included factors such as pain scores, hospital length of stay (LOS), and adverse effects.</p><p><strong>Methods: </strong>51 patients presented for breast reconstruction with abdominally based free flaps and received ITM for postoperative analgesia. Then, 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 PACU (0 mg versus 12.5 mg MEQ; p = 0.009), from PACU to POD 1 (0 mg versus 7.5 mg MEQ; p =0.046), and POD 1 to POD 2 (7.5 mg versus 30 mg MEQ; p = 0.002) 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 decreased LOS. There were similar rates of adverse events.</p><p><strong>Conclusions: </strong>ITM improves postoperative analgesia after abdominally based free flaps compared to PVBs and may facilitate recovery and earlier discharge.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rupture of Breast Implants Does Not Cause Systemic or Local Immune Changes.","authors":"Puja Jagasia, Ramsey Timmerman, David Dolivo, Sophia Allison, Seok Jong Hong, Robert Galiano, John Y S Kim, Megan Fracol","doi":"10.1093/asj/sjae244","DOIUrl":"https://doi.org/10.1093/asj/sjae244","url":null,"abstract":"<p><p>Breast implant rupture occurs in both saline and silicone implants, with estimated risk of rupture between 5.3% and 15.1% over a 10-year period. Concerns regarding the effect of breast implants on the immune system remain despite currently published data that does not support a link between implants, ruptured or not, and autoimmune symptoms. The authors aimed to determine if there were systemic or local immune changes caused by implant rupture. Healthy females with either ruptured or intact breast implants were recruited. Enzyme-linked immunosorbent assay (ELISA) was performed to examine systemic levels of 6 antibodies against breast-related antigens. Bulk RNA-sequencing of breast tissue adjacent to the implant was analyzed to identify differentially expressed genes (DEGs). Sixty-seven females were assessed with ELISA. Of those, 24% (16/67) had ruptured breast implants and 76% (51/67) had intact implants. There were no differences in antibody levels between intact and ruptured implants. Subgroup analyses of ruptured implants revealed no differences in antibody levels between ruptured saline and silicone implants, submuscular and subglandular implants, or textured and smooth implants. Bulk RNA-sequencing of breast tissue adjacent to ruptured implants (n = 5) and intact implants (n = 5) was performed. This revealed only 1 immune-related DEG (MS4A1), which was a downregulated gene related to B cell activation and differentiation. Rupture of breast implants was not associated with systemic changes in antibody levels or local changes in gene expression of breast parenchyma. There was no evidence for immune-related changes that might explain the autoimmune-like clinical symptoms some patients experience after implant rupture. Level of Evidence: 3 (Therapeutic).</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655753","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":"Exosomes Derived from Adipose Stem Cells Inhibit Skin T Cells Activation and Alleviate Wound Inflammation.","authors":"Hongfan Ding, Yichen Wang, Ruiqi Bai, Qiang Li, Boyuan Ren, Jide Jin, Minliang Chen, Xiao Xu","doi":"10.1093/asj/sjaf040","DOIUrl":"https://doi.org/10.1093/asj/sjaf040","url":null,"abstract":"<p><strong>Background: </strong>Skin T cells are essential for maintaining the skin's immune barrier and promoting early wound healing. Exosomes from adipose-derived stem cells (ADSCs-exo) can accelerate wound healing and reduce inflammation, but their impact on skin T cell inflammation is unclear.</p><p><strong>Objectives: </strong>This study aims to explore ADSCs-exo's regulatory effects on skin T cells and wound inflammation.</p><p><strong>Methods: </strong>ADSCs-exo were isolated by differential ultracentrifugation. An in vitro inflammation model using the human skin T cell line HuT 78 was established to analyze the effects of ADSCs-exo on T cell activation markers, inflammatory cytokines, and PI3K/Akt signaling. Apoptosis in HuT 78 cells was assessed with Calcein-AM/PI staining. A full-thickness skin injury model in C57 mice was used to evaluate ADSCs-exo's impact on dendritic epidermal T cells (DETCs) and inflammatory cytokine expression.</p><p><strong>Results: </strong>Phorbol 12-myristate 13-acetate (PMA) enhances IL-2, IL-17A, TNF-α, and IFN-γ mRNA expression, upregulates CD25 and CD69, and decreases Akt and PI3K phosphorylation in HuT 78 cells. PMA also promotes apoptosis. ADSCs-exo alone do not significantly affect CD25 and CD69 expression, but co-treatment with PMA and ADSCs-exo reduces CD25 and CD69 expression, inhibits IL-2 and IL-17A, and increases Akt and PI3K phosphorylation compared to PMA alone. Furthermore, ADSCs-exo can reverse the pro-apoptotic effect of PMA. In vivo, DETCs comprised 1% of mouse epidermal cells and increased at the wound margin post-injury. ADSCs-exo reduced DETC and IL-17A expression early in wound healing.</p><p><strong>Conclusions: </strong>ADSCs-exo inhibited PMA-induced skin T cell activation and inflammatory cytokine expression. While acute trauma increased DETC expression at the wound site, ADSCs-exo inhibited early DETC and IL-17A expression, preventing excessive inflammation.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655803","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":"Optimizing Closed-Approach Preservation Rhinoplasty by Ultrasonic Piezo-assisted Techniques for Enhanced Precision.","authors":"Ruben Guilarte, Gerardo Malzone","doi":"10.1093/asj/sjaf006","DOIUrl":"10.1093/asj/sjaf006","url":null,"abstract":"<p><strong>Background: </strong>Preservation rhinoplasty, particularly dorsal preservation, has gained prominence with the advent of piezoelectric instruments, which minimize trauma and enhance precision in bone reshaping. This approach presents unique challenges, especially in closed techniques, where spatial limitations complicate the use of piezotomes.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate outcomes of piezo-assisted preservation rhinoplasty performed with specialized instrumentation to enhance visibility, precision, and postoperative recovery in closed rhinoplasty procedures.</p><p><strong>Methods: </strong>In a cohort of 734 patients undergoing primary rhinoplasty between May 2021 and April 2023, piezoelectric instruments facilitated closed preservation techniques. Cases were documented with a focus on instrument adaptation, bone reshaping precision, and the mitigation of postoperative complications.</p><p><strong>Results: </strong>A 6% revision rate was observed, predominantly for dorsal contour adjustments, with minimal intraoperative bleeding, swelling, and postoperative pain, demonstrating the effectiveness of piezoelectric assistance. Woodpecker (Guilin, China) SS18 and SS4 inserts were specifically optimized to enhance cutting efficiency for removal of the perpendicular plate of the ethmoid, and for lateral and transverse osteotomies.</p><p><strong>Conclusions: </strong>Piezo-assisted rhinoplasty improves precision and reduces trauma, supporting advanced closed preservation rhinoplasty techniques. Although all osteotomies can now be performed with ultrasonic piezotomes, enhanced instrument design may further refine outcomes, facilitating minimally invasive, aesthetically superior results.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"347-358"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982496","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":"Human vs Machine: The Future of Decision-making in Plastic and Reconstructive Surgery.","authors":"Alpay Duran, Anıl Demiröz, Oguz Çörtük, Bora Ok, Mustafa Özten, Sinem Eroğlu","doi":"10.1093/asj/sjaf015","DOIUrl":"10.1093/asj/sjaf015","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence-driven technologies offer transformative potential in plastic surgery, spanning preoperative planning, surgical procedures, and postoperative care, with the promise of improved patient outcomes.</p><p><strong>Objectives: </strong>To compare the web-based ChatGPT-4o (omni; OpenAI, San Francisco, CA) and Gemini Advanced (Alphabet Inc., Mountain View, CA), focusing on their data upload feature and examining outcomes before and after exposure to continuing medical education (CME) articles, particularly regarding their efficacy relative to human participants.</p><p><strong>Methods: </strong>Participants and large language models (LLMs) completed 22 multiple-choice questions to assess baseline knowledge of CME topics. Initially, both LLMs and participants answered without article access. In incognito mode, the LLMs repeated the tests over 6 days. After accessing the articles, responses from both LLMs and participants were extracted and analyzed.</p><p><strong>Results: </strong>There was a significant increase in mean scores after the article was read in the resident group, indicating a significant rise. In the LLM groups, the ChatGPT-4o (omni) group showed no significant difference between pre- and postarticle scores, but the Gemini Advanced group demonstrated a significant increase. It can be stated that the ChatGPT-4o and Gemini Advanced groups have higher accuracy means compared with the resident group in both pre- and postarticle periods.</p><p><strong>Conclusions: </strong>The analysis between human participants and LLMs indicates promising implications for the incorporation of LLMs in medical education. Because these models increase in sophistication, they offer the potential to serve as supplementary tools within traditional learning environments. This could aid in bridging the gap between theoretical knowledge and practical implementation.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"434-440"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035934","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":"Exploratory Analysis of Upper Facial Muscle Interplay During Emotional Expressions: Magnetic Resonance Imaging (MRI) Insights From Young, Caucasian, Toxin-naïve Individuals.","authors":"Daniel J Rams, Mateusz Koziej, Sachin M Shridharani, Elżbieta Szczepanek, Agnieszka Gleń, Tadeusz J Popiela, Monika Ostrogórska, Galen Perdikis, Mikaela V Cotofana, Sebastian Cotofana, Michael Alfertshofer","doi":"10.1093/asj/sjae246","DOIUrl":"10.1093/asj/sjae246","url":null,"abstract":"<p><strong>Background: </strong>Understanding the interplay of muscle activity in the upper face is crucial because it can significantly impact the effectiveness and safety of aesthetic treatments. Traditional injection algorithms typically focus on the general 2-dimensional and 3-dimensional anatomy of muscles, often neglecting the areas where muscles exert the greatest force during facial expressions.</p><p><strong>Objectives: </strong>The goal of this study was to analyze the location of greatest morphological change in the upper facial muscles including the procerus muscle (PM), corrugator supercilii muscle (CSM), orbicularis oculi muscle (OOM), and frontalis muscle (FM) during various facial expressions.</p><p><strong>Methods: </strong>A total of 34 healthy young individuals (17 females, 17 males), with a mean age of 23.6 ± 2.4 years [range 20-30], were examined with magnetic resonance imaging (MRI) to assess the length, thickness, and width of the upper facial muscles (PM, CSM, OOM, and FM) for 5 different facial expressions: repose, anger, joy, surprise, and sadness.</p><p><strong>Results: </strong>Facial muscle thickness is a key indicator of activity during expressions such as anger, joy, surprise, and sadness. During anger, the PM and CSM decreased in length and width but increased in thickness, whereas the FM passively contracted to stabilize the expression. The OOM showed increased thickness in its medial, inferior, lateral, and superior portions during various expressions, with specific regions activating differently depending on the expression, such as the medial and lateral parts during surprise and the inferior and lateral parts during joy. The medial third of the CSM was the most active region during contraction.</p><p><strong>Conclusions: </strong>Upper facial muscles-as either agonists or antagonists-act together during facial expressions to stabilize facial expressions, emphasizing the need to assess both groups in neuromodulator treatments. The medial third of the corrugator supercilii shows the most significant MRI changes, making it the primary target for injections.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"414-421"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852042","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}