Aesthetic Surgery Journal最新文献

{"title":"Serotonergic Antidepressants and Postoperative Hematoma Risk After Abdominoplasty: A Study Using Propensity Score Matching.","authors":"Agustin N Posso, Audrey Mustoe, Micaela Tobin, Mohammed Yamin, Morvarid Mehdizadeh, Tricia Raquepo, Maria J Escobar-Domingo, Sarah J Karinja, Ryan P Cauley, Bernard T Lee","doi":"10.1093/asj/sjaf113","DOIUrl":"https://doi.org/10.1093/asj/sjaf113","url":null,"abstract":"<p><strong>Background: </strong>The incidence of psychiatric disorders, particularly major depressive disorder, is increasingly observed among patients undergoing plastic surgery procedures. This trend has raised concerns about the impact of serotonergic antidepressants on postoperative complications, especially the incidence of hematomas.</p><p><strong>Objectives: </strong>To investigate the risk of developing postoperative hematoma after abdominoplasty in patients who did or did not use serotonergic antidepressants prior to surgery.</p><p><strong>Methods: </strong>Data from TriNetX (TriNetX, LLC, Cambridge, MA) was used to identify female patients who underwent abdominoplasty. Patients were classified in two cohorts: the exposure cohort included patients with serotonergic antidepressants use, while the control cohort included patients who did not use these medications. Propensity score-matching analyses were performed to adjust for bleeding risk factors. Hematoma diagnosis was used as the primary outcome, while other outcomes included seroma, wound dehiscence, surgical site infection, blood transfusion, and hematoma/seroma evacuation. All outcomes were assessed at 7, 15, and 30 days following surgery.</p><p><strong>Results: </strong>After matching for the 7-day outcomes analysis, each group contained 5,882 individuals. Patients who used serotonergic antidepressants had a significantly increased risk of hematoma (risk ratio [RR] 1.95, p<0.001), transfusion (RR 1.57, p=0.007), and hematoma/seroma evacuation (RR 1.65, p=0.004) within 7 days post-surgery. Similar results were observed at 15 and 30 days after surgery.</p><p><strong>Conclusions: </strong>Patients who used serotonergic antidepressants prior to surgery had an increased risk of hematoma and other related complications after abdominoplasty. These findings underscore the need for preoperative counseling and risk assessment in this population.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482852","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":"Improving Documentation in Plastic Surgery: Sister Bra Size Group and BMI Are More Indicative of Breast Weight than Cup Size.","authors":"Eliana Jolkovsky, Meghan N Miller, Ainaz Dory Barkhordarzadeh, Stacy Piva, Tahera Alnaseri, Ginger C Slack","doi":"10.1093/asj/sjaf114","DOIUrl":"https://doi.org/10.1093/asj/sjaf114","url":null,"abstract":"<p><strong>Background: </strong>Accurate documentation of breast size is critical for surgical planning, insurance authorization, and research in breast reconstruction. However, breast size is inconsistently recorded, often limited to brassiere cup size, which may not reliably predict breast tissue weight.</p><p><strong>Objectives: </strong>This study aimed to evaluate whether \"sister bra size group\"-a previously unverified classification incorporating both bra cup and band sizes-better correlates with breast weight than cup size alone.</p><p><strong>Methods: </strong>A retrospective review was conducted of 209 patients (395 breasts) who underwent mastectomy between 2017 and 2023 at a single institution. Preoperative bra cup and band sizes, mastectomy specimen weights, BMI, and demographic characteristics were recorded. Patients were categorized into sister bra size groups. Spearman's correlation coefficients and multivariate linear regression were used to evaluate associations with breast weight.</p><p><strong>Results: </strong>Sister bra size group showed the strongest Spearman's correlation with breast weight (ρ = 0.76), followed by cup size (ρ = 0.67), BMI (ρ = 0.61), and band size (ρ = 0.48). Age did not have a significant correlation with mastectomy specimen weight (ρ = 0.02). In multivariate analysis, sister size (p = 0.016) and BMI (p < 0.001) remained statistically significant predictors of breast weight, while cup and band sizes did not.</p><p><strong>Conclusions: </strong>Cup size alone is not a reliable predictor of breast tissue weight. Sister bra size group provides a stronger correlation and a more accurate alternative. Incorporating this variable into clinical documentation may improve preoperative planning and create a more standardized framework for research.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526098","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":"Beyond Accuracy: Interpreting AI Performance in Surgical Decision Making.","authors":"Kian Daneshi, Hilary Y Liu, Francesco M Egro","doi":"10.1093/asj/sjaf116","DOIUrl":"https://doi.org/10.1093/asj/sjaf116","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511375","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":"Poly-L-Lactic Acid in Aesthetic Dermatology: A Decade Beyond Volume Restoration Toward Regenerative Biostimulation.","authors":"Diala Haykal, Alessandra Haddad, Hugues Cartier, Luiz Avelar","doi":"10.1093/asj/sjaf121","DOIUrl":"https://doi.org/10.1093/asj/sjaf121","url":null,"abstract":"<p><p>Over the past decade, Poly-L-lactic acid (PLLA), a synthetic, biodegradable, and biocompatible polymer, has evolved from a volumizing solution for HIV-associated lipoatrophy into a foundational tool in regenerative aesthetic dermatology. This systematic review explores PLLA's transformation across clinical generations, emphasizing its role as a biostimulatory scaffold rather than a conventional filler. Through an extensive literature review, we identify and analyze 67 studies published between January 2013 and March 2025. Findings confirm that PLLA induces a regenerative cascade marked by M2 macrophage polarization, TGF-β1-mediated fibroblast activation, and sustained neocollagenesis, thereby promoting long-term remodeling of the extracellular matrix (ECM), improved dermal density, and enhanced skin quality. The applications of PLLA have extended beyond facial volumization to full-body rejuvenation, with significant roles in post-GLP-1 therapy restoration and preventive (\"prejuvenation\") strategies. Protocol refinements, including optimized dilutions and cannula techniques, have enhanced safety and efficacy. This review also highlights emerging areas such as PLLA's integration with energy-based devices, digital imaging, AI diagnostics, and microbiome-focused care. Collectively, the evidence supports PLLA's utility as a versatile biostimulatory agent that bridges aesthetic innovation and regenerative dermatology.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526067","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":"Systematic Review of Poly-4-Hydroxybutyrate in Modern Breast Surgery.","authors":"Nicholas A Vernice, Carter J Boyd, Kshipra Hemal, Chris Amro, Thomas J Sorenson, Jenn Park, Alexis Lakatta, Oriana Cohen, Mihye Choi, Nolan S Karp","doi":"10.1093/asj/sjaf099","DOIUrl":"https://doi.org/10.1093/asj/sjaf099","url":null,"abstract":"<p><p>Several biologic and synthetic adjuncts have been employed to reduce ptosis and improve cosmesis in breast surgery. Poly-4-hydroxybutyrate (P4HB), a fully absorbable polymer, continues to increase in use. This study sought to identify uses of P4HB in both reconstructive and aesthetic breast surgery and synthesize the available data on its outcomes and efficacy. A literature search was performed from inception to May 2024 following PRISMA in PubMed (MEDLINE), EMBASE, and Cochrane databases. Two independent reviewers screened the studies for eligibility. Bibliographies and citing references from selected articles from Scopus (Elsevier) were also reviewed. The search identified 372 studies, with 16 articles included. All prospective and retrospective case series utilizing P4HB reported high rates of patient satisfaction and scaffold incorporation as well as low complication rates including recurrent ptosis, implant malposition, and capsular contracture. One retrospective cohort study reported significantly higher rates of capsular contracture with use of P4HB sling in dual-plane, two-stage breast reconstruction. No other studies reported significantly higher rates of capsular contracture with P4HB and no other significant differences in complication rates were noted. Two animal studies exploring the use of P4HB in nipple reconstruction reported that P4HB promoted the growth of fibrovascular tissue with higher rates of nipple projection with respect to control. This study supports P4HB as a safe and efficacious adjunct in a variety of indications. Large-scale, randomized trials between P4HB and other types of soft-tissue support are needed to further delineate the above trends.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526068","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":"Beyond PlasticSurgeryGPT: The Imperative for Reasoning-Enhanced LLMs in Plastic Surgery.","authors":"Partha Pratim Ray","doi":"10.1093/asj/sjaf122","DOIUrl":"https://doi.org/10.1093/asj/sjaf122","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526096","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":"Development of a Novel Artificial Intelligence Clinical Decision Support System for Aesthetic Surgery: AURA.","authors":"Berk B Ozmen, Nishant Singh, Kavach Shah, Ibrahim Berber, Fnu Damanjit Singh, Eugene Pinsky, Nicholas R Sinclair, Raymond Isakov, Graham S Schwarz","doi":"10.1093/asj/sjaf120","DOIUrl":"https://doi.org/10.1093/asj/sjaf120","url":null,"abstract":"<p><strong>Background: </strong>Aesthetic surgery requires integration of specialized knowledge with clinical expertise, yet traditional literature search methods are time-intensive when addressing specific clinical questions. While artificial intelligence has transformed various aspects of healthcare delivery, no AI clinical decision support systems have been specifically developed to enhance evidence-based practice in aesthetic surgery.</p><p><strong>Objectives: </strong>We aimed to develop and evaluate AURA (Aesthetic surgery Using Retrieval Augmentation), a novel AI-powered clinical decision support system designed specifically for evidence-based guidance in aesthetic surgery.</p><p><strong>Methods: </strong>AURA integrates a comprehensive database of 6,546 full-text open-access aesthetic surgery publications (January 2001-September 2024) with a commercial large language model using retrieval-augmented generation technology. System performance was rigorously assessed across 14 complex clinical scenarios spanning facial rejuvenation, body contouring, breast procedures, and general aesthetic surgery considerations. Evaluation metrics included faithfulness to source materials (0-1), answer relevancy (0-1), G-Eval correctness (0-1), SEM semantic quality scores and SEM confidence ratings.</p><p><strong>Results: </strong>AURA demonstrated exceptional performance with mean scores of 0.94 for faithfulness, 0.86 for answer relevancy, and 0.77 for factual correctness. Semantic evaluation revealed strong results with average scores of 0.73 (SEM Score) and 0.80 (SEM Max Similarity), predominantly with moderate confidence ratings. Performance was notably stronger for established techniques and safety considerations compared to emerging procedures requiring comparative analysis.</p><p><strong>Conclusions: </strong>We present AURA, the first specialized AI clinical decision support system for aesthetic surgery. This novel system effectively delivers relevant, accurate information across diverse aesthetic surgery domains based on peer-reviewed literature. AURA offers aesthetic surgeons an efficient, evidence-based resource for clinical decision support. Future development should focus on expanding knowledge sources and prospective clinical validation, with implementation emphasizing transparent source presentation to complement surgical expertise.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511377","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":"Rheological Characterization of Different Fat-Derived Products.","authors":"Mingheng Xue, Qian Zhang, Xinhui Wang, Juzi Liu, Zhixin Xue, Feng Lu, Yunjun Liao, Junrong Cai","doi":"10.1093/asj/sjaf066","DOIUrl":"https://doi.org/10.1093/asj/sjaf066","url":null,"abstract":"<p><strong>Background: </strong>Fat grafting has been widely used to correct soft-tissue volume loss and facial rejuvenation. Recent innovative advances have led to different types of fat-derived products. Although the composition of cells and extracellular matrix within different fat products has been reported, their physical and rheological properties are poorly defined.</p><p><strong>Objectives: </strong>The authors of this study aim to evaluate the rheological properties of different fat-derived products and assess how these properties change after transplantation.</p><p><strong>Methods: </strong>In this study, the authors assessed the rheological properties of 4 fat-derived products-adipose matrix complex AMCs, high-density fat (HDF), stromal vascular fraction-gel (SVF-gel), and Coleman fat-before and after transplantation. Key parameters, including elastic modulus (G'), viscous modulus (G″), tan delta (tan δ), and yield stress (τy), were measured using a rheometer.</p><p><strong>Results: </strong>Before transplantation, AMC exhibited the highest G' and G″, followed by SVF-gel, HDF, and Coleman fat. After transplantation, G' decreased for all products, indicating reduced elasticity, while G″ increased, suggesting increased viscosity. AMC maintained the highest G' and G″ even after 3 months, with SVF-gel and HDF showing similar values. Coleman fat had the lowest G' and G″ at all time points.</p><p><strong>Conclusions: </strong>Fat-derived products have distinct clinical applications based on their mechanical properties. AMC is ideal for deep structural support, SVF-gel for superficial corrections, and HDF for volume restoration in midface areas with volume loss. Clinicians should select products based on mechanical properties and anatomical needs to optimize outcomes.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504520","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 Wonder of Sutureless Mullerectomy.","authors":"Maya Atar-Vardi, Biana Dubinsky-Pertzov, Shir Butnik-Cohen, Morris E Hartstein, Ran Stein","doi":"10.1093/asj/sjaf115","DOIUrl":"https://doi.org/10.1093/asj/sjaf115","url":null,"abstract":"<p><strong>Background: </strong>Muller muscle-conjunctival resection (MMCR) is a possible treatment for some cases of ptosis. Corneal irritation or erosions are potential complications due to the use of sutures.</p><p><strong>Objectives: </strong>Evaluating the efficacy and safety of sutureless MMCR as a treatment for moderate to severe ptosis, and to assess postoperative eyelid symmetry and surgical success rates.</p><p><strong>Methods: </strong>Retrospective, single-center cohort study. Patients with a positive response to phenylephrine 10% underwent sutureless MMCR performed by the same surgeon. Pre- and postoperative margin-reflex distance 1 (MRD1) measurements were collected at baseline, one week, and eight weeks after surgery. Data was collected from files of 147 patients (252 eyes) with moderate to severe ptosis (MRD1 0-2 mm) who underwent sutureless MMCR between October2019 and October 2023.</p><p><strong>Results: </strong>Surgical success (defined as postoperative MRD1 of ≥3 mm or ±0.5 mm of the preoperative MRD1 after phenylephrine instillation) was achieved in 88.5% of cases, with a mean MRD1 improvement of 1.61±0.89 mm (p<0.001). Symmetry (defined as ≤1 mm difference in MRD1 between eyes) was obtained in 93.3% of bilateral cases. There was no significant difference between preoperative MRD1 after phenylephrine and postoperative MRD1 at eight weeks (p=0.54). Female patients had higher surgical success rates (OR=2.22, 95% CI 1.01-4.95, p=0.047). Complications were minimal, with wound dehiscence occurring in 1.19% of cases. Statistical analysis, including univariable and multivariable regression, was performed to assess factors associated with surgical outcomes.</p><p><strong>Conclusions: </strong>Sutureless MMCR demonstrated high success rates and postoperative symmetry, with low complication rates, supporting its efficacy as a reliable and minimally invasive procedure for the treatment of ptosis.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511378","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":"Bridging the Gap in Rhinoplasty Training: The Effectiveness of 3D Printed Models in Surgical Education.","authors":"Umar Rehman, Natasha Polglase, David Kahn, Teoman Dogan, Santdeep Paun, Alwyn D'Souza, Rajan Uppal, Nicholas Eynon-Lewis, Matt Lechner","doi":"10.1093/asj/sjaf045","DOIUrl":"10.1093/asj/sjaf045","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty is a common facial plastic surgery procedure for both functional and aesthetic indications. The use of 3-dimensional (3D) models has been reported as a potential method for providing hands-on training for learning rhinoplasty without jeopardizing patient care.</p><p><strong>Objectives: </strong>The objective of this study was to develop and validate a novel model for rhinoplasty training.</p><p><strong>Methods: </strong>The rhinoplasty models were designed and produced with proprietary 3D printing technology. Face and content validity were assessed during a rhinoplasty course involving 53 surgeons. Criterion validity was evaluated in a training session with 20 surgical residents, measuring improvements in surgical skills after practice with the 3D models, with an objective structured assessment of technical skills (OSAT).</p><p><strong>Results: </strong>All surgeons (n = 53, 100%) stated that the rhinoplasty model aided in their learning and development. In all, 91% (n = 48) of surgeons rated the realism of the model as excellent or very good in comparison to cadaveric specimens. Assessment of criterion validity showed a statistically significant improvement in OSAT scores among surgical residents, increasing from a baseline of 11.7/40 (SD ± 1.80) to 21.6/40 (SD ± 1.79) post session (P < .0001).</p><p><strong>Conclusions: </strong>The 3D rhinoplasty models showed good content, face, and criterion validity, objectively improving residents' surgical performance. Rhinoplasty 3D models may serve as a precadaveric training adjunct, equipping trainees with fundamental skills before cadaveric dissection, or as a primary training modality in countries with limited cadaver access. Therefore the models offer an innovative approach to training the next generation of rhinoplasty surgeons.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"655-661"},"PeriodicalIF":3.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699358","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}