Shikhar Tomur, Adam Glener, Christoph Andree, Giovanni Bistoni, Barbara Cagli, Stefano Pompei, William P Adams
{"title":"Long-term Outcomes of Poly-4-Hydroxybutyrate (P4HB) in Aesthetic Breast Surgery: An International Experience.","authors":"Shikhar Tomur, Adam Glener, Christoph Andree, Giovanni Bistoni, Barbara Cagli, Stefano Pompei, William P Adams","doi":"10.1093/asj/sjaf173","DOIUrl":"https://doi.org/10.1093/asj/sjaf173","url":null,"abstract":"<p><strong>Background: </strong>Poly-4-hydroxybutyrate (P4HB) is a component of human connective tissue and biomedically produced thermoplastic polyester scaffold that has been used in many surgical subspecialties. The utilization of P4HB in cosmetic and reconstructive breast surgery has been popularized internationally for the past 12 years.</p><p><strong>Objectives: </strong>The purpose of this study was to assess and report long-term international outcomes of P4HB use in aesthetic breast surgery.</p><p><strong>Methods: </strong>A standardized retrospective outcome review was completed from the records of 5 international surgeons, each with significant expertise in using P4HB.</p><p><strong>Results: </strong>A total of 621 patients were included in the review. Average follow up was 1.33 years (Range: 1- 9.3 years). Most patients had P4HB placed during primary breast surgery (N=460; 74%); primary procedures included augmentation-mastopexy (N=253), mastopexy (N=125), breast reduction (N=71). A subset (N=161; 26%) of patients had P4HB placed during breast revisions; revision augmentation with mastopexy (N=81), revision augmentation (N=73), mastopexy with implant removal (N=7). Top indications for revision included recurrent ptosis (N=166), implant malposition (N=64), and capsular contracture (N=61). An overall complication rate of 3.7% (n=23) was observed, the most common being delayed wound healing (N=7) and hypertrophic scarring (N=5). Of the overall complications, device related complications associated with P4HB were observed only in 5 patients (0.8%), while non-device complications were seen in 18 patients (2.9%).</p><p><strong>Conclusions: </strong>This study suggests there is a defined role for the use of P4HB in both primary and revision aesthetic breast surgery; its use does not appear to increase the inherent complication risk of cosmetic breast surgery.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090743","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}
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
{"title":"Serotonergic Antidepressants and Postoperative Hematoma Risk After Abdominoplasty: A Study Utilizing 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":"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>The aim of this study was to investigate the risk of developing postoperative hematoma after abdominoplasty in patients who did or did not use serotonergic antidepressants before surgery.</p><p><strong>Methods: </strong>Data from TriNetX was utilized to identify female patients who underwent abdominoplasty. Patients were classified in 2 cohorts: the exposure cohort included patients with serotonergic antidepressant use, and the control cohort included patients who did not take these medications. Propensity score-matching analyses were performed to adjust for bleeding risk factors. Hematoma diagnosis was the primary outcome; 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 5882 individuals. Patients who were taking serotonergic antidepressants had a significantly increased risk of hematoma (risk ratio [RR] 1.95, P < .001), transfusion (RR 1.57, P = .007), and hematoma/seroma evacuation (RR 1.65, P = .004) within 7 days postsurgery. Similar results were observed at 15 and 30 days after surgery.</p><p><strong>Conclusions: </strong>Patients who took serotonergic antidepressants before 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><p><strong>Level of evidence: 3 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1035-1042"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","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":"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":"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. In this systematic review, the authors explore PLLA's transformation across clinical generations, emphasizing its role as a biostimulatory scaffold rather than a conventional filler. Through an extensive literature review, the authors identify and analyze 63 studies published between January 2013 and March 2025. Findings confirm that PLLA induces a regenerative cascade marked by M2 macrophage polarization, transforming growth factor beta 1-mediated fibroblast activation, and sustained neocollagenesis, thereby promoting long-term remodeling of the extracellular matrix, 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-glucagon-like peptide-1 therapy restoration and preventive (\"prejuvenation\") strategies. Protocol refinements, including optimized dilutions and cannula techniques, have enhanced safety and efficacy. In this review, the authors also highlight the emerging areas such as PLLA's integration with energy-based devices, digital imaging, artificial intelligence diagnostics, and microbiome-focused care. Collectively, the evidence supports PLLA's utility as a versatile biostimulatory agent that bridges aesthetic innovation and regenerative dermatology. Level of Evidence: 3 (Therapeutic).</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1065-1072"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","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":"Enhanced Scar Reduction With Triamcinolone Acetonide and Botulinum Toxin A Combination Therapy Compared to Botulinum Toxin A Monotherapy: A Translational Pilot Study.","authors":"Shu-Hung Huang, Wen-Chin Wang, Hui-Yu Chuang, Shih-Ming Yang, Shang-Yu Yang, Sheng-Hua Wu","doi":"10.1093/asj/sjaf094","DOIUrl":"10.1093/asj/sjaf094","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of combining triamcinolone acetonide (TAC) and botulinum toxin type A (BTX-A) to treat hypertrophic scars and keloids remains unclear.</p><p><strong>Objectives: </strong>This pilot study aimed to compare the clinical efficacy of BTX-A monotherapy and TAC + BTX-A combination therapy in improving scar conditions and to investigate potential mechanisms with a rat burn scar model.</p><p><strong>Methods: </strong>This study was conducted between March 2022 and December 2024. Each patient's scar was randomly divided into 2 equal parts, with 1 part receiving TAC + BTX-A and the other BTX-A alone for 3 sessions at 4-week intervals. Scar thickness was measured with calipers, and the Vancouver Scar Scale (VSS) was administered to assess scar condition. Pain and pruritus were evaluated with a numeric rating scale (NRS) and visual analog scale (VAS), respectively, before each intervention (V1, V2, V3) and 4 weeks after the last session (V4). In the animal study, rats with burn scars were assigned to 5 groups: sham, untreated burn, TAC, BTX-A, and TAC + BTX-A. Scar thickness and expressions of alpha smooth muscle actin (α-SMA), transforming growth factor beta (TGF-β), connective tissue growth factor (CTGF), collagen I/III, laminin, and fibronectin were analyzed histologically.</p><p><strong>Results: </strong>Clinically, both therapies reduced scar thickness, VSS, NRS, and VAS scores. However, combination therapy showed superior reductions in scar thickness (V2-V4) and VSS scores (V3, V4) compared to BTX-A monotherapy. No significant differences were observed in NRS and VAS scores. The animal study confirmed that combination therapy more effectively reduced scar thickness, TGF-β and CTGF levels, and the collagen I/III ratio, and increased the laminin/fibronectin ratio.</p><p><strong>Conclusions: </strong>TAC + BTX-A combination therapy enhances scar reduction by more effectively suppressing fibroblast proliferation and activation through TGF-β and CTGF downregulation, promoting scar remodeling.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1073-1085"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232915","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}
Eliana Jolkovsky, Meghan N Miller, Ainaz Dory Barkhordarzadeh, Stacy Piva, Tahera Alnaseri, Ginger C Slack
{"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":"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>The authors of this study aim 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 = .016) and BMI (P < .001) remained statistically significant predictors of breast weight, whereas 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 groups provide 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><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1017-1025"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448591/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paula Rosso, Jesús Colina, Carlos Jarne, Eva Garrigós, Bárbara Magalhães, Manuel-Anthony Da Costa, Kevin Poupard
{"title":"Enhancing Skin Quality With a Sequential Treatment Using 2 Hyaluronic Acid Dermal Fillers: A Prospective, Multicenter, Interventional Study.","authors":"Paula Rosso, Jesús Colina, Carlos Jarne, Eva Garrigós, Bárbara Magalhães, Manuel-Anthony Da Costa, Kevin Poupard","doi":"10.1093/asj/sjaf111","DOIUrl":"10.1093/asj/sjaf111","url":null,"abstract":"<p><strong>Background: </strong>Skin quality affects facial attractiveness, which can significantly impact self-esteem and overall quality of life. The preferred fillers for enhancing skin quality are noncrosslinked or slightly crosslinked hyaluronic acid gels, such as RHA1 and R1, because they diffuse more easily into peripheral tissues.</p><p><strong>Objectives: </strong>This study was designed to assess the performance and safety of RHA1 treatment for fine lines, such as smiling lines (SLs), including an exploratory arm assessing the performance of subsequent R1 treatments.</p><p><strong>Methods: </strong>SKINQARE was a prospective, multicenter, low-interventional, open-label study. The primary outcome was Global Aesthetic Improvement Scale (GAIS) score recorded at 2 months postinjection with RHA1. Questionnaires were used to evaluate both patient and investigator satisfaction. Skin quality parameters were measured with standard equipment and the VISIA CANFIELD imaging system. Safety assessment covered adverse events (AEs), injection site pain, and common treatment responses.</p><p><strong>Results: </strong>The primary endpoint was met, with 92.7% of patients exhibiting GAIS improvement 2 months after receiving RHA1 treatment for SLs. Subsequent treatment with R1 doubled the \"very satisfied\" rate compared with RHA1 alone at 6 months. Patients also reported prolonged skin firmness, smoothness, and bounce, along with a refreshed feeling. No serious AEs were reported during the study.</p><p><strong>Conclusions: </strong>RHA1 was effective for skin beautification in all indications, including SLs, and subsequent R1 treatment improved performance. Both treatments were well tolerated. These findings highlight the potential benefits of using a combined treatment approach to improve skin quality.</p><p><strong>Level of evidence: 3: </strong>(Therapeutic).</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1051-1064"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281997","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":"Exploring Snapchat Dysmorphia, Body Dysmorphic Disorder Symptoms, and Body Trust in Patients Seeking Aesthetic Medicine Procedures.","authors":"Paolo Mancin, Valentina Gaudenzi, Rossana Telesca, Domenico Centofanti, Emanuele Bartoletti, Silvia Cerea","doi":"10.1093/asj/sjaf185","DOIUrl":"https://doi.org/10.1093/asj/sjaf185","url":null,"abstract":"<p><strong>Background: </strong>Snapchat Dysmorphia is an emerging phenomenon that characterizes individuals seeking aesthetic procedures to replicate the appearance of their digitally altered selfies. This phenomenon has been hypothesized to be linked to Body Dysmorphic Disorder (BDD) symptoms. Additionally, body trust (i.e., perceiving the body as safe and trustworthy, relying on its signals and sensations), which could contrast excessive focus on physical appearance, may moderate this relation. Current literature on Snapchat Dysmorphia reveals a notable lack of comprehensive empirical investigations.</p><p><strong>Objectives: </strong>The study examined the factorial structure and internal consistency of a newly developed measure: the Snapchat Dysmorphia Questionnaire (SDQ). Additionally, it explored the relation between Snapchat Dysmorphia and BDD symptoms, with a focus on the potential moderating role of body trust.</p><p><strong>Methods: </strong>Data was collected from a sample of 163 women seeking aesthetic medicine treatments. The factorial structure and internal consistency of the SDQ were examined. Its association with BDD symptoms was explored within a hierarchical regression model, after controlling for other variables (e.g., motivations to pursue cosmetic procedures). Finally, the potential moderating role of body trust was tested.</p><p><strong>Results: </strong>Findings supported a unidimensional factor structure for the SDQ, which also demonstrated a significant association with BDD symptoms. Body trust did not moderate this relation.</p><p><strong>Conclusions: </strong>Findings provide preliminary support for the validity of the SDQ in women seeking aesthetic medicine procedures and lend empirical weight to anecdotal claims that Snapchat Dysmorphia is distinct yet related to BDD. Finally, while body trust was negatively associated with BDD symptoms, it did not show a moderation effect.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090716","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":"Safety and Efficacy of Low-Temperature Gel of Recombinant Humanized Type III Collagen in the Treatment of Midface Volume Deficit.","authors":"Yue Zhang, Baolin Zhang, Lixia Qiu, Peng Zhao, Xin Yan, Yao Jia","doi":"10.1093/asj/sjaf168","DOIUrl":"https://doi.org/10.1093/asj/sjaf168","url":null,"abstract":"<p><strong>Background: </strong>Midface volume loss contributes significantly to facial contour changes. Congenital traits, genetic predisposition, and environmental factors can reduce collagen fiber quantity and quality, leading to decreased skin firmness, wrinkles, and midface depression. Type III collagen, abundant in the human body, has low immunogenicity, good tissue compatibility, and promising biomedical applications. However, employing animal-derived collagen, typically in liquid form, is limited by potential adverse reactions and disease transmission.</p><p><strong>Objectives: </strong>To assess the safety and efficacy of localized injections of low-temperature gel recombinant humanized Type III collagen (rhCol III) in treating midface volume deficit.</p><p><strong>Methods: </strong>In vivo animal experiments and retrospective clinical data analysis were conducted.</p><p><strong>Results: </strong>Low-temperature gel rhCol III significantly improved facial volume and midfacial contour with a favorable safety profile in subchronic systemic toxicity tests in Sprague-Dawley rats, skin degradation studies in New Zealand white rabbits, and human clinical trials. In humans, the treatment group showed significant improvement in Merz Aesthetic Scale, Global Aesthetic Improvement Scale, and satisfaction scores vs controls at 1 month (P < .0001), with effects lasting at least 6 months.</p><p><strong>Conclusions: </strong>Low-temperature gel rhCol III offers a safe, effective, and durable option for correcting midface volume deficit, with minimal risk of complications. These results suggest potential value in enhancing clinical strategies for facial volume restoration.</p><p><strong>Level of evidence: 3 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090730","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}
Arman J Fijany, Cole A Holan, Thomas Troia, Lisandro Montorfano, Ronnie N Mubang, Kevin Bijan Givechian, Huseyin Karagoz, Jorys Martinez-Jorge, Galen Perdikis, Lauren M Connor, Elizabeth D Slater
{"title":"Tranexamic Acid in Body Contouring Surgery: A Systematic Review and Meta-Analysis.","authors":"Arman J Fijany, Cole A Holan, Thomas Troia, Lisandro Montorfano, Ronnie N Mubang, Kevin Bijan Givechian, Huseyin Karagoz, Jorys Martinez-Jorge, Galen Perdikis, Lauren M Connor, Elizabeth D Slater","doi":"10.1093/asj/sjaf112","DOIUrl":"10.1093/asj/sjaf112","url":null,"abstract":"<p><p>Breast and body contouring procedures are plastic surgery's most popular and effective interventions. Although these procedures are generally safe, they are not without risks and complications. Antifibrinolytic drugs such as tranexamic acid (TXA) have been used as an adjunct to improve outcomes. The authors of this meta-analysis explore the impact of TXA on complications in breast and body contouring procedures. They searched PubMed (US National Library of Medicine, Bethesda, MD) for studies that used TXA in standard breast reconstruction and body contouring procedures. They then performed a meta-analysis on the following complications: hematoma, seroma, infection, and wound-healing complications. A Mantel-Haenszel method random-effects model was used to calculate the odds ratio (OR) within and a 95% CI for dichotomous outcomes. Subgroups were created for studies that utilized systemic (IV), topical or concurrent IV, and topical TXA administration. A total of 13 studies were selected and included in the analysis. There was a significant lower risk of hematoma (OR = 0.37; 95% CI = 0.18-077; P = .008) in the TXA cohort. There were no significant differences observed in terms of wound-healing issues or seroma formation. The subgroup analysis of this study demonstrated significantly decreased risks of infection (OR = 0.41; 95% CI = 0.22-077; P = .005) in the topical TXA cohort. In breast and body contouring procedures, the risk of hematoma and wound-healing complications can potentially be reduced by IV TXA administration. The infection risk can be potentially reduced by topical TXA administration. Level of Evidence: 3 (Therapeutic).</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1026-1034"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281998","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":"One Profile to Rule Them All? A Neural Network Analysis of the Homogenizing Effect of Primary Rhinoplasty.","authors":"Kristina L Khaw, Stephen M Lu","doi":"10.1093/asj/sjaf109","DOIUrl":"10.1093/asj/sjaf109","url":null,"abstract":"<p><strong>Background: </strong>A goal of aesthetic rhinoplasty is to improve nasal aesthetics while preserving individuality.</p><p><strong>Objectives: </strong>We hypothesized that primary rhinoplasty has a homogenizing effect on a patient's appearance and in a distinct manner for a given rhinoplasty surgeon.</p><p><strong>Methods: </strong>Standardized, unedited preoperative and postoperative photographs, including frontal, lateral, and oblique views of 145 Caucasian female primary rhinoplasty patients from the public websites of 3 independent, experienced rhinoplasty surgeons were included (Surgeon A: n = 50, Surgeon B: n = 50, Surgeon C: n = 45). Utilizing Amazon Rekognition, similarities between photographs were calculated by comparing all preoperative photographs to each other and all postoperative photographs to each other. Differences between preoperative and postoperative views were calculated intracohort and intercohort and standardized by the relative change in similarity. Paired t tests evaluated the absolute relative changes, whereas a simple t test assessed the intercohort and intracohort differences.</p><p><strong>Results: </strong>Patients were significantly more similar postsurgery (17.58%, P < .001) in the lateral (19.17%), oblique (19.02%), and frontal (14.38%) views. In the subgroups, Surgeon A similarity increased 37.50%, Surgeon B had a 24.60% increase, and Surgeon C a 17.68% increase. The intercohort similarity increase (14.15%) was significantly less than the intracohort increase (30.89%).</p><p><strong>Conclusions: </strong>This study illustrates that primary rhinoplasty patients have increased homogeneity postoperatively, particularly within surgeon cohorts. This is the first study in which the homogenizing effect of rhinoplasties are quantified with neural networks and show the quantifiable \"signature\" effect of a specific surgeon on their patients' appearances as a population. This study may impact how surgeons set patients' expectations. Level of Evidence: 3 (Therapeutic).</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1012-1016"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274021","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}