Aesthetic Surgery Journal最新文献

{"title":"Calcium Hydroxylapatite in Regenerative Aesthetics: Mechanistic Insights and Mode of Action.","authors":"Jani van Loghem","doi":"10.1093/asj/sjae196","DOIUrl":"10.1093/asj/sjae196","url":null,"abstract":"<p><p>Calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) is a widely utilized soft tissue filler known for its compatibility with human tissue and for its effective volumizing properties. The biodegradable CaHA microspheres function as a scaffold for the formation of new tissue by stimulating a variety of cellular responses leading to the production of collagen, elastin, vasculature, and proteoglycans and thereby enhance skin quality. Despite the promising regenerative effects of CaHA-CMC, substantial gaps remain in understanding its precise underlying mechanisms, and addressing these gaps is crucial to optimizing its clinical applications. A literature search was conducted with PubMed, Google Scholar, and Web of Science for keywords, including \"calcium hydroxylapatite,\" \"tissue regeneration,\" \"macrophages,\" \"fibroblasts,\" and \"calcium.\" This review elucidates the novel mechanisms of CaHA-CMC action within aesthetic medicine, with a focus on the dynamic interactions between macrophages and fibroblasts. The key role of calcium ions as critical biological cues in directing skin regeneration pathways is explored alongside an examination of the distinct physicochemical properties of CaHA-CMC. CaHA-CMC helps in tissue regeneration by providing calcium ions that act as key biological cues, promoting fibroblast activity and collagen production.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"393-403"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370768","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":"Artificial Intelligence for Patient Support: Assessing Retrieval-Augmented Generation for Answering Postoperative Rhinoplasty Questions.","authors":"Ariana Genovese, Sahar Borna, Cesar A Gomez-Cabello, Syed Ali Haider, Srinivasagam Prabha, Maissa Trabilsy, Cui Tao, Keith T Aziz, Peter M Murray, Antonio Jorge Forte","doi":"10.1093/asj/sjaf038","DOIUrl":"https://doi.org/10.1093/asj/sjaf038","url":null,"abstract":"<p><strong>Background: </strong>While artificial intelligence (AI) is revolutionizing healthcare, inaccurate or incomplete information from pre-trained large language models (LLMs) like ChatGPT poses significant risks to patient safety. Retrieval-Augmented Generation (RAG) offers a promising solution by leveraging curated knowledge bases to enhance accuracy and reliability, especially in high-demand specialties like plastic surgery.</p><p><strong>Objectives: </strong>This study evaluates the performance of RAG-enabled AI models in addressing postoperative rhinoplasty questions, aiming to assess their safety and identify necessary improvements for effective implementation into clinical care.</p><p><strong>Methods: </strong>Four RAG models (Gemini-1.0-Pro-002, Gemini-1.5-Flash-001, Gemini-1.5-Pro-001, and PaLM 2) were tested on 30 common patient inquiries. Responses, sourced from authoritative rhinoplasty texts, were evaluated for accuracy (1-5 scale), comprehensiveness (1-3 scale), readability (Flesch Reading Ease, Flesch-Kincaid Grade Level), and understandability/actionability (Patient Education Materials Assessment Tool). Statistical analyses included Wilcoxon rank sum, Armitage trend tests, and pairwise comparisons.</p><p><strong>Results: </strong>When responses were generated, they were generally accurate (41.7% completely accurate); however, a 30.8% nonresponse rate revealed potential challenges with query context interpretation and retrieval. Gemini-1.0-Pro-002 demonstrated superior comprehensiveness (p < 0.001), but readability (FRE: 40-49) and understandability (mean: 0.7) fell below patient education standards. PaLM 2 scored lowest in actionability (p < 0.007).</p><p><strong>Conclusions: </strong>This first application of RAG to postoperative rhinoplasty patient care highlights its strengths in accuracy alongside its limitations, including nonresponse and contextual understanding. Addressing these challenges will enable safer, more effective implementation of RAG models across diverse surgical and medical contexts, with the potential to revolutionize patient care by reducing physician workload while enhancing patient engagement.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633356","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":"Morphological Changes in Rectus Abdominis Muscle Associated With Pregnancy and Abdominoplasty.","authors":"Dong Wei, Xufeng Shi, Jie Ren, Xin Cui","doi":"10.1093/asj/sjaf037","DOIUrl":"https://doi.org/10.1093/asj/sjaf037","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy can alter the rectus abdominis, which abdominoplasty can potentially correct.</p><p><strong>Objectives: </strong>This study aims to examine these muscle changes during pregnancy and evaluate how effectively abdominoplasty with double folds of the rectus abdominis tightens the muscle.</p><p><strong>Methods: </strong>We collected clinical data from nulliparous and pregnant patients who had abdominoplasty with double folds of the rectus abdominis. We measured the linea alba width, rectus abdominis width and thickness, its cross-sectional area, and abdominal circumference. Postoperative complications were also recorded. The assessment of satisfaction with the morphology of the rectus abdominis, both pre- and post-surgery, was conducted using a 5-point Likert scale.</p><p><strong>Results: </strong>The study included 400 women: 171 nulliparous, 106 with one pregnancy (group 1), and 123 with two or more pregnancies (group 2). Complete postoperative data were available for 32 patients (group 3). Significant widening of the linea alba was found in group 1 and group 2. The rectus abdominis width increased significantly in group 1 but not in group 2. Its thickness remained unchanged in group 1 but decreased in group 2, mirroring the pattern of its cross-sectional area. In group 3, both the linea alba and rectus abdominis width decreased, while thickness and cross-sectional area increased. Post-surgery satisfaction with muscle morphology improved significantly, with no serious complications reported.</p><p><strong>Conclusions: </strong>Pregnancy can cause the rectus abdominis muscle to separate, widening the linea alba and flattening the muscle. Abdominoplasty, which reinforces the muscle with double folds, effectively resolves this, resulting in high patient satisfaction and few complications.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596073","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":"Effect of Subcutaneous Injection of Tranexamic Acid on Ecchymosis and Edema after Oculofacial Surgery: A Prospective, Randomized, Split-Face, Double-Blind Study.","authors":"Teresa H Chen, Dylann Fujimoto, Eduardo Damous Feijó, Jose Eduardo Rios, Marisa Novaes de Figueiredo Rassi, Rafael Leão, Jeremiah P Tao, Roberto Murillo Limongi","doi":"10.1093/asj/sjaf036","DOIUrl":"https://doi.org/10.1093/asj/sjaf036","url":null,"abstract":"<p><strong>Background: </strong>Tranexamic acid (TXA) is an antifibrinolytic that is regularly used to reduce bleeding in surgical specialties.</p><p><strong>Objectives: </strong>To assess the effects of subcutaneous TXA in oculofacial plastic surgeries, with the hypothesis that TXA reduces postoperative ecchymosis and edema.</p><p><strong>Methods: </strong>A prospective, randomized, double-blind, split-face study. The sides of the face were randomized to local anesthetic (bupivacaine with epinephrine) mixed with TXA or sodium chloride (placebo). Photographs were taken immediately post-operatively and on post-operative day 7. Photographs were graded by two masked investigators using the Surgeon Periorbital Rating of Edema and Ecchymosis criteria. Patients selected the side that they subjectively determined to have less ecchymosis and edema. As a secondary outcome, patients rated pain on each side of their face using the Wong-Baker FACES pain scale.</p><p><strong>Results: </strong>Twenty-four patients undergoing bilateral, symmetric oculofacial surgery were included in the study. There was a statistically significant difference in postoperative periocular ecchymosis on POD7 (with TXA 0.91 ± 0.73 versus placebo 1.61 ± 1.03; p = 0.020) and in periocular edema on POD1 (with TXA 1.30 ± 0.76 versus placebo 2.00 ± 0.85; p = 0.028). All patients selected the side of the face receiving TXA as having less periocular ecchymosis and edema. There was no statistically significant difference in subjective pain level between the side receiving TXA versus placebo. There were no intraoperative or postoperative complications.</p><p><strong>Conclusions: </strong>Subcutaneous TXA was safe and reduced periocular ecchymosis and edema compared to contralateral placebo injections in this series of patients undergoing bilateral oculofacial plastic surgeries.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596072","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":"Increasing Private Equity Investments in Plastic Surgery Practices in the United States: Analysis of Trends and Consolidation.","authors":"Ravi Dhawan, Kendall Brooks, Orr Shauly, Denys Shay, Anjali Om, Albert Losken, Paul A Ghareeb","doi":"10.1093/asj/sjaf034","DOIUrl":"https://doi.org/10.1093/asj/sjaf034","url":null,"abstract":"<p><strong>Background: </strong>Private equity (PE) investment in healthcare has expanded rapidly, particularly in plastic surgery, where rising demand for aesthetic procedures presents attractive financial opportunities. While PE backing may enhance operational efficiencies, concerns exist regarding its potential impact on care quality, patient outcomes, and healthcare costs.</p><p><strong>Objectives: </strong>This study examines PE acquisitions of U.S. plastic surgery practices, identifying trends in investment growth, geographic distribution, and the financial models adopted by PE-backed practices.</p><p><strong>Methods: </strong>This cross-sectional study analyzed PE acquisitions of U.S. plastic surgery practices from January 1, 2000, to July 1, 2024. Data were obtained from PitchBook, verified through practice websites and follow-up inquiries. The analysis focused on acquisition trends, insurance acceptance policies, and the geographic distribution of PE-backed practices.</p><p><strong>Results: </strong>Between 2000 and 2023, PE-backed acquisitions in plastic surgery grew by 4300% in practice volume and 7630% in capital investment. Acquisitions were concentrated in states such as Texas, Florida, and New York. PE investment was prominent in general, facial, and oculoplastic surgery practices, with a preference for cash-only models, particularly in specialized fields. Many practices employed few plastic surgeons, relying instead on aesthetic clinicians.</p><p><strong>Conclusions: </strong>PE consolidation in plastic surgery is expanding rapidly, driven by demand for elective procedures. While PE investment brings financial and operational advantages, it raises concerns about healthcare quality and equity. Further research comparing PE and non-PE-owned practices is necessary to guide policies ensuring patient care quality and access.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584379","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":"https://doi.org/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 four CBL-514 treatments (2mg/cm², maximum 600mg/treatment) or placebo, administered subcutaneously to the abdomen every 4 weeks. Two follow-up visits were conducted at 4 and 8 weeks post-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 ≥150mL from baseline compared with placebo.</p><p><strong>Results: </strong>In the intention-to-treat (ITT) population, a significantly higher proportion of CBL-514-treated participants achieved ≥150mL 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 ≥150mL subcutaneous fat, compared with none in the placebo group (p<0.001). 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 ≥150mL 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 non-invasive treatment, CBL-514 could be a new, promising alternative therapy for effective targeted subcutaneous fat reduction.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized, Double-Blind, Placebo-Controlled, Multi-centered study to Evaluate the Efficacy and Safety of MEI005 in Reducing Submental Fat in Chinese Adults.","authors":"Wenyun Ting, Junxian Wen, Zhijin Li, Jiaming Sun, Jiaping Zhang, Maoguo Shu, Hongwei Liu, Li He, Bo Yu, Nan Jiang, Chunyu Xue, Qian Tan, Xuewen Xu, Sufan Wu, Dan Jian, Hongyi Zhao, Lei Wang, Nanze Yu, Xiaojun Wang","doi":"10.1093/asj/sjaf031","DOIUrl":"https://doi.org/10.1093/asj/sjaf031","url":null,"abstract":"<p><strong>Background: </strong>Submental fat (SMF) is a common aesthetic concern traditionally treated with liposuction. Non-surgical alternatives like injectable deoxycholic acid are gaining popularity. However, no related products have been clinically approved in China.</p><p><strong>Objectives: </strong>This study evaluated the efficacy and safety of MEI005, a deoxycholic acid-based injectable formulation, in reducing SMF in Chinese adults.</p><p><strong>Methods: </strong>This multicenter, randomized, double-blind, placebo-controlled phase III trial included 325 Chinese adults with moderate to SMF. Participants received MEI005 or a placebo injections every 28 days for up to six sessions. Primary endpoints were ≥2-grade improvements in Clinician and Patient-Reported Submental Fat Rating Scales (CR-SMFRS; PR-SMFRS). Secondary endpoints included SMF volume reductions measured by MRI; patient-reported outcomes on the Patient-Reported Submental Fat Impact Scale (PR-SMFIS) and Subject Satisfaction Rating Scale (SSRS); SMF thickness reductions measured by caliper. Adverse events, self-reports, clinical examinations, and checks for skin laxity were monitored.</p><p><strong>Results: </strong>At 12 weeks post-treatment, 18.9% of MEI005 recipients demonstrated simultaneously ≥2-grade CR-SMFRS and PR-SMFRS improvement versus 1.8% for placebo (P<0.001). Additionally, 68.9% of MEI005 group participants achieved simultaneously ≥1-grade improvement in CR-SMFRS and PR-SMFRS, compared to 21.6% of placebo (P<0.001). MRI revealed ≥10% SMF volume reduction in 50% of MEI005 subjects versus 15.2% of placebo (P<0.001). Scores on the PR-SMFIS and SSRS scales showed greater psychological improvement and satisfaction among MEI005 recipients. Vernier caliper measurements showed a 21.42% thickness reduction versus 6.32% (P<0.001). Adverse events were mostly mild to moderate.</p><p><strong>Conclusions: </strong>MEI005 effectively reduces SMF, offering a safe, minimally invasive option for Chinese adults.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555601","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 Occurrence of Health Symptoms in General Practice Before and After the Explantation of Cosmetic Breast Implants.","authors":"Annemiek S Lieffering, Marc A M Mureau, Juliëtte E Hommes, Lotte Ramerman, Hinne A Rakhorst, R R W J van der Hulst, R A Verheij","doi":"10.1093/asj/sjaf030","DOIUrl":"https://doi.org/10.1093/asj/sjaf030","url":null,"abstract":"<p><strong>Background: </strong>Explantation of breast implants is increasingly performed in response to concerns about Breast Implant Illness (BII), an array of various health symptoms. However, the benefits of explantation remain unclear due to methodological limitations in prior studies.</p><p><strong>Objectives: </strong>To examine the occurrence of health symptoms before and after explantation of cosmetic breast implants.</p><p><strong>Methods: </strong>Retrospective cohort study linking data from the Dutch Breast Implant Registry and Nivel Primary Care Database. The study included 217 cosmetic explantation patients, and control groups of 228 cosmetic replacement patients, and 433 women without breast implants (non-recipients). BII-related health symptoms presented in general practice were compared between groups one year before and after explantation. Outcomes included any symptom, ≥2 symptoms, ≥3 symptoms, ≥3 consultations, and substantial symptoms (≥3 symptoms with ≥2 consultations for two symptoms).</p><p><strong>Results: </strong>The likelihood of ≥3 symptoms, ≥3 consultations, and substantial symptoms reduced significantly after explantation (OR ≥3 symptoms 0.26, 95% CI [0.08-0.85]; OR ≥3 consultations 0.56, 95% CI [0.32-0.96]; OR substantial symptoms 0.36, 95% CI [0.14-0.94]). However, compared to non-recipients, explantation patients still had higher odds of any symptom, ≥2 symptoms and ≥3 consultations after explantation. Replacement patients also had a reduced likelihood of any symptom, ≥2 symptoms, and ≥3 consultations from pre- to post-surgery.</p><p><strong>Conclusions: </strong>Although explantation appears to improve BII-related health symptoms within a year, women still showed an increased likelihood of symptoms compared to non-recipients.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447894","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":"Arterioembolic Characteristics of Differentially Diluted CaHA-CMC Gels Within an Artificial Macrovascular Perfusion Model.","authors":"Danny J Soares, Julia Fedorova, Yu Zhang, Akash Chandawarkar, Alexis Bowhay, Larry Blevins, Thomas J Kean, David K Funt","doi":"10.1093/asj/sjaf028","DOIUrl":"https://doi.org/10.1093/asj/sjaf028","url":null,"abstract":"<p><strong>Background: </strong>Despite the recently increased incidence and improved awareness of filler-induced ischemic injuries, the arterioembolic behavior of filler products has not been well described.</p><p><strong>Objectives: </strong>To evaluate the embolic behavior of varying dilutions of Calcium Hydroxylapatite-Carboxymethylcellulose (CaHA-CMC) gel mixtures within an artificial macrovascular perfusion model of the proximal facial artery with correlation against published instances of ischemic injuries in the literature.</p><p><strong>Methods: </strong>CaHA-CMC gel mixtures were assessed via the Pulsatile Unit for the Laboratory Simulation of Arterioembolic Restrictions (PULSAR) system at different flow rates. The occlusive behavior, embolic particle size distributions, and morphological attributes were evaluated through direct photo and videographic captures followed by digital image processing. The PubMed database was systematically queried for all published instances of CaHA-CMC-associated ischemic injuries.</p><p><strong>Results: </strong>Undiluted CaHA-CMC demonstrated highly cohesive behavior upon PULSAR inoculation, with a tendency toward proximal occlusion. Gel fragmentation resulted in a polydisperse embolic mixture averaging 0.151 ± 0.61 mm² (Interquartile Range: 0.006-0.022 mm²) in size. Product dilution had a profound effect on embolic behavior, with a significant reduction in average particle size (0.018 ± 0.03 mm²; Interquartile Range: 0.005-0.018 mm²; p < 0.0001) and complete elimination of proximally occlusive capacity for hyperdiluted mixtures compared to undiluted product (p = 0.002). Confirmed hyperdiluted CaHA-CMC-associated ischemic injuries represented only 3% of published reports, with a predominantly self-limited clinical course.</p><p><strong>Conclusions: </strong>Embolized CaHA-CMC gels produce polydisperse particle mixtures with a preponderance of microparticles. Hyperdilution profoundly reduced the proximally occlusive potential of the product.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447890","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":"Use of 801 Acellular Dermal Matrices (ADMs) in Direct-to-Implant Breast Reconstruction: A Clinical Observation of Complication Profiles Over a 7-Year Period.","authors":"Haim Yoel Kaplan, Roman Rysin","doi":"10.1093/asj/sjae238","DOIUrl":"10.1093/asj/sjae238","url":null,"abstract":"<p><strong>Background: </strong>The emergence of acellular dermal matrices (ADMs) revolutionized prepectoral breast reconstruction, allowing partial or complete implant coverage. ADM had been described to possess several important benefits; nevertheless, the literature described an increased postoperative complication rate.</p><p><strong>Objectives: </strong>The aim of this study was to delineate H.Y.K.'s experience with ADM in direct-to-implant (DTI) breast reconstruction, and to describe complication rate and patient satisfaction.</p><p><strong>Methods: </strong>This was a retrospective patient cohort that underwent primary or revisional breast reconstruction (DTI) utilizing DermaCell, from Jan 2017 to Jan 2024.</p><p><strong>Results: </strong>A total of 230 consecutive patients, 410 breasts, and 801 DermaCell sheets were evaluated. All were DTI breast reconstructions. Complication rate was described per breast. A total of 92 cases of complication occurred (22.4%). Rippling was seen in 18 breasts (4.39%), skin ischemia in 21 breasts (5.12%), hematoma in 5 (1.21%), and seroma in 9 (2.19%). Seventeen breasts experienced capsular contraction. In the nonirradiated group, capsular contracture (CC), Baker grade 3 to 4, was seen in 4 breasts (1.11%), with 9 (18%) in the irradiated group. The postoperative follow-up period was 18 months (range: 6-84 months). BREAST-Q satisfaction with the breast increased by a mean of 10.45. Satisfaction with the implant was 6.61 out of 8.</p><p><strong>Conclusions: </strong>This cohort study represents the most comprehensive and up-to-date experience with DermaCell for DTI breast reconstructive surgery. The favorable complication profile suggests that DermaCell ADM offers a safe and reliable option, making it an important tool in the armamentarium of reconstructive plastic surgeon. DermaCell is an important component in prepectoral breast reconstruction, contributing to better results, an improved complication profile, and patient satisfaction.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"276-285"},"PeriodicalIF":3.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805830","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}