Aesthetic Surgery Journal最新文献

{"title":"Glucagon-Like Peptide-1 Receptor Agonist-Associated Facial Changes: A Comprehensive Review of Pathophysiology, Clinical Manifestations, Risk Factors, Prevention, and Management.","authors":"Kwang-Ho Yoo","doi":"10.1093/asj/sjag230","DOIUrl":"https://doi.org/10.1093/asj/sjag230","url":null,"abstract":"<p><p>Facial hollowing, skin laxity, and more prominent folds are increasingly reported during weight loss with glucagon-like peptide-1 receptor agonists (GLP-1 RAs). The term 'Ozempic face' can imply a drug-specific adverse effect, although similar changes occur after other forms of substantial weight loss. This review examines the clinical evidence, proposed mechanisms, and implications for aesthetic care. PubMed, Embase, Web of Science, and Google Scholar were searched for January 2014 through August 2026. Selection was reported using PRISMA 2020 where applicable, followed by narrative synthesis. Of 958 records, 46 reports were included. Serial imaging in 20 patients showed a median 9% reduction in midfacial volume, with greater loss in superficial than deep compartments (11% vs 7%). Regression estimated approximately 7% total midfacial volume loss per 10 kg lost. A FACE-Q short-form has been validated, and a survey of 1,226 participants found more reports of facial volume loss and laxity with greater percentage weight loss. Post-bariatric studies also describe facial deflation and increased apparent age, particularly in older patients and after larger losses. Current evidence favors weight-loss-associated deflation superimposed on baseline anatomy and aging. The independent effect of weight-loss rate and the modifying roles of menopause and hormone therapy remain uncertain. Aesthetic treatment evidence is limited and largely uncontrolled.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178924","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":"Predictive Modelling of Waist Reduction in the RibXcar Technique: Correlation Between Angularity of Monocortical Fracture and Aesthetic Result.","authors":"Raúl M Manzaneda Cipriani, Héctor Duran, Gerardo A Adrianzen, Emmanuel Flores, Hassan Ben Moussa, Jose David Salazar, Enrique Romero Algara","doi":"10.1093/asj/sjag223","DOIUrl":"https://doi.org/10.1093/asj/sjag223","url":null,"abstract":"<p><strong>Background: </strong>Aesthetic rib remodeling redefines the waistline through structural modification of the lower rib cage. Ultrasound-guided percutaneous RibXcar reduces rib angularity without skin incisions and contributes to waist narrowing. However, the relationship between rib angulation changes and long-term waist reduction remains insufficiently quantified.</p><p><strong>Objectives: </strong>To evaluate the association between perioperative waist measurements, ultrasound-based rib angulation, and waist circumference at 12 months, and to develop a clinically applicable formula for expected waist reduction.</p><p><strong>Methods: </strong>This study included 257 patients who underwent RibXcar between January 2023 and January 2024. Waist circumference and rib angulation were measured at standardized time points during 12-month follow-up. A multiple linear regression model was developed using perioperative waist measurements and ultrasound-based rib angle variables. After initial model construction, collinearity diagnostics were performed using variance inflation factor and tolerance statistics, allowing refinement of the angular predictors included in the final equation. Model fit was evaluated using R2, adjusted R2, standard error, and regression ANOVA.</p><p><strong>Results: </strong>The revised model retained preoperative waist circumference, immediate postoperative waist circumference, preoperative R10 angulation, and immediate postoperative R11 and R12 angulations. It showed strong predictive performance for 12-month waist circumference (R = 0.910; R2 = 0.828; adjusted R2 = 0.825; standard error = 0.930 cm) and was statistically significant (p < 0.001). The equation was converted into a direct formula to estimate expected waist reduction.</p><p><strong>Conclusions: </strong>Perioperative waist measurements combined with ultrasound-based rib angulation variables allow objective estimation of waist evolution after RibXcar. This model may support surgical planning and patient counseling, but requires external validation.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178961","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":"Fat Grafting Versus Implant-based Breast Reconstruction: Methodological Considerations for a Meaningful Comparison.","authors":"Fernando Rosatti, Andrea Vittorio Emanuele Lisa, Adriana Cordova, Giovanni Zabbia, Gaia Ghiringhelli, Giuseppe Angelo Giovanni Lombardo, Simone La Padula, Francesca De Lorenzi, Valeria Navach","doi":"10.1093/asj/sjag228","DOIUrl":"https://doi.org/10.1093/asj/sjag228","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164854","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 Waist as a 3-dimensional Structure: Clinical Evaluation of an Algorithm-guided Osteocartilaginous Treatment in a 12-month Follow-up Cohort.","authors":"Raúl M Manzaneda Cipriani, Héctor Duran, Gerardo A Adrianzen, Emmanuel Flores, Jose David Salazar, Andres Ervind Mendoza Arteaga, Margiory Fernandez Rodriguez","doi":"10.1093/asj/sjag225","DOIUrl":"https://doi.org/10.1093/asj/sjag225","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, aesthetic waist treatment has focused on soft tissue modification; however, the underlying osteocartilaginous framework may constrain outcomes. The concept of the waist as a three-dimensional structure, defined by transverse width, craniocaudal length and anterior projection, has facilitated the development of targeted osseous remodelling techniques.</p><p><strong>Objectives: </strong>To describe and evaluate a comprehensive therapeutic framework based on a three-dimensional algorithm for the aesthetic treatment of the osteocartilaginous waist, with a 12-month clinical follow-up.</p><p><strong>Methods: </strong>A multicentre, prospective cohort study was conducted between April 2024 and January 2025 across four countries. Three hundred and eighty-four patients with a minimum of 12-month follow-up underwent osteocartilaginous procedures (RibXcar, FrontXribs and Xcrest), either individually or in combination, according to a standardized algorithm based on thoracic width, waist length and anterior projection. The outcomes included waist circumference, rib angulation, thoracic diameter, iliac crest distances, respiratory function, postoperative pain, complications, and BODY-Q satisfaction scores.</p><p><strong>Results: </strong>Baseline characteristics were comparable across all groups. All procedures achieved their expected outcomes, demonstrating sustained improvements at 12 months. Respiratory function remained stable throughout the follow-up period. Postoperative pain resolved without sequelae and there was a significant improvement in BODY-Q scores across all domains.</p><p><strong>Conclusions: </strong>A three-dimensional, algorithm-based approach enables the rational and reproducible treatment of the waist, achieving consistent structural modification through targeted interventions while preserving respiratory function and ensuring high patient satisfaction. This model establishes the waist as a true three-dimensional anatomical unit in body contouring surgery.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178927","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":"XCREST II: The X-factor in Iliac Crest Remodeling for Advanced Waist-to-hip Definition.","authors":"Raúl M Manzaneda Cipriani, Jose David Salazar, Héctor Duran, Gerardo A Adrianzen, Emmanuel Flores, Hassan Ben Moussa, Carlos H García Santana, Enrique Romero Algara, Maribel C Monar Goyes, Margiory Fernandez Rodriguez","doi":"10.1093/asj/sjag226","DOIUrl":"https://doi.org/10.1093/asj/sjag226","url":null,"abstract":"<p><strong>Background: </strong>Modern body contouring has evolved toward structural reshaping, with the waist-hip-gluteal unit as a key determinant of body contour aesthetics. The iliac crest is a critical landmark for lower waist contour.</p><p><strong>Objectives: </strong>To evaluate the aesthetic outcomes, safety, and anatomical contribution of XCREST II, a combined bony and myofascial technique for lower waist contouring.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study included 480 patients who underwent XCREST II between 2024 and 2026. Patients were categorized into four groups: XCREST II alone (n = 180), XCREST II + gluteal fat grafting (n = 84), XCREST II + RibXcar (n = 132), and XCREST II + RibXcar + gluteal fat grafting (n = 84). All underwent ultrasound-guided iliac crest remodeling with partial gluteus medius detachment. Anthropometric and BODY-Q outcomes were assessed preoperatively and at 12 months.</p><p><strong>Results: </strong>Four hundred eighty patients were included. Baseline characteristics were comparable, except for longer operative time in combined procedures (p < 0.001). At 12 months, all anthropometric measures improved significantly from baseline across groups (p < 0.001), without intergroup differences. Complications were low; prolonged postoperative pain and iliac crest pain were more frequent in groups including RibXCar (p = 0.020 and p = 0.017, respectively), without chronic pain. BODY-Q scores improved significantly across all domains (p < 0.001), differing only in body image (p = 0.019) and scar assessment (p < 0.001).</p><p><strong>Conclusions: </strong>XCREST II, a refinement of XCREST incorporating partial gluteus medius detachment, demonstrated favorable 12-month waist contour improvement and high patient satisfaction, with a low complication rate. Outcomes were consistent across subgroups.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179015","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":"RibXcar: Safety Fundamentals and Surgical Protocol for Controlled Costal Osteotomy in Body Contouring Surgery: A Prospective Study of 100 Patients.","authors":"Emmanuel Armando Flores González, Raúl Manzaneda Cipriani, Héctor Durán Vega, Gerardo Adrianzen, Jose David Salazar, Hassan Ben Moussa, Stefan Danilla","doi":"10.1093/asj/sjag224","DOIUrl":"https://doi.org/10.1093/asj/sjag224","url":null,"abstract":"<p><strong>Background: </strong>Aesthetic body contouring surgery has incorporated costal modification techniques to improve waist definition. The lack of standardized protocols and prospective safety data has generated controversy. The RibXcar technique proposes a controlled monocortical costal osteotomy as an alternative to rib resection; however, no prospective studies have comprehensively evaluated its safety profile.</p><p><strong>Objectives: </strong>To describe a standardized surgical protocol for the RibXcar technique and prospectively evaluate its safety, efficacy, impact on pulmonary function, postoperative pain, and patient satisfaction.</p><p><strong>Methods: </strong>A prospective study of 100 consecutive patients who underwent RibXcar alone (n=80) or combined with body liposuction (n=20). A 10-step protocol was described, and outcomes were evaluated: complications, pulmonary function (spirometry), waist diameter, costal angulation (ultrasound), pain (VAS), and satisfaction (Body-Q) preoperatively and at 6 months.</p><p><strong>Results: </strong>The overall minor complication rate was 8%, with no cases of pneumothorax or hemothorax. Pulmonary function showed no significant changes at 6 months in either group. Waist diameter reduction was 5.0 cm (IQR: 3.75-7.0) in the RibXcar group and 10.50 ± 1.73 cm in the combined group (P < .001). Costal angulation decreased significantly in all evaluated ribs (P < .0001). Body-Q scores improved significantly (P < .00001), and pain resolved by 6 months.</p><p><strong>Conclusions: </strong>The results of this series suggest that RibXcar, when performed under a standardized protocol, may constitute a safe and effective alternative for aesthetic rib remodeling in selected patients. The preservation of pulmonary function and the low complication rate observed would support its implementation in advanced body contouring surgery.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178949","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":"Multi-class Identification and Quantification of Breast Implant-related Complications in Ultrasonography Using a Pathology-informed Lesion Graph: A Deep Learning Development and Validation Study.","authors":"Hyokyung Yoo, Byeong Soo Kim, Jae Jin Ock, Ki Yong Hong, Hak Chang, Sungwan Kim","doi":"10.1093/asj/sjag221","DOIUrl":"https://doi.org/10.1093/asj/sjag221","url":null,"abstract":"<p><strong>Background: </strong>Breast ultrasonography (US) is cost-effective for detecting breast implant-related complications, but its reliability remains highly operator-dependent.</p><p><strong>Objectives: </strong>This study developed and validated a deep learning model for the automated multi-class identification and quantitative evaluation of breast implant complications (rupture, capsular contracture, and hematoma).</p><p><strong>Methods: </strong>We retrospectively analyzed 14,679 breast US images across 1,022 breast implant sequences from 908 patients. The proposed architecture integrates multiscale visual encoding, automated probe position mapping, and a pathology-informed mask graph layer with a Gradient Reversal Layer for lumen adversarial debiasing. Four convolutional backbones were benchmarked using an independent patient-level test dataset (N=197 implants).</p><p><strong>Results: </strong>The optimized DenseNet-based framework achieved 96.97% balanced accuracy with expert-guided spatial priors and 88.67% under autonomous baseline conditions. The model yielded 100% sensitivity for normal, rupture, and hematoma cohorts, and 87.88% sensitivity for capsular contracture; minor false-negatives were traced to morphological heterogeneity and coexisting pathologies. Furthermore, the system extracted quantitative morphometric profiles, yielding a mean relative capsule thickness of 2.4±0.4% for capsular contractures and a mean relative fluid area of 13.9±6.4% for hematomas.</p><p><strong>Conclusions: </strong>The proposed multiscale model delivers a comprehensive, clinical-grade output, comprising accurate complication classification, five-zone spatial localization, and objective morphometric metrics, while mitigating operator dependency. This system holds strong potential as an accessible, high-performance decision support tool for long-term safety screening of patients with breast implants.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147304","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":"Inframammary Fold Control in Tensioned Reverse Abdominoplasty: An Anatomical Reference for Integrated Breast and Abdominal Planning.","authors":"Mauro Deos","doi":"10.1093/asj/sjag220","DOIUrl":"https://doi.org/10.1093/asj/sjag220","url":null,"abstract":"<p><strong>Background: </strong>Tensioned Reverse Abdominoplasty (TRA) is used for the treatment of upper abdominal laxity. Because the technique directly involves the inframammary region, control of inframammary fold position should be considered during surgical planning, as inferior migration of the fold may alter thoracoabdominal proportions, modify breast morphology, and compromise outcome predictability.</p><p><strong>Objective: </strong>To evaluate the influence of preoperative definition of inframammary fold position on surgical planning in TRA and on the need, indication, and extent of associated breast treatment.</p><p><strong>Methods: </strong>This retrospective series included 50 consecutive patients who underwent TRA for aesthetic indications between 2019 and 2024. Preoperative assessment included clinical analysis of inframammary fold position, the relationship between the nipple-areola complex and the fold, and the effects of this relationship on breast morphology and thoracoabdominal proportions.</p><p><strong>Results: </strong>A caudally displaced inframammary fold was identified in 19 patients (38%), exclusively among those with prior breast surgery. Thirty-nine patients (78%) had a history of previous breast surgery. An associated breast procedure was performed in 29 patients (58%). Among patients with a caudally displaced fold, 10 (52.6%) underwent breast-base mastopexy, 8 (42.1%) underwent full mastopexy, and 1 (5.3%) underwent unilateral breast-base mastopexy after declining the indicated bilateral correction. At 12 months, all patients maintained inframammary fold stability, with no secondary inferior migration.</p><p><strong>Conclusion: </strong>TRA provides predictable control of inframammary fold position, establishing an anatomical reference for integrated breast and abdominal planning. Preoperative definition of its position may modify breast assessment and guide the need and extent of associated treatment.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102807","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 Profile of Standardized Tranexamic Acid (TXA) Dosing in Rhytidectomy: A Retrospective Comparative Cohort Study.","authors":"Sarah E Langsdon, Samantha Moore, Phillip R Langsdon","doi":"10.1093/asj/sjag219","DOIUrl":"https://doi.org/10.1093/asj/sjag219","url":null,"abstract":"<p><strong>Background: </strong>Tranexamic acid (TXA) has been associated with reductions in intraoperative blood loss, early postoperative bleeding, time to drain removal, and postoperative ecchymosis in rhytidectomy. However, concerns regarding potential cutaneous and systemic complications persist, and interpretation of the literature is limited by variability in dosing, route of administration, and operative technique. As a result, the safety profile of TXA when mixed with local anesthetic in facelift surgery remains incompletely defined.</p><p><strong>Objectives: </strong>To evaluate complications associated with TXA mixed with local anesthetic using a standardized concentration and dosing protocol in patients undergoing combined facial and cervical rhytidectomy.</p><p><strong>Methods: </strong>A retrospective comparative cohort study was conducted of a single surgeon's patients undergoing combined facial and cervical rhytidectomy under intravenous sedation, with and without the use of tranexamic acid (TXA) in local anesthetic infiltration (non-TXA vs TXA cohorts, 2012-2025). TXA was administered at defined concentrations of 9.1 mg/mL for incisional infiltration and 0.8 mg/mL in tumescent solution, with an average total dose of 582.6 mg per case.</p><p><strong>Results: </strong>A total of 1,036 patients were included (TXA, n = 556; non-TXA, n = 480). TXA use was not associated with an increase in minor or major ischemic events or systemic complications. Distal flap vascular compromise requiring topical nitroglycerin occurred at similar rates providing an additional clinical measure of mild flap vascular stress. No cases of permanent nerve paralysis were observed.</p><p><strong>Conclusions: </strong>In this single-surgeon cohort using defined dosing, TXA mixed with local anesthetic was not associated with increased ischemic or systemic complications.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102897","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":"Postoperative Physical Therapy After Breast Reconstruction: A Systematic Review.","authors":"Sevasti Panagiota Glynou, Annie Fritsch, Fedra Britvic, Dimple K Gajjar, Rebecca Knackstedt, Tae Chong, George Kokosis","doi":"10.1093/asj/sjag211","DOIUrl":"https://doi.org/10.1093/asj/sjag211","url":null,"abstract":"<p><strong>Background: </strong>Postoperative physical therapy (PT) is well established after mastectomy to reduce upper-limb dysfunction, pain, and quality-of-life impairment. However, its role following breast reconstruction remains less clearly defined, largely due to concerns regarding reconstruction-specific complications.</p><p><strong>Objectives: </strong>To evaluate the effects of PT on functional shoulder range of motion (ROM), pain, upper-limb function, and quality of life (QoL) after breast reconstruction.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered with PROSPERO (CRD420251025047). PubMed/MEDLINE, Embase, Scopus, CINAHL, and CENTRAL were searched from inception to July 2025. Eligible studies included adults undergoing implant-based or autologous reconstruction receiving preoperative or postoperative PT interventions. Quality was assessed via RoB 2 and ROBINS-I. Due to heterogeneity, a narrative synthesis was conducted.</p><p><strong>Results: </strong>Fifteen studies (n = 1,020) were included. Early and structured physiotherapy consistently improved short-term shoulder ROM, upper-limb function, and quality-of-life outcomes without increasing surgical complications. Initiating rehabilitation within two weeks postoperatively accelerated flexion and abduction recovery compared with traditional four-week immobilization protocols. Functional outcomes varied by reconstruction type, suggesting differing rehabilitation needs following implant-based versus autologous procedures. Massage-based interventions showed limited additional benefit from adjunctive therapies such as acupuncture or meditation. Evidence regarding optimal intervention type, delivery mode, and long-term benefit was limited by heterogeneity and variable study quality.</p><p><strong>Conclusions: </strong>Postoperative PT is probably associated with earlier functional recovery and does not appear to compromise surgical safety, although certainty in this evidence is low across outcomes. However, the current evidence base is limited. High-quality, powered randomized controlled trials with standardized measures and longer follow-up are necessary to establish definitive clinical guidelines.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102878","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}