Aesthetic Surgery Journal最新文献

{"title":"Impact of Synchronized Radiofrequency and High-intensity Facial Electrical Stimulation on Facial Muscles and the Superficial Fascial System in the Midface.","authors":"Konstantin Frank, Kai O Kaye, Gabriela Casabona, Emily Glaue, Rui Zeng, Ting Song Lim, Vanessa Brebant, Lukas Prantl, Nicholas Moellhoff, Sebastian Cotofana","doi":"10.1093/asj/sjae252","DOIUrl":"10.1093/asj/sjae252","url":null,"abstract":"<p><strong>Background: </strong>Midfacial aging involves skeletal changes, muscle weakening, and fat redistribution, resulting in volume loss, skin sagging, and deepened nasolabial folds. High-intensity facial electrical stimulation (HIFES) combined with radiofrequency (RF) is a novel noninvasive method for addressing these changes by enhancing muscle mass and remodeling subcutaneous tissue.</p><p><strong>Objectives: </strong>The goal of this study was to assess the efficacy of HIFES and synchronized RF in improving midfacial aesthetics, specifically muscle thickness, skin displacement, and facial volume.</p><p><strong>Methods: </strong>This prospective, nonrandomized study included 37 participants who underwent 4 HIFES and RF treatments over 24 weeks. Assessments at baseline, 4, 16, and 24 weeks were performed with ultrasound imaging, electromyography (EMG), 3-dimensional surface imaging, and the Modified Fitzpatrick Wrinkle Scale. A related porcine study evaluated the treatment's histological effects.</p><p><strong>Results: </strong>Zygomaticus major muscle thickness increased from 2.06 mm to 2.80 mm, with a 39.3% rise in EMG signal strength, indicating improved muscle function. Skin displacement analysis revealed horizontal (0.90 mm) and vertical (1.01 mm) shifts, particularly laterally. Midface volume increased by 1.43 cm³ at 24 weeks. The porcine study confirmed increased muscle fiber size, myonucleus count, and mass density, aligning with human results.</p><p><strong>Conclusions: </strong>HIFES and synchronized RF treatments significantly improved muscle thickness, skin displacement, and facial volume, effectively rejuvenating the midface. These clinical findings, supported by histological evidence, suggest a promising noninvasive approach for facial rejuvenation. Further randomized studies are needed to confirm these results and assess long-term effects.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"422-428"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920553","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":"Semaglutide and Postoperative Outcomes in Nondiabetic Patients Following Body Contouring Surgery.","authors":"Joshua E Lewis, Mbinui Ghogomu, Stanley J Hickman, Adedamola Ashade, Raven J Hollis, Jimmie E Lewis, Wei-Chen Lee","doi":"10.1093/asj/sjae241","DOIUrl":"10.1093/asj/sjae241","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide is a medication for weight loss in obese patients. Recently, many plastic surgeons have recommended semaglutide following bariatric surgery to increase weight loss. However, postoperative complications such as wound dehiscence, delayed healing, and infection pose significant risks.</p><p><strong>Objectives: </strong>In this study we aimed to examine the relationship between preoperative semaglutide and postoperative complications in nondiabetic obese patients undergoing body contouring surgery. We hypothesized that semaglutide would increase the risk of postoperative complications.</p><p><strong>Methods: </strong>In this retrospective cohort study we utilized the TriNetX Research database. Nondiabetic patients who underwent body contouring surgery between 2021 and 2024 after bariatric procedures were included. Patients were divided into 2 cohorts: Cohort A (4215 patients), which received semaglutide for ≥6 months before surgery, and Cohort B (104,927 patients), without semaglutide. Propensity score matching was employed to create comparable cohorts based on age, gender, race, and BMI. The primary outcomes included postoperative complications within 30 days of surgery.</p><p><strong>Results: </strong>Significant differences were found between the cohorts. Semaglutide patients had higher rates of wound dehiscence (5.19% vs 2.78%, P < .0001); delayed wound healing (2.58% vs 1.21%, P < .0001); surgical site infections (5.37% vs 2.87%, P < .0001); nausea, vomiting, and diarrhea (11.27% vs 5.34%, P < .0001); hypertrophic scar formation (5.53% vs 3.86%, P = .0011); and surgical site pain (6.05% vs 3.29%, P < .0001).</p><p><strong>Conclusions: </strong>Preoperative semaglutide in nondiabetic patients undergoing body contouring surgery following bariatric procedures is associated with higher rates of adverse postoperative outcomes. These findings highlight the need for enhanced preoperative counseling and surgical planning to minimize risks and improve patient outcomes.</p><p><strong>Level of evidence: 3 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"381-386"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811699","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":"Intraoperative Predictors of Salvage in Infected Breast Implants: A Retrospective Study.","authors":"Makenna Ash, Owen Brown, Jennifer Wang, Omar Jean-Baptiste, Angela Cheng, Grant Carlson, Albert Losken, Peter Thompson","doi":"10.1093/asj/sjae242","DOIUrl":"10.1093/asj/sjae242","url":null,"abstract":"<p><strong>Background: </strong>Infectious complications associated with implant-based breast reconstruction (IBBR) can be devastating and may lead to reconstructive failure. Although there are known demographic risk factors for reconstructive failure, few studies have identified intraoperative findings that predict failure after attempted salvage.</p><p><strong>Objectives: </strong>The objective of this study was to identify intraoperative findings in infected breasts that might be predictive of implant failure.</p><p><strong>Methods: </strong>In total, 837 patients undergoing IBBR between January 2017 and July 2023 were included. Intraoperative records of patients who developed a major infection were reviewed. Reconstructive salvage denoted any intervention not resulting in explantation. Failure denoted explantation.</p><p><strong>Results: </strong>Of 837 patients, 8% developed a major infection (n = 71). Within this group, 8% had successful treatment with intravenous antibiotics alone, 38% were salvaged after operative intervention, 28.2% failed without salvage attempt, and 25.4% underwent salvage attempt but ultimately failed. Overall, the rate of reconstructive failure was 53.5% and the rate of implant salvage was 46.5%. A total of 51% of patients returning to operating room were found to have unincorporated acellular dermal matrix (ADM). Seventy-eight percent of patients undergoing intervention had a positive culture, most commonly methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Serratia, Enterobacter, Pseudomonas or Proteus. Unincorporated ADM was significantly associated with reconstructive failure (odds ratio 5.4, P = .003). Serratia infection, hematoma, and gram-negative infection were associated with implant failure, but these findings did not achieve statistical significance.</p><p><strong>Conclusions: </strong>Presence of unincorporated ADM was associated with eventual implant failure. Surgeons should be aware that this finding may portend poor outcomes for patients. These results may be helpful to intraoperative decision-making.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"359-364"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880793","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":"Reevaluating Semaglutide in Postbariatric Contouring Surgery: The Role of Undermined Immune Response and Nutritional Deficiency in Wound Complications.","authors":"Liang Zhang, Qifeng Ou","doi":"10.1093/asj/sjaf008","DOIUrl":"10.1093/asj/sjaf008","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP133-NP134"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998572","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 Dark Side of 3D Simulation in Breast Augmentation: How to Use Its Advantages and Avoid Its Drawbacks.","authors":"Paolo Montemurro, Luca Savani, Paolo Toninello","doi":"10.1093/asj/sjae245","DOIUrl":"10.1093/asj/sjae245","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP129-NP131"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852045","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":"Is Vibration Anesthesia Effective and Safe for Pain Reduction in Botulinum Toxin Injection? A Randomized Split-Face Controlled Trial and Cadaver Experiment.","authors":"Tianzhen Hua, Huan Li, Chun Liang, Guangliang Zhang, Libo Luo, Haoran Jia, Xin Liu, Yuan Chi, Yang An, Youbai Chen","doi":"10.1093/asj/sjae231","DOIUrl":"10.1093/asj/sjae231","url":null,"abstract":"<p><strong>Background: </strong>Pain is an important issue in botulinum toxin injection. Vibration anesthesia is a noninvasive method for pain alleviation, but few studies have reported its use during botulinum toxin injection.</p><p><strong>Objectives: </strong>The aim of this study was to investigate whether vibration anesthesia was effective and safe for pain reduction during botulinum toxin injection for masseter reduction.</p><p><strong>Methods: </strong>A randomized split-face controlled trial was performed in patients who required masseter reduction. Vibration anesthesia was randomly administered on either side. Study outcomes were pain scores on a visual analog scale, duration of effect, satisfaction, and complications. Intergroup comparison and linear regression analyses were performed.</p><p><strong>Results: </strong>In a total of 216 patients, the pain score on the vibration side (2.97 ± 1.44) was significantly lower than that on the nonvibration side (4.72 ± 2.13) (P < .0001), with a higher proportion of mild pain. Linear regression showed that a history of injection and more injection points and doses increased the pain, whereas a 2-mL syringe reduced the pain compared to a 1-mL syringe. Side effects were found in 19 patients and 21 sides (7%), but were not associated with vibration. High satisfaction was reported. A cadaver experiment confirmed that vibration did not alter the diffusion radius and depth of injection.</p><p><strong>Conclusions: </strong>Vibration anesthesia significantly relieved pain during botulinum toxin injection for masseter reduction, and it did not cause adverse effects and or affect duration of effect. Therefore, we recommend vibration anesthesia, a larger syringe size, and fewer injection points to improve patient experience and satisfaction.</p><p><strong>Level of evidence: 3 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP113-NP118"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638556","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":"3D Breast Scanning in Plastic Surgery Utilizing Free iPhone LiDAR Application: Evaluation, Potential, and Limitations.","authors":"Ioannis Kyriazidis, Juan Enrique Berner, Karl Waked, Moustapha Hamdi","doi":"10.1093/asj/sjae251","DOIUrl":"10.1093/asj/sjae251","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) imaging enhances surgical planning and documentation in plastic surgery, but high costs limit accessibility. Mobile light detection and ranging (LiDAR) technology offers a potential cost-effective alternative.</p><p><strong>Objectives: </strong>The objective of this research was to evaluate the accuracy and clinical utility of iPhone-based LiDAR scanning for breast measurements compared to traditional methods, and to establish standardized protocols for clinical implementation.</p><p><strong>Methods: </strong>In this prospective validation study, 25 consecutive patients (mean age: 44 years; range: 32-64 years; mean BMI: 23.2 kg/m2) undergoing breast procedures were evaluated with the \"3D Scanner App\" on the iPhone 15 Pro (Apple Inc., Cupertino, CA). Three standardized measurements (sternal notch-to-nipple, nipple-to-midline, nipple-to-inframammary fold) of LiDAR and manual techniques were compared. Technical error of measurement (TEM) and relative TEM (rTEM) were calculated. Interrater reliability, learning curve assessment, and cost-effectiveness analysis were performed.</p><p><strong>Results: </strong>LiDAR measurements showed very good accuracy for sternal notch-to-nipple (rTEM 1.43%, 95% CI: 1.21-1.65) and nipple-to-midline (rTEM 2.83%, 95% CI: 3.12-3.78) distances. Nipple-to-inframammary fold measurements showed poor accuracy (rTEM 13.05%, 95% CI: 8.21-9.39). Interrater reliability was excellent (ICC = 0.92). Learning curve analysis demonstrated measurement stability after 5 cases. Cost analysis revealed 97.8% reduction in initial investment compared to commercial 3D imaging systems.</p><p><strong>Conclusions: </strong>Mobile LiDAR offers a cost-effective tool for breast surgery planning and documentation. While measurements like sternum-to-nipple and nipple-to-midline are highly accurate, the relatively poor accuracy of nipple-to-IMF highlights limitations with complex curves. As this technology continues to evolve, further improvements in accuracy are anticipated, expanding its role in clinical use.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP99-NP104"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920547","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 Unique Privilege of Mentorship: Mentor and Mentee Perspectives.","authors":"Jad Abi-Rafeh, Foad Nahai","doi":"10.1093/asj/sjae247","DOIUrl":"10.1093/asj/sjae247","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP126-NP127"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942751","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":"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}