Aesthetic Surgery Journal最新文献

{"title":"Ethics of Analyzing Celebrity Plastic Surgery on Social Media.","authors":"Seetha Aribindi, Myles N Sheehan, Allen H Roberts, David H Song","doi":"10.1093/asj/sjag218","DOIUrl":"https://doi.org/10.1093/asj/sjag218","url":null,"abstract":"<p><p>Over the past decade, social media has become a central arena for plastic surgeons to engage the public, giving rise to content in which surgeons analyze the appearances of public figures and speculate on procedures they may have undergone. Although often framed as educational, this practice raises ethical concerns that remain insufficiently addressed within the plastic surgery literature. Current ethical guidance emphasizes patient privacy, consent, and responsible representation within the physician-patient relationship but offers limited direction regarding physicians' obligations to individuals who are not under their care. Consequently, surgeons engaging in celebrity-focused commentary operate within an expanding ethical gray zone, invoking professional authority without the safeguards of clinical evaluation or consent. In this article, the authors examine the ethical implications of this practice through the core principles of medical ethics. They argue that such content risks propagating misinformation, undermining individual autonomy, and eroding professional integrity by leveraging medical authority for visibility and engagement. The authors further contend that physicians' ethical obligations extend beyond formal patient encounters to encompass all public-facing conduct. Finally, practical guidelines are proposed to support ethical social media engagement, emphasizing non-speculation, respect for autonomy, and prioritizing patient-centered education.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102738","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":"Skin Flow and Shape in the Aging Face: A Visualization.","authors":"Val Lambros","doi":"10.1093/asj/sjag173","DOIUrl":"https://doi.org/10.1093/asj/sjag173","url":null,"abstract":"<p><strong>Background: </strong>Although many aspects of the aging face are common knowledge, there are competing opinions about the path of skin across the face with age, here called \"flow\" or \"displacement.\"</p><p><strong>Objectives: </strong>The goal of this exploration was to define the actual pattern and vectors of skin displacement with age and to provide visual models for the visual phenomena of facial aging.</p><p><strong>Methods: </strong>Three-dimensional scans of 280 male participants and 387 female participants in 2 age groups, from 25 to 35 and from 65 and up, were obtained. The digital images were registered and landmarked, and the surface contours were averaged as in previous studies. Novel methods of analysis were applied to create vector maps of skin displacement as well as landmark tracking with age over the entire face.</p><p><strong>Results: </strong>Most of the surface of the model, and by extension the facial skin, flows from superior to inferior relative to the nasion. The entire upper face and cheek down to the level of the nasal base shows minimal displacement, 0 to 2 mm, and then stretches progressively to the jawline. Retrusion of the lips is a major definer of the nasolabial crease/fold complex. Weight has a major effect on the vectors of facial shape.</p><p><strong>Conclusions: </strong>Cheeks age largely by progressive inferior flow of skin. The nasolabial crease is greatly influenced by retrusion of the lips. Other previously described shape changes are confirmed and visualized. The conclusions presented here are largely supported by the videos, which the reader should review.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079487","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":"Achieving High Projection Without Compromise: Process Optimization of a New Resilient Hyaluronic Acid for Deep Structural Support.","authors":"Jimmy Faivre, Killian Flégeau, Camille Vantou, Alice Melotti, Elodie Clerc, François Bourdon","doi":"10.1093/asj/sjag182","DOIUrl":"https://doi.org/10.1093/asj/sjag182","url":null,"abstract":"<p><strong>Background: </strong>Traditional technology used to create cohesive hyaluronic acid (HA) injectables for aesthetic use often relies on increased HA concentration and high crosslinking to maximize strength and robustness. As a result, natural HA integrity may be compromised, leading to less dynamic rheology, difficulty in hyaluronidase degradation, and poor tissue integration.</p><p><strong>Objectives: </strong>The aim of this study was to demonstrate high projection capability, reversibility, and smooth tissue integration with an HA injectable gel produced from an optimized crosslinking process without high 1,4-butanediol diglycidyl ether modification.</p><p><strong>Methods: </strong>TPVM was created using optimized Preserved Network Technology (PNT+) crosslinking technology and evaluated against the existing US-approved and Conformité Européenne (CE)-marked resilient hyaluronic acid (RHA) fillers (RHA1-RHA4 in Europe, RHA Redensity, RHA2-3, and RHA Dynamic Volume in the United States). Assessments included physicochemical properties, rheology, injectability, hyaluronidase degradation, physician-rated injection ease across 3 indications, and long-term tissue integration in minipigs up to 156 weeks.</p><p><strong>Results: </strong>Despite a modification degree of 2.1%, among the lowest in the marketed fillers, TPVM achieved the highest elastic modulus (G' = 629 ± 8 Pa), linear viscoelastic region (454 ± 15 Pa), and resistance to compression force (10.5 ± 0.1 N). Injectability was rated \"very easy\" or \"easy\" in over 94% of cases across midface, chin retrusion, and jawline indications. Like all RHA gels, TPVM reached complete hyaluronidase degradation within 30 min. Histological evaluation at 52 and 156 weeks confirmed smooth tissue integration and progressive gel degradation with no encapsulation or persistent inflammation.</p><p><strong>Conclusions: </strong>Optimized PNT+ crosslinking technology decouples gel mechanical performance from the degree of chemical modification, enabling superior projection capacity while preserving enzymatic reversibility and tissue integration.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073197","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":"Breast Implant Microbiome Differs By Incision Site But Not By Implant Plane: An Analysis of 389 Explanted Implants.","authors":"Tim K Weltz, Shuang Peng, Andreas Larsen, Erik E F Bak, John V Q Tran, Linda R Gudjonsdottir, Simon G Sabroe, Caroline B G Norlin, Marie R Mortensen, Mathilde N Hemmingsen, Mathias Ørholt, Louise V Mielke, Jesper Trillingsgaard, Jens J Elberg, Lisbet R Hölmich, Lisa T Jensen, Peter Vester-Glowinski, Thomas Bjarnsholt, Urvish Trivedi, Xuanji Li, Mark W Clemens, Søren J Sørensen, Mikkel Herly","doi":"10.1093/asj/sjag215","DOIUrl":"https://doi.org/10.1093/asj/sjag215","url":null,"abstract":"<p><strong>Background: </strong>Subglandular implant placement and periareolar incisions have historically been associated with higher capsular contracture rates than subpectoral placement and inframammary fold (IMF) incisions. These differences have often been attributed to greater implant exposure to endogenous breast microbiota.</p><p><strong>Objectives: </strong>To compare microbiome diversity and composition on explanted breast implants between subpectoral and subglandular planes, and among IMF, periareolar, and transaxillary incisions, and assess whether greater parenchymal exposure is associated with persistent microbiome differences.</p><p><strong>Methods: </strong>We analyzed explanted implants from patients undergoing revisional surgery after breast augmentation using 16S rRNA gene amplicon sequencing. We compared alpha- and beta diversity and differential abundance of the dominant genera, adjusting for capsular contracture, implantation time, surface texture, smoking status, and within-patient clustering.</p><p><strong>Results: </strong>We analyzed 389 implants from 219 patients, of which 336 (86%) were subpectoral and 53 (14%) were subglandular. We did not detect differences between plane groups in alpha diversity (Shannon 1.7 vs 1.7, padj=0.62), community composition (PERMANOVA padj=0.46), or differential relative abundance of the dominant genera. In contrast, implants placed with a periareolar incision (n=45) showed higher richness and a distinct composition compared with the IMF group (n=308, Bray-Curtis padj=0.004), with no significant difference between IMF and transaxillary access (n=36, padj=0.12).</p><p><strong>Conclusions: </strong>We did not detect differences in relative microbiome diversity, community composition, or differential relative abundance of dominant genera between implant planes. In contrast, incision site was associated with consistent microbiome differences, suggesting that implantation route may influence the long-term implant microbiome.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057160","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":"Objective Standards and Subjective Preferences in Breast Aesthetics: A Scoping Review of the Ideal Breast.","authors":"Pegah Damavandi, Zhen Yu Wong, Ryan Faderani, Muholan Kanapathy, Afshin Mosahebi","doi":"10.1093/asj/sjag213","DOIUrl":"https://doi.org/10.1093/asj/sjag213","url":null,"abstract":"<p><p>Breast aesthetic ideals are shaped by anthropometric proportions, cultural norms, observer characteristics, and patient-specific expectations, yet the literature remains heterogeneous, with studies using variable measurements, image stimuli, and rating methods. This scoping review aimed to map the current evidence on objective morphometric standards and subjective aesthetic preferences in breast aesthetics and identify recurrent determinants of perceived breast attractiveness. A review was conducted in accordance with PRISMA-ScR guidance. MEDLINE and Embase were searched from inception to 28 October 2024. Studies were eligible if they evaluated breast aesthetic preferences, eye-tracking, ideal breast morphology, nipple-areola complex (NAC) characteristics, anthropometric measurements, or lay/clinician perceptions of breast aesthetics. Forty studies were included, comprising 39 cross-sectional studies and one prospective cohort study. Thirty-one studies (77.5%) primarily addressed general population images or measurements, while nine (22.5%) focused on a specific breast surgery context: breast augmentation (n = 4), breast reconstruction or breast-conserving therapy (n = 4), and reduction mammaplasty (n = 1). Seven overlapping evidence domains were identified: anthropometric, morphometric, eye-tracking, gender-related, cultural/geographic, lay perspective, and physician perspective studies. Recurrent determinants included breast-to-body proportionality, upper-to-lower pole ratio, lower-pole contour, projection, NAC position, areolar dimensions, and symmetry. No single breast morphology was consistently preferred across all populations. These findings support the use of recurring aesthetic domains as a practical framework for patient-centred consultation and outcome assessment, while highlighting the need for future research incorporating three-dimensional evaluation, culturally diverse populations, and validated patient-reported outcomes.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057107","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":"Correction of Crooked Nose in Preservation Rhinoplasty with Asymmetric Let-Down Osteotomy.","authors":"Alper Burak Uslu","doi":"10.1093/asj/sjag214","DOIUrl":"https://doi.org/10.1093/asj/sjag214","url":null,"abstract":"<p><strong>Background: </strong>Correction of nasal axis deviation in rhinoplasty is challenging. In literature most effective treatments include osteotomies and use of asymmetrical spreader graft or flaps with aim of pushing axis into midline. But despite best efforts, recurring and/or residual deviations are very common.</p><p><strong>Objectives: </strong>Preservation rhinoplasty reemerged in late 2010s. Among the perks of this technique lies an innate capability to correct severe axis deviations very effectively and yet easily.</p><p><strong>Methods: </strong>A prospective, randomized, blinded study is planned. 64 patients with severe nasal axis deviations are enrolled in study and randomly assigned to control and experiment groups (n=32). Experiment group underwent nasal axis deviation correction with asymmetrical let-down technique and control group a conventional structural rhinoplasty with dorsal reconstruction using spreader flap & grafts. Data is extracted from pre- and post-operative photographs, operative notes and patient files, assessed the effectivity of asymmetric bone impaction and compared it between groups.</p><p><strong>Results: </strong>An analysis of data showed 90±5.67% correction in the axis deviation on 12th month with use of asymmetrical bone impaction. Comparison of 1st and 12th month results showed no statistically significant recurrence (p>0.05). A statistical analysis comparing groups showed significantly better correction of nasal axis deviations in study group (p<0.01*).</p><p><strong>Conclusions: </strong>In the light of data emerged from this study we report successful employment of asymmetric bone impaction in correction of crooked noses, adding to the armamentarium of surgeons as a viable alternative for the correction of axis deviations in crooked noses.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Angular Reduction: Defining Reconstructive Success After Rib Remodeling.","authors":"Bill Vaca, Alberto Calvo Quiroz","doi":"10.1093/asj/sjag209","DOIUrl":"https://doi.org/10.1093/asj/sjag209","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178913","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":"Elastic Double Arch Model-Guided Alar Cartilage Reinforcement With Ligamentous Reconstruction in East Asian Rhinoplasty: A Multicenter Prospective Observational Study.","authors":"Yang Hu, Chengwu Zhang, Chao Li, Jingjie Qiao, Ping Li, Yang Wang, Yonggan Niu","doi":"10.1093/asj/sjag212","DOIUrl":"https://doi.org/10.1093/asj/sjag212","url":null,"abstract":"<p><strong>Background: </strong>Conventional structural rhinoplasty can provide reliable nasal tip support but may increase stiffness and restrict physiologic tip mobility, particularly in East Asian patients requiring projection and lengthening.</p><p><strong>Objectives: </strong>To evaluate the aesthetic, functional, and dynamic outcomes of an Elastic Double Arch Model-guided rhinoplasty technique in East Asian patients undergoing primary or revision rhinoplasty.</p><p><strong>Methods: </strong>This multicenter prospective observational study enrolled 213 consecutive East Asian patients who underwent primary or revision rhinoplasty using thin cortical costal cartilage grafts for alar arch reinforcement combined with nasal tip ligamentous reconstruction. Fifteen patients were lost to follow-up, leaving 198 patients for final analysis, including 72 primary and 126 revision cases. Outcomes included VAS-cosmetic, FACE-Q Rhinoplasty Module, VAS-functional, NOSE score, quantitative nasal tip mobility, and complications.</p><p><strong>Results: </strong>Aesthetic and functional outcomes improved significantly in both groups. Among patients with available 36-month data, VAS-cosmetic improved from 5.02 ± 0.88 to 8.40 ± 0.85 and FACE-Q from 42.5 ± 8.6 to 84.2 ± 7.5 in primary cases; corresponding values improved from 4.87 ± 0.91 to 8.20 ± 0.92 and from 40.2 ± 9.1 to 81.5 ± 8.2 in revision cases. Functional scores also improved. Nasal tip mobility was preserved in primary cases and markedly restored in revision cases. Complications were uncommon.</p><p><strong>Conclusions: </strong>This anatomically integrated technique was associated with improved aesthetic and functional outcomes while preserving or restoring clinically meaningful nasal tip mobility in selected East Asian rhinoplasty patients.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035928","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":"Response to: Lower Eyelid Phenotyping to Interpret Satisfaction After Transconjunctival Orbital Fat Removal.","authors":"Takahiko Tamura, Hiroo Teranishi","doi":"10.1093/asj/sjag210","DOIUrl":"https://doi.org/10.1093/asj/sjag210","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023675","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":"Long-Term Biostimulatory Efficacy of Polycaprolactone Facial Fillers: A Two-Year Quantitative Assessment of Neocollagenesis Using Second-Harmonic Generation Microscopy.","authors":"Zhang Shu Jiang, Wei Xiao, Xia Li, Hsiang I Chu, Shuhan Wang, Lixin Yuan, Hongjiang Liu, Huaqian Long, Satoshi Aya, Chen Lai","doi":"10.1093/asj/sjag208","DOIUrl":"https://doi.org/10.1093/asj/sjag208","url":null,"abstract":"<p><strong>Background: </strong>Polycaprolactone (PCL) microsphere-based facial fillers are used for aesthetic enhancements but understanding their long-term biostimulatory efficacy in inducing neocollagenesis requires precise, quantitative structural evaluation.</p><p><strong>Objectives: </strong>To investigate and quantitatively assess the long-term efficacy of PCL facial fillers (e.g., Ellansé-S) in driving collagen regeneration and structural remodeling.</p><p><strong>Methods: </strong>Using a two-year subcutaneous rabbit model (n=30), the study integrated advanced second harmonic generation (SHG) microscopy for high-resolution imaging. Automated image analysis software (CT-FIRE V3.0 and CurveAlign V5.0) was used to quantify collagen density, alignment, and structural parameters.</p><p><strong>Results: </strong>Sustained neocollagenesis was demonstrated throughout the 24-month period, marked by significant increases in collagen fiber density and network maturation (improved fiber alignment). Compared with tissue without implanted material, the density of the collagen fiber network increased by 79.2% at 12 months, after which it began to decline. This result was consistent with clinical observations. Crucially, the structure and organization of the regenerated collagen did not differ significantly from native tissue.</p><p><strong>Conclusions: </strong>PCL fillers provide immediate volumization along with durable, physiologically integrated tissue regeneration, proving sustained neocollagenesis over a two-year period.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015252","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}