Aesthetic Surgery Journal最新文献

{"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}

{"title":"Beyond Volume: Tissue-Level Considerations on Combined Filler Regimens for GLP-1 RA-Associated Facial Changes.","authors":"Qifeng Ou, Ding Pan","doi":"10.1093/asj/sjag176","DOIUrl":"https://doi.org/10.1093/asj/sjag176","url":null,"abstract":"","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":"149023616","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":"Botulinum Toxin Type A for Postoperative Scar Prevention: A Systematic Review and Meta-analysis.","authors":"Yi-Hsin Ho, Te-Wei Chang, Chun-Wei Hsu, Yi-Yun Ho, Chih-Chiang Chen, Ching-Po Lin","doi":"10.1093/asj/sjag204","DOIUrl":"https://doi.org/10.1093/asj/sjag204","url":null,"abstract":"<p><p>Postoperative scars may impair quality of life. Prophylactic botulinum toxin type A (BoNT-A) may reduce scarring, but optimal timing, dose density, injection plane, and anatomic indications remain uncertain. This systematic review and meta-analysis evaluated prophylactic BoNT-A for postoperative scar prevention and examined effect modification by timing, dose density, and anatomic site; injection-plane practices were summarized descriptively. Four databases were searched through January 2026 for comparative trials of perioperative or postoperative BoNT-A administration. Random-effects meta-analysis used standardized mean differences (SMDs); subgroup analyses and meta-regression examined timing, dose density, and anatomic site. Seventeen studies (656 treatment sites; 456 participants) were included. BoNT-A improved clinician composite scores (SMD, -0.864; 95% CI, -1.137 to -0.591; low certainty), clinician VAS (SMD, -0.951; 95% CI, -1.468 to -0.434; very low certainty), and objective scar width (SMD, -0.924; 95% CI, -1.119 to -0.728; moderate certainty). Exploratory pooled analyses using the original study-level timing assignments suggested a larger effect with delayed injection (SMD, -1.240; moderate certainty) than with immediate injection (SMD, -0.559; low certainty). Timing and anatomic site jointly accounted for 81% of heterogeneity (P = .0008), with effects largest in chest and smallest in fine facial sites. Moderate-certainty evidence supports reduced objective scar width; clinician composite scales improved with low certainty. Pooled clinician-composite analyses suggested larger effects with delayed injection, although direct within-site timing studies have reported conflicting findings. Immediate-injection evidence and patient-reported outcomes remain uncertain, and cross-study dose escalation within 4-10 U/cm was not associated with additional benefit.</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":"149015244","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":"Safe Submandibular Gland Reduction in 7 Steps: The Carina Technique.","authors":"T Gerald O'Daniel, Maxwell B Duff","doi":"10.1093/asj/sjag206","DOIUrl":"https://doi.org/10.1093/asj/sjag206","url":null,"abstract":"<p><strong>Background: </strong>Patient awareness and demand for SMG reduction are advancing at a significant rate, yet most plastic surgeons receive no formal training in SMG management. Surgeons are increasingly performing this procedure with less anatomic preparation and operative experience.</p><p><strong>Objectives: </strong>To present a seven-step operative algorithm for safe SMG reduction, developed from over 24 years of single-surgeon experience, and to report associated outcomes and complications.</p><p><strong>Methods: </strong>Records from 2018 to 2022 of patients undergoing a deep cervicoplasty that included SMG reduction were reviewed.</p><p><strong>Results: </strong>Of 1,100 patients, 922 underwent SMG reduction (1,844 glands). Complications included bilateral temporary lower lip dysfunction in all anterior neck lift patients (asymmetric recovery, 7.1%), transient xerostomia (2 patients), and recurrent sialadenitis (1 patient). No sialoceles, uncontrolled intraoperative hemorrhage, or postoperative hematomas occurred. A seven-step operative algorithm is described: (1) incision placement, (2) wide platysmal elevation, (3) visual axis optimization, (4) optical cavity creation, (5) gland mobilization, (6) controlled reduction (Carina technique), and (7) capsular reconstruction.</p><p><strong>Conclusions: </strong>Standardized, sequential operative protocols have been shown across surgical disciplines to reduce complications and improve reproducibility, and the seven-step algorithm presented here applies this principle to SMG reduction by structuring access, exposure, and reduction so that each step establishes the conditions necessary for the next. The favorable outcomes in this series reflect that the algorithm provides a reproducible framework for safely structuring this procedure and does not substitute for the anatomic command and judgment required to perform it.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001181","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":"Structural and Functional Considerations in Rhinoplasty of the Aging Nose.","authors":"Nuray Bayar Muluk","doi":"10.1093/asj/sjag201","DOIUrl":"https://doi.org/10.1093/asj/sjag201","url":null,"abstract":"<p><p>To investigate the age-related anatomical, structural, and functional changes occurring in the human nose, and to evaluate the most effective surgical techniques utilized for structural rejuvenation and airway restoration in older patients. A comprehensive narrative literature review was conducted utilizing established scientific databases, including PubMed/Medline, Scopus, Web of Science, and Embase, covering articles published up to 2024. A structured search strategy was applied using keywords such as \"aging nose,\" \"rhinoplasty,\" \"tip ptosis,\" \"nasal valve collapse,\" and \"nasal cartilages.\" Peer-reviewed clinical trials, anatomical evaluations, and authoritative surgical guidelines were included to synthesize the current evidence regarding morphological age-related changes and the efficacy of structural surgical techniques in older patients. The aging process fundamentally alters nasal morphology, primarily resulting in tip ptosis, dorsal pseudohump formation, and nasal valve collapse. These changes are driven by diminished skin elasticity, soft-tissue atrophy, and the weakening of cartilaginous suspensory ligaments. Because standard septoplasty often fails to resolve airway obstruction in older adults, robust structural modifications are required. Techniques utilizing septal extension grafts, columellar struts, and tongue-in-groove positioning successfully restore tip rotation and projection. Concurrently, the application of spreader grafts and alar strut grafts effectively counteracts dynamic internal and external nasal valve collapse, thereby significantly improving nasal airflow. The aging nose presents intertwined aesthetic and functional challenges caused by progressive tissue and cartilage degradation. Surgical management must move beyond simple resection and prioritize strong cartilaginous reinforcement and valve stabilization to achieve durable cosmetic outcomes and optimal functional breathing in older patients.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987634","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":"Can the Use of Closed Incision Negative Pressure Wound Therapy in Immediate Prepectoral Breast Reconstruction With Polyurethane-Coated Implants Reduce the Rate of Early Complications?: A Comparative Study.","authors":"Marzia Salgarello, Niccolò Lazzeri Domar, Giuseppe Visconti, Lorenzo Scardina, Sabatino D'Archi, Alba Di Leone, Gianluca Franceschini, Liliana Barone Adesi","doi":"10.1093/asj/sjaf211","DOIUrl":"10.1093/asj/sjaf211","url":null,"abstract":"<p><strong>Background: </strong>Immediate prepectoral breast reconstruction with polyurethane-coated implants provides esthetic and functional benefits compared with subpectoral techniques, but early postoperative complications remain a concern. Closed incision negative pressure wound therapy (ciNPWT) has demonstrated benefits in other surgical fields, though evidence in breast reconstruction is limited.</p><p><strong>Objectives: </strong>To evaluate whether ciNPWT reduces early postoperative complications after immediate prepectoral reconstruction with polyurethane-coated implants, particularly in high-risk patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 620 patients undergoing unilateral or bilateral conservative mastectomy with immediate prepectoral reconstruction using polyurethane-coated implants between May 2021 and February 2024. Patients were divided into 2 cohorts: 257 treated with ciNPWT and 363 with conventional dressings. Subgroup analyses considered mastectomy flap thickness (0.5-0.6 cm, 0.7-0.9 cm, ≥1.0 cm) and specimen weight (<500 g vs ≥500 g). Early complications (≤30 days) were classified as major (requiring reoperation or hospitalization) or minor.</p><p><strong>Results: </strong>ciNPWT significantly reduced major complications compared with controls: wound dehiscence (1.17% vs 6.61%), flap ischemia (0% vs 2.2%), major infection (0.39% vs 2.48%), and implant extrusion (0.39% vs 2.2%). Minor complications, including periprosthetic seromas, were also reduced (4.28% vs 5.79%). The protective effect was most evident in patients with thin mastectomy flaps (0.5-0.9 cm) and specimen weight ≥500 g. Correlation between intraoperative flap thickness and preoperative Rancati score confirmed benefits in high-risk patients (Rancati type 1).</p><p><strong>Conclusions: </strong>ciNPWT reduces early complications in immediate prepectoral reconstruction, with greatest benefit in high-risk patients. Integration into reconstructive protocols may enhance safety and broaden indications. Prospective randomized trials are warranted.</p><p><strong>Level of evidence: 3 (therapeutic): </strong>For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1075-1083"},"PeriodicalIF":4.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342882","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":"Current Concepts and Emerging Technologies in Aesthetic Outcome Assessment of Breast Reconstruction.","authors":"Deyu Lyu, Felix H Vollbach, Irene Mesas Aranda, Benedikt Fuchs, Sinan Mert, Constanze Kuhlmann, Christine S Hagen, Riccardo E Giunta, Nikolaus Thierfelder, Nicholas Moellhoff","doi":"10.1093/asj/sjag101","DOIUrl":"10.1093/asj/sjag101","url":null,"abstract":"<p><p>Aesthetic outcomes are a crucial determinant of the overall success of breast reconstruction. Recently, aesthetic assessment has evolved from relying mainly on subjective impressions to incorporating more quantitative methods. This systematic review summarizes current concepts and emerging technologies in aesthetic outcome assessment after breast reconstruction. A comprehensive search of studies evaluating aesthetic outcomes following implant-based, autologous or hybrid breast reconstruction was performed between 2000 and 2025. Assessments were classified as subjective or objective. Extracted variables included assessment characteristics, aesthetic outcome domains, and patient-centered outcomes. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Levels of evidence were classified according to the Oxford Centre for Evidence-Based Medicine. A total of 51 studies involving 7711 participants from 16 countries were included. Subjective tools were most frequently employed, led by the BREAST-Q (35/51, 69%), followed by expert- or panel-based evaluations (17/51, 33%) and the visual analog scale (2/51, 4%). Objective methods were applied in 19 studies and included 3-dimensional surface imaging (8/51, 16%), BCCT.core (7/51, 14%), eye tracking (3/51, 6%), and artificial intelligence-based analyses (3/51, 6%). Although subjective tools captured satisfaction with breast appearance, objective tools quantified morphological parameters and positional landmarks. BREAST-Q remains the cornerstone of outcome evaluation after breast reconstruction, providing patient-centered perspectives, including, but not limited to, aesthetic perception. A progressive shift toward multimodal evaluation was noticed, as no single modality comprehensively addressed all aesthetic domains. Future research should focus on integrating subjective and objective assessment methods within a unified framework. Level of Evidence: 3 (Therapeutic) For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1116-1126"},"PeriodicalIF":4.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969653","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}