Aesthetic Surgery Journal最新文献

{"title":"Wide Double-Eyelid Fold Repair Using an Orbital Septum Flap and an Suborbicularis Oculi Fascial-Fat Flap in Cases Requiring Preservation of the Original Incision Scar.","authors":"Qian Chen, Gang Zhang, Gaofeng Li, Xiaojia Liu","doi":"10.1093/asj/sjaf064","DOIUrl":"10.1093/asj/sjaf064","url":null,"abstract":"<p><strong>Background: </strong>Double-eyelid blepharoplasty is a common cosmetic surgery. However, blepharoplasty can lead to poor results, necessitating repair surgery. One of the most frequent poor results after double-eyelid blepharoplasty is an excessively wide double-eyelid fold.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the clinical efficacy of wide double-eyelid repair using an orbital septum flap and a suborbicularis oculi fascial-fat flap in cases requiring preservation of the original incision scar.</p><p><strong>Methods: </strong>This retrospective study, undertaken between June 2019 and June 2022, included 35 female patients who underwent wide double-eyelid repair. An orbital septum flap and a suborbicularis oculi fascial-fat flap were prepared. Deep and superficial scar adhesions were fully released to correct the uneven contour at the original incision scar site. The orbital septum flap was turned downward and sutured to the inferior orbicularis oculi muscle and pretarsal fascia. Thereafter, a postoperative follow-up was conducted to observe the results in terms of width of double eyelid, postoperative scars, and patient satisfaction.</p><p><strong>Results: </strong>The difference between the double eyelid width before operation and at the last postsurgical follow-up was statistically significant. No visible scars were seen in patients after the operation, and the width of double eyelid was corrected. The operation was effective: the surgical results were rated as satisfactory in 21 patients and basically satisfactory by 10 patients; 4 patients rated the results as unsatisfactory. The satisfaction rate was 88.57%.</p><p><strong>Conclusions: </strong>For wide double-eyelid fold repair in cases requiring preservation of the original incision scar, the use of an orbital septum flap and a suborbicularis oculi fascial-fat flap achieves good effects in releasing adhesions, preventing abnormal readhesions, and reconstructing natural-looking double-eyelid folds.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"882-886"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960126","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":"Comparative Efficacy and Safety of Injectable Tranexamic Acid Combination Therapies for Melasma: A Network Meta-analysis of Randomized Controlled Trials.","authors":"Houriah Nukaly, Khalid Alshareef, Ibrahim Abdullah S Albalawi, Waseem Alhawsawi, Zainab Ridha, Malika Ladha, Ruaa Alharithy, Abdulhadi Jfri","doi":"10.1093/asj/sjaf097","DOIUrl":"10.1093/asj/sjaf097","url":null,"abstract":"<p><p>Melasma is a challenging hyperpigmentation disorder affecting predominantly women with darker skin tones. Despite various treatments, achieving consistent and effective results remains difficult. Tranexamic acid (TXA) has emerged as a promising therapeutic agent, particularly through intradermal injections, but its optimal concentration, delivery method, and combination therapies remain unclear. In this study, the authors aim to evaluate the efficacy and safety of injectable TXA, focusing on its use alone and in combination with other treatments, such as hydroquinone, for melasma. A network meta-analysis of 9 randomized controlled trials was conducted, involving 358 participants. Data on melasma subtype, TXA concentration, delivery method, and treatment outcomes (Melasma Area and Severity Index [MASI] scores) were extracted. Statistical analysis was performed using a random-effects model, assessing both direct and indirect comparisons. The combination of TXA and 4% hydroquinone showed the most significant improvement in MASI scores compared with other interventions, demonstrating superior efficacy. Adverse effects were mild and transient, including injection-site pain and erythema, underscoring a favorable safety profile. Injectable TXA, especially in combination with hydroquinone, is an effective treatment for melasma. Standardized protocols and long-term studies are needed to optimize its use. Level of Evidence: 3 (Therapeutic).</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"947-956"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537786","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":"Platelet-Derived Exosome Vulvar Injections for Sexual Dysfunction: A Retrospective Review.","authors":"Savas Ozgur Aglamis","doi":"10.1093/asj/sjaf104","DOIUrl":"10.1093/asj/sjaf104","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP)-derived exosomes have been used for a very long time in genital area rejuvenation applications.</p><p><strong>Objectives: </strong>The authors of this study aim to investigate the effect of the newly defined genital PRP-derived exosome injection point compared with conventional genital injection points.</p><p><strong>Methods: </strong>PRP-derived exosomes were taken into two 1 cc syringes. Four injection areas were determined. Only 1 area was injected in each group. In Group A, a total of 2 cc of exosome was injected into the right and left lateral parts of the clitoral glans at 3 to 9 o'clock with a 32 G 4 mm syringe tip. The procedure was applied so that the entire 4 mm syringe tip entered the tissue. In Group B, a total of 2 cc of exosome was injected into the G-spot area around the distal third of the anterior wall with a point-by-point technique with a 32 G 4 mm syringe tip. In Group C, exosome injection was performed with a 32 G 4 mm syringe tip, 1 cc on the right side, 1 cc on the left side, and 2 cc in total, to the periurethral area. In Group D, exosome injection was performed at the junction point of frenulum, prepuce, and labium minus and its surroundings: 1 cc on the right side, 1 cc on the left side, and 2 cc in total. This procedure was performed in 3 sessions, 4 weeks apart. All patients were evaluated with the Female Sexual Function Index (FSFI) scale before the first session and 6 and 12 months after the third session.</p><p><strong>Results: </strong>The difference between the FSFI increase levels in 2 different periods for each group was evaluated. Accordingly, the FSFI increase in Group A was similar to the increase in Group D (P = .715). The FSFI increase in Group B was similar to the increase in Group C (P = .437). The FSFI increase in Groups A and D was statistically greater than the increase in Groups B and C (Group A vs Group B, P = .001; Group A vs Group C, P = .015; Group D vs Group B, P = .027; Group D vs Group C, P = .018).</p><p><strong>Conclusions: </strong>This study is the first example in the literature in terms of evaluating the difference between the points where PRP-derived exosomes were applied. This new point injection increased FSFI better than Group A and was as effective as Groups B and C. The effectiveness of this newly defined method has been investigated with a single-point injection point, and it is seen that the frequency of application will increase because of its easy applicability, low cost and low side effect rate.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"922-927"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214687","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":"Aesthetic Surgery Journal Welcomes the Kuwait Plastic Surgery Society.","authors":"Hisham Burezq, Jeffrey M Kenkel","doi":"10.1093/asj/sjaf087","DOIUrl":"10.1093/asj/sjaf087","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"987"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126615","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":"Perspectives on the Development of a Plastic Surgery-Specific Large Language Model.","authors":"Kian Daneshi, Hilary Y Liu, Francesco M Egro","doi":"10.1093/asj/sjaf072","DOIUrl":"10.1093/asj/sjaf072","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP179-NP180"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961268","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":"Utilizing Generative Text-to-Image Artificial Intelligence Models to Explore Race, Gender, and Age in Plastic and Aesthetic Surgery.","authors":"Maissa Trabilsy, Ariana Genovese, Srinivasagam Prabha, Sahar Borna, Cesar A Gomez-Cabello, Syed Ali Haider, Cui Tao, Antonio J Forte","doi":"10.1093/asj/sjaf084","DOIUrl":"10.1093/asj/sjaf084","url":null,"abstract":"<p><strong>Background: </strong>It is unclear how representative and inclusive of various patient populations generative text-to-image artificial intelligence (AI) models are.</p><p><strong>Objectives: </strong>This project explores the diversity of race, gender, and age in the images generated by AI models: DALL-E3, Midjourney, and Adobe Firefly, in response to prompts focused on liposuction, blepharoplasty, and rhinoplasty.</p><p><strong>Methods: </strong>Prompts were designed to prompt the AI model to generate images of surgical outcomes for liposuction, blepharoplasty, and rhinoplasty for each gender, race, and age combination: male vs female, Caucasian or White, Black or African American, Latino or Hispanic, and age groups: 20 to 30, 31 to 45, and 46+ years. Each generated image was evaluated for representation of skin color by Fitzpatrick and Monk scales, sex parity using a 4-item questionnaire, and the incorporation of westernized beauty standards. Analysis was then conducted, utilizing the Kruskal-Wallis test or the Fisher's exact test between the 3 models (P < 0.05).</p><p><strong>Results: </strong>There was no significant difference between the representation of light skin color (Fitzpatrick I-III and Monk 1-5) vs dark skin color (Fitzpatrick IV-VI and Monk 6-10) between the models (P = 0.26 and P = 0.31). A significant difference was found between the models and between females vs males regarding aging (P < 0.0001 and P = 0.0009). There were also significant differences found for the depiction of clear skin (P < 0.0001), large and/or light-colored eyes (P = 0.0010), and narrow noses (P < 0.0001).</p><p><strong>Conclusions: </strong>Although there is fair representation of light skin colors and dark skin colors across the models, the depiction of gender bias and westernized beauty standards can be improved.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP172-NP178"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075464","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 Effect of Patient Involvement in Implant Size Selection on Satisfaction With Breast Size: An Analysis of 1840 Primary Augmentations.","authors":"Jerzy Kolasiński, Małgorzata Kolenda, Szymon Kołacz, Anna Kasielska-Trojan","doi":"10.1093/asj/sjaf085","DOIUrl":"10.1093/asj/sjaf085","url":null,"abstract":"<p><strong>Background: </strong>Aesthetic breast surgery is a specific field in which the aim is not to achieve any universally defined standard but to meet the patient's expectations.</p><p><strong>Objectives: </strong>The aim of this study was to determine the proportion of women who were dissatisfied with their breast size following primary breast augmentation and opted to undergo revision surgery. The study presents and verifies an algorithm for breast implant selection which involves the patient in the decision-making process.</p><p><strong>Methods: </strong>A retrospective analysis was performed of medical charts covering the period from January 2012 to December 2022 from 1 private center. The final analysis included 1840 patients. All had implants chosen according to the Patient Decision-Making Process on Implant Size Selection (PIS) algorithm.</p><p><strong>Results: </strong>Of the studied cases, 18 opted to undergo implant exchange due to dissatisfaction with breast size (0.98%). This group differed significantly from the controls (n = 1822) in the following aspects: lower BMI during primary procedure, lower mean implant volume, and shorter follow-up. In all but 2 women, mean BMI increased by 1 unit before revisional surgery (from 19.7 to 20.6 kg/m2).</p><p><strong>Conclusions: </strong>Dissatisfaction with breast implant size is a rare cause of revision in breast augmentation surgery when the patient is involved in the final decision on the volume of the implants. The PIS algorithm yielded a rate of dissatisfaction with breast size of less than 1% in long-term follow-up.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"899-905"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075458","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":"Commentary on: The Medicolegal Challenges of Facial Plastic Surgery: A Systematic Review.","authors":"Christopher L Nuland","doi":"10.1093/asj/sjaf124","DOIUrl":"10.1093/asj/sjaf124","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"985-986"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504518","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: Perspectives on the Development of a Plastic Surgery-Specific Large Language Model.","authors":"Berk B Ozmen, Ibrahim Berber, Graham S Schwarz","doi":"10.1093/asj/sjaf081","DOIUrl":"10.1093/asj/sjaf081","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP181-NP182"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075455","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":"Postsurgical Pyoderma Gangrenosum in Breast Surgery: An Updated Systematic Review, Takeaways, and the 6 Commandments.","authors":"Giorgio Caddia, Delphine Voulliaume, Laura Dettori, Corrado Rubino, Emmanuel Delay","doi":"10.1093/asj/sjaf095","DOIUrl":"10.1093/asj/sjaf095","url":null,"abstract":"<p><p>Postsurgical pyoderma gangrenosum (PSPG) is a rare and under-recognized inflammatory dermatosis that can develop after surgery. When it occurs following breast procedures, its clinical presentation often mimics surgical-site infection or necrosis, leading to delayed diagnosis and inappropriate treatment, with potentially severe aesthetic and functional consequences. In this study, the authors aim to update the literature on PSPG following reconstructive and aesthetic breast surgery and provide clinicians with practical tools for early recognition and management, including clinical red flags, a diagnostic framework, and therapeutic guidelines. A systematic review was conducted in March 2025 according to PRISMA guidelines, updating the work of Ehrl et al by including studies published from 2017 onward. Data from 65 new cases were extracted and analyzed descriptively. The authors also report 3 institutional cases and 1 case of recurrence to provide additional clinical insight. A total of 65 new PSPG cases were identified across 45 studies, for a cumulative total of 152. Reduction mammoplasty was the most frequent surgical trigger. The condition involved multiple sites in 71.4% of combined breast-abdominal procedures. Pain was the most common symptom (86.2%), and the nipple-areola complex (NAC) was spared in 80.7% of cases. C-reactive protein (CRP) was often elevated (>200 mg/L), and microbiological cultures were negative in 76.9% of cases. Systemic corticosteroids were the most effective treatment. Mean healing time was 4.5 months; surgical reconstruction was needed in 29% of the cases. PSPG remains a diagnostic challenge with significant consequences if unrecognized. Key clues include exaggerated postoperative pain, NAC sparing, elevated CRP, and poor response to antibiotics. In this study, the authors propose a practical flowchart and summarize 6 core management principles. Preoperative counseling and informed consent, particularly in reduction mammoplasty, should include this rare but serious complication. Level of Evidence: 3 (Therapeutic).</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP142-NP153"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141143","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}