Aesthetic Surgery Journal最新文献

{"title":"Intrathecal Morphine vs Paravertebral Nerve Blocks for Analgesia After Breast Reconstruction With Abdominally Based Free Flaps.","authors":"Matthew W Swisher, Austin T Nguyen, Miriam Becker, Jacklynn F Sztain, Wendy B Abramson, Paige S Tsuda, Brenton S Alexander, Chris M Reid, Engy T Said","doi":"10.1093/asj/sjaf043","DOIUrl":"10.1093/asj/sjaf043","url":null,"abstract":"<p><strong>Background: </strong>Breast reconstruction with abdominally based free flaps can be associated with more significant acute pain and longer hospital stays than implant-based techniques. As new pain management strategies are developed, there have not been any studies conducted to analyze the analgesic effects of intrathecal morphine (ITM) for patients undergoing abdominally based free flap reconstruction.</p><p><strong>Objectives: </strong>The primary outcome analyzed in this retrospective study was opioid consumption, which was measured from the postoperative anesthesia care unit (PACU) through postoperative day (POD) 2. Secondary outcomes of the study analyzed included factors such as pain scores, hospital length of stay (LOS), and adverse effects.</p><p><strong>Methods: </strong>Fifty-one patients presented for breast reconstruction with abdominally based free flaps and received ITM for postoperative analgesia. Results obtained were compared with a cohort that included an equal number of patients who received paravertebral nerve blocks (PVBs).</p><p><strong>Results: </strong>Results showed that patients who received ITM displayed a lower median consumption in the PACU (0 mg vs 12.5 mg MEQ; P = .009), from PACU to POD 1 (0 mg vs 7.5 mg MEQ; P = .046), and POD 1 to POD 2 (7.5 mg vs 30 mg MEQ; P = .002) when compared with those who received PVBs. Those who received ITM also had lower median pain scores in the PACU and from PACU to POD 1 and a decreased LOS. There were similar rates of adverse events.</p><p><strong>Conclusions: </strong>ITM improves postoperative analgesia after abdominally based free flaps when compared to PVBs and may facilitate recovery and earlier discharge.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"605-610"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655831","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: Patient Factors That Impact FACE-Q Aesthetics Outcomes: An Exploratory Cross-sectional Regression Analysis.","authors":"Aaron Lee Wiegmann, Sammy Sinno","doi":"10.1093/asj/sjaf046","DOIUrl":"10.1093/asj/sjaf046","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"552-553"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662076","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":"Efficacy and Safety of CBL-514 Injection in Reducing Abdominal Subcutaneous Fat: A Randomized, Single-Blind, Placebo-Controlled Phase II Study.","authors":"Michael Gold, Joel Schlessinger, Greg J Goodman, Steven Dayan, Janet DuBois, Yu-Fang Ling, An-Yi Sheu, Wilson W S Ho, Yin-Chia Chou","doi":"10.1093/asj/sjaf032","DOIUrl":"10.1093/asj/sjaf032","url":null,"abstract":"<p><strong>Background: </strong>A small-molecule injectable drug, CBL-514, has shown promising efficacy and safety for subcutaneous fat reduction.</p><p><strong>Objectives: </strong>To further evaluate the efficacy and safety of CBL-514 for abdominal subcutaneous fat reduction.</p><p><strong>Methods: </strong>In this single-blind, randomized, parallel-group, placebo-controlled Phase 2 trial, 76 participants were randomized (2:1) to receive up to 4 CBL-514 treatments (2 mg/cm2, maximum 600 mg/treatment) or placebo, administered subcutaneously to the abdomen every 4 weeks. Two follow-up visits were conducted at 4 and 8 weeks following final treatment. Changes in abdominal subcutaneous fat thickness and volume were measured by ultrasound. The primary endpoint was the proportion of participants with subcutaneous fat volume loss of ≥150 mL from baseline compared with placebo.</p><p><strong>Results: </strong>In the intention-to-treat population, a significantly higher proportion of CBL-514-treated participants achieved ≥150 mL subcutaneous fat volume reduction from baseline compared with placebo-treated participants at both follow-up visits. At 8 weeks post final treatment, 69.6% of CBL-514-treated participants lost ≥150 mL subcutaneous fat, compared with none in the placebo group (P < .001). Moreover, 60.9% of participants in the CBL-514 group further achieved the ≥200 mL subcutaneous fat loss threshold. Of the 28 participants in CBL-514 group (n = 50) who lost ≥150 mL subcutaneous fat, 42.9% (12/28 participants) achieved this target after a single treatment. The most common treatment-emergent adverse events were injection site reactions and were of mild-to-moderate severity.</p><p><strong>Conclusions: </strong>CBL-514 treatment significantly reduced abdominal subcutaneous fat volume with a favorable safety profile. As a noninvasive treatment, CBL-514 could be a new, promising alternative therapy for effective targeted subcutaneous fat reduction.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"611-620"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555605","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":"Closed Preservation Rhinoplasty in the Mestizo Patient: Challenges and Techniques for Nasal Tip Support.","authors":"Cesar Valdivia, Paul D Durand, Baris Çakir","doi":"10.1093/asj/sjaf017","DOIUrl":"10.1093/asj/sjaf017","url":null,"abstract":"<p><strong>Background: </strong>Closed preservation rhinoplasty continues to grow in popularity. Nevertheless, many surgeons remain wary of performing closed preservation rhinoplasty in certain patient populations. Mestizo noses have a thick soft-tissue envelope and weak nasal tip support. These inherent characteristics have led many surgeons to favor open structural techniques when addressing the tip in the mestizo patient.</p><p><strong>Objectives: </strong>The aim of this article was to describe a set of techniques that have been successfully utilized by the authors to maximize tip support and definition when performing closed preservation rhinoplasty in a patient population for which structural techniques were once thought to be the only viable option.</p><p><strong>Methods: </strong>A total of 417 primary rhinoplasty cases were studied retrospectively between January 2022 and December 2023. All the cases were performed by a closed approach and with dorsal preservation of the soft-tissue envelope. All patients underwent 1 of 4 types of surgical technique for the tip area: Type I, 105 patients; Type II, 124 patients; Type III, 181 patients; Type IV, 7 patients.</p><p><strong>Results: </strong>Of the 417 patients, 331 (79.3%) were female and 86 (20.6%) were male. Patient age ranged from 15 to 66 years, with a median age of 23 years. Patients were followed for a period of 6 months to 1 year postoperatively. Seven patients underwent revision surgery (1.7%).</p><p><strong>Conclusions: </strong>Even with its various potential benefits, there is still apprehension about performing closed preservation rhinoplasty in certain patient populations. The authors present several techniques that have been successfully utilized to maximize tip support and definition when performing closed preservation rhinoplasty in the mestizo patient.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"568-573"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057647","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":"Commentary on: Aesthetic Efficacy and Safety of Combined Microfocused Ultrasound With Visualization and Calcium Hydroxylapatite Treatment: A Systematic Review of Human Evidence.","authors":"Lawrence S Bass","doi":"10.1093/asj/sjaf020","DOIUrl":"10.1093/asj/sjaf020","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"643-644"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253984","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":"Extended vs Inpatient Chemoprophylaxis for Venous Thromboembolism in DIEP Flap Breast Reconstruction: A Systematic Review and Meta-analysis.","authors":"Chandler Hinson, Matthew Sink, Rudolf F Buntic, Bauback Safa, Douglas M Sammer, Andrew Y Zhang, Christopher Pannucci, Andrei Odobescu","doi":"10.1093/asj/sjaf024","DOIUrl":"10.1093/asj/sjaf024","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) is a significant complication following deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. The optimal duration of chemoprophylaxis remains debated, with differing recommendations on short-term chemoprophylaxis (STC) vs long-term chemoprophylaxis (LTC) for VTE prevention. This systematic review and meta-analysis compared the efficacy and safety of STC vs LTC in preventing VTE and hematoma in patients undergoing DIEP flap reconstruction. Four studies with a total of 1114 patients were included, with no significant differences in patient characteristics, including Caprini scores, between the STC and LTC groups. The pooled incidence of VTE was 1.83%, with 2.19% in the STC group and 1.33% in the LTC group, yielding a risk ratio (RR) of 1.42 for STC compared to LTC, although this was not statistically significant (P = .62). The mean incidence of hematoma was 8.65%, with 8.32% in the STC group and 9.02% in the LTC group, resulting in an RR of 0.78 for STC compared to LTC, which was also not statistically significant (P = .25). These findings suggest that extending chemoprophylaxis beyond hospitalization does not significantly reduce VTE incidence and underscores the importance of individualized risk-based anticoagulation strategies. Future studies are necessary to further refine guidelines for chemoprophylaxis duration in this population, balancing the risks of VTE and anticoagulation-related complications to optimize patient outcomes.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"599-604"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254006","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":"https://doi.org/10.1093/asj/sjaf081","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Occurrence of Health Symptoms in General Practice Before and After the Explantation of Cosmetic Breast Implants.","authors":"Annemiek S Lieffering, Marc A M Mureau, Juliëtte E Hommes, Lotte Ramerman, Hinne A Rakhorst, René R W J van der Hulst, Robert A Verheij","doi":"10.1093/asj/sjaf030","DOIUrl":"10.1093/asj/sjaf030","url":null,"abstract":"<p><strong>Background: </strong>Explantation of breast implants is increasingly performed in response to concerns about breast implant illness (BII), an array of various health symptoms. However, the benefits of explantation remain unclear because of methodological limitations in previous studies.</p><p><strong>Objectives: </strong>To examine the occurrence of health symptoms before and after explantation of cosmetic breast implants.</p><p><strong>Methods: </strong>This is a retrospective cohort study linking data from the Dutch Breast Implant Registry and Nivel Primary Care Database. The study included 217 cosmetic explantation patients, control groups of 228 cosmetic replacement patients, and 433 female patients without breast implants (nonrecipients). BII-related health symptoms presented in general practice were compared between groups 1 year before and after explantation. Outcomes included any symptom, ≥2 symptoms, ≥3 symptoms, ≥3 consultations, and substantial symptoms (≥3 symptoms with ≥2 consultations for 2 symptoms).</p><p><strong>Results: </strong>The likelihood of ≥3 symptoms, ≥3 consultations, and substantial symptoms reduced significantly after explantation (odds ratio [OR] ≥3 symptoms 0.26, 95% CI [0.08-0.85]; OR ≥3 consultations 0.56, 95% CI [0.32-0.96]; OR substantial symptoms 0.36, 95% CI [0.14-0.94]). However, compared with nonrecipients, explantation patients still had higher odds of any symptom, ≥2 symptoms, and ≥3 consultations after explantation. Replacement patients also had a reduced likelihood of any symptom, ≥2 symptoms, and ≥3 consultations from pre- to postsurgery.</p><p><strong>Conclusions: </strong>Although explantation appears to improve BII-related health symptoms within a year, patients still showed an increased likelihood of symptoms compared with nonrecipients.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"589-598"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447894","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":"Functional and Aesthetic Outcomes After Upper Blepharoplasty: A Systematic Review and Meta-analysis of Randomized Control Trials.","authors":"Dominik Todorov, Sebastian Mitchell, Mustafa Al-Hashimi, Zaid Dajani, Kelvin Sunn Hoah Yap, Hassan Imtiaz, Kian Daneshi, Ankur Khajuria","doi":"10.1093/asj/sjaf022","DOIUrl":"10.1093/asj/sjaf022","url":null,"abstract":"<p><p>Upper blepharoplasty addresses aging-related changes by removing excess skin, muscle, and fat from the upper eyelids. This systematic review, which was registered a priori, improves upon previously published reviews regarding functional and aesthetic outcomes following upper blepharoplasty. Custom search strategies were applied across multiple databases, namely MEDLINE (United States National Library of Medicine, Bethesda, MD), Embase (Elsevier, Amsterdam, the Netherlands), Google Scholar (Alphabet, Inc., Mountain View, CA), Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Library, London, UK), Science Citation Index (Clarivate Analytics, Philadelphia, PA), PubMed (United States National Library of Medicine), and PsychInfo (American Psychological Association, Washington, DC). Bias was assessed with the Cochrane RoB 2 tool, and methodological quality was evaluated with GRADE. Out of 6799 articles, 12 randomized controlled trials with 450 patients (39 men, 411 women) were included. The meta-analysis showed significant reduction in dry eye symptoms post-upper blepharoplasty compared with preoperative status (odds ratio [OR], 0.22; 95% CI, 0.13-0.36; P < .00001). No significant difference in postoperative dry eye incidence was found between orbicularis oculi muscle plus skin excision and skin-only excision (OR, 1.55; 95% CI, 0.86-2.80; P = .25). However, muscle plus skin excision had a higher incidence of lagophthalmos (OR, 7.98; 95% CI, 1.41-45.21; P = .02). No significant differences were observed in eye irritation (OR, 1.21; 95% CI, 0.51-2.84; P = .66) or patient satisfaction (OR, 1.14; 95% CI, 0.42-3.14; P = .80). Continuous suturing techniques increased eye irritation compared with subcuticular suturing (OR, 1.77; 95% CI, 1.07-2.91; P = .03). All studies were high quality with a low risk of bias. The findings support upper blepharoplasty's efficacy in reducing dry eye symptoms, with muscle-sparing techniques minimizing lagophthalmos and maintaining high patient satisfaction.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"554-562"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727532","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":"A Randomized, Double-Blind, Placebo-Controlled, Multicentered Study to Evaluate the Efficacy and Safety of MEI005 in Reducing Submental Fat in Chinese Adults.","authors":"Wenyun Ting, Junxian Wen, Zhijin Li, Jiaming Sun, Jiaping Zhang, Maoguo Shu, Hongwei Liu, Li He, Bo Yu, Nan Jiang, Chunyu Xue, Qian Tan, Xuewen Xu, Sufan Wu, Dan Jian, Hongyi Zhao, Lei Wang, Nanze Yu, Xiaojun Wang","doi":"10.1093/asj/sjaf031","DOIUrl":"10.1093/asj/sjaf031","url":null,"abstract":"<p><strong>Background: </strong>Submental fat (SMF) is a common aesthetic concern traditionally treated with liposuction. Nonsurgical alternatives, like injectable deoxycholic acid, are gaining popularity. However, no related products have been clinically approved in China.</p><p><strong>Objectives: </strong>This study evaluated the efficacy and safety of MEI005, a deoxycholic acid-based injectable formulation, in reducing SMF in Chinese adults.</p><p><strong>Methods: </strong>This multicenter, randomized, double-blind, placebo-controlled Phase III trial included 325 Chinese adults with moderate-to-severe SMF. Participants received MEI005 or a placebo injection every 28 days for up to 6 sessions. Primary endpoints were ≥2-grade improvements in Clinician and Patient-Reported Submental Fat Rating Scales (CR-SMFRS and PR-SMFRS). Secondary endpoints included SMF volume reductions measured by MRI; patient-reported outcomes on the Patient-Reported Submental Fat Impact Scale (PR-SMFIS) and Subject Self-Rating Scale (SSRS); and SMF thickness reductions measured by caliper. Adverse events (AEs), self-reports, clinical examinations, and checks for skin laxity were monitored.</p><p><strong>Results: </strong>At 12 weeks posttreatment, 18.9% of MEI005 recipients demonstrated simultaneously ≥2-grade CR-SMFRS and PR-SMFRS improvement vs 1.8% for placebo (P < .001). Additionally, 68.9% of MEI005 group participants achieved simultaneously ≥1-grade improvement in CR-SMFRS and PR-SMFRS, compared with 21.6% of placebo (P < .001). MRI revealed ≥10% SMF volume reduction in 50% of MEI005 patients vs 15.2% of placebo (P < .001). Scores on the PR-SMFIS and SSRSs showed greater psychological improvement and satisfaction among MEI005 recipients. Vernier caliper measurements showed a 21.42% thickness reduction vs 6.32% (P < .001). AEs were mostly mild to moderate.</p><p><strong>Conclusions: </strong>MEI005 effectively reduces SMF, offering a safe, minimally invasive option for Chinese adults.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"629-637"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555601","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}