Aesthetic Surgery Journal最新文献

{"title":"Optimal Practices in the Delivery of Aesthetic Medical Care to Patients on Immunosuppressants and Immunomodulators: A Systematic Review of the Literature.","authors":"Leila Cattelan, Steven Dayan, Sabrina G Fabi","doi":"10.1093/asj/sjae141","DOIUrl":"10.1093/asj/sjae141","url":null,"abstract":"<p><p>Nonsurgical aesthetic procedures have been steadily growing in popularity among patients of all ages and ethnicities. At present, the literature remains devoid of guidelines on optimal practices in the delivery of aesthetic medical care to patients on immunosuppressant medications. The authors of this review sought to determine the physiologic responses of immunocompromised patients related to outcomes and potential complications following nonsurgical aesthetic procedures, and to suggest recommendations for optimal management of these patients. A comprehensive systematic review of the literature was performed to identify clinical studies of patients who had undergone nonsurgical aesthetic procedures while immunosuppressed. Forty-three articles reporting on 1690 immunosuppressed patients who underwent filler injection were evaluated, of which the majority (99%; 1682/1690) were HIV patients, while the remaining 8 were medically immunosuppressed. The complication rate of filler in this population was 28% (481/1690), with subcutaneous nodules the most frequently reported adverse event. A detailed synthesis of complications and a review of the inflammatory responses and impact of immunosuppressants and HIV infection on filler complications is presented. The authors concluded that patients on immunomodulatory medications may be at increased risk of filler granuloma relative to the general population, while patients on immunosuppressants may be at increased risk of infectious complications. Rudimentary guidelines for optimal preprocedural patient assessment, aseptic technique, injection technique, and antibacterial and antiviral prophylaxis are reviewed. Ongoing advancements in our understanding of the mechanisms underlying these inflammatory processes will undoubtedly optimize management in this patient population.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP819-NP828"},"PeriodicalIF":3.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533412","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: Silicone Lymphadenopathy Following Augmentation Mammoplasty With Silicone Implants.","authors":"Louis L Strock","doi":"10.1093/asj/sjae161","DOIUrl":"10.1093/asj/sjae161","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1176-1178"},"PeriodicalIF":3.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730972","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":"Management of Hyaluronidase Allergies: The Importance of Specialist Evaluation.","authors":"Monica T Kraft, Casey T Kraft","doi":"10.1093/asj/sjae160","DOIUrl":"10.1093/asj/sjae160","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"NP850-NP851"},"PeriodicalIF":3.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730973","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":"Navigating the Evolving Roles of GLP-1 Agonists Safely and Effectively.","authors":"Kyle M Ockerman, Heather J Furnas, Amy Sheer, Sarah Sorice-Virk","doi":"10.1093/asj/sjae166","DOIUrl":"10.1093/asj/sjae166","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"1241-1245"},"PeriodicalIF":3.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747169","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":"Improving the Supraalar Groove Aesthetic Subunit and Lateral Crura Convex-Concave Deformity.","authors":"Ruben Guilarte, Baris Çakir","doi":"10.1093/asj/sjae210","DOIUrl":"https://doi.org/10.1093/asj/sjae210","url":null,"abstract":"<p><strong>Background: </strong>Lateral crura surface problems are one of the most difficult challenges in nose tip surgery. Closed Preservation Rhinoplasty (CPR) is a revolutionary concept keeping nose tip flexibility and elasticity. Solving lateral crura surface problems and keeping tip flexibility the surgeon will accomplish a sharper supraalar groove transition between the dorsum and the tip.</p><p><strong>Objectives: </strong>The convex-concave lateral crura deformity (CCLCD) or S shape lateral crura is one of the biggest constraints to accomplish a beautiful tip and dorsum-tip transition (DTT). This deformity is the reason of commonly said parenthesis deformity of cephalic malposition. This LLC convexityconcavity shape creates a C shape shadow. This DTT is one of the key areas to accomplish natural results and it depends on different nose structures, not just the lower lateral cartilages (LLC).</p><p><strong>Methods: </strong>A total 560 rhinoplasty cases were studied retrospectively between September and December 2023. Three hundred and twenty patients had at least 1 year of follow-up. Patients had follow-up at 2 weeks, 1 month, 3 months, 6 months and 1 year after surgery. No secondary rhinoplasty was included. Just 2 secondary septoplasty cases were included without any nose skin undermining in the previous surgery. Surgical details were documented, including the 6 fundamental steps of this technique (1) mucosal lower lateral incision, (2) dorsum subperichondral dissection and vertical scroll release, (3) lateral crura tail caudal release, lateral crura steal and slide under flap lateralization, (4) upper laterals caudal resection, (5) vertical scroll reconstruction, and (6) turning point extension graft.</p><p><strong>Results: </strong>Three hundred and twenty patients had at least 1 year of follow-up. 516 underwent a closed approach and 47 patients an open approach. All patients had subperichondral dissection of the hump envelope. All patients who underwent a closed approach had a low strip let down dorsal preservation technique. All patients who underwent an open approach had structural technique with spreader flaps or grafts at the keystone area. All the patients underwent their osteotomies with a piezoelectric device. Twenty-three revision surgeries were necessary.</p><p><strong>Conclusions: </strong>CPR taught us how important ligament and soft tissue preservation are. It taught the less damage you do to the nose soft tissues and scaffold the less support you need on it. Surgeons have been over grafting the lateral crura to solve postoperative problems mainly due to dissection problems and lack of lateral crura support. This paper shows how to solve lateral crura surface problems keeping the tip flexible and elastic creating also a nice and natural supraalar groove transition by applying 6 surgical manoeuvres.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456098","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 Cosmetic Readiness Questionnaire (CRQ): Validation of a Pre-Operative Psychological Screening Tool for Aesthetic Procedures.","authors":"Toni D Pikoos, Ben Buchanan, David Hegarty, Susan L Rossell","doi":"10.1093/asj/sjae207","DOIUrl":"https://doi.org/10.1093/asj/sjae207","url":null,"abstract":"<p><strong>Background: </strong>Several psychological risk factors are associated with patient dissatisfaction with aesthetic procedures, such as body dysmorphic disorder (BDD), unmanaged mental health concerns or unrealistic expectations. Identifying these risks via preoperative screening may protect patients from adverse psychological outcomes and provide reputational or legal protection for practitioners.</p><p><strong>Objectives: </strong>This study aimed to further develop and validate the Cosmetic Readiness Questionnaire (CRQ), a comprehensive psychological screening tool to assess patient suitability for surgical and non-surgical aesthetic procedures.</p><p><strong>Methods: </strong>The CRQ was validated across two studies in clinical contexts, examining structural and construct validity in a sample of 8031 individuals who completed the CRQ as part of routine clinical care. In a further sample (n = 574), criterion validity was explored through the relationship between the CRQ and dissatisfaction with past aesthetic treatments. Risk category cut-off scores were developed.</p><p><strong>Results: </strong>Results supported the reliability and validity of a five-factor CRQ which measures Body Dysmorphia, Psychological Distress, Self-Criticism, Unrealistic Expectations and Lack of Openness. High scorers on the CRQ were 78% more likely to report dissatisfaction with a past cosmetic procedure than low scorers.</p><p><strong>Conclusions: </strong>The CRQ is a comprehensive and valid screening measure to identify patients who may require further psychological assessment or additional support prior to aesthetic treatment. Instructions are provided on how to implement the CRQ in clinical practice.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387335","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":"Vertıcal Internal Brow Suspensıon: A Technıque to Avoıd Lateral Relapse After Endoscopıc Brow Lıft.","authors":"Ozan Bitik","doi":"10.1093/asj/sjae208","DOIUrl":"https://doi.org/10.1093/asj/sjae208","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic brow lift is an integral component of upper face surgical rejuvenation protocols. Lateral relapse is one of the leading causes of dissatisfaction after endoscopic brow lift.</p><p><strong>Objectives: </strong>This study introduces and evaluates the Vertical Internal Brow Suspension (VIBS), a novel fixation technique designed to prevent lateral brow relapse following endoscopic brow lifts.</p><p><strong>Methods: </strong>A retrospective review was conducted on 118 consecutive endoscopic brow lift cases performed by the author between January 2019 and June 2024, using the VIBS technique. Additionally a subgroup of 29 patients who underwent isolated endoscopic brow lifts, with at least one year of follow-up, were included in a quantitative analysis of long-term brow position and forehead height.</p><p><strong>Results: </strong>Significant increases in brow height across all measurement levels (P<0.001) were observed in the quantitative analysis subgroup. No significant change in forehead height was noted (P=0.927). The VIBS technique also beneficially reduced apparent forehead height in patients with initially high foreheads. Frontal suture extrusions (6.8%) and temporary hairloss around scalp incisions (5.1%) were the most common complications observed from the retrospective analysis of 118 patients.</p><p><strong>Conclusions: </strong>The VIBS technique effectively prevents lateral brow relapse, achieving stable lateral brow elevation. It is a safe technique with minor complications. It addresses one of the longstanding challenges of the endoscopic brow lift surgery, representing a valuable advancement in upper face rejuvenation procedures.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387336","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: Artificial Intelligence Analysis of Periorbital Rejuvenation.","authors":"Christopher L Nuland","doi":"10.1093/asj/sjae206","DOIUrl":"https://doi.org/10.1093/asj/sjae206","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379943","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":"Evaluating the Impact of BoNT-A Injections on Facial Expressions: A Deep Learning Analysis.","authors":"Gulay Aktar Ugurlu, Burak Numan Ugurlu, Meryem Yalcinkaya","doi":"10.1093/asj/sjae204","DOIUrl":"https://doi.org/10.1093/asj/sjae204","url":null,"abstract":"<p><strong>Background: </strong>Botulinum Toxin Type A (BoNT-A) injections are widely used for facial rejuvenation, but their effects on facial expressions remain unclear.</p><p><strong>Objectives: </strong>This study aims to objectively measure the impact of BoNT-A injections on facial expressions using deep learning techniques.</p><p><strong>Methods: </strong>180 patients aged 25-60 years who underwent BoNT-A application to the upper face were included. Patients were photographed with neutral, happy, surprised, and angry expressions before and 14 days after the procedure. A Convolutional Neural Network (CNN)-based Facial Emotion Recognition (FER) system analyzed 1440 photographs using a hybrid dataset of clinical images and the Karolinska Directed Emotional Faces (KDEF) dataset.</p><p><strong>Results: </strong>The CNN model accurately predicted 90.15% of the test images. Significant decreases in the recognition of angry and surprised expressions were observed post-injection (p<0.05), with no significant changes in happy and neutral expressions (p>0.05). Angry expressions were often misclassified as neutral or happy (p<0.05), and surprised expressions were more likely to be perceived as neutral (p<0.05).</p><p><strong>Conclusions: </strong>Deep learning can effectively assess the impact of BoNT-A injections on facial expressions, providing more standardized data than traditional surveys. BoNT-A may reduce the expression of anger and surprise, potentially leading to a more positive facial appearance and emotional state. Further studies are needed to understand the broader implications of these changes.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370769","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":"Calcium Hydroxylapatite in Regenerative Aesthetics: Mechanistic Insights and Mode of Action.","authors":"Jani Van Loghem","doi":"10.1093/asj/sjae196","DOIUrl":"https://doi.org/10.1093/asj/sjae196","url":null,"abstract":"<p><p>Calcium Hydroxylapatite-Carboxymethylcellulose (CaHA-CMC) is a widely used 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 enhancing 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 for optimizing its clinical applications. A literature search was conducted using PubMed, google scholar and web of science for key words 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 biocues 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":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-04","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}