Aesthetic Surgery Journal最新文献

{"title":"A Deep Learning-based Ensemble Model for Automated Nasolabial Fold Severity Grading.","authors":"Hengqing Cui, Ziqi Zhang, Wenjun Zhang, Jun Zhang, Haiyan Cui","doi":"10.1093/asj/sjaf161","DOIUrl":"https://doi.org/10.1093/asj/sjaf161","url":null,"abstract":"<p><strong>Background: </strong>Nasolabial fold (NLF) severity is a key indicator of facial aging and a frequent target in aesthetic treatments. The Wrinkle Severity Rating Scale (WSRS) is widely used for clinical grading but remains inherently subjective and vulnerable to inter-observer variability.</p><p><strong>Objectives: </strong>This study aimed to develop and validate DeepFold, a deep learning-based ensemble model for automated, objective, and clinically interpretable grading of NLF severity based on the WSRS.</p><p><strong>Methods: </strong>A dataset of 6,718 facial images was constructed, including 1,718 images from clinical outpatients and 5,000 from the CelebA dataset. All images were split into left and right halves and annotated independently by three senior plastic surgeons using the WSRS. ResNet-50 served as the base model architecture, and an ensemble strategy was applied using majority voting over three independently trained networks. Model training used focal loss to address class imbalance and was conducted in PyTorch with early stopping based on validation loss. Performance was assessed using accuracy, F1-score, and confusion matrix analysis.</p><p><strong>Results: </strong>The DeepFold ensemble model achieved a validation accuracy and F1-score of 0.917, outperforming individual baseline models such as ResNet-50 (accuracy: 0.904) and SeResNet-50 (accuracy: 0.882). Ensemble strategies reduced prediction variance and enhanced model robustness under class imbalance.</p><p><strong>Conclusions: </strong>DeepFold provides a reliable and standardized approach to NLF severity assessment, offering potential clinical value in aesthetic evaluation, treatment planning, and outcome monitoring.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833716","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":"Tranexamic Acid and the Risk of Hematoma and Seroma Following Implant-Based Breast Reconstruction: A Retrospective Study of 1782 Patients.","authors":"Caroline Barskov Norlin, Tim Kongsmark Weltz, Erik Eiler Frydshou Bak, Amelia Lau, Andreas Larsen, Mathilde Nejrup Hemmingsen, John Vinh Quang Tran, Randa Bismark Kullab, Anne Karen Bennedsen, Iselin Saltvig, Nicco Krezdorn, Pia Cajsa Leth Andersen, Lisa Toft-Jensen, Rikke Bredgaard, Lisbet Rosenkrantz Hölmich, Peter Vester-Glowinski, Mathias Ørholt, Mikkel Herly","doi":"10.1093/asj/sjaf154","DOIUrl":"https://doi.org/10.1093/asj/sjaf154","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative tranexamic acid is used increasingly during implant-based breast reconstruction to reduce hematoma and seroma formation. However, evidence supporting the effectiveness of tranexamic acid in this setting remains limited.</p><p><strong>Objectives: </strong>This study aims to compare the risk of hematoma and seroma in patients treated with and without intraoperative intravenous tranexamic acid during implant-based breast reconstruction.</p><p><strong>Methods: </strong>Medical records of patients who underwent breast reconstruction at three plastic surgical departments between 2010 and 2023 were retrospectively reviewed. We compared the risk of hematoma and seroma between patients treated with and without intraoperative intravenous tranexamic acid using Robust Multivariable Cox regression with inverse probability of treatment weighting.</p><p><strong>Results: </strong>We included 1782 patients who underwent implant-based breast reconstruction, of whom 352 received intraoperative intravenous tranexamic acid. Multivariable analysis showed a non-significant reduction in the risk of hematoma (HR 0.81; p=0.51) and seroma (HR 0.88; p=0.68) in patients who received tranexamic acid. Furthermore, the time to hematoma was significantly longer (2 vs. 1 day, p=0.03), as well as the time to drain removal (7 vs. 6 days, p<0.001) for patients treated with tranexamic acid. However, the time to discharge was significantly shorter (4 vs. 5 days, p<0.001).</p><p><strong>Conclusions: </strong>Intraoperative administration of tranexamic acid was associated with a non-significant reduction in the risk of hematoma and seroma, suggesting a limited clinical effect in patients undergoing implant-based breast reconstruction. However, future studies are needed to definitively determine the effects in implant-based breast reconstruction.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833720","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":"Surviving Sniper Alley, Negotiating the Minefield, and Crossing the Tightrope: Project 100, a Tactical Guide for a Longer, Healthier, and More Fulfilling Life.","authors":"Neil Bulstrode","doi":"10.1093/asj/sjaf067","DOIUrl":"10.1093/asj/sjaf067","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":"45 Supplement_2","pages":"S66-S68"},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833722","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 Health Benefits of Hair Transplant Surgery.","authors":"Greg Williams","doi":"10.1093/asj/sjaf092","DOIUrl":"10.1093/asj/sjaf092","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":"45 Supplement_2","pages":"S59-S61"},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833726","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 Value of Aesthetic Surgery for Health.","authors":"Michael Paul Tyler","doi":"10.1093/asj/sjaf083","DOIUrl":"10.1093/asj/sjaf083","url":null,"abstract":"","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":"45 Supplement_2","pages":"S35-S39"},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833758","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":"Microvascular Insights Into Hyaluronic Acid Filler Dispersal Within an Artificial Model of Arterial Embolism.","authors":"Danny J Soares, Shoshana Trudel, Robyn Siperstein, Thomas J Kean, Alec D McCarthy","doi":"10.1093/asj/sjaf155","DOIUrl":"https://doi.org/10.1093/asj/sjaf155","url":null,"abstract":"<p><strong>Background: </strong>Hyaluronic acid (HA) filler-induced vascular occlusion is a serious complication in aesthetic medicine, yet the microvascular behavior of HA gels under physiologically relevant flow conditions remains poorly characterized.</p><p><strong>Objectives: </strong>To evaluate the embolic fragmentation, dispersal, and occlusive behavior of five commercially available HA fillers within a physiologically calibrated microvascular perfusion model.</p><p><strong>Methods: </strong>Five HA fillers were tested using a modified PULSAR system incorporating a branched microtubular adapter (200-1000 µm channels) with physiologic arterial flow parameters. Products were injected via 22G and 27G microcannulas and assessed for occlusion patterns, fragment morphology, and particle size. Flow dynamics were recorded via videography and fragment characteristics were analyzed using imaging software. Statistical comparisons were conducted across products and cannula gauges.</p><p><strong>Results: </strong>HA gels fragmented extensively into microparticles (mean area = 0.140 mm²; IQR: 0.024-0.254 mm²) generating high rates of occlusion predominantly in channels ≤ 300 µm (p < 0.0001). 22G injection produced larger particles and higher occlusion rates than 27G (31% vs. 17%, p = 0.025), most notably with large particle, high-elasticity products. Fragment morphology varied with rheology: solid gels fractured into ovoid embolic particles, while soft, high-tan δ gels formed filamentous, non-occlusive strands. Across all products, particle size was lower in the microvascular simulation compared to prior macrovascular experiments, indicating vessel-caliber-dependent fragmentation.</p><p><strong>Conclusions: </strong>HA fillers behave as deformable embolic particles that disperse distally under physiologic microtubular conditions. These findings support a concurrent microembolic mechanism underlying filler-induced ischemia. Product rheology, cannula gauge, and vascular anatomy are important determinants of embolic particle behavior.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833718","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 Health Benefits of Aesthetic Body Surgery.","authors":"Nora Nugent, Éilís Fitzgerald, Thangasamy K Sankar","doi":"10.1093/asj/sjaf079","DOIUrl":"10.1093/asj/sjaf079","url":null,"abstract":"<p><p>Aesthetic body surgery (encompassing body contouring surgery and female aesthetic genital surgery) procedures continue to rise in numbers year after year. As plastic surgeons, we see the transformative benefits for our patients as they return to see us after surgery. However, as with all medical practice, anecdotal reports or opinions on the benefits are not enough to evidence our practice or to ensure best medical practice for our patients. The purpose of this paper is to look at the evidence behind the health benefits of abdominoplasty, body contouring surgery after weight loss, and female aesthetic genital surgery (aesthetic body surgery) in the medical literature and collate the benefits and evidence for the readership. This is one of the papers in a series within the Supplement, Health Benefits of Aesthetic Surgery, looking at the evidence behind the perceived benefits of the surgery that we perform. A literature review looking for evidence behind the benefits of aesthetic body contouring surgery encompassing the 3 areas of abdominoplasty, body contouring after weight loss, and female aesthetic genital surgery was performed. All 3 areas showed consistent benefits for physical and functional as well as psychosocial outcomes across a range of studies within the medical literature.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":"45 Supplement_2","pages":"S52-S58"},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833723","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 Psychological Health Benefits of Aesthetic Surgery.","authors":"Lucy Kozlowski","doi":"10.1093/asj/sjaf117","DOIUrl":"10.1093/asj/sjaf117","url":null,"abstract":"<p><p>Heightened rates of psychological distress and mental health disorders are observed in aesthetic surgery populations and are frequently cited as motivating factors for the pursuit of such procedures. Although mental health disorders are often considered a contraindication due to the risk of adverse outcomes posttreatment, the therapeutic benefits of aesthetic surgery are well documented and can lead to the resolution of distress and disorders. This paper presents a literature review of the psychosocial health outcomes for such populations and the associated clinical guidance for clinicians. A review of the literature indicates that although for a minority of patients the presence of psychological or a mental health disorder can increase the risk of poor posttreatment outcomes, the majority of aesthetic surgery patients achieve positive psychosocial and psychological outcomes. These include the resolution of depression, anxiety, and eating disorder and personality disorder symptomatology, as well as enhanced functioning in several key life domains and improvements in body image, self-esteem, and overall quality of life, indicating that aesthetic surgery provides a significant therapeutic function. This literature review concludes that the presence of a psychological or mental health disorder is not necessarily a contraindication for aesthetic surgery and should not automatically preclude patients from treatment. Psychological screening, informed by validated assessment measures developed for aesthetic surgical clinics and general hospital settings, should be an integral aspect of pretreatment processes. This ensures prompt identification of those at elevated risk for poor posttreatment outcomes, enabling timely referral for comprehensive psychological risk assessment and treatment.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":"45 Supplement_2","pages":"S62-S65"},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833757","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 Health Benefits of Aesthetic Breast Surgery.","authors":"Reza Nassab, Mark Ho-Asjoe","doi":"10.1093/asj/sjaf093","DOIUrl":"10.1093/asj/sjaf093","url":null,"abstract":"<p><p>Aesthetic breast surgery is one of the most performed procedures in women worldwide. There can be many indications for surgery of the breast, from hypoplasia to hypertrophy, as well as congenital anomalies. The outcomes of aesthetic breast surgery not only affect the physical appearance of the patient, but also contribute to a wealth of additional functional, psychological, and emotional benefits. This article aims to deliver an overview of some the latest literature regarding the benefits of aesthetic surgery of the breast, including breast augmentation, reduction mammaplasty, and tuberous breast deformity correction.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":"45 Supplement_2","pages":"S40-S46"},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833724","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 Health Benefits of Aesthetic Facial Surgery.","authors":"Fateh Ahmad, Dan B Saleh, Manaf Khatib","doi":"10.1093/asj/sjaf118","DOIUrl":"10.1093/asj/sjaf118","url":null,"abstract":"<p><p>Aesthetic facial surgery is a commonly sought treatment to manage cosmetic, physical, psychological, and emotional maladies. Although there is much in the literature regarding the impact of such procedures on appearance, there remains a dearth of evidence in relation to the many functional benefits that accompany these treatments. This invited article aims to expand upon the abundance of evidence to support the contention that aesthetic surgery to the face, eyes, and nose addresses not only appearance-related improvements, but also has a significant impact upon psychological, mental, and emotional well-being.</p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":"45 Supplement_2","pages":"S47-S51"},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833725","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}