151
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Aguilar HA, Palacios Huatuco RM, Ruffa T, Chirvechez A, Mayer HF. Synchronous pneumothorax and venous thromboembolism after body contouring surgery. Int J Surg Case Rep 2024; 119:109706. [PMID: 38678998 PMCID: PMC11063891 DOI: 10.1016/j.ijscr.2024.109706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024] Open
Abstract
INTRODUCTION Lipoabdominoplasty is one of the most common abdominal body contouring procedures performed today; however, it carries the risk of significant complications. Pneumothorax is a rare complication of liposuction, while, venous thromboembolism has a low short-term mortality and long-term morbidity. PRESENTATION OF CASE A 57-year-old woman with a history of diabetes mellitus, hypertension, obesity, and severe COVID-19 three years earlier. The patient underwent 360-degree liposuction and abdominoplasty. In the immediate postoperative period, the patient developed a right pneumothorax and followed by deep vein thrombosis (DVT) and pulmonary embolism (PE), which were diagnosed and treated early. After six months of follow-up, the patient presented a complete recovery. DISCUSSION Pneumothorax is recognized as a rare complication of liposuction and has been limited to case reports and small case series in the medical literature with an incidence of 0.04 %. In plastic and aesthetic surgery, body contouring procedures such as lipoabdominoplasty are associated with a risk of DVT and PE of 0.2-0.6 %, and 0.3 %, respectively. In addition, we believe that performing combined aesthetic procedures may increase the risk of complications. CONCLUSION This is the first reported case of pneumothorax, DVT and PE after body contouring surgery. We highlight the importance of awareness of these complications and the need for a high index of suspicion for early diagnosis and treatment, which is critical for patient survival.
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Affiliation(s)
- Hernán A Aguilar
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., 1st. floor (C1991ABB), Buenos Aires, Argentina
| | - René M Palacios Huatuco
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., 1st. floor (C1991ABB), Buenos Aires, Argentina.
| | - Tatiana Ruffa
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., 1st. floor (C1991ABB), Buenos Aires, Argentina
| | - Alejandra Chirvechez
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., 1st. floor (C1991ABB), Buenos Aires, Argentina
| | - Horacio F Mayer
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., 1st. floor (C1991ABB), Buenos Aires, Argentina
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152
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Chen YH, Baan F, Bruggink R, Ko EWC, Bergé S, Xi T. Clockwise versus counterclockwise rotation in bimaxillary surgery: 3D analysis of facial soft tissue outcomes. Oral Maxillofac Surg 2024; 28:693-703. [PMID: 37981624 DOI: 10.1007/s10006-023-01196-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE This study aimed to compare facial 3D soft tissue changes in subjects with Class III deformities who underwent bimaxillary clockwise (CW) and counterclockwise (CCW) rotational orthognathic surgery. METHODS Asian Class III subjects who completed bimaxillary surgical orthodontic treatments were enrolled and categorized into CW and CCW groups based on maxillary occlusal plane alterations. Preoperative and 9-month follow-up cone-beam computed tomography (CBCT) and 3D stereophotogrammetry were obtained, superimposed, and quantified for skeletal movements and soft tissue changes in six facial regions. Inverse probability of treatment weighting (IPTW) adjusted for potential confounding factors. RESULTS Thirty-seven subjects were included (CW group, n = 20; CCW group, n = 17). Postsurgical chin volume significantly reduced in the CW group compared to the CCW group (mean difference 6362 mm3; p = 0.037), and intergonial width significantly decreased in the CW group (mean difference 6.2 mm; p = 0.005). The postoperative alar width increased by 1.04 mm and 1.22 mm in the CW and CCW groups, respectively (p = 0.70). However, these changes were not significantly correlated to the direction of MMC pitch. CONCLUSION Clockwise rotation of the bimaxillary complex demonstrated a significant advantage in reducing chin volume and intergonial width compared to counterclockwise rotation, leading to a reduced frontal lower face width among Asian Class III subjects.
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Affiliation(s)
- Yi-Hsuan Chen
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Frank Baan
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robin Bruggink
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ellen Wen-Ching Ko
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Geert Grooteplein 10, 6525, Ga, Nijmegen, The Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Geert Grooteplein 10, 6525, Ga, Nijmegen, The Netherlands.
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153
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Maltezou HC, Pavli A. Challenges with medical tourism. Curr Opin Crit Care 2024; 30:224-230. [PMID: 38441086 DOI: 10.1097/mcc.0000000000001148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
PURPOSE OF REVIEW With the return of international travels to almost prepandemic levels, the number of patients who travel abroad to seek healthcare services is once again growing rapidly. Nevertheless, the expected benefits of medical tourism may be challenged by serious infectious complications. This review summarizes the evolving published evidence on infectious complications related with medical tourism of the last eighteen months. RECENT FINDINGS There has been an increase of reported infectious complications in patients who had received healthcare abroad. Such complications were frequently associated with serious and prolonged morbidity, repeated treatments and hospitalizations, high healthcare costs, and occasionally fatalities. A devastating outbreak of fungal meningitis occurred among US residents who underwent epidural anesthesia for cosmetic surgery in two clinics in Mexico. Overall, as of July 5, 2023 there were 31 cases with severe cerebrovascular complications and eight deaths. Infections caused by nontuberculum mycobacteria and Candida sp have been also reported the last years. SUMMARY Considering the expected expansion of medical tourism in the forthcoming years, public health authorities and scientific societies should raise awareness of such infections among physicians and other healthcare professionals and issue recommendations for their management. A system to report complications in patients receiving healthcare abroad is needed.
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Affiliation(s)
| | - Androula Pavli
- Department of Travel Medicine, National Public Health Organization, Athens, Greece
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154
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Heron MJ, Tiongco RFP, Zhu KJ, Habibi M, Cooney CM, Broderick KP. Anthropometric indices fail to predict complications after mastectomy for gynecomastia in adolescents. J Plast Reconstr Aesthet Surg 2024; 93:210-212. [PMID: 38705122 DOI: 10.1016/j.bjps.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/06/2024] [Accepted: 04/05/2024] [Indexed: 05/07/2024]
Affiliation(s)
- Matthew J Heron
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rafael Felix P Tiongco
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katherine J Zhu
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mehran Habibi
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Carisa M Cooney
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristen P Broderick
- Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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155
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Xu X, Sun X, Fu Q, Zhou G, Ning Y, Zheng C, Yang X, Yu Y, Chen M. Superselective Arterial Hyaluronidase Thrombolysis is an Effective Treatment for Hyaluronic Acid-Induced Retinal Artery Occlusion: Study in a Rabbit Model. Aesthetic Plast Surg 2024; 48:2190-2196. [PMID: 38429528 DOI: 10.1007/s00266-024-03891-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/30/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND There are serious complications associated with hyaluronic acid (HA) facial injections, including vision impairment due to retinal artery ischemia. In this study, we put forth a clinically relevant model of retinal ischemia and reperfusion in rabbit. We used this to verify the efficacy of hyaluronidase intra-artery thrombolysis in the treatment of hyaluronic acid-induced retinal artery occlusion. METHODS Retinal artery ischemia was induced by injecting HA into the ophthalmic artery (OA) of adult chinchilla rabbit, and reperfusion was achieved by intra-artery thrombolysis therapy with hyaluronidase following 60 min and 4 h of occlusion. Digital subtraction angiography (DSA) and fundus fluorescein angiography (FFA) were used to evaluate blood flow in the retina. Electroretinogram (ERG), hematoxylin and eosin staining and transmission electron microscope were used to evaluate the structure and function of the retina after ischemia and reperfusion following 60 min and 4 h of occlusion. RESULTS DSA and FFA images confirmed occlusion of the ophthalmic and central retinal arteries, as well as reperfusion after hyaluronidase thrombolysis. ERG indicated retinal dysfunction following ischemia, and thrombolysis partially rescued its impairment following 4 h of occlusion. Hematoxylin and eosin staining and TUNEL staining revealed ischemia-induced histological damages in the retina at different time windows, and hyaluronidase thrombolysis partially mitigated these damages. CONCLUSIONS We report a method to establish a HA-induced retinal artery occlusion animal model. Hyaluronidase intra-artery thrombolysis was used to recanalize the embolized OA at different time points. Using our method, we achieved retinal reperfusion, and an improvement was observed in the visual function of rabbits after hyaluronidase thrombolysis following 4 h of occlusion. We believe that hyaluronidase intra-artery thrombolysis is an effective method to treat HA-induced retinal artery occlusion in clinic. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xiao Xu
- Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, No. 69 Yongding Road, Haidian District, Beijing, 100039, China
| | - Xuer Sun
- Medical School of Chinese PLA, Beijing, China
| | - Qiang Fu
- Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Rd, Haidian District, Beijing, 100048, China
| | - Guiwen Zhou
- Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Rd, Haidian District, Beijing, 100048, China
| | - Yi Ning
- Department of Interventional Radiology, The Fourth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Rd, Haidian District, Beijing, 100048, China
| | - Can Zheng
- Medical School of Chinese PLA, Beijing, China
| | - Xinji Yang
- Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, No. 69 Yongding Road, Haidian District, Beijing, 100039, China.
| | - Youtao Yu
- Department of Interventional Radiology, The Fourth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Rd, Haidian District, Beijing, 100048, China.
| | - Minliang Chen
- Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Rd, Haidian District, Beijing, 100048, China.
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156
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Seretis K. Learning from Abdominoplasty to Reduce the Seroma Rate following Deep Inferior Epigastric Perforator Flap with Umbilectomy. J Reconstr Microsurg 2024; 40:e1-e2. [PMID: 37579779 DOI: 10.1055/a-2153-4629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, Medical School, University of Ioannina, Ioannina, Greece
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157
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Innocenti A, Tamburello S, El Araby Mohamed M. Comment on "The combination of endoscopic subcutaneous mastectomy and liposuction (Liu and Shang's 2-hole 7-step method) as the treatment of gynecomastia". Surgery 2024; 175:1623. [PMID: 38092634 DOI: 10.1016/j.surg.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 05/12/2024]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
| | - Sara Tamburello
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy
| | - Marzouk El Araby Mohamed
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
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158
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Kim SH, Choi BG, Chung KJ. Modified Deep-Plane Face Lift and Lower Midface Lifting Using Deep Fat Compartment Mobilization and Zygomaticus Major Muscle Plication. Plast Reconstr Surg 2024; 153:1084e-1091e. [PMID: 37184450 DOI: 10.1097/prs.0000000000010642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Most face-lift techniques greatly improve the lower face; however, techniques for lifting the midface are limited and difficult. Original deep-plane face lift is a way to lift the superficial musculoaponeurotic system and skin as a compound unit. Although it minimizes tear of the superficial musculoaponeurotic system during dissection, damage to the vascular system, and the incidence of skin necrosis, and can be easily used in secondary cases, the deep-plane face lift does not adequately improve nasolabial fold. The authors perform a modified and enhanced deep-plane face lift to improve the midface. In this article, the authors explain the effects and procedures of the method. METHODS This retrospective study included patients ( n = 632) on whom deep-plane face lift (DPF group; n = 299) and modified deep-plane face lift (M-DPF group; n = 333) was performed by a single surgeon from January of 2014 to January of 2017, and from February of 2017 to December of 2020, respectively, at a local clinic. The degree of improvement in wrinkles in the patients' nasolabial fold was assessed using the five-grade Wrinkle Severity Rating Scale (WSRS). RESULTS The preoperative WSRS score was 2.95 ± 0.89 in the DPF group and 2.89 ± 0.92 in the M-DPF group. There was no significant difference in the preoperative WSRS score between the two groups ( P = 0.058). The postoperative WSRS score was 1.81 ± 0.68 in the DPF group, which was significantly greater than the 1.65 ± 0.66 found in the M-DPF group. CONCLUSION This method developed by the authors that combines deep-plane face lift with deep fat compartment mobilization and zygomaticus major muscle plication is safe and directly improves the nasolabial fold and promotes a smiling expression for rejuvenation effects. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
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Affiliation(s)
| | - Bong Gyu Choi
- Department of Plastic and Reconstructive Surgery, Gangjin Medical Center
| | - Kyu-Jin Chung
- Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine
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159
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Armengou X, Frank K, Kaye K, Brébant V, Möllhoff N, Cotofana S, Alfertshofer M. Facial Anthropometric Measurements and Principles - Overview and Implications for Aesthetic Treatments. Facial Plast Surg 2024; 40:348-362. [PMID: 37487528 DOI: 10.1055/s-0043-1770765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023] Open
Abstract
Facial anatomy is highly individual in each patient. Anthropometric measurements can be a useful tool to objectively analyze individual facial anatomy to allow for better comparability before and after treatments to ultimately improve standardization of facial procedures, both nonsurgical and surgical. The aim of this study was to provide a comprehensive overview over clinically relevant and feasible facial anthropometric measurements and principles for aesthetic medicine. A literature review was conducted to describe the most important and clinically relevant anthropometric measurements and principles for both the entire face and for three aesthetically relevant facial regions: the periorbital region, the nose, and the perioral region. A multitude of different anthropometric measurements and principles have been described in the literature for both the overall facial appearance and specific facial regions. Certain generally accepted anthropometric principles and proportions need to be respected to achieve aesthetic and harmonious results. For the overall facial appearance, a focus on symmetry, certain proportions, facial angles, and indices has been described. Principles and measurements were also described for the periorbital region, the nose, and the perioral region. Although attractiveness and aesthetic perception are subjective, objective evaluation of facial surface anatomy via anthropometric measurements can improve pre- and postinterventional analysis of the face and help the treating physician to individualize treatments, both nonsurgical and surgical.
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Affiliation(s)
| | - Konstantin Frank
- Centre for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Marbella, Spain
| | - Kai Kaye
- Centre for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Marbella, Spain
| | - Vanessa Brébant
- Department of Plastic, Aesthetic and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Bayern, Germany
| | - Nicholas Möllhoff
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital Munich, Ludwig Maximilian University, Munich, Germany
| | - Sebastian Cotofana
- Department of Dermatology, Erasmus Hospital, Rotterdam, The Netherlands
- Centre for Cutaneous Research, Blizard Institute, Queen Mary University of London, London, UK
| | - Michael Alfertshofer
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital Munich, Ludwig Maximilian University, Munich, Germany
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160
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Salehi PP, Shah HP, Torabi SJ, Heiser A, Salehi P, Peng GL, Nassif P, Lee YH, Azizzadeh B. Characterizing the Rhinoplasty Outcomes Most Important to Patients, Surgeons, and the General Population. J Craniofac Surg 2024; 35:1129-1133. [PMID: 38688025 DOI: 10.1097/scs.0000000000010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/24/2024] [Indexed: 05/02/2024] Open
Abstract
Understanding rhinoplasty characteristics important to patients, physicians, and society is essential for evaluating outcomes and designing optimal treatment plans. The authors aimed to elucidate specific rhinoplasty-related outcomes that are most important to patients, surgeons, and the general population. A cross-sectional survey comprising 11 rhinoplasty-specific characteristics, was distributed to patients, facial plastic surgeons, and the general population. Adult patients presenting for rhinoplasty consideration or follow-up after undergoing rhinoplasty were recruited. Characteristics rankings were compared between the 3 respondent groups using Spearman's rank correlation coefficient (ρ). Responses from 150 surgeons, 111 patients, and 102 lay individuals from the general population were included for analysis. When ranking rhinoplasty-specific characteristics in order of importance, patients and the general population ranked "ability to breathe through nose while awake" first and "overall appearance of nose" as second. Surgeons ranked "overall appearance of nose" first and "ability to breathe through nose while awake" second. There were strong correlations between patients' and surgeons' rankings (Spearman's ρ=0.836, P =0.002), between patients' and the general population's rankings (Spearman's ρ=0.773, P =0.007), and between surgeons' and the general population's rankings (Spearman's ρ=0.782, P =0.006). Our results highlight a significant correlation between characteristics of the "ideal" nose as determined by patients, surgeons, and the general population.
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Affiliation(s)
- Parsa P Salehi
- Department of Facial Plastic Surgery, Newport Beach
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT
| | - Hemali P Shah
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Sina J Torabi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine
| | - Alyssa Heiser
- Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, MA
| | - Pauniz Salehi
- Department of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY
| | | | | | - Yan H Lee
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery, Beverly Hills, CA
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161
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Gallo L, Churchill IF, Wong Riff KWY, Bulstrode NW, Berenguer B, Cui C, Li Y, Zhang R, Klassen AF, Rae C. Patient factors associated with novel EAR-Q appearance, psychosocial, and social scales: A cross-sectional study and regression analysis. J Plast Reconstr Aesthet Surg 2024; 93:62-69. [PMID: 38663166 DOI: 10.1016/j.bjps.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/29/2024] [Accepted: 04/05/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION The EAR-Q is a rigorously validated patient-reported outcome measure, which evaluates ear appearance and health-related quality of life (HRQL) in patients with congenital or acquired ear conditions. The aim of this study was to conduct an exploratory analysis to examine the factors associated with EAR-Q appearance and HRQL scale scores. METHODS In this study, 862 participants, aged 8-29 years, with congenital or acquired ear conditions, completed the EAR-Q as part of an international field-test study. Patients responded to demographic and clinical questions as well as the EAR-Q. Univariable and multivariable linear regression analyses were used to determine factors that were significant predictors for the scores on the EAR-Q Appearance, Psychological, and Social scales. RESULTS Most participants were men (57.4%), awaiting treatment (55.0%), and had a microtia diagnosis (70.4%), with a mean age of 13 (±4) years. Worse ear appearance scores (p < 0.02) were associated with male gender, microtia, no history of treatment, ear surgery within 6 months, unilateral involvement, and greater self-reported ear asymmetry. Decreased psychological scores (p < 0.01) were associated with increasing participant age, no treatment history, recent ear surgery, and dissatisfaction with ears matching or overall dissatisfaction. Lower social scores (p ≤ 0.04) were associated with no treatment history, those awaiting surgery, ear surgery within the last 6 months, bilateral involvement, and self-reported ears matching or overall appearance. CONCLUSION This analysis identified patient factors that may influence ear appearance and HRQL scale scores. These findings provide evidence of patient factors that should be adjusted for when undertaking future observational research designs using the EAR-Q in this patient population.
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Affiliation(s)
- Lucas Gallo
- Department of Surgery, Division of Plastic Surgery, McMaster University, Hamilton, ON, Canada
| | | | - Karen W Y Wong Riff
- University of Toronto and the Hospital for Sick Children, Toronto, ON, Canada
| | - Neil W Bulstrode
- Division of Plastic Surgery, Great Ormond Street Hospital, London, UK
| | - Beatriz Berenguer
- Division of Plastic Surgery, Hospital General Universitario Gregorio Maranon, Madrid, Spain
| | - Chunxiao Cui
- Division of Plastic Surgery, Shanghai 9th People's Hospital, Shanghai, China
| | - Yiyuan Li
- Division of Plastic Surgery, Shanghai 9th People's Hospital, Shanghai, China
| | - Ruhong Zhang
- Division of Plastic Surgery, Shanghai 9th People's Hospital, Shanghai, China
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
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162
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Cheng CY, Lin TM, Chang SL, Hu S, Huang YL. Transcutaneous lower eyelid blepharoplasty with micro-autologous fat transplantation harvested from orbital fat pads for lower eyelid aging treatment. J Plast Reconstr Aesthet Surg 2024; 93:111-113. [PMID: 38678813 DOI: 10.1016/j.bjps.2024.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/04/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024]
Abstract
The aging process of lower eyelids results in lower eyelid wrinkles, tear troughs, and eye bags. Many therapies have been described for treatment of lower eyelid aging, and transcutaneous blepharoplasty is often used for treating cases with eyebags and dermatochalasis. However, it may cause depression near the medial orbit resulting in a hollowed look. In the present study, we developed an innovative method transferring the herniated fatty tissue to volume loss area during the surgical procedure of transcutaneous lower eyelid blepharoplasty by means of micro-autologous fat transplantation harvested from resected orbital fat pads. Besides, we also analyze it efficacy and safety compared with traditional methods of transcutaneous lower eyelid blepharoplasty. We reviewed the records of the patients who underwent transcutaneous lower eyelid blepharoplasty with and without micro-autologous fat transplantation, for lower eyelid aging improvement. We used global aesthetic improvement scale, Hirmand's classification system, and Wrinkle Severity Rating Scale to evaluate the cosmetic outcome at 1 week, 1 month, and 3 months after operation by two independent investigators. We found patients received transcutaneous lower eyelid blepharoplasty with autologous fat graft had significantly higher global aesthetic improvement scale and Wrinkle Severity Rating Scale improvement than those underwent transcutaneous lower eyelid blepharoplasty only in each evaluation timepoints. There was no significant difference of adverse effects between both surgical methods. The present study demonstrated the efficacy and safety of the lower eyelid blepharoplasty with micro-autologous fat transplantation harvesting from resected orbital fat pads.
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Affiliation(s)
- Chun-Yu Cheng
- Department of Dermatology, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan; College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan; Center of Tissue Engineering, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan
| | - Tsai-Ming Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, No. 100, Ziyou 1st Road, Sanmin Dist., Kaohsiung City 807, Taiwan; Charming Institute of Aesthetic and Regenerative Surgery (CIARS), 2F.-1, No. 172, Ziqiang 2nd Road, Qianjin Dist., Kaohsiung City 801, Taiwan
| | - Shyue-Luen Chang
- Department of Dermatology, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan; College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan
| | - Sindy Hu
- Department of Dermatology, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan; College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan
| | - Yau-Li Huang
- Department of Dermatology, Chang Gung Memorial Hospital, No.123, Dinghu Rd., Guishan Dist., Taoyuan City 333, Taiwan; College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 333, Taiwan.
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Niu EF, Honig SE, Wang KE, Amro C, Davis HD, Habarth-Morales TE, Broach RB, Fischer JP. Obesity as a Risk Factor in Cosmetic Abdominal Body Contouring: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg 2024; 48:2121-2131. [PMID: 37644187 DOI: 10.1007/s00266-023-03602-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The incidence of obesity is on the rise around the globe. Outside of the massive weight loss (MWL) patient population, knowledge of risk factors associated with abdominal body contouring (BC) is limited. This systematic review and meta-analysis assesses the impact of obesity has on cosmetic abdominal BC outcomes. METHODS A systematic review conducted in accordance with PRISMA 2020 was done. PubMed, Embase, Scopus, and COCHRANE databases were reviewed under search syntax "obesity," "abdominoplasty," "panniculectomy," and "body contouring" for articles. Cosmetic was defined as abdominoplasty or panniculectomy outside the context of MWL. Obesity was defined as BMI ≥ 30 kg/m2. Studies reporting postoperative outcomes with less than 50% of their population involving MWL patients were included. Postoperative outcomes were assessed by pooled analysis and meta-analysis. RESULTS Of 3088 initial studies, 16 met inclusion criteria, and nine were used for pooled and meta-analysis. Meta-analysis demonstrated that obesity was associated with more seromas (OR 1.45, 1.06-1.98, p = 0.02), hematomas (OR 2.21, 1.07-4.57, p = 0.03), and total surgical site occurrences (OR 1.99, 1.30-3.04, p = 0.0016). There was no significant difference in odds of any other complications. Analysis by obesity class showed no significant increase in odds in seromas or wound dehiscence. CONCLUSIONS This review demonstrates obesity increased odds of postoperative complications following cosmetic abdominal BC. However, risk of complications does not continue to increase with higher obesity class. A BMI ≥ 30 kg/m2 should not be a strict contraindication to cosmetic abdominal BC. Instead, plastic surgeons should evaluate patients on a case-by-case basis. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Ellen F Niu
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
| | - Stephanie E Honig
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Katherine E Wang
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
| | - Chris Amro
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Harrison D Davis
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Theodore E Habarth-Morales
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Robyn B Broach
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - John P Fischer
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
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Radulesco T, Ebode D, Medawar C, Penicaud M, Michel J. Prospective Evaluation of Aesthetic and Functional Outcomes following Video-Assisted Rhino-Septoplasty. Aesthetic Plast Surg 2024:10.1007/s00266-024-04146-3. [PMID: 38819447 DOI: 10.1007/s00266-024-04146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Conservative techniques have been developed in the field of rhinoplasty, focusing on limited tissue resection while emphasizing the reshaping of nasal structural elements. OBJECTIVES We aimed to prospectively evaluate aesthetic and functional outcomes following Video-Assisted Rhino-Septoplasty (VARS) using validated tools. METHODS Patients' self-reported outcomes were assessed before and 6 months after surgery. Aesthetic evaluations used FACE-Q Rhinoplasty modules (FQRM) Satisfaction with Nose and Nostrils. Functional evaluations were performed with NOSE scores. T-tests were used to determine the significance of the change in scores before and after surgery. p value < 0.05 was considered statistically significant. RESULTS Fifty patients were included (sex ratio = 0.16, mean age = 30 y.o., 78% primary cases). All patients had associated septoplasties, and 32 had inferior turbinate reductions. Mean FQRM Nose scores were 28.1 ± 16.3 before vs. 83.4 ± 17.2/100 after surgery. Mean FQRM Nostrils scores were 61.5 ± 28.6 before vs. 85 ± 21/100 after surgery. Mean NOSE scores were 49.5 ± 36.3 before vs. 14.8 ± 16.6/100 after surgery. All p <0.001. We found no correlation between FQRM Nose and NOSE scores after surgery (ρ = -0.1553, IC95% (-0.41;0.12), p = 0.28). CONCLUSION Our study showed that VARS is an effective technique, yielding high patient satisfaction in both aesthetic and functional outcomes. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Thomas Radulesco
- Aix Marseille Univ, APHM, CNRS, IUSTI, La Conception University Hospital, ENT-HNS, Department, Marseille, France.
| | - Dario Ebode
- Aix Marseille Univ, APHM, CNRS, IUSTI, La Conception University Hospital, ENT-HNS, Department, Marseille, France
| | | | - Martin Penicaud
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, 147 Bd Baille, 13005, Marseille, France
| | - Justin Michel
- Aix Marseille Univ, APHM, CNRS, IUSTI, La Conception University Hospital, ENT-HNS, Department, Marseille, France
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165
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Polat E, Polat YB, Senturk E, Dogan R, Yenigun A, Tugrul S, Eren SB, Aksoy F, Ozturan O. Evaluating the accuracy and readability of ChatGPT in providing parental guidance for adenoidectomy, tonsillectomy, and ventilation tube insertion surgery. Int J Pediatr Otorhinolaryngol 2024; 181:111998. [PMID: 38830271 DOI: 10.1016/j.ijporl.2024.111998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/08/2024] [Accepted: 05/30/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES This study examined the potential of ChatGPT as an accurate and readable source of information for parents seeking guidance on adenoidectomy, tonsillectomy, and ventilation tube insertion surgeries (ATVtis). METHODS ChatGPT was tasked with identifying the top 15 most frequently asked questions by parents on internet search engines for each of the three specific surgical procedures. We removed repeated questions from the initial set of 45. Subsequently, we asked ChatGPT to generate answers to the remaining 33 questions. Seven highly experienced otolaryngologists individually assessed the accuracy of the responses using a four-level grading scale, from completely incorrect to comprehensive. The readability of responses was determined using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores. The questions were categorized into four groups: Diagnosis and Preparation Process, Surgical Information, Risks and Complications, and Postoperative Process. Responses were then compared based on accuracy grade, FRE, and FKGL scores. RESULTS Seven evaluators each assessed 33 AI-generated responses, providing a total of 231 evaluations. Among the evaluated responses, 167 (72.3 %) were classified as 'comprehensive.' Sixty-two responses (26.8 %) were categorized as 'correct but inadequate,' and two responses (0.9 %) were assessed as 'some correct, some incorrect.' None of the responses were adjudged 'completely incorrect' by any assessors. The average FRE and FGKL scores were 57.15(±10.73) and 9.95(±1.91), respectively. Upon analyzing the responses from ChatGPT, 3 (9.1 %) were at or below the sixth-grade reading level recommended by the American Medical Association (AMA). No significant differences were found between the groups regarding readability and accuracy scores (p > 0.05). CONCLUSIONS ChatGPT can provide accurate answers to questions on various topics related to ATVtis. However, ChatGPT's answers may be too complex for some readers, as they are generally written at a high school level. This is above the sixth-grade reading level recommended for patient information by the AMA. According to our study, more than three-quarters of the AI-generated responses were at or above the 10th-grade reading level, raising concerns about the ChatGPT text's readability.
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Affiliation(s)
- Emre Polat
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey.
| | - Yagmur Basak Polat
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Erol Senturk
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Remzi Dogan
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Alper Yenigun
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Selahattin Tugrul
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Sabri Baki Eren
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Fadlullah Aksoy
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Orhan Ozturan
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
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166
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Wu TJ, Huang YL, Kang YN, Chen KH, Chen C. Comparing Energy-Based Devices for Striae Improvement: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Dermatol Surg 2024:00042728-990000000-00825. [PMID: 38820425 DOI: 10.1097/dss.0000000000004252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
BACKGROUND Striae distensae (SD) are cutaneous lesions that are caused by hormones or mechanical stress leading to rapid expansion of skin. Therefore, SD are now a cosmetic concern. However, improving SD is notoriously difficult. Among different treatments, energy-based devices (EBDs) are much more effective and controllable. OBJECTIVE The aim of this review was to determine the most effective type of EBD for improving the appearance of striae. MATERIALS AND METHODS The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The population comprised patients suffering from striae. Different types of EBDs used to improve striae were compared. The primary outcome of the reduction in the width of striae was evaluated. A random-effects model was performed. The means and standard deviations were extracted. RESULTS Eighteen randomized controlled trials were included. The network meta-analysis revealed that after a comparison among the 4 types of EBDs, no significant differences were observed in the reduction of striae width. CONCLUSION Radiofrequency, ablative lasers, nonablative lasers, and intense pulsed light are all effective treatments for reducing the striae width. None of them was superior to the others. However, radiofrequency and ablative lasers may have the highest chance of improving the appearance of striae.
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Affiliation(s)
- Ting-Ju Wu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Cathay General Hospital, Taipei, Taiwan
| | - Ya-Li Huang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-No Kang
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kee-Hsin Chen
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Evidence-based Knowledge Translation Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | - Chiehfeng Chen
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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167
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Díez-Montiel A, Pose-Díez-de-la-Lastra A, González-Álvarez A, Salmerón JI, Pascau J, Ochandiano S. Tablet-based Augmented reality and 3D printed templates in fully guided Microtia Reconstruction: a clinical workflow. 3D Print Med 2024; 10:17. [PMID: 38819536 PMCID: PMC11140883 DOI: 10.1186/s41205-024-00213-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Microtia is a congenital malformation of the auricle that affects approximately 4 of every 10,000 live newborns. Radiographic film paper is traditionally employed to bidimensionally trace the structures of the contralateral healthy ear in a quasi-artistic manner. Anatomical points provide linear and angular measurements. However, this technique proves time-consuming, subjectivity-rich, and greatly dependent on surgeon expertise. Hence, it's susceptible to shape errors and misplacement. METHODS We present an innovative clinical workflow that combines 3D printing and augmented reality (AR) to increase objectivity and reproducibility of these procedures. Specifically, we introduce patient-specific 3D cutting templates and remodeling molds to carve and construct the cartilaginous framework that will conform the new ear. Moreover, we developed an in-house AR application compatible with any commercial Android tablet. It precisely guides the positioning of the new ear during surgery, ensuring symmetrical alignment with the healthy one and avoiding time-consuming intraoperative linear or angular measurements. Our solution was evaluated in one case, first with controlled experiments in a simulation scenario and finally during surgery. RESULTS Overall, the ears placed in the simulation scenario had a mean absolute deviation of 2.2 ± 1.7 mm with respect to the reference plan. During the surgical intervention, the reconstructed ear was 3.1 mm longer and 1.3 mm wider with respect to the ideal plan and had a positioning error of 2.7 ± 2.4 mm relative to the contralateral side. Note that in this case, additional morphometric variations were induced from inflammation and other issues intended to be addressed in a subsequent stage of surgery, which are independent of our proposed solution. CONCLUSIONS In this work we propose an innovative workflow that combines 3D printing and AR to improve ear reconstruction and positioning in microtia correction procedures. Our implementation in the surgical workflow showed good accuracy, empowering surgeons to attain consistent and objective outcomes.
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Affiliation(s)
- Alberto Díez-Montiel
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | - Alicia Pose-Díez-de-la-Lastra
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain.
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés, 28911, Spain.
| | - Alba González-Álvarez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés, 28911, Spain
| | - José I Salmerón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | - Javier Pascau
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés, 28911, Spain
| | - Santiago Ochandiano
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, 28007, Spain
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
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168
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Bonomi F, Limido E, Weinzierl A, Harder Y, Menger MD, Laschke MW. Preconditioning strategies for improving the outcome of fat grafting. TISSUE ENGINEERING. PART B, REVIEWS 2024. [PMID: 38818802 DOI: 10.1089/ten.teb.2024.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Autologous fat grafting is a common procedure in plastic, reconstructive and esthetic surgery. However, it is frequently associated with an unpredictable resorption rate of the graft depending on the engraftment kinetics. This, in turn, is determined by the interaction of the grafted adipose tissue with the tissue at the recipient site. Accordingly, preconditioning strategies have been developed following the principle of exposing these tissues in the pre-transplantation phase to stimuli inducing endogenous protective and regenerative cellular adaptations, such as the up-regulation of stress-response genes or the release of cytokines and growth factors. As summarized in the present review, these stimuli include hypoxia, dietary restriction, local mechanical stress, heat and exposure to fractional carbon dioxide laser. Preclinical studies show that they promote cell viability, adipogenesis and angiogenesis, while reducing inflammation, fibrosis and cyst formation, resulting in a higher survival rate and quality of fat grafts in different experimental settings. Hence, preconditioning represents a promising approach to improve the outcome of fat grafting in future clinical practice. For this purpose, it is necessary to establish standardized preconditioning protocols for specific clinical applications that are efficient, safe and easy to implement into routine procedures.
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Affiliation(s)
- Francesca Bonomi
- Saarland University, Institute for Clinical & Experimental Surgery, Homburg, Germany;
| | - Ettore Limido
- Saarland University, Institute for Clinical & Experimental Surgery, Homburg, Germany;
| | - Andrea Weinzierl
- Saarland University, Institute for Clinical & Experimental Surgery, Homburg, Germany
- University Hospital Zurich, Department of Plastic Surgery and Hand Surgery, Zurich, Switzerland;
| | - Yves Harder
- Ente Ospedaliero Cantonale (EOC), Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Lugano, Switzerland
- Università della Svizzera italiana, Faculty of Biomedical Sciences, Lugano, Ticino, Switzerland;
| | - Michael D Menger
- Universitätsklinikum des Saarlandes, nstitut für Klinisch-Experimentelle Chirurgie, Geb. 65/66, Homburg, Germany, 66421;
| | - Matthias W Laschke
- Saarland University, Institute for Clinical & Experimental Surgery, Kirrbergerstrasse 100, Homburg, Germany, 66421;
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169
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Assiri H, Alfaleh M, AlEnazi A, Alarfaj A. Perception of Rhinoplasty Outcome Utilizing Patients' Photography. J Craniofac Surg 2024:00001665-990000000-01652. [PMID: 38819168 DOI: 10.1097/scs.0000000000010344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/03/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Patient satisfaction with rhinoplasty results is evaluated in a manner of subjective and qualitative values, and to a certain degree, it can indicate successful outcomes in rhinoplasty. METHODS The present study was a descriptive study that assessed the rhinoplasty outcome of adult patients who underwent septorhinoplasty between January 2015 and August 2023 at a single center in Saudi Arabia utilizing Rhinoplasty Outcome Evaluation scores and Nasal Obstruction Symptom Evaluation scores pre-operatively, postoperatively, and postoperatively with showing the patients their photo before surgery. RESULTS The comparison of Rhinoplasty Outcome Evaluation scores and Nasal Obstruction Symptom Evaluation scores showed statistically significant with P value of 0.000 when comparing these scores pre-operatively, postoperatively, and postoperatively with showing the patient their photos before surgery. CONCLUSION Presenting patients with pre-operative images may help them recognize changes in their clinical appearance and, consequently, score higher on the postoperative satisfaction scale. It can help the surgeon to increase patient satisfaction postoperatively.
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Affiliation(s)
- Hassan Assiri
- Department of Otolaryngology-Head and Neck-Facial Plastic Surgery, King Abdulaziz University Hospital
| | - Moath Alfaleh
- Department of Otorhinolaryngology and Head and Neck Surgery
| | - Abdulaziz AlEnazi
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Fahad Hospital of the University, Al-Khobar, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Alarfaj
- Department of Otorhinolaryngology-Head and Neck, College of Medicine, King Saud University, Riyadh
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170
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Sun N, Cao Z, Wu P, Qing L, Yu F, Pan D, Zeng L, Peng L, Pang X, Tang J. Individualized design program of multiple flaps for adapting different zones to repair large irregular wounds in children. Heliyon 2024; 10:e31179. [PMID: 38803926 PMCID: PMC11128512 DOI: 10.1016/j.heliyon.2024.e31179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 05/08/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024] Open
Abstract
Objective Management of large irregular wounds in children had been confusing plastic and reconstructive surgeons. Herein, this study was aimed to propose a new treatment method based on the principle of adapting different recipient zones to overcome the intractable wounds, simplifying and programing the design process of targeted flaps for covering large irregular soft-tissue defects. Patients and methods From January 2009 to December 2020, 31 children (9 girls and 22 boys) aged 3-16 years (mean 9.8 years) underwent multiple modular flaps with edge to edge splicing reconstruction of the lower extremities. All the wounds were large with non-adjacent defects and with or without a dead space. Several variants of flaps were harvested according to the needs and reconstruction requirements of patients. Results A total of 71 flaps were harvested from 31 patients and all flaps donor sites received primary closure. Nine patients underwent split-thickness skin grafting, and three cases of flaps survived from vascular crisis by rebuilding the vessels and the rest accepting LD flap transplants. And five partial necrosis of the distal epidermis flaps recovered using skin grafting and dressing change. No major complication was encountered in other patients and donor sites, except one heel ulcer. During the follow-up (ranging from 16 to 38 months, mean 27.7 months), aesthetic and functional results of reconstructed limbs were satisfactory in all patients. Conclusions The Individualized design program of multiple flaps for adapting different recipient zones is an alternative for repairing large irregular soft-tissue defects in children, beneficial for plastic and reconstructive surgeons to simplify and program the process of designing and perform multiple flaps to achieve this goal. Level of evidence III, Retrospective.
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Affiliation(s)
- Nianzhe Sun
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zheming Cao
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Panfeng Wu
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Liming Qing
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Fang Yu
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ding Pan
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Lei Zeng
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Lingli Peng
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoyang Pang
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Juyu Tang
- Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Mukit FA, Kim EY, Hilliard G, Pilkinton S, Walker ME, Wilson MW, Fowler BT. Scope of practice of oculofacial plastic and reconstructive surgeons: a public perception survey. Orbit 2024:1-7. [PMID: 38815176 DOI: 10.1080/01676830.2024.2348015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/21/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE The purpose of this study is to determine the public's perception of the scope of practice for oculofacial plastic and reconstructive surgeons (OFPRS). METHODS A 49-question survey was distributed by QualtricsⓇ to a panel similar to the US demographic composition. Responses collected underwent bivariate statistical analysis. RESULT A total of 530 responses were obtained, with most respondents being white, female, over the age of 35, from the Midwest, and with at least a college education or above. Most respondents did not think ophthalmologists or optometrists were surgeons, and only 158 people (29.8%) knew the primary specialty of OFPRS was ophthalmology. Board certification was preferred by 98.87% of respondents, and 95.28% preferred ASOPRS-trained OFPRS. CONCLUSIONS Our study highlights the gap in knowledge about OFPRS as a field, the qualifications and training required, and the scope of practice. Notably, even for OFPRS-specific procedures, PRS remained the leading subspecialist chosen for interventions such as orbital decompression (58.5% vs. 71.5%), orbital reconstruction (57.9% vs. 74.2%), enucleation/evisceration (48.1% vs. 53.4%), optic nerve-related surgery (39.8% vs. 43.4%), orbital cancer resection (42.8% vs. 46.8%), and tear duct surgery (41.9% vs. 52.5%). Additionally, most respondents did not feel that facial fillers, laser skin resurfacing, eyelid cancer removal, or cataract surgery were within the OFPRS scope of practice.
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Affiliation(s)
- Fabliha A Mukit
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Emily Y Kim
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Grant Hilliard
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Sophie Pilkinton
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Marc E Walker
- Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Matthew W Wilson
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Brian T Fowler
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
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172
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Janipour M, Bastaninejad S, Mohebbi A, Amali A, Owji SH, Jazi K, Mirali RA, Moshfeghinia R. Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis. BMC Anesthesiol 2024; 24:194. [PMID: 38816731 PMCID: PMC11138079 DOI: 10.1186/s12871-024-02563-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Nasal surgeries, addressing anatomical variations for form and function, require careful anesthesia administration, including dexmedetomidine and remifentanil. This meta-analysis evaluates their safety and efficacy variations in nasal surgeries, emphasizing patient comfort and optimal outcomes. METHODS Four electronic databases (PubMed, Scopus, Web of Science, and CINAHL Complete) were searched for records in English. Studies that measure the effect of dexmedetomidine versus remifentanil on patients underwent nasal surgery were included. The Cochrane Collaboration's tool was used to assess the quality of the included studies. A random-effect model was preferred and statistical analysis was performed by Stata software version 17. RESULTS Out of an initial pool of 63 articles, five studies were selected for this analysis. All of these chosen studies were Randomized Controlled Trials (RCTs). The meta-analysis involved a total of 302 participants, with 152 in the remifentanil group and 150 in the dexmedetomidine group. The analysis aimed to compare the effects of Dexmedetomidine and Remifentanil on heart rate (HR) and mean arterial pressure (MAP) during surgery. Both groups exhibited similar MAP and HR, with the exception of a slightly lower HR in the remifentanil group at the 15th minute of surgery (Standardized Mean Difference: -0.24 [-0.83, 0.34]). Furthermore, when evaluating the impact of these medications on post-surgery outcomes, including pain levels, the use of pain relief medications, patient-surgeon satisfaction, agitation scores, and recovery time, no significant differences were observed between the two medications in any of these aspects. CONCLUSION In summary, the study compared Dexmedetomidine and Remifentanil in nasal surgeries anesthesia. No significant differences were found in heart rate, blood pressure, satisfaction, pain, agitation, or recovery time. The study had limitations, and future research should establish standardized protocols and consider various surgical factors.
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Affiliation(s)
- Masoud Janipour
- Otolaryngology Research Centre, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahin Bastaninejad
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mohebbi
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Amali
- Otorhinolaryngology Research Center, Otorhinolaryngology Head and Neck Surgery Department, Imam Khomeni Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Owji
- Otolaryngology Research Centre, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Kimia Jazi
- Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
| | | | - Reza Moshfeghinia
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Psychiatry and Behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran
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173
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Silverstein ML, Sorice-Virk S, Wan DC, Momeni A. Microsurgical Breast Reconstruction can be Performed Safely in Patients with Obesity. J Reconstr Microsurg 2024. [PMID: 38815573 DOI: 10.1055/s-0044-1787266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND Numerous studies have shown that obesity is a risk factor for postoperative complications following breast reconstruction. Hence, obesity has traditionally been considered a relative contraindication to microsurgical breast reconstruction. In this study, we investigated the impact of obesity on outcomes following microsurgical breast reconstruction. METHODS A retrospective analysis of 200 consecutive patients who underwent microsurgical breast reconstruction with free abdominal flaps was performed. Subjects were divided into Nonobese (body mass index [BMI] < 30 kg/m2) and Obese (BMI ≥ 30 kg/m2) cohorts. Univariate and multivariate analyses were performed to evaluate differences in patient characteristics, complication rates, and efficiency metrics between the two groups. RESULTS Of the 200 subjects included in the study, 128 were Nonobese, 72 were Obese. The prevalence of diabetes (3.9 vs. 16.9%, p = 0.002) and hypertension (14.7 vs. 39.4%, p < 0.001) were significantly greater in the Obese cohort. Among unilateral reconstructions, postoperative length of stay (LOS) was longer among Obese patients (3.1 vs. 3.6 days, p = 0.016). Seroma occurred more frequently in Obese patients following bilateral reconstruction (5.7 vs. 0.0%, p = 0.047). Otherwise, there were no significant differences in complication rates between the groups. On multivariate analysis, BMI was not independently associated with complications, LOS, or operative time. CONCLUSION The improvements in clinical and patient-reported outcomes that have been associated with postmastectomy breast reconstruction do not exclude obese women. This study indicates that microsurgical breast reconstruction can be performed safely and efficiently in patients with obesity.
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Affiliation(s)
- Max L Silverstein
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California
| | - Sarah Sorice-Virk
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California
| | - Derrick C Wan
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California
| | - Arash Momeni
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California
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174
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Daungsupawong H, Wiwanitkit V. ChatGPT and Clinical Questions on the Practical Guideline of Blepharoptosis: Correspondence. Aesthetic Plast Surg 2024:10.1007/s00266-024-04152-5. [PMID: 38816655 DOI: 10.1007/s00266-024-04152-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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175
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Soto-Galindo GA, Saghir M, Apaydin F. Twelve Steps to Optimize Scar Outcomes in External Rhinoplasty. Facial Plast Surg 2024. [PMID: 38698638 DOI: 10.1055/a-2318-0866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
A well-healed scar extends beyond a mere superficial concern, reflecting the precision and care underlying the surgery. This study addresses the lack of recent literature on the complete closure technique for external rhinoplasty scars, emphasizing its potential impact on patient satisfaction and overall aesthetic quality. The main purpose of this article was to introduce and assess the efficacy of a novel closing suture technique for external rhinoplasty and emphasize on 12 specific steps for wound closure. A cohort of 104 patients who underwent external rhinoplasty utilizing the proposed closing suture technique were evaluated. Standardized photographic documentation and scar assessment were performed using the Vancouver-Manchester scale, considering notching, skin level differences, pigmentation, and overall appearance. The surgical approach involved a combination of vertical mattress and interrupted simple sutures, creating an effective closure framework. Analysis revealed an absence of poor scars, with 83.6% classified as good. Note that 65.5% of the good scars achieved a perfect 6-point score. While one moderate scar scored 3 points, the majority demonstrated optimal outcomes. Clinical photographs further illustrated the technique's success, showcasing imperceptible scars and reinforcing the efficacy of the complete closure approach. Our study introduces and assesses the efficacy of the complete closure technique for external rhinoplasty scars. The approach consistently yields positive outcomes, with an emphasis on almost imperceptible scars. While not achieving a 100% imperceptible scar rate, this study underscores the need for ongoing research to refine techniques and enhance patient satisfaction in external rhinoplasty. The proposed technique contributes significantly to scar management practices and encourages further exploration within the evolving landscape of rhinoplasty.
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Affiliation(s)
- Germán A Soto-Galindo
- International Fellow of the European Academy of Facial Plastic Surgery, Ege University, Izmir, Turkiye
| | - Meshari Saghir
- Facial Plastic Surgeon and ENT Specialist, Al Jahra Hospital, Al Jahra, Kuwait
| | - Fazil Apaydin
- Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, Ege University, Izmir, Turkiye
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176
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Das RK, Drolet BC. Decoding Cosmetic Surgery-Can Artificial Intelligence Chatbots Aid in Informed Surgeon Selection? Aesthetic Plast Surg 2024:10.1007/s00266-024-04141-8. [PMID: 38816654 DOI: 10.1007/s00266-024-04141-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 05/13/2024] [Indexed: 06/01/2024]
Affiliation(s)
- Rishub Karan Das
- Department of Plastic and Reconstructive Surgery, Vanderbilt University Medical Center, 1161 21st Ave S, Nashville, TN, 37232, USA.
| | - Brian C Drolet
- Department of Plastic and Reconstructive Surgery, Vanderbilt University Medical Center, 1161 21st Ave S, Nashville, TN, 37232, USA
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177
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Biermann N, Eigenberger A, Felthaus O, Brébant V, Heine N, Brix E, Spoerl S, Prantl L, Gurtner G, Anker AM. Breast Lipofilling: Is the Bra Really Full? Clinical Bra Pressure Measurement and In Vitro Testing of Processed and Unprocessed Fat Cells. Aesthetic Plast Surg 2024:10.1007/s00266-024-04116-9. [PMID: 38814346 DOI: 10.1007/s00266-024-04116-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Breast lipofilling, a popular cosmetic and reconstructive procedure, involves the transplantation of autologous fat to enhance breast volume and contour. Despite its widespread use, cell processing and the aftertreatment remain controversial. This study investigates the pressure applied by a compression bra and reports in vitro stress tests of processed and unprocessed fat cells. METHODS Clinical bra pressure measurements were conducted on a cohort of 45 patients following lipofilling, reduction mammoplasties and DIEP flaps. Laboratory analysis included cell vitality testing using Resazurin assays of processed and unprocessed fat cells after exposure to mechanical or hyperbaric pressure. RESULTS Our findings show a mean overall pressure value of the compression bra for all patients of 6.7 ± 5.7 mmHg (range 0-35). Cell processing is superior to sedimentation only regarding fat cell vitality. However, neither mechanical pressure within the specified range nor hyperbaric oxygen exposure significantly affected fat graft survival as measured by Resazurin assays. CONCLUSION The in vitro measurements showed that it was impossible to harm fat cells with external pressure during lipofilling procedures, regardless of their processing. In the clinical context, the compression bra applied pressure values deceeding the perfusion pressure and may therefore not diminish oxygen supply nor harm the transplanted cells. Therefore, we recommend the use of a compression bra for all lipofilling procedures around the breast. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Niklas Biermann
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany.
| | - Andreas Eigenberger
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany
- Medical Device Lab, Regensburg Center of Biomedical Engineering (RCBE), Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule Regensburg, Galgenbergstraße 30, 93053, Regensburg, Germany
| | - Oliver Felthaus
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany
| | - Vanessa Brébant
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany
| | - Norbert Heine
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany
| | - Eva Brix
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany
| | - Steffen Spoerl
- Clinic and Polyclinic for Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany
| | - Geoffrey Gurtner
- Department of Plastic and Reconstructive Surgery, Stanford University School Medicine, 291 Campus Drive, Stanford, CA, 94305, USA
| | - Alexandra M Anker
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany
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178
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Albanese R, Tomaselli F, Tambasco D. The Use of Preoperative Hyperbaric Oxygen Therapy (HBOT) in Reduction Mammaplasty: A Useful Algorithm to Simplify Choices. Aesthetic Plast Surg 2024:10.1007/s00266-024-04153-4. [PMID: 38816656 DOI: 10.1007/s00266-024-04153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Affiliation(s)
- Roberta Albanese
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy.
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, Santa Maria Misericordia Hospital, University of Udine, Piazzale Santa Maria della Misericordia 15, 33100, Udine, UD, Italy.
| | - Federica Tomaselli
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy
| | - Damiano Tambasco
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy
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179
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Deng Y, Wang B, Yang Y, Yang Y, Pan B, Song Y, Jiang H. Minimally Invasive Costal Cartilage Harvesting Incision for Chest Deformity in Microtia Reconstruction. Aesthetic Plast Surg 2024:10.1007/s00266-024-04124-9. [PMID: 38811386 DOI: 10.1007/s00266-024-04124-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Chest deformity is a potential complication associated with auricular reconstruction using autologous costal cartilage. The impact of the incision size employed for costal cartilage harvesting on chest deformities remains unclear. This study aimed to investigate the correlation between the incision size used for harvesting costal cartilage and the occurrence of chest deformities. METHODS We retrospectively analyzed patients who underwent ear reconstruction using autologous costal cartilage between June 2021 and September 2022. The patients were categorized into two groups based on the size of the costal cartilage incision: large and small. Chest computed tomography (CT) was performed 18-24 months postoperatively, followed by three-dimensional color map quantification to assess the degree of asymmetry of the chest surface. Subsequently, quantitative data analysis was performed to compare the extent of chest asymmetry between the large- and small-incision groups. The Visual Analog Scale (VAS) was used to assess patient satisfaction with chest morphology. RESULTS This study included 62 patients, with an equal distribution of 31 in each group. The mean asymmetry value of the small and large incision groups was -3.15 ± 1.88 and -5.27 ± 3.63, respectively. Moreover, the mean VAS score for the small and large incision groups was 7.48 ± 0.72 and 5.09 ± 0.94, respectively. Statistically significant differences were observed between the two groups. CONCLUSIONS Small incision costal cartilage harvesting can effectively alleviate the severity of chest deformities and significantly enhance patient satisfaction. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yiwen Deng
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ben Wang
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanlong Yang
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Yang
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Pan
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yupeng Song
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Haiyue Jiang
- Department of Auricular Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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180
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Albanese R, Tomaselli F, Tambasco D. A Single Stage Augmentation Mastopexy: Which Surgical Technique to Choose? Aesthetic Plast Surg 2024:10.1007/s00266-024-04151-6. [PMID: 38811385 DOI: 10.1007/s00266-024-04151-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 05/21/2024] [Indexed: 05/31/2024]
Affiliation(s)
- Roberta Albanese
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy.
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, Santa Maria Misericordia Hospital, University of Udine, Piazzale Santa Maria della Misericordia 15, 33100, Udine, UD, Italy.
| | - Federica Tomaselli
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy
| | - Damiano Tambasco
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy
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181
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Hou D, Tian B, Wang X, Wang Q, Zhu Y. Cause Analysis and Surgical Treatment of Aponeurotic Ptosis With Upper Eyelid Depression. J Craniofac Surg 2024:00001665-990000000-01644. [PMID: 38810237 DOI: 10.1097/scs.0000000000010155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/18/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Ptosis and upper eyelid depression were previously diagnosed as 2 separate diseases. The authors found that in patients with aponeurotic ptosis accompanied by upper eyelid depression, the main cause of upper eyelid depression was impaired dynamic transmission of the levator aponeurosis. OBJECTIVE To analyze the causes of upper eyelid depression in patients with aponeurotic ptosis accompanied by upper eyelid depression and to introduce the best treatment methods. METHODS The authors enrolled 15 eyes (11 patients) with aponeurotic ptosis accompanied by upper eyelid depression from October 2021 to August 2022. The authors analyzed the causes of upper eyelid depression in those patients and performed aponeurotic ptosis correction surgery and orbital septum fat release surgery. After 6 to 12 months of follow-up, the authors reviewed the patient's medical records and photographs to evaluate the treatment outcomes. RESULTS After surgery, ptosis was corrected and upper eyelid depression significantly improved in all the patients. One patient had poor eyelid morphology and upper eyelid depression due to habitual brow lifting, which was relieved after an injection of botulinum toxin into the frontalis muscle. One patient had overcorrection of the upper eyelid depression on the affected side and no other complications. CONCLUSION The main cause of upper eyelid depression in patients with aponeurotic ptosis is impaired dynamic transmission of the levator aponeurosis. Aponeurotic ptosis repair surgery and orbital septum fat release surgery are simple surgical procedures that restore the normal anatomy and physiology of the upper eyelid and maintain the normal structure of the eyelid, with good post-operative outcomes.
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Affiliation(s)
- Dan Hou
- Department of Ophthalmic Cosmetology, Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated People's Hospital of Northwest University, Xi'an, Shaanxi, China
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182
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Meyer A, Soleman A, Riese J, Streichert T. Comparison of ChatGPT, Gemini, and Le Chat with physician interpretations of medical laboratory questions from an online health forum. Clin Chem Lab Med 2024; 0:cclm-2024-0246. [PMID: 38804035 DOI: 10.1515/cclm-2024-0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES Laboratory medical reports are often not intuitively comprehensible to non-medical professionals. Given their recent advancements, easier accessibility and remarkable performance on medical licensing exams, patients are therefore likely to turn to artificial intelligence-based chatbots to understand their laboratory results. However, empirical studies assessing the efficacy of these chatbots in responding to real-life patient queries regarding laboratory medicine are scarce. METHODS Thus, this investigation included 100 patient inquiries from an online health forum, specifically addressing Complete Blood Count interpretation. The aim was to evaluate the proficiency of three artificial intelligence-based chatbots (ChatGPT, Gemini and Le Chat) against the online responses from certified physicians. RESULTS The findings revealed that the chatbots' interpretations of laboratory results were inferior to those from online medical professionals. While the chatbots exhibited a higher degree of empathetic communication, they frequently produced erroneous or overly generalized responses to complex patient questions. The appropriateness of chatbot responses ranged from 51 to 64 %, with 22 to 33 % of responses overestimating patient conditions. A notable positive aspect was the chatbots' consistent inclusion of disclaimers regarding its non-medical nature and recommendations to seek professional medical advice. CONCLUSIONS The chatbots' interpretations of laboratory results from real patient queries highlight a dangerous dichotomy - a perceived trustworthiness potentially obscuring factual inaccuracies. Given the growing inclination towards self-diagnosis using AI platforms, further research and improvement of these chatbots is imperative to increase patients' awareness and avoid future burdens on the healthcare system.
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Affiliation(s)
- Annika Meyer
- Institute of Clinical Chemistry, Faculty of Medicine and University Hospital, 27182 University Hospital Cologne , Cologne, Germany
| | - Ari Soleman
- Faculty of Medicine and University Hospital, 27182 University Hospital Cologne , Cologne, Germany
| | - Janik Riese
- Institute of Pathology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Thomas Streichert
- Institute of Clinical Chemistry, Faculty of Medicine and University Hospital, 27182 University Hospital Cologne , Cologne, Germany
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183
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Dal'Forno T, Birck MS. The Abdominal Skin Remodeling Technique: A Novel Protocol for Abdominal Laxity After Weight Loss. Dermatol Surg 2024:00042728-990000000-00820. [PMID: 38810280 DOI: 10.1097/dss.0000000000004251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Affiliation(s)
- Taciana Dal'Forno
- Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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184
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Tambasco D, Tomaselli F, Albanese R. Use of Intraoperative Ultrasonography to Optimize Secondary Liposculpture Results. Aesthetic Plast Surg 2024:10.1007/s00266-024-04150-7. [PMID: 38811384 DOI: 10.1007/s00266-024-04150-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/21/2024] [Indexed: 05/31/2024]
Affiliation(s)
- Damiano Tambasco
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy
| | - Federica Tomaselli
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy
| | - Roberta Albanese
- Plastic Surgery Unit, San Carlo di Nancy Hospital, Via Aurelia 275, Rome, Italy.
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, Santa Maria Misericordia Hospital, University of Udine, Piazzale Santa Maria della Misericordia 15, 33100, Udine, UD, Italy.
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185
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Yang G, Wang P, Yin Y, Qu H, Zhao X, Jin X, Chu Q. Erector spinae plane block versus paravertebral block on postoperative quality of recovery in obese patients undergoing laparoscopic sleeve gastrectomy: a randomized controlled trial. PeerJ 2024; 12:e17431. [PMID: 38827293 PMCID: PMC11141559 DOI: 10.7717/peerj.17431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Purpose To compare the impact of erector spinae plane block (ESPB) and paravertebral block (PVB) on the quality of postoperative recovery (QoR) of patients following laparoscopic sleeve gastrectomy (LSG). Methods A total of 110 patients who underwent elective LSG under general anesthesia were randomly assigned to receive either ultrasound-guided bilateral ESPB or PVB at T8 levels. Before anesthesia induction, 40 mL of 0.33% ropivacaine was administered. The primary outcome was the QoR-15 score at 24 hours postoperatively. Results At 24 hours postoperatively, the QoR-15 score was comparable between the ESPB and PVB groups (131 (112-140) vs. 124 (111-142.5), P = 0.525). Consistently, there was no significant difference in QoR-15 scores at 48 hours postoperatively, numerical rating scale (NRS) pain scores at any postoperative time points, time to first ambulation, time to first anal exhaust, postoperative cumulative oxycodone consumption, and incidence of postoperative nausea and vomiting (PONV) between the two groups (all P > 0.05). No nerve block-related complications were observed in either group. Conclusion In patients undergoing LSG, preoperative bilateral ultrasound-guided ESPB yields comparable postoperative recovery to preoperative bilateral ultrasound-guided PVB.
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Affiliation(s)
- Guanyu Yang
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Pengfei Wang
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Yue Yin
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Huan Qu
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Xin Zhao
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaogao Jin
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Qinjun Chu
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
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Turhal G, Berber V, Isler E, Gode S. Peroperative Cooling in Rhinoplasty: Does it Differ? Aesthetic Plast Surg 2024:10.1007/s00266-024-04105-y. [PMID: 38806826 DOI: 10.1007/s00266-024-04105-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/25/2024] [Indexed: 05/30/2024]
Abstract
The main causes of ecchymosis and edema are osteotomy (bone manipulation), dissection of subcutaneous tissue, and skin manipulation in the rhinoplasty procedure. Eyelid edema following surgery can potentially affect visual acuity, particularly during the initial twenty-four hours after the procedure. These may also delay the patient's return to their normal social life therefore hampering their quality of life. Various surgical and medical methods have been reported to address these issues. This study aimed to compare the effects of using cold saline (0-4 °C) versus room temperature saline (20-25 °C) irrigation throughout the surgery on postoperative edema, ecchymosis, and pain. Fifty patients who underwent open-approach primary rhinoplasty between August 2022 and August 2023 at a tertiary academic center were included. Fifty patients were randomly divided into two groups depending on using cold saline (0-4 °C) (group 1) or room temperature saline (20-25 °C) (group 2) during surgical site irrigation. Patients were assessed for pain, edema, and bruising using a VAS (Visual Analog Scale) on the second and seventh postoperative days. Visual analog score (VAS) was used for subjective outcome analyses. Each patient scored the severity of their periorbital ecchymosis on day two and seven. Periorbital ecchymosis was also evaluated on the second and seventh postoperative days using the SPREE (Surgeon Periorbital Rating of Edema and Ecchymosis) scale. On the second postoperative day, the VAS pain score in group 1, where cold water was used, was found to be statistically and significantly different from the control group (group 2) (p < 0.05). However, there was no statistically significant difference between both groups when comparing the VAS pain scores on the seventh postoperative day. Regarding the VAS ecchymosis score on the seventh postoperative day, there was a statistically significant difference favoring group 1 (p < 0.05). The SPREE scale data also indicated that group 1 had significantly lower scores on the seventh day (p < 0.05). While the SPREE scores on the second day were lower in group 1 than in group 2, this difference did not reach statistical significance (p = 0.061). The findings from our study show that cold saline irrigation may contribute to intraoperative hemostasis by inducing local vasoconstriction. We observed that intraoperative bleeding decreased with the use of cold saline. This approach has the potential to improve patient satisfaction and overall quality of life by reducing postoperative ecchymosis without significantly increasing the cost of the surgical procedure.Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Goksel Turhal
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
| | - Veysel Berber
- Department of Otolaryngology, Sarikamis State Hospital, 36500, Kars, Turkey.
| | - Efe Isler
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
| | - Sercan Gode
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
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187
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Ju X, Rokohl AC, Fan W, Simon M, Li X, Hou X, Ukehajdaraj N, Wawer Matos PA, Guo Y, Heindl LM. Periocular Asymmetry Index in Caucasian Populations Using Three-dimensional Photogrammetry Assessment. Aesthetic Plast Surg 2024:10.1007/s00266-024-04125-8. [PMID: 38806825 DOI: 10.1007/s00266-024-04125-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/02/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE To quantitatively assess the periocular asymmetry and investigate its sex and age-related differences in a Caucasian population using three-dimensional (3D) stereophotogrammetry. METHOD Standardized 3D photos of the periocular region of 301 Caucasians were taken using the VECTRA M3 3D Imaging System. Standardized landmarks were positioned, and data measurements in the periocular region were obtained from these images using VAM software and assessed using intraclass correlation coefficients (ICC) for reliability. Absolute differences and asymmetry index between the right and the left periocular region were calculated with a focus on gender and age-related differences. RESULT Fissure height asymmetry was positively correlated with age (p < 0.01). Furthermore, reflex distance asymmetry was positively correlated with age in the elderly group (p < 0.05). Absolute differences of upper eyelid crease were 0.65 ± 0.79 mm for females and 0.90 ± 0.94 mm for males (p < 0.05). In the elderly group, the absolute differences of reflex distance were 0.664 ± 0.471 mm for males and 0.470 ± 0.408 mm for females (p < 0.05), while the absolute differences of fissure height were 0.619 ± 0.469 mm and 0.436 ± 0.372 mm, respectively (p < 0.05). All measurements had an inter-rater ICC and intra-rater ICC between 0.761 and 0.957. CONCLUSION Periocular asymmetry is more prominent in older and male people. 3D photogrammetry is a reliable tool to detect periocular asymmetry and might provide an accurate and effective reference for periocular cosmetic, plastic, and reconstructive surgery in the clinical routine. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors. www.springer.com/00266 .
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Affiliation(s)
- Xiaojun Ju
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Alexander C Rokohl
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
| | - Wanlin Fan
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Michael Simon
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
| | - Xueting Li
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Xincen Hou
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Nexhat Ukehajdaraj
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Philomena A Wawer Matos
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
| | - Yongwei Guo
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, 88 Jiefang Road, 310009, Hangzhou, China.
| | - Ludwig M Heindl
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
- Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany.
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188
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Karakas E, Ayhan MS, Karasu O, Kocak CO, Yalinay M. In Vivo Comparison of the Efficacy and Duration of Local Antibiotics on Smooth, Textured and Polyurethane Implant Surfaces. Aesthetic Plast Surg 2024:10.1007/s00266-024-04090-2. [PMID: 38806833 DOI: 10.1007/s00266-024-04090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/15/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Capsular contracture is one of the most common complications after breast surgery involving silicone implants. The most likely cause of this condition is biofilm formation. In this study, the efficacy of local antibiotherapy against biofilm formation on implant surfaces was investigated. METHODS Thirty-six rats were divided into six groups. Three pockets were created on the dorsum of each rat, and 1 × 2 cm implant surface samples from smooth, polyurethane and textured implants were randomly placed into pockets. All samples were inoculated with staphylococcus epidermidis. In groups 1-2-3, inoculated samples were placed into the pockets and removed after 1, 6 and 24 h, respectively. In groups 4-5-6, inoculated samples immersed with rifamycin were placed and removed after 1, 6 and 24 h, respectively. Bacterial load was measured with plate count method. RESULTS Bacterial load was lower in groups 4-5-6 than in groups 1-2-3 (p < 0.05). In groups 4-5-6, bacterial load was lower for polyurethane than for textured surfaces at all time points (1, 6 and 24 h; p < 0.05). Again, in groups 4-5-6, bacterial load was lower for smooth than for textured surfaces at 24 h (p < 0.05). In groups 4-5-6, bacterial load was lower for polyurethane than for smooth surfaces at all time points, but difference was not statistically significant (1, 6 and 24 h; p < 0.05). CONCLUSION The results suggest that local antibiotic therapy was effective in reducing the bacterial load on all surfaces. The effectiveness of local rifamycin on the polyurethane surface was higher, and the duration of activity was longer than other surfaces. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Ebubekir Karakas
- Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - M Suhan Ayhan
- Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Oguzhan Karasu
- Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ceren Ozkul Kocak
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Meltem Yalinay
- Department of Medical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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189
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Liu J, Wei J, Dai CC, Yu BF. Scalp Composite Tissue Transplantation for Repairing Upper Lip Defect: A Feasible Clinical Study. J Craniofac Surg 2024:00001665-990000000-01636. [PMID: 38809038 DOI: 10.1097/scs.0000000000010360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/04/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The repair of upper lip defects is difficult and can result in asymmetry. The authors have developed a postauricular scalp composite tissue for the repair of upper lip defects. Herein, the authors, present the feasibility of scalp composite tissue grafts for repairing of upper lip defects. METHODS The authors conducted a retrospective study of 10 patients who underwent scalp composite tissue transplantation for upper lip repair. The surgical procedure consisted of the excision of skin lesions or scar tissue from the upper lip to prepare the recipient area, and then the scalp composite tissue was excised behind the ear and transplanted to the upper lip defect. The authors reviewed the photographs and clinical notes of these patients. The patients' self-reported satisfaction with the repair effect was assessed. Tissue sections and hematoxylin and eosin staining of the scalp composite tissues were performed. RESULTS All patients successfully underwent lesion resection and scalp composite tissue transplantation to repair the wound. There was no necrosis of the scalp composite tissue in the early postoperative period. The lip wound healed completely within 2 weeks. The mean follow-up time was 16 months, ranging from 12 to 20 months. Histologic sections and hematoxylin and eosin staining showed that the scalp composite tissue had abundant capillaries and dense fibrous connective tissue. All 10 patients were satisfied with the clinical effect of the procedure. CONCLUSION Scalp composite tissue transplantation is a viable method for repairing upper lip defects. The special histomorphological characteristics of the scalp provide the basis for clinical application. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Jia Liu
- Department of Burn and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou
| | - Jiao Wei
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chuan-Chang Dai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bao-Fu Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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190
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Luo XY, Hu Y, Yang WJ, Song XZ, Peng JZ. The W-Plasty Serial Excision Method for Treating Medium Congenital Melanocytic Nevi: A Retrospective Analytical Study. Dermatol Surg 2024:00042728-990000000-00817. [PMID: 38809166 DOI: 10.1097/dss.0000000000004245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND Serial excision remains the most commonly used surgical procedure for treating congenital melanocytic nevus (CMN). It is critical to remove as much of the lesion as possible with each procedure to reduce the number of procedures and to shorten the treatment duration. OBJECTIVE To investigate the clinical efficacy of W-plasty serial excision for the repair of postoperative CMN defects. METHODS A retrospective analysis of patients with medium CMN was conducted from April 2018 to March 2022. Treatment options were divided into elliptical serial excision (10 cases) and W-plasty serial excision (10 cases). RESULTS Follow-up occurred over 6 months. The number of elliptical excision procedures was 2 to 4 (mean 2.9). The scar-to-lesion length ratio was 1.5 to 2.0 (mean 1.7). The mean Vancouver Scar Scale (VSS) score was 5.40 ± 0.42. The number of W-plasty excision procedures was 2 to 3 (mean 2.2). The scar-to-lesion length ratio was 1.2 to 1.5 (mean 1.4). The mean VSS score was 2.70 ± 0.26. W-plasty excision was superior to elliptical excision regarding the number of procedures and the effect on postoperative scars. CONCLUSION W-plasty serial excision can be considered a suitable option for the excision of medium CMN, leading to excellent results.
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Affiliation(s)
- Xian Yan Luo
- All authors are affiliated with the Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, China
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191
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Core GB, Steele A. Commentary on: The Ponytail Lift: 22 Years of Experience in 600 Cases of Endoscopic Deep Plane Facial Rejuvenation. Aesthet Surg J 2024:sjae105. [PMID: 38804276 DOI: 10.1093/asj/sjae105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
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192
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Pan C, Liu Z, Liu K. Lower Blepharoplasty with Mid-Face Elevation: A Polydioxanone (PDO) Barbed Suture Loop for Lid-Cheek Junction Blending. Aesthetic Plast Surg 2024:10.1007/s00266-024-04133-8. [PMID: 38806827 DOI: 10.1007/s00266-024-04133-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Anti-aging in the lower eyelid-cheek junction area has always been the most widely sought cosmetic surgery. However, orbital fat removal or a midcheek fat pad lift alone does not achieve the best results. This study describes a new technique of lower blepharoplasty combined with a midcheek lift performed using a polydioxanone barbed suture loop based on the entire anatomy of the lower eyelid-cheek junction area. METHODS We report our experience with lower blepharoplasty combined with a midcheek lift, covering 38 procedures performed over the past 3 years. We reviewed the technique and results and described the various indications for which the new technique is suitable. The efficacy of the surgeries was delineated using both 3D volume calculation and graphic pictures. RESULTS All patients demonstrated significant rejuvenation of the lower eyelid with the elimination of the eyebags, elevation of the lid-cheek junction, and improvement of the nasolabial folds. All the patients were satisfied with the procedure. Complication rates were low, and lower lid retraction temporarily occurred in 3% of patients. CONCLUSIONS This new method of lower blepharoplasty with midcheek elevation is safe, effective, convenient, and long-lasting. The technique is more doctor-friendly, recovery is quick, and complications are minimized. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Chuqiao Pan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China
| | - Zibo Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China
| | - Kai Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
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193
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Liu X, Niu H, Shi M, Chen B, Li X, Wang S, Ren J. Objective Noninvasive Measurement of the Volumizing Effect of a Dermal Filler: An In Vivo Study. Aesthetic Plast Surg 2024:10.1007/s00266-024-04138-3. [PMID: 38806832 DOI: 10.1007/s00266-024-04138-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Information about the volumizing effects of dermal fillers is critical for physicians' understanding of product features and prudent decision-making in clinical practice. It is important for material engineers to develop and optimize new dermal fillers, especially when comparing the physiochemical properties of a new product with those of existing fillers that are used worldwide. OBJECTIVE This study aimed to establish a reliable, noninvasive method for in vivo quantitative evaluation of the filling effect in order to predict possible effectiveness after filler injection and to evaluate the degradation trend over time. METHODS A rabbit model of ear injection with dermal fillers was established. Hyaluronic acid (HA) filler was injected into the subcutaneous layer of rabbit ears, resulting in a stable skin bulge. Ultrasonography was used to noninvasively measure the skin bulge for volume calculation; the volume change was analyzed periodically until 38 weeks. Pathological examination, the gold standard, was performed to confirm degradation. RESULTS The immediate volumizing effect of HA filler injection was macroscopically observed as a local skin bulge. Ultrasound was able to precisely detect the shape of the filler and calculate the length, width, and height of the skin bulge at each time point. The degree of uplift and amount of residual samples in the pathological evaluation were consistent with the results of morphological observation using ultrasound. CONCLUSION Evaluation of the volume impact of dermal filler through the rabbit ear injection model evaluation enables material science evaluation in the early stage of material development, and has certain clinical reference value. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xiaowen Liu
- Department of Medical, Imeik Technology Development Co., Ltd., Beijing, China
| | - Huanyun Niu
- Department of Medical, Imeik Technology Development Co., Ltd., Beijing, China
| | - Mengrou Shi
- Tianjin Institute of Medical and Pharmaceutical Sciences, Tianjin, China
| | - Bin Chen
- Tianjin Institute of Medical and Pharmaceutical Sciences, Tianjin, China
| | - Xin Li
- Tianjin Institute of Medical and Pharmaceutical Sciences, Tianjin, China
| | - Shiwei Wang
- Department of Medical, Imeik Technology Development Co., Ltd., Beijing, China
| | - Jizhen Ren
- The Department of Plastic and Cosmetic Surgery, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, Shangdong Province, China.
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194
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Amara HB, Farjam P, Lutz TM, Omar O, Palmquist A, Lieleg O, Browne M, Taylor A, Verkerke GJ, Rouwkema J, Thomsen P. Toward a disruptive, minimally invasive small finger joint implant concept: Cellular and molecular interactions with materials in vivo. Acta Biomater 2024:S1742-7061(24)00289-7. [PMID: 38815684 DOI: 10.1016/j.actbio.2024.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
Osteoarthritis (OA) poses significant therapeutic challenges, particularly OA that affects the hand. Currently available treatment strategies are often limited in terms of their efficacy in managing pain, regulating invasiveness, and restoring joint function. The APRICOT® implant system developed by Aurora Medical Ltd (Chichester, UK) introduces a minimally invasive, bone-conserving approach for treating hand OA (https://apricot-project.eu/). By utilizing polycarbonate urethane (PCU), this implant incorporates a caterpillar track-inspired design to promote the restoration of natural movement to the joint. Surface modifications of PCU have been proposed for the biological fixation of the implant. This study investigated the biocompatibility of PCU alone or in combination with two surface modifications, namely dopamine-carboxymethylcellulose (dCMC) and calcium-phosphate (CaP) coatings. In a rat soft tissue model, native and CaP-coated PCU foils did not increase cellular migration or cytotoxicity at the implant-soft tissue interface after 3 d, showing gene expression of proinflammatory cytokines similar to that in non-implanted sham sites. However, dCMC induced an amplified initial inflammatory response that was characterized by increased chemotaxis and cytotoxicity, as well as pronounced gene activation of proinflammatory macrophages and neoangiogenesis. By 21 d, inflammation subsided in all the groups, allowing for implant encapsulation. In a rat bone model, 6 d and 28 d after release of the periosteum, all implant types were adapted to the bone surface with a surrounding fibrous capsule and no protracted inflammatory response was observed. These findings demonstrated the biocompatibility of native and CaP-coated PCU foils as components of APRICOT® implants. STATEMENT OF SIGNIFICANCE: Hand osteoarthritis treatments require materials that minimize irritation of the delicate finger joints. Differing from existing treatments, the APRICOT® implant leverages polycarbonate urethane (PCU) for minimally invasive joint replacement. This interdisciplinary, preclinical study investigated the biocompatibility of thin polycarbonate urethane (PCU) foils and their surface modifications with calcium-phosphate (CaP) or dopamine-carboxymethylcellulose (dCMC). Cellular and morphological analyses revealed that both native and Ca-P coated PCU elicit transient inflammation, similar to sham sites, and a thin fibrous encapsulation in soft tissues and on bone surfaces. However, dCMC surface modification amplified initial chemotaxis and cytotoxicity, with pronounced activation of proinflammatory and neoangiogenesis genes. Therefore, native and CaP-coated PCU possess sought-for biocompatible properties, crucial for patient safety and performance of APRICOT® implant.
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Affiliation(s)
- Heithem Ben Amara
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Pardis Farjam
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands
| | - Theresa M Lutz
- School of Engineering and Design, Department of Materials Engineering, Technical University of Munich, Munich, Germany
| | - Omar Omar
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Anders Palmquist
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Oliver Lieleg
- School of Engineering and Design, Department of Materials Engineering, Technical University of Munich, Munich, Germany
| | - Martin Browne
- Bioengineering Science Research Group, School of Engineering, University of Southampton, Southampton, UK
| | | | - Gijsbertus J Verkerke
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands
| | - Jeroen Rouwkema
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden..
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195
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Luong HN, Liu AS, Sharaf BA, Bite U, Wagner LH. Effect of Facial Feminization Surgery (FFS) on Eyelid Anatomic Features. Facial Plast Surg 2024. [PMID: 38677276 DOI: 10.1055/a-2315-7612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024] Open
Abstract
Facial feminization surgery (FFS) improves gender dysphoria. The brows and eyes are crucial in perceived gender, yet brow and eyelid surgeries are relatively underutilized. This study aimed to determine rates of brow and eyelid surgeries as part of FFS and characterize pre- and postoperative periocular features. We conducted a retrospective review to identify all patients with the diagnosis of gender dysphoria who underwent FFS at a single academic institution from 2019 to 2022. Thirty-four patients comprising 38 surgical cases were included. Twelve (35%) eyelid surgeries and 27 (79%) brow lifts were performed. Baseline eyelid measurements did not differ between brow lift and nonbrow lift cases. Those undergoing brow lift and eyelid surgery were older in age (p = 0.022), had a higher rate of negative canthal tilt (p = 0.050), and smaller baseline margin-reflex distance 1 (p = 0.014) than patients who had brow lift alone. Brow lift increased tarsal platform show (p ≤ 0.001) and lash-to-brow distance (p ≤ 0.001), and upper blepharoplasty increased tarsal platform show (p = 0.01). Rates of brow lift are high at our institution, and patients are appropriately selected for eyelid surgery in FFS. Brow lift and upper blepharoplasty can feminize anatomical features when using standards described for cisgender cohorts. The impact of periocular features on gender perception in transgender patients warrants further study.
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Affiliation(s)
- Hanna N Luong
- Department of Ophthalmology, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona
| | - Alice S Liu
- Department of Ophthalmology, Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Basel A Sharaf
- Department of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
| | - Uldis Bite
- Department of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
| | - Lilly H Wagner
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
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196
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Xie W, Li F, Zhang Y, Li B, Chen P, Liu J, Luo Y, Wang H. Elderly Women Have a Higher Survival Rate of Grafted Donor Fat than Do Young Women Under the Influence of Low Estrogen Conditions. Aesthetic Plast Surg 2024:10.1007/s00266-024-04095-x. [PMID: 38806829 DOI: 10.1007/s00266-024-04095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/15/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Fat grafting is widely used in breast reconstruction and aesthetic plastic surgery. However, the success rate and effects of fat grafting, especially in elderly female donors, are observed. This study aimed to explore the difference in the survival rate of donor fat from elderly women and young women in fat grafting. METHODS We collected adipose tissue samples from two healthy Chinese women: a young woman and an elderly woman. In addition, adipose tissue samples were collected from female nude mice in four experimental groups-CON-Y, CON-O, OVX-Y, and OVX-O-after fat transplantation. Grafts were harvested, weighed, and subjected to assessment of histology and angiogenesis. RESULTS An ovariectomy model was successfully established to validate the effect of low estrogen levels on fat grafting results. Due to the influence of low estrogen levels, the graft survival rate of donor site fat was significantly higher in elderly women than in young women, accompanied by a lesser degree of angiogenesis. Low estrogen levels led to adipocyte hypertrophy, which may be related to decreased AQP-7 expression. CONCLUSIONS AQP-7 downregulation due to low estrogen levels induces adipocyte hypertrophy, and donor fat from elderly women exhibits a higher survival rate after fat transplantation. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Wenjie Xie
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, China
- School of Medicine, Jinan University, Guangzhou City, Guangdong Province, China
| | - Fangwei Li
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, China
| | - Yaan Zhang
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, China
| | - Bingqing Li
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, China
- School of Medicine, Jinan University, Guangzhou City, Guangdong Province, China
| | - Peiqi Chen
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, China
| | - Jiaxing Liu
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, China
- School of Medicine, Jinan University, Guangzhou City, Guangdong Province, China
| | - Yingxia Luo
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, China
- School of Medicine, Jinan University, Guangzhou City, Guangdong Province, China
| | - Haibin Wang
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, China.
- School of Medicine, Jinan University, Guangzhou City, Guangdong Province, China.
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou City, Guangdong Province, China.
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Mete U, Demir UL, Güllülü RA, Eker SS, Duman F, Altun N. Exploring the Personality Characteristics of Rhinoplasty Patients: Perfectionism, Rumination, and Self-Compassion. Aesthetic Plast Surg 2024:10.1007/s00266-024-04019-9. [PMID: 38806830 DOI: 10.1007/s00266-024-04019-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/26/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE This study investigates differences in personality characteristics, including perfectionism, ruminative thinking style, and self-compassion, between individuals who have undergone rhinoplasty and a control group without any history of cosmetic surgery. METHODS The study included 33 adult patients who underwent rhinoplasty between 2021 and 2023 at Bursa Uludağ University Faculty of Medicine Hospital and 33 adult patients who visited our centre for other complaints as a control group. The rhinoplasty group consisted of primary surgical patients with functional and cosmetic concerns, excluding those who sought revision surgery or had only functional problems. The control group consisted of individuals with no prior cosmetic surgery history and no expectations of aesthetic interventions. Psychiatric analysis was performed using Frost multidimensional perfectionism scale, ruminative thinking style questionnaire, and self-compassion scale. RESULTS This research revealed that individuals who had rhinoplasty scored higher in perfectionism 109.3 (±23.3) and ruminative thinking 87.9 (±22) compared to those who did not undergo surgery 94.15 (±22.2) and 77.7 (±23), respectively. Additionally, the rhinoplasty group had lower self-compassion scores, 80.4 (±17.3), than the control group, 86.1 (±11.2). Statistically significant differences were observed in perfectionism between the groups (p = 0.009). In rhinoplasty patients, a notably positive correlation was found between perfectionism and ruminative thinking scores (r = 0.482; p = 0.005), while a moderately significant negative correlation was observed between self-compassion and ruminative thinking scores (r = - 0.465; p = 0.006). CONCLUSION Individuals who undergo rhinoplasty generally show increased levels of perfectionism and are more prone to ruminative thinking. They also demonstrate reduced self-compassion compared to non-surgical control groups. Cosmetic surgeons should be aware of these psychological trends and consider using appropriate scales during pre-surgery consultations and follow-up visits. Adopting this informed approach can improve the surgeon-patient relationship and help overcome communication challenges. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Utku Mete
- Department of Otolaryngology-Head and Neck Surgery, Bursa Uludag University Hospital, Görükle Center Campus, Nilüfer, 16059, Bursa, Turkey.
| | - Uygar Levent Demir
- Department of Otolaryngology-Head and Neck Surgery, Bursa Uludag University Hospital, Görükle Center Campus, Nilüfer, 16059, Bursa, Turkey
| | - Rümeysa Ayşe Güllülü
- Department of Psychiatry, Bursa Uludag University Hospital, Görükle Center Campus, Nilüfer, 16059, Bursa, Turkey
| | - Salih Saygin Eker
- Department of Psychiatry, Bursa Uludag University Hospital, Görükle Center Campus, Nilüfer, 16059, Bursa, Turkey
| | - Fatih Duman
- Department of Otolaryngology-Head and Neck Surgery, Bursa Uludag University Hospital, Görükle Center Campus, Nilüfer, 16059, Bursa, Turkey
| | - Nadir Altun
- Department of Otolaryngology-Head and Neck Surgery, Bursa Uludag University Hospital, Görükle Center Campus, Nilüfer, 16059, Bursa, Turkey
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198
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Yu L, Gong J, Sun X, Zang M, Liu L, Yu S. Assessing the Content and Effect of Web-Based Decision Aids for Postmastectomy Breast Reconstruction: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Med Internet Res 2024; 26:e53872. [PMID: 38801766 DOI: 10.2196/53872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Web-based decision aids have been shown to have a positive effect when used to improve the quality of decision-making for women facing postmastectomy breast reconstruction (PMBR). However, the existing findings regarding these interventions are still incongruent, and the overall effect is unclear. OBJECTIVE We aimed to assess the content of web-based decision aids and its impact on decision-related outcomes (ie, decision conflict, decision regret, informed choice, and knowledge), psychological-related outcomes (ie, satisfaction and anxiety), and surgical decision-making in women facing PMBR. METHODS This systematic review and meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 6 databases, PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science Core Collection, were searched starting at the time of establishment of the databases to May 2023, and an updated search was conducted on April 1, 2024. MeSH (Medical Subject Headings) terms and text words were used. The Cochrane Risk of Bias Tool for randomized controlled trials was used to assess the risk of bias. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS In total, 7 studies included 579 women and were published between 2008 and 2023, and the sample size in each study ranged from 26 to 222. The results showed that web-based decision aids used audio and video to present the pros and cons of PMBR versus no PMBR, implants versus flaps, and immediate versus delayed PMBR and the appearance and feel of the PMBR results and the expected recovery time with photographs of actual patients. Web-based decision aids help improve PMBR knowledge, decisional conflict (mean difference [MD]=-5.43, 95% CI -8.87 to -1.99; P=.002), and satisfaction (standardized MD=0.48, 95% CI 0.00 to 0.95; P=.05) but have no effect on informed choice (MD=-2.80, 95% CI -8.54 to 2.94; P=.34), decision regret (MD=-1.55, 95% CI -6.00 to 2.90 P=.49), or anxiety (standardized MD=0.04, 95% CI -0.50 to 0.58; P=.88). The overall Grading of Recommendations, Assessment, Development, and Evaluation quality of the evidence was low. CONCLUSIONS The findings suggest that the web-based decision aids provide a modern, low-cost, and high dissemination rate effective method to promote the improved quality of decision-making in women undergoing PMBR. TRIAL REGISTRATION PROSPERO CRD42023450496; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=450496.
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Affiliation(s)
- Lin Yu
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Jianmei Gong
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Xiaoting Sun
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Min Zang
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Lei Liu
- School of Nursing, Liaoning University of Chinese Traditional Medicine, Shenyang, China
| | - Shengmiao Yu
- Outpatient Department, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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199
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Ju X, Kowanz D, Guo Y, Li X, Wawer Matos PA, Fan W, Rokohl AC, Heindl LM. Dynamic Measurement and Analysis of Upper Eyelid Changes Using Ultrasound Biomicroscopy. ULTRASOUND IN MEDICINE & BIOLOGY 2024:S0301-5629(24)00190-X. [PMID: 38806337 DOI: 10.1016/j.ultrasmedbio.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/12/2024] [Accepted: 04/27/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE To define the regular upper eyelid anatomy and their changes during dynamic motion using ultrasonographically depicted structures. DESIGN A cross-sectional study. METHODS High-resolution ultrasound biomicroscopy (50MHz) was performed on 84 upper eyelids of 42 healthy volunteers without evidence of eyelid conditions. The skin-orbicularis oculi complex (SOOC), levator aponeurosis, and Müller's muscle-conjunctival complex were imaged. The thickness of these structures was measured in primary gaze and downgaze positions. RESULTS SOOC and levator aponeurosis thickness was bigger with eyes open than with eyes closed (p < 0.01). With eyes closed, the thickness of SOOC on the pupillary midline and levator aponeurosis was positively correlated with age (p < 0.05, p < 0.01, respectively), and the thickness of levator aponeurosis and SOOC on the pupil midline was also positively correlated with BMI index (p < 0.05). Similarly, SOOC thickness on the medial and lateral canthus line is also positively correlated with BMI index and age (p < 0.05, p < 0.01, respectively). As for the differences between genders, the mean thickness of SOOC and levator aponeurosis was statistically different (p < 0.05, respectively). The magnitude of levator aponeurosis thickness in men varied more than in women in different ocular positions (p < 0.05). All measurements had an intramethod between 0.624 and 0.792, and inter-rater ICC and intrarater ICC between 0.748 and 0.850. CONCLUSIONS Ultrasound biomicroscopy represents a noninvasive tool for the visualization of upper eyelid morphology. Expanding its application can help to understand the dynamics of upper eyelid physiological movement, aging, and disease research in different populations and evaluate surgical outcomes.
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Affiliation(s)
- Xiaojun Ju
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Dominik Kowanz
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Yongwei Guo
- Eye Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Key Laboratory of Ophthalmology, Hangzhou, China
| | - Xueting Li
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Philomena A Wawer Matos
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
| | - Wanlin Fan
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Alexander C Rokohl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
| | - Ludwig M Heindl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
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200
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Di Pace B, Padley RH. Enhancing treatment compliance in breast cancer patients: A multi-faceted approach. J Surg Oncol 2024. [PMID: 38798274 DOI: 10.1002/jso.27679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Bruno Di Pace
- Division of Clinical and Translational Oncology, Scuola Superiore Meridionale, Naples, Italy
- School of Medicine, Anglia Ruskin University, Cambridge and Chelmsford, UK
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sassari, Italy
| | - Roxanne H Padley
- University Language Centre, University of Bergamo, Bergamo, Italy
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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