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Han J, Wang Z, Lv X, Hou S, Rozen WM, Seth I, Cuomo R. Treatment of Atrophic Acne Scarring with Fractional Microplasma Radiofrequency: A Multicentric Experience. JPRAS Open 2024; 41:25-32. [PMID: 38868740 PMCID: PMC11167203 DOI: 10.1016/j.jpra.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/30/2024] [Indexed: 06/14/2024] Open
Abstract
Background Atrophic scarring is a severe form-disfiguring sequela of acne, which can lead to negative effect on patients' life. Fractional microplasma radiofrequency (RF) has emerged as a promising modality, leveraging dermal fibroblast remodeling to enhance aesthetic results for scars and hyperpigmentation. This study evaluates the efficacy and safety of high-power fractional microplasma RF for atrophic acne scars, considering patient tolerance to procedural discomfort. Methods In this prospective study, 95 Chinese patients with atrophic facial acne scars underwent three sessions of fractional microplasma RF treatment, with assessments at 1, 3, and 6 months post-treatment. Patients were categorized based on treatment power: Group A (50-70 W) and Group B (70-85 W). Efficacy was determined by three independent dermatologists using digital photographs and Echelle d'Evaluation Clinique des Cicatrices d'Acné (ECCA) scores, and patient-reported outcomes gauged satisfaction levels. Results Eighty-six patients completed the study. Significant improvements were observed, with a reduction in ECCA scores from 107.21 to 42.27 (P<0.05), demonstrating notable scar amelioration across both groups, albeit with a superior outcome in Group B. All patients experienced transient side effects such as pain, erythema, and edema, deemed tolerable with no long-term adverse effects reported. The treatment was well-received, with high satisfaction rates, underscoring its efficacy and acceptable safety profile. Conclusion Fractional microplasma RF therapy, particularly at higher power settings, is an effective and safe option for treating atrophic acne scars, offering significant aesthetic improvement with manageable discomfort. This modality presents a valuable addition to acne scar management strategies, especially for patients with darker skin tones seeking minimal downtime and reduced risk of hyperpigmentation.
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Affiliation(s)
- Jingjian Han
- MD, Department of Medical Cosmetology, Jining First People's Hospital
| | - Zhen Wang
- Department of Burn and Plastic Surgery, Jining First People's Hospital
| | - Xiaoyu Lv
- Department of Burn and Plastic Surgery, Jining First People's Hospital
| | - Shuai Hou
- Department of Burn and Plastic Surgery, Jining First People's Hospital
| | - Warren M. Rozen
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria, 3199, Australia
| | - Ishith Seth
- Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria, 3199, Australia
| | - Roberto Cuomo
- Plastic and Reconstructive Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
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Cuomo R, Cuccaro C, Seth I, Rozen WM, Vastarella MG, Lombardo GAG, Ciancio F, Pagliara D, Pieretti G, Ciccarelli F. Experience in Post-Bariatric Abdominoplasty for Patients with Significant Weight Loss: A Prospective Study. J Pers Med 2024; 14:681. [PMID: 39063935 PMCID: PMC11278261 DOI: 10.3390/jpm14070681] [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: 05/19/2024] [Revised: 06/22/2024] [Accepted: 06/23/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Abdominoplasty is a critical aesthetic and functional procedure for individuals who have undergone massive weight loss. Numerous techniques have been proposed to optimize aesthetic results while minimizing complications. METHODS This prospective study examined 500 patients who underwent abdominoplasty during body-contouring procedures between 1 January 2018 and 31 December 2021 at a tertiary center. The Skin-Adipose Tissue-Muscle (SAM) protocol was employed to analyze the operative strategies and complication rates and compare them with the existing literature. Furthermore, patient satisfaction and aesthetic outcomes were measured one year post-operation using a comprehensive four-point questionnaire evaluated by the patients themselves and two independent surgeons. RESULTS Participants had an average age of 34.8 years and a mean BMI of 31.1 kg/m2. The surgeries included 328 full abdominoplasties and 172 T-inverted abdominoplasties. Notable complications included wound infection (4%), wound dehiscence (8.6%), tissue necrosis (0.6%), seroma (8.4%), and hematoma (2.6%). A higher BMI was correlated with an increased risk of complications and lower patient satisfaction. Data analysis was performed using Stata version 18 software. CONCLUSIONS The increasing prevalence of obesity highlights an urgent need for more bariatric surgeries and subsequent abdominoplasties to mitigate the effects of massive weight loss. A crucial link between elevated BMI and a heightened risk of postoperative complications, emphasizing the necessity for standardized surgical protocols tailored to individuals with higher BMI, was noted. Innovatively, future studies must further investigate the intricate dynamics between BMI and surgical risks. Exploring and establishing uniform, adaptive surgical guidelines promise to revolutionize patient care by significantly reducing complications and enhancing recovery and satisfaction following abdominoplasty.
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Affiliation(s)
- Roberto Cuomo
- Plastic Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Claudia Cuccaro
- Organization of Hospital Services Unit, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy
| | - Ishith Seth
- Department of Plastic Surgery, Peninsula Health, Melbourne, VIC 3199, Australia
- Faculty of Science, Medicine, and Health, Central Clinical School at Monash University, The Alfred Centre, 99 Commercial Rd, Melbourne, VIC 3004, Australia
| | - Warren M. Rozen
- Department of Plastic Surgery, Peninsula Health, Melbourne, VIC 3199, Australia
- Faculty of Science, Medicine, and Health, Central Clinical School at Monash University, The Alfred Centre, 99 Commercial Rd, Melbourne, VIC 3004, Australia
| | - Maria Giovanna Vastarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | | | | | - Domenico Pagliara
- Gynecology and Breast Care Center, Mater Olbia Hospital, 07026 Olbia, Italy
| | - Gorizio Pieretti
- Plastic and Reconstructive Surgery Unit, Multidisciplinary, Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
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Pozzi M, Marcaccini G, Giardino FR, El Araby MM, Nisi G, Grimaldi L, Cuomo R. Flowchart in Post-Bariatric Surgery: A Research for the Appropriate Type and Timing of Plasties Reshaping the Body. Aesthetic Plast Surg 2024; 48:1790-1796. [PMID: 38110738 DOI: 10.1007/s00266-023-03763-8] [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: 07/15/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Obesity is a chronic disease with significant health implications. Bariatric surgery is an effective treatment for obesity-related conditions. However, the timing of post-bariatric body contouring surgery remains uncertain. MATERIALS AND METHODS We conducted a retrospective study of 1336 patients who underwent bariatric surgery. We analyzed weight trends and variations after different types of bariatric procedures. The Pittsburgh Index was used to evaluate body contouring outcomes. RESULTS The majority of patients were women, and sleeve gastrectomy was the most common procedure. Weight loss varied depending on the surgery type, with different outcomes for male and female patients. The Pittsburgh Index remained stable in most cases. CONCLUSION Our findings suggest that the timing of body contouring surgery should be tailored to the type of bariatric procedure performed. Abdominoplasty is recommended as a last procedure for sleeve gastrectomy patients, while gastric bypass patients are suitable candidates for early abdominoplasty. Biliopancreatic diversion patients should stabilize their weight before abdominoplasty. The Pittsburgh Index is a valuable tool for assessing the timing of post-bariatric plastic surgery. Further research is needed to optimize surgical planning and outcomes. 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)
- Mirco Pozzi
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Gianluca Marcaccini
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
| | - Francesco Ruben Giardino
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Mohamed Marzouk El Araby
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Giuseppe Nisi
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Luca Grimaldi
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Roberto Cuomo
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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Han J, Ciccarelli F, Pieretti G. Letter on "Modified Levator Resection Technique for Moderate Congenital Blepharoptosis". Aesthetic Plast Surg 2024; 48:827-828. [PMID: 38242976 DOI: 10.1007/s00266-023-03829-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024]
Affiliation(s)
- Jingjian Han
- Department of Medical Cosmetology, Jining First People's Hospital, Jining, China
| | | | - Gorizio Pieretti
- Plastic and Reconstructive Surgery Unit, Multidisciplinary, Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Sakai S, Yuzaki I, Nagashima H, Kajita H, Kiuchi T, Ishii N, Matsuzaki K, Takatsume Y, Kishi K. A Novel Dissection Method of the Internal Mammary (Thoracic) Artery: Anastomotic Vessel of the DIEP Flap. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4960. [PMID: 37101613 PMCID: PMC10125686 DOI: 10.1097/gox.0000000000004960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/06/2023] [Indexed: 04/28/2023]
Abstract
Deep inferior epigastric perforator flaps are commonly used for breast reconstruction using autologous tissue. For such free flaps, the internal mammary artery provides stable blood flow as the recipient for anastomosis. We report a novel dissection method of the internal mammary artery. First, the perichondrium and costal cartilage of the sternocostal joint are dissected with electrocautery. Then, the incision on the perichondrium is extended along the cephalic and caudal ends. Next, this C-shaped superficial layer of perichondrium is elevated from the cartilage. The cartilage is incompletely fractured with electrocautery, with the deep layer of perichondrium intact. Then, the cartilage is completely fractured by leverage and removed. The remaining deep layer of perichondrium is incised at the costochondral junction and shifted aside, revealing the internal mammary artery. The preserved perichondrium creates a rabbet joint to protect the anastomosed artery. This method not only enables a more reliable, safer dissection of the internal mammary artery, but also allows reusage of the perichondrium as underlayment in the setting of anastomosis, and coverage for the incised rib edge, protecting the anastomosed vessels.
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Affiliation(s)
- Shigeki Sakai
- From the Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ikki Yuzaki
- From the Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hayato Nagashima
- From the Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kajita
- From the Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomoki Kiuchi
- Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Tokyo, Japan
| | - Naohiro Ishii
- Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Tokyo, Japan
| | - Kyoichi Matsuzaki
- Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Tokyo, Japan
| | - Yoshifumi Takatsume
- Yoshifumi Takatsume, PhD. Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Kishi
- From the Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Yokote F, Yamauchi Y, Komura H, Tanuma T, Sakao Y, Kawamura M, Komura M. A novel method of tracheal anastomosis healing using a single submucosal injection of basic fibroblast growth factor: initial report. Eur J Cardiothorac Surg 2021; 61:917-924. [PMID: 34918104 DOI: 10.1093/ejcts/ezab542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/13/2021] [Accepted: 11/18/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES For the technical management of tracheal anastomosis, developing new and simple methods is required to relieve anastomotic tension. This study aimed to investigate whether basic fibroblast growth factor (bFGF) only once injected immediately before anastomosis promotes cartilage regeneration at the tracheal anastomosis and whether the regenerated cartilage has the effect of reinforcing the anastomosis in a rabbit model. METHODS New Zealand white rabbits were anaesthetized, and the cervical trachea was exposed through a cervical midline incision, followed by resection of the 10th tracheal cartilage. The rabbits were categorized into 2 groups: the bFGF group (n = 6) and the control group (n = 6). In the former group, bFGF (25 μg) was administered into the submucosal layer of the cartilage using a 27-G needle immediately before tracheal anastomosis. The animals were sacrificed 4 weeks later. Histological, mechanical and biochemical evaluations were performed on this anastomosed trachea. RESULTS At 4 weeks of age, the anastomoses were spindle-shaped and displayed maximum diameter at the injection site compared with those in the control group. Histological evaluation showed that cartilage tissue had regenerated between the 9th and 11th tracheal cartilage rings. Tensile test showed that the anastomoses displayed a significantly high strain/stress ratio (P = 0.035). The collagen type II and glycosaminoglycan levels were significantly increased, and the collagen type I level was significantly decreased (P = 0.019, P = 0.013 and P = 0.045, respectively). CONCLUSIONS A new wound-healing concept of airway anastomosis could be provided by the results that single injection of bFGF regenerated tracheal cartilage in rabbits and strengthened the anastomosis by bridging the regenerated and well-matured cartilage. Further investigation of this method will lead to potential clinical applications for reinforcement of tracheal anastomoses.
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Affiliation(s)
- Fumi Yokote
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshikane Yamauchi
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroko Komura
- Department of Tissue Engineering, Tissue stem cell-Life Dental Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tadashi Tanuma
- Laboratory of Fluid-Structural Simulation and Design, Strategic Innovation and Research Center, Teikyo University, Tokyo, Japan
| | - Yukinori Sakao
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Masafumi Kawamura
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Makoto Komura
- Department of Tissue Engineering, Tissue stem cell-Life Dental Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Ma Z, Huang B, Lu F, Zhao H, Ren L. In Situ Bending Reveals Simultaneous Enhancements of Strength and Ductility of Cortical and Cancellous Layers Induced by the Cartilage Layer. ACS OMEGA 2021; 6:31177-31183. [PMID: 34841160 PMCID: PMC8613877 DOI: 10.1021/acsomega.1c04635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/03/2021] [Indexed: 05/14/2023]
Abstract
The energy absorption and toughening effect of cartilage could effectively protect bone from damage, and the enhancement mechanisms of cartilage on deformation resistance or strength need to be revealed. Using a self-developed in situ bending tester integrated with an optical microscope, in situ bending of the composite bone structure consisting of the cartilage layer and cortical and cancellous layers was carried out, accompanied by simultaneously obtained continuous morphological changes in diverse deformation layers. Although the bending resistance of pure cartilage layer was only 0.3 N, the significant enhancements of bone strength and ductility induced by the cartilage layer were experimentally revealed, as the peak loads and ultimate bending deflections of the composite structure increased by 1.49- to 2.14-fold and 1.43- to 2.12-fold, respectively. The scanning electron microscopy images of the composite bone structure at various locations with disparate stress conditions exhibited significant difference in crack sizes and degrees of tearing damage. The cartilage layer was verified to induce a layered tearing dimple feature to inhibit the crack propagation and further enhance the deformation resistance. The frequency shift comparison between the Raman spectroscopies of various microregions also indirectly verified the inhibition effect of the cartilage layer on the stress increment in the cortical layer.
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Affiliation(s)
- Zhichao Ma
- School
of Mechanical and Aerospace Engineering, Jilin University, Changchun 130025, China
| | - Bin Huang
- School
of Mechanical and Aerospace Engineering, Jilin University, Changchun 130025, China
| | - Fangzhou Lu
- School
of Mechanical and Aerospace Engineering, Jilin University, Changchun 130025, China
| | - Hongwei Zhao
- School
of Mechanical and Aerospace Engineering, Jilin University, Changchun 130025, China
| | - Luquan Ren
- Key
Laboratory of Bionic Engineering Ministry of Education, Jilin University, Changchun 130025, China
- Weihai
Institute for Bionics-Jilin University, Weihai 264207, China
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