The latest medical research on Plastic Surgery

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about plastic surgery gathered by our medical AI research bot.

The selection below is filtered by medical specialty. Registered users get access to the Plexa Intelligent Filtering System that personalises your dashboard to display only content that is relevant to you.

Want more personalised results?

Request Access

Staged Mosaic Punching Excision of a Kissing Nevus on the Eyelid.

Aesthetic Plastic Surgery

A congenital divided nevus, also known as kissing nevus, is a type of congenital compound nevus that affects equal areas of the upper and lower eyelids. The edges of the nevus touch or "kiss" during closure of the lids, owing to its extension to the lid margins. Multiple treatment modalities, such as dermabrasion, cryotherapy, primary closure after excision, and skin grafts, have been proposed; however, complications such as recurrence, ectropion, skin color mismatch, and scar contractures are known to occur. This study aimed to introduce a staged excision using the 10,600-nm CO2 pulsed laser to remove a congenital divided nevus without noticeable complications.

From August 2015 to December 2018, patients with congenital divided nevus underwent staged laser excision. Seven patients underwent staged mosaic pattern punch excision with a laser. Eight patients underwent concomitant excision, and one patient underwent skin grafting of the medial canthus. Patient satisfaction was assessed immediately and at 3 months after the procedure.

During the study period, 15 patients (10 women and 5 men), with a mean age of 26.0 years (range 13-73 years), underwent laser excision. Continuity of the eyelid margins was maintained in 13 patients. In one patient, the eyelashes grew inward and developed inflammation. No patient developed complications during the healing process, except for partial loss of cilia. Eleven patients were very satisfied, whereas three were satisfied with the results. One patient discontinued treatment after two laser sessions.

We performed multiple staged mosaic punching excisions of a congenital divided nevus with the CO2 laser in 15 cases. We observed consistent therapeutic results without definite recurrence, while maintaining the continuity of the eyelid and eyelash.

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 .

Alloplastic Facial Implants: A Systematic Review and Meta-Analysis on Outcomes and Uses in Aesthetic and Reconstructive Plastic Surgery.

Aesthetic Plastic Surgery

Alloplastic materials in facial surgery have been used successfully for various applications in the reconstructive restoration or aesthetic augmentation of the facial skeleton. The objective of this study was to conduct a comprehensive systematic review of alloplastic implant materials utilized to augment the facial skeleton stratified by anatomical distribution, indication, specific material used, and respective outcomes.

A comprehensive systematic review on alloplastic facial implant data was conducted utilizing Medline/PubMed database. Articles were stratified by (1) anatomic localization in the face, as well as (2) alloplastic material.

A total of 17 studies (n = 2100 patients, follow-up range = 1 month-27 years) were included. Overall, mersilene mesh implants were associated with the highest risk of infection (3.38%). Methyl methacrylate implants were associated with the highest rate of hematoma (5.98%). Implants placed in the malar region (2.67%) and frontal bones (2.50%) were associated with the highest rates of infection. Implants placed in the periorbital region were associated with the highest rate of inflammation (8.0%), explantation (8.0%), and poor cosmetic outcome (17.0%). Porous implants were shown to be more likely to potentiate infection than non-porous implant types.

Alloplastic facial implants are a reliable means of restoring facial symmetry and achieving facial skeletal augmentation with a relatively low complication profile. It is important for plastic surgeons to understand the relative risks for each type of implant to develop postoperative complications or poor long-term cosmetic results. Interestingly, porous implants were shown to be more likely to potentiate infection than non-porous implant types.

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 .

Toll-Like Receptors (TLRs) Expression in Contracted Capsules Compared to Uncontracted Capsules.

Aesthetic Plastic Surgery

The etiology of capsular contracture after surgical implantation of breast implants remains unclear, but an important role is seen for the immune system. Toll-like receptors are immune receptors recognizing both pathogen-associated molecular patterns and damage-associated molecular patterns. The former are present on bacteria such as Staphylococcus epidermidis (bacteria earlier associated with capsular contracture), and the latter are released after (mechanical) stress. The aim of this study was to investigate the expression of TLRs 1-10 in relation to capsular contracture.

Fifty consecutive breast capsules were collected during implant removal or replacement. The extent of capsular contracture was scored according to the Baker score. A sample specimen (0.5 cm3) was obtained from all tissues. cDNA was synthesized from isolated mRNA from the collected specimens. PCR analyses were conducted to test for cDNA presence and to quantify concentration. TLR1-10 expression was measured for each of the Baker scores separately and compared to all Baker scores.

Expression of all TLRs in all Baker scores was seen. TLR2 and TLR6 were more often present in contracted samples (Baker 3 or 4) compared to uncontracted samples (Baker 1 or 2) [Baker 2 vs. 3 (p = 0.034) and Baker 2 vs. 3 (p = 0.003), respectively]. None of the TLRs displayed a significantly higher expression in contracted capsules compared to uncontracted capsules.

This study shows that TLR2 and TLR6 are more often expressed in contracted capsules compared to non-contracted capsules however not in higher concentrations.

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 .

Effects of Insulin, Metoprolol and Deferoxamine on Fat Graft Survival.

Aesthetic Plastic Surgery

The main problem faced with fat grafting is unpredictable resorption rates. Many substances have been reported to increase the survival of fat grafts. The aim of this study was to compare the effects of insulin, metoprolol and deferoxamine on fat graft survival.

Inguinal fat pads of male Sprague-Dawley rats were harvested and split into four parts as grafts. The grafts were placed in subcutaneous pockets in four quadrants on the back area of the rats. The insulin and metoprolol group fat grafts were incubated in regular insulin and metoprolol solutions, until they were placed. Deferoxamine and control group fat grafts were placed without incubation. After surgery, the control group fat grafts were injected with 10 doses of NaCl solution once every 3 days, and the deferoxamine group fat grafts were injected with 10 doses of deferoxamine solution once every 3 days. After a graft maturation period of 3 months, the grafts were harvested for weight measurements and histological and immunohistochemical evaluation.

According to the rate of perilipin staining, the metoprolol group had 30% more mature viable adipocytes than the control and insulin group fat grafts (p < 0.05 and p < 0.01, respectively). CD31 activation rates were significantly higher in the deferoxamine and insulin group than in the metoprolol group (p < 0.05). CD34 staining rates did not differ between any groups (p > 0.05).

In this experimental study, we have shown that there was no significantly increased fat graft survival rate seen in any drug treatment group. Low survival rates of stem cells demonstrated that the adipogenesis period ended at 3 months. Treatment of fat grafts with the selective β1-blocker metoprolol resulted in good quality better graft take with more viable mature adipocytes. However, better viability of adipocytes did not result in increased weight of the fat graft. Studies aiming to compare the effects on fat graft survival of beta-blockers with long or short durations of action, different potencies and different receptor selectivity may be designed in the future. In addition, further studies may be performed, in which immunohistochemical markers used to assess inflammation and fibrosis are added to the study after the completion of the fat graft maturation period at the end of the first year to test the permanence of the results.

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 .

Definition of "Gender Angle" in Caucasian Population.

Aesthetic Plastic Surgery

The goal of this study report is to define the "gender angle," a new angle which represents the masculine or feminine nasal shape, for performing a gender-oriented rhinoplasty. The use of the "gender angle" in Caucasian patients will help the plastic surgeon in the search for a suitable nose for the patient's face and above all for the search for maximum patient satisfaction.

The study population was obtained from Caucasian patients who had undergone rhinoplasty between January 1986 and September 2016 at our department. Patients answered the Italian version of the FACE-Q outcome instrument on post-rhinoplasty satisfaction with their nose. Anthropometric measurements were taken retrospectively by AutoCAD for MAC on a photograph of the profile view taken postoperatively at the last follow-up.

A total of 1774 (706 male and 1068 female) patients satisfied the inclusion criteria and were finally enrolled in this study. We identified a gender-specific angle ranging from 168° to 182° for the male nose and from 160° to 178° for the female nose. We subdivided all study patients into 3 ranges of angles as follows: male nose, range 1 = 168°-172°, range 2 = 173°-177°, range 3 = 178°-182°; female nose, range 1 = 160°-166°, range 2 = 167°-171°, range 3 = 172°-178°. All study patients completed the FACE-Q rhinoplasty postoperative module. Analysis was performed of the FACE-Q results and the angle obtained for each nose. The most satisfactory angle range for male patients was range 3 (P = 0.01) and for the female patients was range 2 (P = 0.01).

The "gender angle" might be a parameter that effectively provides the optimal cosmetic result for male and female patients who undergo rhinoplasty.

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 .

Focus on the Importance of Lipomid-Abdominoplasty in the Body Contouring Surgery.

Aesthetic Plastic Surgery

During the last few years, the surgical principles of abdominoplasty remained unchanged. Therefore, many observed results have misaligned, high and straight abdominal transverse scars, leading to the final positioning of the umbilical scar to be very close to the transverse scar, which gives the impression of a short abdomen. We propose that the abdominoplasty should change the basic conception of its marking, because we believe that it is important to place the transverse scar lower in the medial and pubic region, and higher in the lateral extremities, thus allowing a rotation of the flap of the anterior flanks back lumbar in the median inferior direction.

We analyzed 136 patients with abdominal deformities and subjected them to lipomid-abdominoplasty making a marking with strong upper concavity and lateral sides of the scar oriented to the lower transverse line of the abdomen, 4 cm equidistant from the root of the thigh. We also associate liposuction as a complementary treatment to body contouring.

It is important to determine the area of the abdominal deformity and its classification, to establish the strategies of treatment, and association of complementary procedures. A lower marking respecting the treatment areas will allow a better esthetic scar and a harmonic body contour as well as an adequate placement of the elements: umbilical scar, pubis and lateral extremities of transverse abdominal scar.

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 .

Surgical Correction of the Lying Ear Deformities.

Aesthetic Plastic Surgery

In contrast to prominent ear, lying ear can be defined when the antihelix of the ear is excessively folded, i.e., the conchoscaphal angle is much less than 90°. In such case, ears may look smaller than the face. These patients want their ears to be exposed more. In Asia, there is also a tendency to prefer large and long ears. The objective of this study was to present a surgical method for correcting lying ear deformities.

From August 2017 to June 2018, 37 patients (72 ears) underwent surgery using our surgical method for lying ear deformities. After the cartilage was exposed on the posterior auricular surface, the fibrous band present at the conchoscaphal angle was released. Two longitudinal cartilage incisions were performed along the border of the antihelix. Horizontal mattress sutures were performed on the cartilage until the conchoscaphal angle was close to 90°. Onlay cartilage grafting was performed for the most severe portion of the deformity.

We performed reoperation for four patients due to recurrence (n = 2), under-correction (n = 1), and cartilage exposure (n = 1). Most patients obtained satisfactory aesthetic results.

There have been few reports of the surgical method for lying ear deformities. Our surgical method can provide satisfactory clinical outcomes for correcting lying ear deformities.

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 .

Surgeons' Dilemma: Treatment of Implant-Associated Infection in the Cosmetic Breast Augmentation Patient.

Aesthetic Plastic Surgery

Augmentation mammaplasty is the most common plastic surgical procedure performed in the USA. The management of severe implant-associated infection is a challenge, and the traditional two-stage treatment is associated with significant limitations. The aim of this literature review is to provide a comprehensive analysis of all studies dealing with the management of severe infection or implant exposure following cosmetic breast augmentation.

The PubMed and Cochrane databases were searched through February 2018 for studies on the management of severe infection and threatened or actual implant exposure following primary augmentation mammaplasty. Search terms used were "breast implant," "breast prosthesis," "breast augmentation," "breast augmentation complications," "infected implant," "implant salvage" and "implant exposure."

Five articles met inclusion criteria. There was inconsistency in the reporting of several key factors, such as the antibiotic regimens employed, culture sensitivities, time from diagnosis to treatment, implant characteristics, as well as the precise treatment of the capsule and pocket. A total of 58 implants were treated, of which 37 (63.8%) were exposed in the setting of infection and 21 (36.2%) were infected without exposure. One-stage implant salvage was employed in 31 implants and was successful in all. The capsular contracture rate with this approach was 6.5%. Antibiotic-alone, non-operative treatment was employed in the salvage of 22 implants, with success and capsular contracture rates of 77.3 and 13.6%, respectively. In the setting of severe periprosthetic infection in the absence of implant exposure, antibiotic-alone treatment was successful in the salvage of 13 out of 14 implants (92.9%).

The inconsistency and paucity of the data in the literature preclude definitive conclusions with regard to the optimal management of the threatened implant following augmentation mammaplasty. Given the excellent salvage rates in this setting, a more prominent role and liberal utilization of implant salvage are proposed.

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 .

Facial Contouring by Using Dermal Fillers and Botulinum Toxin A: A Practical Approach.

Aesthetic Plastic Surgery

The perception of an attractive face is largely subjective. The purpose of this paper is to provide an insight and a practical approach to facial contouring management with hyaluronic acid (HA) implants and botulinum toxin A.

This study is presenting the clinical experience of the authors regarding facial contouring. After a careful medical history, patients underwent an exhaustive aesthetic assessment that includes photographs and videos. Realistic treatment goals were discussed and agreed with the patient. Comprehensive treatment strategies for facial contouring, including HA implants and/or botulinum toxin A injections, were selected according to the patient needs.

Based on the MD codes®, developed by Mauricio de Maio, these treatment strategies have been adapted to six different basic categories of facial shapes, namely round, square, triangular, inverted triangle, rectangle, oval and oblong faces. The incidence of complications was low and, in all the cases, was mild (edema, erythema and local ecchymosis), of limited duration, and was resolved without sequela.

The current article presented the personal experiences of the authors on a specific subject, and this fact should be considered when interpreting data from this paper. As other aesthetic treatments, facial contouring should be focused on the patient needs and to select a specific aesthetic approach according to different facial shapes. Finally, it is essential to have a good understanding of the potential associated complications, because it will help the specialist to take the necessary precautions to prevent them, and if they ever arise, to be able to deal with them effectively.

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 .

Gender-related Facial Analysis.

Facial Plastic Surgery Clinics of

There exist several known anthropometric differences between the male and female facial skeleton and soft tissues. In general, the female face is l...

Hormonal, Medical, and Nonsurgical Aspects of Gender Affirmation.

Facial Plastic Surgery Clinics of

Although the acronym LGBTQ is often used as a catchall label for sexual and gender minorities, transgender people have unique and individual health...

Preparing for Facial Feminization Surgery: Timing.

Facial Plastic Surgery Clinics of

Facial feminization surgery may be a part of a treatment plan for gender dysphoria. Initial mental health assessment must occur. Referrals for horm...