Aesthetic Results Research Articles

Comparative Outcomes of Superomedial and Inferior Pedicles in Breast Reduction and Mastopexy: A Meta-Analysis of 5123 Breasts.

Superomedial and inferior pedicles are two commonly used techniques in breast reduction and mastopexy. This systematic review and meta-analysis aims to compare the clinical outcomes associated with these two techniques. PubMed, Scopus, and Web of Science were searched for relevant studies. We included all studies with data comparing superomedial and inferior pedicles. Statistical analyses were performed using RevMan version 5.4. The search yielded 1075 studies, of which 15 were included in the meta-analysis, encompassing 2633 patients (5123 breasts), with 3491 breasts receiving superomedial pedicles and 1632 breasts receiving inferior pedicles. Superomedial pedicles were associated with significantly shorter operative length (MD = - 24.71, 95% CI = - 37.63 to - 11.79, p = 0.0002), higher BREAST-Q breast satisfaction scores (MD = 10.34, 95% CI = 7.72 to 12.96, p < 0.00001), lower infection rates (RR = 0.46, 95% CI = 0.24 to 0.86, p = 0.02), higher incidence of seroma (RR = 3.00, 95% CI = 1.15 to 7.79, p = 0.02), and higher incidence of decreased nipple-areola complex (NAC) sensation (RR = 1.50, 95% CI = 1.12 to 2.01, p = 0.006). No significant differences were observed in asymmetry, fat necrosis, NAC loss, and hematoma. Superomedial pedicles demonstrated higher incidences of decreased NAC sensation and seroma formation, lower incidence of infection, shorter operative length, and higher BREAST-Q breast satisfaction scores compared to inferior pedicles. Further research is needed to confirm these findings and explore the long-term aesthetic outcomes associated with both techniques. 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 .

A New Era of Tooth Preparation and Gingitage Retraction Technique: A Case Report

The demand for procedures intended to improve dental aesthetics has increased recently. Preserving the teeth and surrounding soft structures to the greatest extent possible is preferred in this situation by both patients and dentists. When using fixed prostheses, maintaining the stability and health of soft tissues is a constant struggle. Bone tissue health and soft tissue health are directly correlated. The long-term efficacy of prosthetic therapy thus depends on preserving tissue health and being free of mucositis. This case report describes the successful application of the gingitage technique in a patient requiring aesthetic enhancement of the gingival margins surrounding dental restorations. The patient presented with uneven gingival contours and mild inflammation around subgingival margins of existing restorations, compromising both function and aesthetics. Results demonstrated significant improvements in gingival health, a more balanced gingival margin, and an enhanced aesthetic outcome. Follow-up assessments revealed stable gingival contours and an overall increase in patient satisfaction. This case report underscores the effectiveness of the gingitage technique as a minimally invasive solution for enhancing soft tissue aesthetics and supporting the longevity of dental restorations.

Measuring concern about smile appearance among adults.

To adapt and estimate the psychometric properties of Utrecht Questionnaire for esthetic outcome assessment in rhinoplasty (OAR) to assess concern about smile appearance and to estimate the influence of demographic characteristics on this concern in adults. This was a cross-sectional observational study. Individuals aged between 18 and 40 years participated in the study. The Portuguese version of OAR was adapted for smile assessment in dental practice and was named Questionnaire for Outcome Assessment of Smile Aesthetic (OA-Smile). Data validity was estimated using factorial validity [confirmatory factor analysis (CFA)-CFI, Tucker-Lewis index (TLI), SRMR)] and convergent validity (average variance extracted). Reliability was assessed using the alpha ordinal coefficient (αordinal) and the omega coefficient (ω). A structural model was elaborated to assess the contribution of demographic characteristics to smile appearance concerns. Model fit was evaluated, and the z-test (α = 5%) was used to estimate the significance of the path estimates (β). 2.523 subjects participated in the study [mean age = 32.86 (SD = 11.39) years, 68.1% female]. The factor model of orofacial appearance (OA)-Smile presented an adequate fit to the data [CFA: comparative fit index (CFI) = 0.99, TLI = 0.99, SRMR ≤ 0.05]. Convergent validity (AVE ≥ 0.80) and reliability (αordinal and ω ≥ 0.85) were adequate. The structural model presented an acceptable fit (CFI = 0.974; TLI = 0.991 and SRMR = 0.053). Women, younger people, single people, people with lower income, people using dental prostheses, undergoing dental treatment, and those who do not like their smile were more concerned about their smile appearance. Nonprobability sampling, online data collection, and cross-sectional design are considered limitations of the study. OA-Smile is a suitable scale to assess smile appearance concerns, and the data obtained with this scale were valid and reliable. Demographic characteristics should be considered when measuring concerns about smile appearance.

Comparative Efficacy of Classic Versus Horizontal Incision Techniques in Skin-Reducing Mastectomy: A Single Center Retrospective Analysis.

Background: The reconstruction of large breasts carries a heightened risk profile. While skin-reducing mastectomy (SRM) techniques facilitate the correction of breast ptosis, they are frequently associated with a high incidence of vascular complications. This study compares two SRM techniques-the horizontal incision and the classic inverted T incision-by examining their clinical and surgical outcomes. Methods: We retrospectively analyzed data from 24 patients (30 breasts) who underwent SRM with immediate prosthetic reconstruction between 2019 and 2023 at the European Institute of Oncology in Milan, Italy. Our comparison focused on breast aesthetic outcome, reconstruction quality, complication rates (early and late), and patient satisfaction, utilizing the BREAST-Q questionnaire to gauge the latter. Results: Among the 24 patients included in the study, 16 (20 breasts) were treated with the inverted T technique, and 8 (10 breasts) with the horizontal incision approach. A higher overall complication rate was observed with the inverted T technique compared to the horizontal method, with early complications outnumbering late ones. The most common issues were recurrent seroma and skin necrosis leading to implant exposure. Notably, there were no cases of implant infection. Although the horizontal incision technique achieved slightly higher patient satisfaction scores, the difference was not statistically significant. Discussion: The inverted T and horizontal incision techniques each have unique benefits and drawbacks. Our findings indicate enhanced patient satisfaction and reduced complication rates with the horizontal incision technique. The selection of the technique should be customized based on the patient's individual risk factors, tissue quality, and preferences.

UV Exposure Time Optimization for Enhanced Conversion, Hardness, and Flexural Strength in UDMA/TEG-DMA Composite Resins

This study examines the effects of varying ultraviolet (UV) exposure times on the properties of UDMA/TEG-DMA composite resins, focusing on degree of conversion, surface morphology, water absorption, shrinkage, hardness, and flexural strength. Composite resin samples were exposed to UV light for 30, 60, 90, and 120 min. The degree of conversion was assessed using Fourier Transform Infrared Spectroscopy (FTIR). Surface morphology was analyzed via Scanning Electron Microscopy (SEM). Water absorption and shrinkage were measured following standard procedures, while mechanical properties, including hardness and flexural strength, were evaluated using a Vickers hardness tester and a 3-point bending test, respectively. The results indicate that a UV exposure time of 90 min optimizes the composite resin properties, achieving the highest degree of conversion at 77 %, optimal surface morphology, minimal water absorption and shrinkage, and superior mechanical properties, including maximum flexural strength and hardness. In contrast, both shorter and longer UV exposure times detrimentally affected these properties, with prolonged exposure causing thermal degradation and reduced performance. This research underscores the importance of precise UV curing time control to enhance the performance and durability of UDMA/TEG-DMA composite resins, providing valuable insights and practical guidelines for their application in dental and industrial fields. HIGHLIGHTS The incorporation of UDMA/TEG-DMA in composite resin formulations significantly enhanced mechanical properties such as flexural strength and modulus. Exposure to UV light affected the degree of conversion of the resin, impacting its polymerization kinetics and potentially influencing long-term durability. The study revealed notable changes in surface morphology, indicating potential implications for bonding characteristics and aesthetic outcomes. Investigating water absorption and shrinkage behavior provided insights into material stability and dimensional changes over time, critical for clinical longevity and patient satisfaction. GRAPHICAL ABSTRACT

A breast sharing technique using the pedicled IMAP flap for delayed breast reconstruction and contralateral symmetrising mammaplasty: A case series and evolution of the surgical technique in selected patients

IntroductionThe ‘breast-sharing’ procedure uses the disposable tissue as a flap to reconstruct the post-mastectomy defect. This enables simultaneous breast reconstruction and contralateral symmetrisation without additional donor site morbidity. However, controversies related to the oncological safety of this procedure have prevented its widespread uptake. We aim to present this technique based on a pedicled internal mammary artery perforator (IMAP) flap and discuss its technical feasibility and oncological safety. Patients and methodsBetween April 2013 and May 2022, a series of 10 consecutive patients underwent a breast-sharing procedure using the pedicled IMAP flap for breast reconstruction. Clinical and surgical aspects of the breast-sharing procedure were analysed. ResultsIn all cases, the breast-sharing technique allowed for simultaneous breast reconstruction and contralateral breast symmetrisation. Immediate complications included two total venous congestions and one hematoma. Three flaps had distal flap congestion. One flap required debridement and local flap reconstruction. All flaps required fat grafting during the secondary procedures to improve breast symmetry. With an average follow-up of 5,6 years, there was no evidence of recurrent disease. All patients were satisfied to very satisfied with the aesthetic outcome of this reconstructive option. ConclusionsThe breast-sharing technique based on the IMAP flap combines breast reconstruction and contralateral symmetrisation with good aesthetic outcomes in selected patients. The flap has a high complication rate related to venous drainage. Flap design modification and using ICG imaging may reduce venous congestion. A secondary venous micro-anastomosis at the axilla is highly recommended for persistent flap congestion. The reported incidence of contralateral breast cancer is low and thus the residual tissue obtained from the contralateral breast mammaplasty can be safely used for breast reconstruction. Level of EvidenceLevel IV

The Role of Extracorporeal Shock Wave Therapy in Keloids and Hypertrophic Scars: A Systematic Review.

Keloids and hypertrophic scars are pathological scars that result from a prolonged and aberrant response to wound healing, resulting in raised and thickened skin lesions. Traditional treatments include occlusive dressings, compression therapy, intralesional steroids, and surgical excision with refashioning. Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment method that employs mechanotransduction to stimulate a biological cascade resulting in tissue regeneration. This review aims to explore the literature for published evidence on the role of ESWT in the treatment of keloids and hypertrophic scars. A literature search following the PRISMA guidelines was conducted on PUBMED, Google Scholar, and the Cochrane Database of Systematic Reviews, for studies demonstrating the use of ESWT in keloids and hypertrophic scars. From this, 79 articles were identified, 12 of which met the eligibility criteria and were thus analyzed and included in the study. As monotherapy for keloids, ESWT showed comparable improvements in functional and aesthetic outcomes compared to traditional intralesional steroid therapy. Keloids treated with combination therapy of ESWT with intralesional steroids had better outcomes than those treated with intralesional steroids alone. Improvements in hypertrophic scar cosmesis, discomfort, and function with the use of ESWT were reported. Histologic improvements such as decreased collagen content, reduction of fibrotic markers, and fibrogenic cytokines were also described. ESWT is a promising treatment modality for pathological scars, offering comparable outcomes to traditional therapies with added benefits such as non-invasiveness. Further research is warranted to establish optimal protocols and its role in pathological scar management.

Physiological and Functional Restoration of the Modiolus Using a Double Tendon Sling in Patients With Full-Thickness Oral Defects.

Reconstruction of the oral modiolus should be considered for facial defects involving the lip and cheek. We have performed free flap reconstruction using a novel technique that includes a vertical and a horizontal sling for full-thickness defects involving the oral commissure. We used a free radial forearm flap and the palmaris longus tendon to correct lip and cheek defects in 6 patients (3 men, 3 women; age, 55-84 years). The tendon was divided into 2 portions for use as the double sling. One sling was used to connect the upper and lower stumps of the orbicularis oris in the vertical direction and the other to connect the vertical sling and masseter muscle. The outcomes assessed were esthetic appearance and functional results. The facial defects ranged in size from 3.0 cm × 4.0 cm to 7.0 cm × 6.0 cm and the mucosal defects from 1.5 cm × 4.0 cm to 6.5 cm × 5.0 cm. The length of the harvested tendon ranged from 11.5 to 13.5 cm. All flaps survived without complications. Good esthetic outcomes were achieved (excellent facial appearance, n = 1; no lip deviation or drooping, n = 5). Functionally, all patients had acceptable mouth opening and were able to eat a regular diet. Good physiological and functional results can be achieved using a double tendon sling for reconstruction of the modiolus in patients with full-thickness defects involving the oral commissure.

"In Their Own Words": Families' Experiences With Tooth Autotransplantation for the Replacement of Maxillary Incisors in Children.

To examine families' experiences, including motivation and barriers to undergoing tooth autotransplantation (AT), and their perceptions of associated esthetic and functional outcomes. Semi-structured, in-depth-interviews (IDIs) were conducted in person with families who had children that underwent the AT procedure. Interviews were audio recorded and transcribed. Transcripts were coded and thematically analyzed both deductively and inductively. A facilitatorsand barriers matrix and journey maps were created to draw inferences on patterns arising from main themes. Twenty families selecting AT as a solution for a missing maxillary incisor were recruited and interviewed. Overall, all families interviewed had a positive experience with the AT procedure. Motivating factors for undergoing the AT procedure included wanting an earlier intervention for the missing incisor, wishing to mitigate negative psychosocial effects, and the anticipated positive outcomes that would last into adulthood. Barriers to uptake of the AT procedure included the lack of dental practitioner awareness of AT as a potential solution and a large number of appointments and travel. Families were also initially concerned over potential complications that could arise from their child undergoing this procedure. The cost of the procedure was both a barrier and a facilitator for treatment. The study results demonstrate that the overall AT is favorably considered by the families of growing children for the replacement of maxillary incisors and highlight factors that may act as motivators or barriers to its uptake.

An assessment of in vitro lead (Pb) bioaccumulation of Dianthus chinensis L. (Chinese pink).

Heavy metals (HM) also known as potentially toxic elements (PTEs), are well-known environmental pollutants, among which lead (Pb) is a widespread and hazardous soil contaminant. Its removal from soil sediments is often difficult to achieve. In this study, in vitro experiments were conducted to investigate the bioaccumulation capability of Dianthus chinensis L. in solid and liquid Murashige and Skoog (MS) medium supplemented with varying concentrations (0, 10, 100, and 200µM) of Pb as lead nitrate [Pb(NO3)2] for 30days. The objectives of the study were to assess the efficiency of the selected plant as a bio-accumulator in the in vitro system and to obtain data on morphological, biochemical, and molecular changes during Pb salt-induced stress. Significant growth patterns of initial growth promotion up to 100µM lead nitrate supplemented medium were observed, with maximum shoot length and biomass production along with remarkable lead bioaccumulation. Molecular studies on in vitro raised plantlets confirm the high degree of genetic uniformity (98.3%) of the selected plants after a considerable duration (30days) of Pb exposure. Biochemical parameters revealed significant stress effects, including a 284% reduction in total chlorophyll content, altered carotenoid, and proline level during the study. The experiment revealed the high tolerance capacity of D. chinensis to Pb salt and its bioaccumulation potential (397.33mg/kg). This increases the possible use of such an ornamental and floriculture plant as a prospective candidate for the efficient removal of soil Pb pollutants, as they can remediate soils, coupled with aesthetic and profitable outcomes for the growers.

Surgical Management of Moderate Rhinophyma with Nasal Nodules: An Electrosurgery Approach

Introduction: Rhinophyma, a severe manifestation of rosacea, is characterized by hypertrophy of sebaceous glands and fibrosis of the nose, often leading to significant aesthetic and functional impairments. Surgical treatment is the preferred approach for advanced cases to restore nasal appearance and function. Case Report: We present the case of a 60-year-old man with moderate rhinophyma and nodules on the nostrils. Surgical management under local anesthesia involved the use of thermal loops for excision of the lesions and bipolar electrosurgery for hemostasis. The patient was also treated for rosacea with topical agents, including metronidazole and azelaic acid, and oral doxycycline for inflammatory lesions. Directed healing followed the surgery, along with LED phototherapy and ablative erbium laser sessions to optimize results. Discussion: The use of thermal loops and electrosurgery allowed for precise excision and control of bleeding. Postoperative care, including daily greasy vaseline dressings, facilitated rapid healing. Mild infection at the excision sites was treated with topical and prophylactic antibiotics. Six sessions of LED therapy combining four types of light (infrared, red, yellow, and blue) improved healing and reduced inflammation. Ablative erbium laser was proposed to further enhance the aesthetic outcome. Conclusion: A combined surgical approach and careful postoperative management yielded satisfactory results in the treatment of rhinophyma.

Innovative Approach to Severe Esthetic Zone Trauma: Integrating Root Submergence With Guided Bone Regeneration.

Acute traumatic defects in the esthetic zone pose a significant challenge in dental implant rehabilitation, requiring innovative techniques to achieve optimal functional and esthetic outcomes. This article investigates the use of a novel combination of root submergence and guided bone regeneration (GBR) to address these defects. The goal is to evaluate the potential of this integrated approach for achieving predictable bone regeneration and long-term tissue stability. Studies have shown significant improvements in soft-tissue contour, papilla preservation, and emergence profile when root submergence is employed. Despite these benefits, the integration of root submergence with GBR remains underexplored in the literature. This combination shows considerable potential for achieving predictable bone regeneration and sustaining tissue stability in the esthetic zone. The integration of root submergence with GBR offers a promising solution for managing traumatic defects in the esthetic zone by enhancing soft-tissue contours and facilitating predictable bone regeneration. However, additional clinical studies are needed to support the long-term success of this innovative approach in dental implant rehabilitation. The combined use of root submergence and GBR for treating acute traumatic defects in the esthetic zone represents a notable advancement in dental implant rehabilitation. This article presents a detailed analysis of the rationale, technique, and clinical outcomes of this approach, underscoring its importance in achieving optimal esthetic and functional outcomes for patients with complex clinical needs.

Outcomes of ADM-Assisted Implant-based Breast Reconstructions According to Division Types of the Pectoralis Major Muscle.

In implant-based breast reconstruction (IBR), several surgical techniques are based on the implant insertion planes. Ideal location for breast implants has become a popular topic in IBRs because each technique has advantages and disadvantages. Herein, we report the outcomes of three different division types of the pectoralis muscle and suggest an algorithm for selecting the division types. Charts of patients who underwent IBRs between October 2017 and December 2020 were retrospectively reviewed. The patients were classified into three groups (prepectoral, high subpectoral, and subpectoral) according to the division types of the pectoralis muscle. Aesthetic outcomes were assessed in terms of animation deformity, rippling deformity, and visibility of the upper implant border. Total 104 cases were included. 25, 38, and 41 were in the prepectoral, high-subpectoral, subpectoral IBR groups, respectively. Animation deformities frequently appeared in the subpectoral group. Nipple displacement was most prominent in the subpectoral group. Skin rippling at rest was mostly detected in the prepectoral group, whereas ripping during contraction was commonly observed in the subpectoral group. Visibility of upper border was more prominent in the prepectoral group than the other groups. We propose an algorithm for selecting the division types of the pectoralis muscle. If the pectoralis muscle is thick, prepectoral plane is most preferred to avoid the animation deformity. In cases with thin pectoralis muscle, thickness of the mastectomy flap is considered next. If it is thicker than 1cm, prepectoral plane is better than the subpectoral plane; otherwise, high-subpectoral plane is preferable for better aesthetic outcomes. 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.

Utility and Outcomes of a Keystone Perforator Island Flap for Reconstruction at Various Anatomical Locations: A Prospective Study.

Background In Yemen, traumatic wounds are prevalent, imposing a substantial burden on plastic surgery teams operating within limited-resource settings. Advanced microsurgical reconstruction options are scarce, and expertise in free flap techniques is limited. While local flaps are commonly used for soft tissue reconstruction, there is a need for simpler, effective alternatives with lower complication rates. This study aimed to evaluate the effectiveness and outcomes of the keystone island perforator flap (KIPF) as a viable alternative for soft tissue coverage in resource-challenged facilities. Methods From February 2021 to December 2023, a single surgeon's team in three plastic and reconstructive surgery departments in Sana'a, Yemen, conducted this prospective study, which included 35 patients who underwent KIPF for various soft tissue defects. We assessed patient demographics, intraoperative variables, and postoperative outcomes, including aesthetic outcomes evaluated using the Patient and Observer Scar Assessment Scale (POSAS) at six months postoperatively. We analyzed the factors influencing flap success and complication rates. Results The mean age of patients was 29 ± 11.75 years, with the majority being males, comprising 86% of the sample. Trauma was the leading cause of tissue defects (77.1%), primarily affecting the legs (57.14%) and feet (11.43%). The mean operative time was 73.57 minutes. Complications occurred in 26% of patients, with flap dehiscence being the most common (11.43%). Ninety-seven percent of patients experienced flap survival, and 91.4% experienced complete wound healing within a median of 16 days.Scar assessments at six months postoperatively indicated satisfactory aesthetic outcomes, with scars resembling normal skin. Conclusion The KIPF technique proves to be a reliable and practical option for soft tissue reconstruction in resource-limited settings. Its simplicity, minimal postoperative care needs, and high flap survival rates make it an advantageous alternative to more complex reconstructive techniques. This study supports the adoption of KIPF as a standard approach in similar environments with limited reconstructive surgery capabilities.

Evaluation of electrophotobiomodulation as a recent tool in the armamentarium of treatment of fingertip injuries

BackgroundTraditional reconstructive options of fingertip injuries are technically difficult, usually need donor site skin grafting, leave visible scars, and need a protracted period of finger immobilization resulting in joint stiffness. Electro-photobiomodulation (EPBM), is the process of combining intense pulsed light and radiofrequency to modify tissues to help the body heal itself, lower inflammation, and promote wound healing.Patients and methodsThis study included 60 patients presented with fingertip injuries. Patients were randomly divided into two groups. Group 1 includes patients who were treated by EPBM. Group 2 includes patients who were treated by cross finger flap (CFF). Six months after complete healing, evaluation was performed for aesthetic and functional outcome and patient satisfaction.ResultsCompared to group 2 patients, group 1 patients had statistically significant better sensory outcome, better total active motion of affected digits, grip strength, patient satisfaction, healing time, and plastic surgeon general aesthetic evaluation and also, they had statistically significant less adverse events and cold intolerance with absent donor site pain and deformity.ConclusionEPBM is safe and effective treatment of fingertip injuries which shortens the healing time, produces the best aesthetic and functional result while avoiding donor site morbidity of the traditional reconstructive options.

Optimizing Safety and Precision for Secondary Liposuctions: Integrating Intraoperative Ultrasound With VASER Technology.

Liposuction has gained significant popularity, leading to increased demand for secondary procedures due to complications such as scars and fibrosis that affect aesthetic outcomes. High-Definition Liposuction (HDL) has emerged as a preferred technique, but the presence of fibrosis from prior surgeries may limit its effectiveness. This study explores the application of ultrasound-assisted VASER (Vibration Amplification of Sound Energy at Resonance; VASER-Solta Medical, Bothell, WA) liposuction in secondary abdominal liposculpture to address these challenges. A prospective cohort study was conducted from May 2022 to May 2023, including patients undergoing secondary abdominal liposculpture with ultrasound-assisted VASER liposuction, at least 12 months post their initial procedure. Pre-operative ultrasound examinations were performed to identify and mark findings related to previous liposuction. Data on demographics, photographic results, and complications were collected and analyzed. Intraoperative ultrasound (I-US) significantly improved the detection of fibrotic lesions, leading to more precise, rapid, and atraumatic outcomes. The use of I-US optimized surgical procedures, reducing both costs and operation time. Clear communication with patients regarding potential limitations due to chronic damage was essential for setting realistic expectations. I-US has proven to be an invaluable tool in secondary liposculpture, enhancing surgical precision and outcomes. This methodology allows for better recognition of complications, promoting effective treatment strategies and ultimately improving patient satisfaction in the context of secondary abdominal liposculpture.

GINGIVAL MARGIN, CORRECTION IN ORTHOPEDIC DENTISTRY

A big problem for obtaining aesthetic and functional results of dental treatment is the condition of the gingival papillae. The effectiveness of orthopedic interventions without high-quality correction of the marginal edge of the gums can lead to an unsatisfactory result and the occurrence of numerous complications Materials and methods. A literature search was conducted in the PubMed and Medline databases for the period 2000-2024, for which the following keywords were used: correction of soft gingival tissues, fixed dentures, effectiveness, front group of teeth. A general search revealed 112 sources regarding gingival margin correction in fixed dentures. The primary exclusion referred to literary sources in which the correction of the gingival margin applied to all types of prosthetics. Literary sources that contained only reference information were included in the secondary exclusion. As a result, only relevant full-text articles in professional journals remained (n=25). The purpose of the research is to analyze the methods of gingival margin correction in orthopedic dentistry at the current stage, to formulate relevant tasks for further research. Research results. Methods of restoration of the aesthetics of the marginal part of the gums during orthopedic treatment are divided into the following groups: plastic of soft and bone tissues; laboratory and technical procedures; use of materials for artificial gums. It has been established that the plastic-surgical method is used for the loss of the gingival papilla, defects of the ridge of the alveolar process, asymmetric contour of the gums, and their unaesthetic shape. Correction of the gums allows to achieve satisfactory aesthetic results both at the final stage of orthopedic treatment (prosthetics with fixed orthopedic prostheses) and at the intermediate stage of temporary prosthetics with plastic fixed prostheses. It was found that the most common methods of gingival margin correction are flap operations on the gums using the technique of lateral movement of the muco-osseous flap. These include the following types of interventions: endothelial modification from the tooth-alveolar ridge; oblique displaced flap; periosteally stimulated flap; partial or complete split flap. The positive effect of hyaluronic acid on the healing of the gingival margin and tissue regeneration has been proven. Several researches have shown the positive effects of hyaluronic acid on gingival margin healing and tissue regeneration due to its properties to stimulate cell adhesion, migration and proliferation, mediate cell signaling. The authors indicate a better effectiveness of hyaluronic acid in relation to periodontal parameters during the correction of the marginal gingival margin. The use of a laser scalpel is characterized by less pronounced traumatization of tissues, lower temporary costs for intervention, reduced blood loss, less pronounced signs of inflammation in the postoperative period, relative simplicity and cost-effectiveness of use. Conclusions. To date, only a combination of various orthopedic and surgical manipulations allows to achieve an optimal aesthetic result during prosthetics with fixed dentures of the front group of teeth.

Long-term Functional and Aesthetic Outcomes of Labiaplasty: A Review of the Literature.

The incidence of female genital cosmetic surgery (FGCS), and specifically labiaplasty, is on the rise. Common motivators for labiaplasty include hygiene concerns, functional impairment, difficulties with physical and sexual activity, and dissatisfaction with genital appearance, amongst others. However, there have been few reports on long-term functional and aesthetic outcomes and complications of labiaplasty. The aim of this literature review was to report on long-term outcomes of labiaplasty, as defined as ≥1 year post-operatively, to inform safety and efficacy recommendations for the procedure. A comprehensive literature review was conducted on Pubmed and Embase from inception to December 1, 2023 following PRISMA guidelines. Articles were selected according to predetermined eligibility criteria. A manual search was performed to identify additional relevant studies. Nine studies reported on the long-term postoperative complications associated with labiaplasty, with a cumulative total of 748 patients. The most commonly reported complications included postoperative asymmetry (n=45, 6.02%), scarring (n=14, 1.87%), and the need for revision surgery (n=42, 5.61%). Of note, the majority of patients (n=621 of 748) were not reported to have any postoperative complications. From the seven studies that examined psychological outcomes associated with labiaplasty, all studies reported improvement in sustained genital appearance scores as well as aesthetic and sexual satisfaction in the long-term.

Modern Aspects of Closed and Open Rhinoplasty (Literature Review)

Open and closed rhinoplasty are two primary approaches to nasal modification. According to the current literature, there is no consensus among plastic surgeons and otolaryngologists regarding the preferred method in terms of aesthetic outcomes, complications, and patient satisfaction. This review aims to analyze published scientific materials to determine whether open or closed rhinoplasty leads to more favorable patient outcomes. For this systematic review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and conducted a literature search across four databases according to our search strategy. The articles were then imported into COVIDENCE, where they underwent primary screening and full-text review. A total of twenty studies were selected for this review after analyzing 243 articles. Among them, there were four case series, twelve retrospective cohort studies, one prospective cohort study, one case-control study, and two outcome studies. The analysis included three cosmetic studies, eight functional studies, and nine studies that addressed both cosmetic and functional components. Sixteen studies used both open and closed rhinoplasty techniques, while four focused exclusively on open rhinoplasty. Both methods demonstrated high satisfaction rates among patients and professionals, with no significant advantage found for either technique. Based on the available studies, we cannot conclude the superiority of either open or closed rhinoplasty in achieving better patient outcomes. Several studies indicated that both open and closed rhinoplasty resulted in comparable levels of patient satisfaction. To enhance the reliability and consistency of outcome reporting, authors should focus on using the Nasal Obstruction Symptom Evaluation (NOSE) scale and other standardized rhinoplasty outcome assessments.

Use of De-Epithalialized Flap for Elevating the Alar Base in Patients With Cleft Lip.

Alar base asymmetry is a common problem in cleft lip patients. Caused by a lack of bone support and soft tissue deficiency, it is one of the problems that must be corrected during cleft lip repair. While it is encountered during primary lip repair, it can also be seen as a secondary cleft lip nasal deformity after repair. This study aimed to provide alar base symmetry with a de-epithelialized muscle-skin flap during the primary cleft lip repair of incomplete cleft lip patients and secondary cleft lip deformity repair. In incomplete cleft lip patients, the tissue under the incomplete part is de-epithelialized and elevated as a superiorly based flap. The flap is rotated and sutured under the alar base for the elevation. In secondary patients, scar tissue to be removed is de-epithelialized and elevated as a superiorly based flap. It is turned over and sutured under the alar base for augmentation. The effect of the surgery is monitored during the follow-up period. There were no complications related to the flap, and no volume loss was observed. Using a de-epithelialized musculocutaneous flap, the augmentation of the alar base and nasal sill can be achieved without additional incisions in patients undergoing primary incomplete cleft lip repair and in patients undergoing secondary cleft lip deformity repair. We think it is an effective and safe method, improving the esthetic outcomes of cleft lip patients.