Aesthetic Results Research Articles

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.

Surgical Reconstruction of the Congenital Absent Earlobe

Introduction: A simple technique for earlobe reconstruction in a single stage, with satisfactory esthetic results and minimal morbidity. Cases: Two patients with congenital absent earlobe are presented. In both cases, a bilobed flap comprising skin, subcutaneous tissue, and fat was used to reconstruct the lower border of the earlobe. Discussion: Different techniques for earlobe reconstruction are discussed, including flap overlap, the use of skin and cartilage grafts, and double-bilobed flaps. Conclusion: The procedure described in this article is based on a modification of Gavello’s surgical technique, supplying a simple and effective approach for earlobe reconstruction in a single procedure.

Comparative Analysis of Tailored Minicraniotomy versus Standard Pterional Craniotomy in the Treatment of Anterior Circulation Aneurysms: A Single-Center Case–Control Observational Study

Abstract Introduction Multiple minicraniotomies (Mct) have been proposed as alternatives to standard pterional craniotomy (Pct) for intracranial aneurysm treatment. These approaches offer limited surgical corridors and distinct working angles, posing challenges in addressing all aneurysm types with one method. We suggest a tailored Mct technique, comprising three minimally invasive approaches targeting anterior circulation aneurysm sites (middle cerebral artery, internal carotid artery, anterior communicating artery). Methods We conducted a retrospective, case–control study at a single center comparing Pct and Mct outcomes for ruptured and unruptured aneurysms. Parameters evaluated included conversion rates to Pct or decompressive hemicraniectomy (DHC), intraoperative rupture (IOR), surgical complications, complete aneurysm exclusion, 6-month modified Rankin Scale (mRS) scores, and aesthetic outcomes using a visual analog scale. A total of 146 patients were included, with 103 in the Mct group and 43 in the Pct group, comparable in mean age, sex, and aneurysm topography. Hunt–Hess scores and Fisher grades were lower in the Mct group initially. Results No cases required conversion from Mct to Pct or DHC. No significant differences were observed in IOR, surgical complications, and aneurysm exclusion rates between groups. The Mct group demonstrated better 6-month mRS scores and aesthetic outcomes. Conclusion Our study indicates that tailored Mct is as safe and effective as standard Pct for intracranial aneurysms, with significant cosmetic benefits. Thus, tailored Mct can be considered a valuable alternative not only to Pct but also to other minimally invasive surgical methods for these aneurysms.

Reconstructive Techniques Following Malignant Eyelid Tumour Excision-Our Experience.

Background: Malignant eyelid tumours present a considerable challenge in the field of ophthalmic oncology, necessitating a combination of precision oncological care and meticulous reconstruction to ensure the preservation of eyelid functionality and the maintenance of facial aesthetics. Method: This study presents a review of the outcomes of 167 patients who underwent eyelid reconstruction following the excision of primary non-melanocytic malignant tumours. The choice of reconstruction technique was dependent on a number of factors, including the stage of the tumour, its location, and the characteristics of the patient. The most commonly used techniques included regional flaps, local flaps, and skin grafts. The most frequently employed reconstruction techniques were forehead flaps (59 cases), simple excisions (38 cases), and Mustarde cheek flaps (16 cases). Result: The postoperative complications, including ectropion, epiphora, and flap necrosis, were recorded. However, no significant correlation was found between the risk of complications and either the location of the tumour or the reconstruction method employed. Despite the complexity of medial canthal and lower eyelid reconstruction, satisfactory aesthetic and functional outcomes were generally achieved. Conclusions: This study emphasises the importance of individualised surgical planning, highlighting the advantages and limitations of various techniques to optimise both the functional and aesthetic results.

Exploratory study on a novel minimally invasive tunnel like flap approach for orthodontic movement of dental implants.

To propose a new flap design that utilize a minimally invasive approach to move implants. We also propose a 3D method to track changes in implant position without the need for CBCT. Implants were inserted in two mongrel dogs then a minimally invasive tunnel like flap was made. Bone cutting around implants was done using piezotome device and orthodontic force was applied on the implants. For tracking positional changes of implants, an impression was taken then scanned with an identical implant copy inside. The pre- and post-treatment 3D images were then superimposed over each other to detect changes in implant position. Healing of the flap was rapid with minimal swelling and edema. The position of the interdental papilla was preserved maintaining optimal esthetic outcome. Implant pocket depth was maintained. Our 3D imaging method was able to accurately detect the movement that occurred in the dental implants after their movement with significantly higher resolution than CBCT (6μm for this method versus 76-300μm for the CBCT). This flap can preserve the esthetic soft tissue contour of implants during orthodontic movement allowing rapid healing with minimum swelling and edema. Moreover, our proposed 3D method has many advantages over CBCT in tracking the movement of implants by being non harmful and cheap thus allowing several follow up points. Orthodontic movement of implants can be required in cases of improperly placed implants or to intentionally place the implant in a certain position then altering it to avoid the need for bone grafting.

Total Stripping of the Great Saphenous Vein in Varicose Vein Patients with Thrombophlebitis

Introduction. Patients with varicose disease of the lower extremities may suffer from subcutaneous vein thrombophlebitis with an incidence of more than 50%. However, saphenous vein thrombophlebitis occurs against the background of varicose veins in 80% of patients. Aim. To improve the efficacy of phlebectomy in patients with varicose veins complicated by saphenous vein thrombophlebitis. A modified method of total stripping of the great saphenous vein was developed and introduced into clinical practice in City Clinical Hospital No. 21 (Ufa, Russia). The modified surgical technique is aimed at reducing the severity of postoperative hematomas, increasing the cosmetic effect and reducing the incidence of damage to the cutaneous nerve located near the large saphenous vein. The surgery technique was patented (Patent No. RU2812293C1). Materials and methods. From 2022 to 2023, total stripping of the great saphenous vein was performed in 26 patients with varicose veins of the lower extremities and thrombophlebitis of the great saphenous vein in Cardiac Surgery Department of City Clinical Hospital No. 21. The examined patients were divided into a control group (18 patients) and a comparison group (8 patients). The quality of life of all patients was assessed before and after surgical intervention using the Visual Analog Scale (VAS). Results and discussion. All patients underwent total stripping of the great saphenous vein. Prior to surgery, no statistically significant difference was reported in the assessment of quality of life between the groups. The group of the modified stripping technique demonstrated positive clinical and aesthetic results after surgery. Performing total stripping of the great saphenous vein using the modified technique statistically significantly improved the quality of life in the postoperative period. Control points of examinations were on days 1, 7, 30, 90 after surgery. Conclusion. The comparative analysis of the treatment results proved the efficacy of the modified technique of total stripping in varicose vein patients with thrombophlebitis, including a higher level of quality of life, better clinical and aesthetic result of surgical treatment.

Biologically Oriented Preparation Technique Through a Digital Workflow, a Case Report Part 1.

In every prosthetic treatment, the final purpose of the restoration is to restore function and esthetics for the patient, respecting biology and anatomical parameters. Regarding full coverage restorations, there are some factors to take into consideration: like the finish line (chamfer, shoulder, featheredge, etc.), the management of the provisional restoration and tissue healing, the material for the final restoration, and the impression technique. All these aspects will determine the treatment process and its possible results. In recent years, vertical preparation and more specifically biologically oriented preparation technique has generated great interest since its introduction in prosthodontics, changing the periodontal tissues, and providing long-term stability. With this technique, the objective is to change the position of the gingival margin, moving it more apically or coronally, depending on the modifications of the provisional. The relining of the provisional is a fundamental step of this technique: the intrasulcular part of the provisional is modified giving a new emergence profile and providing an augmentation of the tissue in the healing process. In vertical preparation, there is no predetermined margin. The dental technician should position the finish line more apically or coronally, depending on the depth of the sulcus and on the esthetic needs. Ceramic restorations should not invade the epithelial attachment, otherwise it may cause biological and mechanical problems, repetition of the impression, and of the crown restoration, which lead to increased clinical and laboratory time usage as well as expenses. One challenge is communicating the shape and contour of the temporary restoration to the dental lab to ensure accurate information for the final restoration. Finally, the objective of this article is to describe a technique for transferring all necessary information of the provisional and obtaining a predictable result for the final restoration by using an intraoral scanner system and the fabrication of two 3D printed prototypes. One for the final volume of the crowns and the other for the finish line position. The fabrication of 3D printed prototypes allows for a more predictable final restoration, reducing possible communication errors between clinician and technician when restoring with biologically oriented preparation technique. In any esthetic treatment where the restoration does not have a predetermined margin, it is possible with this additional clinical step to provide a more esthetic outcome.

Contemporary Rationales for Cemented Implant Restorations in the Esthetic Zone.

This article explores the ongoing relevance of cement-retained implant restorations, focusing on their contemporary rationales for their successful use. Comprehensive considerations include esthetic, positional, and occlusal factors alongside recent technological advancements designed to mitigate previous known challenges. In certain clinical scenarios, cement-retained implant restorations offer distinct advantages such as eliminating access holes for improved esthetics, particularly for malpositioned implants. Modern advancements in materials and techniques have enhanced their predictability, safety, and overall outcomes while minimizing biological risks. When performed within appropriate protocols, cement-retained implant restorations can effectively address diverse clinical challenges. Recent technical advancements further bolster their utility, supporting esthetic, technical, biomechanical, and biological outcomes in implant rehabilitation of the partially edentulous esthetic zone. Understanding the justifications and guidelines for cement-retained implant restorations, along with recent technological advancements, enables clinicians to optimize treatment outcomes with greater flexibility while minimizing common limitations in practice.

Quantitative Evaluation of the Effects of Blepharoplasty on Visual Field, Corneal Changes, and Cosmetic Appearance.

Blepharoplasty is an important eyelid surgical procedure, involving aesthetic and functional changes to the eyelids. The aim of this study is to investigate the effects of upper eyelid blepharoplasty on changes in the visual field, corneal changes, and cosmetic appearance. This study was performed with preoperative and postoperative facial photographs of 32 patients who underwent bilateral blepharoplasty. Marginal reflex distance (MRD1), percentage of corneal exposure area (CEA), and brow height (BH) were obtained from photographs. intraocular pressure (IOP) and ocular biometric parameters were also obtained. The morphometric and ocular parameters obtained from preoperative, postoperative first-month, and postoperative third-month patients were compared using repeated measures ANOVA test. Significant differences in MRD1, CEA, and BH were observed between preoperative, postoperative first-month, and postoperative third-month patients. Improvements were observed in left axis and right corneal astigmatism axis measurements in the postoperative third month compared with preoperative measurements, and the positive change was statistically significant (P=0.020, P=0.036). Upper eyelid blepharoplasty could provide satisfactory functional and aesthetic outcomes by contributing to the improvement of pseudoptosis and reduction in eyebrow height postoperatively.

ORAL FINDINGS AND CLINICAL BEHAVIOR IN PATIENT HAVING AUTOIMMUNE POLYENDOCRINOPATHY CANDIDIASIS ECTODERMAL DYSTROPHY (APECED)

Introduction: APECED (Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy) is a rare autosomal recessive disease with significant impacts on oral health, including oral candidiasis and varying degrees of enamel hypoplasia. Objective: To present the oral findings of a girl with APECED and the minimally invasive approach taken in recovery and rehabilitation, taking into account the complexity of her medical condition. Material and methods: A case of a 16-year-old girl with APECED, who visited the dental clinic due to defects of the hard dental tissues and severe dentinal hyperesthesia, is described. There was an underbite with a reduced lower facial floor and enamel hypoplasia in the coronal and middle third of the anterior teeth and first molars. Results: Through direct composite restorations and a minimally invasive approach, a good healing, functional and aesthetic result was achieved.

Eyebrow reconstruction by simple elliptical excision with beveled incision – A case series of twelve patients

Patients seeking reconstructive facial surgery desire aesthetically pleasing outcomes with minimal visible scarring. For scalp incisions, bevelled angle of 45° is typicallypreferred to preserve hair follicles. However, no consensus exists regarding the ideal incision angle for the brow area. This observational study analyzed the surgical outcomes of 12 patients with eyebrow defects treated using a simple elliptical excision with a bevelled incision, addressing various indications such as posttraumatic scars, post-burn scars, and tumors. Outcomes were evaluated using the Physician Global Esthetic Improvement Scale at 7 days and 3 months post-surgery. At 7 days, 50% of patients showed very good improvement, and the other 50%showed moderate improvement. By 3 months, 33% of patients exhibited exceptional improvement, 50% showed very good improvement, and 17% demonstrated moderate improvement. This study concludes that direct excision and approximation with an angled incision along the hair follicle direction provide favorable aesthetic results for eyebrow reconstruction.

Nasal Tip Reshaping in Orthognathic Surgery: A Novel Intraoral Minimally Invasive Approach.

Current concepts in orthognathic surgery focus on not just rectifying dentoskeletal irregularities but also improving facial aesthetic and function. In this respect, nasal reshaping holds extraordinary significance in determining surgery effectiveness and patient satisfaction. Facial preoperative evaluations emphasize the paramount functional and aesthetic impacts of caudal septum in tip reshaping. Deviations in this anatomical subunit could lead to significant nasal obstructions and aesthetic changes as twisted nasal tip, affecting projection, rotation, and columellar-alar relationship. These considerations are essential in orthofacial surgery, as maxillary movements might exacerbate or worsen preexisting nasal tip deformity. In this paper, we aim to describe a novel and innovative minimally invasive approach presenting a detailed account of a rhinoseptoplasty in which the entire nasal tip reshaping procedure was performed intraorally during orthognathic surgery. The technique focused on achieving optimal nasal tip projection and rotation, centering, and stabilization through strategic maneuvers such as incremental dissection of maxillary spine chondroperiosteal junction, superoposterior strut preservation, vertical and caudal septum resection, and anterior nasal spine tip support. Techniques including subnasal drilling and septal stabilization suture are detailed. Specific attention is given to addressing deficiencies in posterior septal angle and labiocolumellar relationship. Postoperative care is described and subjective evaluations were performed to assess patient and surgeon satisfaction with facial symmetry and overall aesthetic improvements. In our experience, the described approach offers valuable surgical finesse to orthognathic surgery, effectively targeting caudal septum deviations and nasal tip droopy. Its unique perspective enhances both functional and aesthetic results, particularly in the context of profiloplasty. No external nasal incision was performed and the totality of nasal tip reshaping was scarless and performed through an intraoral approach. Surgical precision in execution of this novel and tailored surgical approach has been shown to have a profound impact for enhancing outcomes of orthofacial surgery procedure.

Functionality and Scar Evaluation of the Donor Site in Extended Radial Forearm Flap Phalloplasty: How Affected Is the Arm in Day-to-Day Life?

Background: The radial forearm flap remains the gold standard in phalloplasty in gender-affirming surgery due to its versatility and functional outcome, but the significant donor site morbidity and its impact on daily functioning and aesthetic perception remains understudied. This study provides valuable insights into the mid-term functional and aesthetic outcomes of the forearm in transgender individuals following radial forearm flap phalloplasty using widespread instruments for assessment scoring systems and for the evaluation of postoperative wound healing of surgical interventions in general. Methods: Between January 2013 and March 2018, a total of 47 patients underwent radial phalloplasty at AGAPLESION Markus Hospital, and 20 consented to participate in this cross-sectional, retrospective study evaluating functional and aesthetic outcomes post-radial forearm flap phalloplasty using standardized questionnaires (DASH, POSAS, and SBSES). A univariate median regression of each score was performed to determine the associations with selected variables, and correlation analyses between scores was performed using a nonparametric Spearman rank correlation. Results: Among the 20 participants, the median Quick DASH, DASH functionality, DASH sport and music, and DASH work scores indicated minimal to no functional impairment. Scar evaluations using the PSAS, OSAS, and SBSES scales showed overall patient satisfaction with minimal concerns regarding pigmentation and scar texture. Notably, an increase of 0.27 cm2 in wound surface area added one point to the DASH sport and music score (p = 0.037). Statistical analysis also demonstrated a significant correlation between functional and aesthetic assessment scores. Conclusions: The radial forearm phalloplasty donor site, evaluated by the PSAS, OSAS, and SBSES scales, leads to minimal or no functional impairment; however, the worsening of the DASH sport and music score with increasing wound surface reflects a direct relation between wound size and functional impairment.

The Negative Pressure Wound Therapy for Flap Salvage

Negative Pressure Wound Therapy (NPWT) effectively manages complex wounds by promoting fluid drainage, stabilizing the wound environment, and reducing bacterial load. It aids in granulation tissue formation and modulation of inflammatory reactions. NPWT is increasingly used in reconstructive surgery, particularly in flap procedures, enhancing wound healing and cosmetic outcomes while reducing flap complications. Despite concerns about flap compromise, clinical trials demonstrate low flap loss rates with NPWT. Strategies like observation windows and implantable Doppler devices help overcome monitoring challenges. However, conclusive evidence regarding NPWT's safety and impact on flap vascularity is limited due to scarce studies. The study involved 40 healthy adult patients, mostly male, with soft tissue defects primarily caused by road traffic accidents. They were split into two groups: NPWT (25 patients) and conventional dressing (15 patients). The NPWT group was further categorized into high pressure (8 patients) and low pressure (17 patients) subgroups. Results showed lower flap edema in NPWT groups compared to controls, but high pressure NPWT led to higher flap ischemia and infection rates. Overall, low pressure NPWT yielded the best clinical and aesthetic outcomes with fewer complications. The study suggests a delayed NPWT approach and low-pressure settings for optimal vascular perfusion in Fasciocutaneous flaps, emphasizing the need for further trials to establish its efficacy and determine ideal pressure settings for different flap types.

Enhanced alveolar ridge preservation with hyaluronic acid-enriched allografts: a comparative study of granular allografts with and without hyaluronic acid addition

PurposeRidge preservation is essential to restore alveolar ridge volume and to enhance esthetic and functional outcomes for dental implants. The addition of hyaluronic acid to allogeneic bone substitute materials might enhance these outcomes. This clinical study evaluated the efficacy of ridge preservation after tooth extraction using granular allografts with and without hyaluronic acid addition.MethodsIn this retrospective study, 40 patients with compromised extraction sockets were enrolled. Among them, 19 received particulate allogeneic bone substitutes (Allo), 21 received allogeneic bone substitutes with hyaluronic acid (AlloHya). Vertical and horizontal graft stability, graft shrinkage rate, and bone mineral density were assessed using radiographic measurements on CBCT scans conducted before tooth extraction, directly after ridge preservation and after four months. Patients were followed up 12 months post-implantation.ResultsVertical height loss after 4 months was significantly greater in the Allo group (-0.82 ± 0.95 mm) compared to the AlloHya group (-0.19 ± 0.51 mm; p = 0.011). Graft shrinkage rate was 16.9 ± 11.5% (Allo) and 10.3 ± 7.7% (AlloHya) (p = 0.038). After four months, average bone density was significantly higher in the AlloHya compared to the Allo group (p = 0.004). Nearly all implants (39 out of 40) were classified as “Success” according to the ICOI scheme, with no differences in implant quality between the two study groups.ConclusionsImproved graft stability, reduced resorption, and increased bone density were observed in hyaluronic acid-enriched allografts compared to pure allografts. Adding hyaluronic acid to allogeneic bone grafts significantly enhanced outcomes in ridge preservation.

Modified Technique of Gummy Smile Treatment: Double M-V Plasty for Esthetic and Functional Lip Reposition Surgery.

Excessive gingival display is a common problem that results in an unaesthetic appearance while smiling. Lip reposition surgery is a powerful, noninvasive surgery approach for gummy smile treatment, frequently performed in outpatient oral and maxillofacial surgery units. The procedure as such, provides camouflage of the increased gingival display through re-attachment of the upper lip and limits the pull effect of the muscles by reducing the depth of the upper vestibule. Few techniques of surgical treatment of maxillary gingiva overexposure have been described so far. Proposed midline double V- plasty provides anatomic reposition of the frenulum, whereas bilateral vertical M-plasty enables wider excision of the mucosa than the conventional approach providing better adaption of the wound margins without residual dog-ear defects giving more functional, esthetic, and satisfactory effect to the patients. It can also be performed in patients who do not desire orthognathic surgery with good esthetic results.

Longitudinal tooth fracture indicating a questionable prognosis for an endodontist

Introduction and Objectives: Longitudinal fracture or vertical fracture of a tooth occurs at any level in the root and extends vertically. It has a high incidence of occurrence in the first molars. The most frequent sites to occur are the buccolingual surface and proximal surfaces of teeth. The etiology of fracture involves different factors in endodontically treated and non-endodontically treated teeth. Longitudinal fractures become the most challenging to diagnose and treat. This paper reviews these aspects of challenges and discusses the advantages and limitations of dental materials used for the treatment. Review Methods: PubMed and Google Scholar databases were searched for articles on longitudinal tooth fractures between 2007 and 2022. The 16 current articles were selected. Brief Description of the State of Knowledge: As per the review of the literature, longitudinal fracture of the tooth is the most common fracture to occur due to excessive forces on the root canal-treated tooth. This occurs in endodontically treated teeth due to long-term application of calcium hydroxide, cracks caused during root canal preparation extended by the pressure of root canal obturation, and in non-endodontically treated teeth due to cyclic and heavy masticatory stress, and habitual chewing of hard food especially in males. Summary: Functional and esthetic outcomes following longitudinal fracture treatment are important considerations in the case of anterior teeth. Longitudinal fracture or vertical fracture of a tooth occurs mostly in the first molars. It is crucial to identify and manage actors for good prognosis, as restoration at a time can reduce fracture extension prevent microleakage.

The Efficacy of Leukocyte-Platelet-Rich Fibrin in Combination with Sub-Epithelial Connective Tissue Graft in Peri-Implant Soft Tissue Augmentation: A Randomized Controlled Clinical Trial

Aims and Background The aim of the current study is to assess and compare the efficacy of the leukocyte-platelet-rich fibrin [L-PRF] in combination with sub-epithelial connective tissue graft [SCTG] and SCTG only in promoting aesthetic results and strengthening the state of the soft tissue surrounding implants. Materials and Methods A parallel-arm randomized controlled clinical trial was used for this investigation. A total of 120 patients who had missing teeth with a thin gingival biotype [less than 1.5 mm] were included in this study. The patients of Group I were treated with PRF and SCTG during second-stage implant surgery, while the patients of Group II were treated with SCTG only. Treatment outcomes included the assessment of the width and thickness of the keratinized tissue at the baseline, 3 and 6 months postoperatively; pro- and anti-inflammatory cytokines [IL-1β, TNF-α, and IL-4] in the peri-implant crevicular fluid on the 1st, 7th and 30th days after surgical procedure; swabs from the surface of postoperative wounds of the mucous membrane on days 3, 5, 7, and 10; Pink aesthetic score [PES] 6 months after prosthesis placement; and laser Doppler flowmetry on days 1, 7, and 14 after augmentation. Results and Discussion Patients who received L-PRF+SCTG had a significant increase in keratinized tissue thickness [KTT] [p = 0.08] than those who received SCTG only [KTT 1.86 ± 0.17 Vs 1.48 ± 0.15] 6 months after surgery. The mean [±SD] of PES was found to be 13.1 [±0.02] for Group I and 11.3 [±0.08] for Group II. The cytology, LDF, and local immunoassay analysis demonstrated faster epithelialization and better revascularization in Group I. Conclusion The use of L-PRF and SCTG is an effective method in augmenting peri-implant soft tissue and improving gingival biotype and aesthetic outcomes, which would help overcome complications and increase patients’ satisfaction.

Advancing aesthetic outcomes: A critical analysis of autologous free flap reconstruction post-minimally invasive mastectomy.

Advancing aesthetic outcomes: A critical analysis of autologous free flap reconstruction post-minimally invasive mastectomy.