Invasive and minimally invasive cosmetic procedures in patients with autoimmune or inflammatory skin disorders can carry an increased risk of surgical site infection, disease exacerbation, atrophic/hypertrophic scarring, or suboptimal cosmetic results. As facial procedures continue to rise in popularity, increasing complications are being reported in association with underlying dermatologic disease. In this review, we aim to bring attention to these dermatologic conditions and the potential challenges that they pose to the facial plastic surgeon. A comprehensive literature search was conducted across PubMed, Embase, and MEDLINE for articles published before January 2025 describing one or more patients with complications following facial or scalp procedures relating to a pre-existing or underlying dermatologic disorder or systemic condition with dermatologic manifestations. Articles were screened according to PRISMA guidelines, and data extraction included dermatologic disease diagnosis and severity, facial procedure performed, perioperative or postoperative complications, and resolution/treatment. Our search criteria identified 2452 articles; 53 articles met the inclusion criteria. In a total of 469 patients with pre-existing dermatologic conditions, mild-severe complications were reported after blepharoplasty (41/469, 8.7%), rhinoplasty (254/469, 54.2%), rhytidectomy (25/469, 5.3%), hair transplantation (37/469, 7.9%), cosmetic injections (35/469, 7.5%), lasers (15/469, 3.2%), and microneedling (50/469, 10.7%). Dermatologic disorders included acne, atopic dermatitis, frontal fibrosing alopecia, lichen planopilaris, rosacea, and vitiligo; systemic conditions with dermatologic manifestations included Ehlers-Danlos syndrome, sarcoidosis, scleroderma, and systemic or discoid lupus erythematosus. Complications ranged from mild postoperative disease exacerbation to severe hypertrophic scarring, ulcerations, and wound healing defects. The existing literature, while limited to case reports and small case series, demonstrates potential risks following facial procedures in patients with dermatologic disorders. This review highlights the importance of consideration of dermatologic disease in facial surgery planning and decision-making and summarizes effective strategies to minimize any potential risk.

Introduction: Intraoperative hypothermia is a common yet underrecognized concern in plastic surgery, contributing to increased risks of surgical site infections, coagulopathy, and delayed recovery. This study characterizes intraoperative temperature dynamics and identifies procedure-specific risks to guide warming strategies. Methods: We performed a retrospective review of 1923 elective plastic and reconstructive surgeries under general anesthesia at a single academic institution. Preincision and postoperative core temperatures were recorded using nasopharyngeal or esophageal monitoring. Intraoperative temperature change was defined as the difference between these measurements. Multivariable linear and logistic regression models assessed associations between procedure type and both temperature change and postoperative hypothermia (<36.0 °C), adjusting for surgery duration, inpatient status, and preincision temperature. Results: The mean intraoperative temperature change across all procedures was +0.16 °C. However, substantial variation existed by procedure. Free flap breast reconstruction, facial procedures, oncoplastic breast reduction, and panniculectomy were associated with temperature increases, while hand surgery showed significant decreases (P = .002). Preincision hypothermia was present in 36.6% of cases and postoperative hypothermia in 32.3%. On multivariable analysis, body contouring (OR = 1.84, P = .005) and hand procedures (OR = 3.91, P = .004) were significantly associated with increased odds of postoperative hypothermia, while aesthetic breast revision trended toward significance (OR = 1.84, P = .055). Neither surgery duration nor inpatient status predicted postoperative hypothermia. Conclusions: Hypothermia remains highly prevalent in plastic surgery procedures performed under general anesthesia, particularly among patients undergoing hand and body contouring procedures. High rates of preincision hypothermia further underscore the need for improved perioperative warming protocols. Multimodal warming strategies should be implemented consistently to maintain normothermia and reduce the risk of hypothermia-related complications.

We thank Shauly and Wolmer for their thoughtful and insightful letter regarding our recent article, “Use of Text-to-Image Artificial Intelligence Model in Preoperative Counseling for Lip-Lift Procedures.”1 Their engagement reflects the evolving and multidisciplinary interest in the integration of artificial intelligence (AI) into surgical counseling and patient education. We appreciate their recognition of our work’s contribution toward reshaping the patient consultation experience. We fully agree that the current limitations of DALL·E2, particularly in terms of anatomical accuracy, scar simulation, and functional modeling, highlight the importance of viewing text-to-image models as adjuncts rather than replacements for established 3-dimensional imaging systems. In fact, as of the time of this writing, DALL·E2 has been deprecated and replaced by newer models, such as DALL·E3, which paradoxically does not currently reproduce the same capacity for iterative, inpainting-based modeling seen in its predecessor. As the authors rightly point out, it remains to be determined whether these limitations are unique to DALL·E2 or generalizable across current text-to-image AI. In our experience and as supported by current literature, even next-generation models, such as Midjourney-v7, continue to fall short in replicating clinically relevant anatomic precision, particularly in applications requiring subtle 3-dimensional facial modeling.2 This suggests that the challenges may reflect broader constraints inherent to this class of models at present. We appreciate the authors’ reference to commercial platforms, such as VECTRA and Crisalix. While VECTRA provides powerful photogrammetric and volumetric tools, the ability to simulate a lip lift remains highly dependent on the user’s manual manipulation and familiarity with the system.3 Crisalix offers a more consumer-facing interface and may be useful in certain applications, such as breast augmentation, where volumetric changes are more generalized.4 However, in our hands, Crisalix may not offer the level of fine detail required for simulating nuanced facial procedures. Ultimately, whether using professional-grade systems or emerging AI tools, all simulation platforms remain limited by their inability to reliably capture the biological variability of healing, scarring, and tissue remodeling that ultimately shape the postoperative outcome. As artificial intelligence and 3-dimensional morphing systems continue to mature, we envision a hybrid workflow in which the structural precision of engineered imaging platforms is complemented by the flexible, patient-facing strengths of generative AI. Importantly, as the authors noted, these tools must be implemented with transparency. AI-generated visualizations should be framed as educational aids, not definitive forecasts of surgical outcomes. In our own practice, we have begun evaluating additional platforms beyond DALL·E, including Midjourney and Adobe Firefly. These tools introduce new possibilities for dynamic and contextual rendering, and we look forward to assessing their role in enhancing the surgical counseling process. Finally, we appreciate the authors’ suggestion to expand the application of these technologies beyond aesthetic lip surgery. We agree that domains such as breast reconstruction, craniofacial procedures, and gender-affirming surgery, where individualized aesthetic and psychosocial outcomes are of paramount importance, may particularly benefit from innovations that help bridge expectation and reality. We echo the call for future studies incorporating patient-reported outcomes, qualitative assessments, and validation against real-world surgical results. DISCLOSURE The authors have no financial support of conflicts of interest to declare in relation to the content of this communication.

Optimal aesthetic and functional outcomes in facial surgery depend on effective wound healing. Although the impact of cigarette smoking on postoperative healing has been widely studied, its specific influence in the context of facial procedures remains debated. This review evaluates how smoking compromises wound healing and increases the risk of postoperative complications by synthesizing current evidence on its influence in facial surgical procedures. This scoping review included original observational studies (cross-sectional, case-control, and cohort) published in English that examined associations between cigarette smoking and wound healing following facial procedures. Eligible participants included patients of any age or sex undergoing facial surgery or sustaining facial trauma. Exposure was defined as active smoking or a history of smoking and was compared with non-smokers or those with documented cessation. Primary outcomes included complications such as skin slough, wound dehiscence, infection, and flap or graft necrosis. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. Of 129 screened records, nine studies met the inclusion criteria. Across various facial procedures, active smoking was consistently associated with impaired wound healing, with reported complication risks ranging from 1.8-fold to 12-fold higher among smokers. Commonly reported adverse outcomes included flap necrosis, infection, and wound dehiscence, although several studies reported no statistically significant association in specific procedural contexts. Smoking is strongly associated with poorer wound healing following facial surgery, particularly in flap-based procedures. These findings emphasize the importance of perioperative smoking cessation to improve healing and reduce preventable postoperative complications.

Inappropriate facial scarring can lead to significant physical and psychosocial morbidity. There is a need to better understand how scar perception varies across ethnic groups, and how it impacts broader quality-of-life domains such as career and sexual well-being. This study evaluates White and Asian patients' perceptions of facial scars related to symptoms, appearance, psychosocial health, and career/sexual well-being. Facial surgery patients from 5 providers were recruited to complete the SCAR-Q and Career/Sexual Well-Being (CS) scales through phone or email. Higher scores on both assessments indicate more positive patient perceptions. Among the 147 respondents, 50.3% were Asian and 49.7% were White. Procedures included blepharoplasty (n=56), rhinoplasty (n=20), eyelid revision (n=19), facelift (n=18), Mohs surgery (n=7), chin augmentation (n=6), craniotomy (n=6), and other facial procedures (n=16). White patients scored significantly higher than Asian patients on the SCAR-Q total (median=260 versus 234), appearance (76 versus 59), psychosocial (100 versus 87), and CS (16 versus 12.5) scales ( P =0.004, P <0.001, P =0.026, and P <0.001, respectively). Symptom scores positively correlated with time since surgery in both groups (Asian: r =0.326, P =0.004; White: r =0.319, P =0.011). Asian patients reported more negative perceptions of scar appearance, symptoms, psychosocial impact, and career/sexual well-being than White patients. These findings underscore the importance of tailored follow-up care and counseling to address ethnic differences in scar perception and quality-of-life outcomes.

Transconjunctival Lower Blepharoplasty.

Malpractice litigation remains a source of professional and financial risk in aesthetic surgery. Prior Westlaw/LexisNexis studies typically focus on single procedures. We assessed aesthetic surgery malpractice across five common procedures and compared verdicts and indemnity between body and facial domains. Retrospective review of Westlaw Edge for U.S. malpractice cases adjudicated 1982-2022 involving abdominoplasty, breast augmentation, breast reduction, blepharoplasty, and facelift. Variables included procedure, allegations, injuries, verdict, and payout. Outcomes were categorized as defense versus non-defense (plaintiff verdict or settlement). Awards are reported in unadjusted U.S. dollars. χ2 and Mann-Whitney U tests compared verdict distributions and indemnity. 534 lawsuits met inclusion (408 body; 126 facial). Non-defense outcomes were 33.6% in body vs 38.1% in facial cases (χ2 = 1.74, p = 0.19). Among paid cases, median (IQR) award was $155,000 ($52,000-$586,371) for body and $337,500 ($118,750-$650,000) for face (Mann-Whitney U, p = 0.04). By procedure, non-defense proportions were 46.9% facelift, 39.5% breast augmentation, 32.5% blepharoplasty, 32.0% breast reduction, and 23.3% abdominoplasty. Lack of informed consent was associated with higher odds of a non-defense outcome on unadjusted comparison (p = 0.03). Major injury/death was associated with larger awards (median~$780,000 vs $210,000; p < 0.01). Over four decades, defense verdicts predominated, yet facial procedures carried greater indemnity than body procedures among paid cases. Findings support expectation forward informed consent, reliable postoperative communication, and risk stratification for combination body procedures as practical targets to reduce medicolegal exposure while improving patient understanding. 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 .

Large language models (LLMs) are increasingly used in healthcare, but their role in aesthetic surgical procedures remains unexplored. These interventions present unique challenges, marked by high patient expectations, emotionally charged decision-making, and subtle yet impactful outcomes on self-perception and psychosocial health. This cross-sectional in silico study evaluated the performance of ChatGPT-4 (OpenAI, 2025), DeepSeek V3 (DeepSeek AI/High-Flyer, 2025), and Gemini 2.5 Pro Experimental (Google, 2025) in preoperative and postoperative counselling for aesthetic facial surgery. Twenty-six standardised patient-oriented questions were submitted, and the anonymised responses of the chatbots were independently assessed by two calibrated oral and maxillofacial surgeons across four domains: accuracy, empathy, readability (Flesch-Kincaid Reading Ease (FKRE) and Grade Level (FKGL)), and referencing reliability (including the identification of fabricated or non-verifiable citations, a phenomenon referred to as "hallucination" in LLM outputs). Statistical tests included Kruskal-Wallis, Mann-Whitney U with Bonferroni correction, Spearman correlation, and chi-squared. DeepSeek achieved the highest accuracy (4.77 (0.51), p=0.0078) and readability (FKRE 2.92 (0.27), p<0.00001), while Gemini outperformed in empathy (4.08 (0.89), p<0.001). GPT-4 produced the most hallucinated citations (36%) compared with Gemini (14%) and DeepSeek (8.8%) (p<0.00001). A negative correlation between empathy and readability (r=-0.34, p=0.002) suggested a trade-off between affective tone and accessibility. Overall, LLMs generated satisfactory counselling responses with distinct performance profiles, supporting their potential in patient-centred communication while reinforcing the need for human oversight.

The facial artery (FA) is the main vascular supply to the anterior face, but it exhibits considerable anatomical variation that impacts surgical planning. We review FA anatomy and variants, examining clinical and radiological data since 2010, and introduce the updated Landfald Classification of FA variants. The common linguofacial trunk (LFT), in which the facial and lingual arteries arise as a single trunk, is the most prevalent variant (approximately 15 % of cases) (Herrera-Núñez et al., 2020; Triantafyllou et al., 2024). Rare variants include the thyrolinguofacial trunk (TLFT, <3 %) and true arterial duplication or early termination (on the order of a few percent) (Zaccheo et al., 2023; Yoon et al., 2024). These anomalies disrupt the usual FA territory and can increase the risk of tongue or facial ischemia during head and neck surgery, free flap failure, or inadvertent vascular occlusion in cosmetic injections. High-resolution angiographic imaging is essential: computed tomography angiography (CTA) and magnetic resonance angiography (MRA) reliably delineate FA course and branches, though CTA involves ionizing radiation (Furukawa et al., 2013). We present an enhanced Landfald Classification with five major types (I-V) and fourteen subtypes (Ia-Vb) that stratify FA anatomy by branching pattern, clinical implications, and imaging detectability. This framework supports tailored surgical approaches and risk mitigation. For example, classical ("Type I") FA patterns allow predictable flap design, whereas hypoplastic or aberrant ("Type IV-V") variants often necessitate alternative strategies. Surgeons and radiologists should apply detailed preoperative mapping - including CTA, MRA, Doppler ultrasonography, or augmented-reality simulations - to identify FA variants and plan safe dissections. In conclusion, recognizing the full spectrum of FA variation and using the Landfald classification can improve surgical precision and patient safety in reconstructive, oncologic, and aesthetic facial procedures.

Cataract surgery, one of the most commonly performed surgery worldwide, not only restores visual function but may also influence patients' psychosocial behavior. This study aimed to investigate whether cataract surgery influences the trend for cosmetic surgery, particularly facial aesthetic procedures, by utilizing the TriNetX database. We hypothesized that improved postoperative vision may prompt patients to seek cosmetic procedures due to the change of self-perception. We conducted a retrospective cohort study using the TriNetX US Collaborative Network. Two cohorts were defined: patients with cataract extraction status (CES) and those who did not (nCES). 1:1 propensity score matching was applied. We assessed the relative risk (RR) of cosmetic procedures and applied Cox proportional hazards models to identify independent predictors of blepharoplasty. Adverse events, including dry eye syndrome and visual disturbances, were evaluated in the CES subgroup. Patients in the CES cohort were significantly more likely to undergo blepharoplasty (RR: 1.83, 95% CI: 1.70-1.96) and rhytidectomy (RR: 1.67, 95% CI: 1.22-2.28). Adverse events, including dry eye syndrome (RR: 1.80, 95% CI: 1.66-1.95) and impaired vision (RR: 1.35, 95% CI: 1.24-1.47), were observed more frequently in patients undergoing blepharoplasty post-cataract surgery. Multivariable Cox regression confirmed cataract surgery as an independent predictor of blepharoplasty (HR: 6.31, 95% CI: 2.57-15.50, p < 0.0001). Cataract surgery is associated with an increased trend for certain cosmetic surgeries, particularly facial procedures. However, blepharoplasty after cataract surgery may elevate the risk of ocular complications, emphasizing the need for careful postoperative care.

Background: Skin cancers are the most common malignant tumors, with nonmelanoma skin cancers (NMSCs) being the predominant group. In recent years, the diagnosis of NMSCs has increased. Today, patients are more sensitive to aesthetic outcomes, necessitating that surgeons also focus on the final appearance of the scar, especially in facial procedures. A satisfactory visual outcome significantly influences patients' perception of comfort, quality of treatment, and overall quality of life. Methods: In our study, we surveyed patients who underwent surgery for facial skin cancer to assess their aesthetic satisfaction. We analyzed their responses based on six criteria: age, gender, number of tumor foci, lesion location, extent of excision, and tumor type. The questionnaire addressed satisfaction with the overall aesthetic effect, scar visibility, preserved facial symmetry, and willingness to recommend our clinic. Results and Conclusions: We collected responses from 698 patients. Among the questions, satisfaction was lowest for scar visibility. Gender did not show a statistically significant difference in satisfaction levels. Satisfaction with the aesthetic outcome decreased with age. Of the operated locations, the highest aesthetic satisfaction was noted for eye area excisions, and the lowest for the nose. The number of cancerous lesions did not affect aesthetic satisfaction. Both incomplete excisions and tumor recurrences lowered satisfaction, with recurrences having a more significant impact. Patients treated for basal cell carcinoma (BCC) reported greater satisfaction with the aesthetic outcome than those treated for squamous cell carcinoma (SCC).

The Gliding Brow Lift (GBL) is a minimally invasive technique for brow elevation; however, its limitations include restricted redraping areas, potential surface irregularities, and ineffective results, particularly in patients with a short brow-to-hairline distance. The Extended Gliding Brow Lift (E-GBL) was developed as an innovative solution to address these challenges by expanding the dissection surface area and incorporating dual-plane dissection. This retrospective study included 122 patients with at least a 1-year follow-up who underwent E-GBL alone or in combination with other facial procedures between August 2018 and August 2023. The surgical technique involved subcutaneous dissection in the face, deep-plane dissection in the hair-bearing scalp, connection of these two planes, and precise skin redistribution using a surgical net. Brow position analysis was performed by measuring the vertical distance from the midpupil line to the tail of the brow using ImageJ software. Outcomes were assessed at the 1-year follow-up using patient satisfaction surveys evaluating brow shaping. The mean follow-up period was 14.1 months. Minor complications occurred in 12 patients (9.8%) all successfully managed. The mean elevation at the tail of the brow was 3.2 ± 0.8 mm (p < 0.001). Among all respondents, 47 patients (38.5%) rated their satisfaction as "very satisfied," while 65 (53.3%) were "satisfied" (p<0.01). By expanding the dissection area, incorporating dual-plane techniques, and utilizing advanced skin redistribution with a simple maneuver, E-GBL ensures long-term results and effectively reduces the length of required incisions, demonstrating its practicality and adaptability to diverse patient needs.

Patient-facing materials in gender-affirming surgery are often written at a level higher than the NIH-recommended eighth grade reading level for patient education materials. In efforts to make patient resources more accessible, ChatGPT has successfully optimized linguistic content for patients seeking care in various medical fields. This study aims to evaluate and compare the ability of large language models (LLMs) to analyze readability and simplify online patient-facing resources for gender-affirming procedures. Google Incognito searches were performed on 15 terms relating to gender-affirming surgery. The first 20 text results were analyzed for reading level difficulty by an online readability calculator, Readability Scoring System v2.0 (RSS). Eight easily accessible LLMs were used to assess texts for readability and simplify texts to an eighth grade reading level, which were reevaluated by the RSS. Descriptive statistics, t-tests, and one-way ANOVA tests were used for statistical analyses. Online resources were written with a mean reading grade level of 12.66 ± 2.54. Google Gemini was most successful at simplifying texts (8.39 ± 1.49), followed by Anthropic Claude (9.53 ± 1.85) and ChatGPT 4 (10.19 ± 1.83). LLMs had a greater margin of error when assessing readability of feminizing and facial procedures and when simplifying genital procedures (p < .017) Online texts on gender-affirming procedures are written with a readability more challenging than is recommended for patient-facing resources. Certain LLMs were better at simplifying texts than others. Providers should use caution when using LLMs for patient education in gender-affirming care, as they are prone to variability and bias.

Introduction: Dermatological ultrasound has emerged as an invaluable tool in facial aesthetic procedures by offering real-time, high-resolution imaging of soft tissue layers. Its use improves procedural precision, minimizes complications, and enhances treatment outcomes. The integration of ultrasonography into aesthetic dermatology is changing practice standards globally. Objective: This review aims to evaluate the applications, benefits, and limitations of dermatological ultrasound in facial aesthetic procedures and surgeries. Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar. Studies from the last five years were prioritized, focusing on facial procedures involving injectables, threads, liposuction, and surgical planning aided by ultrasonography.Results and Discussion: Findings reveal that ultrasound enables safer filler injections, facilitates vascular mapping, improves complication management, and supports preoperative planning. Additionally, new technologies such as high-frequency ultrasound probes have enhanced the ability to differentiate skin layers and subcutaneous structures with unprecedented clarity. Conclusion: Dermatological ultrasound is a critical advancement in aesthetic medicine. Its incorporation into routine clinical protocols can significantly elevate the safety and accuracy of facial procedures.

Facial paralysis significantly impacts patients' quality of life, primarily through facial asymmetry and disfigurement, which affect psychosocial well-being. While dynamic reanimation remains the ideal approach, many patients—particularly older adults and those with long-standing or irreversible paralysis—benefit from static procedures such as rhytidectomy. This review examines the role of rhytidectomy as an adjunctive, primarily aesthetic intervention aimed at addressing secondary deformities, including facial soft tissue ptosis and asymmetry. Evidence indicates that static facelift procedures can produce substantial improvements in facial symmetry, patient satisfaction, and quality-of-life metrics, especially in elderly populations unsuitable for dynamic techniques. Though rare, the risk of nerve injury must be considered, but overall, rhytidectomy is a safe and effective option for enhancing facial appearance and psychosocial well-being in appropriately selected patients. These findings support the integration of static facial procedures into comprehensive management strategies for facial paralysis, emphasizing their value in achieving meaningful aesthetic and functional outcomes.

Preoperative facial markings are critical to surgical precision and aesthetic outcomes in plastic surgery, yet remain operator-dependent and variably documented. Generative artificial intelligence (AI), particularly large multimodal models, offers potential for the automated illustration of surgical plans. This study compares the performances of ChatGPT-4o and Gemini Advanced in generating standardised preoperative markings for aesthetic facial procedures. Methods: Six text prompts describing common facial aesthetic surgeries were developed using established marking protocols. Each prompt was submitted once to ChatGPT-4o and Gemini Advanced, yielding twelve illustrations. Three board-certified plastic surgeons independently evaluated the images using a five-domain Likert scale assessing incision clarity, anatomical accuracy, template conformity, clinical usefulness, and overall graphic quality. A composite score out of 25 was calculated. Data were analysed using paired t-tests, and interrater reliability was assessed with intraclass correlation coefficients. Results: ChatGPT-4o significantly outperformed Gemini Advanced in composite scores (mean 18.0 ± 1.4 vs. 13.9 ± 1.6, p = 0.001, Cohen’s d = 1.69). Superior performance was noted across all domains, particularly in clarity (mean difference 0.83, p = 0.002) and graphic quality (mean difference 0.90, p = 0.001). Interrater reliability was good (ICC = 0.82). Discussion: ChatGPT-4o demonstrated higher fidelity in translating surgical prompts into anatomically appropriate, clinically useful illustrations. However, neither system achieved the precision required for clinical implementation without revision. These models may serve as adjuncts in education and preliminary planning. Future work should explore model fine-tuning, surgeon-guided generation, and performance in reconstructive procedures.

Many transgender and gender-diverse (TGD) individuals rely on online resources to obtain gender-affirming surgery (GAS) information. In 2021, US Centers for Medicare and Medicaid Services (CMS) mandated that hospitals disclose prices for common services and procedures. The aim of this study was to assess the online information and price availability for GAS in US-based hospitals. The largest 100 hospitals by inpatient bedvolume were included. Hospital websites were searched in October 2023 for terms pertaining to GAS, and price estimator tools were queried for 66 common CPT codes used in GAS. Data on hospital ownership, hospital income, Medicaid revenue, plastic surgery residency programpresence, ZIP code median income, social vulnerability index score, and state-level nondiscrimination laws were also collected. Out of 100 hospitals, 59 publicly offered GAS. Hospitals located in the US South and Church-owned hospitals were the least likely to have any GAS information availability (41.5% and 36.4%, respectively). Hospitals in states with laws protecting GASinsurance access and those with plastic surgery residency programs were more likely to publicly offer GAS. Only 48 hospitals offered any GAS pricing information. Of these hospitals, the median number of prices displayed was two, and only five hospitals disclosed prices for more than ten procedures. Pricing information was particularly limited for genital and facial procedures. Significant gaps exist in the public availability of GAS information and price transparency, with notable regional and institutional disparities. Standardizing price estimator tools would enhance informed decision-making and reduce barriers to care. http://www.springer.com/00266 LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

INTRODUCTION: The cosmetic industry has seen significant growth, with an increasing number of men utilizing procedures and rejuvenation therapies. This shift has expanded the consumption of cosmetic services but also raised concerns about risks affecting eye health. Cosmetic products and procedures can cause irritation, allergies, and infections, posing serious health risks. AIMS: This study analyzes trends in the use of cosmetic products and facial procedures, aiming to assess their potential risks to eye health. METHODS: A documentary method was applied, involving a systematic review of literature from electronic databases such as PubMed, Scopus, Web of Science, and Research Gate using specialized software. The analysis focused on existing trends and risks related to cosmetic procedures, with keywords including "dry eye," "eye cosmetics," "safety," "cosmeticians," and "opticians." A sociological method was also employed through a survey conducted in November 2024 among students (n=53) and faculty members (n=5). RESULTS: Survey data indicated that 55.2% (n=32) of participants experienced burning or irritation in their eyes after procedures such as chemical peels and micropigmentation. More severe reactions, such as allergies or burns, were reported by 10.3% (n=6) of respondents. The findings highlight the need for educational campaigns to promote safe cosmetic practices. CONCLUSION: Improved health awareness among medical professionals and consumers about the risks of cosmetic procedures is essential. Educational campaigns targeting both consumers and professionals are recommended. Systematic information on the safety of these procedures is needed.

Objective: This study aimed to establish precise topographic relationships between the facial artery (FA) and Ricketts' esthetic plane (EP) to enhance safety in minimally invasive facial procedures. Study Design: A descriptive observational study was conducted. Setting: For seven days in November 2024, the investigation was carried out in the cadaver labs of the Latin American Center for Research and Training in Minimally Invasive Surgery in Bogota, Colombia. Methods: We dissected thirty freshes cadaveric hemifaces (52.4% male, 47.6% female) at CLEMI, Bogotá. After we injected red latex, we identified four key FA superficialization points through superficial dissection. We established a parallel plane to Ricketts' EP as a reference and took measurements using a calibrated Vernier caliper. We analyzed distances between FA points and the reference plane using R software. Results: We successfully identified all four FA superficialization points in 93.3% of specimens (n=28). We measured mean distances from EP at the lateral nasal ala (3.73±0.10 cm), medial genian zone (4.64±0.18 cm), lateral labial commissure (3.66±0.08 cm), and superior nasomental groove (6.20±0.25 cm). The measurements showed an overall mean distance of 5.1 cm, with points progressing at consistent intervals (10 mm, 9 mm, and 6 mm). Conclusion: This study provides precise measurements defining the relationship between FA superficialization points and Ricketts' EP, establishing a novel clinical reference system for safer, minimally invasive facial procedures. The consistent progression pattern of FA points relative to EP offers a reliable topographic guide for clinical practice.

Objectives: Orthognathic surgery (OGS) is performed to correct dentofacial deformities, improving both function and aesthetics. While prior research suggests positive impacts on quality of life (QoL), self-esteem, and psychosocial well-being, a comprehensive assessment incorporating emotional stability and depressive symptoms remains limited. This study aimed to evaluate the psychological and social effects of OGS, including indication-specific QoL, self-esteem, depression, and emotional stability. Methods: A cross-sectional study was conducted using validated questionnaires: the Orthognathic Quality of Life Questionnaire (OQLQ), FACE-Q, Rosenberg Self-Esteem Scale (RSES), Freiburg Personality Inventory (FPI), and Patient Health Questionnaire-9 (PHQ-9). Data were collected from 90 patients who had undergone OGS at a single institution. Results were compared to existing normative data and reference studies on patients before and after OGS and purely aesthetic facial procedures. Results: Postoperative patients demonstrated significantly improved QoL across all OQLQ domains. FACE-Q scores indicated high satisfaction with facial appearance and function, aligning with reference studies. The study group exhibited higher self-esteem scores compared to the general population (p < 0.001) and showed predominantly balanced emotional stability. However, depressive symptoms were more prevalent in the study group compared to normative data, particularly among male participants (p < 0.001). Conclusions: The findings suggest that OGS leads to significant improvements in QoL, self-esteem, and emotional stability, reinforcing its positive psychological impact. However, the persistence of depressive symptoms in a subset of patients highlights the need for psychological support during treatment. Given the cross-sectional design, future longitudinal studies are necessary to confirm long-term effects and optimize patient care.