Online Instructions Research Articles

A Study on the Aesthetic Parameters and Proportions of the External Contour for Minimally Invasive Facial Injection.

The aim of this study was to further guide the diagnosis and treatment programs for clinical facial contouring with injectable fillers by studying the facial contour parameters and proportion preferences consistent with Asian aesthetics. A total of 89 subjects (42 males and 47 females aged 20-60 years) who met the inclusion criteria were enrolled in this study. The subjects were grouped by age, sex, and external contour attractiveness score, and the external contour aesthetic parameters and proportions of the subjects in different groups were measured and analysed. The upper facial breadth and lower facial breadth decreased with age, with significant differences between the 50-60-year age group and other age groups (P<0.01). The nasomental angle showed a decreasing trend with age, with significant differences between the 40-49-year age group and the 20-29-year and 30-39-year age groups (P<0.05). Males and females were significantly different in calva height, total head height, lower facial height, and calva height to total head height ratio (P<0.05). With increasing age, the external contour attractiveness scores of males and females both showed decreasing trends, with significant differences between the 50-60-year age group and other age groups (P<0.05). The calva height and the cranioauricular angle have a significant impact on external contour attractiveness. In general, temporal depression, cheek sagging, lateral cheek depression, and an ill-defined mandibular border will occur due to ageing, collagen loss, ligament laxity and sagging, and soft tissue atrophy and sagging, reducing the attractiveness of the external contour. 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 .

Temporary Delayed Hypersensitivity Reaction to Botulinum Toxin-A After COVID-19 Vaccination: A Case Series.

The occurrence of a hypersensitivity reaction with the injection of botulinum toxin type A (BTX-A) in cosmetic use is a rare complication. We report the largest case series of temporary delayed hypersensitivity reaction (DHR) with BTX-A following COVID-19 vaccination and the first cases to incobotulinum toxin A (incoBTX-A). A retrospective multicentric case series of patients who developed a DHR to BTX-A after COVID-19 vaccination. Twelve patients were treated with BTX-A injections for the management of facial rhytids. The age range was between 29 and 45years. Ten (83.3%) were female. Ten (83.3%) patients received incoBTX-A, and two received onabotulinum toxin A (onaBTX-A). All patients had COVID-19 vaccination (mRNA vaccine) between 1 and 7months before. Within an average time of 24h after BTX-A injection, all patients developed progressive facial swelling and erythema that were more prominent at the injection points. Intradermal allergic tests to BTX-A were performed in six (50%) patients, and the results were all negative. Adequate clinical control was achieved with systemic corticosteroids and antihistamines. After 1year with no further vaccination, a new BTX-A treatment (provocation test) was performed in all patients with no secondary effects. Previous COVID-19 vaccination and the absence of new adverse events with further BTX-A injections suggest a temporary DHR. Clinicians should be aware of the importance of immunization history and its potential post-vaccine immunogenic effects with BTX-A. 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 .

Three-Dimensional Computed Tomography Scanning Study of the Superior Labial Artery in Chinese Individuals for Assessing Filler Injection Safety.

Lip filler injection is one of the most common minimally invasive cosmetic procedures involving the face; however, vascular complications are not uncommon. The aim of this study was to investigate the anatomy of the superior labial artery (SLA) and provide precise topographic information for dermal filler injection into the lips. Computed tomography (CT) scans of 52 cadaveric heads injected with lead oxide were obtained. We then used Mimics software to construct 3D images of the SLA described by a coordinate system based on the bilateral external auditory canal and the left orbit. This study aimed to classify the SLA in the Han Chinese population, measure its diameter at specific points, and determine the thickness of the lip at those points. Ultimately, we utilized a thermal imaging technique to illustrate the course and depth of the SLA within the lip. The objective of this study was to provide safe guidance for clinical injections. In this study, the SLA was successfully identified in all cadavers. The mean overall diameter of the superior labial arteries was 1.36±0.28 mm. The superior labial artery showed a general course from deep to shallow with an average depth of 5.68±1.68 mm from the oral commissure to the midline. There are anatomical differences in the superior labial arteries among Chinese people. Furthermore, 3D CT images can digitally elucidate the exact positions of the superior labial artery via a coordinate system, improving the safety of upper lip filler injections in clinical settings. 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 .

Breast Implant Removal-Only: The Role of Targeted Compression.

The number of women seeking explantation of their breast implants has increased in recent years. Anxiety due to potential health problems has been one of the major catalysts. Mastopexy with or without autoaugmentation and fat grafting are the main techniques used in breast implant removal surgery. To analyse the aesthetic and satisfactory outcomes after simple breast implant removal assisted by targeted compression. Twenty-eight patients were included in the series. Targeted compression of the breast after implant removal was performed during the 1st month. A satisfaction survey using a Likert scale was used before and after the final visit. The patients were followed up for 1year. The mean age of the patients was 41years old, and the mean time between implantation and removal was 10years. Subjective reasons for removal (46.4% of the patients) were more frequent in women with less time since implantation (5 years) versus 15years for implant-related problems. A total of 57.14% of the women were satisfied with the aesthetic result, and 42.86% were very satisfied. Only 17.8% of the total would consider an aesthetic refinement. Simple breast implant removal yields good aesthetic outcomes, and patients are satisfied with the results. Good management of compression of the breast and close follow-up to treat any collection in the pocket provides good adhesion and allows for effective management of the process of deflation and setting of the breast mound. 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.

Assessment strategies and challenges of teachers in evaluating students during online learning

Education was forced to modify face-to-face classes into three pedagogical approaches: synchronous, asynchronous, and blended learning, requiring teachers to change the grading system, assessment, and evaluation of student performance. This study aimed to determine the assessment tools, strategies, and challenges that teachers encounter during online learning. The researchers conducted an online and face-to-face survey that consisted of 75 questions to 50 online teachers who were selected through convenience sampling from seven public and private elementary schools. Findings indicate that most teachers apply traditional assessment strategies to evaluate students in online learning. Some online assessment applications like Edpuzzle, Google Classroom, Kahoot, and Quizzes are rarely used to assess student learning. Teachers, however, frequently utilized Facebook and Messenger in delivering assessments. They applied multiple assessment strategies in online learning to accommodate the learning styles of their students. However, data revealed that most teachers have difficulty ensuring the quality of participation, integrating authentic assessment into online learning, and using online assessment applications. It is recommended for teachers to provide their students with balanced assessment, timely communication, constructive feedback, group multimedia projects, appropriate instructional materials, and alternative online tools to enable meaningful learning.

Is the Severity of Preoperative Eyelid Dermatochalasis Directly Correlated with Patient Satisfaction After Upper Blepharoplasty? A Prospective Study Based on PROMs.

Facial ageing, particularly in the periorbital region, is a growing concern in contemporary culture. Upper blepharoplasty, a widely performed cosmetic surgery, addresses both aesthetic and functional issues related to eyelid dermatochalasis. This study aims to investigate patient satisfaction, the relationship between satisfaction and preoperative dermatochalasis severity, and the functional impact of preoperative skin excess. A prospective study was conducted from April 2022 to April 2023, evaluating primary upper blepharoplasty outcomes. Patient-reported outcomes were measured using the FACE-Q questionnaire, assessing quality of life and satisfaction. Preoperative symptoms were evaluated using a functional questionnaire. Dermatochalasis severity was classified into three groups. Statistical analyses were performed using SPSS. Seventy-nine patients met inclusion criteria. Postoperative FACE-Q results demonstrated significant improvements in upper eyelid appraisal and satisfaction with eyes. Functional questionnaire results indicated an overall clinical improvement (p<0.01). Visual field tests showed statistically significant improvement in group 3. No correlation was found between preoperative dermatochalasis severity and postoperative aesthetic satisfaction. The study emphasizes the importance of validated questionnaires, particularly FACE-Q, in evaluating patient satisfaction and discomfort with upper lid ageing. Regardless of functional impairments, any degree of dermatochalasis may warrant treatment to ensure patient satisfaction with the cosmetic outcome. On the other hand, the functional benefits and improvements in the visual field also support the impact that the procedure has beyond purely aesthetic aspects. 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 .

Preparedness and Competencies of Higher Education Teachers to Teach Online: A Study in North-East India

This study explores the significance of the online teaching ability of higher education teachers, and how teachers perceived their level of competence in teaching online in north-east (NE) India. The Faculty Readiness to Teach Online (FRTO) instrument developed by Martin et al. (2019) was adapted to conduct a study from 130 teachers in higher education institutions across NE India. The ability to teach online was categorised into four categories, i.e., course design, course communication, time management, and technical competence. Structural Equation Modelling (SEM) was carried out to do direct and indirect path analysis of the proposed conceptual model. Multiple regression analysis was used in analysing the demographic profiles of the teachers and their perceptions of the importance of online teaching competencies. The findings indicate that the perceived readiness to teach online was not significantly influenced by course design, course communication, time management and technical competencies. Furthermore, regression analysis showed that both age and gender negatively impacted perceptions towards readiness to teach online, with older and female teachers having lower perception scores.

Lessons from business education's online transition: A Saudi Arabian case study

We survey business school faculty and students from a major Saudi Arabian university that transitioned to online learning because of the COVID-19 lockdown. This study leverages the Unified Theory of Acceptance and Use of Technology (UTAUT) framework to explore the factors influencing faculty and student willingness and acceptance of online learning as we move to a post-COVID-19 new normal. We use partial least square structural equation modeling to examine the factors that impact faculty and student satisfaction and their behavioral intention to the continued use of online learning in the future. The results of the study indicate that when faculty perceive that e-learning improves their teaching performance and effectiveness (performance expectancy) and find that online teaching tools are relatively easy to use (effort expectancy) then they are more open to consider online teaching and using digital tools even after the pandemic. Further analysis, however, indicates that as faculty perceive a greater loss of control in the classroom, they are less likely to consider teaching/learning online courses and using digital tools in the future. Like faculty, students value online learning when they perceive it helps improve their learning and performance (performance expectancy) and find that e-learning tools are easy to use (effort expectancy) but in contrast to faculty, image, and peer pressure (Social influence) also plays an important role in their acceptance of online learning. Additionally, the changing classroom dynamics, specifically the professor-student power equation under online teaching, is less of a concern for students as compared to faculty.

Could Abdominoplasty with Diastasis Recti Abdominis Correction Improve Stress Urinary Symptoms? A 1-Year Follow-up Prospective Study.

Diastasis recti abdominis (DRA) indicates an abnormal separation of the rectus abdominal muscles from the midline, resulting in abdominal bulging. Recent literature shows a correlation between DRA and back pain, stress urinary incontinence. Primary goal of this study is to check the correlation between DRA correction in abdominoplasty and improvement of urinary symptoms. This is a prospective study on patients with post-pregnancy rectus diastasis who underwent surgical correction of diastasis through conventional abdominoplasty. All patients were asked to complete the ICIQ-FLUTS questionnaire, which assesses urinary disorders, and the SF-36 questionnaire, aimed at quantifying health-related quality of life. The questionnaires were administered to patients the day before surgery and one year after surgery. The recruited patients (n = 51) were then stratified on the presence or absence of stress urinary incontinence. Of the 39 patients with preoperative incontinence, the average scores of the ICIQ-FLUTS were analyzed. In particular, for the questions relating to stress urinary incontinence a statistically significant difference was reported between the preoperative mean and the 1-year mean for all questions (p value<0.05). As regards quality of life, comparing the average scores of each question of SF-36 there is an improvement in the values of all the variables of the questionnaire. The strength of this study, which distinguishes it from other literature, is that the changes in abdominal pressure post-abdominoplasty which should lead to a worsening of stress incontinence, do not cause it. On the contrary, we have demonstrated the improvement of this symptom after conventional abdominoplasty surgery in most patients. 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.

Implementation of Online Teacher Professional Development Programs: Physical Education Teacher Perspectives

One current focus in education is the importance of developing professionalism among physical education teachers to meet the demands and challenges of physical education in the 21st century. Several challenges faced by physical education teachers in implementing online professional development programs include limited access to technology, reduced social interaction, and difficulties in assessing and providing immediate feedback. Additional challenges that require further investigation include the relevance of content and its adaptation specifically to the physical education curriculum and practical contexts. The relevance of physical education teachers' understanding of online professional development programs involves program design and improvement, professional growth and efficacy, implementation and adoption, policy, and advocacy. This study aims to explore the perspectives of physical education teachers on participating in online professional development programs. The method used is quantitative research with a descriptive quantitative design. The sampling technique employed is census sampling, involving all members of the population in the survey, thus including 245 teachers from across Indonesia who are participating in the online development program. The results show that over 80% of participants were able to receive and assimilate the material provided by instructors through a Learning Management System (LMS) during the specified duration of the online teacher development program. Indeed, more than 75% of participants were able to not be disturbed by network issues in their area. Significant differences were reported beyond these percentages, including differences in age groups, teaching experience, and geographical location. Other findings from this study reveal that more than 50% of participants were not interested in the online teacher development program. Factors causing this lack of interest include limited social interaction, digital fatigue, mistrust in effectiveness, and limitations in technology and internet access. The practical implications of these findings are to enhance interactivity, address digital fatigue, improve content relevance, and provide technological support. Future research directions on this topic include longitudinal studies to evaluate the long-term impact of online learning programs on teaching practices and learning outcomes, aiming to identify ongoing changes and improvements in teaching practices. Key Words: Implementation, Perception, Physical Education, Teacher Professional Development

New Aesthetic Unit (NAU) Method: A Comprehensive Method Based on Accurate Anatomical Assessment and PreciseMultilayering Panfacial Treatment for Hyaluronic Acid Fillers.

Recent progress in anatomy enables a more sophisticated approach to treat patients with facial aesthetic concerns (PFAC) with HA fillers. Furthermore, advances in rheology have offered a range of HA fillers with different biomechanical properties adapted to different indications. Based on recent anatomical and rheological progresses, the author has developed a new methodology that couples an accurate patient assessment tool and a panfacial precisetreatment instrument. In the presented method, the face is divided into 6 units called New Aesthetic Units (NAU). NAUs are classified on the extent of volume deficiency and asymmetry, ranging from none to moderate to severe deficiencies. After discussion with the patient regarding the assessment findings, a customized treatment plan, including timelines and number of sessions, is recommended. The modalities of the treatment are exhaustively described for each NAU based on multilayering, best practice medicine, and expert consensus available in the literature. Before-and after-case studies are presented to illustrate how the NAU method is used in routine practice for the treatment of two patients with HA fillers. The NAU method is not only a practical and accurate roadmap for the assessment and treatment of PFAC with HA fillers, but also facilitates communication between injectors and patients and data analysis. 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 .

Enacting the signature pedagogies of arts education in the online learning environment for primary teacher education

ABSTRACT In Australia, where initial teacher education is offered both on-campus and in a fully online mode, future primary-school generalist teachers study teaching across the school curriculum. This includes the arts curriculum where opportunities for future teachers to engage in authentic arts learning themselves are generally seen as essential for developing their arts teaching capabilities. However, a number of university educators have reservations about being able to do this effectively in the online environment because of the practical, experiential, and performative nature of arts learning. This study reviews the learning design of two compulsory arts education units in a fully online Bachelor of Education (Primary). It uses the “signature pedagogies” conceptualisation of the distinctive, durable, and pervasive pedagogical features of a discipline and explores whether arts education’s signature pedagogies can be sustained in the online environment. Using qualitative content analysis methodology, the study shows that the learning design preserves arts education’s signature pedagogies in the online context, though the expression of these is re-imagined for this learning environment. Augmented by survey data from students’ unit evaluations, the study shows that online teacher education can offer meaningful arts learning in units designed for future primary-school teachers.

Reduction Mammoplasties: Risk Factors and Early Complications-About 1442 Cases.

Breast reduction surgery is a widely performed plastic surgery procedure. The incidence of such complications has been steadily decreasing in recent years but is still nonetheless 5.6%. The primary aim of this study was to analyze the incidence of the main postoperative complications of breast reduction surgery. In addition, we identified cause-and-effect links between complications and characteristics of the patients, such as smoking, age, weight resection, BMI, and wound drainage. This retrospective study was performed on a population of 1442 women who underwent breast reduction surgery between January 2016 and October 2022 in the plastic surgery unit at Saint-Louis Hospital, Paris, France. At the follow-up examination, we evaluated the patients for complications. The average resection weight was 1297.7 g in a population for which the average BMI was 28.9. We found 19.9% rate of total complications, of which 3.5% were major complications. We found that only the resection weight was a risk factor for complications. The main strength of our study is the size of our sample. The large number of patients allowed us to conduct numerous analyses and obtain significant results despite the rarity of certain events. This large cohort was also responsible for the high statistical power of our results. The risk of developing a postoperative infection was 7.5% for resections of less than 2.4 kg, increasing to 13.9 % when greater than that. Thus, the administration of prophylactic antibiotic therapy to affected women to reduce the risk of infection is a distinct consideration. For the other factors, while none of them appeared to promote the occurrence of adverse events and, therefore, do not formally contraindicate breast reduction surgery, some preventive measures still strike us as being relevant, such as blade drainage, weight loss, diabetes control, and smoking cessation. 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 .

Evaluating the Effectiveness of the High-SMAS Facelift Technique: Objective Clinical Outcomes at 1-year.

The primary goal of the facelift is to rejuvenate the face without changing its natural features. This involves working on the deeper layers to preserve the surface look while adjusting the fat pads beneath. Thus, we often use a modified High-SMAS facelift method, following this deep-layer approach. The study evaluates whether the high-SMAS facelift, focusing on optimal repositioning, can effectively reduce aging signs in the mid to lower face and neck. Conducted from 2018 to 2022, this retrospective cohort study included demographic data, relevant comorbidities, and operative details of patients undergoing lateral extended high-SMAS facial lifting, excluding revision cases. Complications were recorded, and a minimum one-year follow-up was ensured. The technique's effectiveness was assessed using pre- and one-year post-surgery images analyzed by three masked examiners with a validated scoring method by La Padula et al. RESULTS: The study included 325 patients, with no major complications reported. Significant improvements were noted in post-operative High-SMAS visual scores compared to pre-operative scores (p<0.0001), particularly in cheek fullness, jawline, and cervical angle definition. The High-SMAS facelift technique, evaluated using the Face- and Neck-Lift Objective Photo-Numerical Assessment Scale, demonstrated significant cosmetic enhancements. This technique, focusing on optimal flap draping vectors, effectively restores a youthful appearance by improving facial contours. 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 .

Digital literacy and EFL teachers’ anxiety with teaching online via a virtual classroom software

This study employed qualitative analysis to investigate the technology anxiety experienced by Iranian EFL teachers conducting online classes, taking into account their digital literacy levels. A digital literacy questionnaire was administered to a group of EFL teachers teaching English online at two branches of a language institute in Iran using the virtual classroom software BigBlueButton. Based on the questionnaire responses, 12 teachers were categorized as high (N=6) and low (N=6) digital literates. Through semi-structured interviews and reflective journals, the study delved into teachers’ anxiety regarding online teaching, identifying three primary types of anxiety: pedagogical anxiety, technological anxiety, and social anxiety. The findings revealed that pedagogical anxiety stemmed from disruptions in teaching and learning processes, technological anxiety arose from challenges such as internet disconnections, and social anxiety related to judgments based on technological proficiency. While effective language instruction was a shared concern among high and low digital literate teachers, their approaches to managing anxiety varied significantly. High digital literate teachers demonstrated greater resilience in addressing online teaching challenges, whereas low digital literate teachers experienced reduced confidence and struggled with virtual classroom management. The study emphasizes the importance of addressing technology-related anxiety among language teachers in online education to enhance teaching efficacy and student outcomes. It suggests integrating digital literacy courses and providing expert support to alleviate teaching and technology-related anxiety and stress among EFL teachers, leading to more effective teaching practices.

The Impact of Metabolic Syndrome on Postoperative Outcomes in Abdominal Body Contouring: A Propensity Score-Matched Nationwide Analysis.

Metabolic syndrome (MetS) represents cardiometabolic dysregulation, defined by hypertension, obesity, diabetes, and dyslipidemia. There remains a significant gap in our understanding of whether MetS impacts outcomes of abdominal body contouring procedures. We aimed to assess the influence of MetS on postoperative outcomes of abdominal body contouring by concurrent abdominoplasty and panniculectomy. The ACS-NSQIP database was utilized to identify patients who underwent concurrent abdominoplasty and panniculectomy procedures from 2012 to 2022. Through propensity score matching, distinct cohorts were established based on the presence of MetS, characterized by patients receiving medical interventions for diabetes mellitus and hypertension, with a body mass index exceeding 30kg/m2. Univariate and multivariate analyses were conducted to evaluate differences between groups. A total of 14,642 patients underwent abdominal body contouring from 2012 to 2022. Following propensity score matching, 730 patients were included in the analysis, with 365 in each group (MetS vs. non-MetS). Bivariate analysis revealed a longer hospital length of stay (2.3 vs. 1.6days; p = 0.007) in the MetS cohort compared to the non-MetS cohort. Patients diagnosed with MetS had an average length of stay of 0.6days longer than non-MetS patients (95% CI [0.17, 1.01]; p = 0.007). No noteworthy disparities were observed in the rates of 30-day wound complications, mild systemic, and severe systemic complications, and readmission rates between the groups. Our findings suggest that abdominal body contouring remains a secure option for patients with MetS. Nonetheless, the longer hospital length stays observed in patients with MetS may translate to increased overall costs to the healthcare system. Continued research is warranted to comprehensively assess the economic implications of MetS in the context of abdominal body contouring. 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 .

Concentrated Deoiled Fat: A Novel Method of Fat Processing to Improve Fat Graft Survival-A Basic Research.

Oil compromises graft outcomes via inflammation, which accounts for the unpredictability of volume retention rates as low as 20%. Existing techniques for oil removal are relatively inefficient. In this study, a novel approach was taken to prepare concentrated deoiled fat (CDF) by utilizing flocculation and centrifugation to remove the oil. The hypothesis put forward in this study was that CDF would exhibit improved volume retention and quality by enhancing purification efficiency and reducing inflammation. This basic research involved both in vitro and in vivo experiments using samples obtained from women who underwent abdominal liposuction. The CDF was prepared by flocculation and centrifugation. In the vitro experiments, the microstructure of fat was assessed using Calcein acetoxymethyl ester (AM) staining for living cells and propidium iodide (PI) staining for dead nuclei in two groups: Coleman fat group and CDF group. Additionally, the glucose uptake capacity of these two groups was evaluated using the glucose transport test (GTT). In the vivo experiments, the study included three groups: two experimental groups (low-volume concentrated deoiled fat, LCDF; high-volume concentrated deoiled fat, HCDF) and one control group (Coleman fat), with 10 healthy female BALB/c nude mice in each group, 1ml of the graft was injected subcutaneously to each mouse. After 8weeks, the fat grafts were harvested and subjected to volume evaluation, HE staining and immunostaining for perilipin to assess graft outcomes. In the vitro experiments, the concentration rate of the CDF was found to be 79.6% that of Coleman fat, with 15.1% more oil separated. Cell viability, as assessed by AM/PI staining, did not show a significant difference between the two grafts, but the results of the GTT showed that the tissue viability of the CDF was higher than that of Coleman fat. In the vivo experiments, the CDF had higher volume retention than Coleman fat, as measured by water displacement. Histopathologic scoring indicated that HCDF group and LCDF group had a more intact fat structure with fewer vacuoles, inflammation, and fibrosis compared to Coleman fat. Additionally, the percentages of perilipin-positive area in the LCDF group and HCDF group were higher than in the Coleman group, indicating improved graft quality and outcome with the use of concentrated deoiled fat. "Concentrated deoiled fat" refers to an autologous fat graft from which oil has been removed by flocculation and centrifugation. This process increases volume retention and viable cells and decreases infiltrated inflammatory cells. 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 .

"Autologous Breast Dermal Filler": A Novel Technique for Breast Reconstruction After Nipple- or Skin-Sparing Mastectomy in Pubertal Gigantomastia.

For females in puberty, mastectomy caused by pathological gigantomastia usually brings significant psychological problems. Appropriate immediate breast reconstruction method is necessary. The aim of this study is to present a novel method of breast reconstruction that requires neither implants nor donor-site sacrifice. All patients who were diagnosed with pathological gigantomastia and indicated for nipple-sparing or skin-sparing mastectomy (NSM or SSM) were selected. All extra skin was de-epithelialized, followed by NSM or SSM through a vertical incision on the lower pole of the breast. Then, a skin and dermal envelope in all directions was formed. Whether to preserve the nipple-areolar complex depended on its perfusion. The dermal flap was folded inward to serve as the "autologous dermal filler" and reconstruct the breast. A second surgery of inframammary fold elevation for larger projection was performed at least 6 months. Follow up for at least 1 year and record complications as well as pre- and postoperative BREAST-Q Scores. A total of 11 breasts were included. Four (36.4%) were NSM and seven (63.6%) were SSM. Nipple to sternal notch distance in NSM and SSM was 32.3±9.1cm and 35.1±4.4cm, respectively. No complications occurred, while one breast with NSM showed nipple upward displacement. The BREAST-Q indicated significant postoperative improvements in breast satisfaction (20.5 ± 11.3 vs 80.2 ± 10.4) and psychosocial well-being (23.4 ± 8.9 vs. 81.4 ± 11.3). Preliminary study demonstrated the efficacy and long-term safety of "autologous breast dermal filler." For adolescents, it is a less invasive autologous breast reconstruction method, or transitional plan for further adjustment in adulthood. 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 Gaze into the Eyebrow Standards of Asian Versus Caucasian Women.

Eyebrow position affects perceived facial expression and youthfulness, and its modification is a key component of facial rejuvenation. This investigation aimed to assess the preferred vertical eyebrow position, apex location, and eyebrow shape in Caucasian and Asian individuals and to analyze gaze patterns during aesthetic judgment using eye-tracking technology. The study included 76 Asian and Caucasian volunteers with no medical background. Eye movements were captured with a Tobii Pro Nano eye-tracker. Participants viewed AI-generated images of Caucasian and Asian females with varied eyebrow positions (ratios 1:1.3 to 1:2.5), shapes (angles 8° to 20°), and apex positions. Aesthetic preferences were rated on a 5-point Likert scale. Eye-tracking metrics and aesthetic ratings were statistically analyzed using ANOVA and bivariate correlations. Both genders across ethnicities preferred a moderate eyebrow position ratio of 1:1.6. For eyebrow shapes, a 12° angle received the highest ratings, while extremes were less favored, indicating a preference for moderately curved eyebrows. The most appealing apex position was above the lateral canthus for Asians, and halfway between the lateral limbus and lateral canthus for Caucasians. Eye-tracking revealed longer fixations on unattractive features, suggesting more complex cognitive processing, while attractive features were processed more efficiently. The study revealed that aesthetic preferences for eyebrow features are influenced by both ethnic background and gender, with a general preference toward moderately curved eyebrows and subtle variations in preferred positions. These findings suggest a need for culturally sensitive approaches in facial aesthetic procedures and highlight the potential of eye-tracking technology to enhance surgical planning. Surgeons are advised to adopt a conservative, patient-centered approach when modifying eyebrow features, considering individual and cultural aesthetics to maximize patient satisfaction. 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 .

Jawline Sharp Contouring With Hybrid Filler.

Having a well-defined jawline is a sign of youth and attractiveness among both men and women. Soft tissue fillers, such as calcium hydroxylapatite (CaHA) and hyaluronic acid (HA) fillers, offer nonsurgical alternatives for rejuvenating the lower face and enhancing the jawline. The aim of this study was to investigate the use of a premixed combination of HA with cohesive polydensified matrix technology (CPM, Belotero Intense, CPM-I) and CaHA to create a sharply defined jawline. A total of 126 patients were enrolled in the study and treated with a premixed combination of CPM-I and CaHA using a retrograde fanning injection technique with cannulas. The injection volumes and product ratios were customized according to the patients' needs. The cohort consisted of 75 females and 51 males. The average injected volume of premixed CaHA:CPM-I was 5.83mL. In the majority of patients, a 1:1 syringe ratio of CaHA:CPM-I was applied (n = 81, 64.2%). No adverse events were reported during the 6-month follow-up period. The hybrid filler approach investigated in this study shows promise for achieving well-defined, long-lasting jawline contours. 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 .