Plastic Surgery Research Articles

Comparison of Sexual Function, Satisfaction, and Assertiveness in Genital Cosmetic Surgery Groups: A Randomized-Sampling Cross-Sectional Study.

Sexual dissatisfaction is one of the main motivations for seeking female genital cosmetic surgery (FGCS), though the outcomes of such surgeries are controversial. Evaluation of the sexual function, satisfaction, and assertiveness in FGCS groups. From five clinical centers in Tehran, Iran, 200 women in the study group (women seeking or had undergone labiaplasty (LP), women seeking or had undergone multi-procedure (MP) of FGCS simultaneously) and the control group were randomly selected. Participants completed the Female Sexual Function Index (FSFI), the Global Measure of Sexual Satisfaction (GMSEX), and the Hurlbert Index of Sexual Assertiveness (HISA). The groups were compared using the Chi-square, one-way ANOVA with post hoc analysis. In women seeking LP, the mean FSFI, GMSEX, and HISA score was lower than that of women who had undergone LP (FSFI: 18.41 vs 21.36, p =0.04, GMSEX: 20.36 vs 28.03 p <0.001, HISA: 49.7 vs 62.5 p <0.001). Our finding showed as well that women seeking MP also had lower mean FSFI, GMSEX, and HISA scorecompared to women had undergone MP (FSFI: 23.02 vs 18.02, p <0.001, GMSEX: 19.63 vs 28.94 p <0.001, HISA: 45.72 vs 60.62 p <0.001). Women who had completed FGCS experienced better sexual function, satisfaction, and assertiveness compared with women seeking surgery. 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 .

Energy-Based Skin Rejuvenation: A Review of Mechanisms and Thermal Effects.

Energy-based photoelectric and ultrasonic devices are essential for skin rejuvenation and resurfacing in the field of plastic surgery and dermatology. Both functionality and appearance are impacted by factors that cause skin to age, and various energy types have variable skin penetration depths and modes of transmission. The objective is to advise safe and efficient antiaging treatment while precisely and sensitively controlling and assessing the extent of thermal damage to tissues caused by different kinds of energy-based devices. A literature search was conducted on PubMed to review the mechanisms of action and thermal effects of photoelectric and ultrasonic devices in skin remodeling applications. This paper reviews the thermal effects of energy-based devices in skin resurfacing applications, including the tissue level and molecular biochemical level. It seeks to summarize the distribution form, depth of action, and influencing factors of thermal effects in combination with the mechanisms of action of various types of devices. Accurate control of thermal damage is crucial for safe and effective skin remodeling treatments. Thorough investigation of molecular biochemical indicators and signaling pathways is needed for real-time monitoring and prevention of severe thermal injury. Ongoing research and technological advancements will improve the accuracy and control of thermal damage during treatments.

Perioperative antibiotic prophylaxis in implant breast reconstruction

Implant infection is the most common and serious complication in implant-based breast reconstruction. To prevent infection, many surgeons have adopted a perioperative antibiotic prophylaxis regimen for managing patients. However, there has been considerable debate regarding the duration of antibiotic prophylaxis. After reading this article, plastic surgeons should manage their patients with an understanding of the evidence supporting perioperative antibiotic prophylaxis.

Fat embolism: a systematic review to facilitate the development of standardised procedures in pathology.

Fat embolism (FE) is a historically recognised but still actively researched topic in forensic pathology. Several aspects remain not fully elucidated, such as its aetiopathogenesis, its causal role in death determination, the impact of interfering factors (e.g. cardiopulmonary resuscitation or other medical procedures) and both qualitative and quantitative diagnostic methodologies in clinical and forensic contexts. These issues are further underscored by the potential involvement of FE in the causal determination of non-traumatic deaths, which often raises questions of professional liability. The present study aims to provide a comprehensive and up-to-date overview of the most recent scientific evidence relevant to forensic pathology. Our systematic research has included 58 articles from 1990 to the present on the topic of FE and fat embolism syndrome (FES). From these articles, we identified 45 case reports, from which the authors' descriptions were extracted to provide information on individual cases and the operational methods of forensic pathologists. Additionally, 21 experimental studies were identified, and their key findings have been summarised narratively. It has emerged that both traumatic and non-traumatic cases are frequently reported in the forensic context, with orthopaedic and cosmetic surgery being among the highest-risk specialities. Experimental studies have re-evaluated the role of a patent foramen ovale in the pathogenesis of FE, as well as the impact of cardiopulmonary resuscitation in causing FE severe enough to result in death. Additionally, there are new findings regarding diagnostic techniques, including radiological and immunohistological methods; however, they have not yet fully bridged the reliability gap compared to an accurate autopsy-histological evaluation. The major critical points that emerged include the lack of complete and detailed information on premortem clinical conditions, the underutilisation of grading systems and the methodological heterogeneity applied, resulting in considerable variability regarding the organs studied histologically and the diagnostic techniques used. Despite the limitations associated with the analysis of case reports and the heterogeneity of included experimental studies, we believe that this study can provide a comprehensive overview of the FE topic. It furnishes pathologists with an updated overview useful for clinical practice and guiding future research trends, as well as facilitating the development of standardised procedures.

Experience with Lipofilling in Children with Localized Scleroderma: Case Study

Background. Localized scleroderma (LS) is an inflammatory sclerosing disease of unknown etiology. It is characterized by progressive lesion of connective tissue leading to sclerosis and/or atrophy of the skin and underlying tissues. The LS prevalence is 27 cases per 1 million per year, and 3.4 cases occur in children. Clinical case description. This article presents two clinical cases of LS in children under the age of 12 years. Contour plastic surgery with adipose tissue (lipofilling) was performed in both cases. It was possible to achieve volume correction via lipoaspirate, to increase derma and subcutaneous fat thickness in sclerosis focus, to reduce skin tightness, and to improve microcirculation during the treatment. Conclusion. Surgical management of children with lipofilling allows to eliminate gross facial defects, to increase the subcutaneous fat layer in sclerosis foci. Moreover, these patients report an improvement in psycho-emotional state after autotransplantation of adipose tissue.

Comparison of Efficacy of Intralesional Triamcinolone and Combination of Triamcinolone With 5-Fluorouracil in The Treatment of Keloid

Objectives: To study the efficacy of intralesional Triamcinolone and combination of Triamcinolone with 5-Fluorouracil in the treatment of keloid in terms or reduction in height of lesion. Study Design: Cross-sectional analytical study. Place and Duration Of Study: Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, Jul 2020 to Mar 2021. Methodology: A total of 56 patients suffering from keloid formation were included in our study. Patients who had received previous treatment for keloids were excluded. All patients were assessed for volume of keloid before and after 8 weeks of intervention. Group A patients received therapy with intralesional Triamcinolone 4 mg with 5-Fluorouracil 45 mg once weekly while Group B patients received intralesional Triamcinolone 10 mg alone once weekly. Patients were followed up after 8 weeks to ascertain mean reduction in volume of keloid post-intervention. Data was analyzed by SPSS 26.0. Results: The difference in total volume post-treatment between the two groups was significant, (p=0.001), however the difference in total volume reduction across both groups with treatment was not significant, (p=0.382). Treatment was effective in 23(82.1%) of with the combination of Triamcinolone and 5-Fluorouracil, while this figure was only 16(57.1%) with Triamcinolone alone, (p=0.042). Conclusion: The combination of intralesional Triamcinolone and 5-Fluorouracil is superior to intralesional Triamcinolone alone in the treatment of keloids, and may be considered for therapy in patients who do not respond to treatment with single agents.

A Novel Method for Identifying Patients with High Risk of Litigation in Plastic Surgery: Introducing the FATIMA Acronym.

In recent years, there has been an upward tendency in the number of claims against Plastic Surgeons in some countries, while remaining among the most litigated specialists worldwide. Identifying the most frequent traits in Plastic Surgery claimants could aid surgeons in performing better patient selection and avoid liability. The three main legal databases in Spain were consulted for Plastic Surgery litigations in Spain over a five-year period. Data from the plaintiffs, defendants and judicial processes were collected. In addition, expert witnesses were interviewed and data from the main medico-legal association in Spain was collected. This data was contrasted with the available literature regarding litigation in Plastic Surgery worldwide. A total of 199 court resolutions were analyzed, two expert witnesses were interviewed and "The Patient's Advocate Association" of Spain was consulted. The most frequent traits observed in the plaintiffs were summarized in the acronym FATIMA that describes a Female patient using Antidepressants or Anxiolytics, presenting body Tattoos, suing after undergoing a breast surgery with the use of Implants, Middle-aged and with Access to free legal services. The use of the acronym FATIMA in the identification of patients with high risk of litigation in Plastic Surgery could aid surgeons in performing adequate patient selection and avoiding medical liability. 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 .

Health Tourism and Grey Tourism: A Virgin Opportunity for Economical growth of Nepal

Health tourism has emerged as a growing fashion worldwide in last few decades. It is driven by the longing to travel to other countries to improve/maintain their health while experiencing the indigenous, cultural and tourist attractions of destinations. Health tourism can be defined as traveling to foreign countries for no less than a day and no more than a year to get the treatment they need to get better. According to Magablih (2001), health tourism is the movement of a patient, with the purpose of getting services that help in recovering his ailment, or at least in stabilizing his medical case, outside his own country for a period of time not less than 24 hours and up to 1 year, each time, and the patient has no intent to work or reside permanently. Available Literatures shows two major branches of Health tourism viz. medical tourism and wellness tourism. Medical tourism involves traveling to foreign countries to seek modern medical treatments and procedures, including elective surgeries, dental treatments, cosmetic surgeries, transplant and specialized surgeries like cardiac surgery and orthopedic therapy. Wellness tourism, on the other hand, focuses on holistic health practices such as yoga, meditation, Ayurveda, and the use of local herbs. This branch emphasizes positive human functioning and preventive care rather than treating illness. Nepal is doing well in wellness tourism but has lot of possibilities in health and grey tourism.

Plastic Surgeons and Portraits Before the Invention of Photography.

The aim of this paper is to review portraits from the Renaissance to the Romantic eras, created before the invention of photography, and to discuss their usefulness to plastic surgeons. Before photography and film were invented, portraits played a critical role in documenting individuals, conveying power, and immortalizing people's appearance and identity. Portraits were not merely simple representations of a person's physical appearance; they played a crucial role in conveying the subject's inner qualities and social position, as well as the cultural values of the era. Artists often idealized or embellished certain features to align with the cultural and aesthetic ideals of their time. Portraits of the Renaissance to Romantic eras could have a significant impact on plastic surgeons' understanding of beauty and aesthetics. A plastic surgeon drawing on Renaissance ideals might prioritize symmetry and balanced facial features, which continue to be regarded as attractive in contemporary beauty standards. Beauty standards during these times favored curvaceous and lively figures, potentially inspiring modern plastic surgeons to focus on creating more dramatic or unique appearances. A plastic surgeon inspired by Romantic art might value uniqueness and avoid rigid beauty standards, focusing instead on enhancing a person's natural traits rather than conforming to a singular "ideal" appearance. Plastic surgeons could gain a richer, more classical perspective on aesthetics by studying historical art, potentially leading to more personalized and balanced outcomes. However, integrating these classical ideals into modern practice must also consider the diverse and varying definitions of beauty prevalent in today's multicultural society.

Plastic Surgeons’ Attitudes and Understanding of Body Dysmorphic Disorder

Plastic Surgeons’ Attitudes and Understanding of Body Dysmorphic Disorder

Assessing the Effectiveness of a Short Form Screening Tool (COPs) for Body Dysmorphic Disorder in Cosmetic Surgery Patients: A Study of Pre- and Post-Operative Outcomes.

Recent regulatory changes in Australian cosmetic surgery necessitate preoperative screening for body dysmorphic disorder (BDD). This study, which focuses on patient outcomes, evaluates the COPs tool's efficacy and examines its implications on patients undergoing cosmetic procedures. A total of 189 patients were included: 78 underwent Medicare-classified "cosmetic" surgeries, and 111 underwent "medically necessary" procedures. Patients completed the COPs assessment pre- and post-operatively, with a score >40 indicating BDD susceptibility. Results show no significant pre- to post-operative change in COPs scores across different surgical procedures (body, breast, facial, and mixed) in both "cosmetic" (p = 0.2-0.4) and "itemised" groups (p = 0.15-0.33). However, overall, there was a marked reduction in COPs scores post-operatively (p < 0.001), indicating improved self-perception. Specifically, 91% of patients initially BDD-prone showed scores < 40 post-operatively. Conversely, 3.8% of initially low-scoring patients developed BDD-prone scores post-operatively. Comparison between cosmetic and itemised groups revealed higher preoperative COPs scores in the itemised group (p = 0.006), though post-operative scores did not differ significantly (p = 0.33). Incidences of post-operative BDD-prone scores or scores < 40 did not differ between groups (p = 0.61). Complication rates and the need for revision surgery were similar between groups. These findings suggest two plausible interpretations: First, preoperative screening with the COPs tool may positively influence self-perception related to BDD among cosmetic surgery patients, potentially serving as a therapeutic adjunct for those at risk. Second, while screening tools are beneficial, they may have limitations in predicting post-operative outcomes related to BDD development. Further research should explore these dynamics to refine screening practices and optimise patient outcomes in cosmetic surgery contexts. Level of Evidence III 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 .

Anesthetic Management of a Child with Frontonasal Encephalocele and Hemifacial Microstomia Syndrome for Repair of Encephalocele and Microstomia Correction

AbstractAnesthetic management of a child with hemifacial microstomia and frontonasal encephalocele can be challenging due to factors such as a difficult airway, associated systemic conditions, young age, and prolonged operating time. Hereby, we outline the intraoperative management of a 3-year-old child undergoing repair of multiple defects requiring multidisciplinary involvement of neurosurgery, plastic surgery, and anesthesia team. In our case, a size 0 mask and hyper-angulated D-blade video laryngoscopy were used to prevent sac compression and facilitate intubation. Blood conservation strategies included tranexamic acid, precise fluid management, and maintenance of normothermia. Extubation was carefully planned, considering blood loss and airway edema, and performed when the child was fully awake, ensuring a stable postoperative period and successful recovery. This report emphasizes the importance of meticulous preoperative assessment, readiness for a challenging airway, efficient management of intraoperative blood loss, and the value of teamwork.

Real-world Referral Pattern of Unplanned Excision in Patients With Soft-tissue Sarcoma: A Multicenter Study Conducted by the Bone and Soft-tissue Tumor Study Group of the Japan Clinical Oncology Group.

Despite the well-publicized clinical outcomes after unplanned excision (UE) and re-excision (re-excision) in patients with soft-tissue sarcoma (STS), there is little information about the real-life referral patterns for UE, such as patient profile, details of procedures, and subsequent management after UE. We aimed to investigate the characteristics of patients with UE who were referred to sarcoma-specific centers. Between May 2022 and June 2023, we registered 97 patients who underwent UE and were referred to sarcoma-specific centers in Japan. We excluded those with well-differentiated liposarcomas and dermatofibrosarcoma protuberances. We investigated the details of UE and additional treatment after UE. There were 49 men and 48 women, with a mean age of 62 years. A broad range of surgeons performed UE; 36 plastic surgeons, 22 orthopedic surgeons, 17 general surgeons, 17 dermatologists, and 5 others. The mean tumor size was 4.1 cm. Local anesthesia was administered to 58 patients. Forty-five patients underwent UE without prior magnetic resonance imaging. Inappropriate transverse skin incisions were performed in 42 patients. Of the 97 patients, 82 underwent re-excision after UE. The mean time between UE and date of initial presentation at the referral hospital was 46 days. The mean interval between UE and re-excision was 96 days. Of the 82 patients, 59 underwent soft-tissue reconstruction after re-excision. A broad range of surgeons performed UE. Continuous education about STS should be considered for all surgeons. UE should be avoided because residual tumors are common, and reconstructive surgery may be necessary.

Oncological and Surgical Outcomes of Oncoplastic Reduction Mammoplasty: A Single-centre Retrospective Study.

Breast-conserving surgery is the preferred treatment for early-stage breast cancer but can often result in unsatisfactory cosmetic outcomes. Oncoplastic surgery aims to improve both oncologic and aesthetic outcomes by combining local excision with plastic surgery techniques. Using breast reduction techniques in breast cancer treatment has been shown to allow for wider margins of excision, leading to enhanced oncological safety and reduced recurrence rates without causing significant asymmetry. This study aimed to analyze the surgical and oncological outcomes of a large cohort of patients undergoing oncoplastic reduction mammoplasty (ORM). A retrospective analysis of postoperative surgical and oncological outcomes of all patients who underwent ORM at a single center between January 2018 and December 2023 was performed. Preoperative patient characteristics, operative and post-operative outcomes were recorded and analyzed. A total of 67 patients that underwent oncologic breast reduction were included in the final analysis - representing a total of 71 ORM, with a mean (SD) age of 53.1 (10.5) years and a mean (SD) BMI of 28.8 (5.9) kg/m2 A superomedial pedicle-based technique was the most frequently used (36.6%), followed by inferior pedicle-based technique (28.1%). A complication rate of 18.3% on the ipsilateral side was observed. Salvage surgery was necessary in five cases (7.0%) due to positive margins - with one patient (1.4%) requiring margin expansion surgery and four (5.6%) a completion mastectomy. This monocentric retrospective study shows that ORM is safe, with a complication rate on par with conventional breast reduction and offers satisfactory oncological outcomes.

Challenging frontiers in neuroplastic cranial reconstruction: addressing neurosurgical wound healing complications through interdisciplinary collaboration – an observational study

Background and objectivesAlthough rare, complications like skin dehiscence and necrosis after neurosurgery pose significant challenges by increasing the risk of infections spreading to the epidural, subdural, or intracerebral spaces. This retrospective, single-center study aims to assess the prior clinical courses, neuroplastic repair, and outcomes of patients with skin defects following cranial neurosurgical procedures, and to outline our interdisciplinary reconstructive protocol.MethodsA retrospective analysis was performed on cranial surgeries conducted at the Department of Neurosurgery, spanning from 2017 to 2023. Patients with skin defects requiring the combined expertise of neurosurgery and plastic surgery for effective treatment were included. The sizes of the skin defects were measured using intraoperative photographs analyzed with the freeware ImageJ software, version 2018. All patients provided informed consent for the surgeries. If informed consent was not possible due to neurological deterioration, consent was sought from adult representatives or next of kin except for acute circumstances. All patients admitted to our hospital agree to the pseudonymized use of their medical data and tissue specimens for research purposes in their treatment contract.ResultsA cohort of 24 patients experiencing wound healing complications after neurosurgical procedures underwent a total of 29 interdisciplinary surgeries for the reconstruction of skin, dural, and bone defects. After the neuroplastic surgery, 8 out of 24 patients (33.3%) developed surgical complications, with 6 of these requiring revision surgeries due to persistent cranial infection. In all cases, permanent wound closure was successfully achieved following adherence to the proposed treatment algorithm.ConclusionsOur study underscores the necessity of an integrated neurosurgical and plastic surgical approach to effectively manage wound healing complications in a single stage surgery. Key interventions include differentiation between necrosis and gaping lesions, alongside precise management of neurosurgical issues like cerebrospinal fluid fistulas and hydrocephalus. Plastic surgical expertise in assessing the possibilities and limitations of both local and free flap surgeries is essential.

Exploring the Plastic Surgery Related Experiences, Needs, Confidence and Knowledge Gaps of Foundation Year Doctors

Plastic surgery is a diverse speciality relevant to non-plastic doctors, as plastic surgeons frequently collaborate with other specialities and its basic principles are transferable across multiple specialities. Foundation-year (FY) doctors are the most junior doctors in the workforce and may need to apply plastic surgery knowledge and principles during their clinical duties. Despite this, formal plastic surgery education for junior doctors is limited, resulting in an educational gap. This study gains insight into the perceived confidence, knowledge gaps, skills, educational activities and needs related to plastic surgery. This qualitative study uses phenomenology through semi-structured individual interviews with eight FY doctors. Data was analysed using reflexive thematic analysis. This study revealed that plastic surgery features diversely in the work life of FYs, who often manage patients with a lack of knowledge and confidence, influencing patient care and FY wellbeing. FYs primarily acquire knowledge and confidence through experiential learning and individual initiative. A need for curriculum improvements was expressed. FYs are an essential part of the workforce who exhibited educational gaps and a lack of confidence in plastic surgery knowledge. We suggest improved integration of plastic surgery into the FY curriculum for improved FY knowledge and patient care.

Clinical Practice Patterns and Evidence-Based Medicine in Blepharoplasty: A 15-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery.

The American Board of Plastic Surgery (ABPS) Continuous Certification tracer data on blepharoplasty offers valuable information on national trends in clinical practice. The present study was performed to analyze evolving trends in blepharoplasty and compare practice patterns to Evidence-Based Medicine (EBM) publications within the same timeframe. Tracer data for blepharoplasty procedures performed by ABPS-certified surgeons between 2005 and 2020 was analyzed. Data between two timeframes, 2005-2014 (early cohort, EC) and 2015-2020 (recent cohort, RC), were compared to identify evolving trends in blepharoplasty over time. Results were then compared to EBM-based publications. Of 3,050 blepharoplasties (1,510 EC; 1,540 RC), 82% were performed in female patients and the average age was 56 years. Blepharoplasty was most frequently performed in an ambulatory setting (56%) compared to in hospital (25%); significantly more cases are being performed in the office (p< 0.001) in the RC compared to the EC. Mean surgical duration has decreased by 13 minutes (p< 0.001), and fewer surgeries are being performed with concomitant procedures (p< 0.001). Fewer surgeons use antibiotics (p< 0.001), and fewer surgeons use DVT prophylaxis in the form of sequential compression devices after anesthesia (p< 0.001). More skin resections were performed for upper blepharoplasties (p=0.016), while fewer cases of lower lid blepharoplasty involved either skin-muscle flaps (p=0.038) or transcutaneous fat removal (p=0.004). Most surgeons did not perform canthal tightening during their blepharoplasty (82%). A review of over 15-years of ABPS blepharoplasty tracer data allows surgeons to compare their practice with national trends and EBM. The tracer data illustrates a shift in technique towards shorter and simpler procedures in the office setting.

OS IMPACTOS DO TAPING NO PÓS-OPERATORIO EM ABDOMINOPLASTIA E LIPOASPIRAÇÃO: REVISÃO INTEGRATIVA

With a progressive increase in the number of plastic surgeries, the role of physiotherapy has been evolving exponentially. With this, it highlights the importance of using specific procedures in the postoperative period in order to reduce possible complications and reactions from surgery such as edema, seroma, fibrosis, hematoma, pain, scarring and tissue adhesions. The main objective of physiotherapeutic treatment in the preoperative period of plastic surgery is to avoid or reduce complications such as the incidence of scars, adhesions, edema, hematomas and pulmonary complications. The present study is an integrative literature review, carried out through an electronic search of the Medical Literature Analysis System (PudMed) Scientific Electronic Library Online (Scielo) database. This study can conclude with this study that the use of lymphatic taping in the postoperative period of abdominoplasty and liposuction is effective in reducing edema, preventing bruising and reducing the patient's pain, due to its action on the lymphatic system, thus having fewer complications. and complications.

Northeastern Society of Plastic Surgeons Craniomaxillofacial Abstracts Presented at the 41st Annual Meeting

Northeastern Society of Plastic Surgeons Craniomaxillofacial Abstracts Presented at the 41st Annual Meeting

A Bibliometric Analysis of the Articles Published in the Aesthetic Plastic Surgery Journal (1976-2023).

Despite the important role of the Aesthetic Plastic Surgery (APS) journal in the field of aesthetic plastic surgery, there is a notable absence of literature that focuses exclusively on the bibliometric analysis of this journal. In recognition of APS's 48 years of publishing, this study aims to perform a bibliometric analysis of the articles published in the APS (1976-2023). Articles published in the APS were extracted from the Web of Science Core Collection database. VOSviewer was employed to perform bibliometric analyses. Microsoft Excel was utilized to analyse the publication and citation trends. From 1976 to 2023, 5134 articles were published in the APS. These articles were contributed by 12,963 researchers from 3354 institutions across 91 countries. The USA and China were the leading contributors. The most prolific author is Luan Jie from China. The co-citation networks highlighted the influence of the journal Plastic and Reconstructive Surgery. We categorized the articles into four groups, and the results show that articles with the highest publications and citations in the APS are related to facial cosmetic surgery. In terms of specific surgical procedures, breast augmentation surgery has garnered consistent attention from researchers over the past 48 years, ranking first in both the number of publications and citations. The findings of this study indicate that the APS is a significant scientific journal, is widely utilized by global researchers in the field of aesthetic plastic surgery, and spans diverse knowledge domains. 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 .