Significant Aesthetic Improvement Research Articles

Improvement in Temple Hollowing with VYC-20L Hyaluronic Acid Filler: A Multicenter, Randomized Controlled Trial of Safety and Effectiveness.

Temple hollowing is characterized by the reduction of volume in the temporal fossa, which can result in a skeletonized look and contribute to an aged appearance. This study aimed to evaluate the safety and effectiveness of the VYC-20L injectable gel for improvement of temple hollowing. Adults with minimal, moderate, or severe temple hollows were randomized 2:1 to receive VYC-20L or no treatment. Participants were followed for 13 months for safety and effectiveness assessments. Treatment effectiveness was assessed by blinded evaluating investigators using the validated Allergan Temple Hollowing Scale (ATHS) and the Global Aesthetic Improvement Scale (GAIS), and by participants using GAIS, FACE-Q scales, and patient satisfaction questionnaires. Adverse events and injection site responses (ISRs) were monitored. At Month 3, 80.4% of the treatment group vs 13.5% of the untreated control group achieved a ≥1-grade improvement in both temples on the ATHS (P < 0.0001). The ATHS responder rate remained high throughout Month 13. The GAIS responder rates at Month 3 (responses of Improved or Much improved) were high in the treatment group, as assessed by the blinded evaluating investigator (83.8%) and participants (92.9%). Furthermore, satisfaction with Facial Appearance and Temples on the FACE-Q questionnaires increased significantly from baseline (both P < 0.0001). Adverse events and ISRs were mostly mild and consistent with the known safety profile of fillers. VYC-20L treatment showed favorable safety and effectiveness results in restoring temple volume, with significant aesthetic improvement and high participant satisfaction. Treatment effects lasted for over a year.

Orthodontic treatment for preserving periodontally hopeless teeth in a middle-aged patient: a case report.

In this case report, we show a strategic approach to prolonging the lifespan of pathologically migrated maxillary canines with a hopeless prognosis in a 57-year-old female patient, highlighting the potential of orthodontic management for middle-aged patients to enhance both occlusion and facial esthetics while minimizing the need for extensive prosthetic treatment. According to the visual treatment objective, the nonextraction treatment plan showed advantages in the type of orthodontic tooth movement and final occlusal relationship. Therefore, considering the favorable periodontal treatment results and single-root teeth, the hopelessly migrated maxillary canines were relocated, eliminating the existing trauma from occlusion. Segmental tooth movement was performed, and orthodontic temporary skeletal anchorage devices were used to support strategic orthodontic tooth movement. After 27 months of treatment, proper occlusion was established with a significant improvement in facial esthetics. The periodontally compromised teeth were preserved with adequate periodontal support. The patient expressed satisfaction with the results, and the 30-month follow-up records confirmed the stability of treatment outcomes.

Intradermal Incobotulinum Toxin A for Postbreast Cancer Treatment Asymmetry: A Literature Review and Case Report.

Botulinum toxin (BTX) is globally the most common aesthetic procedure. Its usage has expanded beyond facial treatments to therapeutic areas, including managing scars and postsurgical deformities. Breast cancer survivors often face significant deformities and asymmetry during recovery. This study systematically reviewed literature from the past 4 years on botulinum toxin applications in breast cancer survivors and presented a case report of a patient treated with Incobotulinum toxin (IncoBonTA; Xeomin, Merz Pharmaceuticals GmbH, Frankfurt, Germany) for left breast deformity postchemotherapy and radiotherapy. Following PRISMA guidelines, a systematic search was conducted on PubMed and Scopus using keywords: "botulinum toxin," "breast cancer," and "breast asymmetry," identifying relevant literature from 2020 to 2024. Five full-text articles were included. Additionally, a 2024 case report of a patient with significant breast asymmetry postsurgery and radiotherapy was published. The literature review indicated botulinum toxin's primary uses in breast cancer include pain management, upper limb impairment, postsurgical scars, and capsular contracture. Although some benefits were reported, further research is needed. In the case report, the patient was treated in one session with IncoBonTA at two different dilutions based on contracture severity without complications. The review showed promising advances in using botulinum toxin for deformities secondary to oncological treatment in breast cancer patients. The therapy was administered to a 53-year-old patient, resulting in significant aesthetic improvement, especially at the nipple and areola, suggesting that it was a viable option for these patients.

Fat graft for facial contouring in patients with post-surgical and post- traumatic defects: A case series study

Background and objective: Facial deformities provide a considerable challenge for both the patient and the facial reconstructive surgeon. They can be caused by congenital, traumatic, and oncological ablative surgery. The aim of the study is to evaluate the reliability of autologous fat grafting in residual facial deformities. Methods: This is a case series study of 10 patients with secondary facial defects induced by trauma, parotidectomy and orthognathic surgery. The patients were more than18 yeas old age and of both sexes. The study was conducted at Sulaimani Teaching Hospital from May to December 2021. The defects were grafted with autologous fat grafts harvested from the abdomen and suprapubic region using two techniques, en-bloc and structural fat grafting (minimum 10 cc to maximum 35 cc). Result: Mean graft volume (20.8 cc) Revision was required for 10% of patients. Mean satisfaction score (8.3). Patient’s satisfaction score increased with graft volume p-value &lt;0.01. No major complications were reported. Conclusion: Autologous fat graft is a reliable and cost-effective method for correcting mild to moderate facial soft tissue and hard tissue asymmetry, resulting in a significant improvement in the patients' facial esthetics and psychology.

EXPLORING THE INTEGRATION OF TRADITIONAL BATIK TECHNIQUES AND NANOTECHNOLOGIES IN CONTEMPORARY JEWELRY: PERSPECTIVES, INNOVATIONS

Purpose: The study explores the integration of traditional batik techniques into contemporary jewelry design, aiming to create innovative pieces that blend tradition with modernity. It aims to develop new techniques and materials, improve the accessibility and durability of batik jewelry, and promote cultural heritage. The research focuses on the application of technological innovations such as digital printing, nanotechnology, LED integration, augmented reality, and 3D printing to revolutionize jewelry design and bring significant aesthetic and functional improvements. Methodology. Various research methods are presented for studying the integration of batik into contemporary fashion accessories. These methods include historical research analyzing the tradition of batik and its evolution in the context of contemporary jewelry. Typological research classifies types of jewelry that incorporate batik elements and those that imitate batik. The author examines the design and techniques used in jewelry, including the combination of tradition and innovation through formal-stylistic analysis. The analysis of cultural and ethnic influences is also present, studying how batik reflects and promotes cultural heritage, adding a touch of authenticity and originality. Finally, the technological research method investigates technological innovations such as nanotechnology and 3D printing and their impact on jewelry design. Results. The study reveals multiple ways of integrating batik into contemporary jewelry, including batik inlays, elements that imitate batik, and the incorporation of batik fabrics into designs. A classification of types of jewelry with batik elements is provided, along with examples and possibilities for creative exploration. Different types of elements that imitate batik are also identified and categorized based on material and technique. Technological innovations such as digital printing, nanotechnology, LED integration, augmented reality, and 3D printing offer new possibilities for creating batik jewelry. Examples include using nanotechnology for fabric protection, LED integration for illuminated elements, and 3D printing for complex jewelry elements. The study discusses the advantages and disadvantages of these innovations, highlighting their potential to revolutionize contemporary jewelry design and improve its durability, aesthetics, and functionality. Additionally, combining nanotechnologies with batik in jewelry design opens opportunities for innovations such as smart jewelry with nanosensors, composite materials for durability, and enhanced dyeing processes for vibrant, fade-resistant colors. The discussions emphasize the importance of combining tradition with innovation in contemporary jewelry design and address the prospects and challenges of using batik and nanotechnologies in this field. Scientific novelty. The study demonstrates how integrating traditional batik techniques into contemporary jewelry design, combined with technological innovations such as nanotechnology, 3D printing, and augmented reality, can enhance the durability, aesthetics, and functionality of these jewelry pieces, thus opening new horizons in jewelry design. Practical significance. The practical novelty of this study lies in proposing concrete and applicable solutions for developing contemporary jewelry that integrates batik and nanotechnologies. By presenting specific examples of jewelry, the study provides inspiration and practical guidance for designers and manufacturers in the jewelry industry.

Corporal Filler HD, a Minimally Invasive Technique for Male Body Contouring: A Pilot Study.

The perception of body image is highly influenced by culture and society. Lean, more muscular, and strong bodies are usually pursued by men. Body aesthetics procedures have become popular, and minimally invasive procedures have been used to achieve body image satisfaction. This article describes a technique that utilizes hyaluronic acid filler to enhance muscular contours in the abdominal and pectoral regions. The procedure involves injecting hyaluronic acid filler at a level anterior to the pectoralis major and rectus abdominis muscles through marked entry points, creating an illusion of light and shadow that accentuates muscle definition. Additionally, the iliac region can be addressed to enhance the oblique muscles. The results are illustrated with pre- and postprocedure images, demonstrating a significant aesthetic improvement, high patient satisfaction, and absence of serious adverse events. This minimally invasive technique is suitable for patients with a low body fat percentage and a desire to enhance muscle definition, providing immediate results with no downtime. Although the scientific literature on filler applications in the thoracoabdominal region is limited, this study demonstrates that precision in minimally invasive procedures can yield highly satisfactory outcomes.

Comparative study of microneedling monotherapy versus microneedling with autologous platelet-rich plasma for the treatment of stretch marks (striae distensae) and post-surgical scars: Clinical and dermoscopy outcomes.

Stretch marks and post-surgical scar marks may have negative cosmetic and psychological impacts.. Thus, this study aimed to compare the efficacy and safety of microneedling monotherapy versus microneedling in combination with autologous platelet-rich plasma (PRP) for the treatment of stretch marks and post-surgical scars. This was a prospective randomized non-controlled study. A total of 30 study participants with stretch marks and post-surgery scars were enrolled and randomly divided into two groups, each with 15 study participants. All received three treatment sessions using microneedling monotherapy (Group A) or autologous PRP with microneedling (Group B) at 4-week intervals. Clinical response to treatment was assessed at the end of 20 weeks by comparing clinical photographs, Manchester Scar scale (MSS) score, dermoscopy images, and patient satisfaction scores. At the end of the study, statistically significant esthetic improvement in terms of MSS scores was seen in Group B when compared to Group A. In Group A, 73.3% of the study participants were satisfied while in Group B, 86.6% were very satisfied with the results. Dermoscopy pictures substantiated the findings of clinical improvement. No major side effects were documented. PRP in combination with microneedling has a better outcome as compared to microneedling monotherapy. Furthermore, dermoscopy is a non-invasive tool that can be used to evaluate therapeutic response.

The role of orthodontics in the prevention and management of gingival recession

Careful management of orthodontic patients presenting with thin periodontal phenotype is paramount. Combined orthodontic-periodontal input is helpful both in terms of diagnosis and stabilisation but also to coordinate care. Well-executed orthodontics offers the potential to safeguard periodontal health but also to induce significant aesthetic improvement either in isolation or combined with increasingly predictable muco-gingival procedures.

The Lateral Wall of the Inferior Meatus as a New Graft Source for Rhinoplasty: Radiological Study and Surgical Technique.

Generally, revision rhinoplasty cases require the use of stiff grafts to restore the lost support. However, the majority of patients indicated for revision surgery present with a lack of a bony cartilaginous framework of the septum, especially after previous septoplasty. Thus, surgeons are compelled to harvest costal cartilage. At the same time, rib graft harvesting is associated with additional trauma and a risk of serious complications. Being ENT surgeons, we often resect a part of the lateral wall of the inferior nasal meatus during the extended endoscopic approach to the maxillary sinus. We supposed that this bone plate could be used as a donor site for rhinoplasty graft harvesting. The aim of our study was a radiological assessment of the feasibility and limits of using the inferior meatus lateral wall (IMLW) as a donor site for rhinoplasty bone graft.A retrospective evaluation of 100 CT scans of sinuses was conducted. Further measurements of the IMLW were performed: average length and width (28.06 ± 4.03 mm and 19.73 ± 3.08 mm, respectively), thickness (0.62 ± 0.21 mm), and average deviation from the sagittal plane (17.7 ± 9.53 degrees). According to the obtained measurements, the described donor site is appropriate for harvesting nice straight bony fragments.The IMLW bone graft was used in four revision rhinoplasty cases. There were no postoperative complications. During the long-term follow-up, patients reported significant improvement in aesthetics, function, and social aspects according to Rhinoplasty Outcome Evaluation. Thus, the described technique is an easy and safe method for bone harvesting for revision rhinoplasty. Our first experience demonstrated the convenience and stability of IMLW grafts for revision rhinoplasty during the follow-up period of up to 2 years.

Application of Free Flaps in Reconstruction of Head and Neck Soft Tissue Defects With Bone Exposure.

Reconstruction of head and neck soft tissue defects with bone exposure is both challenging and technically demanding for plastic surgeon. Objectives in head and neck soft tissue defects with bone exposure reconstruction are consistent restoration of functionality while also improving appearance. This study retrospectively analyzed the results of head and neck reconstructions using various types of free flaps over the past 4 years. A retrospective analysis was conducted from June 2019 to June 2023 on 12 patients treated at our hospital for head and neck soft tissue defects with bone exposure due to various causes. These included 4 cases of trauma from car accidents, 1 burn case, and 7 postoperative malignant tumor removals. The defect sizes ranged from 4 × 6 to 15 × 45 cm. Different free flaps were used for repair based on the defect, including 6 anterolateral thigh flaps, 3 forearm flaps, 2 latissimus dorsi flaps, and 1 dorsalis pedis flap. Flaps were designed and harvested to match the defect size and transplanted via anastomosed vessels. All 12 flaps survived successfully. One patient required flap thinning surgery postoperatively. All patients were followed up for over 3 months, showing good color and texture of the transplanted flaps, satisfactory healing, and significant aesthetic improvement. Donor sites showed significant scarring without functional impairment. Free flap repair for head and neck soft tissue defects with bone exposure is feasible and yields good results.

A Case Study on Orthodontic-Surgical Management of Skeletal Class III Malocclusion in Adults: Clinical Approach and Outcomes

This article presents a case study illustrating the successful management of skeletal Class III malocclusion in an adult through an orthodontic-surgical approach. The clinical case outlines the entire process, from initial assessment to post-treatment outcomes, conducted within our service. Key steps include diagnostic planning using advanced tools such as 3D imaging and virtual surgery simulation. Pre-surgical orthodontic treatment was carefully planned to prepare dental and skeletal structures for surgical correction. Orthognathic surgery was performed precisely according to the established plan, followed by a post-surgical orthodontic phase to finalize occlusion. Short-term and long-term outcomes are evaluated, highlighting significant improvement in facial aesthetics, occlusal function, and post-treatment stability. This case study demonstrates the effectiveness of our integrated approach in managing skeletal Class III malocclusions in adults, underscoring the importance of interdisciplinary collaboration for optimal outcomes

Nonsurgical synergistic full-arch vertical intrusion treatment of bimaxillary protruded hyperdivergent skeletal Class II malocclusion using aligners.

A bone-borne full-arch vertical control strategy using miniscrews was deployed with aligners to treat a case of skeletal hyperdivergent Class II malocclusion with bimaxillary protrusion. Miniscrews were inserted in the posterior buccal and palatal regions and the anterior buccal region of the maxilla to distribute vertical intrusive force through the upper arch by anchoring vertical elastics from the miniscrews to the aligners. Synergetic lower anterior intrusion was completed using bilateral posterior miniscrews to counteract the extrusive force generated. Substantial full upper arch and lower anterior vertical intrusion was achieved. In conjunction with en masse anterior-posterior retraction, synergetic posterior and anterior vertical intrusion facilitated counterclockwise rotation of the mandible, creating significant esthetic improvement. Anterior vertical elastics also provided flaring of the anterior teeth, reducing the side effect of lingual tipping from en masse retraction, while successfully controlling overbite and incisor torque during space closure. The bone-borne full-arch vertical intrusion strategy can work well with aligners to address hyperdivergent skeletal Class II malocclusion with bimaxillary protrusion.

Treatment of Atrophic Acne Scarring with Fractional Microplasma Radiofrequency: A Multicentric Experience

BackgroundAtrophic scarring is a severe form-disfiguring sequela of acne, which can lead to negative effect on patients’ life. Fractional microplasma radiofrequency (RF) has emerged as a promising modality, leveraging dermal fibroblast remodeling to enhance aesthetic results for scars and hyperpigmentation. This study evaluates the efficacy and safety of high-power fractional microplasma RF for atrophic acne scars, considering patient tolerance to procedural discomfort. MethodsIn this prospective study, 95 Chinese patients with atrophic facial acne scars underwent three sessions of fractional microplasma RF treatment, with assessments at 1, 3, and 6 months post-treatment. Patients were categorized based on treatment power: Group A (50-70 W) and Group B (70-85 W). Efficacy was determined by three independent dermatologists using digital photographs and Echelle d'Evaluation Clinique des Cicatrices d'Acné (ECCA) scores, and patient-reported outcomes gauged satisfaction levels. ResultsEighty-six patients completed the study. Significant improvements were observed, with a reduction in ECCA scores from 107.21 to 42.27 (P<0.05), demonstrating notable scar amelioration across both groups, albeit with a superior outcome in Group B. All patients experienced transient side effects such as pain, erythema, and edema, deemed tolerable with no long-term adverse effects reported. The treatment was well-received, with high satisfaction rates, underscoring its efficacy and acceptable safety profile. ConclusionFractional microplasma RF therapy, particularly at higher power settings, is an effective and safe option for treating atrophic acne scars, offering significant aesthetic improvement with manageable discomfort. This modality presents a valuable addition to acne scar management strategies, especially for patients with darker skin tones seeking minimal downtime and reduced risk of hyperpigmentation.

Combined Double-breasted Full-thickness Abdominal Flap Plication and Acellular Dermal Matrix in Prune-belly Syndrome Reconstruction.

Reconstruction of the abdominal wall in patients with prune-belly syndrome (PBS) following previous intra-abdominal procedures is a challenging problem with a high incidence of revision due to persistent bulging or herniation. The abdominal wall flaccidity not only produces a severe psychological and aesthetic discomfort for the patient but often determines functional disabilities, including inability to cough properly, impaired bowel and bladder function, and delay in posture and balance. The authors describe three cases of reconstruction of abdominal wall using a modified double-breasted abdominoplasty fascial plication with additional acellular dermal matrix interposition and review the literature for innovations in the use of abdominal repair for reconstruction of these difficult cases. Three children with PBS at a mean age of 7.3 years achieved successful reconstruction of the abdominal wall, using the modified double-breasted abdominoplasty fascial plication with acellular dermal matrix interposition. Patients underwent previous procedures, including orchiopexy in two patients and bilateral nephrectomy in one patient. No postoperative complications have been found, apart from superficial skin dehiscence along the abdominal incision treated conservatively in one child. At mean follow-up of 42 months (range 28-56 months), no patient presented incisional hernia, persistent or recurrent fascial laxity with abdominal bulging. All patients achieved significant aesthetic and functional improvements, including children's ability to cough, spontaneous gain of abdominal tonus, balance, and ambulation. Modification of the original vertical, two-layer plications of the deficient abdominal interposing biological mesh has the purpose of improving strength, aesthetics, and function of the abdominal wall in pediatric patients with PBS.

A minimally invasive approach to smile enhancement

An 18-year-old male patient presented with generalised hypoplasia affecting the appearance of his maxillary anterior teeth. Aiming to keep any restorative intervention as minimally invasive as possible, a combination of tooth whitening, particle abrasion, resin infiltration and direct composite masking were used in this case to deliver significant aesthetic improvement. CPD/Clinical Relevance: This article explores minimally invasive approaches to restorative dental procedures and provides an understanding of the motivations for these approaches, the considerations for treatment planning and the impacts on treatment outcomes for patients.

Assessment of Patient Satisfaction and Functional Outcomes in Orthognathic Surgery.

Orthognathic surgery is a surgical procedure performed to correct severe jaw misalignments that can affect a patient's facial aesthetics and functional occlusion. While the primary goal of orthognathic surgery is to improve functional outcomes and facial appearance, it is essential to assess patient satisfaction as a crucial aspect of overall treatment success. Patient selection: We conducted a prospective study involving 50 patients who underwent orthognathic surgery. All patients had a confirmed diagnosis of severe jaw misalignment, as determined by clinical and radiographic assessments. The surgical procedures performed included maxillary advancement, mandibular setback, or a combination of both, depending on the patient's specific diagnosis. Preoperative orthodontic treatment was provided to align the teeth and prepare the patient for surgery. Patients were evaluated preoperatively and at postoperative intervals of 3 months, 6 months, and 1 year. Patient satisfaction scores and functional outcomes were as follows: aesthetics of facial profile (1-year post-op): mean score = 4.6, chewing function (1-year post-op): mean score = 4.4, speech function (1-year post-op): mean score = 4.3, and overall satisfaction with surgical outcome (1-year post-op): mean score = 4.5. Objective assessments revealed a significant improvement in occlusion and facial aesthetics. The mean reduction in overjet was 4.8 mm, and the mean reduction in overbite was 3.2 mm. Additionally, the mean postoperative ANB angle improved by 3.7°, indicating a better facial balance. Orthognathic surgery in our cohort of 50 patients resulted in high levels of patient satisfaction with both functional outcomes and facial aesthetics. Objective measurements also indicated significant improvements in occlusion and facial balance.

A Novel Chin-Reductive Drawer Genioplasty Using Subapical and Mandibular Contouring Ostectomy.

As the most prominent feature of the lower face, the chin is crucial to human facial morphology, and plays a large role in contributing to facial attractiveness and harmony. Although an increasing number of genioplasty procedures are being introduced for chin augmentation, chin reduction procedures are rarely performed. Because of the inevitable cervicomental angle widening and relaxation of the floor-of-mouth muscles caused by chin shortening and the elevation of the lower edge of the mandible, chin reduction remains a challenging procedure. The authors' novel drawer-genioplasty approach involves a flexible chin-reducing procedure using subapical and mandibular contouring ostectomy. This technique can effectively shorten various types of long chin for improved facial proportions and maximize floor-of-mouth muscle protection during surgery, thereby avoiding postoperative submental sagging. Several measures, including the ratio between the lower (subnasale to menton distance) and middle facial heights (glabella to subnasale distance) (R1), the ratio between the anterior midline bone heights of the mandible (stomion to menton distance) and maxilla (subnasale to stomion distance) (R2), and the cervicomental angle, were used to evaluate the outcome of the procedure. Comparing the preoperative and postoperative measures revealed that there was a significant decrease in both R1 (1.25 ± 0.15 versus 1.09 ± 0.12) and R2 (1.94 ± 0.24 versus 1.58 ± 0.11). Although cervicomental angle increased from 107.3 ± 8.2 degrees preoperatively to 112.4 ± 7.0 degrees postoperatively, this value was still within the normal range. In addition to providing effective and significant aesthetic improvements, drawer genioplasty is safe and involves no complications. Therapeutic, IV.

Radiofrequency therapy as an effective treatment for granulomatous cheilitis: A CARE case report

IntroductionGranulomatous cheilitis is a rare disorder characterized by recurrent, idiopathic, and painless lip swelling. The diagnosis is proven by histopathological examination. The unknown aetiology and poorly understood underlying mechanism contribute to the difficulty in establishing an effective treatment. This case study proposes the effectiveness of radiofrequency therapy in the management of refractory granulomatous cheilitis. Case summaryA 68-year-old patient presented with hypertrophy and swelling of the lower lip, and a biopsy revealed actinic cheilitis. The patient underwent lip shaving and an advancement mucosal flap, and definitive histologic examination confirmed the diagnosis of granulomatous cheilitis. No other signs of orofacial granulomatosis were observed, and the complementary aetiological study was negative for systemic disease. The lip swelling reappeared and persisted, which interfered with the quality of life. Hence, radiofrequency therapy was performed in the submucosal and subdermal layers of the lip, resulting in significant aesthetic and functional improvement and no further relapses after five years. DiscussionThe management of granulomatous cheilitis is challenging. The current mainstay treatment is corticotherapy or reduction cheiloplasty in severe cases. Radiofrequency has potential as a treatment option in debilitating macrocheilia, presenting worthy long-lasting functional and aesthetical results, with minimal morbidity.

Patient-Specific Implants for Correction of Midfacial Aging.

The nasolabial folds (NLFs) may be shallowed with the use of nostril base augmentation. This study aimed to design and customize patient-specific implants (PSIs) with computer-aided design/computer-aided manufacturing (CAD/CAM) to correct NLF deepening caused by midfacial aging. The patient's head computed tomography data obtained and were used for reconstruction. The PSIs were customized by CAD/CAM techniques, which were implanted into a nasal base for shallow NLFs caused by midfacial aging. Preoperative and postoperative photos and a wrinkle severity rating scale were used to evaluate the changes in NLFs. Also, the global esthetic improvement scale was used to investigate the surgical satisfaction of patients. Eleven patients (22 NLFs) received PSIs in the nasal base (22 implants). The customized PSI matched well with premaxilla, reducing the difficulty of operation. After 3 to 12 months of follow-up, PSI was stable without foreign body reaction or inflammatory reaction. Postoperative wrinkle severity rating scale scores showed that NLF severity was reduced in all patients, with a significant esthetic improvement compared with preoperatively ( P < 0.01). The global esthetic improvement scale showed an extremely satisfied improved NLF in 27.27% of patients, much improved in 63.63%, and improved in 9.90% (2/22), and none reported change or poor NLF. Patient satisfaction with their midface appearance differed significantly before and after surgery ( P < 0.01). Individualized PSI designed with high precision and matching degree by CAD and prepared using CAM could be applied to overcome the limitations of noncustomized implants.

Breast Explantation With Simultaneous Mastopexy and Volume Restoration: An Analysis of Clinical Outcomes and Prospective Quality of Life.

An increasing number of patients are undergoing explantation to alleviate symptoms attributed to the presence of a prothesis or dissatisfaction with the appearance of their breasts. The authors aim to evaluate the clinical effectiveness and quality of life (QoL) of simultaneous explantation, capsulectomy, and mastopexy for patients requesting implant removal. Two hundred sixty-two simultaneous explantation, capsulectomy, and mastopexy (ECM) procedures were performed in 131 patients from 2009 to 2019. Prospective QoL assessment was administered for all patients. Inclusion criteria included a minimum postoperative follow-up of 6 months and completion of a practice-generated patient reported outcomes (PRO) questionnaire. Wilcoxon signed-rank test was performed to compare changes in QoL scores. Mean follow-up and BMI were 23 months (6 months to 8 years) and 24.8 kg/m2 (18-34 kg/m2), respectively. Mean age was 48.3 years (26-75 years). Autologous fat grafting was performed simultaneously in patients 47.3% (n = 62). The complication rate was 3.8% (n = 10 breasts) in 9 patients (6.9%). The overall reoperation rate was 7.3% of procedures (n = 19 breasts) and 9.2% of patients (n = 12), including secondary autologous fat grafting (11.3%, n = 7). PRO results demonstrated a significant improvement in all QoL domains, including physical well-being (P < .005), psychological well-being (P < .005), sexual well-being (P < .005), breast shape (P < .005), and breast appearance (P < .005). With respect to breast implant illness symptoms, 59 patients (88.1%) noted reduced pain, myalgias/arthralgias, and fatigue after ECM. This study presents an effective paradigm to manage implant removal through simultaneous explantation, capsulectomy, and mastopexy with acceptable clinical outcomes and a significant improvement in QoL and breast aesthetics.