Skin Preservation Research Articles

Biophysical and permeability characterization of lyophilized (freeze-dried) human cadaver skin

The in vitro permeation testing (IVPT) of topical products is performed across the human cadaver skin, which is stored frozen for a prolonged duration. The cryo-preservation technique is not economical and is a cumbersome process. Moreover, prolonged skin preservation in a frozen state and frequent freeze-thawing are known to affect the integrity of the skin barrier. Therefore, lyophilization was explored as an alternative to protect the skin tissue from microbial contamination and degeneration. Notably, the project's objective was to investigate the impact of the freeze-drying process on the skin's barrier properties. The morphometrics of the lyophilized skin were measured. Histological studies did not reveal any notable changes in the organization and intactness of the layers due to the freeze-drying process. The biophysical attributes of the skin, such as transepidermal water evaporation rate and transepidermal electrical resistivity (TEER), were not significantly different between the control skin (not subjected to the freeze-drying process) and the freeze-dried skin (FDS). The permeability of caffeine, a hydrophilic model permeant, and nicotine, a lipophilic model permeant, were consistent across the control and the FDS. It is evident from the studies that the lyophilization process did not significantly impact the barrier properties and permeability of the skin.

Treatment of Fournier's gangrene with "firebreak" drainage based on skin preservation

Objective: To observe the clinical efficacy of a new type of "firebreak" drainage with skin preservation in the treatment of Fournier's gangrene. Methods: This technique is suitable for patients with perianal necrotizing fasciitis who can tolerate surgery without large area of skin blackness and necrosis. Procedure and key points: (1) The dividing line between inflammatory tissue and normal tissue was determined according to imaging examination and intraoperative exploration; (2) The abscess cavity was cut along the most obvious part of the abscess fluctuation, with a long diameter of 3~4 cm and a short diameter of 1~2 cm; (3) Necrotic tissue was discreetly separated and removed from the main incision to the outer edge of the infection. A fusiform incision was made every 3 to 5 cm, with a long diameter of 2 to 3 cm and a short diameter of 1 cm, and discreetly separated until the normal tissue, and a hose was hung between the adjacent incisions for drainage. (4) Each adjacent edge cut between the stealth separation and hanging hose drainage, forming a "firebreak"; (5) Rinse the wound repeatedly; (6) If the infection invades the rectum, colostomy is performed as required. The case data of 11 patients with perianal necrotizing fasciitis admitted to the Second Affiliated Hospital of Nanjing University of Chinese Medicine from July 2019 to February 2023 were retrospectively analyzed. All patients were treated with emergency surgical debridement by "firebreak" drainage with skin preservation. Results: All 11 cases were cured with 100%. One case underwent multiple operations. The hospitalization time was 11-46 days, with an average of 22 days. The wound healing time was 28-75 days, with an average of 43 days. Except for 1 patient with trauma, all the other patients had no significant anal function injury after surgery. All the 11 patients recovered and were discharged from hospital with a median follow-up of 136 (115-413) days. Conclusions: The "firebreak" drainage based on skin preservation has the advantages of less trauma and faster recovery, and do not cause obvious anal function damage.

An Eco-Friendly Approach to Preserve Goatskins Using Tamarindus Indica Leaf

Hides and skins, the main raw materials for leather industries, are traditionally preserved with sodium chloride (NaCl). Due to the excessive use of salt (around 40 to 50% w/w) in the curing process, total dissolved solids (TDS), and salinity are produced in large quantities by the soaking effluent during the leather processing. To address the resulting environmental threat from the tanneries and replace traditional curing, plant-based curing is a cutting-edge green technology. In this study, Tamarindus indica leaves were used as a combination of 5% powder + 10% salt and 10% paste + 10% salt to preserve goat skin for 28 days. The organoleptic characteristics, hydrothermal stability, moisture content, nitrogen content, and bacterial load were periodically monitored. After curing, the goatskin was processed into leather, the environmental impact of the wastewater was evaluated, and its physical and fibre strength was assessed. The TDS value, chloride content, biochemical oxygen demand, and chemical oxygen demand were reduced up to 65.62%, 69.38%, 31.08%, and 27.06% respectively. The prepared shoe-upper leather exhibited equivalent physical properties compared to the control. Scanning electron microscopy (SEM) image ensured the conformity of the fibre structure of the experimental leather with control. A significant correlation was seen among the skin preservation efficiency parameters, while the strongest correlation was (r = -0.996, p<0.001) between moisture content and shrinkage temperature. Therefore, T. indica leaves powder as well as paste could be an effective curing agent by reducing the use of salt in leather industries.

Cellular structure of dinosaur scales reveals retention of reptile-type skin during the evolutionary transition to feathers

Fossil feathers have transformed our understanding of integumentary evolution in vertebrates. The evolution of feathers is associated with novel skin ultrastructures, but the fossil record of these changes is poor and thus the critical transition from scaled to feathered skin is poorly understood. Here we shed light on this issue using preserved skin in the non-avian feathered dinosaur Psittacosaurus. Skin in the non-feathered, scaled torso is three-dimensionally replicated in silica and preserves epidermal layers, corneocytes and melanosomes. The morphology of the preserved stratum corneum is consistent with an original composition rich in corneous beta proteins, rather than (alpha-) keratins as in the feathered skin of birds. The stratum corneum is relatively thin in the ventral torso compared to extant quadrupedal reptiles, reflecting a reduced demand for mechanical protection in an elevated bipedal stance. The distribution of the melanosomes in the fossil skin is consistent with melanin-based colouration in extant crocodilians. Collectively, the fossil evidence supports partitioning of skin development in Psittacosaurus: a reptile-type condition in non-feathered regions and an avian-like condition in feathered regions. Retention of reptile-type skin in non-feathered regions would have ensured essential skin functions during the early, experimental stages of feather evolution.

Role of Imaging in Predicting the Deep Surgical Margin in Gingivobuccal Complex Cancers: A Pilot Study.

Cancers arising from the gingivobuccal complex are one of the most common types of cancer in the oral cavity and are associated with poor prognosis. Among the various prognostic factors, positive surgical margin is the most important one that can be controlled by the operating surgeon. The deep surgical margins for buccal mucosa cancers is normally assessed by palpating the skin for induration and skin pinchability. The present study evaluates the role of imaging in assessing the deep surgical margin and its efficacy for skin preservation in buccal mucosa/ gingivobuccal carcinomas. The patients of gingivobuccal complex squamous cell carcinomas after histopathological confirmation were selected for the study. In imaging, the distance between the base of the tumour and skin (epidermis) of the cheek was measured by a senior radiologist preoperatively. The frozen section findings were confirmed by histopathological examination and the depth of invasion of the tumour was measured and the clearance of the deep surgical margin was confirmed. The correlation between imaging, skin pinch test and histopathological examination of the specimen was assessed. The sensitivity and specificity of imaging to predict the skin preservation (deep surgical margin more than 5mm) is 100% and 75% respectively compared to sensitivity and specificity of skin pinch test of 82.6% and 50% respectively. Imaging is an effective tool in predicting the skin preservation and skin excision compared to skin pinch test. Compared to the skin pinch test, imaging appears to be a useful tool for advising surgeons on skin preservation vs excision.

Recovery of subcutaneous orbital fascia under preserved skin below the original crease in the repair of excessively high double-eyelid folds

BackgroundHigh-eyelid fold is a common complication of upper eyelid surgery. This study proposed a novel technique for correcting high-eyelid fold in Asian patients with little eyelid skin and thick orbital fascia to improve cosmetic outcomes and patient satisfaction. MethodsWe retrospectively analysed the clinical data of 38 patients with high-eyelid fold repaired at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from July 2017 to April 2022. All patients were treated using this method of preserving the high-eyelid fold and reconstructing the subcutaneous orbital fascia. Postoperative outcomes were reviewed and analysed using objective measures and subjective surgeon and patient evaluations. ResultsThirty-eight patients (71 eyes) were included. Postoperative follow-up was for 6–25 months. At 6 months postoperatively, the mean anatomic crease height decreased from 10.45 mm to 6.22 mm, mean pretarsal show decreased from 3.20 mm to 1.61 mm, and mean margin reflex distance in 1 of the 31 patients with ptosis increased from 2.93 mm to 3.87 mm (P < 0.001). The compliance rate between the surgeon's assessment and patient satisfaction was 89.5%, with 31 cases considered good by both the surgeon and patient and one case considered poor by both (undercorrected ptosis), though a satisfactory result was achieved after reoperation. Neither recurrence of the original crease nor serious complications were reported. ConclusionBy preserving high-eyelid folds and reconstructing the subcutaneous orbital fascia, unnaturally high- and deep-eyelid folds were converted to lower, nondepressed folds.

Effects of Siegesbeckia herba extract against particulate matter 10 (PM10 ) in skin barrier-disrupted mouse models.

Skin barrier disruption is a significant problem of the older population in an aging society. It is characterized by increased transepidermal water loss and decreased skin water content, and particulate matter (PM) is a social issue that can contribute to the exacerbation of skin inflammation. Thus, addressing this problem is urgent. Skin barrier-disrupted mouse models were induced by two methods using acetone application or tape-stripping. This study investigated the antioxidative and anti-inflammatory properties of the Siegesbeckia herba extract (SHE) on PM-induced changes in skin barrier-disrupted mouse models. To examine changes in skin water content, inflammatory cytokines, and keratinocyte differentiation markers, mouse models were treated with vehicle 100μL, PM10 100μL (100μg/mL), SHE 100μL, or PM10 100μL (100μg/mL) plus SHE 100μL. SHE preserved skin hydration in the skin barrier-disrupted mouse models regardless of the presence of PM10 . SHE also inhibited the upregulation of inflammatory cytokines such as interleukin (IL)-1β, IL-4, IL-6, IL-8, and tumor necrosis factor-α and normalized the downregulation of keratinocyte differentiation markers against PM10 in skin barrier-disrupted mouse models. This study elucidated the therapeutic effects of SHE against PM10 in skin barrier-disrupted mouse models.

Aggregation-induced emission photosensitizer for antibacterial therapy of methicillin-resistant Staphylococcus aureus.

A cationic aggregation-induced emission photosensitizer (AIE-PS) MNNPyBB has been reported to have antibacterial effects against both Gram-positive and Gram-negative bacteria. The bacterial kill mechanism has been investigated and elucidated. In a methicillin-resistant Staphylococcus aureus subcutaneous infection model, wound closure has been achieved with normal re-epithelialization and preserved skin morphology.

Nanoscale Composite Lignin Colloids with Tunable Visible Colors Used for Anti-UV Cosmetics.

Nanoscale composite lignin colloids were prepared on a large scale with a process of assembly-mediated internal cross-linking in a good solvent, thus possessing absolutely nanoscale dimensions, excellent robustness, and less aggregation. The therefore prime UV resistance and various natural visible colors contribute to the preservation and beautification of skin.

Radiation and free flaps: what is the optimal timing?

The debate over when to perform flaps in patients undergoing radiation remains an ongoing dilemma without definitive resolution. Classically, reconstructive surgeons recommended avoiding exposure of autologous flaps to radiotherapy due to concerns over surgical complications and poor aesthetic outcomes. However, delayed reconstruction carries its own risk profile and aesthetic limitations, given the irreversible changes to the breast envelope. Immediate reconstruction not only confers psychosocial benefits but allows for preservation of the native breast skin and footprint. In recent years, a growing body of evidence suggests that with modern radiation techniques, long-term outcomes of immediate vs. delayed autologous reconstruction may be more similar than previously thought. This review examines the advantages and disadvantages of each treatment algorithm and critically evaluates the existing literature on autologous breast reconstruction in the setting of post-mastectomy radiotherapy. Importantly, radiation regimens have varied widely over time and between institutions, introducing significant heterogeneity in published outcomes of flap contracture or fat necrosis after immediate reconstruction. While delayed autologous reconstruction remains a reasonable pathway, the benefits of immediate reconstruction should not be dismissed. Our findings ultimately corroborate the view that immediate flap reconstruction is a sound treatment option that can be safely offered to patients. The decision regarding which pathway to pursue should ultimately be patient-centric and driven by multidisciplinary consensus, rather than by prior dogma.

Formulation And Evaluation Of Herbal Soap

The majority of commercial soaps contain ingredients that may hurt skin. Natural herbal soaps can be a good substitute. In terms of medicine and commerce, herbal products have gained relevance on a global scale, and their use has grown due to their efficacy and safety. The most common skin infections in people are caused by bacteria, necessitating careful attention for treatment, improved skin preservation, and maintenance of healthy, youthful-looking skin. Some herbal plant extracts have properties that are antimicrobial, antibacterial, anti-inflammatory, and so forth. The current study's goal is to create antibacterial poly herbal bath soap using ingredients like Curcuma longa, citrus limon, olea europaea, crocus sativus L., vitellaria paradoxa, cocos nucifera (L.), Prunus amygdalus dulcis, and ricinus communis, among others. Good results were seen when the manufactured Polyherbal soap was tested for several physicochemical parameters like ph and foam retention time. Plants are easily accessible, have positive skin effects, and provide producers with advantages in terms of cost-effectiveness, accessibility, and side effects that are minimal or nonexistent. The purpose of this research is to create an antibacterial poly herbal bath soap using Curcuma longa, Citrus limon, and Olea europaea because some herbal plant extracts have antibacterial qualities. After the polyherbal formulation was created, it was evaluated for pH, moisture content, saponification, foaming index, foam retention duration, ethanol soluble matter, and antibacterial activity using various soap solution concentrations and comparing them to standards. Additionally, the assessment tests revealed that the herbal soap has good antibacterial outcomes.

Surgical treatment of penile foreign body granuloma: Penile shaft reconstruction with single- versus two-stage scrotal flap techniques.

To report outcomes of surgical treatment in patients with penile foreign body granuloma and compare surgical outcomes between single- and two-stage scrotal flap reconstructions. Medical records of patients with penile foreign body granuloma who underwent surgical treatment were reviewed. Patients with single- and two-stage scrotal flap reconstructionswere compared. Forty-two patients underwent surgical treatment from January 1, 2018 to October 31, 2022. Twenty-three patients underwent single-stage reconstruction with bilateral scrotal flap while 12 patients underwent two-stage repair with 19 operations. Five patients underwent circumcision; one had excision with primary closure. Another patient underwent reconstruction by penile skin preservation technique. There was no statistically significant differences between single- and two-stage groups in wound infection (8.69% vs. 0%, RR 2.71, 95%CI; 0.14-52.29), wound dehiscence (21.74% vs. 8.33%, RR 2.61, 95%CI 0.34-19.87), reoperation rate (26.08% vs. 8.33%, RR 3.13, 95%CI; 0.42-23.10). Postoperative fever was significantly higher in single-stage group (56.52 vs. 8.33%, RR 6.78, 95%CI; 1.01-43.83). Total length of hospital stay was shorter in single-stage group (7.43 ± 3.19 days vs. 10.86 ± 1.57 days, MD -3.42, 95%CI; -5.28 to -1.57). Incidence of patients without Clavien-Dindo surgical complications was significantly lower in single-stage group (43.48% vs. 83.33%, RR 0.53, 95%CI; 0.31-0.89). Both single- and two-stage techniquesmay be considered for penile foreign body granuloma reconstruction. Although the hospital stay was longer in two-stage group, the complication rates were lower.

Effects of storage conditions on permeability and electrical impedance properties of the skin barrier

The aim of this study was to investigate the effect of various skin preservation protocols on in vitro drug permeation, epidermal-dermal drug distribution, and electrical impedance properties of skin membranes. Acyclovir (AC) and methyl salicylate (MS) were selected as model drugs due to their different physicochemical properties and skin metabolic profiles. In particular, AC is relatively hydrophilic (logP −1.8) and not expected to be affected by skin metabolism, while MS is relatively lipophilic (logP 2.5) and susceptible to metabolism, being a substrate for esterase residing in skin. Skin from pig ears was used and freshly excised into split-thickness membranes, which were divided and immediately stored at five different storage conditions: a) 4 °C overnight (fresh control), b) 4 °C for 4 days, c) and d) −20 °C for 6 weeks and one year, respectively, and e) −80 °C for 6 weeks. Based on the combined results, general trends are observed showing that fresh skin is associated with lower permeation of both model drugs and higher skin membrane electrical resistance, as compared to the other storage conditions. Interestingly, in the case of fresh skin, significantly lower amounts of MS are detected in the epidermis and dermis compartments, implying higher levels of ester hydrolysis of MS (i.e., higher esterase activity). In line with this, the concentration of salicylic acid (SA) extracted from the dermis is significantly higher for fresh skin, as compared to the other storage conditions. Nevertheless, for all storage conditions, substantial amounts of SA are detected in the receptor medium, as well as in the epidermis and dermis, implying that esterase activity is maintained to some extent in all cases. For AC, which is not expected to be affected by skin metabolism, freeze storage (protocols c-e) is observed to result in higher accumulation of AC in the epidermis, as compared to the case of fresh skin, while the AC concentration in dermis is unaffected. These observations can be rationalized primarily by the observed lower permeability of fresh skin towards this hydrophilic substance. Finally, a strong correlation between AC permeation and electrical skin resistance is shown for individual skin membranes irrespective of storage condition, while the corresponding correlation for MS is inferior. On the other hand, a strong correlation is shown for individual membranes between MS permeation and electrical skin capacitance, while a similar correlation for AC is lower. The observed correlations between drug permeability and electrical impedance open up for standardizing in vitro data for improved analysis and comparisons between permeability results obtained with skin stored at different conditions.

Utilization of phyto-based material for preservation of raw skin: A less salt and cleaner bio-intervention

Utilization of phyto-based material for preservation of raw skin: A less salt and cleaner bio-intervention

Comparison of Tympanoplasty Done with Removal of Posterior Canal Wall Skin versus Tympanoplasty Done with Preservation of Canal Wall Skin

Aims and Objectives: The aim of this study is to compare the outcomes of type 1 tympanoplasty in terms of graft uptake, hearing improvement, operative time, and healing time in patients operated with posterior canal skin preservation or without it. Materials and Methods: This is a prospective study of 100 patients operated for type 1 tympanoplasty surgery at a tertiary care hospital from August 2021 to June 2023 and operated by a single surgeon. Patients were divided into two groups and were randomly allocated (one with posterior canal skin preservation and other without it). Inclusion criteria were all patients operated for tympanoplasty between 12 and 50 years of age. Exclusion criteria were patients with mixed hearing loss or sensorineural hearing loss and patients who had to undergo ossicular chain reconstruction and revision cases were also excluded from the study. The outcomes were evaluated on follow-up by otoendoscopy and pure-tone audiometry. Observation and Discussion: In terms of graft uptake at 3-month postoperative period, no significant difference was found between both the groups. In terms of hearing improvement and healing time, P &gt; 0.1 was noted, and hence the difference was not significant. However, the operative time was significantly lower for the group with posterior canal wall skin removal. Conclusion: Removal of skin from posterior surface of external auditory canal improves visualization during tympanoplasty. It reduces operative time and provides same success rates in terms of graft uptake and hearing improvement. It has almost the same healing time, and granulations or other canal-related complications are minimal. Graft medialization or lateralization is also minimal when anterior tucking and lateral tucking of graft is done.

Effects of Vitrification Techniques on the Formation of Skin Cryobank of the Ocelot (Leopardus Pardalis)

BACKGROUND: Skin cryobanks represent important tools for the conservation of the maximum genetic representation of a population, especially those with a certain degree of threat to extinction, such as the ocelot. A relevant step towards the proper establishment of these banks is the definition of adequate cryopreservation techniques for the conservation of the skin. OBJECTIVE: We evaluated the effects of two different techniques [direct vitrification in cryovials (DVC) and solid-surface vitrification (SSV)] for the preservation of ear skin derived from ocelot. MATERIALS &amp; METHODS: For both techniques, we vitrified the ear skin using Dulbecco's modified Eagle's medium with 3.0 M dimethyl sulfoxide, 0.25 M sucrose, and 10% fetal bovine serum. Non-cryopreserved tissues were used as control (control group). All tissues were analyzed for their morphometric characteristics by conventional histology and morphological/functional analysis by cell ability during the culture. RESULTS: While tissues cryopreserved by DVC showed similar values for dermis thickness and number of perinuclear halos to the control, tissues cryopreserved by SSV showed similarities to the control regarding the number of melanocytes, percentage of collagen fibers, and numbers of viable cells by apoptosis analysis. Additionally, none of the vitrification techniques affected stratum corneum thickness, number of keratinocytes, tissue proliferative activity, cell viability, or metabolism. CONCLUSION: Both vitrification techniques (DVC and SSV) can be used for the conservation of ocelot skin; however, SSV guarantees a higher cellular quality after in vitro tissue culture in most of the parameters evaluated, such as viability, metabolism, and apoptosis analysis.

Ultrasound Measurement of the Distance between the Breast Tumor and the Skin: A Cut-Off Value for Safe Skin Preservation – Diagnostic Accuracy Study

Background: In superficial tumors of the breast, it is necessary to plan the thickness of surgical skin flaps, and whether skin can be preserved for esthetics results. This study aimed to find an ultrasound-measured cut-off distance between tumor and skin (TSD) that allows patients to have the skin over the tumor spared. Methods: This is a diagnostic accuracy study comparing preoperative ultrasound TSD with pathological TSD and the thickness of the skin flaps. We recruited all consecutive women diagnosed with breast cancer between January 2017 and December 2019 whose surgical planning allowed to have the tumor and overlying skin to be removed in bloc (reconstruction procedures, situations where skin removal would not lead to esthetic problems, and superficially located tumors). Measurements were made: preoperatively (by ultrasound), during surgery (using a metal caliper to obtain the thickness of surgical skin flap), and after surgery (pathological). A pathological tumor-skin distance greater than surgical skin flap thickness would indicate preservation of skin above the tumor. Results: We evaluated 95 consecutive patients with 102 lesions. The average surgical flap thickness was 5.5 mm (3–10 mm). The ultrasound-measured cut-off TSD of 2.1 mm obtained 96.0% accuracy in predicting free anterior margin, considering a 5-mm-thick surgical flap. Conclusion: In breast superficial tumors, a cut-off distance of 2.1 mm or more measured preoperatively by ultrasound allows safe preservation of the skin above the tumor. Future studies need to follow up for longer the women submitted to skin preservation surgeries, especially those not undergoing radiotherapy.

67 (PB-067) Poster - Ultrasound measurement of the distance between the breast tumor and the skin: a cut-off value for safe skin preservation. Diagnostic accuracy study

Background and purpose: In superficial tumors of the breast, it is necessary to plan the thickness of surgical skin flaps, and whether skin can be preserved for esthetics results. Ultrasound scans allow the evaluation of the tumoral size and location, and its relationship with adjacent structures such as the skin. However, because the patient is usually lying down with the arms extended behind the head during the exam, the breast may be flattened, and the distance measured by ultrasound may be different than the same measurement on a surgical or pathological specimen.

Aesthetic and Functional Results after Single- and Two-Stage Resection and Reconstruction of Penile Paraffinomas – Experience from Two Tertiary Centers and a Surgical Management Algorithm

The treatment of choice of penile paraffinoma (PP) is surgical resection. Penile soft tissue coverage in a combined Urology/Plastic Surgery procedure, is often needed. ObjectiveTo describe the surgical techniques, aesthetics and functional outcomes, and to provide a practical algorithm for the surgical management of symptomatic PP. MethodsWe retrospectively recruited PP patients treated with surgical resection, from 2004 to 2020, in the Reina Sofia Hospital of Murcia (Spain) and Sourasky Medical Center (Israel). Procedural and postoperative erectile function, according to the short version of the International Index of Erectile Function (IIEF-5) data were collected. ResultsEight patients underwent surgery. The mean age was 30 years. The mean time between substance injection and surgery was 6 years. The most frequently injected material was liquid paraffin (50%), followed by Vaseline. Extensive skin involvement was present in all patients with liquid paraffin, requiring 2-stage surgery or skin graft. PP surgical treatment was successfully achieved in an Urology/Plastic Surgery joined effort. Postoperative erectile function was preserved in all cases. ConclusionPP can pose a surgical challenge. A combined surgical approach with urology and plastics allows for functional and aesthetic preservation. The extent of PP and the viability of shaft skin preservation should guide surgical approach.

Analysis of The Safety and Efficacy of Different Types of Anesthesiological Support During Aesthetic Interventions For The Breast Glands In Ukraine

In the prevailing era, mammoplasty is prevalent among women. Undeniable benefits of the method are the preservation of most anatomical structures and skin, and also better psychological status of patients after intervention. Hence, the present study intends to examine the features of aesthetic and reduction surgical interventions on the mammary glands in Ukraine. Materials and methods. The study was conducted by analyzing the inpatient ambulatory cards of 320 patients. Anesthesia was provided by propofol (n=130), sevoflurane (n=140) and combined use of sevoflurane and nalbuphine (n=50). The results of the study. It was found that usage of combined inhalation analgesia of sevoflurane with opioids was characterized by 41.9% less recovery time. It was found that 8 hours after surgery, the individual assessment of pain was lower in the group of combined analgesia with opioids relative to intravenous anesthesia with propofol (87.5%, p&lt;0.05) and inhalation anesthesia with sevoflurane (71, 3%, p&lt;0.05). After 24 hours all patients reported about pain below 1.0 point, however, in groups where sevoflurane and nalbuphine were used, the level of pain self-esteem was 2.61 and 3 times lower than after intravenous propofol. It was found that within 1 hour after surgery, the average cognitive score on the Montreal scale decreased in the group of intravenous propofol by 5.0% (p&lt;0.05) and by 1.7% under inhalation anesthesia with sevoflurane. Under combined anesthesia the cognitive score remained at 12.0 points. The frequency of postoperative nausea was the highest level in the group of inhalation anesthesia - 16.7%. The addition of nalbuphine to sevoflurane significantly reduced the risk of postoperative nausea (? 2=7.250; p=0.007). Conclusions. Combined anesthesia with opioids is a highly effective anesthetic choice for aesthetic and reconstructive interventions on the mammary glands.