The increasing prevalence of implant-based breast surgeries highlights a critical gap in patient knowledge regarding implant information, exacerbated by inadequate record-keeping and emerging safety concerns. The authors of this study address the need for reliable implant identification methods by developing a deep learning model capable of classifying breast implants using ultrasound images. Retrospective data of 28,712 breast ultrasound PNG files from 4136 breast implants in 2580 patients obtained from multiple institutions were utilized to train and validate this model. The findings demonstrate that the deep learning model achieved high diagnostic accuracy, with a balanced accuracy of 0.893 for manufacturer classification and 0.971 for implant texture classification in external test datasets. The model's performance was enhanced by employing Gradient-Weighted Class Activation Mapping (Grad-CAM) for interpretability. By automating the identification process, this tool alleviates the reliance on specialized training among plastic surgeons regarding breast ultrasound, streamlining patient care. Despite limitations, the model shows promise for improving clinical workflows and patient outcomes.

Simultaneous rhytidectomy and laser resurfacing has become a common single-stage facial rejuvenation technique. However, concerns remain, particularly with photothermal injury to undermined tissue. This is the first methodologically robust systematic review and meta-analysis to evaluate the safety, satisfaction, and predictors of outcomes for this dual-modality procedure. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a systematic review was conducted through April 2025. Data extracted included patient satisfaction, postoperative complications, and covariates for meta-regression. Seventeen studies comprising 1361 patients were included. The pooled patient satisfaction rate was 98.1%. Complications were rare: full-thickness flap necrosis (0.01%), skin slough (0.21%), secondary superficial infections (0.74%), hypertrophic scarring (0.51%), hematoma (0.35%), ectropion (0.12%), nontransient dyspigmentation (0.35%), contour irregularity (0.04%), and delayed reepithelialization (0.03%). Meta-regression demonstrated that lasering in areas undermined in the facelift dissection at the same energy density as nondissected regions of the face was significantly associated with higher skin slough rates. Superficial musculoaponeurotic system manipulation and biplanar rhytidectomy techniques were more likely to result in nontransient dyspigmentation compared to endoscopic subperiosteal techniques. Additionally, lasering undermined flaps with multiple different techniques was associated with higher rates of nontransient dyspigmentation. Procedures performed by plastic surgeons also were associated with lower rates of hypertrophic scarring when compared to dermatologists. Concomitant rhytidectomy and laser resurfacing appears safe with high patient satisfaction when laser and surgical technique are optimized. Identification of modifiable risk factors provides guidance to reduce complications and improve outcomes. Level of Evidence: 3 (Therapeutic).

Periprosthetic infection after postmastectomy breast reconstruction remain a significant issue and may result in explantation, with many patients choosing to forego reconstruction thereafter. Evaluate the use of absorbable and non-absorbable prophylactic antibiotic cement to reduce infection rates in implant-based breast reconstruction. A multi-institutional, retrospective review was performed of patients who underwent tissue expander (TE) reconstruction with permanent or absorbable antibiotic-loaded cement. Patients received either 1) non-absorbable polymethylmethacrylate (PMMA) plates loaded with vancomycin and tobramycin or 2) absorbable calcium sulfate (CS) beads or discs loaded with gentamycin and vancomycin. Medical history, perioperative details, and complications were collected. Comparisons were made between those who received non-absorbable PMMA and those who received absorbable CS. A total of 295 TE reconstructions were performed on 189 patients. Ninety-three (31.5%) breasts received PMMA, and 202 (68.5%) received CS. Seven (2.4%) breasts had infections, with 1 (0.3%) occurring beyond 6 weeks post-operatively and 6 (2.0%) occurring within 6 weeks. Four infected breasts had previous debridement due to wound dehiscence or mastectomy flap necrosis, and 1 occurred within the setting of an infected drain site. One TE was lost from infection. Antibiotic-loaded, non-absorbable PMMA and absorbable CS had no significant differences in infection rates (4.3% vs 1.5%, respectively). Patients did not receive prophylactic oral antibiotics. Antibiotic-loaded cement can be effective for infection prevention in implant-based reconstruction. Non-absorbable PMMA and absorbable CS for local antibiotic delivery resulted in similar safety profiles. Oral prophylactic antibiotics can be omitted safely with utilization of local antibiotic delivery.

Labiaplasty improves women's genital self-image, sexual function, and mental well-being, while enhancing male partners' sexual satisfaction and overall couple sexual harmony. This study aims to evaluate the effects of labiaplasty on women's genital self-perception, sexual function, psychological state and sexual satisfaction levels of male partners in women with physical and functional complaints about labium minus. 97 women and their partners who underwent labiaplasty between January 2021 and June 2024 were included in the study. Beck Depression Inventory (BDI), Female Sexual Function Index (FSFI), Quality of Sexual Experience Scale (QSES), Female Genial Self-Image Scale (FSGIS), Sexual Quality of Life - Female (SQoL-F) questionnaires were applied to women before and after labiaplasty. Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-Ejd), Golombok-Rust Sexual Satisfaction Scale (GRISS), New Sexual Satisfaction Scales (NSSS) were applied to male partners. Preoperative and postoperative data were compared with participants who were one year postoperatively. In female participants, significant improvements were found in genital self-perception, sexual function, sexual pleasure, lubrication, orgasm and overall quality of sexual life, and a statistically significant decrease in depression scores was observed. In male partners, ejaculatory function remained constant, but positive changes were found in general sexual satisfaction, impotence, premature ejaculation and satisfaction levels. Labiaplasty operation provides significant gains not only in terms of aesthetics but also psychological and sexual well-being in women, and indirectly positively affects the quality of sexual life of male partners. It is thought that surgical intervention can increase sexual harmony in couple relationship as well as individual satisfaction.

Total mastectomy for breast cancer is an impactful procedure, and breast reconstruction plays a crucial role for women diagnosed with the disease. The objective of our study is to compare satisfaction, morbidity, and timelines of two breast reconstruction techniques after breast cancer: breast prosthesis and exclusive lipofilling. This is a comparative, retrospective, unicentric study on patients who underwent total mastectomy between May 2014 and May 2020. Satisfaction is assessed using the BREAST-Q questionnaire at least 2 years after the start of the reconstruction (4.8 (± 0.16) years in the implant group and 5.4 (± 0.12) years the lipofilling group, p value = 0.044). Morbidity is evaluated using the Clavien-Dindo classification. One hundred and one patients were included in the study (60 in the prosthesis group and 41 in the lipofilling group). The response rate to the questionnaire was 63.3% (38 patients) in the prosthesis group and 70.7% (29 patients) in the lipofilling group. The lipofilling technique appears to provide better satisfaction for the "sexual well-being" item of the BREAST-Q in multivariate analysis (65.75 +/-1.92 versus 54.87 +/-1.46, multivariate p-value = 0.03). Major complication (grade III, IV or V) rate was 20% in the prosthesis reconstruction group compared to 0% in the lipofilling group (multivariate p-value = 0.05). Lipofilling often requires longer reconstruction times, but reoperations are more frequent in prosthesis reconstruction, extending the reconstruction periods. Our data should be confirmed by other studies to better guide the choice of reconstruction type.

Heightened rates of psychological distress and mental health disorders are observed in aesthetic surgery populations and are frequently cited as motivating factors for the pursuit of such procedures. Although mental health disorders are often considered a contraindication due to the risk of adverse outcomes posttreatment, the therapeutic benefits of aesthetic surgery are well documented and can lead to the resolution of distress and disorders. This paper presents a literature review of the psychosocial health outcomes for such populations and the associated clinical guidance for clinicians. A review of the literature indicates that although for a minority of patients the presence of psychological or a mental health disorder can increase the risk of poor posttreatment outcomes, the majority of aesthetic surgery patients achieve positive psychosocial and psychological outcomes. These include the resolution of depression, anxiety, and eating disorder and personality disorder symptomatology, as well as enhanced functioning in several key life domains and improvements in body image, self-esteem, and overall quality of life, indicating that aesthetic surgery provides a significant therapeutic function. This literature review concludes that the presence of a psychological or mental health disorder is not necessarily a contraindication for aesthetic surgery and should not automatically preclude patients from treatment. Psychological screening, informed by validated assessment measures developed for aesthetic surgical clinics and general hospital settings, should be an integral aspect of pretreatment processes. This ensures prompt identification of those at elevated risk for poor posttreatment outcomes, enabling timely referral for comprehensive psychological risk assessment and treatment.

The key to correcting moderate-to-severe saddle-nose deformities is restoring septal support. Owing to the heterogeneity in the extent and severity of septal defects, constructing a cartilage framework tailored to specific conditions is challenging. The authors of this study aimed to introduce their procedure utilizing a novel integrated biomimetic groove graft (IBGG) technique for cartilage framework construction in the correction of moderate-to-severe saddle-nose deformities and to evaluate its clinical outcomes. The authors of this retrospective study included patients who underwent surgical correction for moderate-to-severe saddle-nose deformity using the IBGG from February 2023 to February 2024. Patients were categorized into 3 categories based on Cakmak algorithm-defined septal defect characteristics including location and severity. Three IBGG variants were applied to construct the composite framework to address the deformity. Outcomes were assessed using objective measurements and subjective evaluations. Thirty-three patients completed the study, with a mean follow-up of 16.4 months. Postoperatively, subjective evaluation demonstrated favorable patient satisfaction with a mean Visual Analog Scale score of 8.57. As for objective assessment, nasal tip rotation and saddle index decreased, whereas nasal tip projection increased significantly across all categories. The nasofrontal angle showed no significant change in Category 1 but decreased significantly in Categories 2 and 3. The application of the IBGG in cartilage framework construction enables effective restoration of septal support. Objective measurements and subjective outcomes confirmed the technique's reliability, demonstrating the utility of the IBGG as a powerful tool for correcting moderate-to-severe saddle-nose deformities.

Recent anecdotal reports from respected surgeons suggest a potential link between tranexamic acid (TXA) in local anesthetic solutions and wound healing complications during facelift procedures. The authors of this study evaluate outcomes in patients undergoing facelift with and without local TXA injection. A single-surgeon retrospective cohort study was conducted on patients who underwent facelift surgery under general anesthesia between 2014 and 2024. All received subcutaneous injections of 0.5% lidocaine with 1:200,000 epinephrine, with or without TXA. Patients were matched for age, BMI, sex, and hypertension. Operative time and postoperative complications were assessed. Each group had 261 patients with a median follow-up of 232 days. No significant differences were observed in age (P = .22), BMI (P = .59), sex (P = 1.00), hypertension (P = .52), primary vs secondary facelifts (P = .19), fat grafting (P = .66), or chemical peels (P = .83). Minor wound healing complications were similar (P = .16). Delayed healing occurred in 4.6% (non-TXA) vs 2.3% (TXA) (P = .15). Minor skin necrosis was noted in 1 non-TXA patient (0.4%) and 2 TXA patients (0.8%) (P = 1.00). Two major complications, major skin necrosis, were reported in the non-TXA group, none in TXA (P = .5). Hematoma rates were comparable (P = 1.00). The authors of this large-scale, single-surgeon, retrospective cohort study of matched patients challenge previous claims associating TXA use with wound healing complications. Local administration of TXA in a concentration of 1 to 2 mg/mL is not associated with an increased risk for minor or major wound healing complications in patients undergoing facelift procedures with wide skin undermining. TXA appears safe when used with appropriate dosing, screening, and technique. : 3 (Therapeutic).

Lower eyelid blepharoplasty addresses under-eye bags and tear troughs, but traditional evaluations lack objectivity. Three-dimensional (3D) imaging and grayscale analysis offer a novel, quantitative approach. The aim of the authors is to objectively assess blepharoplasty outcomes using 3D imaging and grayscale analysis, validating their effectiveness in capturing morphological and skin texture changes. A self-controlled study of 68 patients (January-June 2023) utilized 3D imaging (EinScan H2) and grayscale analysis to measure preoperative and postoperative changes. Key landmarks and grayscale values were analyzed using SPSS 22.0. Postoperative 3D measurements showed reduced sagittal distance (P < .05) and increased grayscale values (P < .05), indicating improved morphology and skin texture. intraclass correlation coefficient values exceeded 0.80, confirming reproducibility. The 3D imaging and grayscale analysis provide objective, reliable evaluation of blepharoplasty outcomes, enhancing precision and paving the way for personalized treatment despite technical challenges.