Adipose tissue is vital for plastic and reconstructive surgery due to its accessibility and regenerative potential via abundant stromal vascular fraction (SVF) and adipose-derived stem cells (ADSCs). However, unpredictable graft resorption remains a major limitation, for which cryopreservation offers a potential solution. Yet, cryopreserving excised adipose tissue in commercial freezers with mechanical isolation of ADSCs remains unexplored. Human adipose tissue from 22 donors was preserved as tissue blocks or lipoaspirates at -20 °C or -80 °C for up to 4 months. Across 284 technically replicated experiments, oil release, mitochondrial activity (XTT assay), SVF yield and viability (trypan blue and flow cytometry), and ADSC multilineage differentiation were assessed. Fresh samples served as controls. Rapid thawing at 37 °C (thawing method 3) minimized oil leakage (0.02 ml) and better preserved SVF yield with viability (3.03 and 0.64 × 10 4 cells/ml) after 2 months of tissue block preservation at -80 °C compared with lipoaspirates, per gram of fat. After 4 months, -80 °C-stored samples retained more SVF cells (88%) with 68% viability and showed stronger ADSC marker expression (CD73⁺/CD90⁺/CD105⁺: 70-80%) than -20 °C samples. ADSCs from -80 °C stored blocks differentiated into adipogenic, chondrogenic, and osteogenic lineages, whereas -20 °C stored samples showed poor adhesion and no differentiation. Cryopreserving adipose tissue blocks at -80 °C, followed by rapid thawing at 37 °C and mechanical isolation, provides a practical, xeno-free, and scalable approach to long-term storage. This strategy effectively preserves viable ADSCs, supporting their potential clinical application in regenerative therapies.

Surgeons pursuing improvement in the aesthetic outcomes of their cleft lip repairs may benefit from a granular scale evaluating individual objectives of the repair. A working group of 9 surgeons convened to develop an assessment scale for nasolabial aesthetics after unilateral cleft lip repair. The group identified objectives of the repair that could be evaluated using two-dimensional facial photographs. Scale items were developed to appraise success or failure in achieving each objective. Scale items were iteratively tested and refined. The scale was subsequently implemented as part of a Continuing Medical Education course that included self-evaluation and peer-to-peer education, culminating in the formation of individual plans for improvement. Twelve distinct objectives of unilateral cleft lip repair were identified, of which 10 could be evaluated using photographs routinely obtained in clinical practice. A comprehensive scale was developed, incorporating these 10 objectives. Each scale item takes the form of a binary (yes/no) question evaluating a specific aesthetic concept, with accompanying reference images. Intrarater reliability for each item ranged from moderate to substantial (kappa value, 0.57 to 0.81). Interrater reliability ranged from fair to substantial (kappa value, 0.27 to 0.81). When implemented in a Continuing Medical Education course, the scale enabled surgeons to identify specific opportunities for improvement in their repair and specific surgical maneuvers to adopt in pursuit of these improvements. A new scale for evaluating outcomes of unilateral cleft lip repair is presented. The scale provides specific, actionable evaluations for individual objectives of the repair.

This study assessed the long-term outcome of secondary gingivoperiosteoplasty (GPP) and alveolar bone grafting (ABG) in unilateral and bilateral alveolar cleft groups during mixed dentition. This retrospective study included patients with complete unilateral and bilateral alveolar clefts who underwent either secondary GPP or secondary ABG from 2014 to 2020, with a minimum follow-up of five years. The outcomes were measured using Bergland and Witherow's scales in both occlusal and cone-beam computed tomography (CBCT) scans. A total of one hundred patients participated in the study, which included 126 sites. The GPP comprised 57 patients (38 with unilateral and 19 with bilateral), while the ABG included 43 patients (36 with unilateral and 7 with bilateral). When comparing outcomes between treatment groups, no statistically significant difference was observed in the success rates in the unilateral groups (p = 0.755). However, a statistically significant difference was identified between the GPP and ABG groups in bilateral cases (p = 0.006). Secondary gingivoperiosteoplasty provides reliable long-term outcomes in selected patients with alveolar clefts, especially in unilateral cases. Both GPP and secondary alveolar bone grafting are effective when appropriately indicated, though direct comparisons between the techniques should be interpreted cautiously, given differences in case selection.

Facial aging is a multifactorial process that results from deflation and descent of facial soft tissue. Modern deep layer face-lift techniques aim to restore a youthful facial shape by using the superficial musculoaponeurotic system (SMAS) to reposition descended facial fat into areas of deflation within the lateral cheek and malar eminence. Although there are many advocates of various SMAS techniques and numerous descriptions of methods to manipulate and fixate repositioned facial fat, there is no consensus in the literature as to a "best" SMAS technique. The authors' investigation aimed to determine whether there should be a consensus on the preferred method of SMAS manipulation in terms of improving contour in the aging face. A systematic review was performed to investigate the current body of literature on SMAS face-lift techniques. Careful review of operative technique was performed, and techniques were classified as medially or laterally based, depending on the extent of sub-SMAS dissection. Analysis of aesthetic outcomes and complications was performed to determine the superiority of one technique over another in achieving a youthful facial contour. A total of 17 articles were selected for review that clearly described operative technique and reported aesthetic outcomes. Patient satisfaction and improvement in overall facial contour was noted across studies. Various SMAS techniques can provide excellent aesthetic outcomes; however, medially based "deep plane" techniques, which carry dissection medial to the stout retaining ligaments, have not been shown to provide significant improvement in the appearance of the midface or improved longevity of results.

Food deserts (FDs) are areas characterized by high rates of food insecurity, limited access to healthy food, and a high concentration of unhealthy food options. This study evaluated the comorbidity burden in patients residing in FDs and assessed the impact of residing in an FD on postoperative outcomes following mastectomy. A retrospective review was conducted of patients undergoing mastectomy between January of 2014 and November of 2018. Low food access (LFA) was defined as an area where residents lived more than 1 mile (urban) or more than 10 miles (rural) from the nearest supermarket. Primary outcomes included minor and major complications (ie, return to the operating room). A total of 1553 patients were included. Of these, 675 (43.5%) resided in LFA areas and 878 (56.5%) in non-LFA (NLFA) areas. The mean body mass index was 28.4 ± 8.0 and 28.6 ± 7.3 kg/m 2 , respectively ( P = 0.897). The mean Charlson Comorbidity Index score was 2.6 ± 1.3 and 2.3 ± 1.2, respectively ( P < 0.001). The LFA group experienced more minor complications than the NLFA group ( n = 190 [28.1%] versus n = 187 [21.3%]; P = 0.002). The LFA group had a higher incidence of reoperation than the NLFA group ( n = 83 [12.3%] versus n = 64 [7.3%]; P = 0.001). An LFA subanalysis revealed that patients with low income had a higher incidence of reoperation ( n = 28/158 [17.7%] versus n = 55/517 [10.6%]; P = 0.018). The findings suggest a potential relationship among food access, increased comorbidities, and postoperative complications. Further studies are warranted to assess the relationship between FDs and postoperative outcomes to address social determinants of health for patients undergoing breast reconstruction.