Abstract:Objective To validate the agreement between BCCT.core(breast cancer conservative treatment.cosmetic results),an objective assessment tool,and the Japanese Breast Cancer Society(JBCS)subjective scale for evaluating cosmetic outcomes after breast-conserving surgery,thereby providing reliable evidence for the clinical application of BCCT.core.Methods From January 2021 to December 2024,this study included 107 patients who underwent BCS for breast cancer,consisting of 46 cases of conventional BCS(43%),34 cases of oncoplastic BCS(32%),and 27 cases of endoscopic BCS(25%).Postoperative frontal breast photographs of the patients were subjected to automated aesthetic analysis using the BCCT.core software.Simultaneously,three breast surgeons scored the cosmetic results using the JBCS scale.Intraclass correlation coefficient(ICC)was used to assess the inter-rater consistency among the surgeons'scores;Spearman's rank correlation coefficient was used to analyze the correlation between the BCCT.core software score and the surgeons'scores.Results Inter-rater reliability among the surgeons demonstrated moderate agreement(ICC=0.63).The scores from BCCT.core showed a high correlation with the mean ratings of the three surgeons(Spearman's rho=0.87,P<0.001).Compared to the evaluation using the JBCS scale by physicians,the BCCT.core software offers advantages such as user-friendly operation,high efficiency,standardized assess-ment,and reproducible results.Consequently,its clinical application can save considerable time,manpower,and material resources.Conclusion The evaluation results of the BCCT.core software are highly correlated and comparable with subjective surgeon ratings.Its objectivity and reliability support its use as an auxiliary tool for assessing cosmetic outcomes after breast-conserving surgery.

Abstract:Objective To evaluate the efficacy and safety of chemical peeling by supramolecular lactic acid in patients with mild to moderate acne vulgaris.Methods A self-controlled clinical study was conducted on 36 patients with mild-to-moderate acne vulgaris.Graded concentrations of supramolecular lactic acid chemical peeling were applied to the facial skin at weeks 0,2,4,6,and 8.Evaluations were performed before each treatment and at the 4-week follow-up after the last treatment(week 12).Assessments included lesion count,Investigator's Static Global Assessment(ISGA)score,skin color measurements(a and L values)to evaluate improvements in acne lesions and sequelae such as post-inflammatory erythema(PIE)and post-inflammatory hyperpigmentation(PIH),as well as measurements of skin physiological parameters transepidermal water loss(TEWL),stratum corneum hydration,and sebum secretion rate).Safety was assessed through subjective adverse event evaluations by both subjects and investigators.Results At the primary efficacy time point(week 12,4 weeks after the fifth treatment),the ISGA score showed an effective improvement rate of 44.4%in acne lesions.The effective rate for PIE was 75%,with a significant reduction in a value compared to baseline.The effective rate for PIH was 88.9%,and the L value in the treated ar-eas significantly increased compared to baseline.Comedones improved more rapidly,showing a significant reduction by week 8 compared to baseline(P<0.05).No significant changes were observed in stratum corneum hydration or sebum secretion rate,while TEWL significantly decreased at weeks 8 and 12 compared to baseline,indicating no negative impact on the skin barrier.Most patients tolerated the supramolecular lactic acid chemical peels well,with only one subject reporting immediate significant burning sensation after the week 8 treat-ment,which resolved after cold compress.Conclusion Chemical peels using supramolecular lactic acid effectively improve mild to mod-erate acne vulgaris,particularly comedones,post-inflammatory erythema,and hyperpigmentation,without significantly affecting the skin barrier.The treatment demonstrates high safety and good tolerability.

Abstract:Objective To investigate the safety and clinical efficacy of combined macrofat and microfat layered grafting in the correction of temporal depression.Methods A retrospective analysis was conducted on 38 patients from June 2019 to June 2024.Adipose tissue was harvested from the medial thigh using vacuum-assisted liposuction.Macrofat(centrifuged at 1200×g)and microfat(prepared via mechanical emulsification followed by 200×gcentrifugation)were prepared respectively.During the procedure,macrofat was injected into the deep temporal space to provide structural support,while microfat was injected into the subcutaneous fat layer for refined contouring.The injection volume per side ranged from 8 to 15 mL until the temporal area reached a state of noticeable over-correction.Patient satisfaction and complications were evaluated during the follow-up period.Results Patient satisfaction rates at 1,3,and 6 months postoperatively were 89.47%,78.94%,and 68.42%,respectively.The difference in efficacy between preoperative and 6 month postoperative assess-ments was statistically significant(P<0.05).Significant improvement in temporal depression was observed in all cases.Five patients achieved satisfactory results after a second filling procedure.No palpable nodules,secondary deformities,or paresthesia were reported.Conclusion Combined macrofat and microfat layered grafting is a safe and effective approach for correcting temporal depression.It yields satisfactory clinical outcomes and merits wider clinical promotion.

Abstract:Objective To prepare a novel modified advanced platelet-rich fibrin(A-PRF)formulation and evaluate its functional properties.Methods From June 2025 to July 2026,venous blood samples were collected from volunteers,and varying volumes of van-comycin were added prior to centrifugation.Vancomycin(5 mg/ml)was added to fresh blood prior to centrifugation,and the blood samples were divided into Group V1(0.25 ml vancomycin),Group V2(0.5 ml vancomycin),Group V3(0.75 ml vancomycin),Group V4(1.0 ml vancomycin),and a control group(no vancomycin added).The vancomycin-loaded A-PRF(vancomycin/A-PRF)was subjected to morpho-logical assessment,scanning electron microscopy(SEM),Fourier-transform infrared(FTIR)spectroscopy,growth factor release analysis,drug-release kinetics evaluation,and antibacterial testing.Results(1)Morphology of vancomycin/A-PRF:A-PRF clots formed in the V1 group(0.25 ml vancomycin),whereas no A-PRF formation was observed in V2(0.5 ml),V3(0.75 ml),or V4(1.0 ml)groups,all of which exhibited increased clot volume.(2)Microstructure of vancomycin/A-PRF:SEM revealed a fibrous surface morphology in A-PRF,with in-terconnected fibrin bundles forming a fibrin network.In contrast,vancomycin/A-PRF displayed a smooth surface without visible drug crys-tals.(3)FTIR analysis:A prominent absorption peak at 3324 cm-1 indicated the presence of hydroxyl groups characteristic of fibrin.The peak at 1259 cm-1 corresponded to the phenolic hydroxyl group of vancomycin.No new absorption peaks appeared in vancomycin/A-PRF compared with vancomycin or A-PRF alone,suggesting no structural integration between the drug and the fibrin matrix.(4)Drug-release kinetics:A-PRF slowed vancomycin release but failed to sustain controlled release at concentrations required for therapeutic efficacy.(5)In vitro growth factor release:Growth factor release profiles of vancomycin/A-PRF did not differ significantly from those of A-PRF(P>0.05).(6)Antibacterial activity:A-PRF showed no significant inhibition of MRSA,whereas vancomycin/A-PRF exhibited marked antibacterial effects.Conclusion A novel vancomycin-loaded A-PRF was successfully developed.It released growth factors continuously and demon-strated strong anti-MRSA activity.Although A-PRF attenuated the release of vancomycin,it did not achieve controlled release at thera-peutically effective concentrations.

Abstract:Objective To investigate the effects of combined helium-neon laser and ultrasonic debridement on the wound mi-croenvironment in patients with chronic non-healing wounds(CRW).Methods This study selected 140 patients with CRW who visited our hospital between May 2023 and May 2025.Patients were divided into a vacuum sealing drainag(VSD)group,an Ultrasonic Debride-ment+VSD group,and a Combined group based on their treatment methods.A 1∶1∶1 matching was performed using Propensity Score Matching(PSM).The general data and clinical efficacy of CRW patients in the three groups were compared.Differences in pain scores and wound microenvironment indicators before and after treatment in CRW patients were analyzed.Repeated measures ANOVA was used to examine the changes in wound tissue growth factors among the three groups of CRW patients.Generalized Estimating Equations(GEE)were employed to analyze the impact of different treatment methods on wound microenvironment indicators.Results After PSM,each group consisted of 30 patients,and the baseline sociodemographic characteristics of the three groups reached balance.The wound healing time and dressing change frequency in the combined group were lower than those in the VSD group and the ultrasound debridement+VSD group,while the completely healed wound area was bigger than that in the VSD group and the ultrasound debridement+VSD group.Two weeks after treatment,the visual analogue scale(VAS),vancouver scar scale(VSS),and total score in the combined group were lower than those in the VSD group and the ultrasound debridement+VSD group.The wound temperature in the combined group was higher than that in the VSD group and the ultrasound debridement+VSD group.Additionally,the levels of exudate pH,Staphylococcus aureus,Pseudomonas aeruginosa,Staphylococcus epidermidis,and Escherichia coli were lower in the combined group compared to the VSD group and the ultra-sound debridement+VSD group,while the tissue growth factor levels were higher,with all these differences being statistically significant(P<0.001).Results of repeated measures analysis of variance showed that the time effect,between-group effect,and interaction effect of platelet-derived growth factor(PDGF),vascular endothelial growth factor(VEGF),fibroblast growth factor(FGF),transforming growth factor(TGF),and insulin-like growth factor(IGF)among the three groups were all statistically significant(P<0.05).Generalized estimating equa-tions(GEE)analysis revealed that two weeks after treatment,wound temperature increased[β=1.687,95%CI(0.861～2.514)],while exudate pH,Staphylococcus aureus,Pseudomonas aeruginosa,Staphylococcus epidermidis,and Escherichia coli levels decreased[β=-0.957,95%CI(-1.193～-0.727);β=-9.568,95%CI(-10.143～-9.012);β=-9.540,95%CI(-10.667～-8.397);β=-4.711,95%CI(-5.126～-4.294);β=-2.623,95%CI(-2.814～-2.426)].Furthermore,in the combined group,wound temperature,exudate pH,Staphylococcus aureus,Pseu-domonas aeruginosa,Staphylococcus epidermidis,and Escherichia coli levels exhibited interactive effects two weeks after treatment,with all differences being statistically significant(P<0.001).Conclusion The combined use of VSD,helium-neon laser therapy with an ultra-sonic debridement device yields superior efficacy in treating chronic refractory wounds,resulting in shorter wound healing times and re-duced pain.This approach effectively improves the wound microenvironment,thereby promoting the healing of CRW.

Abstract:Objective To develop a GAN-based system to simulate post-treatment appearance after micro-plasma radiofre-quency(MPR)therapy for pathological scars,enabling visual outcome prediction from a single pre-treatment clinical photograph to support counseling and individualized decision-making.Methods Standardized paired photographs were retrospectively collected from patients receiving MPR monotherapy between 2020 and 2024,with follow-up images acquired at 6 months.A total of 100 cases were included and split into a training set(n=80)and a test set(n=20).A paired,conditional GAN was built with a ResNet-based encoder decoder generator(9 residual blocks)and a PatchGAN discriminator,optimized using adversarial loss plus a weighted L1 loss(λ=100).Agreement between generated and ground-truth follow-up images was evaluated using MSE,PSNR,and SSIM,along with representative qualitative examples.Results The model reproduced major post-MPR visual trends,including preserved scar morphology,smoother margins,and reduced ery-thema.Test-set performance was:MSE(0.053±0.024)95%CI(0.042,0.064),PSNR(37.069±3.215)dB 95%CI(35.564,38.574),and SSIM(0.736±0.036)95%CI(0.719,0.753).Conclusion The proposed system is feasible for simulating post-MPR scar appearance and may serve as a visual aid for pre-treatment counseling and decision support.Further multicenter validation and integration of clinical pa-rameters and multimodal data are warranted.

Abstract:Objective To investigative a comparative study on the efficacy of the facial artery nasolabial groove perforator flap and the supratrochlear artery forehead flap in nasal tip defect reconstruction.Methods A total of 43 patients with nasal tip defects who underwent reconstructive surgery in our hospital from January 2024 to May 2025 were selected.Based on the surgical plan,they were di-vided into an observation group(n=23)and a control group(n=20).The observation group received repair using the facial artery nasolabial groove perforator flap,while the control group was treated with the supratrochlear artery flap.The therapeutic outcomes of both groups were observed.Results There was no statistically significant difference in surgical time,intraoperative blood loss,and postoperative drainage volume between the observation group and the control group(P>0.05).Similarly,no statistically significant difference(P>0.05)was ob-served in the nasal frontal angle,nasal facial angle,nasal tip convexity,and nasolabial angle between the observation group and the control group 6 months after surgery.The POSAS scores for the observation group were as follows:scar area,3(1～5)points;thickness,2(1～4)points;softness,2(0～3)points;pigmentation,4(2～6)points;and total score,15(8～23)points.These scores were significantly lower than those of the control group(P<0.05).The satisfaction rate of the observation group patients was higher than that of the control group(P<0.05),with a satisfaction rate of 100.00%.Conclusion Compared with the frontal trochlear artery flap,the facial artery nasolabial groove perforating branch flap has the advantages of less scarring and higher patient satisfaction in nasal tip defect plastic surgery.

Abstract:Facial depressive deformities can adversely affect patients'facial appearance and psychological state.Autologous fat features excellent histocompatibility and has been widely applied in the management of facial depressive deformities.This paper reviews the acquisition of autologous fat and its clinical application in facial depressive deformities,aiming to provide more therapeutic strategies for the treatment of such deformities.

Abstract:Objective To explore the clinical efficacy and safety of fractional microneedle radiofrequency(FMR)combined with hyaluronic acid(HA)micro-filling in the treatment of facial atrophic acne scars(AAS).Methods A retrospective analysis was conducted on the clinical data from 65 patients with facial AAS treated in our department from January 2022 to July 2024.According to different treatments,the patients were divided into control group(treated with FMR alone,n=33)and combination group(treated with FMR+HA filling,n=32).Treatments were administered every 3 months for 3 cycles,with 3-month follow-up post-treatment.Both groups were eval-uated before and after treatment for clinical efficacy,ECCA score,VISIA skin physiological indicators,VAS pain score,patient satisfaction and adverse reactions.Results The total effective rate in the combination group(93.75%)was significantly higher than that in the control group(75.76%),P<0.05.There was no statistically significant difference in ECCA scores between the two groups before treatment(P>0.05);af-ter treatment,the ECCA scores were markedly decreased in both groups,and the decrease in the combination group was lower than that in the control group,with a statistically significant difference(P<0.05).Among the VISIA skin physiological indicators,there were no statistically significant differences in the eight indicators between the two groups before treatment(P>0.05);after treatment,compared with the control group,the combination group had significantly lower scores in the five indicators including spots,texture,pores,porphyrin and inflamma-tion(P<0.05),while no significant differences were observed in wrinkles,ultraviolet spots and brown spots(P>0.05).There was no statisti-cally significant difference in VAS pain scores between the two groups(P>0.05).The main adverse reactions were erythema and edema,the incidence of which in the combination group(15.63%)was lower than that in the control group(36.36%),P<0.05,and the healing time of the combination group was shorter than that of the control group(P<0.05).The patient satisfaction of the combination group(93.75%)was higher than that of the control group(72.73%),P<0.05.Conclusion FMR combined with HA micro-filling can significantly improve the depression and skin texture of AAS,with good safety and high patient satisfaction,which is worthy of clinical promotion and application.

Abstract:Absorbable injectable materials for facial rejuvenation have gained significant traction in minimally invasive aesthetic medicine owing to their favorable biocompatibility,degradability,and low immunogenic risk.Representative materials include:hyaluronic acid(HA),collagen(CLG),poly-L-lactic acid(PLLA),polycaprolactone(PCL),and calcium hydroxylapatite(CaHA).They have demon-strated not only substantial efficacy in volumizing and contour restoration,but also in promoting collagen neogenesis,improving skin tex-ture,and delaying facial aging.This review systematically summarizes the physicochemical characteristics and biological mechanisms of the five principal absorbable injectable materials,along with their formulation forms,clinical techniques,and multi-site indications.The emerging trends of combination therapy and structural optimization are also discussed.

Abstract:Objective To explore the clinical effect of fractional carbon dioxide laser-assisted betamethasone delivery in the treatment of hypertrophic scars.Methods Data from consecutive patients with hypertrophic scars treated between January 2024 and Jan-uary 2025 were collected and divided 190 patients into groups based on different treatment methods.The observation group received frac-tional CO2 laser treatment followed immediately by topical application of betamethasone injection and ointment to seal the wounds,while the control group received local injection of compound betamethasone injection.Treatments were administered once a month,with four sessions constituting one course.Follow-up was conducted six months after the final treatment.Evaluations were performed using the Vancouver scar scale(VSS),the visual analog scale(VAS)for pain,and by recording the occurrence of complications.Results Hypertrophic scars in both groups showed significant improvement.However,the observation group demonstrated a lower VSS score compared to the control group(P＜0.05),indicating better scar treatment outcomes.The observation group also reported a lower VAS score(P＜0.05),reflecting less pain.Furthermore,the incidence of complications was lower in the observation group(9.1%and 28.8%).Conclusion Fractional car-bon dioxide laser-assisted betamethasone delivery is a safe,effective and valuable strategy for treating hyperplastic scar.

Abstract:Objective To compare the effects of endoscopic-assisted prosthetic augmentation mammaplasty and traditional pros-thetic augmentation mammaplasty through a systematic review.Methods Databases were searched including Embase,PubMed,Cochrane Library,Web of Science,CNKI,China Biomedical Literature Database,VIP,Wanfang Database,etc.The search is available until January 1,2025.Literature was screened in accordance with the inclusion and exclusion criteria by two independent reviewers.Data were extracted,and the quality of the literature was evaluated.The Cochrane risk of bias tool was employed for randomized controlled trials,and the New-castle-Ottawa Scale(NOS)was used for cohort studies for literature quality assessment.Meta-analysis of the literature was conducted using Review Manager 5.4 software.Results A total of 26 articles were included,consisting of 14 randomized clinical controlled trials and 12 cohort studies,involving 2559 patients,among which 1289 were in the endoscopic group and 1270 in the traditional group.The results of the Meta-analysis indicated that the endoscopic group outperformed the traditional group in terms of the incidence of postoperative com-plications[OR=0.21,95%CI(0.15,0.29),P＜0.00001],postoperative satisfaction[OR=4.39,95%CI(3.20,6.02),P＜0.00001],intraoper-ative blood loss[MD=-34.59 ml,95%CI(-39.92,-29.26)ml,P＜0.00001],and wound healing time[MD=-5.28 d,95%CI(-7.15,-3.41)d,P＜0.00001],with statistically significant differences(P<0.05).There was no significant differences in the the operation time[MD=-2.48 min,95%CI(-12.04,7.30)min,P=0.63].Conclusion Compared to traditional prosthetic augmentation mammaplasty,the adoption of endoscopic-assisted prosthetic augmentation mammaplasty can lower the incidence of postoperative complications,decrease intraoperative blood loss,shorten the wound healing time.It also has higher postoperative satisfaction.

Abstract:Objective To investigate the clinical efficacy and safety of acupoint injection of concentrated growth factor(CGF)in the treatment of facial photoaging.Methods From January to December 2024,60 patients with facial photoaging diagnosed as liver-kid-ney deficiency pattern according to Traditional Chinese Medicine(TCM)syndrome differentiation were enrolled from the Department of Plastic and Cosmetic Surgery at Jiangsu Province Hospital of Traditional Chinese Medicine.Patients were randomly assigned using a ran-dom number table into an experimental group and a control group,with 30 patients in each group.The control group received facial mesotherapy with 3 ml CGF injection.The experimental group received the same treatment as the control group in combination with distal acupoint injection of 3 ml CGF at bilateral Xuanzhong(GB39),Sanyinjiao(SP6),and Zusanli(ST36).Both groups received treatment once monthly for 3 months.The VISIA Complexion Analysis System was used to evaluate scores for spots,texture,wrinkles,and pores at base-line and at 30,90,and 180 days post-treatment.The Global Aesthetic Improvement Scale(GAIS)was employed to assess overall efficacy at 180 days post-treatment.Results Repeated measures ANOVA revealed statistically significant time×group interactions for spots,texture,and wrinkles scores(all P＜0.001).At 180 days post-treatment,the experimental group showed improvements of 14.3,14.7,and 11.0 points in spots,texture,and wrinkles scores respectively,while the control group showed improvements of 7.8,7.4,and 6.8 points.The mean relative improvement rates for spots,texture,and wrinkles were 27.9%,29.8%,and 25.2%in the experimental group,significantly higher than 14.5%,15.0%,and 17.4%in the control group(P＜0.05).The interaction effect for pores score was not statistically significant(P=0.265).For GAIS scores,the physician-rated score in the experimental group was 4(4.00～4.50),significantly higher than 3(2.50～3.50)in the control group(P＜0.001);patient self-rated scores were 5(4.00～5.00)in the experimental group versus 3(3.00～3.75)in the control group(P＜0.001).No statistically significant difference was observed in the incidence of adverse events between groups(P＞0.05),and no serious adverse events occurred.Conclusion This study preliminarily demonstrates that the combination of local facial and distal acupoint in-jection of CGF shows superior efficacy compared to local injection alone in treating facial photoaging,with more effective improvement in spots,texture,and wrinkles,higher patient satisfaction,and a good safety profile.This approach reflects the advantages of integrating tradi-tional Chinese and Western medicine and shows promising potential for clinical application.However,further validation through larger sample sizes and longer follow-up periods is warranted.

Abstract:Objective To explore the clinical repair methods of different types of flaps for external nasal defects,and to evaluate their effects.Methods From May 2014 to May 2024,53 patients with different types of nasal defects were selected to be retrospectively analyzed.These defects of the external nose have been reconstructed by different flaps including limberg skin flap,Rieger flap,bilateral lobe flap,nasolabial flap,auricular composite tissue flap,dilated frontal flap,and retrograde upper arm canal.The advantages and disadvantages of different flaps and the repair effects were compared.Results All flaps survived after surgery.The shape and ventilation function of nose were good,and the color,appearance,texture of the reconstructed nose were close to the surrounding normal tissues.There were no serious complications occurred.Conclusion In order to achieve good results,different surgical methods should be selected based on the compre-hensive consideration of the defect site,scope and surrounding tissues.

Abstract:Hair loss disorders such as androgenetic alopecia are prevalent problems worldwide,and their therapeutic strategies have long been a research hotspot.In recent years,regenerative therapies based on platelet concentrates,especially platelet-rich plasma(PRP),have shown great potential in hair loss treatment.As the third-generation platelet concentrate,injectable platelet-rich fibrin(i-PRF)has attracted widespread attention due to its simple preparation process,no need for additives(e.g.,anticoagulants),as well as its high con-centrations of leukocytes,cytokines,and optimized three-dimensional fibrin scaffold structure.As a safe and effective autologous biological therapy,i-PRF provides a novel treatment option for patients with hair loss and boasts broad application prospects.This review aims to summarize and analyze the current action mechanisms,clinical efficacy,and application protocols of i-PRF in hair loss treatment,so as to provide insights for formulating standardized clinical therapies in the future.

Abstract:Objective To address the incongruence between high postoperative complications and patient satisfaction in plastic rhinoplasty,we developed a prognostic prediction model and clinical decision system based on Automated Machine Learning(AutoML).Methods Retrospectively,256 rhinoplasty patients from Xijing Hospital(March 2019 to January 2024)were included.Multidimensional data encompassing clinical baselines,surgical procedures,perioperative management,and postoperative behaviors were collected.Prog-nostic indicators included 1-month adverse events and 1-year Rhinoplasty Outcome Evaluation(ROE)scores.An Improved Catch Fish Optimization Algorithm(ICFOA)constructed the AutoML framework,validated and optimized via CEC2022 benchmark functions.SHAP analysis quantified key variables,culminating in a MATLAB-based visual Clinical Decision Support System(CDSS).Results The IC-FOA-AutoML model outperformed others in the test set:AUC for 1-month complications reached 0.9158,and R2 for 1-year ROE score re-gression was 0.8783.SHAP(SHapley Additive exPlanations)identified core predictors-short-term:postoperative nasal collisions,preoperative enlarged nostril pores,postoperative nasal folliculitis;long-term:preoperative ROE scores,education level,and suboptimal prosthesis carving.Decision curve analysis confirmed enhanced net benefits over traditional methods.Conclusion This study established an AutoML-driven prognostic management framework for rhinoplasty patients,bridging the gap between surgical practice and patient-reported outcomes through dynamic risk stratification and explainable artificial intelligence,offering a novel paradigm for aesthetic surgical decision-making.

Abstract:Objective To investigate the clinical efficacy of the"triangular fixation"technique for orbital septal fat pedicle in transconjunctival orbital fat repositioning for the correction of lower eyelid bags with tear trough deformity.Methods A retrospective analysis was conducted on 721 patients with lower eyelid bags and tear trough deformity treated between June 2023 and June 2025.All pa-tients underwent transconjunctival orbital fat repositioning using the"triangular fixation"technique,which combines two-point external fixation with one-point periosteal internal fixation.Postoperative outcomes were assessed based on patient satisfaction scores and improve-ment in Hirmand tear trough classification.Results All surgeries were completed,with a mean operative time of(40.0±4.6)min and a mean follow-up period of(8.0±5.4)months.The patient satisfaction score was(4.5±0.7),with 462 patients being delighted and 191 satisfied.Significant improvement was observed in Hirmand classification across type Ⅰ,Ⅱ,and Ⅲ tear trough deformities.Postopera-tive complications were minimal,including 5 cases of minor hematoma,15 cases of under-correction,21 cases of transient dry eye,and 5 cases of temporary diplopia,all of which resolved without sequelae.Conclusion The"triangular fixation"technique in transconjunctival orbital fat repositioning is a safe and effective method for simultaneously addressing lower eyelid bags and tear trough deformity,yielding high patient satisfaction and low complication rates,which warrants its clinical application.

Abstract:Objective To evaluate the clinical efficacy and aesthetic outcomes of kite-shaped flaps utilizing the superficial mus-culoaponeurotic system(SMAS)as a vascular pedicle for the reconstruction of nasal ala and adjacent soft tissue defects.Methods This retrospective study analyzed 36 cases of nasal alar and adjacent soft tissue defects treated with flap reconstruction between June 2023 and June 2025.A triangular"kite"-shaped flap was designed along the alar margin on one side of the wound,with the incision modified into an arc shape along the alar groove,and the flap was advanced to repair the defect area.Results All flaps demonstrated complete survival with primary intention healing.Postoperative follow-up spanning up to 3 to 24 months revealed no evidence of flap contracture,structural deformation,or significant scar hypertrophy.Conclusion This flap provides a novel surgical approach for defects of the nasal ala and sur-rounding skin,offering both functional and aesthetic restoration,and is worthy of clinical promotion.

Abstract:As the third most common facial cosmetic surgery globally,rhinoplasty faces a core contradiction hindering its ad-vancement:a high incidence of complications and medical disputes.This article aims to systematically analyze the multidimensional factors contributing to the high complication rates in recent years.These include the complex anatomy and physiology of the nose,inherent techni-cal challenges,and the lack of assessment for the subjectivity of aesthetic perception and patient psychology.Furthermore,the article re-views emerging cutting-edge technologies aimed at reducing complications,such as digital 3D surgical planning and the application of sur-gical robotics.Finally,it prospectively proposes that the future development of rhinoplasty must establish a new paradigm.This paradigm should be built on the foundation of standardized psychological assessment,driven by artificial intelligence(AI)and augmented reality(AR)technologies,and aimed at achieving highly efficient and precise surgical execution.This shift is essential to propel the field from a heavily experience-dependent"artisanal craft"towards a predictable and reproducible"precision medicine"paradigm.

Abstract:Objective To evaluate the clinical efficacy of the anterior auricular triangular fossa composite tissue flap in the cor-rection of moderate to severe alar margin retraction.Methods A retrospective analysis was conducted on 32 patients(60 sides)with mod-erate to severe alar margin retraction who were treated at Shenzhen Guanghe Outpatient Department from December 2023 to January 2025.Remove the auricular composite tissue flap from the preauricular triangular fossa.Make an incision on the mucosal side of the vestibule,fully release the tension near the alar margin to expose the"transplant bed".Adjust the composite tissue flap to an appropriate position,pass through the tissue flap and the alar skin,and intermittently suture the incision and the composite tissue flap.Follow-up assessments were carried out at 1,3,and 6 months postoperatively to evaluate clinical outcomes.Nasal alar retraction distance was objectively quantified using a three-dimensional digital imaging system,ensuring high precision and reproducibility.Patient-reported satisfaction and indepen-dent expert evaluations were obtained from two board-certified rhinoplasty surgeons who had no involvement in the surgical procedure.These assessments focused on nasal rim appearance and symmetry,measured using the visual analogue scale(VAS),thereby providing a multi-perspective and reliable appraisal of aesthetic outcomes.Results Statistically significant improvements were observed when com-paring preoperative outcomes with those immediately postoperatively and at each follow-up time point(all P＜0.05).However,no statistical-ly significant differences were found among the postoperative follow-up groups(all P＞0.05),indicating stable long-term results.Six months after the operation,the satisfaction rate of patients with the appearance of the nasal alar margin was 90.63％(29/32).The satisfaction rates of the two physicians were 100％(32/32)and 96.88％(31/32),respectively.The satisfaction rate of patients with the symmetry of the alar margin was 90.63％(29/32).The satisfaction rates of the two physicians with the symmetry of the alar margin were 84.38％(27/32)and 90.63％(29/32),respectively.Conclusion The use of the anterior auricular triangular fossa composite tissue flap is a safe and reliable surgical technique for correcting moderate to severe alar margin retraction.