Age-related atrophy of the upper eyelid orbital septal fat is a primary cause of sunken upper eyelid, contributing to an aged appearance. Safe and effective volume restoration remains a clinical challenge. To evaluate the efficacy, safety, and durability of sharp needle injection of Type I collagen into the orbital septal fat for upper eyelid augmentation. In this prospective study, 92 subjects with bilateral sunken upper eyelid received sharp needle injections of Type I collagen into the orbital septal layer. Primary outcome measures included physician-assessed improvement in sunken upper eyelid and patient satisfaction Visual Analog Scale (VAS) scores. Secondary outcomes included safety assessments. Follow-ups were conducted immediately, and at 1, 3, and 6 months post-treatment. Significant improvement in sunken upper eyelid depth was observed at all follow-up time points (P<0.05). Patient satisfaction scores were high. All adverse events were mild and transient. Sharp needle injection of Type I collagen into the orbital septal layer is an effective, safe, and durable method for restoring upper eyelid volume, with high satisfaction from both physicians and patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
The demand for interventions to enhance personal appearance continues to grow, driving the need for effective treatments to improve overall skin quality. This study aimed to evaluate the efficacy and safety of intradermal injection of a lyophilized compound sodium hyaluronate for ameliorating facial skin quality. This multicenter, randomized, evaluator-blinded study was conducted across seven research centers in China and enrolled 446 eligible subjects presenting with facial skin dryness and dullness. The treatment group received three intradermal injection sessions at intervals of 4 weeks, with follow-up to 3 months post final injection. The primary efficacy endpoint was the treatment response rate, defined by the modified Global Aesthetic Improvement Scale (mGAIS) score at 4 weeks after the third injection. Secondary endpoints included changes in mGAIS assessed by blinded evaluators, GAIS assessed by subjects at other time points, Allergan Fine Lines Scale (AFLS), Allergan Skin Roughness Scale (ASRS), and stratum corneum water content measured using a Corneometer® at each follow-up visit. All adverse events occurring throughout the trial period were collected. Blinded evaluator-assessed mGAIS response rates at the primary endpoint (4 weeks post final injection) favored treatment over control (84.9 www.springer.com/00266 .
Temporal hollowing may reflect constitutional craniofacial morphology, acquired soft-tissue loss, or age-related change. High-quality evidence specifically validating poly-L-lactic acid (PLLA) for temporal augmentation remains sparse. This study evaluated the efficacy, safety, and durability of PLLA microspheres for temporal hollowing correction. In a multicenter, randomized, evaluator-blinded trial, 162 adults with mild-to-severe bilateral temporal hollowing (Allergan Temple Hollowing Scale [ATHS] grades 2–4) were randomized (2:1) to PLLA microspheres (up to 3 sessions) or no treatment. The primary endpoint was the blinded-evaluator-assessed ATHS responder rate at Month 6. Secondary endpoints, interpreted as exploratory, included ATHS responder rates at Months 1, 3, 9, and 12, 3D volumetric changes, Global Aesthetic Improvement Scale (GAIS), and subject satisfaction/pain assessments. The Full Analysis Set included 161 subjects. At Month 6, the ATHS responder rate was 80.2 www.springer.com/00266 .
Male patients may encounter chest aesthetic sequelae following bariatric surgery. We employed CT imaging and questionnaires to analyze alterations in breast gland parameters and postoperative appearance satisfaction in males with gynecomastia or pseudogynecomastia. We enrolled 21 patients with gynecomastia and 15 with pseudogynecomastia. Chest CT images were analyzed for imaging parameters, and the BODY-Q questionnaire evaluated postoperative patient-reported outcomes. Bariatric surgery significantly reduced BMI and improved multiple metabolic indicators. Breast axial diameter, vertical percentage, and density increased significantly while subcutaneous tissue thickness decreased significantly in both groups post-surgery (all P < 0.05). However, the breast vertical diameter showed no significant change in the pseudogynecomastia group. Preoperative breast axial diameter (β = 0.856, CI 0.74, 1.058, P < 0.001) significantly predicted postoperative breast axial diameter. Postoperative breast vertical diameter was significantly predicted by preoperative BMI (β = 0.307, CI 0.057, 0.294, P = 0.005) and preoperative breast vertical diameter (β = 0.683, CI 0.302, 0.594, P < 0.001). Although BODY-Q scores showed no significant differences between groups, postoperative breast axial in the gynecomastia group and subcutaneous tissue thickness in the pseudogynecomastia group correlated with multiple BODY-Q scale scores. Breast imaging morphology changed significantly after bariatric surgery, especially in patients with gynecomastia. The postoperative breast axial diameter can be predicted by preoperative breast axial diameter, while the postoperative vertical diameter can be predicted based on preoperative BMI and breast vertical diameter. Breast dimensions in patients with gynecomastia and subcutaneous tissue thickness in patients with pseudogynecomastia may impact the subjective satisfaction after bariatric surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266
