BACKGROUND:Post-inflammatory hyperpigmentation (PIH) is a frequent but underrecognized complication following energy-assisted liposuction and may compromise aesthetic outcomes, particularly in procedures marketed as minimally invasive and scarless. Although Q-switched Nd:YAG laser therapy is considered a standard treatment, incomplete resolution and recurrence remain common, suggesting the need for adjunctive therapies targeting the inflammatory tissue microenvironment. OBJECTIVES:To evaluate whether hyperbaric oxygen therapy (HBOT) enhances the efficacy of Q-switched Nd:YAG laser therapy in the treatment of post-liposuction PIH. METHODS:A retrospective observational study was conducted on 186 patients who developed clinically relevant PIH (Post-Aspiration Hyperpigmentation Index [PAHPI] >10) after ultrasound-assisted liposuction (VASER®) between 2019 and 2024. Patients were divided into two groups: Group A (laser therapy alone, n=93) and Group B (HBOT followed by laser therapy, n=93). HBOT consisted of 20 sessions at 2 ATA for 45 minutes. PIH severity was assessed using PAHPI scores at baseline and after treatment, with a minimum follow-up of 6 months. Multivariable analyses evaluated the influence of procedural variables. RESULTS:Both groups demonstrated significant PAHPI reduction after treatment (p<0.0001). However, the combined HBOT and laser group showed significantly greater improvement compared with laser alone (p<0.001). The greatest improvements were observed in the abdomen and back, while lower limbs showed higher residual pigmentation. In the combined group, a significant inverse correlation was observed between lipoaspirated volume and PAHPI reduction (p<0.001). VASER application time was not independently associated with baseline PIH severity. CONCLUSIONS:Adjunctive HBOT significantly enhances the efficacy of Q-switched Nd:YAG laser therapy in post-liposuction PIH treatment without increasing adverse events.

Implant-based reconstruction failure remains a significant complication following breast reconstruction, with substantial implications for patient outcomes. Reliable preoperative risk prediction tools are lacking. A retrospective single-center cohort study was conducted, including 381 IBR procedures performed from 2006 to 2023. Reconstruction failure was defined as explantation without immediate replacement within one year. Elastic net regression was used to develop a multivariable model based on age, BMI, smoking status, radiation therapy, chemotherapy, use of expander, and implant plane. Internal bootstrap validation was performed following the 2024 TRIPOD + AI guidelines. Model performance was assessed using AUC, calibration curves, and decision curve analysis. A real-time online calculator was deployed for clinical use. The mean follow-up was 38.2 ± 27.2 months. The observed IBR failure rate was 5.5 https://urls.fr/BIWCeO ). This study presents a robust, internally validated predictive model for implant loss following IBR. The online calculator suggests real-time, individualized risk estimation, supporting preoperative counseling and surgical decision-making in the future. External validation and clinical implementation studies are warranted to confirm its broader applicability. 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.

BACKGROUND:Liposuction has gained significant popularity, leading to increased demand for secondary procedures due to complications such as scars and fibrosis that affect aesthetic outcomes. High-definition liposuction has emerged as a preferred technique, but the presence of fibrosis from previous surgeries may limit its effectiveness. OBJECTIVES:The aim of this study was to explore the application of ultrasound (US)-assisted VASER (vibration amplification of sound energy at resonance; VASER-Solta Medical, Bothell, WA) liposuction in secondary abdominal liposculpture to address these challenges. METHODS:A prospective cohort study was conducted between May 2022 and May 2023 of patients undergoing secondary abdominal liposculpture with US-assisted VASER liposuction, at least 12 months after their initial procedure. Preoperative US examinations were performed to identify and mark findings related to previous liposuction. Data on demographics, photographic results, and complications were collected and analyzed. RESULTS:Intraoperative ultrasound (I-US) significantly improved the detection of fibrotic lesions, leading to more precise, rapid, and atraumatic outcomes. The use of I-US optimized surgical procedures, reducing both costs and operation time. Clear communication with patients regarding potential limitations due to chronic damage was essential for setting realistic expectations. CONCLUSIONS:I-US has proven to be an invaluable tool in secondary liposculpture, enhancing surgical precision and outcomes. This methodology allows for better recognition of complications, promoting effective treatment strategies and ultimately improving patient satisfaction in the context of secondary abdominal liposculpture. LEVEL OF EVIDENCE: 4 (THERAPEUTIC):

Massive weight loss after bariatric surgery frequently results in redundant abdominal skin that can compromise posture, gait, and joint biomechanics. This prospective study investigated the functional effects of circumferential lipoabdominoplasty in post-bariatric patients. Eighteen individuals (mean BMI 29.3 kg/m²), all weight-stable for at least 12 months, underwent 360° lipoabdominoplasty with removal of ≥4 kg of tissue. Hip and knee range of motion (ROM) was measured preoperatively, at 1 month, and at 12 months postoperatively. Patient-reported outcomes were assessed using the BODY-Q Physical Symptoms (PS) and Physical Function (PF) domains. At 12 months, mean hip flexion improved from 110° ± 8° to 120° ± 7°, and knee flexion from 130° ± 10° to 140° ± 9° (p < 0.05). PS scores increased from 58 ± 10 to 80 ± 9, and PF from 60 ± 11 to 79 ± 8 (p < 0.05). No significant correlation was observed between ROM gains and BODY-Q scores, suggesting that improvements are mediated by mechanical release, postural realignment, and psychosocial benefits rather than mobility alone. These findings indicate that lipoabdominoplasty, while traditionally performed for aesthetic purposes, may play a significant role in enhancing functional recovery and quality of life following massive weight loss.

Low back pain (LBP) significantly impairs quality of life and is frequently associated with diastasis recti abdominis (DRA), particularly in postpartum women. This study aims to evaluate the impact of lipoabdominoplasty with rectus muscle plication on LBP, core function, and health-related quality of life (HRQL) in women with DRA. We prospectively enrolled female patients who underwent lipoabdominoplasty with rectus muscle plication in 2023 for DRA correction (2–10 cm). Exclusion criteria included BMI ≥ 35 kg/m2, hernias, prior abdominal wall surgery, major comorbidities, and unrealistic expectations. Pain and function were assessed preoperatively (T0) and postoperatively at 6 months (T1) and 12 months (T2) using the Numerical Rating Scale (NRS) for LBP and BODY-Q Physical Function and Symptoms domains. Complication rates were recorded. A total of 42 patients met inclusion criteria. Mean NRS scores decreased from 5.6 ± 1.2 at T0 to 2.9 ± 1.1 at T1 and 2.3 ± 1.0 at T2 (p < 0.001). BODY-Q Physical Function scores improved from 56.2 ± 8.4 at T0 to 75.5 ± 7.9 at T2 (p < 0.001). Physical Symptoms domain scores increased from 58.6 ± 9.1 to 78.3 ± 8.5 (p < 0.001). Minor complications occurred in 5 patients (11.9 www.springer.com/00266 .

High-definition abdominal liposuction is a complex procedure requiring optimal anesthetic management to ensure patient safety and favorable outcomes. This study evaluates and compares the safety and efficacy of general anesthesia and deep sedation in this context. We retrospectively analyzed 681 patients who underwent high-definition abdominal liposuction between 2015 and 2023. Patients were divided into two groups: 187 received general anesthesia (Group I), while 484 underwent deep sedation (Group II). Perioperative management, including the use of compression garments, Caprini score-based thromboprophylaxis, and standardized follow-up protocols, was consistent across groups. No statistically significant differences in major complications such as hematomas (p = 0.08), infections (p = 0.15), or VTEs (p = 1.00) were observed between the groups. Both techniques facilitated early mobilization and timely discharge. Tailored interventions, including preoperative risk assessments and perioperative warming, contributed to a low overall complication rate. Despite the absence of tranexamic acid, outcomes remained favorable, likely due to adequate tumescent infiltration times and other precautionary measures. Both general anesthesia and deep sedation are effective and safe for high-definition abdominal liposuction. The findings underscore the importance of individualized risk management strategies and highlight the feasibility of deep sedation as a routine alternative. This study provides evidence-based guidance for selecting anesthetic techniques in cosmetic 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 .

Background: Plastic surgery aims to enhance patients’ positive features and improve perceived flaws without seeking complete transformation. The body is a living organism, not a sculptural object to be reshaped at will. Aesthetic standards are influenced by subjective factors, including technology and social media’s effect on self-perception and beauty ideals. Understanding body perception requires consideration of personal views, mirror reflections, and external perspectives. Methods: We analyzed data from more than 4000 patients to obtain objective insights into contemporary aesthetic preferences. We examined the influence of globalization on beauty standards, the relationship between physical activity and desired body definitions, and regional preferences for specific body shapes. In addition, we assessed how patients’ aesthetic preferences are shaped more by the surgical centers they choose than by their nationality. Results: Our findings indicate that globalization has diversified perceptions of beauty, highlighting personal and cultural differences. We noted a significant correlation between patients’ aesthetic preferences and the surgical center, reflecting the impact of medical tourism and social media on shaping beauty ideals. Conclusions: As patient opportunities expand, the remote management of complex procedures necessitates skilled surgeons to ensure safe and effective care. Our experience provides valuable data on current patient preferences, essential for adapting practices in the evolving landscape of plastic surgery.

BACKGROUND:Lipoabdominoplasty, primarily sought for cosmetic enhancement, has shown potential benefits beyond physical transformation. Emerging evidence suggests that aesthetic procedures may positively affect mental health by improving body image and self-esteem. This study aims to assess the impact of lipoabdominoplasty on pharmacologic therapy (ie, benzodiazepines) use in patients with preexisting depression or anxiety disorders. METHODS:This prospective cohort study included 69 patients who underwent lipoabdominoplasty. All patients were taking benzodiazepines before surgery, with dosage frequency recorded. Follow-up assessments were conducted postoperatively to document changes in drug use and evaluate mental health improvements using validated scales, including the BODY-Q. RESULTS:A significant reduction in benzodiazepine use was observed postoperatively. At follow-up, 17% of patients discontinued medication, and 61% required a lower dosage ( P < 0.05). Complications occurred in 16% of cases, including seroma ( n = 6), infection ( n = 2), hematoma ( n = 2), and necrosis ( n = 1); 1 patient required reintervention. BODY-Q scores demonstrated significant improvements in body image and self-esteem. CONCLUSIONS:Lipoabdominoplasty may contribute to reduced drug use, likely driven by improvements in body image and psychologic well-being. These findings underscore the potential of aesthetic surgery to enhance mental health in patients with depression or anxiety, offering an integrated holistic care approach. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.

SUMMARY:Thighplasty is a widely performed body contouring procedure, using various surgical techniques for thigh lifting, including medial scar positioning, vertical and horizontal procedures, and liposuction. Despite its popularity, thighplasty is associated with high complication rates and suboptimal postoperative outcomes. This article presents a novel technique: the J-medial thighplasty combined with helium plasma radiofrequency (HPRF) technology to address moderate skin and soft-tissue laxity and ptosis in the inner thighs. Between 2020 and 2023, 21 patients underwent this combined procedure. The surgical approach involved selective liposuction in targeted areas, skin resection, and preservation of deep tissue layers, coupled with the application of HPRF in the lower third of the medial thigh. Results demonstrated significant reductions in thigh laxity, correction of skin overhang, and fat reduction, yielding improved functional and aesthetic outcomes in the lower thigh region. By strategically avoiding lymphatic vessels in superficial areas, the risk of secondary lymphedema was minimized. Patient satisfaction was notably high, with both patients and surgeons reporting favorable results. In conclusion, the J-medial thighplasty combined with HPRF offers an effective and straightforward method for enhancing the lower thigh area with minimal complications. This innovative technique provides a promising solution for patients seeking improved thigh contouring while ensuring high levels of patient satisfaction. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.