1. Comput Assist Surg (Abingdon). 2026 Dec;31(1):2614532. doi: 10.1080/24699322.2026.2614532. Epub 2026 Jan 10. The impact of three-dimensional simulation and virtual reality technologies on surgical decision-making and postoperative satisfaction in aesthetic surgery: a preliminary study. Ersan M(1), Demirbaşoğlu H(2), Kolcu B(3), Yıldız HA(1). Author information: (1)Department of Plastic, Reconstructive and Aesthetic Surgery, Yeditepe University Faculty of Medicine, Istanbul, Türkiye. (2)Department of Plastic, Reconstructive and Aesthetic Surgery, Van Training and Research Hospital, University of Health Sciences, Van, Türkiye. (3)Department of Plastic, Reconstructive and Aesthetic Surgery, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, University of Health Sciences, Şanlıurfa, Türkiye. BACKGROUND: Three-dimensional (3D) simulation and virtual reality (VR) technologies are increasingly used in aesthetic surgery consultations to enhance decision-making and expectation management. However, their impact on surgical decision-making and postoperative satisfaction across different procedures remains unclear. OBJECTIVES: This study aimed to evaluate the influence of 3D simulation and VR technology in patients undergoing rhinoplasty, breast augmentation, mastopexy, augmentation-mastopexy and breast reduction. METHODS: A retrospective study was conducted with 75 female patients who underwent primary aesthetic surgery. Preoperative 3D simulations and VR visualizations were generated using the Crisalix Virtual Esthetics system (Crisalix S.A., Switzerland). Patients were assessed postoperatively at one year using structured surveys to evaluate the influence of 3D simulation and VR technology on their decision-making and satisfaction. Statistical analyses included the Kruskal-Wallis H test, the Chi-Square test, and Spearman's correlation. RESULTS: 3D simulation had the greatest influence on breast augmentation (8.4/10), rhinoplasty (7.6/10), and augmentation-mastopexy (7.1/10) patients but was less impactful for mastopexy (6.6/10) and breast reduction (3.8/10) patients (p < 0.001). The most decisive factors were previous patient photos (30.7%) and communication with the surgeon (29.3%), with simulation ranking third (18.7%). Postoperative similarity ratings were highest in breast augmentation (7.9/10) and rhinoplasty (7.5/10) patients. While 70.7% of patients would recommend 3D simulation, VR headset use did not influence decisions (p < 0.001). CONCLUSIONS: 3D simulation enhances patient engagement and expectation management across various aesthetic procedures. While its influence is more significant in surgeries primarily focused on aesthetic outcomes, it serves as a complementary tool rather than a definitive factor in decision-making. DOI: 10.1080/24699322.2026.2614532 PMID: 41518093 [Indexed for MEDLINE] 2. JPRAS Open. 2026 Jul 31;52:70-80. doi: 10.1016/j.jpra.2026.07.029. eCollection 2026 Nov. Autologous fat-derived products for skin and scar optimization in rhinoplasty and nasal reconstruction: A systematic review. Aljahdali DA(1), Aljahdali NA(2), Alharbi RA(1), AlAbdullah G(2), Albarrati AM(3), Almohaimeed NA(4), Mobarki HJ(3), Aljahdali TA(2), Alalola R(5). Author information: (1)College of Medicine, Princess Nourah University, Riyadh, Saudi Arabia. (2)College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. (3)Faculty of Medicine, Jazan University, Jazan, Saudi Arabia. (4)College of Medicine, King Saud University, Riyadh, Saudi Arabia. (5)Department of Plastic and Reconstructive Surgery, Security Forces Hospital, Riyadh, Saudi Arabia. BACKGROUND: Rhinoplasty and nasal reconstruction are technically demanding procedures in which optimization of the skin and soft-tissue envelope remains challenging, particularly in revision surgery and in patients with thin or scarred skin. Autologous fat-derived products have emerged as regenerative adjuncts that may improve scar quality, skin texture, and aesthetic outcomes beyond simple volumetric augmentation. OBJECTIVE: To systematically evaluate the clinical outcomes of autologous fat-derived product grafting in rhinoplasty and nasal reconstruction, focusing on scar quality, skin characteristics, aesthetic outcomes, patient satisfaction, safety, and durability. METHODS: This systematic review followed PRISMA 2020 guidelines and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251087473). A comprehensive search of PubMed, Embase, Web of Science, the Cochrane Library, and Google Scholar was conducted from database inception to June 2025. Human clinical studies reporting outcomes of autologous fat-derived products in rhinoplasty or nasal reconstruction were included. Study selection, data extraction, and risk-of-bias assessment were performed using predefined criteria. Because of substantial clinical and biological heterogeneity, a structured qualitative (narrative) synthesis informed by Synthesis Without Meta-analysis (SWiM) guidance was undertaken, with outcomes organised by product class. RESULTS: Twelve studies published between 2007 and 2024, involving 768 patients in aggregate across non-pooled studies, met the inclusion criteria. Interventions included microfat, nanofat, stromal vascular fraction, adipose-derived stromal cells, platelet-rich fibrin-enriched fat, and diced fat composites. Most studies reported improvements in scar appearance, skin quality, and tissue pliability, with favorable aesthetic outcomes and high patient satisfaction. Only one study used objective three-dimensional imaging; the remainder relied on subjective assessment. Complications were infrequent and generally minor. CONCLUSIONS: Autologous fat-derived products appear to be well tolerated and may be useful adjuncts in rhinoplasty and nasal reconstruction, with a consistently low rate of minor, self-limiting complications. However, the available evidence is of low certainty: it is drawn predominantly from small, uncontrolled, subjectively assessed studies that pool biologically distinct fat preparations and is geographically concentrated in East Asian populations. Reported aesthetic benefits should be interpreted with caution. Well-designed comparative studies using standardised processing protocols, blinded three-dimensional outcome assessment, and adequate follow-up are needed before firm clinical recommendations can be made. © 2026 The Authors. DOI: 10.1016/j.jpra.2026.07.029 PMCID: PMC13545689 PMID: 42701521 Conflict of interest statement: None. 3. Aesthet Surg J. 2026 Aug 11;46(46 Suppl 2):S127-S137. doi: 10.1093/asj/sjag110. Retrospective Validation of a Tissue-Preserving Breast Augmentation Approach: From Native Tissue Geometry to Surgical Practice. Chacon-Quiros M, Burke R, Gordon A, Herrera-Mora G, Solis-Torres J, Solis-Chaves P, van der Pot W. BACKGROUND: Breast augmentation has traditionally focused on implant volume and pocket selection, often overlooking the variability of native breast anatomy. OBJECTIVES: Breast tissue preservation (BTP) emphasizes preservation of fascial planes and tissue integrity, enabling prepectoral implant placement within a preserved tissue envelope. When combined with 3-dimensional (3D) imaging and ultrasound-based geometric analysis, BTP supports selective implant positioning tailored to regional deficiencies, potentially improving stability and natural aesthetic outcomes while reducing reliance on larger implant volumes and the need for scaffold support. METHODS: A single center retrospective study analyzed 111 patients undergoing primary breast augmentation or augmentation-mastopexy using tissue preservation techniques, including transaxillary and inframammary approaches. Pre- and 12-month postoperative assessments incorporated 3D imaging and high-resolution ultrasound to evaluate breast geometry, tissue distribution, volumetric and angular changes, and stability. Safety outcomes and patient satisfaction were evaluated over 12 months. RESULTS: Among 111 patients, complication rates were low (4.5%), with no Baker III-IV capsular contracture, no implant ruptures and high satisfaction scores. Geometric analysis demonstrated consistent increases in upper, medial, and lateral angles, procedure specific inferior angle changes, preserved nipple alignment with maximal projection, and improved breast stability, supporting controlled and reproducible volume redistribution. These changes were achieved through targeted regional volume placement. CONCLUSIONS: This study highlights the clinical value of a comprehensive native breast assessment in real-world practice. Integrating volumetric, topographic, and angular analysis enables individualized planning, precise implant positioning, with minimally invasive BTP techniques. This approach supports biomechanical stability, demonstrates a favorable safety profile, and promotes natural outcomes in everyday surgical practice. Level of Evidence: 4 (Therapeutic). © The Author(s) 2026. Published by Oxford University Press on behalf of The Aesthetic Society. DOI: 10.1093/asj/sjag110 PMCID: PMC13594680 PMID: 42579317 [Indexed for MEDLINE] 4. Bioengineering (Basel). 2026 Aug 9;13(8):899. doi: 10.3390/bioengineering13080899. Relative Agreement and Feasibility of Low-Cost Passive Stereophotogrammetry for Nasal Three-Dimensional Surface Imaging: A Comparison of COLMAP and Agisoft Metashape with a Handheld Structured-Light Scanner. Li X(1), Yan S(1), Zhu Z(1), Zhang C(1), Wu Y(1), Meng F(2), Yun L(1). Author information: (1)West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu 610041, China. (2)School of Basic Medical Sciences, Xinjiang Medical University, Urumqi 830017, China. Portable handheld three-dimensional (3D) scanners have improved facial surface measurement workflows in plastic and reconstructive surgery and have potential applications in preoperative planning, postoperative assessment, and customized implant design. However, the relative agreement of low-cost passive stereophotogrammetry for nasal surface reconstruction remains insufficiently characterized when compared with handheld structured-light scanning. This study evaluated the feasibility and relative surface-deviation performance of two passive stereophotogrammetry-based systems for nasal 3D surface reconstruction in healthy participants. Twenty-five healthy participants were enrolled, and nasal 3D models were reconstructed using Artec Eva, COLMAP, and Agisoft Metashape. COLMAP- and Agisoft Metashape-derived models were aligned to the corresponding Artec Eva models in MeshLab. Geometric deviations were quantified using root mean square (RMS) surface deviation, mean surface distance (MSD), and Hausdorff distance (HD), and regional discrepancies were visualized using surface-distance heat maps. Both passive pipelines produced deviations generally within previously reported ranges for facial or nasal 3D imaging, with median RMS and MSD values below 0.5 mm. Hausdorff distance showed larger local deviations, particularly in the alar and perinasal regions, and was significantly lower for Agisoft Metashape than for COLMAP. These findings suggest that low-cost passive stereophotogrammetry may support standardized nasal surface measurement under controlled acquisition conditions. DOI: 10.3390/bioengineering13080899 PMCID: PMC13510088 PMID: 42649788 Conflict of interest statement: The authors declare no conflicts of interest. 5. Plast Reconstr Surg Glob Open. 2026 Aug 5;14(8):e7999. doi: 10.1097/GOX.0000000000007999. eCollection 2026 Aug. Preoperative 3-dimensional Simulation in Aesthetic Surgery. Atiyeh BS(1), Issa OB(1), Daoud FJ(1), Baajour JA(1). Author information: (1)From the Faculty of Medicine, Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon. BACKGROUND: Many patients cannot visualize the expected outcome of aesthetic interventions. Better than verbal descriptions and confusing diagrams, preoperative simulation of outcome displays complex ideas simply and improves surgeon-patient communication. Unfortunately, objective assessment of the factors that affect simulation accuracy is still lacking. Moreover, there is no real discussion about the ethical and legal implications of an eventual mismatch between preoperative simulation and the actual surgical outcome. This review aimed to summarize the current status of 3D simulation applications in aesthetic surgery. METHODS: A systematic literature search was conducted to identify clinical studies related to aesthetic surgery, measuring and reporting the accuracy of preoperative simulation compared with the achieved outcome. RESULTS: Seventeen studies (12 on breast augmentation and 5 on rhinoplasty) were identified and included for review. No studies about other aesthetic procedures were identified. Simulation accuracy varied for rhinoplasty. Although high accuracy has been reported in various 3D breast augmentation simulation software programs, dissatisfaction with the accuracy of preoperative simulation information is not negligible. Relying solely on simulation may lead to inaccuracies. CONCLUSIONS: Undoubtedly, 3D simulation has been a significant step forward in aesthetic surgery. Originally introduced to enhance patient consultations, it is now becoming a strategic tool in planning and refining surgical interventions. The possible mismatch between simulation and outcome must be well recognized. Despite its numerous advantages, if misused, the technology can be counterproductive for both patient and surgeon. Making patients aware that simulations may not represent the final surgical outcome is essential. Copyright © 2026 The Authors. Published by Wolters Kluwer Health, LLC. on behalf of The American Society of Plastic Surgeons. DOI: 10.1097/GOX.0000000000007999 PMCID: PMC13441132 PMID: 42559587 Conflict of interest statement: The authors have no financial interest to declare in relation to the content of this article. 6. J Craniofac Surg. 2026 Jul 29. doi: 10.1097/SCS.0000000000013213. Online ahead of print. Three-Dimensional Digital Planning and Long-Term Outcome Analysis in Aesthetic Rhinoplasty. Horoz U(1), Sariguney Y(2). Author information: (1)Departments of Reconstructive and Aesthetic Surgery Clinic, Private Plastic, 34421, Istanbul. (2)Plastic, Reconstructive, and Aesthetic Surgery, Sanko University, Gaziantep, Turkey. BACKGROUND: Preoperative digital imaging and simulation technologies have become increasingly important in aesthetic rhinoplasty for improving surgical planning, surgeon-patient communication, and patient expectation management. However, data evaluating the relationship between preoperative simulation and long-term postoperative outcomes remain limited. METHODS: This retrospective study included 198 patients who underwent aesthetic rhinoplasty. The study population consisted of 138 female and 60 male patients with a mean age of 28 years. All patients underwent preoperative 2-dimensional (2D) photographic analysis and 3-dimensional (3D) digital simulation before surgery. Long-term postoperative outcomes, revision rates, postoperative discrepancies between preoperative planning and actual outcomes, and patient satisfaction were evaluated over a 3-year follow-up period. The study was conducted in accordance with ethical standards, and written informed consent was obtained from all participants. RESULTS: The overall revision rate was 12.6% (25/198 patients). Revision rhinoplasty was performed in 11 patients (44%) for inadequate dorsal contour depth, in 8 patients (32%) for tip ptosis, and in 6 patients (24%) for intermittent functional breathing problems associated with septal deviation. Most postoperative dorsal contour discrepancies remained within clinically acceptable limits. Eleven patients demonstrated a ∼1 mm discrepancy, 10 patients a ∼1.5 mm discrepancy, 5 patients a ∼2m m discrepancy, and 3 patients a ∼3 mm discrepancy between preoperative simulation and postoperative outcomes without requiring revision surgery. Preoperative 3D simulation improved visualization of surgical goals and facilitated patient understanding of postoperative expectations. CONCLUSIONS: Preoperative 2D and 3D digital imaging and simulation techniques represent valuable adjuncts in modern rhinoplasty practice. These technologies improve patient communication, facilitate expectation management, and may contribute to greater long-term postoperative satisfaction by improving consistency between preoperative planning and actual surgical outcomes. Copyright © 2026 by Mutaz B. Habal, MD. DOI: 10.1097/SCS.0000000000013213 PMID: 42522961 Conflict of interest statement: The authors report no conflicts of interest. 7. Front Glob Womens Health. 2026 Jul 1;7:1822760. doi: 10.3389/fgwh.2026.1822760. eCollection 2026. Three-dimensional assessment of macromastia: linking breast morphology to quality of life. Wang H(1), Jin X(1), Chen X(1), Shi X(1), Wang J(1), Yi C(1). Author information: (1)Department of Plastic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. BACKGROUND: Macromastia is associated with substantial physical and psychosocial burden, yet existing diagnostic thresholds, particularly for gigantomastia, are largely derived from weight-based criteria established in Western populations. These standards may be suboptimal for preoperative assessment in Asian women, where breast composition and body habitus differ. METHODS: In this cross-sectional study, adult women with breast volumes > 400 mL were recruited from a tertiary plastic surgery center. Preoperative breast morphology was assessed using the VECTRA® XT 3D imaging system, including breast volume, breast width, SNN distance, and ptosis grade. QoL was evaluated using the BREAST-Q Reduction/Mastopexy Module (version 2.0). Associations among morphological parameters, BMI and BREAST-Q domains were comprehensively analyzed. RESULTS: A total of 145 patients underwent 3D imaging and 168 completed the BREAST-Q questionnaire. Fifty-three patients completed both assessments and were included in analyses integrating breast morphology and patient-reported outcomes. Breast volume was positively correlated with BMI and ptosis severity (P < 0.05). SNN distance demonstrated a stronger correlation with ptosis grade (ρ = 0.657, p < 0.001). Patients with breast volumes ≥ 1,000 mL demonstrated significantly greater ptosis severity and lower physical well-being scores compared with those with moderate macromastia. BMI showed stronger unadjusted associations with psychosocial well-being, sexual well-being, and satisfaction with breasts than breast volume alone. However, these associations were attenuated after multivariable adjustment. CONCLUSIONS: Three-dimensional imaging combined with BREAST-Q assessment provides complementary information on the anatomical and patient-reported burden of macromastia. Breast volumes of 1,000 mL or greater were associated with increased ptosis severity and poorer physical well-being and may represent a clinically relevant threshold warranting further investigation. These findings support a multidimensional approach to preoperative evaluation that incorporates breast morphology, body habitus, and patient-reported outcomes. © 2026 Wang, Jin, Chen, Shi, Wang and Yi. DOI: 10.3389/fgwh.2026.1822760 PMCID: PMC13368729 PMID: 42459573 Conflict of interest statement: The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. 8. Br J Oral Maxillofac Surg. 2026 Jul;64(6):439-456. doi: 10.1016/j.bjoms.2026.02.018. Epub 2026 Apr 29. Facial gender-affirming surgery: a state-of-the-art overview based on 18 years of specialised practice. Gutiérrez-Santamaría J(1), Bailón C(2), Bellinga RJ(2), Juliá MÁ(2), Masià-Gridilla J(2), Pérez de Perceval Tara M(2), Penedo Á(2), Labrot I(2), Capitán-Cañadas F(2), Simon D(2), Capitán L(2). Author information: (1)The Facialteam Group, HC Marbella International Hospital, Marbella, Málaga, Spain. Electronic address: javiergutierrez@facialteam.eu. (2)The Facialteam Group, HC Marbella International Hospital, Marbella, Málaga, Spain. Facial gender-affirming surgery (FGAS), historically termed facial feminisation surgery, has evolved into a highly specialised field characterised by increasing technical refinement, safety, and patient expectations. Based on a consecutive cohort of 3582 patients treated between 2008 and 2025, this Special Topic paper presents a state-of-the-art overview of contemporary FGAS practice, focusing on surgical sequencing, anatomical planning, and quality standards. The manuscript is organised by facial thirds-upper, middle, lower-and the cervical region, which reflects both anatomical logic and clinical workflow. Current surgical strategies are described for each region, emphasising bone-driven structural feminisation as the foundation for predictable outcomes, followed by staged soft-tissue adaptation when required. The role of advanced diagnostic protocols, three-dimensional imaging, patient-specific cutting guides, piezoelectric instrumentation, and biologically adjunctive therapies is highlighted. Beyond technical aspects, this work underscores the importance of meticulous preoperative assessment, realistic management of expectations, and ethical responsibility in a heterogeneous and vulnerable patient population. By synthesising nearly two decades of focused clinical experience, this article aims to define contemporary standards and provide practical guidance for safe, systematic, and patient-centred FGAS practice. Copyright © 2026 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. DOI: 10.1016/j.bjoms.2026.02.018 PMID: 42185126 [Indexed for MEDLINE] 9. Aesthetic Plast Surg. 2026 Jul;50(13):4962-4978. doi: 10.1007/s00266-026-05853-9. Epub 2026 May 19. Shaping the Future of Nasal Surgery: A Systematic Review of Preservation Rhinoplasty. Gucuk D(#)(1), Knoedler L(#)(2)(3), Niederegger T(#)(4), Fenske J(2), Hundeshagen G(5), Heiland M(2), Cetrulo CL(3), Mathieu O(6), Schaschinger T(4), Lellouch AG(7)(8)(9). Author information: (1)Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland. (2)Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Mittelallee 2, 13353, Berlin, Germany. (3)Division of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. (4)Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany. (5)Department of Hand, Plastic and Reconstructive Surgery, Department of Plastic and Hand Surgery, Burn Center, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany. (6)Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. (7)Division of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. alexandre.lellouch@csmc.edu. (8)Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. alexandre.lellouch@csmc.edu. (9)Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, 75006, Paris, France. alexandre.lellouch@csmc.edu. (#)Contributed equally BACKGROUND: Preservation rhinoplasty has transformed nasal surgery by prioritizing structural conservation while achieving aesthetic refinement and functional optimization. Unlike traditional rhinoplasty, which relies on extensive resection and reconstruction, preservation techniques aim to maintain key anatomical components, reducing complications and improving long-term stability. Recent advancements, including open dorsal preservation approaches and hybrid rhinoplasty techniques (bridging preservation and structural concepts), have expanded its indications, making it applicable to a broader range of nasal deformities and functional impairments. However, the efficacy, limitations, and functional outcomes of these techniques remain to be synthesized. METHODS: A systematic review was conducted following PRISMA 2020 guidelines, searching PubMed/MEDLINE, EMBASE, and Web of Science databases up to March 1st, 2025. Studies evaluating surgical techniques, functional and aesthetic outcomes, complications, and patient satisfaction in preservation rhinoplasty were included. Given the heterogeneity of study designs and outcome measures, a narrative synthesis was performed. RESULTS: Thirteen studies comprising 855 patients were included, with publication years ranging from 2020 to 2024 and a mean Newcastle-Ottawa Scale score of 5.8 (SD 0.4), indicating moderate methodological quality. Dorsal preservation techniques-including push-down, let-down, and subdorsal strip methods-consistently yielded favorable results. Patient satisfaction was high, with Rhinoplasty Outcome Evaluation (ROE) scores exceeding 85 in up to 90.3% of patients. Functional improvement was reported across techniques, with increased nasal patency scores and reduced Nasal Obstruction Symptom Evaluation (NOSE) scores. Hybrid approaches such as mix-down and Low Strip Unifying Hybrid Rhinoseptoplasty (LUHRS) were especially beneficial in complex nasal anatomies, with RHINO scores rising from 37.6 to 88.2. Reported revision rates across all approaches ranged from 0 to 7.9%, typically addressing minor contour irregularities without major complications. CONCLUSION: Preservation rhinoplasty has emerged as a potentially promising alternative to traditional structural techniques and may offer favorable dorsal contour preservation, low reported complication rates, and high levels of patient satisfaction in selected patients. Careful patient selection appears to remain essential, with ideal candidates often presenting with straight nasal profiles, minimal dorsal deviation, and relatively intact nasal anatomy. While early outcomes are encouraging, the predominance of observational data, limited use of standardized objective functional assessments, and relatively short follow-up periods restrict definitive conclusions regarding long-term durability and comparative effectiveness. Future research should aim to further refine patient selection criteria, clarify the role of hybrid techniques in more complex cases, and explore the integration of technologies such as 3D imaging and artificial intelligence to potentially enhance surgical planning and outcome assessment in modern nasal surgery. LEVEL OF EVIDENCE II: 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 . © 2026. The Author(s). DOI: 10.1007/s00266-026-05853-9 PMCID: PMC13433595 PMID: 42154257 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Conflict of interest: The authors declare that they have no conflicts of interest to disclose. Ethical Approval: This article does not contain any studies with human participants or animals performed by any of the authors. Informed Consent: For this type of study, informed consent is not required. 10. Plast Reconstr Surg. 2026 Jul 1;158(1):56-65. doi: 10.1097/PRS.0000000000012683. Epub 2025 Dec 4. 3-Dimensional Simulation for Breast Augmentation: Does the Software Actually Work? Lorange E(1), Bouhadana G(1), Oiknine N(1), Luc M(2), Borsuk DE(1). Author information: (1)From the Division of Plastic and Reconstructive Surgery, University of Montreal. (2)Division of Plastic and Reconstructive Surgery, McGill University. BACKGROUND: Recent advances in 3-dimensional (3D) imaging, such as the Vectra XT 3D imaging system (Vectra; Canfield Imaging Systems), have enabled simulations for breast augmentation. These simulations are popular and valuable in preoperative consultations, but no studies have evaluated the system's predictive volume accuracy with a large sample size or explored the patient-specific and surgical factors influencing these simulations. METHODS: A prospective cohort study was conducted on patients undergoing breast augmentation simulations with Vectra between January of 2021 and December of 2022. Predictive volumetric accuracy was analyzed with a ±10% precision threshold and Bland-Altman visualization. Linear breast measurements were compared using mean and median absolute error analysis, and a generalized linear model with generalized estimating equations was used to identify factors affecting volume prediction accuracy. RESULTS: The study included 78 patients (154 breasts). Accurate predictions (±10% error) were achieved in 73% of cases, with an average margin of error of 7.52%. The most accurate measurement was sternal-nipple ( P = 0.64) and the least accurate measurement was nipple-inframammary fold ( P = 0.001). Factors influencing prediction accuracy included pregnancy history, preoperative breast volume, and implant volume. CONCLUSIONS: Vectra accurately predicts postoperative breast volumes within a 10% margin of error, although precision decreases with larger breasts (greater than 650 cc). Patient-specific factors, such as pregnancy history and preoperative breast characteristics, should guide preoperative consultations. The system enhances patient education, shared decision-making, and participation in care, reinforcing its value in preoperative planning for breast augmentation. Copyright © 2025 by the American Society of Plastic Surgeons. DOI: 10.1097/PRS.0000000000012683 PMID: 41344311 [Indexed for MEDLINE] 11. Facial Plast Surg Aesthet Med. 2026 Jul-Aug;28(4):371-374. doi: 10.1177/26893614251360696. Epub 2025 Jul 18. Artificial Intelligence (AI)-Enhanced Simulation of Facial Filler Sequencing. Wiegmann AL(1), Rohrich RJ(1). Author information: (1)Dallas Plastic Surgery Institute (DPSI), Dallas, Texas, USA. Preprocedural simulation can be an important tool for patient counseling and setting patient expectations in a plastic surgeon's office. Simulation technologies are used widely in plastic surgery and can involve expensive three-dimensional imaging suites that allow the plastic surgeon to alter patient photographs to simulate postprocedural results. Artificial intelligence (AI) is gaining traction in many facets of the plastic surgery world. However, AI has not been significantly utilized in preprocedural simulation. AI represents a new frontier in plastic surgery simulation as inexpensive AI "generative fill" technology can instantly alter and rejuvenate specifically demarcated areas of patient photographs to render realistic postprocedural results. The authors aimed to assess the feasibility of using AI to simulate whole-face rejuvenation with soft tissue fillers by performing injection simulations on real patient photographs. This article lays the foundation for future studies applying more sophisticated AI models in plastic surgery preprocedural simulation. DOI: 10.1177/26893614251360696 PMID: 40681302 [Indexed for MEDLINE] Conflict of interest statement: Author Disclosure StatementThe authors have no financial conflicts of interest to disclose relevant to the content of this article. 12. J Craniofac Surg. 2026 Jun 26. doi: 10.1097/SCS.0000000000013081. Online ahead of print. Three-Dimensional Facial Aesthetic Analysis of Oval and Rectangular Face Shapes in Han Chinese Women for Plastic Surgery Applications. Yang F(1), Wei B(2), Zhao Q(1), Chen J(3), Huang X(1), Long X(1), Feng Z(2), Song M(2), Huang C(1), Cao J(4). Author information: (1)Department of Plastic and Cosmetic Surgery, Zhejiang Hospital. (2)College of Computer Science and Technology, Zhejiang University, Xihu District, Hangzhou. (3)Department of Plastic Surgery, Zhengzhou University Affiliated Zhengzhou Central Hospital, Zhongyuan District, Zhengzhou. (4)Department of General Practice, Hui Min Street Community Health Service Center, Jiashan County, Jiaxing, China. This study used 3-dimensional scanning to quantitatively compare facial parameters between oval and rectangular face shapes in Han Chinese women, assess the applicability of traditional "3 Regions and 5 Eyes" aesthetic standards, and provide objective reference data for facial plastic surgery. Scans were obtained from 80 women (45 oval, 35 rectangular; mean age 29.6±8.4 y). Fourteen anthropometric landmarks were identified, and 20 parameters (height, width, convexity, and ratios) were calculated and compared between groups using unpaired t tests (P<0.05). Oval faces exhibited significantly lower upper, middle, and lower facial heights; narrower upper, middle, and lower facial widths; and a larger ratio of total facial height to middle facial width than rectangular faces (P<0.05). Relative to midface height, the upper height ratio was larger and the lower height ratio smaller in oval faces; relative to midface width, the upper width ratio was larger and the lower width ratio smaller. The ratio of palpebral fissure width to intercanthal width was also greater in oval faces (P<0.05). Regarding convexity, oval faces showed greater upper facial convexity, a smaller sagittal projection of the zygomatic point from the tragion, and a larger sagittal projection of the pogonion from the subnasale (P<0.05). No measured ratios conformed to the traditional "3 Regions and 5 Eyes" proportions. Three-dimensional imaging effectively quantifies distinct facial features, suggesting that traditional aesthetic standards should be refined using contemporary anthropometric data to better inform cosmetic surgery planning. Copyright © 2026 by Mutaz B. Habal, MD. DOI: 10.1097/SCS.0000000000013081 PMID: 42359499 Conflict of interest statement: The authors report no conflicts of interest. 13. Aesthetic Plast Surg. 2026 Jun;50(11):4085-4096. doi: 10.1007/s00266-026-05811-5. Epub 2026 Apr 8. Postoperative Displacement of the Inframammary Fold in Breast Augmentation: A 12-Month Observational Study. Benito-Ruiz J(1). Author information: (1)Antiaging Group Barcelona Ronda General Mitre 84, 08021, Barcelona, Spain. drbenito@antiaginggroupbarcelona.com. BACKGROUND: The inframammary fold (IMF) plays a central role in breast augmentation surgery, yet its long-term positional stability following implant placement remains insufficiently characterized. Accurate prediction of IMF location is essential for aesthetic outcomes, particularly when selecting surgical approaches or implant types. METHODS: A retrospective observational study was conducted on 156 breasts (78 patients) who underwent augmentation between 2018 and 2022, with a minimum follow-up of 12 months. Pre- and postoperative measurements were obtained using 3D imaging in arm-adducted position. Variables included SN-Ni, Ni-Ni, Ni-IMF, SN-Nimid, Ni-IMFmid, and SN-IMFmid. Patients were stratified by implant shape (anatomic vs. round), placement plane (submuscular, subfascial, dual plane II), and incision type. Statistical analyses were performed to evaluate IMF displacement and associated factors. RESULTS: The IMF was displaced by more than 10 mm from the planned position in 53.8% of cases. Anatomic implants demonstrated slightly less fold displacement than round implants (3 ± 14.7 mm vs. 8.1 ± 14 mm), although this was not statistically significant. Submuscular placement significantly increased lower pole expansion and IMF descent compared to subfascial placement (p < 0.05). There was no significant difference in fold stability based on incision type, including inframammary incisions where reinforcement sutures were used. CONCLUSIONS: Caudal displacement of the IMF is common following breast augmentation. Submuscular placement contributes significantly to this effect. Anatomic implants may offer improved fold stability. Preoperative planning using the implant radius from the sternal midline is reliable. IMF reinforcement appears non-essential but warrants further study. LEVEL OF EVIDENCE IV: 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 . © 2026. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery. DOI: 10.1007/s00266-026-05811-5 PMID: 41951896 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Conflict of interest: Nothing to disclosure 14. J Craniofac Surg. 2026 Jun 1;37(6):1583-1587. doi: 10.1097/SCS.0000000000012151. Epub 2025 Nov 12. Beyond Hounsfield Units: A Comparative Study of Semiquantitative Morphological Features for Differentiating Silicone from Autologous Costal Cartilage Nasal Implants on CT Imaging. Deng M(1), Zhang M, Wang Y. Author information: (1)Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing, China. INTRODUCTION: Identifying the type of existing nasal implant is crucial for preoperative planning of revision rhinoplasty in patients with secondary cleft lip nasal deformity. However, patients often lack accurate information. Although Hounsfield Units (HUs) on computed tomography (CT) offer a potential solution, their discriminatory power remains uncertain. This study evaluated the efficacy of a novel three-dimensional (3D) density measurement method and compared it with semiquantitative morphologic assessment for differentiating silicone from autologous costal cartilage implants. MATERIALS AND METHODS: A retrospective study enrolled nine patients undergoing secondary rhinoplasty (4 with costal cartilage implants, 5 with silicone implants). Preoperative CT scans were analyzed using Mimics software to create 3D models of the implants and calculate the average HU value of their entire volume. Interobserver and intraobserver reliability were assessed using the intraclass correlation coefficient (ICC). The Mann-Whitney U test was used to compare density values and semiquantitative scores for morphologic features (implant boundary clarity and heterogeneous calcification) between groups. RESULTS: The novel 3D measurement method demonstrated excellent reliability (ICC > 0.98). The median HU values showed no significant difference between the costal cartilage and silicone implant groups (265.96 HU versus 118.17 HU, P = 0.754). In contrast, semiquantitative morphologic assessment revealed significant differences. The costal cartilage group had significantly higher (worse) scores for boundary clarity (median: 2.5 versus 0, P < 0.05) and heterogeneous calcification (median: 1.75 versus 0, P < 0.05), indicating blurrier boundaries and more frequent calcification compared with silicone implants. CONCLUSION: Although CT density values alone are insufficient for reliable implant differentiation, specific morphologic features-particularly implant boundary clarity and heterogeneous calcification-serve as highly discriminatory radiologic markers when assessed semiquantitatively. We recommend prioritizing semiquantitative morphologic evaluation over density measurement in the CT assessment of these patients to enhance preoperative planning for revision surgery. Copyright © 2025 by Mutaz B. Habal, MD. DOI: 10.1097/SCS.0000000000012151 PMID: 41222239 [Indexed for MEDLINE] Conflict of interest statement: Conflicts of Interest: The authors report no conflicts of interest. 15. Biomedicines. 2026 May 28;14(6):1215. doi: 10.3390/biomedicines14061215. Autologous Nanofat Indications in Wound Healing: A Systematic Review. Bonini S(1), Fuentes P(1)(2), Claytor RB(1)(3). Author information: (1)Claytor Noone Plastic Surgery, Bryn Mawr, PA 19010, USA. (2)Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA. (3)Plastic Surgery, Main Line Health, Bryn Mawr, PA 19010, USA. Introduction: Chronic wounds and pathologic scars remain a persistent challenge in plastic surgery. Conventional treatments can be costly and inconsistent, prompting interest in regenerative approaches that utilize autologous tissue. Emulsified fat produces nanofat through mechanical processing and contains adipose-derived stem cells, stromal vascular fractions, extracellular matrix proteins, cytokines and growth factors. The purpose of this systematic review is to evaluate the use of autologous nanofat for wound healing and scar management, with emphasis on preparation techniques, treatment indications, and outcomes. Methods: A comprehensive PubMed search with no date restrictions was conducted in January 2026 using MeSH terms and keywords related to nanofat and wound-healing applications. Studies were screened independently by two reviewers using the Rayyan platform. Eligible studies evaluated nanofat for wound healing in human or animal subjects; non-English articles, studies not involving nanofat, editorials, and conference abstracts were excluded. The extracted data included study characteristics, participant numbers, treatment details, indications, adjunct therapies, follow-up duration, outcomes, and complications. Studies were grouped by clinical application, with individual reports included in multiple categories when relevant. Results: The search identified 53 records, of which 22 studies met the inclusion criteria after screening. These included 20 human and two animal studies spanning randomized controlled trials (n = 3), prospective trials (n = 6), retrospective analyses (n = 6), case series (n = 4), and case reports (n = 3). Mechanical emulsification was the predominant autologous nanofat preparation method (91%), often combined with filtration or centrifugation. Clinical indications in human studies were diverse, most commonly including scar treatment (n = 14) (acne, burns, depressed, and post-surgical), followed by chronic wounds (n = 3) and reconstructive applications (n = 3). Nanofat was administered via injection in 86% of studies (n = 19), typically using fine-gauge needles or microcannulas with intradermal or subdermal placement, while three studies used non-injection approaches such as topical, membrane, or dressing-based delivery. Scar or aesthetic parameters, measured using VSS, POSAS, physician grading, photography, pigmentation analysis, or clinical appearance, were evaluated in 73% of studies (n = 16), and all reported improvement in variables such as pigmentation, pliability, thickness, texture, or overall appearance. Wound-healing endpoints were assessed in 36% (n = 8), with 100% (n = 8) demonstrating accelerated healing, improved epithelialization, or defect closure. Patient-reported outcomes, including satisfaction or quality of life, were measured in 32% (n = 7), and all showed improvement. Objective imaging modalities (e.g., 3D imaging, ultrasound, angiography, digital analysis) were used in 23% (n = 5), each confirming structural or physiologic improvement. Histologic or biomolecular analyses were performed in 27% (n = 6) and uniformly demonstrated regenerative changes, such as increased angiogenesis, collagen remodeling, or growth factor expression. Treatment was well tolerated, with 77% of studies (n = 17) reporting minimal or no complications and only transient mild adverse effects, including mild pain, bruising, erythema, and edema. Conclusions: Current evidence suggests that autologous nanofat is a promising regenerative therapy for wound healing and scar modulation. Across diverse clinical applications, nanofat has been associated with improved tissue quality, enhanced healing, and favorable patient-reported outcomes, with minimal complications. The mechanical processing of autologous tissue may also involve fewer regulatory concerns compared with more extensively manipulated cellular products. DOI: 10.3390/biomedicines14061215 PMCID: PMC13295952 PMID: 42351643 Conflict of interest statement: The authors declare no conflicts of interest. 16. Plast Reconstr Surg. 2026 May 19. doi: 10.1097/PRS.0000000000013190. Online ahead of print. A Multicenter Prospective Study of Enhanced Viability Fat Transfer for Cosmetic Augmentation and Reconstruction of the Breast. Shridharani SM(1), Eagan S(2), Tessler O(3), Medina MA 3rd(4), Saul SM(5), Calobrace MB(6)(7). Author information: (1). Plastic Surgeon in Private Practice - New York, NY. (2). Plastic Surgeon in Private Practice - Overland Park, KS. (3). Plastic Surgeon in Private Practice - Scottsdale, AZ. (4). Department of Plastic and Reconstructive Surgery, Miami Cancer Institute Baptist Health South, Miami FL. (5). Medical Affairs, Tiger Aesthetics Medical, LLC. (6). Division of Plastic Surgery, University of Louisville, Louisville, Kentucky. (7). Division of Plastic Surgery, University of Kentucky, Lexington, Kentucky. BACKGROUND: . Autologous fat transfer (AFT) is a well-established technique for cosmetic breast augmentation and reconstructive breast procedures. Historically, however, graft retention has been highly variable. The Viality™ system (Tiger Aesthetics Medical, Conshohocken, PA) is an FDA-cleared, in-line fat processing device designed to concentrate viable adipocytes, improving retention. METHODS: . In this prospective, 14-center study (NCT05258305), 190 patients underwent AFT for cosmetic (n=85) or reconstructive (n=105) breast procedures. Harvested fat was processed with Viality and AuraClens™ surfactant wash. Volumetric analysis, based on 3D imaging, was performed at baseline and 1, 3, 6, and 12 months. Percentage retention and impact of patient factors on retention at 12 months were assessed. RESULTS: . Mean (95% CI) retention was 86.6% (85.4 to 87.7) at month 1, 83.1% (81.8 to 84.4) at month 3, 84.1% (82.8 to 85.5) at month 6, and 84.8% (83.2 to 86.5) at month 12. Mean retention was significantly greater at all timepoints than the historical benchmark of 70% (P <.0001) with no significant changes in retention over time. Similar trends were observed for reconstruction and cosmetic cohorts. Retention was affected by fat transfer volume (P<.0001), weight change (P<.0001), and graft-to-recipient breast volume ratio (P=.0187). CONCLUSIONS: . Early graft steady state, sustained high-percentage volume retention, and consistent results suggest that the Viality system is an effective, predictable modality for processing fat for cosmetic and reconstructive breast surgery, setting a new standard for sustained volume retention. Copyright © 2026 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved. DOI: 10.1097/PRS.0000000000013190 PMID: 42153746 17. J Craniofac Surg. 2026 Apr 27. doi: 10.1097/SCS.0000000000012803. Online ahead of print. Optimizing Aesthetic Outcomes in Unilateral Cleft Lip Repair: Three-Dimensional Anthropometric Analysis of the Modified Onizuka Technique. Chaisrisawadisuk S(1), Jaruniphakul K(1), Seesun P(2), Nakkon M(2), Apichonbancha S(1), Sinmaroeng C(1), Chaisrisawadisuk S(3). Author information: (1)Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University. (2)Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok. (3)Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. This study evaluates anthropometric outcomes of a modified Onizuka technique for unilateral cleft lip (CL) repair using 3-dimensional (3D) photogrammetry, with emphasis on anatomic subunit reconstruction without preoperative numerical measurements. A prospective cohort study was conducted at a tertiary craniofacial center. Sixty-one patients with unilateral CL and/or palate who underwent CL repair using the modified Onizuka technique were enrolled. The technique relocates key landmarks to the footplate of the medial crus, preserves an 80° angular design at the peak of Cupid's bow, and uses a V-Y advancement flap for frenulum reconstruction. Concurrent primary rhinoplasty and gingivoplasty were performed. Anthropometric symmetry was assessed via 3D imaging at ≥1-year follow-up, including nostril width, columellar height, central and medial lip height, lateral lip height and length, and hemi-Cupid's bow width. The cohort comprised 60.7% males, with 70.5% having left-sided clefts and 67.2% having complete clefts. Median age at surgery was 5.0 months. All intraclass correlation coefficient values exceeded 0.75, indicating good to excellent reliability. No statistically significant differences were observed between cleft and noncleft sides (all P>0.05). Mean differences were <0.2 mm, below the threshold of human visual perception. The modified Onizuka technique achieves symmetric outcomes in unilateral CL repair, validated by objective 3D metrics. Its emphasis on anatomic subunit reconstruction without preoperative numerical marking offers a versatile, reproducible approach for diverse cleft phenotypes. Copyright © 2026 by Mutaz B. Habal, MD. DOI: 10.1097/SCS.0000000000012803 PMID: 42042599 Conflict of interest statement: The authors report no conflicts of interest. 18. Clin Plast Surg. 2026 Apr;53(2):211-217. doi: 10.1016/j.cps.2025.11.004. Epub 2025 Dec 13. Coming Full Circle: Journey Back to the Inframammary Fold. Bengtson BP(1). Author information: (1)Department of Plastic Surgery, Bengtson Center for Aesthetics and Plastic Surgery, 2155 East Paris Avenue, SE, Suite 100, Grand Rapids, MI 49546, USA. Electronic address: drb@bcaps.com. This article chronicles a 30 year evolution in breast augmentation, highlighting advances in implants, techniques, and anatomic understanding while reaffirming foundational surgical principles. It traces the transition from subglandular to submuscular placement following the 1992 Food and Drug Administration moratorium on silicone implants, and the subsequent return to the inframammary fold (IMF) approach after 2006. Detailed anatomy of the IMF is emphasized as critical for preventing complications such as malposition. Major advancements include stronger, more cohesive implants, improved imaging and surgical precision, infection-reducing techniques, and high-resolution ultrasound diagnostics, setting a new standard for safe, precise, and esthetically refined breast augmentation. Copyright © 2025 Elsevier Inc. All rights reserved. DOI: 10.1016/j.cps.2025.11.004 PMID: 41826042 [Indexed for MEDLINE] 19. Gland Surg. 2026 Mar 23;15(3):71. doi: 10.21037/gs-2025-1-577. Epub 2026 Mar 18. Suitability of 3D scanning as a screening tool for reduction mammoplasty referrals for plastic surgery-a pilot study. Kuuskeri M(1), Sarantola H(2), Tähtinen R(3), Luukkaala T(4), Palve J(1). Author information: (1)Center for Musculoskeletal Disease, Department of Plastic Surgery, Tampere University Hospital, Tampere, Finland. (2)Department of Radiology, Tampere University and Tampere University Hospital, Tampere, Finland. (3)Department of Obstetrics and Gynecology, Tampere University and Tampere University Hospital, Tampere, Finland. (4)Research, Development and Innovation Center, Tampere University Hospital and Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland. BACKGROUND: Reduction mammoplasty is a common procedure in plastic surgery. However, patients need to fulfill resection weight criterion in order to get state or insurance coverage for the procedure. General practitioners in health centers might not have large experience for evaluating the breast size and this could lead to inadequate referrals. These referrals lead to expenses and use of limited health care resources. For this reason, the accurate estimation of breast size and resection weight is important. The conventional methods have inherent limitations in accurately capturing volumetric details and there is an urge to a shift towards more precise methods. There are many different three-dimensional (3D) imaging devices commercially available and used also for this purpose. The goal of our study was to evaluate if a handheld easy-to-use 3D scanner would be usable as an assistive device for general practitioners in the breast size evaluation to avoid unnecessary referrals. The aim of the current study was not to validate a 3D scanner. METHODS: The study population comprised 50 women recruited for the study in Tampere University Hospital, Finland. Of these patients 25 were recruited from the gynecological and 25 from the plastic surgery outpatient clinic. Patients had mammography imaging and 3D scanning performed to calculate breast volumes. The results were compared and statistical analyses were performed. RESULTS: We found that 3D scanning correlated with mammography in patients with smaller breasts, but it gave systematically 300 cc smaller volumes than volumes obtained from mammograms. This phenomenon is most likely related to difficulties in cropping the breast and defining the border between the thoracic wall and breast. CONCLUSIONS: In conclusion, with this study population of 50 patients we established that as it stands the handheld 3D scanning device has sufficient technical properties for breast scanning. However, the underestimation of volume in a described quantity is not acceptable and could lead to incorrectly rejected referrals. The need for standardized positioning of the patients and need for more comprehensive training for the use of the 3D scanner becomes apparent before its use in screening in daily general practice. © AME Publishing Company. DOI: 10.21037/gs-2025-1-577 PMCID: PMC13062867 PMID: 41969940 Conflict of interest statement: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-2025-1-577/coif). The authors have no conflicts of interest to declare. 20. Plast Reconstr Surg Glob Open. 2026 Mar 18;14(3):e7529. doi: 10.1097/GOX.0000000000007529. eCollection 2026 Mar. The Role of 3-dimensional Imaging and Telemedicine in Breast Augmentation Consultations: A Prospective Cohort Study of 1153 Cases and a Randomized Controlled Trial in Thailand. Pruksapong C(1)(2), Permpool L(3). Author information: (1)From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand. (2)Absolute Beauty Clinic, Bangkok, Thailand. (3)School of Nursing, King Mongkut Institute of Technology Ladkrabang, Bangkok, Thailand. BACKGROUND: This study evaluated the effectiveness of 3-dimensional (3D) imaging-based telemedicine consultations compared with traditional face-to-face consultations, focusing on patient satisfaction, decision-making, and the potential applications of 3D imaging data. The introduction of 3D imaging technology offers new opportunities for detailed analysis of breast anatomy, providing insights previously unavailable to surgeons. METHODS: A prospective cohort study was conducted to analyze the correlation among breast anatomy, implant dimensions, parity status, and surgical procedures using data from 3D surface imaging. Additionally, a randomized controlled trial was performed to investigate the efficacy and patient satisfaction of 3D imaging combined with telemedicine in preoperative consultations. RESULTS: A total of 1153 patients were included in the cohort study, revealing significant correlations among parity status, the addition of mastopexy to breast augmentation, and implant selection. The average time to revision in secondary augmentation procedures was 5.2 ± 3.45 years. In the randomized controlled trial, 120 patients were enrolled, with 60 in the 3D telemedicine group and 60 in the conventional face-to-face consultation group. The 3D telemedicine group demonstrated significantly shorter face-to-face consultation times (10.14 ± 2.23 versus 22.43 ± 5.45 min) and higher patient satisfaction scores compared with the conventional group. CONCLUSIONS: Three-dimensional surface imaging technology provides comprehensive breast parameter assessments, including breast volume, width, and projection, enabling enhanced preoperative planning and individualized implant selection. When combined with telemedicine, this technology significantly reduces face-to-face consultation time while improving patient satisfaction, making it a valuable tool in modern breast augmentation practice. Copyright © 2026 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. DOI: 10.1097/GOX.0000000000007529 PMCID: PMC12999135 PMID: 41859503 Conflict of interest statement: The authors have no financial interest to declare in relation to the content of this article. 21. J Craniofac Surg. 2026 Mar-Apr 01;37(3-4):848-854. doi: 10.1097/SCS.0000000000012414. Epub 2026 Jan 30. AI Tools in Plastic Surgery: A Scoping Review. Garg SP(1), Collins AS, Rios-Diaz AJ. Author information: (1)Department of Surgery, Division of Plastic Surgery, University of Miami/Jackson Health System, Miami, FL. BACKGROUND: The use and standardization of innovative artificial intelligence (AI) tools continue to grow and have the potential to enhance the field of plastic surgery. Despite the rapid growth of validated AI tools, there remains a need for a consolidated reference summarizing AI applications in plastic surgery. METHODS: A literature search was conducted to identify peer-reviewed articles studying AI tools applied to the fields of plastic surgery. Tools were organized into the fields of clinical efficiency, imaging and documentation, communication and workflow, and research and data analysis. RESULTS: There exists a wide variety of AI tools demonstrating clinical utility. Regarding clinical efficiency, virtual assistants such as AIVA improve patient communication, specifically in accurately answering postoperative questions. Large language models such as DeepSeek support decision-making and reduce documentation burden. AI can significantly improve the creation of 2D and 3D imaging for surgical planning, facial analysis, and volumetric prediction through tools such as Vectra and Crisalix. Tools such as Elicit and OpenEvidence can accelerate literature search, chart review, and data extraction. Lastly, workflow tools including TigerConnect and DAX Copilot can improve communication, and FS-net/FLAPMATE has been able to monitor free flaps with high sensitivity. CONCLUSIONS: AI's precision and efficiency at a multitude of clinical and surgical tasks position it as a pivotal tool optimizing patient safety and satisfaction by reducing physician burden and burnout. As AI continues to become more sophisticated and specialized for plastic surgery, these tools will become an integral part of the field, driving safe, efficient, high-quality results for aesthetic and reconstruction procedures. Copyright © 2026 by Mutaz B. Habal, MD. DOI: 10.1097/SCS.0000000000012414 PMID: 41614695 [Indexed for MEDLINE] Conflict of interest statement: The authors report no conflicts of interest. 22. Aesthetic Plast Surg. 2026 Jan;50(2):635-644. doi: 10.1007/s00266-025-05078-2. Epub 2025 Aug 7. The Usefulness of 3D-printed Nasal Implant Based on Virtual Plastic Simulation on Asian Rhinoplasty: A 1-Year Follow-Up Study. Suh MK(1)(2), Won JY(3), Kim YH(2)(4), Hur JY(5), Park SH(2)(4), Moon HK(3), Lee WJ(6)(7). Author information: (1)JW Plastic Surgery Center, Gangnam-gu, Seoul, Republic of Korea. (2)Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea. (3)Clinical and Translational Research Institute, Anymedi Inc., Seoul, South Korea. (4)Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. (5)YoungYoung Plastic Surgery Clinic, Gangnam-gu, Seoul, Republic of Korea. (6)Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea. pswjlee@yuhs.ac. (7)Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. pswjlee@yuhs.ac. BACKGROUND: Advances in three-dimensional (3D) imaging simulation surgery and 3D-printing have led to the development of patient-specific implants for Asian rhinoplasty. In this study, we present the results of 50 patients who received patient-specific nasal implants after virtual plastic surgery for rhinoplasty. METHODS: Facial photographs and cone beam computed tomography (CBCT) scan images were obtained preoperatively and at one year postoperatively. We examined whether the patient-specific nasal implant fit exactly well with the nasal bone and was anatomically aligned one year after surgery and how much preoperative virtual simulation surgery matched postoperative clinical results. Additionally, patient and operator satisfaction were evaluated using the Rhinoplasty Outcome Evaluation (ROE) questionnaire and Global Aesthetic Improvement Satisfaction (GAIS). RESULTS: The patient-specific nasal implant was anatomically consistent with the surface structure and was aligned with the nasal bone even one year after insertion. The nasal implant remained parallel to the nasal bone one year postoperatively, with an average distance of 0.71 mm in the sagittal view. There was no statistically significant difference in the distance measured from the implant undersurface to the nasal dorsal skin. The difference in distance was approximately 0.01 mm in the bone region and 0.61 mm in the cartilage region. This indicates that the patient's request was realized by accurately reflecting it in the virtual plastic surgery simulation and patient-specific implants. Additionally, there was an increase in researcher satisfaction (GAIS=1.34) and patient satisfaction (ROE) after surgery by 60%. CONCLUSIONS: Patient-specific nasal implants fabricated using virtual surgery simulation may be an alternative material for augmentation rhinoplasty. LEVEL OF EVIDENCE IV: 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 . © 2025. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery. DOI: 10.1007/s00266-025-05078-2 PMID: 40775193 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Conflict of interests: The authors declare that they have no conflicts of interest to disclose. Ethical Approval: This study was conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study protocol was approved by the institutional review board. Informed Consent: Informed consent was obtained from all individual participants included in the study. 23. Plast Reconstr Surg. 2025 Dec 3. doi: 10.1097/PRS.0000000000012647. Online ahead of print. Triangular Fossa Cartilage Graft in Rhinoplasty: A Three-Dimensional Anatomical and Technical Feasibility Study. Huang CJ(1)(2), Yen CI(1), Chang CS(3), Chen HC(3), Yang SY(1), Chang SY(1), Hsiao YC(3). Author information: (1)Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. (2)Deapartment of Plastic and Reconstructive Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan. (3)Elysée Aesthetic Medical Center, Taipei, Taiwan. Aesthetic rhinoplasty relies on a stable framework for long-term structural integrity, often requiring autogenous cartilage grafts. While conchal cartilage is commonly used, its volume may be insufficient, particularly in secondary or revision rhinoplasty. This study presents a novel technique for simultaneous harvesting of triangular fossa cartilage through the same posterior auricular incision as the conchal graft. This approach increases available graft material without requiring additional donor sites, minimizing morbidity while preserving auricular aesthetics.A retrospective analysis of 14 patients (15 ear donor sites) was conducted to evaluate postoperative auricular morphology using three-dimensional (3D) imaging. Patients were classified into three groups: conchal cartilage only, conchal + triangular fossa cartilage without helix crux preservation, and conchal + triangular fossa cartilage with helix crux preservation. Postoperative 3D analysis demonstrated no significant differences in ear height, width, or conchal cavity dimensions. A mild reduction in triangular fossa area was observed but did not result in visible deformity or functional impairment. Preservation of the helix crux maintained the natural curvature of the antihelix, ensuring donor site stability.This technique provides an effective alternative for cases requiring additional cartilage, particularly in revision rhinoplasty and structural augmentation. By expanding graft availability through a single incision, it enhances surgical efficiency while maintaining a natural ear contour. Future studies incorporating long-term follow-up and patient-reported outcomes will further validate its role in clinical rhinoplasty. Copyright © 2025 by the American Society of Plastic Surgeons. DOI: 10.1097/PRS.0000000000012647 PMID: 41335126 24. J Cosmet Dermatol. 2025 Dec;24(12):e70600. doi: 10.1111/jocd.70600. Assessment of Hyaluronic Acid Filler in Gluteal Augmentation and Contouring: A 1-Year Prospective Study. Bussade M(1), Faria G(2), Barros M(1), Mourão C(1), Kichler M(1), Viana R(3), Zattar L(2), de Sousa Nogueira MA(4), Boggio R(2). Author information: (1)MD Institute, São Paulo, Brazil. (2)Instituto Boggio, São Paulo, Brazil. (3)Independent Investigator, São Paulo, Brazil. (4)University of São Paulo (USP), São Paulo, Brazil. BACKGROUND: Minimally invasive gluteal augmentation techniques have gained popularity as alternatives to surgical procedures, offering reduced downtime and an improved safety profile. Hyaluronic acid (HA) fillers have emerged as a promising option due to their biocompatibility and favorable rheological characteristics. OBJECTIVES: To evaluate safety, efficacy, durability, and patient satisfaction of a cross-linked HA filler for gluteal augmentation and contouring over a 12-month period, and to conduct a pilot exploratory substudy assessing serum HA levels up to 90 days. METHODS: This was a 12-month, prospective, multicenter, open-label study including 30 healthy women undergoing gluteal augmentation with a cross-linked HA filler (UP Max). Each participant received up to 60 mL of HA filler, administered using a quadrant-based technique, guided by anatomical landmarks. Outcomes included safety (adverse events), efficacy (standardized photography and 3D imaging, ultrasound), durability and patient satisfaction. In addition, serum HA levels were measured in a pilot subgroup of patients. RESULTS: The mean injected volume was 43.60 ± 11.48 mL. Patient satisfaction peaked at Day 30 (90%) and declined to 62% at 12 months, consistent with HA biodegradation. Ultrasound confirmed subcutaneous placement and progressive filler absorption and integration, with no signs of migration, fibrosis or nodularity. Serum HA levels showed a transient increase at Day 30 and returned to near baseline at Day 90. No serious adverse events were reported, and minor complications were infrequent. CONCLUSIONS: HA filler demonstrated a favorable safety profile, high patient satisfaction, and aesthetic improvements over 1 year. These findings support its use as a safe and effective option for nonsurgical gluteal augmentation and body contouring. © 2025 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC. DOI: 10.1111/jocd.70600 PMCID: PMC12719548 PMID: 41423732 [Indexed for MEDLINE] Conflict of interest statement: This study was supported by Ilikia Brasil, which provided the hyaluronic acid filler used. Renata Viana serves as a scientific consultant for Ilikia. The authors declare no other potential conflicts of interest with respect to the research, authorship, or publication of this article. 25. Aesthetic Plast Surg. 2025 Dec;49(23):6485-6496. doi: 10.1007/s00266-025-05072-8. Epub 2025 Jul 14. Qualitative Terms Used In Rhinoplasty: A Scoping Review -Toward Establishing a Bridge Between Qualitative Terminology and Quantifiability. Çelikoyar M(1), Beeching A(2), Sarino EM(3), Dobratz E(4), Topsakal O(5). Author information: (1)Department of Otolaryngology, Demiroglu Bilim University School of Medicine, Büyükdere Cad. No:120/1 34394 Esentepe, Şişli, Istanbul, Turkey. mazhar.celikoyar@demiroglu.bilim.edu.tr. (2)Department of Computer Sciences, Florida Polytechnic University, Lakeland, FL, 33805, USA. (3)Eastern Virginia Medical School, Brickell Medical Sciences Library, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, P.O. Box 1980, Norfolk, VA, 23501-1980, USA. (4)Department of Otolaryngology Head and Neck Surgery, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, 23507, USA. (5)Department of Computer Science and Engineering, University of South Florida, 4202 E. Fowler Avenue, ENG 030, Tampa, FL, 33620, USA. BACKGROUND: Rhinoplasty is one of the most commonly performed aesthetic surgical procedures. Both patients and surgeons rely on qualitative descriptors such as "plunging nose," "bulbous tip," or "twisted nose" to describe nasal features. Despite their frequent use, there is limited standardization of these terms and their correlation with objective measurements. METHODS: A scoping review was conducted following the PRISMA-ScR guidelines. The study searched three electronic databases (PubMed/MEDLINE, Ovid/MEDLINE, and Web of Science) for English language articles published between 1949 and 2021. Qualitative descriptors and semi-quantitative and quantitative measures were extracted and categorized. RESULTS: A total of 459 studies were included, comprising retrospective studies (272), prospective studies (38), technical descriptive articles and literature reviews (180), and letters to the editor (5). Qualitative terms were recorded 23.5% (237/1007) of the time, semi-quantitative terms 16% (162/1007), and quantitative descriptions 57% (578/1007). The most commonly described nasal features were the tip (20.8%), dorsum (13.2%), and alar base (12.3%). Measurement techniques varied, with photography being the most common (60%), followed by surgeon assessment (20.3%) and 3D imaging (5.4%). CONCLUSIONS: This review highlights a gap in the correlation between qualitative rhinoplasty descriptors and quantitative analysis. Standardization and integration of objective measurement tools may enhance clinical communication and surgical planning. LEVEL OF EVIDENCE IV: 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 . © 2025. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery. DOI: 10.1007/s00266-025-05072-8 PMID: 40660031 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Conflict of Interests: The authors declare that they have no conflicts of interest to disclose. Human and Animal Rights: This article does not contain any studies with human participants or animals performed by any of the authors. Informed Consent: For this type of study informed consent is not required 26. Plast Reconstr Surg Glob Open. 2025 Nov 10;13(11):e7203. doi: 10.1097/GOX.0000000000007203. eCollection 2025 Nov. Pushing Boundaries in Aesthetic Breast Surgery: Precise Surgical Planning With Online Consultation and 3-dimensional Simulation. Barbon C(1)(2), Hedén P(3), Otte M(3). Author information: (1)From the University of Zurich, Zurich, Switzerland. (2)University Hospital of Zurich, Zurich, Switzerland. (3)The Faculty, Stockholm, Sweden. BACKGROUND: In the past decade, there has been an increase in the implementation of telemedicine and 3-dimensional (3D) imaging in plastic and reconstructive surgery. This retrospective study assessed the feasibility of precise surgical planning for breast procedures and the conversion rate of online consultations with 3D imaging for surgeons who work in multiple countries. METHODS: Fifteen consecutive patients underwent online visits with 3D imaging for breast augmentation (10), hybrid augmentation (2), mastopexy (2), and breast reduction (1). All patients were physically seen for the first time the day before the operation; however, the surgical plan and the types of implants were decided with the online consultation. The conversion rate was compared with that of 30 consecutive patients seen in the same timeframe in the regular outpatient clinic. RESULTS: The procedures could be performed as foreseen. The implants chosen were accurate in 100% of the patients; only 1 implant per breast could be ordered for 80% of patients and 2 for the other 20%. The patients were effortlessly followed up with online consultations and expressed satisfaction with the results. The conversion rate was 87% for the online consultations compared with 90% for the regular encounters (P = 0.74). CONCLUSIONS: Online consultations with 3D imaging transcend geographic limitations by providing effective result visualization and allowing for accurate planning, without affecting the conversion rate. Considering limited real-world data, our findings help fill a key gap and support broader adoption in global plastic surgery. Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. DOI: 10.1097/GOX.0000000000007203 PMCID: PMC12599628 PMID: 41220879 Conflict of interest statement: Dr. Hedén is a speaker for Mentor and Motiva. He is a key opinion leader for both and is compensated for his lectures. Dr. Otte is a speaker for POLYTECH Health & Aesthetics GmbH. He has been compensated for speaker presentations (International Society of Aesthetic Plastic Surgery, Cartagena), launching events (MESMO launch in Shanghai), and online workshop for Aleamed. The other author has no financial interest to declare in relation to the content of this article. 27. J Clin Med. 2025 Oct 27;14(21):7622. doi: 10.3390/jcm14217622. Symmetry After Breast Reconstruction Surgery: A Comparison of Immediate vs. Delayed-Immediate Breast Reconstruction Using Smartphone-Based 3D Surface Imaging. Hartmann R(1), Chrobot N(2), Festbaum C(2), Alfertshofer M(3), Obermeier KT(1), Smolka W(1), Ettl T(4), Prantl L(2), Brébant V(2). Author information: (1)Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University (LMU), Lindwurmstrasse 2a, 80337 Munich, Germany. (2)University Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany. (3)Department of Plastic and Hand Surgery, Technical University Munich, 81675 Munich, Germany. (4)Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany. Background: Breast reconstruction surgery (BRS) is a vital coping mechanism for patients undergoing mastectomy. Various methods have been introduced, including immediate and delayed-immediate BRS. This study employs a smartphone-based approach for three-dimensional (3D) surface imaging to compare outcomes after immediate vs. delayed-immediate BRS. Methods: Twenty-six patients who underwent BRS using the deep inferior epigastric perforator (DIEP) flap at our institution from 1 October 2018 to 1 October 2023 were included in this study. Thirteen patients underwent immediate BRS and thirteen underwent delayed-immediate BRS. Following successful BRS, each patient underwent a digital anthropometric examination that included 14 measurements and the calculation of the symmetry index (SI) using the iPhone 15 Pro along with the 3D Scanner App and the Vectra Analysis Module (VAM). Measurements were subsequently compared between immediate and delayed-immediate BRS using the t-test for independent samples. Results: For 11 of 14 measurements, no significant differences were detected between immediate and delayed-immediate BRS. The SI did not differ significantly between immediate (M = 0.85) and delayed-immediate (M = 0.88) BRS (t-test for independent samples; p = 0.23, n = 26, two-tailed). Additionally, no significant differences were found between patients' age, height, weight, BMI, time since first diagnosis, and flap weight using a t-test for independent samples. Conclusions: No statistically significant differences in breast symmetry were detected between immediate and delayed-immediate reconstruction in this cohort. This study supports the integration of smartphone-based 3D imaging into routine plastic surgery. DOI: 10.3390/jcm14217622 PMCID: PMC12609946 PMID: 41227018 Conflict of interest statement: The authors declare that they have no conflicts of interest. 28. J Clin Med. 2025 Oct 2;14(19):6989. doi: 10.3390/jcm14196989. Native Collagen for Surgical Wound and Scar Prevention-A Six-Case Clinical Series. Borzykh OB(1), Karpova EI(2), Petrova MM(3), Shnayder NA(3)(4), Danilova SV(5). Author information: (1)Plastic Surgery and Cosmetology Clinic "Dr. Albrecht", Voronezh 394036, Russia. (2)Department of Plastic, Reconstructive Surgery, Cosmetology and Cellular Technologies, Pirogov Russian National Research Medical University, Moscow 119435, Russia. (3)Shared Core Facilities "Molecular and Cell Technologies", Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk 660022, Russia. (4)Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V. M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, Saint Petersburg 192019, Russia. (5)Galaktika Clinic, Moscow 121205, Russia. Background: Excessive scarring remains a frequent complication in plastic surgery, yet standardized preventive strategies are lacking. Type I collagen-based biomaterials may support regenerative processes and improve scar outcomes. Methods: This case series includes six female patients (ages 24-52) undergoing wound management after trauma and procedures including blepharoplasty, abdominoplasty, and revision mammaplasty. Native collagen type I (7% or 15%) was injected along wound margins or into hypertrophic scars at 3-4 week intervals. Outcomes were assessed through patient-reported symptoms and Antera 3D imaging (vascularity, pigmentation, surface topography). Results: Patients reported reduced tightness, pruritus, and scar stiffness after initial sessions. Antera 3D imaging showed decreased vascular and pigment indices, and a reduction in surface elevation over follow-up (up to 14 months). No adverse effects such as atrophy or infection were observed. Conclusions: Native type I collagen was well tolerated and may be a useful adjunct for wound healing and scar modulation following plastic surgery. DOI: 10.3390/jcm14196989 PMCID: PMC12524737 PMID: 41096069 Conflict of interest statement: The authors declare no conflicts of interest.