Search Results (94)

The annual congress of the Italian Association of Plastic Aesthetic Surgery (AICPE), with more than 700 members, represents one of the most relevant conference meetings in Europe relating to Aesthetic Plastic Surgery due to the number of participants and due to the faculty of invited speakers chosen for their renowned scientific value. The 13th meeting was held in Rome (Italy) from 10 to 12 April 2026. Key focus areas of the scientific program concerned breast (reduction, lifting supported or not by mesh, implant surfaces, augmentation), face and neck (lifting, blepharoplasty, malar implants, feminization), body (abdominoplasty and torsoplasty, post-partum and ex-obesity surgery, body and limb contouring, complication treatments) and nose surgery combined with medical innovations in energy devices, threads and aesthetic medicine procedures. Special attention was also given to the theme of the therapeutic role of aesthetic surgery, which is increasingly becoming an integral part of a clinical pathway useful for restoring the patient’s psycho-physical balance. Presented here is a report of the abstracts accepted due to their innovative or cutting-edge content that were selected to be given as oral presentations during the congress sessions. The 2nd edition of the Saccomanno memorial award for the best abstract presented by a young surgeon has been organized with the endorsement of Surgical Techniques Development by MDPI. Full article

Monopolar radiofrequency (MRF) is a well-established modality for non-invasive facial rejuvenation; however, its clinical utility is frequently constrained by patient discomfort and inconsistent thermal delivery. This study evaluated the efficacy, safety, and mechanistic profile of a novel MRF system incorporating continuous water cooling (RF-CWC) designed to optimize thermal distribution and enhance patient tolerance. In a prospective, single-arm clinical trial involving 22 female participants, a single RF-CWC treatment utilizing region-specific static and sliding delivery modes yielded statistically significant improvements in jawline lifting, alongside a volumetric increase in the midface and a concomitant volumetric reduction in the lower face (p < 0.001) over an 8-week follow-up period, with no adverse events reported. To elucidate the underlying cellular mechanisms, the system was further evaluated using an ultraviolet B (UVB)-induced ex vivo human skin model and an in vivo porcine model. Histological, immunohistochemical, and ELISA analyses revealed that RF-CWC effectively mitigated UVB-induced dermal degradation ex vivo by significantly up-regulating elastin, insulin-like growth factor, and hyaluronic acid, while down-regulating matrix metalloproteinase-1, interleukin-1α, and heat shock protein 72 (p < 0.05). Furthermore, the in vivo model demonstrated time-dependent increases in collagen types I and III and elastin without thermal tissue damage, with the sliding mode and higher shot counts correlating with enhanced extracellular matrix (ECM) remodeling. Comparative analyses demonstrated that RF-CWC achieved superior ECM restoration and reduced inflammatory cell infiltration relative to traditional cryogen spray-cooled RF systems. Taken together, these findings suggest that the RF-CWC system may promote robust ECM remodeling and significant facial neocollagenesis while minimizing inflammatory responses, potentially presenting an optimized, highly effective, and patient-friendly advancement in MRF technology. Full article

The annual congress of the Italian Association of Plastic Aesthetic Surgery (AICPE) is one of the most relevant conference meetings in Europe concerning aesthetic plastic surgery as there are a number of participants, over 400, and an international team of invited speakers chosen for their renowned scientific value. The 12th meeting was held in Rimini (Italy) from 6 to 8 June 2025. The scientific issues concerned new advancements in aesthetic surgery. This book of abstracts contains research related to facial surgery, body contouring, breast surgery, and rhinoplasty, also including aesthetic medicine, AI’s impact on the medical profession, and forensic medicine. For the first time, the AICPE established an award in memory of Flavio Saccomanno for the best paper presented by a young surgeon with the endorsement of Surgical Techniques Development by MDPI. Full article

Objectives: Hyaluronic acid augmentation of the mandibular angle has become a widely performed procedure for improving lower facial contour and definition; however, because of its anatomical proximity to the masseter muscle, concerns remain regarding possible functional effects on the stomatognathic system. This longitudinal study investigated whether hyaluronic acid injection in the mandibular angle could affect neuromuscular recruitment patterns of the masseter and temporalis muscles through surface electromyography assessment. Methods: Ten adults were assessed at baseline and at 15, 30, and 60 days after injection. Electromyographic activity was recorded during mandibular tasks and chewing conditions. Repeated measures ANOVA with Bonferroni correction was used for statistical analysis (p < 0.05). Effect sizes were calculated using partial eta squared (η²p), and pairwise comparisons were explored using Cohen’s d. Data are presented as means with 95% confidence intervals (95% CIs), and individual trajectories were analyzed to characterize temporal patterns and within-subject variability. Results: Most variables did not show significant changes over time (p > 0.05), with small-to-moderate effect sizes. Significant reductions were observed in the right masseter during left laterality (p = 0.03; η²p = 0.17) and in the left masseter during maximum voluntary contraction with and without parafilm (p = 0.02–0.04; η²p = 0.19–0.22). These findings were temporary and were not consistently identified among subjects. Chewing conditions remained stable across all time points (p > 0.05). Conclusions: Hyaluronic acid injection in the mandibular angle was not associated with clinically relevant electromyographic changes. The observed variations were transient, showed small-to-moderate effect sizes, and demonstrated interindividual variability, suggesting preservation of neuromuscular function and physiological adaptive responses. Full article

Background and Objectives: Frontal bone osteomas are benign tumors characterized by the abnormal proliferation of bone. Though typically asymptomatic, these masses often produce visible forehead deformity and may cause localized discomfort. Endoscopic resection has emerged as an optimal technique for appropriately selected frontal osteomas because it enables complete excision while minimizing visible scarring and risk of neurovascular injury. This case series reviews the senior author’s patient outcomes and complications using a scalp-based, endoscopic-assisted surgical approach for frontal bone osteoma excision. Materials and Methods: A review was conducted of all patients (n = 22) who underwent endoscopic-assisted frontal bone osteoma excision performed by a single surgeon between February 2019 and December 2025. All procedures involved endoscopic visualization through remote scalp incisions, osteoma excision, and frontal bone contouring. Patient demographics, presenting symptoms, CT imaging findings, operative details, histopathology results, and postoperative outcomes were recorded. Results: Twenty-two patients underwent endoscopic-assisted excision of frontal bone osteomas performed by the senior author (NT). The primary concern prompting surgical intervention was aesthetic deformity, with localized pain reported in some cases. For all patients, CT imaging was obtained preoperatively to evaluate lesion size and anatomical relationships to nearby facial structures. Histopathology confirmed cortical bone consistent with osteoma in all cases. Postoperative swelling and ecchymosis were common in the first week but resolved spontaneously. No contour irregularities, fluid collections, residual bone, or sensory deficits were observed. Some alopecia was noted in the first three patients, prompting the senior author to modify the technique. All patients healed with small, flat, well-concealed scars adjacent to the hairline. Conclusions: This single-surgeon experience demonstrates that endoscopic-assisted excision of frontal bone osteomas is a safe and effective technique that permits complete excision with excellent aesthetic outcomes and minimal morbidity. The operative framework presented in this study, including surgical planning, technique steps, and postoperative management, supports endoscopic resection as an ideal alternative to traditional direct approaches for frontal bone osteomas. Full article

Background: Congenital muscular torticollis (CMT) is usually managed conservatively during infancy, whereas surgical treatment is considered for persistent deformity in older children. However, evidence remains limited regarding the outcomes of distal resection combined with proximal release of the sternocleidomastoid muscle in children presenting beyond infancy. This study aimed to evaluate the functional and cosmetic outcomes of this combined approach in patients aged 3 years and older. Methods: This retrospective single-surgeon series included 37 patients with CMT aged 3 to 14 years who underwent distal resection combined with proximal release of the sternocleidomastoid muscle between 2002 and 2024. Preoperative and postoperative assessments were performed using the clinical outcome framework originally described by Lee et al., goniometric measurement of cervical rotation and lateral flexion, and clinical evaluation of head tilt, facial asymmetry, scar appearance, lateral band formation, and sternocleidomastoid V-column contour. Patients were also analyzed according to age at surgery, as 3–10 years and 11–14 years. Results: The mean age at surgery was 4.7 years, and the mean follow-up duration was 3.4 years. Significant postoperative improvement was observed in all major functional outcomes. Mean cervical rotation improved from 54.2 ± 8.6° to 87.9 ± 3.4°, and mean lateral flexion improved from 24.1 ± 6.8° to 44.5 ± 3.2° (both p < 0.001). Preoperative functional assessment scores averaged 6.8 ± 1.4, whereas postoperative total outcome scores averaged 14.2 ± 0.9. At final follow-up, no patient had residual head tilt. Mild residual facial asymmetry persisted in 3 patients (8.1%). Overall, postoperative outcomes were rated as excellent in 33 patients (89.2%) and good in 4 patients (10.8%). A slight partial loss of the sternocleidomastoid V-column contour was observed in 34 patients (91.9%), although this finding was not documented as a major cosmetic concern in the available clinical records. Hypertrophic scarring developed in 1 patient (2.7%). No lateral band formation, recurrence, revision surgery, infection, or hematoma was observed. Conclusions: Distal resection combined with proximal release provided favorable functional and cosmetic outcomes in children older than 3 years with CMT. The technique was associated with marked improvement in cervical motion, correction of head tilt, low complication rates, and a high proportion of excellent or good results. Full article

An edge-based and curve-based rule-driven nose detection framework is designed to improve the reliability of face detection. The designed framework combines quadratic curve fitting with a calibrated scoring mechanism that fuses geometric, photometric, and structural information into a unified model. These stages jointly enforce symmetry consistency, reliable tip position, and clear wing boundaries. Candidate face regions are first refined by skin filtering and ellipse validation, from which a mid-lower facial ROI is framed for nasal candidate extraction. We further incorporate eye/mouth hints (EyeMap/MouthMap) to restrict the region of interest (ROI) to the region below the eyes, above the mouth, and between the two eyes. When a mouth is detected, this ROI refinement supersedes the chrominance-red (Cr) channel trimming; otherwise, we fall back to the Cr channel horizontal projection to detect dominant mouth peaks and trim the lower-lip band, thereby suppressing lip interference. A multi-threshold Canny procedure with histogram projection is employed to collect multiple nose rectangles by selecting various vertical and horizontal peaks under three adaptive threshold scales. Within each rectangle, edge contours are quadratically fitted and categorized into U-shape (nasal base), N-shape (nostril rim), and C-shape (nasal wings), enabling rule-based selection of the base, wings, and nostrils. The fused features are then processed by a calibrated geometric–photometric–structural scoring module that uses YCbCr contrasts and red/black penalties to suppress lip and eye confounders. Experiments with diverse faces and lighting conditions show accurate and stable nose localization, with notably reliable wing fitting and nasal base detection, improving the accuracy of face detection. Full article

Background: With the increasing demand for non-surgical facial rejuvenation, injectable collagen biostimulators such as poly-L-lactic acid (PLLA), calcium hydroxyapatite (CaHA), polycaprolactone (PCL), poly-D,L-lactic acid (PDLLA) and powdered polydioxanone (PPDO) have become widely used by facial aesthetic practitioners. These agents stimulate neocollagenesis, providing gradual improvement in skin firmness, elasticity and facial contour with long-lasting results. While manufacturers emphasize the efficacy and favorable safety profile of these products, adverse events such as nodules, edema, inflammatory reactions and, in rare cases, granulomas have been reported. To date, no comprehensive systematic review has evaluated the proportion and nature of adverse effects associated with all major collagen biostimulators in facial aesthetic procedures. This study aims to synthesize current evidence on the proportion of adverse events linked to injectable collagen biostimulators. Methods: The systematic review will include clinical studies involving adults undergoing facial aesthetic procedures with PLLA, PDLLA, CaHA, PCL and PPDO that report adverse events during or after treatment. The search will be conducted in six main databases: CENTRAL, EMBASE, LILACS, PubMed, SCOPUS and Web of Science. No restrictions will be applied regarding language or publication date. The screening process will occur in two phases: first, two independent reviewers will assess titles and abstracts against the eligibility criteria; second, the same reviewers will conduct full-text evaluations. Data will be synthesized narratively, with a meta-analysis of proportions performed if appropriate. Additionally, sample characteristics, treatment protocols, study design and main findings will be reported. The risk of bias will be assessed independently by two reviewers using appropriate tools, based on the study design, with the support of artificial intelligence. PROSPERO registration number: CRD420251062785. Full article

The reconstruction of complex orbitomaxillary defects requires biomaterials that can simultaneously provide structural stability, biocompatibility, and accurate restoration of facial volume and contour. While rigid polymers such as polyetheretherketone (PEEK) offer reliable mechanical support, they do not adequately replicate the viscoelastic behavior of soft tissues. This report presents a translational revision case employing a personalized hybrid biomaterial approach that combines a 3D-printed PEEK implant for structural orbital floor support with a patient-specific polydimethylsiloxane (PDMS) implant for malar volumetric augmentation. Reconstruction was planned using CT segmentation and contralateral mirroring. Patient-specific implants were subsequently designed using CAD/CAM techniques, combining a rigid PEEK implant for structural orbital support with a flexible PDMS implant for malar volumetric augmentation with complementary mechanical properties. Revision surgery included the removal of inadequately positioned titanium hardware, the release of incarcerated extraocular muscles, and the restoration of orbital anatomy and facial symmetry. Postoperative imaging demonstrated stable implant positioning and sustained orbitomaxillary stability. Despite successful anatomical reconstruction, residual functional sequelae, including strabismus related to the severity of the initial orbital trauma, persisted and were addressed separately in a staged manner, resulting in satisfactory ocular alignment and resolution of diplopia in primary gaze. This case underscores the complementary functional roles of rigid and elastic polymers and highlights the translational potential of PDMS as a permanent, patient-specific implant material for volumetric and contour restoration in craniofacial reconstruction. Full article

Background: Defects following total parotidectomy represent a distinctive reconstructive challenge. Restoration of facial volume and contour must be balanced with protection of the preserved facial nerve and reliable healing, particularly after extensive dissection and when adjuvant radiotherapy is anticipated. Multiple reconstructive options exist, each involving trade-offs regarding volume, pliability, long-term stability, and donor-site morbidity. We report our early clinical experience using the adipofascial infragluteal perforator (AIGP) free flap for reconstruction after total parotidectomy with skin and facial nerve preservation. Methods: We retrospectively reviewed the results of three consecutive patients undergoing total parotidectomy for parotid tumors, receiving immediate reconstruction with an AIGP free flap, operated between June and July 2025. The flap, based on terminal branches of the infragluteal vessels, was anastomosed to cervical recipient vessels. To address the two-compartment defect created by facial nerve preservation, the adipofascial tissue was tailored in a chimeric configuration to separately restore the superficial and deep parotid spaces. Results: All flaps survived. One patient developed a postoperative hematoma managed conservatively. Two patients developed minor donor-site seromas after drain removal, which resolved without intervention. Facial contour was satisfactorily restored in all cases, with mild overcorrection in one patient. Facial nerve function improved during follow-up. Donor-site scars were concealed within the infragluteal crease. Conclusions: In this preliminary case series, the AIGP free flap proved to be a feasible option for reconstruction after total parotidectomy with skin and facial nerve preservation, offering satisfactory contour restoration and low donor-site morbidity. Larger studies with longer follow-up are required to define indications and long-term outcomes. Full article

Artificial intelligence (AI) is increasingly reshaping esthetic and reconstructive plastic surgery by improving measurement accuracy, treatment planning, and prediction of surgical outcomes. This article provides a scientific overview of current AI applications, including automated image analysis, machine-learning-based outcome forecasting, and generative models for preoperative simulation. AI-driven three-dimensional morphometrics allow precise, reproducible quantification of facial and body structures, supporting more objective assessments of symmetry, proportion, and contour. Predictive algorithms trained on large clinical datasets can estimate postoperative results and complication risks with higher consistency than traditional subjective evaluation. Intraoperative AI tools, such as real-time image guidance and robotic assistance, show potential to increase procedural precision and reduce variability. Despite these advances, important limitations persist. Algorithmic bias, restricted data diversity, opaque model architectures, and unresolved ethical concerns regarding data privacy and esthetic standardization challenge widespread clinical adoption. Overall, AI offers a powerful framework for enhancing precision and reproducibility in esthetic surgery, but its safe and responsible integration will require rigorous validation, transparent methodology, and continued human oversight. Full article

Facial aging involves progressive changes to the skin, soft tissue, and skeletal framework, driven by genetic, social, and environmental factors. Rhytidectomy, or facelift surgery, has developed from simple skin excision to anatomically based techniques that reposition deeper tissues, restore volume, and enhance natural contours. The purpose of this review is to discuss the history of rhytidectomy, key anatomical foundations, and surgical techniques. Surgical approaches covered include subcutaneous, superficial musculoaponeurotic system (SMAS) manipulation, and deep plane procedures. Rhytidectomy remains a cornerstone of facial rejuvenation, with continuous refinements aimed at improving durability, minimizing risk, and achieving natural, patient-specific outcomes. Full article

Introduction: Facial aging is characterized by progressive soft-tissue descent, affecting all anatomical layers—from bone structures to the skin envelope. Early manifestations include downward displacement of the midface soft tissues, deepening of the nasolacrimal and nasolabial folds, and the appearance of soft-tissue “puckering” in the lower third of the face. At this stage, patients typically seek aesthetic correction to restore youthful facial contours with minimal or no visible signs of surgical intervention. Methods: This study is an observational analysis of a prospectively maintained surgical database including 201 female patients who underwent TESL between 2006 and 2024. Patient demographic data, surgical technique specifics, and postoperative outcomes were collected. A total of 612 procedures were performed. The cohort was stratified into two age groups: 30–35 years (n = 72) and 36–45 years (n = 129). Results: No cases of facial nerve injury or neurological complications were observed. Complications included 13 cases of localized cicatricial alopecia (6.47%) and four postoperative hematomas (1.99%). Eleven patients (5.47%) required minor secondary revision to address preauricular skin pleating. The technique demonstrated consistent and favorable outcomes in restoring soft-tissue volume and positioning, eliminating early lower-face “puckering,” and improving the cervicomental and mandibular contours. Conclusions: For patients under 45 years of age presenting with early signs of facial soft-tissue ptosis, endoscopic subcutaneous midface elevation with vertical SMAS plication is a safe, effective, and minimally invasive approach to rejuvenating the mid and lower face. Full article

The proper wearing of safety helmets is critical for worker safety in high-risk construction environments, with the fastening of the chin strap serving as a key indicator of correct usage. However, existing detection methods primarily focus on identifying helmet presence, neglecting the crucial assessment of chin strap compliance. This paper proposes an intelligent detection approach that integrates YOLOv8 object detection, instance segmentation, and skin tone recognition to evaluate chin strap wearing status. The system first employs YOLOv8 to detect workers and helmets, filtering out non-wearers before performing facial and neck region segmentation, thereby concentrating computational resources on compliance verification. To address challenges in distinguishing chin straps from similar skin tones under complex lighting conditions, the method incorporates illumination compensation and YCbCr-based skin segmentation. Finally, strap status is determined through morphological operations and contour analysis, with visual annotation of the detection results. This study utilizes a dataset comprising 2000 safety helmet images, which was partitioned into training, validation, and test sets in an 8:1:1 ratio for model training and evaluation. The experimental results demonstrate that the proposed method achieves an accuracy of 96% in detecting chin strap status, exhibits robust performance across diverse construction site conditions, and holds significant practical value and application potential. Full article

Poly-l-Lactic acid (PLLA) is a synthetic, absorbable injectable implant widely used in both facial and body cosmetic applications. Originally approved by the Food and Drug Administration (FDA) for treating facial lipoatrophy in Human Immunodeficiency Virus (HIV) patients, PLLA is now also indicated for correcting facial wrinkles, and its use has been more recently evaluated to enhance body areas such as the cheeks, hands, neck, thighs, and gluteal region. This narrative review specifically examines PLLA’s versatility in rejuvenating not only the face but also a variety of body regions, reflecting its growing popularity as a minimally invasive, natural-looking solution for diverse patient groups including men and millennials. PLLA works by restoring lost volume and gradually stimulating collagen production, which improves skin quality and contour over time. The product’s effectiveness and safety are supported by clinical research, with most patients reporting satisfaction. Although differences in PLLA formulations may influence outcomes, direct comparative studies are still lacking. This article provides an updated overview of PLLA’s physicochemical properties, mechanism of action, and clinical uses for both face and body, aiming to encourage its broader integration into cosmetic practice. Full article