BACKGROUND: Projection and upper rotation to the tip is fundamental in the nasal rejuvenation, as a matter of fact the tip is the most important and has strongly effects on the improve appearance and quality of life. The aim of the present study was to evaluate reshaping the tip of the nose by cross-linked hyaluronic acid using Italian technique.
METHODS: In a period between November 2019 and 2023, a total of one hundred and forty healthy, 95 females and 45 man patients, were performed with a mean age 44±5 (age range: 31-52 years old) affected by tip of congenital (22) or ageing nose hypotonia (118), and reduced volume that need of an elevation of the nose tip. The anatomic markers have been considered for the anthropometric measurements after the filler rhinoplasty. Two infiltrations were performed, one in the infiltration into the antero-caudal access over the columella produce upward rotation of the tip of the nose and second infiltration into the antero-superior access produce the projection of the tip of the nose. Medical device used in the study was Neofound STRUCT LIDO (LOVE COSMEDICAL srls-Via Toniolo 9, 57022 Castagneto Carducci, ITALY) containing sodium hyaluronate/hyaluronic acid high molecular weight (1.500RESULTS: The effect on the upward rotation of the tip nose was evaluated using Global Aesthetic Improvement Scale and morphometric evaluation. All the subjects showed at least 2-3 grade improvement in GAIS score after HA filler injection. The analysis of patient satisfaction after the last follow-up visits clearly demonstrated good results. A significant morphometric difference was detected comparing the T0 and T90 (p<0,0001), while no difference was present comparing T90 and T180 means (p=0.11). The outcome of the present clinical study gives greater projection and upper rotation to the tip with great gratification of the patients and the surgeon. An augmentation of the tip nose with hyaluronic acid filler produces a rejuvenation of the nose area resulted in a more youthful appearance. No adverse event was observed. In 35 patients, additional HA infiltration had to be performed after 2 weeks.
CONCLUSIONS: In conclusion, the Italian technique descripted in the present paper is safe, simply, and efficacious for rejuvenation of the nose, with elevated levels of patient satisfaction.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

BACKGROUND: Sunken eyes have become a most important target of periorbital area aesthetics. Throughout history, the aesthetics of the periorbital region have been emphasized, and various surgical techniques related to this region have been described. Most of these techniques provide only soft tissue solutions; therefore, additional surgical interventions may be required. The aim of our study was to introduce an endoscopic supraorbital shaving (SOS) technique for the treatment of individuals with sunken eyes.
METHODS: Between 2020 and 2021, 34 patients (30 females, 4 males; mean age 36.2 years) with sunken eyes were treated with our described technique. All patients underwent an endoscopic SOS procedure under general anesthesia.
RESULTS: A total of 34 patients (30 women and four men), aged 23-59 years old (mean = 36.2 years), underwent the endoscopic SOS procedure. The mean follow-up period was 13 months (range: 12-16 months). Postoperatively, significant improvement in lateral convexity was achieved in all patients. Physical examinations performed at the control visits revealed no functional problems in any patients and no visible or palpable irregularities or contour deformities. No complications were encountered regarding the SOS procedure.
CONCLUSIONS: The technique described here provides significant improvement in lateral convexity compared to other techniques used in patients with sunken eyes. No additional eyelid intervention is needed. Unlike the techniques previously described in the literature, intervention is made in the bone structure, thereby providing more accurate results.
METHODS: 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 .

Inadequate tissue volume at the lower pole of the breast following tumor excision can compromise aesthetic outcomes when employing the conventional inverted-T reconstruction technique. With the aim of reducing postoperative deformities, we have refined this technique. A total of 104 patients underwent the T technique, while 32 underwent the modified T technique and 72 underwent the traditional T technique. In this study, we present the surgical outcomes of the modified T technique group and compare both surgical and oncological outcomes with those of the traditional T technique group. In the modified T technique group, the average tumor size was 23.34 mm, and the mean operation duration was 107.75 min, which was significantly shorter than that of the traditional T technique (p = 0.039). Additionally, the average blood loss was 95.93 mL, which was significantly lower than that of the traditional T technique (p = 0.011). Although complication rates did not differ significantly between the two groups (p = 0.839), the modified T technique yielded superior aesthetic outcomes compared to the traditional T technique (p = 0.019). Survival analysis indicated no significant difference in 5-year recurrence-free survival between the two groups, both before and after propensity score matching (p = 0.381 vs. p = 0.277). As part of our series of oncoplastic techniques for the lower breast quadrant, the modified inverted-T technique utilizes a cost-effective flap to address lower pole defects, mitigating deformities and restoring the breast\'s natural shape.

BACKGROUND: The test-retest (TRT) reliability of FACE-Q Aesthetic scales is yet to be assessed. The aim of this study was to establish the TRT reliability of 17 FACE-Q Aesthetic scales and determine the smallest detectable change (SDC) that can be identified using these scales.
METHODS: Data were collected from an online international sample platform (Prolific). Participants ≥20 years old, who had been to a dermatologist or plastic surgeon for a facial aesthetic treatment within the past 12 months were asked to provide demographic and clinical information and complete an online REDcap survey consisting of 17 FACE-Q Aesthetic scales. Participants were asked if they would be willing to complete the survey again in 7 days. Only the participants who reported no important change in the scale construct and completed the retest within 14 days were included.
RESULTS: A total of 342 unique participants completed the TRT survey. The mean age of the sample was 36.6 (±11.5) years, and 82.4% were female. With outlier data removed, all FACE-Q scales demonstrated an intraclass correlation coefficient >0.70 indicating \"good\" TRT reliability. The standard error of measurement for the included scales ranged from 3.37 to 11.87, corresponding to a range of SDCgroup from 0.95 to 3.23 and SDCind from 9.34 to 32.91.
CONCLUSIONS: All included FACE-Q scales demonstrated sufficient TRT reliability and stability overall after the outlier data were removed. Moreover, the authors calculated the values for the SDC for these scales.

Introduction: Sarcoma resection often leaves patients with big defects only amenable through microsurgical reconstruction. In such cases, it is hard for the surgeon to uphold low donor-site morbidity with an aesthetic result. The purpose of this study was to investigate the clinical outcome and the patient\'s perception regarding the donor site in a cohort of patients undergoing microsurgical reconstruction with lateral thigh and lower abdominal perforator flaps. Methods: A retrospective evaluation of all patients who underwent sarcoma reconstruction with flaps harvested from the lower abdominal region (deep inferior epigastric artery perforator flap, superficial circumflex iliac artery perforator flap) or lateral thigh region (anterolateral thigh perforator flap and its variations) was performed. Only patients with defects greater than 100 cm2 were included. Patient demographics and operative variables were recorded, together with complications. Patient satisfaction and quality of life with the donor site were registered using the SCAR-Q questionnaire, which was administered at least six months post-operatively. Results: Eighteen anterolateral thigh (ALT) perforator flaps and twenty-two deep inferior epigastric artery perforator (DIEP) and superficial circumflex iliac artery perforator (SCIP) flap procedures were performed. The two groups were homogeneous for major post-operative complications (p > 0.999). Patient satisfaction with the donor site measured using the SCAR-Q questionnaire showed significantly higher scores in the DIEP/SCIP group when compared with the thigh group (p < 0.001), indicating a superiority of the lower abdominal area as an aesthetic donor site. Conclusions: The DIEP and SCIP flaps are a versatile option for reconstructing large soft-tissue defects following sarcoma resection. Therefore, flaps harvested from the lower abdomen yield a higher patient satisfaction with the donor site, which is a feature worth considering when planning a reconstructive procedure.

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UNASSIGNED: Pediatric dental treatment is challenging in patients with early childhood caries. For clinician its difficult to manage child and provide good work at the same time. Its necessity to have the best equipments as well as materials. Nowadays, aesthetics play an important role in managing decayed teeth. Zirconia crown is better option but requires excessive preparation. As Bioflx is newly developed crown and has combined stainless steel and zirconia properties.
UNASSIGNED: To assess the clinical performance and child and parental satisfaction of Bioflex crowns compared to zirconia and stainless steel crowns.
UNASSIGNED: In this comparative study of Bioflx crowns with zirconia and stainless steel crowns, children aged three to seven years old will be selected, and 72 primary teeth requiring crowns will be randomly distributed into three groups, n = 24: Group I: Preformed stainless steel crown, control; Group II: Preformed Bioflex crown; Group III: Preformed zirconia crown. Crowns will be evaluated for recurrent caries, plaque accumulation, restoration failure, gingival status opposing tooth wear, and clinicians and parental satisfaction at zero, three, six, and 12 months.
UNASSIGNED: Bioflx crown will have better clinical as well as parental satisfaction among zirconia and stainless steel crowns.
UNASSIGNED: The Bioflx crown can be used as an alternative economical esthetic full-coronal restoration for primary teeth.
UNASSIGNED: CTRI registration number: CTRI/2023/05/052256; Date of registration: May 03, 2023.
UNASSIGNED: Two; Date: April 22, 2023.

UNASSIGNED: The present study investigated the skeletal and dental effect in class II division I growing patients due to mandibular deficiency treated with the hybrid aesthetic functional (HAF) appliance.
UNASSIGNED: A sample of 16 growing patients (5 boys and 11 girls; mean age: 9.50 years, standard deviation: 1.15) with class II division I malocclusion were treated using the HAF appliance for an average period of 10±3 months. For each patient, a cephalometric radiograph was taken before and after treatment, and digital analysis was applied using the WebCeph program. The statistical analysis was performed to evaluate dental and skeletal changes associated with the HAF appliance and determine if there were any statistically significant variations in anatomical measurements between the start and completion of the treatment.
UNASSIGNED: The data showed a significant increase in SNB angle (P=0.002), leading to a significant decrease in ANB angle (P=0.001). The mandibular length significantly increased (P=0.008), the lower incisors were flared significantly (P=0.028), and the lower molars were extruded significantly (P≤0.001). Also, this study revealed a significant decrease in Wits appraisal (P≤0.001), overjet (P≤0.001), and overbite (P=0.041). Additionally, a significant increase in lower anterior facial height (P≤0.001), total facial height (P=0.001), and posterior facial height (P=0.037) were observed.
UNASSIGNED: The HAF appliance showed that it could be used to correct class II division 1 skeletal discrepancy by mandibular advancement. The HAF appliance increased all facial heights significantly.

OBJECTIVE: The purpose of this clinical study was to evaluate the efficacy of the preseptal transconjunctival approach with Y modification of the cutaneous extension for the management of zygomaticomaxillary complex (ZMC) fractures.
METHODS: This prospective interventional study was conducted at our institute from 2012 to 2020. The study included patients aged 15-65 years with displaced ZMC fractures. Patients with uncontrolled systemic conditions, infected and/or comminuted fractures were excluded. The variables evaluated were age, gender, mechanism of injury, fracture side, clinical features, surgical exposure time, adequacy of exposure, complications, scar evaluation scores and cosmetic outcomes. The parameters for comparison were operated versus non operated side Eye Fissure Index (EFI) and surgical exposure time was compared with respect to the types of scars.
RESULTS: A total of 49 patients were included in this study. The average exposure time was 18.87 ± 1.92 min. The exposure of fracture site was excellent in 73.5 % and satisfactory in 26.5 %. The mean EFI of operated side was 34.2 ± 5.04 mm while that of non-operated side was 34.22 ± 5 mm. On comparison of the same there was no significant difference. Invisible scars were noted in 71.4 % and barely visible scars in 22.4 %. The comparison of exposure time with type of scars showed a significant association (p = 0.02). The complications noted were chemosis, lower eyelid edema, conjunctival granuloma and entropion. Cosmetic outcomes were fairly satisfactory.
CONCLUSIONS: The Y modification of the transconjunctival approach can provide excellent surgical exposure without the need for a second incision. Although this approach is technique sensitive and requires experience, the advantages outweigh the learning curve. Since this approach has been widely studied, a systematized review is recommended to further substantiate its reliability and advantages.

OBJECTIVE: This study investigates differences in personality characteristics, including perfectionism, ruminative thinking style, and self-compassion, between individuals who have undergone rhinoplasty and a control group without any history of cosmetic surgery.
METHODS: The study included 33 adult patients who underwent rhinoplasty between 2021 and 2023 at Bursa Uludağ University Faculty of Medicine Hospital and 33 adult patients who visited our centre for other complaints as a control group. The rhinoplasty group consisted of primary surgical patients with functional and cosmetic concerns, excluding those who sought revision surgery or had only functional problems. The control group consisted of individuals with no prior cosmetic surgery history and no expectations of aesthetic interventions. Psychiatric analysis was performed using Frost multidimensional perfectionism scale, ruminative thinking style questionnaire, and self-compassion scale.
RESULTS: This research revealed that individuals who had rhinoplasty scored higher in perfectionism 109.3 (±23.3) and ruminative thinking 87.9 (±22) compared to those who did not undergo surgery 94.15 (±22.2) and 77.7 (±23), respectively. Additionally, the rhinoplasty group had lower self-compassion scores, 80.4 (±17.3), than the control group, 86.1 (±11.2). Statistically significant differences were observed in perfectionism between the groups (p = 0.009). In rhinoplasty patients, a notably positive correlation was found between perfectionism and ruminative thinking scores (r = 0.482; p = 0.005), while a moderately significant negative correlation was observed between self-compassion and ruminative thinking scores (r = - 0.465; p = 0.006).
CONCLUSIONS: Individuals who undergo rhinoplasty generally show increased levels of perfectionism and are more prone to ruminative thinking. They also demonstrate reduced self-compassion compared to non-surgical control groups. Cosmetic surgeons should be aware of these psychological trends and consider using appropriate scales during pre-surgery consultations and follow-up visits. Adopting this informed approach can improve the surgeon-patient relationship and help overcome communication challenges.
METHODS: 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 .