Letter to the Editor on "Guyuron B, Son JH. String fat/dermis graft for correction of wrinkles and scars. Plast. Reconstruct. Surg. 2019; 144:93-96"

Special surgical trick to augment the nasolabial fold with fat/dermis graft or SMAS graft to reduce its depth

A Case of Systemic Inflammatory Response Syndrome after Liposuction-assisted Abdominoplasty

A 51-year-old woman underwent liposuction-abdominoplasty. After surgery, she developed hypotension and bradycardia, attributed to iatrogenic opioid-intoxication. After discontinuing opioids, the patient had several episodes of hypotension and tachycardia, responding well to fluid resuscitation. The initial differential diagnosis of postoperative bleeding was ruled out with a CT-scan. Other potential causes of hemodynamic instability, such as pulmonary embolism and fat embolism, were considered unlikely in absence of corresponding symptoms. Based on leukocytosis and tachycardia, the patient was diagnosed with systemic inflammatory response syndrome, a disproportional inflammatory reaction to surgery. The patient was managed expectantly with intravenous fluid administration and recovered without further treatment or complications

Statements on the Safety of Permanent Soft Tissue Fillers in Europe

Increasing reported complications associated with permanent soft tissue fillers have led the national medical societies and governmental institutes in Europe to send out warnings regarding their use. Regulation and legislation for the introduction of new products and the use of existing products are necessary to guarantee patient safety

Lifting the Mouth Corner:A Systematic Review of Techniques, Clinical Outcomes, and Patient Satisfaction

BACKGROUND: Mouth corners are an essential part of the centro-facial area for perception of attractiveness and emotions. Downturned mouth corners are a result of aging or have a congenital origin. Different mouth corner lifting techniques are described in the literature. OBJECTIVES: This review was performed to systematically assess and compare invasive and non-invasive mouth corner lifting techniques and their effectiveness, patient satisfaction and adverse effects. METHODS: MEDLINE (via PubMed), EMBASE and The Cochrane Central Register of controlled trials databases were searched for clinical and observational studies published in peer-reviewed academic journals with abstracts available (searched from May 18, 2019, to December 18, 2021). Outcomes of interest were aesthetic mouth corner lifting techniques, the degree of lift as well as the longevity of the lifting effect, patient satisfaction and adverse effects. Techniques were subdivided in invasive techniques and non-invasive techniques. RESULTS: Eleven out of 968 studies were included in the qualitative analysis. In general, surgical techniques seem to have a better mouth corner lifting effect in comparison to non-surgical techniques; however, objective evidence is weak, and surgery inevitably results in a scar. Reported patient satisfaction was good for both surgical and non-surgical techniques and no severe complications have been described. CONCLUSIONS: Surgical techniques seem to have a better lifting effect on mouth corners than non-surgical techniques. Nevertheless, objective evidence is weak, and a scar is inevitable

A layered approach to model interconnected infrastructure and its significance for asset management

Physical infrastructures facilitate much of societal and economic wellbeing of countries, regions and urban areas. In our increasingly urbanizing world, infrastructures in urban areas are densely located and interconnected. The effects of this interconnectedness are being studied increasingly, particularly in light of climate change effects. In this paper, we develop an agent-based simulation model that allows us to study interconnected infrastructure. We present a layered approach that is analogous to GIS overlay approaches, which allows us to integrate representations of different infrastructures. We explore how this approach can help asset managers to gain insights in interconnected infrastructure by estimating their total damage and repair requirements during a flood event. The results show a difference in these estimates, when compared to non-integrated models, highlighting the need for asset managers to consider interconnectedness in infrastructure

Reply: Modern primary breast augmentation: best recommendations for best results

This article compares 3 different methods how to identify the new IMF for a certain breast implant volumes / dimensions, including our own method that is called "The Pythagorean Theorem Method"