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Background: Abdominoplasty is a critical aesthetic and functional procedure for individuals who have undergone massive weight loss. Numerous techniques have been proposed to optimize aesthetic results while minimizing complications. Methods: This prospective study examined 500 patients who underwent abdominoplasty during body-contouring procedures between 1 January 2018 and 31 December 2021 at a tertiary center. The Skin–Adipose Tissue–Muscle (SAM) protocol was employed to analyze the operative strategies and complication rates and compare them with the existing literature. Furthermore, patient satisfaction and aesthetic outcomes were measured one year post-operation using a comprehensive four-point questionnaire evaluated by the patients themselves and two independent surgeons. Results: Participants had an average age of 34.8 years and a mean BMI of 31.1 kg/m2. The surgeries included 328 full abdominoplasties and 172 T-inverted abdominoplasties. Notable complications included wound infection (4%), wound dehiscence (8.6%), tissue necrosis (0.6%), seroma (8.4%), and hematoma (2.6%). A higher BMI was correlated with an increased risk of complications and lower patient satisfaction. Data analysis was performed using Stata version 18 software. Conclusions: The increasing prevalence of obesity highlights an urgent need for more bariatric surgeries and subsequent abdominoplasties to mitigate the effects of massive weight loss. A crucial link between elevated BMI and a heightened risk of postoperative complications, emphasizing the necessity for standardized surgical protocols tailored to individuals with higher BMI, was noted. Innovatively, future studies must further investigate the intricate dynamics between BMI and surgical risks. Exploring and establishing uniform, adaptive surgical guidelines promise to revolutionize patient care by significantly reducing complications and enhancing recovery and satisfaction following abdominoplasty. [ABSTRACT FROM AUTHOR]

The use of hyaluronic acid (HA)‐based aesthetic therapies is growing steadily, and according to the International Society of Aesthetic Plastic Surgery, more than 4.3 million aesthetic procedures using HA were performed in 2019, an increase of 15.7% than 2018. More people are offering these types of services, often without proper training or qualifications. Therefore, there is an increasing number of reports in the literature relating to possible adverse events, with subsequent therapeutic problems and more or less serious consequences for patients. The aim of this research is to carry out a review of the literature in order to evaluate the impact of hyaluronic acid‐based fillers in patients with autoimmune inflammatory diseases, in particular scleroderma and Systemic Lupus Erythematosus (SLE). Although HA plays a central role in the inflammatory process, the use of HA‐based fillers in patients with autoimmune inflammatory diseases is still controversial. HA, in fact, in inflamed tissues helps to propagate the inflammatory response and, injected in the form of a dermal filler, could potentially promote reactivation of the underlying disease. For this reason, many specialists do not perform HA‐based aesthetic treatments in patients with scleroderma or SLE. However, recent scientific evidence suggests that the use of HA‐based fillers in patients with scleroderma can lead to improvement of skin lesions, with satisfactory results. In the literature, there are no clinical studies that contraindicate the administration of HA‐based dermal fillers in patients with inflammatory disease. [ABSTRACT FROM AUTHOR]

• Pre-menopausal women with lowest breast fat-density (fatty breast) vs. higher breast fat-density (non-fatty breast) are high-risk population for cardiovascular diseases and worse prognosis. • The worse cardiovascular prognosis could be due to expression in the breast fat tissue in fatty vs. non-fatty pre-menopausal women of sodium glucose transporter 2 (SGLT2), inflammatory cytokines and sirtuins. • Indeed, these molecular effectors could condition the intima-media wall thickness (IMT), left ventricle mass (LVM), left ventricle ejection fraction (LVEF), and myocardial performance index (MPI), and its normalization. • The fatty vs. non-fatty breast women over-expressed SGLT2/inflammatory cytokines, and down-regulated breast sirtuins. • SGLT2/inflammatory cytokines expression and inversely the tSIRT3 and breast percentage density linked to ΔMPI at 1 year of follow-up. • Fatty breast and SGLT2 inversely predicted the normalization of cardiac performance (NCP). • SIRT-3 increased the probability of NCP at 1 year of follow-up. To evaluate the expression of sodium-glucose transporter 2 (SGLT2), inflammatory cytokines, and sirtuins in breast fat tissue at baseline, and serum cytokines of fatty vs. non-fatty pre-menopausal women at baseline, and at 12 months of follow-up. To correlate SGLT2/cytokines/sirtuins expression to clinical variables, and their changes (Δ) at follow-up, as intima-media wall thickness (IMT), left ventricle mass (LVM), left ventricle ejection fraction (LVEF), and myocardial performance index (MPI), and its normalization. Pre-menopausal women with the lowest breast fat density (fatty breast) vs. higher breast fat density (non-fatty breast) are a high-risk population for cardiovascular diseases and worse prognosis. We analyzed SGLT2/cytokines/sirtuins of excised fatty breasts of fatty vs. non-fatty pre-menopausal women. We correlated SGLT2/cytokines/sirtuins to Δ IMT, Δ LVM, Δ LVEF, and Δ MPI, and normal cardiac performance (NCP) at 1 year of follow-up. fatty vs. non-fatty breast over-expressed SGLT2/inflammatory cytokines, with lowest values of sirtuins (p <0.05). We found a direct correlation between SGLT2 (R2 0.745), TNFα (R2 0.262), and ΔMPI (p <0.05), and an inverse correlation between breast density (R2 -0.198), SIRT-3 (R2–0.181), and ΔMPI (p <0.05). Fatty breast (0.761, CI 95% [0.101–0.915]), SGLT2 (0.812, CI 95% [0.674–0.978]) and SIRT-3 (1.945, CI 95% [1.201–3.148]) predicted NCP at 1 year of follow-up. fatty vs. non-fatty breast women over-expressed SGLT2/inflammatory cytokines, and down-regulated breast sirtuins. SGLT2/inflammatory cytokines expression and inversely the tissue sirtuin 3 (tSIRT3) and breast percentage density linked to ΔMPI at 1 year of follow-up. Fatty breast and SGLT2 inversely predicted NCP; SIRT-3 increased the probability of NCP at 1 year of follow-up. [Display omitted] [ABSTRACT FROM AUTHOR]

Due to the increased prevalence of obesity in the last decades, bariatric surgery has been on the rise in recent years. Bariatric surgery is a compelling option for weight loss in obese patients with severe obesity-related comorbidities or for whom lifestyle modifications have proven ineffective. Redundant skin following significant weight loss is a common occurrence affecting up to 96% of patients who undergo bariatric surgery, negatively impacting physical and psychosocial health and detracting from activities of daily living. Statistics of the American Society of Plastic Surgeons show that 46,577 body contouring procedures were performed after massive weight loss in the USA in a 2020 report. Abdominoplasty, a well-established cosmetic surgery procedure for improving body contour, is performed by removing excess skin and fat from the abdominal wall and thereby restoring musculofascial integrity and skin elasticity, resulting in a more ideal body shape and increasing quality of life. Although abdominoplasty is a safe procedure, it has been associated with a higher complication rate compared with other body-contouring procedures. Technologic advances over the past decade have been developed as non-invasive alternatives or adjunctive tools to surgery to enhance cosmetic results and minimize complications. New energy-based technologies may supplant invasive surgery for mild to moderate skin laxity and/or diminish the extent of surgery and resulting scars. Plastic surgeons play a significant role in improving the quality of life of patients who suffer from obesity and underwent bariatric surgery. We are deeply convinced, however, that the advancement of knowledge and research in this field will determine the introduction of new technologies and custom-made techniques. This advancement will reduce the complication rate with a rapid reintegration of the patient into the world of work and resumption of daily activities. [ABSTRACT FROM AUTHOR]

Background: Endoscopic carpal tunnel surgery (ECTR) is a procedure that gained wide popularity resulting in reduced scar length and faster recovery. Different studies focused on how the type of skin closure affected the quality and the appearance of the final scar in carpal surgery release. In this study, we investigated the efficiency of a well-established primary skin closure method using Steri-Strips that, to date, has never been described in ECTR. Methods: We retrospectively reviewed data of 47 consecutive patients who underwent unilateral endoscopic carpal tunnel release at our clinic. All patients underwent the same surgical procedure performed by two different surgeons that differed only in the final skin closure: one used only Steri-Strips (group A), while the other used continuous absorbable subcuticular 4/0 monofilament polyglytone 6211 sutures (group B). Data collected included photographs at 10 days and three months after surgery and the visual analogue scale (VAS) for pain evaluation, while the measure for the scar evaluation was the Stony Brook Scar Evaluation Scale. We also performed the Wilcoxon rank test to assess if there was a statistically significant difference between the two groups in terms of pain and scar quality. Results: A total of 47 patients were included in this study. According to skin closure technique performed, the patients were categorised into two groups, A and B. Group A comprised 26 patients in which only Steri-Strips were used for the final skin closure; group B included 21 patients in which the closure was performed through 4/0 polyglytone. Data obtained from the VAS and from the Stony Brook Scar Evaluation Scale showed no significant difference between the two groups (p > 0.05). Data obtained from the evaluation of the visual analogue scale showed no significant differences in the median scores and similar postoperative pain between the two groups for all the 7 days of data recorded (p > 0.05). Conclusions: Skin closure with Steri-Strips is a safe, secure and cheap method that leads to excellent aesthetic results. It is both a first choice and a valid alternative to intradermal suture for wound closure after endoscopic carpal tunnel release. Level of evidence: Level IV, therapeutic study. [ABSTRACT FROM AUTHOR]

The role of sirtuin 6 (SIRT6) in adipose abdominal tissue of pre-diabetic (pre-DM) patients is poorly known. Here, we evaluated SIRT6 expression in visceral abdominal fat of obese pre-diabetic patients and the potential effects of metformin therapy. Results indicated that obese pre-DM subjects showed low SIRT6 protein expression and high expression of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), peroxisome proliferator-activated receptor gamma (PPAR-γ), and sterol regulatory element-binding transcription factor 1 (SREBP-1). Obese pre-DM patients showed high values of glucose, insulin resistance (HOMA-IR), C reactive protein (CRP), nitrotyrosine, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6), and low values of insulin (p < 0.05). Of note, abdominal fat tissue of obese pre-DM patients treated with metformin therapy presented higher SIRT6 expression and lower NF-κB, PPAR-γ, and SREBP-1 expression levels compared to pre-DM control group. Collectively, results show that SIRT6 is involved in the inflammatory pathway of subcutaneous abdominal fat of obese pre-DM patients and its expression responds to metformin therapy. [ABSTRACT FROM AUTHOR]