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In recent years, immediate replacement with a prosthesis (direct-to-implant, DTI) is gaining more popularity than two-staged methods (tissue expander followed by an implant, TEI). The safety of immediate implant-based breast reconstruction (IBR) is debatable when postmastectomy radiotherapy (PMRT) is indicated. This meta-analysis aims to evaluate the outcomes of DTI and TEI procedures followed by PMRT.Studies searched in the PubMed/Embase/The Cochrane Library databases (1995-2021) were filtered by exclusion criteria. Cases were divided into PMRT and non-irradiated groups, PMRT with a permanent implant or tissue expander. The outcomes were capsular contracture and other complications.A total of 22 studies with 6964 patients were included. PMRT increased the risk of capsular contracture in DTI patients and caused other complications in TEI patients. In PMRT and non-irradiated groups, the mean rates of capsular contracture were 17.01% versus 3.30% (p 0.01) in IBR and 15.49% versus 5.70% (p 0.01) in DTI. The mean rates of other complications were 22.59% versus 11.29% (p 0.01) in IBR, 31.88% versus 27.87% (p = 0.35) in DTI, and 22.11% versus 9.90% (p 0.01) in TEI. Implants and tissue expanders caused a similar rate of capsular contracture and other complications.PMRT is related to a higher risk of complication and capsular contracture in IBR, including DTI procedure. This negative effect may not be related to the type of breast contents during radiotherapy.

Li S, Xiao Y, Wang Y, Bai M, Du F, Zhang H. Clin Cosmet Investig Dermatol. 2023;16:103–110. The authors advise that the funding section on page 109 is incorrect. The funding statement should read as follows. Funding This project was supported by the grant from Peking Union Medical College Hospital Central High-level Hospital Clinical Scientific Research Project (Grant number: 2022-PUMCH-B-040). The authors apologize for this error.

Background Facial abnormality is the most significant feature in acromegaly patients. However, it is unclear whether and how patient facial appearance improves after treatment. This study aimed to identify 3D facial changes in acromegaly patients after surgical treatment. Methods This study included 30 acromegaly patients who underwent resection of a pituitary GH adenoma. The location and extent of facial changes were identified by comparing baseline and 2-year follow-up 3D images of the face. Relationships between facial changes and GH and IGF-1 were evaluated with simple or multivariable linear regression models. Results Significant soft tissue improvements were observed in acromegaly patients with complete remission, especially in the nose and lip region. Significant reductions in nasal width (3.46 mm, P < 0.001), tip protrusion (1.18 mm, P = 0.003), face curve length (3.89 mm, P = 0.004) and vermilion area (1.42 cm3, P = 0.001) were observed at the 2-year follow-up. Further, changes in nasal width were associated with decreases in GH (β = 4.440, P = 0.017), the GH nadir (β = 4.393, P = 0.011) and IGF-1 (β = 5.263, P = 0.002). The associations were maintained after adjusting for confounders. Conclusions Acromegaly patients achieved considerable facial improvements after surgical treatment. The change in nose width was associated with GH and IGF-1 decrease. Better control of patient hormone levels after surgery improves patient facial recovery.

The skin redraping method for medial epicanthoplasty is characterized by some shortcomings which warrants modification. In this study, clinical data of 193 patients who underwent medial epichanthoplasty by the modified skin redraping technique or the classic skin redraping technique were reviewed retrospectively. The patients underwent operation between May 2018 and June 2020 and were followed up for not less than 6 months. Interepicanthal distance, interpupillary distance, patient satisfaction, and postoperative complications were evaluated. In terms of interepicanthal distance/inter-pupillary distance ratio ( P0.05) and satisfaction score ( P = 0.759), the modified skin redraping technique and the classic skin redraping technique were similar. In the classic skin redraping group, there were 3 cases of visible scarring in the lower eyelid, corresponding to significantly more cases than in the modified skin redraping group (n = 0, P0.001). There were more out-fold cases in the modified skin redraping group (76/90) than in the classic skin redraping group (17/88) ( P0.001). Utilizing the modified skin redraping medial epicanthoplasty can prevent medial hooding of the upper eyelid, reduce the probability of visible scarring, and produce more out-fold with concurrent double eyelidplasty compared with classic skin redraping epicanthoplasty. Level of evidence: IV.

Background and objectives Giant juvenile fibroadenoma (GJF) is a rare benign tumor that disfiguring affects the breast shape and quality of life of patients. This study aimed to report the experience of GJF management. Methods A Wise-pattern skin reducing tumor resection followed by immediate breast reconstruction with a dermal flap pocket was used. The long-term outcomes were assessed retrospectively by BREAST-Q questionnaire from 2008 to 2018. Results The study included eight patients with GJF. All patients achieved satisfactory results without severe complications. The BREAST-Q revealed that postoperative scores for satisfaction with breasts (69.3 ± 17.6) and sexual wellbeing (62.3 ± 27.6) were higher than the normative scores. The psychosocial wellbeing (69.7 ± 14.6) and physical wellbeing-chest (86.8 ± 13.0) scores were slightly lower than the normative scores. Conclusion Although GJF is a benign tumor, it should be surgically removed. And the Wise-pattern skin reducing tumor resection with immediate breast reconstruction is a proper way to improve patients' satisfaction with breast size and shape and quality of life.