Autologous adipose tissue transplantation is a versatile surgical procedure used for aesthetic, reconstructive, and regenerative purposes. Cryopreservation of adipose tissue collected during liposuction reduces the need for repeated fat collection, minimizing patient discomfort while preserving volumetric and regenerative properties. There are currently no studies in the literature correlating cellular viability, before and after thawing, with patient-specific variables and collection techniques. This study investigates patient-specific factors affecting cellular viability before and after thawing to refine protocols for patient selection and tissue collection. A retrospective analysis of 55 patients from the University Hospital Policlinico of Modena was conducted. Intraoperative factors (disinfectant used, type of anesthesia, operators, associated procedure, duration of surgery, harvesting area, quantity collected) and clinical variables (age, sex, smoking status, comorbidities, antiblastic therapy, hormonal therapy, radiation therapy, immunological therapy) were analyzed. Cell count and metabolic activity tests were performed pre- and post-cryopreservation. Hormonal therapy significantly correlates with reduced cellular metabolic activity and viability, both pre- and post-thawing. The findings underscore the need to evaluate adjuvant therapies when planning adipose tissue collection. Optimizing timing and preparation can improve graft viability, reducing resorption rates and enhancing volumizing and regenerative effects. Preoperative planning must account for the timing of hormonal and other therapies to ensure effective autologous adipose transplants with improved outcomes.

Background: In recent years, aesthetic medicine has progressively prioritized conservative treatment volumes, subtle enhancements, and skin quality improvement over volumization. This study evaluates patient-reported psychosocial outcomes, satisfaction, and regret rates following minimally invasive aesthetic procedures using validated instruments. Methods: A review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Cochrane Library were searched for studies reporting outcomes using validated PROMs (FACE-Q, GAIS, Decision Regret Scale, BDDQ, DCQ and COPS) with a minimum follow-up of 6 months. Studies evaluating facial botulinum neurotoxins, hyaluronic acid fillers, and biostimulation treatments were included. Given the heterogeneity in study design and outcome reporting, findings were synthesized narratively with descriptive comparisons across treatment modalities. Results: Increased treatment intensity was not consistently associated with greater satisfaction, and higher dose or volume often corresponded to more dissatisfaction and regret. The evidence for this pattern was stronger for botulinum toxin and hyaluronic acid fillers; weaker for biostimulators and preliminary for post-GLP-1 facial changes. Conservative approaches were associated with favorable PROMs, and unrealistic expectations, body dysmorphic disorder, and insufficient pre-treatment counseling were the principal predictors of poor outcomes. Conclusions: Patient satisfaction was not proportional to treatment intensity, particularly when results were perceived as unnatural or overcorrected. This relationship appears associative rather than causal, as patients receiving more intense treatment may differ in expectations, history, and psychological profile. A PROM-driven, patient-tailored approach seems more likely to produce durable satisfaction and minimize regret.

Reconstruction of the distal lower limb is often complex due to limited local tissues. The pedicled extensor digitorum brevis (EDB) flap is a reliable, loco-regional option for small- to medium-sized ankle and foot defects. This review summarizes literature on pedicled EDB flaps, focusing on indications, outcomes, and donor-site morbidity. A search of PubMed, Embase, and Scopus (1987–2024) using predefined terms identified studies on pedicled EDB flaps for lower limb reconstruction. Exclusions included anatomical studies, case reports, and free or multiple flaps. Out of 88 records, 26 met criteria, covering 296 patients. Trauma was the leading indication for reconstruction (31.4%), followed by postsurgical dehiscence, infections, and chronic ulcers. Most flaps were pure muscle with an average size of 14.55 cm², covering defects of about 11.89 cm². Complications included total necrosis (4.4%) and partial necrosis (3.7%), all in antegrade flaps. Donor-site issues were limited, mainly delayed healing (5.1%) and wound dehiscence (5.1%), rarely causing major problems. The pedicled EDB flap offers predictable anatomy, easy harvest, and minimal functional issues, ideal for small- to medium-sized defects when microsurgery isn’t available. However, necrosis risk and trauma links emphasize the need for careful patient selection and vascular assessment. The pedicled EDB flap is a reliable option for distal lower-limb reconstruction, showing good results with manageable complications. More studies are needed to define its long-term role.