[Change of perception of aged male attractiveness by conventional or male facelift: 3D simulation study of a new facelift concept for men]. / Veränderung der Wahrnehmung männlicher Attraktivität im Alter durch Standard- oder männliche Gesichtsstraffung: 3D-Simulationsstudie eines neuen Facelift-Konzeptes für Männer.

BACKGROUND: Facelift is now the fourth most common aesthetic procedure in men. Facial ageing is very different in men and women. Therefore, individual techniques are used since a uniform concept for the surgical facelift in men does not exist. This study aims to evaluate a gender-specific facelift concept especially developed for men. MATERIAL AND METHODS: Women and men (n = 10 each) were subjected to a three-dimensional face scan and a subsequent simulation of a V-shaped lift vector (standard lift) and a new facelift concept especially for men in a double T shape (male lift). In an online survey with 262 participants, the simulated as well as the unchanged images were presented and the attributes masculinity, femininity, attractiveness and youthfulness were queried. Statistical models were used to identify attributes of lifting as well as other factors and differences between the simulations. RESULTS: Facelift changes are generally associated with a significant improvement in the attributes of youthfulness and attractiveness compared with unchanged control faces. As expected, a male lift leads to masculinisation, while a standard lift leads to feminisation, regardless of the sex of the subjects. The male lift led to higher values for the attribute attractiveness in male subjects, as did the standard lift in female subjects. The standard lift developed for women is indeed more suitable for women and is associated with a significantly higher probability for the attribute youthfulness, whereas this is not the case in the newly introduced male lift concept. CONCLUSION: The new facelift concept for male patients is significantly associated with masculinity and attractiveness, while the standard lift suitable for women is associated with significantly higher evaluations of femininity and youthfulness. The results of the SIMALIFT study are the first evidence of the need for a more differentiated, gender-specific approach to facelifting.

Coating of an anti-Fas antibody on silicone: first in vivo results.

BACKGROUND: Although the etiology of capsular contracture after breast augmentation has not yet been definitively clarified, the literature contains numerous reports placing the blame on a foreign body reaction. We have developed a procedure for covalently activating a silicone surface with an anti-Fas antibody, which might suppress the foreign body reaction on the silicone surface. OBJECTIVES: The authors evaluate whether surrounding tissue might be influenced by anti-Fas antibody coating on silicone disks in comparison to untreated silicone disks in an in vivo model. METHODS: During this study, 4-mm anti-Fas-coated silicone disks were implanted subcutaneously in the paravertebral region of mice (C57/BL6). Silicone disks passing the activation coating process without anti-Fas antibody incubation were defined as the control group. Twelve weeks after implantation, the disks were removed and the surrounding tissue examined. RESULTS: The tissue surrounding the silicone disks in the experimental group showed significantly increased levels of collagen type 3, elevated levels of matrix metalloproteinase 9, markedly decreased levels of transforming growth factor ß2, and a reduced CD68 expression in the pericapsular tissue. CONCLUSIONS: The first in vivo data reveal that the tissue surrounding a silicone surface can be influenced by the vectored binding of an anti-Fas antibody.

Capsular contracture by silicone breast implants: possible causes, biocompatibility, and prophylactic strategies.

The most common implanted material in the human body consists of silicone. Breast augmentation and breast reconstruction using silicone-based implants are procedures frequently performed by reconstructive and aesthetic surgeons. A main complication of this procedure continues to be the development of capsular contracture (CC), displaying the result of a fibrotic foreign body reaction after the implantation of silicone. For many years, experimental and clinical trials have attempted to analyze the problem of its etiology, treatment, and prophylaxis. Different theories of CC formation are known; however, the reason why different individuals develop CC in days or a month, or only after years, is unknown. Therefore, we hypothesize that CC formation, might primarily be induced by immunological mechanisms along with other reasons. This article attempts to review CC formation, with special attention paid to immunological and inflammatory reasons, as well as actual prophylactic strategies. In this context, the word "biocompatibility" has been frequently used to describe the overall biological innocuousness of silicone in the respective studies, although without clear-cut definitions of this important feature. We have therefore developed a new five-point scale with distinct key points of biocompatibility. Hence, this article might provide the basis for ongoing discussion in this field to reduce single-publication definitions as well as increase the understanding of biocompatibility.

Attack the tumor counterattack-c-FLIP expression in Jurkat-T-cells protects against apoptosis induced by coculture with SW620 colorectal adenocarcinoma cells.

BACKGROUND: Cancer development relies on a variety of mechanisms that facilitate tumor growth despite the presence of a functioning immune system, employing different mechanisms to escape immune rejection. Tumors may eliminate tumor-infiltrating lymphocytes and suppress anti-tumor immune responses, a process called "tumor counterattack," based on activation-induced cell death via the FAS/FAS-ligand system. To overcome this tumor-cell survival strategy, we examined the hypothesis that the sensitivity of FAS mediated apoptosis of Jurkat-T-cells can be suppressed by FLIP transfection of Jurkat-T-cells. MATERIALS AND METHODS: Jurkat-T-cells were transfected with the FLICE-inhibitory protein FLIP in order to bestow them with a resistance to FAS-receptor-mediated apoptosis. FLIP-transfected and non-transfected Jurkat-T-cells were grown in coincubation with SW620 cells and the rates of apoptosis measured via FACS-analysis of Annexin-V. RESULTS: First, the tumor-counterattack described in the literature was confirmed. About 20% of Jurkat-T-Cells underwent apoptosis in coculture with SW620 cells. After coincubation of SW620 cells with FLIP transfected Jurkat-T-cells the apoptotic rate was significant reduced at levels below 4%. CONCLUSION: Transfection of Jurkat-T-cells with FLIP reduces the sensitivity of Jurkat-T-cells to FAS-mediated apoptosis and may lead to an improved capability to antagonize the inherent tumor survival strategy of SW620 cells.

Delayed flap coverage of open extremity fractures after previous vacuum-assisted closure (VAC) therapy - worse or worth?

BACKGROUND: Controversy remains regarding timing in the management of complex traumatic lower extremity defects. Many authors recommend a definitive bony and soft tissue reconstruction within a critical period of 72 h, yet in many patients this may be impossible due to concomitant injuries or delayed referral. However, little data are available on the results of delayed flap reconstruction of complex traumatic extremity defects, especially using new technologies of wound coverage such as vacuum-assisted closure (VAC((R))) therapy which may reduce the disadvantages of conventional open wound therapy prior to a subsequent flap reconstruction. METHODS: We retrospectively analysed the soft tissue reconstructions in 43 open extremity fractures during a 4-year period with special regard to complications, overall flap loss and wound infection. RESULTS: A total of 29 male and 13 female patients with 33 open fractures of the lower and 10 of the upper extremity were included. All patients had been referred from a trauma centre at a mean interval of 19 days (range 1-96 days) after the trauma event with temporary VAC((R)) of their wounds after initial fracture fixation and initial debridement of necrotic tissue. Flap reconstruction was thus only possible later than 72 h and definitive wound closure was achieved at a mean time of 28 days (range 3-106 days). Overall, three pedicled flaps were lost and one of 38 microsurgical free flaps (2.6%) underwent necrosis, the cause of which was unrelated to treatment delay. CONCLUSIONS: According to this study, the flap reconstructions performed beyond the frequently quoted critical interval yielded similar results to those of immediate reconstruction within the first 3 days, as reported in the literature. This strategy is in accordance with the principles of 'Damage Control Orthopaedics (DCO)' and may reduce the importance of emergency reconstructions, especially in poly-traumatised patients.