Background: Quantitative skin assessments have transitioned from subjective evaluations to objective approaches. However, clinical application has remained limited due to high costs and reliance on specialized equipment. High-intensity focused ultrasound and radiofrequency are the two most widely used noninvasive modalities for skin tightening and wrinkle improvement. This study investigated investigate the efficacy of artificial intelligence (AI)-based skin analysis as a more accessible and cost-effective tool for assessing skin firmness and wrinkle improvement. Methods: A retrospective analysis was conducted on 34 patients treated simultaneously with high-intensity focused ultrasound and bipolar radiofrequency between January and February 2025. AI-based skin assessments, evaluating firmness and wrinkle scores, were obtained pre-treatment, immediately post-treatment, and at a 2-month follow-up. Standardized clinical photographs were independently evaluated by two blinded human raters. Logistic regression and correlation analyses were conducted to determine alignment between AI and human evaluations. Results: AI analysis showed significant improvements in both firmness and wrinkle scores immediately after treatment and at the 2-month follow-up (P<0.05). Human evaluations demonstrated high inter-rater agreement (Cohen’s κ=0.72–0.91). Logistic regression analyses indicated that changes in AI scores significantly predicted human-rated treatment effectiveness at both time points (area under the curve [AUC] for firmness=0.86; AUC for wrinkles=0.73–0.93). Spearman correlation coefficients and the Mann-Whitney U test further supported strong alignment between AI and human assessments. Conclusions This study validates the clinical utility of AI-based skin analysis as a reliable quantitative measure for evaluating wrinkle improvement and skin tightening following energy-based rejuvenation treatments. Its predictive validity aligns well with expert human judgment, particularly at delayed follow-up.

Background: Quantitative skin assessments have transitioned from subjective evaluations to objective approaches. However, clinical application has remained limited due to high costs and reliance on specialized equipment. High-intensity focused ultrasound and radiofrequency are the two most widely used noninvasive modalities for skin tightening and wrinkle improvement. This study investigated investigate the efficacy of artificial intelligence (AI)-based skin analysis as a more accessible and cost-effective tool for assessing skin firmness and wrinkle improvement. Methods: A retrospective analysis was conducted on 34 patients treated simultaneously with high-intensity focused ultrasound and bipolar radiofrequency between January and February 2025. AI-based skin assessments, evaluating firmness and wrinkle scores, were obtained pre-treatment, immediately post-treatment, and at a 2-month follow-up. Standardized clinical photographs were independently evaluated by two blinded human raters. Logistic regression and correlation analyses were conducted to determine alignment between AI and human evaluations. Results: AI analysis showed significant improvements in both firmness and wrinkle scores immediately after treatment and at the 2-month follow-up (P<0.05). Human evaluations demonstrated high inter-rater agreement (Cohen’s κ=0.72–0.91). Logistic regression analyses indicated that changes in AI scores significantly predicted human-rated treatment effectiveness at both time points (area under the curve [AUC] for firmness=0.86; AUC for wrinkles=0.73–0.93). Spearman correlation coefficients and the Mann-Whitney U test further supported strong alignment between AI and human assessments. Conclusions This study validates the clinical utility of AI-based skin analysis as a reliable quantitative measure for evaluating wrinkle improvement and skin tightening following energy-based rejuvenation treatments. Its predictive validity aligns well with expert human judgment, particularly at delayed follow-up.

Background: Quantitative skin assessments have transitioned from subjective evaluations to objective approaches. However, clinical application has remained limited due to high costs and reliance on specialized equipment. High-intensity focused ultrasound and radiofrequency are the two most widely used noninvasive modalities for skin tightening and wrinkle improvement. This study investigated investigate the efficacy of artificial intelligence (AI)-based skin analysis as a more accessible and cost-effective tool for assessing skin firmness and wrinkle improvement. Methods: A retrospective analysis was conducted on 34 patients treated simultaneously with high-intensity focused ultrasound and bipolar radiofrequency between January and February 2025. AI-based skin assessments, evaluating firmness and wrinkle scores, were obtained pre-treatment, immediately post-treatment, and at a 2-month follow-up. Standardized clinical photographs were independently evaluated by two blinded human raters. Logistic regression and correlation analyses were conducted to determine alignment between AI and human evaluations. Results: AI analysis showed significant improvements in both firmness and wrinkle scores immediately after treatment and at the 2-month follow-up (P<0.05). Human evaluations demonstrated high inter-rater agreement (Cohen’s κ=0.72–0.91). Logistic regression analyses indicated that changes in AI scores significantly predicted human-rated treatment effectiveness at both time points (area under the curve [AUC] for firmness=0.86; AUC for wrinkles=0.73–0.93). Spearman correlation coefficients and the Mann-Whitney U test further supported strong alignment between AI and human assessments. Conclusions This study validates the clinical utility of AI-based skin analysis as a reliable quantitative measure for evaluating wrinkle improvement and skin tightening following energy-based rejuvenation treatments. Its predictive validity aligns well with expert human judgment, particularly at delayed follow-up.

Reconstruction of lower extremity wounds in patients with abnormalities in vascular anatomy is often challenging. A 71-year-old man was admitted to our hospital after sustaining two contact burns on his right leg while sleeping on an electric blanket. Fourth-degree burns amounting to approximately 3% of total body surface area were confirmed, with eschar formation on the right instep and pretibial area. Both wounds on the lower leg required flap reconstruction. In addition, the patient had anterior tibial artery hypoplasia. We considered a two-flap reconstruction method that should leave the source artery and muscle intact and generally has a good prognosis. A peroneal artery perforator-based keystone flap was used on the right lower leg, and a right dorsalis pedis island flap on the foot dorsum. Surgery was performed successfully, and at 8 months postoperatively, the patient walked naturally and had no complaints of discomfort. Additionally, cosmetic results were satisfactory. Accordingly, we introduce a surgical method that is useful in cases similar to that described.

An 88-year-old man presented with a left temporal pulsatile mass that developed after blunt trauma. Based on suspicion of hematoma, needle aspiration was performed with the removal of approximately 15 mL of blood. No evident improvement was noted, and active arterial bleeding was observed at the needle puncture site. Doppler ultrasonography revealed a “yin-yang” sign, and the mass was diagnosed as a pseudoaneurysm of the left superficial temporal artery. Under general anesthesia, the superficial temporal artery was ligated and the pseudoaneurysm was removed. Superficial temporal artery pseudoaneurysm is a rare facial tumor that generally occurs after blunt trauma. Due to its rarity, pseudoaneurysms are often misdiagnosed as hematoma. The treatment of choice is excision, although endovascular intervention is a potential treatment option. However, when a pseudoaneurysm is small, conservative treatment can be used.

The nose is a complex three-dimensional structure and represents a major aesthetic focus of the face. As a gold standard for nasal soft tissue reconstruction, the ‘forehead flap’ provides reconstructive surgeons a robust pedicle and large amount of tissue to reconstruct almost any defect. However, during this process, some hair can be unintentionally introduced to the nose. Accordingly, laser hair removal is sometimes needed, but blood circulation and flap survival should be carefully monitored.Despite careful evaluation, a third-degree burn occurred in our patient that required eight weeks to heal. Here, we report on a burn resulting from epilation conducted 2 weeks after forehead flap for nasal reconstruction.

The nose is a complex three-dimensional structure and represents a major aesthetic focus of the face. As a gold standard for nasal soft tissue reconstruction, the ‘forehead flap’ provides reconstructive surgeons a robust pedicle and large amount of tissue to reconstruct almost any defect. However, during this process, some hair can be unintentionally introduced to the nose. Accordingly, laser hair removal is sometimes needed, but blood circulation and flap survival should be carefully monitored.Despite careful evaluation, a third-degree burn occurred in our patient that required eight weeks to heal. Here, we report on a burn resulting from epilation conducted 2 weeks after forehead flap for nasal reconstruction.

Hidradenitis suppurativa (HS) is a chronic inflammatory condition with an unclear etiopathogenesis that is considered to be a follicular occlusive disease. We present a case of HS that was suspected to have developed as a complication of subdermal excision. A 19-year-old man who had undergone subdermal excision due to osmidrosis presented 7 months after surgery with a persistent painful mass in his left axilla. Despite medical treatment, incision, and drainage, a painful enlarged abscess recurred in the left axilla and was cured completely by deroofing surgery. However, 15 months after subdermal excision, he revisited the hospital because of a painful mass in the right axilla. The patient’s condition met the diagnostic criteria of HS. After several recurrences, a cure was achieved by radical wide excision. Mechanical stress like that associated with subdermal excision is considered to be a possible etiological factor of HS. In addition, pathological changes at the sebofollicular junction allow rupture and leakage of folliculopilosebaceous units upon exposure to mechanical stress, which may result in the aggressive subcutaneous extension of inflammation. We suggest that HS should be considered in patients with a recurrent abscess after subdermal excision, and recommend surgical treatment as a possible option if conservative treatment is clinically ineffective.

It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.
Aged ; Ankle ; Buttocks ; Caregivers ; Debridement ; Diagnosis ; Diagnostic Errors ; Dissent and Disputes ; Elbow ; Hemodynamics ; Humans ; Intensive Care Units ; Jurisprudence ; Male ; Necrosis ; Negative-Pressure Wound Therapy ; Plastics ; Pneumonia, Bacterial ; Pressure Ulcer ; Sepsis ; Skin Ulcer ; Skin ; Wounds and Injuries

Conventional sub-orbicularis oculi fat (SOOF) lifting during lower blepharoplasty is performed by anchoring the SOOF to the periosteum of the infraorbital rim. This procedure helps to improve the concavity at the central portion of the lower eyelid and the lid-cheek junction. However, over time, the periosteum becomes progressively weaker, diminishing the anchoring effect. This paper introduces a new lower blepharoplasty technique in which the SOOF is fixed to a bony hole to strengthen the holding force and provide sustainability.
Adipose Tissue ; Aged ; Aging ; Blepharoplasty ; Eyelids ; Humans ; Lifting ; Periosteum ; Rejuvenation