Gregory Nicolas

Background: Facial paralysis results in multifaceted functional and aesthetic deficits, including lagophthalmos, oral incompetence, and profound asymmetry. Although surgical reanimation is the primary treatment for functional restoration, hyaluronic acid (HA) fillers have emerged as a minimally invasive adjunctive tool for soft-tissue support and aesthetic refinement. Methods: A comprehensive narrative review was conducted using PubMed, Embase, Scopus, and the Cochrane Library databases through November 15, 2025. This study follows the rigorous methodological framework for narrative synthesis, emphasizing clarity of scope, reflexivity, and thematic sufficiency. Studies evaluating HA fillers for lagophthalmos, oral competence, and facial symmetry were analyzed. Results: Data from prospective and retrospective studies indicate that HA fillers can notably improve lagophthalmos by providing mechanical lid loading, reducing residual gaps from an average of 5.5 to 0.8 mm. In the perioral region, HA injections have been shown to increase labial strength by 1.4-fold, reducing bolus spillage and improving speech articulation. Patient-reported outcomes show substantial improvements in psychosocial distress ( P < 0.0001) and quality of life. However, evidence for neuromuscular recovery is absent, and there is a documented risk of vascular complications, including central retinal artery occlusion. Conclusions: HA fillers provide immediate mechanical and aesthetic benefits as an adjunctive treatment for facial paralysis and should be considered complementary to surgical interventions where indicated; however, they do not restore nerve function and cannot replace surgery. Future research must focus on standardized protocols and the long-term safety of periorbital injections.

Background: Fat grafting is a common procedure in plastic and reconstructive surgery. It is associated with several disadvantages and complications, especially in patients undergoing recurrent procedures. Researchers are exploring the implications of cryopreserving adipose tissue and stem cells in plastic surgery. This article aimed to evaluate whether autologous fatty tissue and adipose-derived stem cells obtained through liposuction can be safely stored via cryopreservation for future surgical use. Methods: A comprehensive literature search was conducted across 3 databases, including PubMed, ScienceDirect, and Ovid MEDLINE, using specific keywords, yielding 75 articles. Studies that were not written in English or conducted in vitro were excluded. Only studies published in English within the last 5 years, and focusing on the use of cryopreservation of adipose tissue, were included. After review, a total of 22 articles met the inclusion criteria and were analyzed. Results: Cryopreserving adipose tissue and adipose-derived stem cells shows great potential in plastic surgery. Patient factors such as harvesting site, age, and obesity significantly impact the yield. The highest yield was obtained by harvesting from the abdomen and thigh. Additionally, cryopreservation requires cryoprotective agents, among which a combination of dimethyl sulfoxide and human serum albumin was most effective. Despite the advancement in cryoprotective agents, thawing adipose tissue results in cell death and impaired extracellular matrix integrity. However, cryopreserved stromal vascular fraction gel demonstrated fewer complications and better retention. Conclusions: The cryopreservation of adipose tissue and stromal vascular fraction gel demonstrates promising advancements for future applications in plastic surgery and regenerative medicine.

Background: The interaction between the surface of the implant and the human body results in a local and systemic inflammatory reaction that leads to the formation of a peri-implant capsule and entails complications. This study aimed to evaluate and compare the local and systemic inflammatory reactions of silicone implants coated with polyurethane foam and those with a nanotextured surface. Methods: Using indirect enzyme-linked immunosorbent assay, the levels of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) were measured in the serum and per-implant capsule of rats submitted to surgical placement of the 2 different types of implants. The statistical analysis was conducted within each group, comparing the parameters according to the times at which the rats were euthanized at 3 distinct durations of exposure (30, 60, and 90 d). Results: The results show that at both 30 and 60 days, there was no significant increase in the levels of markers in either group; however, a change becomes evident at 90 days. The nanotextured surface showed a decreased production of inflammatory markers at 30 and 60 days as compared with the polyurethane group. Nevertheless, at 90 days, there is a marked increase in these markers observed in the nanotextured group and a decrease in the polyurethane group, yet without any statistical significance between either group at that time. Conclusions: After a lapse of an extended period of time (90 d), nanotextured surface implants cause a local and systemic inflammatory reaction similar to those with a polyurethane foam surface.