Buccal Fat Pad Excision for Facial Rejuvenation: The Relationship Between the Resected Position and Its Influence on Facial Shape and Volume.

Background: To date, facelift surgery has been the most common choice for those seeking antiaging solutions. However, buccal fat pad (BFP) excision has also been utilized recently. Objectives: An interrelation between the BFP, resection area, and its influence on facial shape and volume is scrutinized to achieve "tailor-made" outcomes in patients with BFP-related symptoms. Methods: Patients were categorized into 2 groups: Type I with a bottom-heavy face and Type II with ptotic lower cheeks, typically seen in older people. The lower face was divided into upper and lower segments bilaterally. Then, the relationship between the resected position of the BFP and its influence on facial shape and volume was studied. Results: BFP excision was performed for 133 patients (118 females and15 males) between May 2020 and June 2022. Sixty-one of these patients were categorized into Type I (39 patients) and Type II (22 patients) and were followed up for 12 months postoperatively. The volume of all lower facial segments decreased postoperatively in both types of patients. The variation rate of the upper segment volume in Type II patients was less than that in Type I patients. The results were consistent with a technique that did not remove large chunks of the BFP from the upper segment in Type II patients. Conclusions: BFP excision is an effective facial rejuvenation treatment if proper candidates are selected. To improve the accuracy of BFP excision, the relationship between the resected position of the BFP and its influence on facial shape and volume should be well understood.

Aesthetic Values of the Buccal Fat Pad Excision in Middle-Aged Patients.

Background: Despite buccal fat pad (BFP) excision being an effective and established surgery for the reduction of lower facial volume, there are very few reports explaining a systematic and reliable method for this surgery. The author will demonstrate one method for BFP excision surgery with some important tips and information on the procedure. Objectives: The author performed BFP excision surgery for patients seeking facial slimming or improvement of the ptotic lower face. To know the true efficacy of this surgery, objective facial scales were compared preoperatively and postoperatively. Methods: Preoperative and postoperative three-dimensional (3D) pictures were taken, and numerical data for cheek volume and horizontal lower facial length were obtained from 3D picture analysis. The data were statistically analyzed to reveal postoperative improvements. Results: The average age of the patients was 54.23 ± 10.31 years old. BFP excision surgery took 60.30 ± 5.93 minutes. Preoperative and 12 months postoperative body weight was 52.3 ± 6.84 and 52.3 ± 6.75 kg, respectively. The average weights for excised BFP were 1.74 ± 0.72 g right and 1.59 ± 0.71 g left. The average of preoperative lower facial volumes was 209.36 ± 30.22 mL right and 209.03 ± 30.13 mL left. The average 12 months postoperative lower facial volumes were 205.00 ± 30.37 mL right and 204.43 ± 30.02 mL left. The results showed a significant difference in both sides (P < 0.01). The average of horizontal lower facial lengths was 238.73 ± 10.87 mm preoperatively and 235.06 ± 10.57 mm 12 months postoperatively. The results affirm that there is a significant difference (P < 0.01). Conclusions: A properly executed BFP excision can achieve distinct facial slimming for the capacious face and can also contribute to improving lower face sagging due to BFP ptosis in middle-aged patients.

Large-Gap Magnetic Topological Heterostructure Formed by Subsurface Incorporation of a Ferromagnetic Layer.

Inducing magnetism into topological insulators is intriguing for utilizing exotic phenomena such as the quantum anomalous Hall effect (QAHE) for technological applications. While most studies have focused on doping magnetic impurities to open a gap at the surface-state Dirac point, many undesirable effects have been reported to appear in some cases that makes it difficult to determine whether the gap opening is due to the time-reversal symmetry breaking or not. Furthermore, the realization of the QAHE has been limited to low temperatures. Here we have succeeded in generating a massive Dirac cone in a MnBi2Se4/Bi2Se3 heterostructure, which was fabricated by self-assembling a MnBi2Se4 layer on top of the Bi2Se3 surface as a result of the codeposition of Mn and Se. Our experimental results, supported by relativistic ab initio calculations, demonstrate that the fabricated MnBi2Se4/Bi2Se3 heterostructure shows ferromagnetism up to room temperature and a clear Dirac cone gap opening of ∼100 meV without any other significant changes in the rest of the band structure. It can be considered as a result of the direct interaction of the surface Dirac cone and the magnetic layer rather than a magnetic proximity effect. This spontaneously formed self-assembled heterostructure with a massive Dirac spectrum, characterized by a nontrivial Chern number C = -1, has a potential to realize the QAHE at significantly higher temperatures than reported up to now and can serve as a platform for developing future "topotronics" devices.

Mucoepidermoid carcinoma of the liver: report of a rare case and review of the literature.

Although a mucoepidermoid carcinoma is sometimes seen as a neoplasm originating from the salivary glands, its origination from the liver is rare. A review of the medical literature in the English language disclosed only 16 cases originating from the hepatic system. The case explored here is that of an 81-year-old female, without any significant medical history, who was referred to our hospital for elevated liver function tests. Computed tomography (CT) showed a huge tumor, 10 cm in diameter, in the right lobe of the liver. The central part of the tumor was consistently un-enhanced, suggesting a large necrotic area. The liver tumor was diagnosed as mucoepidermoid carcinoma by a percutaneous biopsy. Despite chemotherapy with radiation therapy, the tumor showed very aggressive malignancy, resulting in early mortality. We herein report on a rare case of primary mucoepidermoid carcinoma of the liver with pulmonary and lymph node metastasis, confirmed by autopsy, and review the literature.

Cytological analysis of glycogen-rich carcinoma of the breast: report of two cases.

BACKGROUND: Glycogen-rich carcinoma is a rare special histologic subtype of breast cancer and its incidence is estimated to be 1.4% in breast malignancies. However, its precise characteristics in cytological specimens have not yet been fully clarified. CASE: Fifty-nine-year-old and 53-year-old women underwent fine-needle aspiration biopsy cytology (FNABC) of a breast tumor, confirming malignancy. A mastectomy with axillary dissection was performed. Cytologically, a moderate amount of eosinophilic, finely granular cytoplasm was seen in the majority of the tumor cells, however, foamy and vacuolated cytoplasm was noted in some tumor cells. Histologically, the tumor cells of both cases had clear and granular cytoplasm, which showed a positive reaction with periodic acid-Schiff, eliminated by diastase. CONCLUSION: While clear cytoplasm in the tumor cells in the FNABC seemed to be a pivotal cytological characteristic of glycogen-rich carcinoma, it may not be a major component of cytological specimens. Routine periodic acid-Schiff staining may be required to diagnose glycogen-rich carcinoma in cytological methods.