Plastic and reconstructive surgery最新文献_第10页

Volume-based Trends in Medicare Reimbursement for Plastic and Reconstructive Surgery Procedures from 2013 to 2022. 2013 - 2022年整形和重建手术医疗保险报销的基于数量的趋势

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-06 DOI: 10.1097/PRS.0000000000013103

Jason Zhang, Christian Arcelona, Kayla Haydon, Sahita Manda, Anitesh Bajaj, Taylor Hallman, Hannah Soltani, Arun K Gosain

{"title":"Volume-based Trends in Medicare Reimbursement for Plastic and Reconstructive Surgery Procedures from 2013 to 2022.","authors":"Jason Zhang, Christian Arcelona, Kayla Haydon, Sahita Manda, Anitesh Bajaj, Taylor Hallman, Hannah Soltani, Arun K Gosain","doi":"10.1097/PRS.0000000000013103","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013103","url":null,"abstract":"Introduction: Medicare reimbursement rates for plastic surgery have been consistently falling. Our study is the first to analyze reimbursement by case volume of all procedure codes billed to Medicare by plastic and reconstructive surgeons from 2013 to 2022.Methods: All procedure codes billed to Medicare Part B by plastic and reconstructive surgeons were extracted from the CMS Physician and Other Practitioners database. Reimbursements were determined through the Medicare Physician Fee Schedule. Dollar amounts were inflation-adjusted to 2022.Results: 254 procedure codes were included for analysis. From 2013 to 2022, the mean Medicare reimbursement rate for plastic surgery procedures decreased by 22.2% from $337.01 in 2013 to $262.07 in 2022. This results in an average decrease of $7.16 annually (p<0.001). The largest average decreases in reimbursement were observed in musculoskeletal procedures (37.3%, $240.17 to $150.56) and flaps and grafts (31.7%, $617.14 to $421.50). The smallest average decreases in reimbursement were for nervous system (9.6%, $419.99 to $379.65) and hand and upper extremity procedures (14.3%, $610.64 to $523.61). Reimbursement for head and neck procedures decreased by 24.1% from $793.37 to $601.89. Reimbursement for breast procedures decreased by 19.5% from $1216.81 to $979.64. None of the procedure types in our study had an average increase in reimbursement. There was no correlation between changes in volume and reimbursement (R=0.01; p=0.848).Conclusions: Medicare reimbursement for plastic surgery is consistently decreasing regardless of case volume. The continued decline in reimbursement for plastic surgeons can have negative implications for practice management and access to care.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Serratus Anterior Plane Block with Methylene Blue and Ropivacaine for analgesia in Prosthetic Breast Augmentation: A Randomized Controlled Trial. 亚甲基蓝和罗哌卡因在假体隆胸镇痛中的锯肌前部阻滞：一项随机对照试验。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-06 DOI: 10.1097/PRS.0000000000013102

Fu-Shan Xue, Dan-Feng Wang, Xiao-Chun Zheng

引用次数: 0

"Cost-Effectiveness and Budget Impact of Facial Feminization Surgery". “面部女性化手术的成本效益和预算影响”。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-06 DOI: 10.1097/PRS.0000000000013106

Samira Glaeser-Khan, Yizhuo Shen, Thao Wolbert, Thayer Mukherjee, George Goshua, Satoko Ito, Michael Alperovich

{"title":"\"Cost-Effectiveness and Budget Impact of Facial Feminization Surgery\".","authors":"Samira Glaeser-Khan, Yizhuo Shen, Thao Wolbert, Thayer Mukherjee, George Goshua, Satoko Ito, Michael Alperovich","doi":"10.1097/PRS.0000000000013106","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013106","url":null,"abstract":"Background: Facial feminization surgery (FFS) is an important aspect of gender affirming care and improves quality of life. However, FFS is sparsely covered by insurance and is the most commonly denied gender affirming procedure. We conducted, to our knowledge, the first cost-effectiveness and budget impact analysis of undergoing FFS.Methods: We designed a Markov cohort model of 30-year-old transgender women to evaluate the cost effectiveness of FFS compared to no FFS, with 5- and 10-year time-horizons from a U.S. health system perspective, across all accepted willingness-to-pay thresholds (WTPs) in the U.S. ($50,000-$150,000/quality-adjusted life-years [QALYs]). The primary outcomes were the incremental cost-effectiveness ratio in U.S. Dollars (USD) per QALY and the per-member-per-month (PMPM) cost of covering FFS. Transition probabilities and utilities were population-specific and were sourced from published data. Our budget impact model considers projected trends in demand for FFS.Results: Compared to not receiving the surgery, FFS accrued $23,200 more dollars and 0.5 more QALYs across five years, with an ICER of $44,300 [95% CI: $32,200- $63,800]. FFS remained cost effective across all scenarios and sensitivity analyses, notably even with a diminishing mental health benefit of FFS across 10 years. FFS was favored in 100% of 10,000 probabilistic iterations at a WTP of $100,000/QALY. The budget impact of FFS was $0.049 in 2025 and is projected to decrease over the next five years despite a projected increase in demand for FFS.Conclusions: Insurance coverage of FFS is cost-effective at a WTP of $100,000/QALY with a low budget impact.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breast Codes: Triple-Plane Autologous Fat Grafting in Mastopexies and Reduction Mammaplasties without Implants. 乳房代码：乳房切除术和乳房缩小成形术中的三平面自体脂肪移植术。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-01 Epub Date: 2025-08-13 DOI: 10.1097/PRS.0000000000012385

Ricardo T Nóra, Lydia M Ferreira

引用次数: 0

Prophylactic Muscle Flap Closure after Spinal Fusion Improves Outcomes and Reduces Health Care Costs. “脊柱融合术后预防性肌瓣关闭可改善预后并降低医疗费用”。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-01 Epub Date: 2025-09-16 DOI: 10.1097/PRS.0000000000012448

Grant G Black, Makayla Kochheiser, Nancy Qin, Matthew A Wright, Michael S Virk, Anjile An, Ali Jalali, David M Otterburn

{"title":"Prophylactic Muscle Flap Closure after Spinal Fusion Improves Outcomes and Reduces Health Care Costs.","authors":"Grant G Black, Makayla Kochheiser, Nancy Qin, Matthew A Wright, Michael S Virk, Anjile An, Ali Jalali, David M Otterburn","doi":"10.1097/PRS.0000000000012448","DOIUrl":"10.1097/PRS.0000000000012448","url":null,"abstract":"Background: Spinal degeneration and deformities affect more than 27% of US adults, and $14.1 billion is spent annually on spinal fusion to address these pathologies. Wound closure using local muscle flaps has been associated with reduced complication rates, including infection and reoperation. The high prevalence of degenerative deformities and health care expenditures highlight the need for resource utilization studies to inform decision-makers on best operative practices.Methods: A retrospective review was performed on adult patients who underwent posterior spinal fusion for degenerative or deformity indications at the authors' institution between 2019 and 2022. Patients were stratified by the prophylactic use of muscle flap closure, and outcomes were compared between groups. Costs were applied to consumed resources, and univariate and multivariable regression analyses were performed to measure the impact of muscle flaps on overall costs.Results: Of 520 included patients, 240 received muscle flap closures. These patients had significantly fewer readmissions (odds ratio [OR], 0.49 [95% CI, 0.29, 0.84]), reoperations (OR, 0.49 [95% CI, 0.26, 0.89]), and hardware failures (OR, 0.09 [95% CI, 0.00, 0.45]), but greater odds of seroma (OR, 5.22 [95% CI, 2.12, 15.7]). They also had shorter hospital stays (5.4 versus 6.5 days [ P = 0.033]), but operative time did not vary by closure type. Multivariable regression revealed that muscle flap closure was associated with a $7152 reduction in overall costs per patient ( P < 0.03).Conclusions: Muscle flap closure correlates with reduced complication rates and decreased overall costs per patient. These findings support the use of prophylactic muscle flap closure from safety and health economics perspectives.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"581e-590e"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of Vascularized Lymph Node Transfer in Reducing the Rate of Cellulitis in Breast Cancer-Related Lymphedema. 血管化淋巴结转移对降低乳腺癌相关淋巴水肿患者蜂窝织炎发生率的影响

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-01 Epub Date: 2025-08-26 DOI: 10.1097/PRS.0000000000012412

Alejandro Perez, Mark V Schaverien, Monica George-Palop, Edward I Chang, Carlos H Barcenas, George M Viola

{"title":"The Impact of Vascularized Lymph Node Transfer in Reducing the Rate of Cellulitis in Breast Cancer-Related Lymphedema.","authors":"Alejandro Perez, Mark V Schaverien, Monica George-Palop, Edward I Chang, Carlos H Barcenas, George M Viola","doi":"10.1097/PRS.0000000000012412","DOIUrl":"10.1097/PRS.0000000000012412","url":null,"abstract":"Background: Poorly managed breast cancer-related lymphedema may lead to recurrent cellulitis. Advances in the management of lymphedema have evolved beyond conservative decongestive therapy to include vascularized lymph node transfer (VLNT). In this article, the authors analyze the impact of VLNT in the reduction of upper extremity cellulitis in breast cancer survivors.Methods: The authors reviewed all patients at their institution who had breast cancer, underwent mastectomy, experienced upper extremity lymphedema, and proceeded with VLNT from 2017 to 2021. Patients were included if they had 1 or more episodes of cellulitis within the year before VLNT and were followed up for at least 12 months.Results: The authors included 66 patients who fulfilled their strict inclusion criteria, with a median age of 57 years (interquartile range, 23 to 76 years). All patients were female, and most were White (88%), with a mean ± SD body mass index of 29.4 ± 6.7 kg/m 2 . Many presented with invasive ductal carcinoma (82%), had axillary lymph node dissection (98%), and received chemotherapy (94%) and radiation therapy (86%). VLNT was performed at a median of 92 months after mastectomy (interquartile range, 32 to 156 months). Overall, 58 (88%) patients remained infection-free with an infection rate decrease from an average of 2.27 before the index VLNT to 0.17 ( P < 0.0001) after VLNT.Conclusions: VLNT is associated with significantly decreased cellulitis rates. It should be considered as part of the treatment for infectious diseases of recurrent upper extremity cellulitis caused by breast cancer-related lymphedema with no adequate clinical improvement from conservative management alone.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"463e-470e"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Temporal Modified Orbicularis Repositioning: Going beyond the Limits of Temporal Lifting. 颞部移位（改良轮匝肌复位）：超越颞部提升。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-01 Epub Date: 2025-08-19 DOI: 10.1097/PRS.0000000000012391

Stefano Cotrufo

引用次数: 0

Impact of Palatoplasty on Middle-Ear Effusion in Children with Cleft Lip and Palate. 腭裂患儿腭裂成形术前后中耳积液相关因素的回顾性研究。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-01 Epub Date: 2025-08-26 DOI: 10.1097/PRS.0000000000012413

Edward Hung-Lun Chu, Te-Wei Cheng, Philip Kuo-Ting Chen, Yen-Chun Chen, Hann-Ziong Yueh, Shih-Chun Lu, Hua-Kai Chi, Chen-Yeh Yu, Che-Hsuan Lin

{"title":"Impact of Palatoplasty on Middle-Ear Effusion in Children with Cleft Lip and Palate.","authors":"Edward Hung-Lun Chu, Te-Wei Cheng, Philip Kuo-Ting Chen, Yen-Chun Chen, Hann-Ziong Yueh, Shih-Chun Lu, Hua-Kai Chi, Chen-Yeh Yu, Che-Hsuan Lin","doi":"10.1097/PRS.0000000000012413","DOIUrl":"10.1097/PRS.0000000000012413","url":null,"abstract":"Background: Previous studies have primarily evaluated postoperative middle-ear outcomes following palatoplasty and ventilation tube insertion (VTI), with a focus on patient age and cleft severity. However, few have investigated the influence of cleft sidedness and variations in Furlow-based palatoplasty techniques. This study aimed to assess the presence of otitis media with effusion (OME) before and after palatoplasty, with or without VTI, and to identify factors associated with OME, including baseline patient characteristics, cleft sidedness, and surgical approach.Methods: The authors retrospectively analyzed 86 children with cleft palate or cleft lip and palate who underwent palatoplasty at their hospital from October of 2017 to December of 2021, with at least 2 years of follow-up evaluating middle-ear outcomes.Results: Age at palatoplasty date, sex, congenital anomalies, and cleft severity were not significantly associated with preoperative OME. Complete clefts showed a higher OME incidence than incomplete cleft palate in univariable analysis, but not in multivariable analysis. The use rate of Furlow palatoplasty combined with hard palate repair increased with increasing cleft severity. Neither the choice of palatoplasty technique nor cleft sidedness was significantly associated with the presence of OME before palatoplasty or with the development of OME after palatoplasty. Postoperative OME rates were similar between children with OME undergoing VTI and those without OME treated by palatoplasty alone.Conclusions: Cleft sidedness and surgical technique did not influence OME before or after palatoplasty. Ventilation tube insertion is beneficial for patients with OME but may be unnecessary in those without prior effusion.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"709-718"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Demystifying Deep Layer Face-Lift Techniques: A Systematic Review of Superficial Musculoaponeurotic System Techniques. “揭开深层拉皮技术的神秘面纱：内侧基SMAS技术的系统回顾”。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-01 Epub Date: 2025-10-16 DOI: 10.1097/PRS.0000000000012526

Kelly P Schultz, Rami Sherif, Nishant Ganesh Kumar, James M Stuzin, Rod J Rohrich

{"title":"Demystifying Deep Layer Face-Lift Techniques: A Systematic Review of Superficial Musculoaponeurotic System Techniques.","authors":"Kelly P Schultz, Rami Sherif, Nishant Ganesh Kumar, James M Stuzin, Rod J Rohrich","doi":"10.1097/PRS.0000000000012526","DOIUrl":"10.1097/PRS.0000000000012526","url":null,"abstract":"Background: Facial aging is a multifactorial process that results from deflation and descent of facial soft tissue. Modern deep layer face-lift techniques aim to restore a youthful facial shape by using the superficial musculoaponeurotic system (SMAS) to reposition descended facial fat into areas of deflation within the lateral cheek and malar eminence. Although there are many advocates of various SMAS techniques and numerous descriptions of methods to manipulate and fixate repositioned facial fat, there is no consensus in the literature as to a \"best\" SMAS technique. The authors' investigation aimed to determine whether there should be a consensus on the preferred method of SMAS manipulation in terms of improving contour in the aging face.Methods: A systematic review was performed to investigate the current body of literature on SMAS face-lift techniques. Careful review of operative technique was performed, and techniques were classified as medially or laterally based, depending on the extent of sub-SMAS dissection. Analysis of aesthetic outcomes and complications was performed to determine the superiority of one technique over another in achieving a youthful facial contour.Results: A total of 17 articles were selected for review that clearly described operative technique and reported aesthetic outcomes. Patient satisfaction and improvement in overall facial contour was noted across studies.Conclusions: Various SMAS techniques can provide excellent aesthetic outcomes; however, medially based \"deep plane\" techniques, which carry dissection medial to the stout retaining ligaments, have not been shown to provide significant improvement in the appearance of the midface or improved longevity of results.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"615-620"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discussion: Perioperative Vitamin D Insufficiency Impacts Postoperative Outcomes in Abdominally Based Breast Reconstruction. 讨论：围手术期维生素D不足影响腹部乳房再造术的术后结果。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-04-01 Epub Date: 2026-03-25 DOI: 10.1097/PRS.0000000000012661

Min-Jeong Cho

引用次数: 0