Plastic and reconstructive surgery最新文献

{"title":"Comparative Efficacy of Masseteric-to-Facial Nerve Transfer with and without Fascia Lata Grafts in Reanimating Facial Paralysis.","authors":"Yu-Lu Zhou, Gang Chen, Wen-Jin Wang, Hao Ma, Hui-Cai Wen, Wei Wang","doi":"10.1097/PRS.0000000000011871","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011871","url":null,"abstract":"<p><strong>Background: </strong>Masseteric-to-facial nerve transfer excels in dynamic reanimation but is lacking in restoring baseline resting tone. Combining it with fascia lata grafts is expected to more fully enhance facial symmetry. Comprehensive comparison of the results of masseteric-to-facial nerve transfer versus combined static suspension may provide valuable insights into the most appropriate treatment for patients with subacute facial paralysis.</p><p><strong>Methods: </strong>In this retrospective study, 104 patients with facial paralysis were categorized by surgical procedure: 39 received masseteric-to-facial nerve transfer (group A), and 65 underwent transfer combined with a fascia lata graft (group B). The groups were further divided by oral commissure drooping, with severity graded as slight (A1, B1) or severe (A2, B2) asymmetry.</p><p><strong>Results: </strong>Patients in group B2 exhibited significantly better static symmetry than those in group A2, with improvements of 87.87% versus 40%, respectively (P < 0.001). No significant difference was observed between groups A1 and B1 in slight asymmetry. The Terzis Smile Function Grading System showed no dynamic symmetry differences (P > 0.05). On objective evaluation, postoperative outcomes indicated better static symmetry in both B groups, and improved dynamic symmetry in group A1, with no statistical difference between groups A2 and B2.</p><p><strong>Conclusions: </strong>Masseteric-to-facial nerve transfer combined with fascia lata grafts significantly enhanced both static and dynamic symmetry for patients with varying degrees of asymmetry, particularly benefitting those with severe asymmetry. Patients with slight asymmetry who underwent the combined procedure achieved satisfactory static symmetry, although with a minor compromise of approximately 1 mm in dynamic symmetry compared with those who underwent masseteric-to-facial nerve transfer alone.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1011-1022"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161239","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}

{"title":"Discussion: Levator Advancement Surgery with or without Lateral Horn Incision: Effect of Lateral Horn Incision for Severe Involutional Blepharoptosis.","authors":"Arthur Y Yu","doi":"10.1097/PRS.0000000000011883","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011883","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"943-946"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161317","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}

{"title":"The Art of Tactful Response.","authors":"Gordon C Wong, Kevin C Chung","doi":"10.1097/PRS.0000000000011985","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011985","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"907-913"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161345","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}

{"title":"Discussion: Mastectomy for Individuals with Gender Dysphoria Younger Than 26 Years: A Systematic Review and Meta-Analysis.","authors":"Lacey Foster, Morvarid Mehdizadeh, Samuel J Lin","doi":"10.1097/PRS.0000000000011787","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011787","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"928-929"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161324","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}

{"title":"Discussion: Spontaneous Recovery of Active Shoulder External Rotation in Patients with Brachial Plexus Birth Injury.","authors":"Nicholas Pulos, Robert J Spinner, Alexander Y Shin","doi":"10.1097/PRS.0000000000011987","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011987","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1054e-1055e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161337","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}

{"title":"Limb Salvage for Chronic Lower Extremity Wounds.","authors":"Rajiv P Parikh, Justin M Sacks","doi":"10.1097/PRS.0000000000012006","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012006","url":null,"abstract":"<p><strong>Learning objectives: </strong>After studying this article, the participant should be able to: 1. Describe perioperative management and a multidisciplinary approach to limb salvage and functional limb restoration. 2. Summarize preoperative strategies to optimize patients for limb salvage procedures. 3. Discuss the indications for limb salvage versus amputation. 4. Develop an operative plan for limb salvage that is patient and defect centered and emphasizes the goal of functional limb restoration. 5. Understand adjunct biomechanical procedures and technical considerations to optimize functional outcomes following limb salvage.</p><p><strong>Summary: </strong>This article highlights principles and evolving concepts in limb salvage for chronic lower extremity wounds. Limb salvage is an increasingly important topic, as chronic lower extremity wounds associated with diabetes and/or peripheral vascular disease increase morbidity and long-term mortality rates, decrease quality of life, and contribute to substantial health care costs. The goal of a contemporary reconstructive approach to limb salvage is functional limb restoration. This concept involves optimizing function and minimizing residual disability. In this article, the authors review key concepts in the multidisciplinary approach to patients with limb-threatening lower extremity wounds and introduce the concept of end-stage limb disease. The indications to guide surgical decision-making for limb salvage versus functional amputation are discussed. A patient- and defect-centered reconstructive approach is delineated, with representative case examples provided. Recent developments, such as supermicrosurgical techniques, are also highlighted. Finally, the authors detail important considerations to facilitate success in this complex and challenging patient population, including microvascular technique, adjunct biomechanical operations, flap selection, and recipient vessel selection.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1056e-1070e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161339","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}

{"title":"PRS Journal Club: Evolving Landscape of Autologous Breast Augmentation and Reconstruction.","authors":"Christopher L Kalmar, Amanda R Sergesketter, Ilana G Margulies","doi":"10.1097/PRS.0000000000012062","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012062","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1055-1056"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161341","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}

{"title":"Long-Term Volume Retention of Breast Augmentation with Fat Grafting Depends on Weight Changes: A 3-Year Prospective Magnetic Resonance Imaging Study.","authors":"Mathias Ørholt, Tim K Weltz, Mathilde N Hemmingsen, Andreas Larsen, Erik E F Bak, Caroline B Norlin, Liv Hart, Jens Jørgen Elberg, Peter V Vester-Glowinski, Mikkel Herly","doi":"10.1097/PRS.0000000000011841","DOIUrl":"10.1097/PRS.0000000000011841","url":null,"abstract":"<p><strong>Background: </strong>Fat grafting is increasingly used for breast augmentation. However, long-term volume retention, time to reach steady state, and the effect of postoperative weight changes on these outcomes are not fully understood.</p><p><strong>Methods: </strong>In this prospective study, we included patients undergoing breast augmentation with fat grafting and examined them with magnetic resonance imaging preoperatively and up to 3 years postoperatively. We modeled fat graft retention over time and calculated the time to volumetric steady state of the fat graft. In addition, we used their model to assess the effect of postoperative weight changes on fat graft retention and to determine the association between the graft-to-recipient volume ratio and the percentage breast augmentation at steady state. Finally, we assessed patient satisfaction using the BREAST-Q questionnaire.</p><p><strong>Results: </strong>The study included 28 patients (46 breasts). The time to steady state was 253 days (95% CI, 185 to 283 days) postoperatively, with a volume retention of 46% (95% CI, 35% to 58%). Patients with a weight loss of 1 body mass index point after surgery had a volume retention of 22% (95% CI, 4.7% to 38%), whereas those increasing 1 and 2 body mass index points had retention rates of 57% (95% CI, 45% to 69%) and 85% (95% CI, 72% to 98%), respectively. Increasing graft-to-recipient volume ratio was associated with higher percentage augmentation with no plateau in this relationship even up to ratios of 2:1. Postoperative Satisfaction with Breasts and Sexual Well-Being increased substantially.</p><p><strong>Conclusions: </strong>Breast augmentation with fat grafting reached volumetric steady state after 8 months with a volume retention of 46%. Weight loss following fat grafting leads to significantly lower volume retention.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"947-954"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505908","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}

{"title":"Superior Retention of Aged Fat Graft by Supplementing Young Adipose-Derived Stromal Cells in a Murine Model.","authors":"Vinh Vuong The Tran, Xian Jin, Xin Ye Zhou, Ki Yong Hong, Hak Chang","doi":"10.1097/PRS.0000000000011810","DOIUrl":"10.1097/PRS.0000000000011810","url":null,"abstract":"<p><strong>Background: </strong>In 2021, a meta-analysis showed that fat graft retention varied from 26% to 83%. In a retrospective study including patients with Parry-Romberg syndrome, the younger age group had higher satisfaction scores (3.8 versus 3.0) after fat grafting. Cell-assisted lipotransfer could be an alternative to overcome the instability of volume loss; however, no study has investigated its effect on older recipients.</p><p><strong>Methods: </strong>In an in vitro study, adipose-derived stromal cells (ASCs) from aged and young (52 and 8 weeks old) DsRed B6 mice were characterized by proliferation rates as percentages of Ki-67-positive cells. In addition, 68-week-old wild-type B6 mice received 150 µL of green fluorescent protein fat (from 69-week-old B6 mice) mixed with saline or 3 × 10 5 aged or young DsRed ASCs (N, A, and Y groups, respectively) on the scalp ( n = 6/group). After 8 weeks, graft volumes were evaluated using microcomputed tomography. Vessel densities were tracked by percentages of CD31 using immunofluorescence staining.</p><p><strong>Results: </strong>Young ASCs showed higher proliferation than aged ASCs (47.1% and 26.2%, respectively; P < 0.05). The Y group showed the highest graft retention (median: N, 41.0%; A, 52.2%; Y, 65.2%; P < 0.05) and percentage of blood vessels (median: N, 27.7%; A, 43.5%; Y, 54.7%; P < 0.05) among the 3 groups.</p><p><strong>Conclusions: </strong>Cell-assisted lipotransfer is effective with older recipients. Higher effect was observed by supplementation with younger ASCs because of higher angiogenesis stimulation. Further validation of safety, toxicity, and allogenic grafting is required.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"959-968"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505911","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}

{"title":"Skin Graftless Dorsal Metacarpal Island VY Advancement Flap versus Dorsal Rectangular Flap with Skin Grafting in 213 Simple Syndactyly Releases.","authors":"Shaun D Mendenhall, Emily M Graham, Zoe E Belardo, Eliza Buttrick, Elizabeth B Card, Apurva S Shah, Benjamin Chang","doi":"10.1097/PRS.0000000000011925","DOIUrl":"10.1097/PRS.0000000000011925","url":null,"abstract":"<p><strong>Background: </strong>Simple syndactyly is a common congenital upper extremity difference. Traditional reconstructive approaches use skin grafts; however, recent studies suggest that skin graftless techniques may improve outcomes. The authors hypothesized that patients who underwent reconstruction with a skin graftless dorsal metacarpal island VY advancement flap would have fewer postoperative complications compared with those released with a dorsal rectangular flap with skin grafts.</p><p><strong>Methods: </strong>Patients aged 0 to 17 years presenting for primary reconstruction of simple syndactyly were analyzed retrospectively at a large pediatric hospital. Medical records were identified using International Classification of Diseases, Ninth Revision and Tenth Revision codes, CPT codes, and case logs from 6 hand surgeons. Outcomes of interest included early postoperative complications (within 30 days) such as infection, hematoma, seroma, wound healing issues, unplanned returns to the operating room, and digit loss. Late complications (>30 days) included web creep and development of pathologic scar formation.</p><p><strong>Results: </strong>In total, 213 syndactyly repairs from 153 patients were analyzed (rectangular, 94 webspaces and 58 patients; VY, 119 webspaces and 95 patients). The rectangular group had significantly more early complications ( P = 0.04). The rectangular group had significantly higher incidences of web creep and hypertrophic scarring (19.3% versus 1.8%, P < 0.001; 19.1% versus 5.9%, P = 0.003, respectively). The rectangular flap with skin grafts was the only variable predictive of web creep and hypertrophic scar formation on regression analysis ( P < 0.001 and P = 0.004, respectively). Subgroup analyses of syndromic and nonsyndromic cases and incomplete and complete cases mirrored overall cohort results.</p><p><strong>Conclusion: </strong>Simple syndactyly releases with the skin graftless technique produces fewer complications compared with the traditional approach with skin grafts.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"969-981"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838762","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}