Plastic and reconstructive surgery最新文献

{"title":"A Rating Scale for Obtaining Specific, Actionable Evaluations of Nasolabial Aesthetics after Unilateral Cleft Lip Repair.","authors":"Thomas J Sitzman, Thomas D Samson, Raymond W Tse, Damir B Matic, David M Fisher, Stephen P Beals, Alexander C Allori, Jeffrey R Marcus, Michael Bezuhly, Helena Hanna","doi":"10.1097/PRS.0000000000012474","DOIUrl":"10.1097/PRS.0000000000012474","url":null,"abstract":"<p><strong>Background: </strong>Surgeons pursuing improvement in the aesthetic outcomes of their cleft lip repairs may benefit from a granular scale evaluating individual objectives of the repair.</p><p><strong>Methods: </strong>A working group of 9 surgeons convened to develop an assessment scale for nasolabial aesthetics after unilateral cleft lip repair. The group identified objectives of the repair that could be evaluated using two-dimensional facial photographs. Scale items were developed to appraise success or failure in achieving each objective. Scale items were iteratively tested and refined. The scale was subsequently implemented as part of a Continuing Medical Education course that included self-evaluation and peer-to-peer education, culminating in the formation of individual plans for improvement.</p><p><strong>Results: </strong>Twelve distinct objectives of unilateral cleft lip repair were identified, of which 10 could be evaluated using photographs routinely obtained in clinical practice. A comprehensive scale was developed, incorporating these 10 objectives. Each scale item takes the form of a binary (yes/no) question evaluating a specific aesthetic concept, with accompanying reference images. Intrarater reliability for each item ranged from moderate to substantial (kappa value, 0.57 to 0.81). Interrater reliability ranged from fair to substantial (kappa value, 0.27 to 0.81). When implemented in a Continuing Medical Education course, the scale enabled surgeons to identify specific opportunities for improvement in their repair and specific surgical maneuvers to adopt in pursuit of these improvements.</p><p><strong>Conclusions: </strong>A new scale for evaluating outcomes of unilateral cleft lip repair is presented. The scale provides specific, actionable evaluations for individual objectives of the repair.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"891-898"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131597","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}

{"title":"Reply: Transcriptome of Capsular Contracture around Breast Implants Mimics Allograft Rejection: A Matched Case-Control Study.","authors":"Andreas Larsen, Tim K Weltz, John V Q Tran, Erik E F Bak, Mikkel Herly","doi":"10.1097/PRS.0000000000012767","DOIUrl":"10.1097/PRS.0000000000012767","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"157 5","pages":"803e-804e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778490","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":"Observational Study of Ultrasound-Assisted Liposuction for Lower Limb Lipedema on 191 Female Patients.","authors":"Barbara Hersant, Eloi de Clermont-Tonnerre, Giulia Argentino, Malika Bensid, Said Bensaid, Gioanni Roccaro, Oana Hermeziu, Andrea Murante, Simone La Padula, Jean Paul Meningaud","doi":"10.1097/PRS.0000000000012217","DOIUrl":"10.1097/PRS.0000000000012217","url":null,"abstract":"<p><strong>Background: </strong>Lipedema, a chronic condition affecting 11% of women, causes abnormal fat buildup in the lower limbs, leading to disproportionate body shape and functional problems. Often misdiagnosed, its cause is unclear, and conservative treatments are typically tried first. If these fail, surgical options such as lymphatic-sparing liposuction, including ultrasound-assisted liposuction (UAL), may be considered for lower limb lipedema after 6 months of conservative treatment.</p><p><strong>Methods: </strong>The authors' cohort included 191 patients with lower limb lipedema (stages 1 to 3) who underwent 2 stages of lymphatic-sparing UAL following 6 months of conservative treatment. Outcome measures included changes in pain assessment using visual analog scale scores, pannus thickness, aesthetic satisfaction, and the documentation of complications before and 12 months after the complete surgical treatment.</p><p><strong>Results: </strong>The authors' protocol resulted in significant reductions in circumferences across all assessed regions ( P < 0.001), with an average decrease of -6.396 cm (range, -9.268 to -3.523 cm). Pain levels and sensitivity to touch, bruising, and other discomforts significantly decreased after liposuction (all P < 0.0001). Complication rates were within expected ranges, with no instances of postoperative phlebitis. All patients reported high levels of posttreatment satisfaction.</p><p><strong>Conclusions: </strong>The integration of a comprehensive medical protocol for managing lipedema, combined with the use of next-generation lymphatic-sparing UAL in 2-stage procedures for the lower limbs, shows promising potential. These findings highlight the effectiveness and safety of liposuction in treating lipedema, providing valuable insights for clinical practice. Long-term follow-up studies are necessary to confirm sustained efficacy.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"751e-762e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120573","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}

{"title":"Tie2 Activation Enhances Vascularized Lymph Node Transfer in Lymphedema by Improving Lymphatic Endothelial Integrity.","authors":"Do Young Park, Bo-Yoon Park, Dong Hyun Seo, Tae Hyun Kong, Sang-Oh Lee, Kyoo-Ri Kwon, Du-Hyong Cho, Yong-Ha Kim, Choong-Kun Lee, Il-Kug Kim","doi":"10.1097/PRS.0000000000012473","DOIUrl":"10.1097/PRS.0000000000012473","url":null,"abstract":"<p><strong>Background: </strong>Lymphedema (LE) is characterized by inadequate interstitial fluid drainage because of disrupted lymphatic vasculature. Despite the pivotal role of angiopoietin (Ang)-Tie2 signaling in lymphatics, the therapeutic potential of Tie2 modulation in LE remains unknown.</p><p><strong>Methods: </strong>This study investigates the molecular and pathologic changes associated with LE and transcriptomic analyses. In addition, a mouse hindlimb LE model was established by obstructing superficial and deep lymphatic drainage, allowing the evaluation of structural, functional, and molecular alterations accompanying LE. The effects of systemically administered Ang2-binding and Tie2-activating antibody (ABTAA) on LE were assessed, both independently and in combination with vascularized lymph node transfer (VLNT).</p><p><strong>Results: </strong>Immunohistochemistry and transcriptomic analyses of tissues from LE patients revealed significant impairment of lymphatic endothelial cell (LEC) junctions and alterations in Ang-Tie2 signaling. A mouse hindlimb LE model demonstrated the hallmarks of LE, including fluid drainage impairment along with tissue edema, disintegrated LECs, and remodeling of lymphatic vessels. ABTAA significantly improved all the features of LE by activating lymphatic endothelial Tie2, leading to increased LEC junctional stability. Notably, ABTAA exerted an additive effect in relieving LE when combined with VLNT, which was supported by transcriptomic analysis results that indicated enhanced lymphatic vascular integrity, reduced inflammation, and increased vasculogenesis on treatment.</p><p><strong>Conclusions: </strong>Tie2 activation with ABTAA ameliorates LE in a mouse model, both independently and in combination with VLNT treatment. These findings suggest that Tie2 activation may present a novel and effective option, potentially improving the current treatment of LE.</p><p><strong>Clinical relevance statement: </strong>The results of the study highlight the potential of ABTAA treatment in enhancing lymphatic stability, offering plastic surgeons a novel therapeutic approach to improving outcomes in patients undergoing VLNT for LE.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"712e-722e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131575","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":"A Hybrid Surgical Technique for Bilateral Cleft Lip Reconstruction.","authors":"Savannah C Braud, Yuliia Kovach, Zachary D Zapatero, David W Low","doi":"10.1097/PRS.0000000000012424","DOIUrl":"10.1097/PRS.0000000000012424","url":null,"abstract":"<p><strong>Summary: </strong>Treatment of bilateral cleft lip is inherently complex because of discontinuity of the orbicularis oris muscle, significant nasal deformities, and the distinctive anatomical characteristics of the prolabium. Several operative techniques exist, including the well-known Millard and Manchester methods. The Manchester technique preserves the vermilion and white roll of the prolabium, joining them with the lateral lip components. In contrast, the Millard technique discards the dry vermilion and white roll of the central prolabium, connecting the 2 lateral lip components at the midline. Advantages and disadvantages exist for both. The Manchester technique often leads to a widened philtrum, while the Millard technique can pose challenges in wider clefts, resulting in a short lip and notching. Surgeons have therefore sought to modify these traditional techniques to improve patient outcomes. In response to the limitations of the traditional approaches, the authors introduce the Low technique-a hybrid technique designed to improve both aesthetic and functional outcomes. This technique aims to minimize the need for secondary corrective procedures by preserving tissue to prevent lip shortening and strategically placing incisions to address philtral widening. In this article, the authors describe the Low technique in detail and outline its advantages.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"729e-732e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023971","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":"Patient-Reported Outcome Measures following Postbariatric Body Contouring: A Systematic Review and Meta-Analysis.","authors":"Jonathan Mokhtar, Fatemeh Akbarpoor, Marwa Hadi, Guilherme F Machado, Karen Blanco, Lorenzo G Di Martino, Alexandre G Lellouch, Raffi Gurunian, Lucas Kreutz-Rodrigues, Sarah N Bishop","doi":"10.1097/PRS.0000000000012544","DOIUrl":"10.1097/PRS.0000000000012544","url":null,"abstract":"<p><strong>Background: </strong>Massive weight loss after bariatric surgery (BS) often results in excess skin, leading to physical discomfort and impaired quality of life (QoL). Body contouring surgery (BCS) addresses these issues by restoring body image, improving function, and enhancing overall QoL, but its added value on patient-reported outcome measures (PROMs) remains underexplored.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Embase, Web of Science, and Cochrane databases was conducted from inception to March of 2025. Studies comparing PROMs between patients undergoing BS alone and those undergoing BS + BCS were included. Retrieved studies were assessed using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. Outcomes were pooled using random effects models.</p><p><strong>Results: </strong>Fifteen non-randomized studies involving 7339 patients were included (BS, 4339 [59.1%]; BS + BCS, 3000 [40.9%]). Patients undergoing BS + BCS had a significantly greater percentage of total weight loss (mean difference [MD], 4.40% [95% CI, 1.69, 7.10]; P < 0.01). BODY-Q improvements favored the BS + BCS group in body image, physical, psychological, sexual, and social function (MD, 16.07 [95% CI, 12.14, 20.0]; P < 0.01). Among patients receiving only BS, those desiring BCS reported lower body satisfaction (MD, -0.40 [95% CI, -0.70, -0.10]; P < 0.01) and lower appraisal of excess skin scores (standardized MD, -1.09 [95% CI, -1.83, -0.36]; P = 0.02) than those without desire for BCS.</p><p><strong>Conclusions: </strong>BCS after BS yields substantial improvements in overall QoL. These findings highlight the importance of BCS as a fundamental element of comprehensive postbariatric care that significantly enhances long-term patient satisfaction and drives durable multidimensional recovery.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"698e-711e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337489","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":"Transcriptome of Capsular Contracture around Breast Implants Mimics Allograft Rejection: A Matched Case-Control Study.","authors":"Martin Kauke-Navarro, Bohdan Pomahac","doi":"10.1097/PRS.0000000000012517","DOIUrl":"10.1097/PRS.0000000000012517","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"801e-803e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275464","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":"Decentralizing Health Care Manufacturing for a More Resilient Health Care System.","authors":"Amanda Fazzalari, Natalie Baxter, Shailesh Agarwal","doi":"10.1097/PRS.0000000000012534","DOIUrl":"10.1097/PRS.0000000000012534","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"816e-818e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293123","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":"Bridging the Gap: Telemedicine and Remote Consultation in Plastic Surgery-Addressing Regulatory Barriers and Equity in Access.","authors":"Nicholas A Schmitz, Annie M Fritsch, Stephanie M Armas, Mamtha S Raj","doi":"10.1097/PRS.0000000000012552","DOIUrl":"10.1097/PRS.0000000000012552","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"157 5","pages":"818e-819e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778380","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":"Accountability in Action: What Can Starbucks Teach Surgeons?","authors":"Goretti K Tran, Kevin C Chung","doi":"10.1097/PRS.0000000000012460","DOIUrl":"10.1097/PRS.0000000000012460","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"157 5","pages":"791e-796e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778427","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}