Plastic and reconstructive surgery最新文献

{"title":"Strategy versus Tactics: Applications to Medicine.","authors":"Aarushi Ratna, Anne Seyferth, Kevin C Chung","doi":"10.1097/PRS.0000000000011724","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011724","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 2","pages":"229-233"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060161","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":"True Incidence of Marginal Mandibular Nerve Palsy following Neonatal Mandibular Distraction Osteogenesis.","authors":"Sarah Myers, Justin W Beiriger, Madeleine K Bruce, Sayna Matinrazm, Lucas Dvoracek, Anjali Raghuram, Zhazira Irgebay, Anne E Glenney, Joseph Mocharnuk, Nicolás M Kass, John Smetona, Joseph E Losee, Jesse A Goldstein","doi":"10.1097/PRS.0000000000011409","DOIUrl":"10.1097/PRS.0000000000011409","url":null,"abstract":"<p><strong>Background: </strong>In children with Pierre Robin sequence (PRS), mandibular distraction osteogenesis (MDO) is routinely performed to alleviate airway obstruction; however, it involves risk of injury to the marginal mandibular nerve (MMN). The authors hypothesize that MMN palsy incidence following MDO, reported at 1% to 15%, is underestimated. This study investigates the true incidence of MMN palsy after MDO to better guide follow-up care and improve treatment of this complication.</p><p><strong>Methods: </strong>A retrospective review of PRS patients who underwent MDO at a single, tertiary pediatric hospital between September of 2007 and March of 2021 was conducted. Patients who underwent MDO younger than 1 year of age and had postoperative clinical evaluations detailing MMN function were included. Logistic regression analysis was performed to investigate predictors of MMN injury.</p><p><strong>Results: </strong>Of 93 patients who underwent MDO, 59.1% met inclusion criteria, 56.4% were female, 43.6% were syndromic, and average age at MDO was 1.52 ± 2.04 months. The average length of mandibular distraction was 17.3 ± 4.36 mm, the average duration of intubation was 6.57 ± 2.37 days, and the average time until hardware removal was 111.1 ± 23.6 days. Sixteen patients (29.1%) presented with permanent MMN dysfunction, consisting of 8 patients with bilateral weakness and 8 with unilateral weakness. An additional 5 patients (9.1%) presented with transient MMN weakness that resolved within 1 year. Average length of follow-up postoperatively was 6.02 years, and no significant predictors of nerve injury were found.</p><p><strong>Conclusion: </strong>In this 14-year review of patients with PRS who underwent MDO, 38.2% demonstrated evidence of MMN palsy (permanent, 29.1%; transient, 9.1%), which is much greater than previously described.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"317-324"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306487","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 Nasoorbitofrontal Complex in Facial Feminization Surgery.","authors":"Tristan Beaufils, Yanis Berkane, Vlad Luca-Pozner, Éric Watier, Nicolas Bertheuil, Quentin Qassemyar","doi":"10.1097/PRS.0000000000011570","DOIUrl":"10.1097/PRS.0000000000011570","url":null,"abstract":"<p><strong>Background: </strong>With the increasing demand for facial feminization surgery, there is a growing need for reliable and reproducible techniques to enhance outcomes. The authors aimed to evaluate the effectiveness of single-stage nasoorbitofrontal (NOF) complex reshaping in facial feminization surgery. Effectiveness was gauged by computed tomographic assessments and an unvalidated patient satisfaction survey at 6 months postoperatively.</p><p><strong>Methods: </strong>The study included 155 transfeminine patients undergoing surgery of the upper third of the face. Outcomes were compared in patients receiving either orbitofrontal (OF) surgery or combined NOF surgery. A comparative analysis of preoperative and postoperative standardized computed tomography sections was performed, focusing on multiple anatomic angles in 2 dimensions. A self-administered satisfaction questionnaire based on 6 FACE-Q items was completed at 6 months.</p><p><strong>Results: </strong>Among the 155 patients, 65 underwent OF surgery and 90 underwent NOF surgery. The follow-up period ranged from 6 to 36 months, with an average follow-up of 18 months. Significant changes in craniometric measurements were observed. In the OF group, average changes in nasofrontal, frontal tilt, and metopion angles were +12.3 ± 0.2 degrees, -8.5 ± 2.2 degrees, and +20.0 ± 0.1 degrees, respectively ( P < 0.001); in the NOF group, they were +28.5 ± 0.3 degrees, -9.3 ± 2.4 degrees, and +23.9 ± 0.1 degrees, respectively ( P < 0.001). The NOF group demonstrated higher overall satisfaction (median, 4 of 5) compared with the OF group (median, 3 of 5). No early complications were reported.</p><p><strong>Conclusion: </strong>The NOF complex surgery is an effective approach in gender-affirming surgery of the upper third of the face, yielding predictable results and higher patient satisfaction.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"341-351"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301344","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":"Resection of Fourth-to-Fifth Metacarpal Synostosis and Fascial Interposition for Creation of a Functional Grip/Pinch in the Apert Hand.","authors":"Joseph Upton, Kimberly S Khouri","doi":"10.1097/PRS.0000000000011671","DOIUrl":"10.1097/PRS.0000000000011671","url":null,"abstract":"<p><strong>Background: </strong>Fourth-to-fifth metacarpal synostosis, present in a majority of Apert hands, flattens the metacarpal arch, restricts metacarpal descent, may prevent opposition of border rays, and negates any functional flexion. Restoration of position and mobility with arthroplasty changes the plane of flexion and enables both pinch and grip. This report summarizes the evolution of the authors' technique over 5 decades.</p><p><strong>Methods: </strong>In a cohort of 184 Apert patients (368 hands), the presence, anatomy, and level of metacarpal synostosis with a classification was determined. The present technique consists of incision along the ulnar border of the hand, wide excision of the skeletal coalition, release of dorsal structures, and soft-tissue interposition. Data consisted of clinical records, serial molds, radiographs, and occupational therapy records. Follow-up ranged from 3 to 44 years.</p><p><strong>Results: </strong>A total of 147 patients (80% of hands) had bilateral fourth-to-fifth metacarpal synostoses, the extent of which correlated with the Apert hand classification. In 72 patients, the synostosis was resected and cadaveric fascia interposed. Synostosis refusion occurred in 38 hands, all of which were treated early in the series and in patients younger than 6 years old. Despite refusion, the position of the fifth digit had improved, and the flat transverse arch was in a more curved or cupped posture. The distance between the opposing border rays was always improved, and a new grip and pinch mechanism created.</p><p><strong>Conclusions: </strong>Aggressive ostectomy of synostosis and fascial interposition places the ulnar side of the hand in a much more functional position. In conjunction with thumb lengthening, opposition between the thumb and fifth finger becomes a clinical reality in children with Apert syndrome.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"309-314"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875620","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: A Geospatial Analysis of Hand Trauma Care: A Statewide Cross-Sectional Study.","authors":"Aviram M Giladi","doi":"10.1097/PRS.0000000000011544","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011544","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 2","pages":"356e-357e"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060139","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":"Expanded Approaches for Mastopexy in Aesthetic and Reconstructive Breast Surgery.","authors":"Alexandra M Keane, Damini Tandon, Marissa M Tenenbaum, Terence M Myckatyn","doi":"10.1097/PRS.0000000000011764","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011764","url":null,"abstract":"<p><strong>Learning objectives: </strong>After studying this article, the participant should be able to: (1) Understand the unique differences between mastopexy in aesthetic and reconstructive breast surgery. (2) Describe the approach to performing mastopexy with autoaugmentation or after explantation. (3) Have insight into the approach and decision-making process for performing mastopexy with nipple-sparing mastectomy. (4) Apply the mastopexy skin reduction techniques to ptotic women undergoing postmastectomy breast reconstruction.</p><p><strong>Summary: </strong>Techniques and indications for mastopexy are expanding. In aesthetic surgery, access to supportive meshes and higher rates of breast implant explantation without replacement contribute to this. In breast reconstruction, higher rates of nipple-sparing mastectomy and higher expectations for cosmetically favorable outcomes with ptotic breasts are key drivers. A keen understanding of the available blood supply and how it may change over time with a staged approach, thoughtful use of otherwise-discarded tissues, and judicious application of mesh support are important new considerations for plastic surgeons to apply to traditional mastopexy. This evidence-based article focuses on specific aesthetic and reconstructive mastopexy techniques associated with autoaugmentation, explantation, and nipple-sparing mastectomy.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 2","pages":"433e-446e"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060153","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: Optimizing the Aesthetic Outcomes of Reconstructive Surgery and Avoiding Patient Abandonment.","authors":"Ilana G Margulies, Amanda R Sergesketter, Christopher L Kalmar","doi":"10.1097/PRS.0000000000011842","DOIUrl":"10.1097/PRS.0000000000011842","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 2","pages":"399-400"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060159","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: Patient-Specific Factors for Deformity after Upper Blepharoplasty in an Asian Population.","authors":"Arthur Y Yu","doi":"10.1097/PRS.0000000000011574","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011574","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 2","pages":"288e-290e"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060140","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":"Aesthetic Rib Cage Remodeling with Osteosynthesis: Body Structural High-Definition Reshaping (Rib Osteotomy with Osteosynthesis Stabilization).","authors":"Hugo Aguilar Villa, Silvia J Villabona-Florez, Alfredo E Hoyos, Mauricio E Perez Pachon, Hector Mauricio Serrano-Reyes, Cristian J Diaz Sandoval","doi":"10.1097/PRS.0000000000011512","DOIUrl":"10.1097/PRS.0000000000011512","url":null,"abstract":"<p><strong>Background: </strong>Rib cage remodeling has shown promising aesthetic results as a new technique for body contouring, and yet risks and complications associated with the procedure have not been well established. The aim of the authors' study was to assess safety, efficacy, and patient satisfaction rate associated with a new surgical technique for waistline definition.</p><p><strong>Methods: </strong>The authors looked into their records for patients who underwent waist narrowing through a new rib remodeling procedure with osteosynthesis of ribs XI and XII from October of 2022 to June of 2023. Follow-up was carried out at 1 and 3 months after surgery. Outcomes were evaluated based on waist and hip measurements, body image, pain, and a patient satisfaction survey.</p><p><strong>Results: </strong>A total of 27 consecutive patients were included in the analysis. The authors' technique resulted in a significant reduction in waist circumference, as evidenced by a decrease of 12.1 cm and 13.0 cm at the first and third months, respectively ( P < 0.005). A reduction of hip circumference of 6.2 cm and 8.7 cm at the first and third months, respectively, was also reported. A high patient satisfaction rate was reported. Postoperative complications included only 1 case of wound dehiscence and 1 case of mild pain. Pain levels were also reduced, with a mean pain score of 2.4 at week 1 and 0.26 at month 1.</p><p><strong>Conclusions: </strong>Rib osteotomy with osteosynthesis emerges as an innovative, safe, and reliable approach for waist narrowing. The authors' results suggest that this technique can be applied to a wide variety of patients, and it might entail significant advantages compared with other techniques.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"279-288"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868658","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":"Monitoring Postoperative Weight Changes following Reduction Mammaplasty in Adolescents.","authors":"William N Doyle, Aaron Jacobs, Shae Duka, Randolph Wojcik, Robert X Murphy, Marshall Miles","doi":"10.1097/PRS.0000000000011676","DOIUrl":"10.1097/PRS.0000000000011676","url":null,"abstract":"<p><strong>Background: </strong>Macromastia can limit a woman's ability to exercise. Reduction mammaplasty has been reported to subjectively improve exercise capability and stimulate weight loss. Considering the lack of published quantitative data, the authors sought to examine change in weight and body mass index (BMI) in adolescent women following reduction mammaplasty.</p><p><strong>Methods: </strong>Retrospective chart review was performed of patients younger than 21 years who underwent reduction mammaplasty at the authors' institution from 2015 through 2019.</p><p><strong>Results: </strong>Fifty-six patients with follow-up weight measurements were included in the analysis. The median follow-up time was 46.0 months. Only 22 patients (39.3%) experienced a decrease in BMI at final follow-up compared with baseline. Patients classified as having a healthy weight preoperatively (BMI, 18.5 to 24.9 kg/m 2 ) experienced a significant increase in BMI at 2-year, 3-year, 5-year, and final postoperative follow-up visits, compared with baseline. Patients classified as overweight (BMI, 25.0 to 29.99 kg/m 2 ) or obese (≥30 kg/m 2 ) did not experience significant BMI change at final postoperative follow-up.</p><p><strong>Conclusions: </strong>BMI and weight trended upward postoperatively regardless of BMI classification. Reduction mammaplasty alone is not sufficient to stimulate weight loss. Healthy lifestyle changes should be encouraged to help prevent weight gain in adolescent women following reduction mammaplasty.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"247-253"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976346","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}