Plastic and reconstructive surgery最新文献

{"title":"Gluteal Augmentation with Fat Grafting: A Systematic Review and Meta-Analysis of Complications and Procedural Factors.","authors":"Ahmed Elsaftawy, Michał Bonczar, Marta Jagosz, Tomasz Bonczar, Paweł Stajniak, Tomasz Główka, Patryk Ostrowski","doi":"10.1097/PRS.0000000000012437","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012437","url":null,"abstract":"<p><strong>Background: </strong>Fat grafting has become one of the most widely used methods for gluteal augmentation, yet concerns remain regarding its safety and complication profile. This study aims to update and synthesize complication rates associated with gluteal fat grafting, with a particular focus on procedural factors.</p><p><strong>Methods: </strong>A systematic search through PubMed, Embase, Scopus, and Cochrane Library was conducted following PRISMA guidelines. Original clinical studies reporting complications following autologous fat grafting for gluteal augmentation were included.</p><p><strong>Results: </strong>A total of 38 studies comprising 22,151 patients were included. The pooled incidence of minor complications was 3.58% (95% CI: 1.75-5.99%), with seromas occurring in 2.03% and contour irregularities in 2.29% of cases. Pulmonary embolism had a pooled incidence of 0.04%. Ultrasound-guided fat grafting was associated with lower rates of both major (0.02% vs. 0.08%) and minor (2.82% vs. 3.70%) complications. Subcutaneous-only injection planes demonstrated the lowest complication rates compared to intramuscular or combined approaches. The use of lipoaspirate additives and drains did not consistently lower complication rates and was sometimes associated with increased adverse outcomes.</p><p><strong>Conclusions: </strong>Fat grafting is generally safe when performed using evidence-based techniques. Subcutaneous-only injection and ultrasound guidance are associated with improved outcomes and may enhance procedural safety. Continued research with prospective, standardized studies is necessary to refine procedural strategies and minimize complication risks.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233141","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":"Fat Repositioning with Deep Fat Excision in Transcutaneous Lower Blepharoplasty.","authors":"Jianwu Chen, Changhong Li, Fuguang Zhang, Yanhong Wu, Yuzhi Wang, Qi Li, Ningjing Li, Xiangdong Qi, Cheng Biao","doi":"10.1097/PRS.0000000000012416","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012416","url":null,"abstract":"<p><strong>Background: </strong>Lower blepharoplasty has shifted from fat resection to preservation via repositioning, yet severe fat herniation still requires selective excision. Traditional resection may compromise transposition. This study introduces deep fat excision to optimize the balance between removal and repositioning, enhancing aesthetic outcomes.</p><p><strong>Methods: </strong>From 2018 to 2024, 107 patients underwent transcutaneous lower blepharoplasty with deep fat excision. The technique involved incising the orbital septum at the arcus marginalis to selectively resect deep-layer fat, followed by septum-fat flap transposition to correct tear trough deformities. Surgical outcomes were assessed using Hirmand's grading system through evaluations by clinicians, two publicly available AI (Artificial Intelligence) platforms, and the FACE-Q survey.</p><p><strong>Results: </strong>Clinically, 91.6% of patients achieved complete elimination of fat bulges and tear trough deformity, while 8.4% exhibited undercorrection in these areas. AI assessments showed 70.9% consistency with clinical evaluations (κ = 0.58). Lower eyelid FACE-Q scores improved significantly from 66.7 ± 12.5 preoperatively to 21.9 ± 15.4 postoperatively (P < 0.001), with high decision satisfaction (71.1 ± 19.9) and a perceived age reduction of 3.3 years (patient-perceived) and 5.8 years (AI-predicted). Minor complications included undercorrection, orbital hematoma, and residual tear trough deformity.</p><p><strong>Conclusion: </strong>Deep fat excision achieves the balance between fat excision and repositioning, improving aesthetic outcomes in severe fat herniation cases. Additionally, integrating AI-assisted analysis enhances preoperative planning and postoperative evaluation, supporting its potential role in aesthetic surgery.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233209","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":"Perioperative Vitamin D Insufficiency Impacts Postoperative Outcomes in Abdominally Based Breast Reconstruction.","authors":"Zain Aryanpour, Jamie E Cronin, Ananya Shah, Jerry H Yang, Evan J Haas, Julian Winocour, Christodoulos Kaoutzanis, David W Mathes, Katie G Egan","doi":"10.1097/PRS.0000000000012491","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012491","url":null,"abstract":"<p><strong>Background: </strong>Hypovitaminosis D has been associated with wound healing complications in animal models as well as increased morbidity, infection, and hospital length of stay in clinical studies of surgical patients. This study aims to evaluate the association between perioperative Vitamin D (25-OHD) levels and postoperative outcomes in patients undergoing autologous breast reconstruction.</p><p><strong>Methods: </strong>We performed a retrospective review of patients undergoing autologous breast reconstruction at an academic institution. Patients with 25-OHD levels measured within three months of reconstruction were included. Variables of interest included patient demographics, comorbidities, perioperative 25-OHD levels, and postoperative surgical and medical complications. Standard statistical analysis was performed with significance set to p<0.05.</p><p><strong>Results: </strong>147 patients who underwent abdominally based breast reconstruction had undergone 25-OHD testing within three months of reconstruction and were included in analysis. 25-OHD insufficiency (<30 ng/mL) was found to be significantly associated with surgical site infections (OR 2.8, p=0.04), donor site seromas (OR 13.2, p=0.01), and medical complications (OR 4.0, p=0.02) on univariate and multivariable analysis.</p><p><strong>Conclusion: </strong>Our data suggests that 25-OHD insufficiency impacts surgical and medical complications in patients undergoing autologous breast reconstruction. Enhanced understanding of perioperative 25-OHD status may help inform clinical decisions and present opportunities for optimizing patients to improve surgical outcomes in breast reconstruction.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233211","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 Efficacy of Migraine Surgery in Reducing Pharmacological Treatment Requirements.","authors":"Emily C Yanoshak, Lee H Kilmer, Samantha L Mason, Brent R DeGeorge, Jonathan S Black","doi":"10.1097/PRS.0000000000012490","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012490","url":null,"abstract":"<p><strong>Introduction: </strong>Migraines impact 35 million Americans, leading to decreased quality of life and are the third leading cause of disability worldwide. Recent studies have demonstrated a nearly 90% success rate for migraine surgery, defined as the elimination or at least a 50% reduction in symptoms. This study aimed to determine the effect of migraine surgery on medication usage.</p><p><strong>Methods: </strong>A national insurance database containing ICD and CPT codes, along with patient demographics, was utilized. Patients diagnosed with chronic migraines via ICD codes were included. Propensity score matching using medical comorbidities created a treatment group that underwent peripheral nerve decompression or transection surgery (CPT-64716 or CPT-64771) and a control group that did not undergo surgery. Medication usage before and after surgery was compared among surgical patients. A logistic regression was performed to identify predictors of undergoing migraine surgery.</p><p><strong>Results: </strong>In a database of 165 million patients, 10,641,115 (6.4%) were identified with migraines. Of these, 1,852 (0.02%) underwent migraine surgery, with a mean and median time to surgery of 3.1 and 2.3 years, respectively (SD 2.8 years). Propensity score matching resulted in 1,948 patients in both control and treatment groups. Post-surgery, the use of abortive medications, including triptans, ergots, and NSAIDs, significantly decreased (p<0.05). Preventative medication use, including beta-blockers, antiepileptics, calcium channel blockers, and antidepressants, also significantly decreased (p<0.01).</p><p><strong>Conclusions: </strong>Peripheral nerve decompression or transection surgery may be effective in reducing medication usage among migraine patients. Further research is needed to assess the impact of migraine surgery on overall healthcare costs.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233135","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":"Spotlight in Plastic Surgery: October 2025.","authors":"","doi":"10.1097/PRS.0000000000012289","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012289","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 4","pages":"670-673"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149877","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":"Cleft Presurgical Infant Orthopedics: Evolution from Analog to Digital Appliances-Will It Increase Accessibility?","authors":"Winston R Owens, Vamsi C Mohan, Krishnamurthy Bonanthaya, Alvaro A Figueroa","doi":"10.1097/PRS.0000000000012376","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012376","url":null,"abstract":"<p><strong>Summary: </strong>In the present day, presurgical infant orthopedic (PSIO) treatment is routinely implemented by cleft providers to reduce the space between cleft segments before surgical repair as well as to address the coexisting cleft nasal deformity. Since the inception of PSIO treatment, various modifications in both appliances and techniques have developed to improve treatment efficiency, postoperative outcomes, and access. Early PSIO appliances solely addressed alveolar malformations. In the early 1990s, Grayson introduced and popularized the technique of nasoalveolar molding. Following the device and protocol developed by Grayson, successive appliances, such as the modification introduced by Figueroa, have mitigated the risk of complications. Currently, advancements in 3-dimensional technology have revolutionized presurgical cleft care with increased treatment accuracy, efficiency, and reproducibility. Modern PSIO devices have harnessed 3-dimensional technology, including growth and treatment simulation through time, and can play a critical role in increasing accessibility of care in low- and middle-income countries. Nongovernmental organizations such as Smile Train operate to deliver comprehensive cleft care to low- and middle-income countries while helping develop local and national initiatives to create sustainable solutions. In collaboration with national and local health authorities and providers, as well as private industry, nongovernmental organizations can continue to work toward providing sustainable, high-quality comprehensive cleft care across the globe.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 4S-2","pages":"72S-80S"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150284","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":"Financial Disclosure Appendix for \"Fillers: The State of the Science-A Multispecialty, Evidence-Based Initiative\".","authors":"","doi":"10.1097/PRS.0000000000012378","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012378","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 4S-1","pages":"4S"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150302","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":"Introduction to \"Advances in Cleft Care\".","authors":"Larry H Hollier, Richard A Hopper, Roberto L Flores","doi":"10.1097/PRS.0000000000012371","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012371","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 4S-2","pages":"1S-2S"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150432","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":"Association of Sphincter Pharyngoplasty and Long-Term Maxillary Hypoplasia in Patients with Cleft Palate.","authors":"Nghiem H Nguyen, Madeline G Chin, Kelly X Huang, Kaavian Shariati, Jeremiah M Taylor, Juliana Panchura, Kriya Gishen, Justine C Lee, Libby F Wilson","doi":"10.1097/PRS.0000000000012040","DOIUrl":"10.1097/PRS.0000000000012040","url":null,"abstract":"<p><strong>Background: </strong>The current literature on orthognathic growth outcomes after velopharyngeal insufficiency surgery is limited by cohort size or short follow-up duration after surgery. This study evaluates the relationship between sphincter pharyngoplasty and long-term maxillomandibular growth.</p><p><strong>Methods: </strong>All patients with cleft lip and palate (CLP) or isolated cleft palate (iCP) greater than or equal to 15 years of age who underwent sphincter pharyngoplasty from 1992 to 2023 were retrospectively reviewed. An age- and diagnosis-matched control group with CLP/iCP was also identified. Postoperative outcomes include clinical diagnosis of maxillary and mandibular hypoplasia, indication for Le Fort surgery, and sella-nasion-A point and sella-nasion-B point angles.</p><p><strong>Results: </strong>A total of 200 CLP/iCP patients with a mean age of 20.0 ± 3.2 years were included ( n = 114 with pharyngoplasty and n = 86 controls). Within the surgery cohort, pharyngoplasty occurred at a mean age of 12.0 ± 4.5 years with a follow-up duration 9.2 years (interquartile range, 3.5 to 12.2 years) after surgery. Maxillary hypoplasia was diagnosed twice as frequently in pharyngoplasty patients compared with controls (60.5% versus 33.7%; P < 0.001), corresponding to a higher incidence of Le Fort I surgery (45.6% versus 15.1%; P < 0.001) and smaller sella-nasion-A point angles (75.4 ± 4.5 degrees versus 78.2 ± 5.4 degrees; P = 0.03). There were no differences in mandibular hypoplasia or sella-nasion-B point angles. Multivariable analysis indicated that pharyngoplasty was independently associated with a 3-fold increase in later diagnosis of maxillary hypoplasia (OR, 3.8; 95% CI, 1.9 to 7.5; P < 0.001).</p><p><strong>Conclusion: </strong>Patients with a history of pharyngoplasty were 3.8 times more likely to be subsequently diagnosed with maxillary hypoplasia, highlighting the need for longitudinal follow-up of patients after velopharyngeal insufficiency surgery, as there may be long-term orthognathic consequences.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"597-604"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449760","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":"Cleft Photo Mirror Combining Self-Retraction, Scaling, and Antifogging Features for Cleft Palate Documentation.","authors":"Prasad Nalabothu, José Wittor de Macêdo Santos, Benito K Benitez, Yoriko Lill, Sebastian Tapia Coron, Andreas A Mueller","doi":"10.1097/PRS.0000000000012099","DOIUrl":"10.1097/PRS.0000000000012099","url":null,"abstract":"<p><strong>Summary: </strong>Documentation of patients with cleft lip and palate presents a significant challenge due to the necessity for consistent, high-quality imaging throughout the extended treatment period. The use of traditional intraoral mirrors typically necessitates an assisting person for retraction of the lips and cheeks, as well as mirror fog cleaning. This results in variable fields of view and requires extensive resources. Distance measurements are not possible on conventional photographs, limiting their use for objective treatment analysis. To address these 3 challenges at once, the authors developed a customized intraoral mirror incorporating self-retraction, a reference scale, and an antifogging option. The mirror design features lateral extensions for effective lip and cheek retraction and 2 small laser-engraved black triangles, spaced 2 cm apart at the end of the mirror, to measure the width of the cleft, enabling a single operator to capture clear images independently. The mirror is designed in 4 sizes to accommodate patients from newborn babies to adults. Clinical implementation demonstrated that the mirror allows the acquisition of high-quality standardized images without additional assistance, enhancing workflow efficiency and consistency in documentation. By overcoming the limitations of traditional mirrors, the authors' mirror provides a practical and efficient solution for cleft lip and palate documentation and facilitates accurate follow-up of treatment progress beyond orthodontic and surgical evaluation.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"563e-566e"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649921","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}