Plastic and reconstructive surgery最新文献

{"title":"The Hyoid Bone in Robin Sequence: Morphology and Position in the Context of Mandibular Distraction Osteogenesis.","authors":"Annie T Wang, Shelby L Nathan, Hannes Prescher, Callum F Ross, Russell R Reid, Peishu Li","doi":"10.1097/PRS.0000000000013560","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013560","url":null,"abstract":"<p><strong>Background: </strong>Robin Sequence (RS) is a congenital condition marked by micrognathia, glossoptosis, and airway obstruction. Patients with RS exhibit anatomical differences in the hyoid bone, a key mediator of swallowing and respiration. Severe RS is treated with mandibular distraction osteogenesis (MDO) to lengthen the mandible and increase oropharyngeal space, the latter thought to be caused by changes in hyoid position. Here, we test this hypothesis by quantitatively evaluating 3D hyoid position and morphology in patients with RS and comparing them to pediatric controls.</p><p><strong>Methods: </strong>Computed tomography (CT) scans were obtained for 38 patients with RS pre- and post-MDO and 15 control patients. Hyoid position relative to craniomandibular landmarks and hyoid morphology were compared between pre- and post-MDO RS patients and controls.</p><p><strong>Results: </strong>Pre-MDO patients have shorter relative hyoid-menton distances than post-MDOs and controls (p<0.01). Relative hyoid-basion and hyoid-vertebral column distances are comparable between groups. Controls have smaller relative hyoid-temporomandibular joint distances than RS patients (p<0.05). RS patients have a higher prevalence of abnormal hyoid ossification (control: 13.3%; pre-MDO: 36.8%) and demonstrate dimensional differences in hyoid width and angle related to both RS and MDO.</p><p><strong>Conclusions: </strong>MDO does not enlarge the oropharyngeal space by moving the hyoid anteriorly. Instead, we hypothesize MDO improves airway patency by 1) changing tongue shape and the geometry of the anterior pharyngeal wall, and 2) increasing suprahyoid muscle passive tension. Our results provide new insights into the mechanisms of mandibular distraction and highlight importance of the hyoid and its attachments in the pathologic presentation of RS.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224733","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 Evidence for Migraine Surgery Isn't in Doubt. Coverage Still Is.","authors":"Sacha C Hauc, Jeffrey E Janis","doi":"10.1097/PRS.0000000000013535","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013535","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195445","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":"Modified Liacyr-Ribeiro Breast Reduction and Mastopexy: Long-Term Outcomes with More Than 10 Years of Follow-up.","authors":"Mariana Matias, Rita Igreja, Ines Insua, Sergio Teixeira, Francisco Carvalho, Marisa Marques, Antonio S Barros, Antonio Costa-Ferreira","doi":"10.1097/PRS.0000000000013539","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013539","url":null,"abstract":"<p><strong>Background: </strong>Long-term maintenance of breast shape after reduction mammaplasty remains challenging, with inferior pole descent and pseudoptosis as possible late complications. The Modified Liacyr-Ribeiro Technique incorporates an inferior lipo-glandular flap fixed to the chest wall, functioning as an autologous prosthesis to improve internal support. Objective data beyond a decade remain scarce. This study evaluates long-term (>10 years) patient-reported and structural outcomes after the Modified Liacyr-Ribeiro Technique.</p><p><strong>Methods: </strong>A single-center retrospective cohort with prospective follow-up assessment was conducted. Eighty-six patients undergoing bilateral reduction mammaplasty with our technique between 2010 and 2015 were included (mean follow-up of 14 years). Outcomes included patient-reported satisfaction and symptom relief, objective anthropometric measurements, surgeon clinical assessment, and blinded panel-based photographic evaluation. Multivariable regression analysis were used to identify predictors of long-term satisfaction.</p><p><strong>Results: </strong>Overall, long-term satisfaction was high (mean score 4.48/5), with 86.0% of patients reporting high satisfaction. Objective clinical evaluation demonstrated stable breast shape, with adequate upper pole projection in 95.7% and correct nipple position in 97.8%. No cases of pseudoptosis were reported clinically. Blinded photographic assessment confirmed a very low prevalence of pseudoptosis (1%). Age, menopausal status, pregnancy, and postoperative weight variations - including extreme changes requiring bariatric surgery - did not negatively impact long-term satisfaction or structural outcomes.</p><p><strong>Conclusions: </strong>The Modified Liacyr-Ribeiro Technique provides durable structural support and sustained patient satisfaction over more than a decade of follow-up, supporting the autologous prosthesis concept as an effective strategy to preserve breast shape and prevent inferior pole descent, largely independent of major physiological stressors.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195422","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":"Impact of GLP-1 Agonists on Post-Operative Outcomes in Aesthetic & Body Contouring Surgery: A Systematic Review & Meta-Analysis.","authors":"Mary Ellen McMahon, Ruby Wong, Richard P Hanson","doi":"10.1097/PRS.0000000000013542","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013542","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have rapidly expanded in use for weight loss, resulting in a growing population of patients presenting for aesthetic and body-contouring procedures. Despite their increasing prevalence, the effects of GLP-1 RAs on postoperative wound healing and surgical outcomes remain poorly defined.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Embase, and Cochrane CENTRAL were searched from database inception through May 2026. Studies comparing postoperative outcomes in patients undergoing aesthetic and/or body-contouring surgery with and without GLP-1 RA exposure were included. Primary outcomes included infection, wound dehiscence, delayed wound healing, hypertrophic scarring, seroma, hematoma, and venous thromboembolism (VTE). Random-effects meta-analyses were performed using risk ratios (RRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Twelve studies comprising 29,357 patients met inclusion criteria, with 10 studies included in quantitative synthesis. In pooled observational analyses, GLP-1 RA exposure was associated with increased risk of delayed wound healing and hypertrophic scarring. Subgroup analysis comparing GLP-1 RA users with patients who had previously undergone bariatric surgery demonstrated decreased seroma rates in the GLP-1 RA group.</p><p><strong>Conclusions: </strong>GLP-1 RA use in patients undergoing aesthetic and body-contouring surgery was associated in pooled observational analyses with increased risks of delayed wound healing and hypertrophic scarring, while GLP-1 RA use was associated with lower seroma rates in comparison with patients who have undergone bariatric surgery. As GLP-1 RA use become increasingly prevalent, further prospective studies are needed to clarify their perioperative effects and optimize patient selection and surgical outcomes.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194699","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":"Methodological caveats on model overfitting and the temporal validity of length of stay in the MDRO risk nomogram for pediatric burns.","authors":"Luigi Annacontini, Luigi Cagiano, Vincenzo Verdura","doi":"10.1097/PRS.0000000000013544","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013544","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194759","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 Anxiety and Depression with Patient-Reported Outcomes After Functional and Aesthetic Rhinoplasty\".","authors":"Jeremy V Lynn, Christian T Stipho, Ahneesh J Mohanty, Michael J Brenner, Jeffrey S Moyer, Steven R Buchman, Robert H Gilman","doi":"10.1097/PRS.0000000000013540","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013540","url":null,"abstract":"<p><strong>Background: </strong>Body dysmorphic disorder is a well-established predictor of decreased patient satisfaction after rhinoplasty. However, the effect of anxiety and depression on rhinoplasty-specific patient reported outcomes is largely unknown. This study evaluates the association of anxiety and depression with patient satisfaction after functional and aesthetic septorhinoplasty.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included patients undergoing functional or aesthetic septorhinoplasty from 2019-2024. Preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) and Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) scores were extracted from the electronic medical record. Patients with anxiety and/or depression were compared to those without these diagnoses within functional and aesthetic cohorts. Multivariable logistic regression was performed to assess revision rates.</p><p><strong>Results: </strong>Regarding functional septorhinoplasty (n=490), both the control and anxiety/depression group demonstrated improved NOSE (-44.7 and -32.5, p<0.001) and SCHNOS-Obstructive (-44.9 and -46.9, p<0.001) scores postoperatively. Compared to the control group, the anxiety/depression group reported higher (less favorable) postoperative NOSE (35.3 vs 24.1, p<0.001) and SCHNOS-Obstructive (32.1 vs. 24.1, p=0.027) scores, and higher odds of revision surgery (OR 2.56, 95% CI 1.51-4.39, p<0.001). Regarding aesthetic septorhinoplasty (n=179), both the control and anxiety/depression group demonstrated improved SCHNOS-Cosmetic scores postoperatively (-32.3 and -39.6, p<0.001), with no difference in preoperative or postoperative SCHNOS-Cosmetic scores or revision rates between groups.</p><p><strong>Conclusion: </strong>Patients with anxiety or depression undergoing functional septorhinoplasty reported lower postoperative satisfaction and experienced higher revision rates. In contrast, individuals with anxiety or depression undergoing aesthetic septorhinoplasty demonstrated no significant differences in postoperative satisfaction or revision surgery compared to controls.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196195","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 Composite Internal Stabilization Strategy associated with Absence of Postoperative Hematoma After Facelift: A 561-Patient Comparative Series.","authors":"Eduardo Pellini, Valentino Vellone, Valerio Finocchi","doi":"10.1097/PRS.0000000000013519","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013519","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hematoma remains the most common complication following rhytidoplasty, with reported incidences ranging from 0.5% to 8%. Various preventive strategies have been proposed, including blood pressure control, drains, progressive tension sutures and quilting techniques, which have been widely adopted to reduce dead space and improve flap adherence. The authors developed an internal hemostatic network (IHN), combining established suturing principles into a composite technique designed to eliminate dead space and stabilize the facial flap.</p><p><strong>Methods: </strong>A retrospective comparative cohort study was conducted. The study group included 356 consecutive facelift procedures (2018-2025) performed using the IHN technique with progressive tension and quilting sutures, without drains or compressive dressings. A control group consisted of 205 patients (2011-2017) who underwent conventional rhytidoplasty with SMAS plication or SMASectomy and suction drains. The primary outcome was postoperative hematoma requiring surgical evacuation. Secondary outcomes included hospital stay and postoperative complications.</p><p><strong>Results: </strong>No major hematomas requiring surgical evacuation, seromas, or flap necrosis occurred in the study group. Three patients (0.8%) developed small localized blood collections requiring simple aspiration; none progressed or fulfilled the predefined definition of postoperative hematoma. Transient facial nerve weakness occurred in 10.4% of patients, predominantly involving the marginal mandibular branch, with complete recovery after a mean of 7 weeks and no permanent deficits. All patients were discharged on the day of surgery (mean stay 5 hours). In the control group, 12 hematomas (5.9%) required surgical evacuation. Fisher's exact test demonstrated a statistically significant reduction in hematoma incidence with the IHN technique (p < 0.00001).</p><p><strong>Conclusions: </strong>The internal hemostatic network was associated with absence of postoperative hematoma in this retrospective comparative series. By minimizing dead space and stabilizing the flap without drains or external compression, the technique may reduce morbidity and facilitate faster recovery.Level of Evidence: III, retrospective comparative cohort study.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183914","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":"Support or Simplicity: Evaluating Mesh Use in Two-Stage Prepectoral Breast Reconstruction.","authors":"Matthew A DePamphilis, Justin Lee, Madeleine N McGlynn, Caroline Valdes, Josip Plascevic, Berfin Sakar, Yunchan Chen, Michael K Turgeon, William G Austen, Katherine H Carruthers","doi":"10.1097/PRS.0000000000013500","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013500","url":null,"abstract":"<p><strong>Background: </strong>The routine use of surgical mesh in prepectoral two-stage breast reconstruction has increased despite limited high-level evidence supporting its necessity. The purpose of this study was to evaluate whether mesh use impacts postoperative complications, reconstructive failure, or secondary revision rates.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study was conducted of patients undergoing immediate prepectoral two-stage breast reconstruction from 2016 to 2025, stratified by use of mesh at the time of expander placement. Patients undergoing delayed reconstruction or concurrent/planned autologous reconstruction were excluded. Logistic regression models assessed predictors of (1) postoperative complication, (2) reconstructive failure, and (2) secondary revision.</p><p><strong>Results: </strong>The final sample included 1,592 reconstructions in 948 patients, of which 84.4% used mesh. Complications occurred more frequently in reconstructions with mesh (18.2% vs. 12.9%, p=0.039), primarily due to higher infection rates (8.7% vs. 4.8%, p=0.039). On multivariable analysis, mesh use was associated with increased odds of complication (OR: 1.574, 95% CI: 1.047-2.437, p=0.035) but not reconstructive failure (OR: 1.222, 95% CI: 0.684-2.181, p=0.499). Secondary revision rates did not differ significantly between the two cohorts (21.5% vs. 24.4%, p=0.333) and mesh use was not found to be protective of secondary revision (OR: 1.165, 95% CI: 0.821-1.653, p=0.392).</p><p><strong>Conclusion: </strong>In prepectoral two-stage breast reconstruction, mesh use was associated with increased postoperative complications, particularly infection, and did not confer a reduction in reconstructive failure or secondary revision rates. While mesh is a useful adjunctive tool commonly used in breast reconstruction, its routine incorporation in two-stage reconstruction is costly and may not be necessary.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183899","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":"Early Frontalis Suspension with Autologous Fascia Lata for Congenital Blepharoptosis in Children: 23-Year Clinical Experience.","authors":"Federico Sacasa, Gustavo Herdocia Baus, Michael L Bentz, John Noon, John W Siebert, Amanda Nelson, Ruston Sanchez, Myiah P Quach, Marvin González-Quiroz, Samuel O Poore","doi":"10.1097/PRS.0000000000013508","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013508","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183883","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-Specific Mirrored Planning Leads to Superior Symmetry for Late Post-Traumatic Deformity After Orbital Zygomatic Maxillary Complex Fractures.","authors":"Meghan N Miller, Bianca Sjoenell, Jackie Albert, You Jeong Park, Henry K Kawamoto, James P Bradley","doi":"10.1097/PRS.0000000000013505","DOIUrl":"10.1097/PRS.0000000000013505","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic orbital-ZMC deformity is notoriously difficult to correct because of soft tissue contraction and loss of anatomic landmarks. To see whether virtual planning is beneficial, we studied orbital/malar volume correction, globe position, malar projection and patient satisfaction.</p><p><strong>Methods: </strong>Patients were divided into 2 equal groups: 1) traditional intraoperative repositioning ('eyeball test'); 2) virtual mirrored-image planning over a 12-year period (n=32). Outcomes were compared using 1) orbital volume, 2) globe position, 3) malar projection, 4) malar soft-tissue volume; and 5) PROMIS surveys.</p><p><strong>Results: </strong>Groups were comparable: age (38.2 ± 5 years vs 36.8 ± 4 years), mechanism of injury (fall/motor vehicle collision/assault: 35/28/37% vs 31/33/36%), time from injury to reconstruction (4.2 ± 3 years vs 3.8 ± 2 years), follow-up duration (13.1 ± 4 months vs 12.7 ± 2 months). Orbital volume: The traditional group had greater variability in postoperative orbital volume (26.1cc ± 5.1 vs 25.5cc ± 1.7) and globe position. Malar projection: Postoperative deviation from the ideal malar coordinate was lower with VSP, indicating greater accuracy (1.6 mm ± 0.4 vs 4.3 mm ± 3.1). Malar Volume: Both groups improved, but VSP demonstrated lower variability and greater predictability (102.2 cc ± 2.8 vs 98.2 cc ± 8.1). PROMIS scores were superior with VSP, including Anxiety (56 ± 2.4 vs. 61 ± 2.8) and Depression (54 ± 2.2 vs. 59 ± 2.3).</p><p><strong>Conclusions: </strong>For post-traumatic ZMC/ orbital deformity, virtual mirrored-image planning is superior to traditional visual estimation technique regarding symmetry, globe position, malar projection and psychosocial scores.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183917","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}