Plastic and reconstructive surgery最新文献

{"title":"Representation of Asian American, Native Hawaiian, and Pacific Islander Patients in Plastic Surgery Literature.","authors":"Dylan K Kim, Luisa Taverna, Christine H Rohde","doi":"10.1097/PRS.0000000000011856","DOIUrl":"10.1097/PRS.0000000000011856","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1088e-1090e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625979","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":"Science or Spectacle? A Critical Evaluation of the Decade of Aesthetic Medicine Conferences Using the Punctuated Equilibrium Framework.","authors":"Eqram Rahman, Karim Sayed, Parinitha Rao, Nanze Yu, Keming Wang, Patricia E Garcia, Sotirios Ioannidis, Wolfgang G Philipp-Dormston, Jean D A Carruthers, William Richard Webb","doi":"10.1097/PRS.0000000000011899","DOIUrl":"10.1097/PRS.0000000000011899","url":null,"abstract":"<p><strong>Background: </strong>The global aesthetic medicine industry is expanding rapidly, with conferences serving as crucial platforms for knowledge exchange and collaboration. However, concerns have emerged about the increasing prioritization of commercial content over scientifically rigorous presentations. This study critically evaluates the balance between commercial and scientific content at aesthetic medicine conferences, using artificial intelligence (AI) tools to analyze the impact of industry sponsorship and live procedural demonstrations on educational value.</p><p><strong>Method: </strong>Using the punctuated equilibrium framework, AI-driven content analysis, social network analysis, and sentiment analysis were applied to evaluate conference data, including programs, sponsorship details, speaker affiliations, and attendee engagement metrics. The study analyzed global and regional aesthetic medicine conferences from 2014 to 2024, identifying patterns and punctuated shifts in the balance between scientific and commercially driven content.</p><p><strong>Results: </strong>AI-based analysis of 487 conferences, comprising more than 28,000 sessions and 2 million social media posts, revealed an increasing trend toward commercially focused content, particularly in industry-sponsored events. Approximately 44% of sessions were commercially oriented, with significant spikes during product launches. Academic and clinical speakers were more prevalent in scientific conferences, whereas industry-affiliated speakers dominated commercial sessions. Social media sentiment, analyzed using AI tools, reflected high engagement with procedural demonstrations, but also highlighted concerns about educational quality.</p><p><strong>Conclusions: </strong>Although industry-driven sessions garnered higher immediate engagement, they reduced long-term cognitive retention and compromised the educational integrity of conferences. The use of AI in this study enabled a deeper understanding of content trends and their effects. Aesthetic medicine conferences must recalibrate the balance between commercial interests and scientific rigor to ensure sustainable professional development and patient safety.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"986e-1004e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731840","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":"Loren Schechter, Jens Urs Berli, Rachel Bluebond-Langner","doi":"10.1097/PRS.0000000000011963","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011963","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"924-927"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161328","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":"Fine-Tuning on AI-Driven Video Analysis through Machine Learning: Development of an Automated Evaluation Tool of Facial Palsy.","authors":"Takeichiro Kimura, Keigo Narita, Kohei Oyamada, Masahiko Ogura, Tomoyasu Ito, Takashi Okada, Akihiko Takushima","doi":"10.1097/PRS.0000000000011924","DOIUrl":"10.1097/PRS.0000000000011924","url":null,"abstract":"<p><strong>Background: </strong>Establishment of a quantitative, objective evaluation tool for facial palsy has been a challenging issue for clinicians and researchers, and artificial intelligence-driven video analysis can be considered a reasonable solution. The authors introduced facial keypoint detection, which detects facial landmarks with 68 points, but existing models had been organized almost solely with images of healthy individuals, and low accuracy was presumed in the prediction of asymmetric faces of patients with facial palsy. The accuracy of the existing model was assessed by applying it to videos of 30 patients with facial palsy. Qualitative review clearly showed its insufficiency. The model was prone to detect patients' faces as symmetric, and was unable to detect eye closure. Thus, the authors enhanced the model through the machine-learning process of annotation (ie, fine-tuning).</p><p><strong>Methods: </strong>A total of 1181 images extracted from the videos of 196 patients were enrolled in the training, and these images underwent manual correction of 68 keypoints. The annotated data were integrated into the previous model with a stack of 2 hourglass networks combined with channel aggregation block.</p><p><strong>Results: </strong>The postannotation model showed improvement in normalized mean error from 0.026 to 0.018, and qualitative keypoint detection on each facial unit revealed improvements.</p><p><strong>Conclusions: </strong>Strict control of inter- and intra-annotator variability successfully fine-tuned the presented model. The new model is a promising solution for objective assessment of facial palsy.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1071e-1081e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838664","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":"Use of the Superficial Circumflex Iliac Artery Perforator Flap for Urethra and/or Shaft Reconstruction in Gender-Diverse Persons: 10-Year Single-Center Experience.","authors":"Anouk De Gelder, Danny Young-Afat, Karel Claes, Shane Morrison, Nikolaas Lumen, Anne-Françoise Spinoit, Mieke Waterschoot, Salvatore D'Arpa, Stan Monstrey, Marlon Buncamper","doi":"10.1097/PRS.0000000000011830","DOIUrl":"10.1097/PRS.0000000000011830","url":null,"abstract":"<p><strong>Background: </strong>Although the free radial forearm flap (FRFF) is the standard for phalloplasty, the conspicuous donor-site scar, need for microsurgery, and tendency for the phallus to deflate over time leads both patients and surgeons to seek alternatives. The authors describe their long-term experience with the pedicled superficial circumflex iliac artery (SCIP) flap for urethral or penile shaft reconstruction, or both. This flap can be applied for similar indications as FRFF phalloplasty, but with primary closure of the donor sites and without microsurgery.</p><p><strong>Methods: </strong>The authors retrospectively reviewed surgical outcomes of all patients who underwent urethra or shaft reconstruction, or both, using SCIP flaps as part of phalloplasty for gender-affirming surgery in their center between 2012 and 2022.</p><p><strong>Results: </strong>Over a 10-year period, 55 SCIP flaps were performed as part of phalloplasty. This included 47 unilateral SCIP flaps, 10 of which were used for shaft reconstructions and 37 for urethra reconstructions. Primary closure was achieved in 100% of patients. No failures were observed for shaft reconstructions. For urethra reconstructions, 8 SCIP urethras (14%) failed completely, and 3 SCIP flaps were converted to free flaps. In total, 82% of patients with a SCIP urethra reconstruction were able to stand while voiding. Eight bilateral SCIP flaps were performed for 1-stage shaft and urethra creation; among these, 3 patients (38%) experienced urethral fistulas or strictures.</p><p><strong>Conclusions: </strong>This study shows that the SCIP flap is a technically feasible and safe pedicled alternative for urethral and penile shaft reconstruction in gender-diverse individuals, with similar urethral complication rates compared with FRFF and anterolateral thigh flap phalloplasty, but with potentially lower shaft sensation.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1036e-1044e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505923","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":"Spontaneous Recovery of Active Shoulder External Rotation in Patients with Brachial Plexus Birth Injury.","authors":"Maria Hyttinen, Henrikki Rönkkö, Pasi Paavilainen, Mika Helminen, Jarkko Jokihaara","doi":"10.1097/PRS.0000000000011877","DOIUrl":"10.1097/PRS.0000000000011877","url":null,"abstract":"<p><strong>Background: </strong>Brachial plexus birth injury (BPBI) occurs as a result of a difficult delivery. External rotation (ER) of the shoulder (ER) is usually one of the last movements that may recover. There is no consensus about the predicting factors for spontaneous recovery or the optimal timing for surgical treatment of ER in BPBI patients. The aim of this retrospective study was to describe spontaneous recovery of active ER and evaluate predicting factors for the recovery.</p><p><strong>Methods: </strong>The authors screened 562 patients and identified a consecutive cohort of 103 BPBI patients, who had no active ER at the age of 3 months. The authors systematically collected clinical data on recovery. In addition, the authors assessed whether early recovery of elbow flexion, shoulder abduction, or Narakas grade at 1 month predicts ER recovery.</p><p><strong>Results: </strong>Fifty-two patients (51%) spontaneously recovered ER, 44% of whom recovered by the age of 1 year, 83% by 1.5 years, 92% by 2 years, and 98% by 3 years. A breakpoint in the slope of the curve showing proportion of recovered patients occurred at 2 years of age. Recovery of active ER was significantly associated with early elbow flexion and Narakas grade at 1 month, but not with early active shoulder abduction.</p><p><strong>Conclusions: </strong>Most spontaneous recovery of ER in patients with BPBI occurs until 2 years of age, which thus can be considered a meaningful follow-up period for spontaneous recovery of ER. This information should be considered when making decisions about peripheral nerve transfer surgery to improve ER in BPBI.</p><p><strong>Clinical question/level of evidence: </strong>Risk, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1045e-1053e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676536","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":"Three Pedicle-Based Nipple-Sparing Skin-Reducing Mastectomy Combined with Prepectoral Implant-Based Breast Reconstruction: Correction.","authors":"Simone La Padula, Rosita Pensato, Rasmieh Al-Amer, Barbara Hersant, Jean Paul Meningaud, Warren Noel, Francesco D'Andrea, Nicola Rocco","doi":"10.1097/PRS.0000000000012154","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012154","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1057"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161347","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":"Effects of Nanofat in Plastic and Reconstructive Surgery: A Systematic Review.","authors":"Mustafa Uguten, Martin C Harmsen, Berend van der Lei, Hieronymus P Stevens, Joris A van Dongen","doi":"10.1097/PRS.0000000000011836","DOIUrl":"10.1097/PRS.0000000000011836","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1086e-1087e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505907","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":"Levator Advancement Surgery with or without Lateral Horn Incision: Effect of Lateral Horn Incision for Severe Involutional Blepharoptosis.","authors":"Hirotaka Suga, Asako Fukuju, Risa Murakami","doi":"10.1097/PRS.0000000000011833","DOIUrl":"10.1097/PRS.0000000000011833","url":null,"abstract":"<p><strong>Background: </strong>The lateral portion of the levator aponeurosis transforms into fibrous tissue called the lateral horn. Conventional levator advancement surgery for involutional blepharoptosis preserves the integrity of the lateral horn. The impact of incising the lateral horn has not been thoroughly studied.</p><p><strong>Methods: </strong>Sixty-nine patients who had undergone levator advancement surgery for involutional blepharoptosis between 2020 and 2023 were included in the study. In cases where the levator aponeurosis could not be well advanced during surgery, the authors incised the lateral horn to increase the advancement. The authors then retrospectively reviewed cases with or without the incision. The authors also measured the effect of the incision intraoperatively using a sheet with a scale grid.</p><p><strong>Results: </strong>Lateral horn incisions were performed in 32 of the 69 cases. The preoperative degree of blepharoptosis was significantly more severe in cases that necessitated the incision (margin reflex distance 1, 0.5 mm versus 1.0 mm; P < 0.05). Patients receiving the incision were significantly older than those without (73.4 years versus 61.7 years; P < 0.05). There were no significant differences between the 2 groups in postoperative margin reflex distance 1 (2.8 mm versus 3.0 mm; P = 0.20). Intraoperative measurements revealed that the levator aponeurosis was advanced 4.3 mm more caudally and 3.1 mm more medially as a result of the lateral horn incision.</p><p><strong>Conclusions: </strong>Lateral horn incision is effective in levator advancement surgery for severe involutional blepharoptosis. This technique aids in preventing undercorrection of palpebral fissures, especially in the medial region.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"937-942"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472441","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":"Prophylactic Local Antibiotics for Tissue Expansion (PLATE) Improve Breast Reconstruction Outcomes.","authors":"Robert Craig Clark, Priscila Cevallos, Benyamin Dadpey, Andrea Yessaillian, Elizabeth Turner, Augustine Kang, Brian Thornton, Rahim Nazerali, Chris M Reid","doi":"10.1097/PRS.0000000000011832","DOIUrl":"10.1097/PRS.0000000000011832","url":null,"abstract":"<p><strong>Background: </strong>Infection following tissue expander (TE) breast reconstruction is frequent and impactful. Preliminary reports demonstrate value of local antibiotic delivery for implant salvage and prophylactic potential. This article is a multiinstitutional retrospective study using surgeon-crafted tobramycin-vancomycin polymethyl methacrylate plates (prophylactic local antibiotics for tissue expansion [PLATE]) during TE implantation for infection prophylaxis. The authors hypothesized that the intervention would be associated with fewer infections compared with historical practice.</p><p><strong>Methods: </strong>In 2021, surgeons at 3 institutions began independently offering PLATE for primary TE breast reconstructions. After independent institutional review board approvals, data were retrospectively collected for PLATE subjects and preintervention cohorts of equivalent sizes. Subjects were followed up for 7 months, or to second-stage removal. The primary outcome-complication requiring readmission/reoperation-was compared between aggregated cohorts. Analysis included logistic modeling and Kaplan-Meyer survival.</p><p><strong>Results: </strong>The aggregate sample included 183 intervention subjects (292 breasts) and 183 controls (301 breasts), each with 5 ± 2-month follow-up. Overall, complications were significantly less frequent with PLATE (13.1% versus 21.9%; P < 0.01). This was driven by significantly fewer infections (4.8% versus 12.6%; P < 0.01) with no difference in rates of tissue necrosis, seroma, or other complications ( P > 0.05). In multivariable regression, the intervention was associated with significantly reduced odds of any complication (OR, 0.53; 95% CI, 0.3 to 0.93) and infection (OR, 0.22; 95% CI, 0.08 to 0.50). Kaplan-Meyer curves demonstrated significant longitudinal reduction in complication and infection ( P < 0.01) without notable rebound throughout dissipation of the antibiotic eluent.</p><p><strong>Conclusions: </strong>Prophylactic use of intraoperatively crafted PLATE during TE implantation was associated with significant infection reduction without increase in local or systemic complications. This reproducible tool may be highly valuable in alloplastic breast reconstruction.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"974e-985e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505910","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}