Plastic and reconstructive surgery最新文献

{"title":"Discussion: Spontaneous Recovery of Active Shoulder External Rotation in Patients with Brachial Plexus Birth Injury.","authors":"Nicholas Pulos, Robert J Spinner, Alexander Y Shin","doi":"10.1097/PRS.0000000000011987","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011987","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1054e-1055e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161337","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: Evolving Landscape of Autologous Breast Augmentation and Reconstruction.","authors":"Christopher L Kalmar, Amanda R Sergesketter, Ilana G Margulies","doi":"10.1097/PRS.0000000000012062","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012062","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1055-1056"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161341","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":"Long-Term Volume Retention of Breast Augmentation with Fat Grafting Depends on Weight Changes: A 3-Year Prospective Magnetic Resonance Imaging Study.","authors":"Mathias Ørholt, Tim K Weltz, Mathilde N Hemmingsen, Andreas Larsen, Erik E F Bak, Caroline B Norlin, Liv Hart, Jens Jørgen Elberg, Peter V Vester-Glowinski, Mikkel Herly","doi":"10.1097/PRS.0000000000011841","DOIUrl":"10.1097/PRS.0000000000011841","url":null,"abstract":"<p><strong>Background: </strong>Fat grafting is increasingly used for breast augmentation. However, long-term volume retention, time to reach steady state, and the effect of postoperative weight changes on these outcomes are not fully understood.</p><p><strong>Methods: </strong>In this prospective study, we included patients undergoing breast augmentation with fat grafting and examined them with magnetic resonance imaging preoperatively and up to 3 years postoperatively. We modeled fat graft retention over time and calculated the time to volumetric steady state of the fat graft. In addition, we used their model to assess the effect of postoperative weight changes on fat graft retention and to determine the association between the graft-to-recipient volume ratio and the percentage breast augmentation at steady state. Finally, we assessed patient satisfaction using the BREAST-Q questionnaire.</p><p><strong>Results: </strong>The study included 28 patients (46 breasts). The time to steady state was 253 days (95% CI, 185 to 283 days) postoperatively, with a volume retention of 46% (95% CI, 35% to 58%). Patients with a weight loss of 1 body mass index point after surgery had a volume retention of 22% (95% CI, 4.7% to 38%), whereas those increasing 1 and 2 body mass index points had retention rates of 57% (95% CI, 45% to 69%) and 85% (95% CI, 72% to 98%), respectively. Increasing graft-to-recipient volume ratio was associated with higher percentage augmentation with no plateau in this relationship even up to ratios of 2:1. Postoperative Satisfaction with Breasts and Sexual Well-Being increased substantially.</p><p><strong>Conclusions: </strong>Breast augmentation with fat grafting reached volumetric steady state after 8 months with a volume retention of 46%. Weight loss following fat grafting leads to significantly lower volume retention.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"947-954"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505908","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":"Superior Retention of Aged Fat Graft by Supplementing Young Adipose-Derived Stromal Cells in a Murine Model.","authors":"Vinh Vuong The Tran, Xian Jin, Xin Ye Zhou, Ki Yong Hong, Hak Chang","doi":"10.1097/PRS.0000000000011810","DOIUrl":"10.1097/PRS.0000000000011810","url":null,"abstract":"<p><strong>Background: </strong>In 2021, a meta-analysis showed that fat graft retention varied from 26% to 83%. In a retrospective study including patients with Parry-Romberg syndrome, the younger age group had higher satisfaction scores (3.8 versus 3.0) after fat grafting. Cell-assisted lipotransfer could be an alternative to overcome the instability of volume loss; however, no study has investigated its effect on older recipients.</p><p><strong>Methods: </strong>In an in vitro study, adipose-derived stromal cells (ASCs) from aged and young (52 and 8 weeks old) DsRed B6 mice were characterized by proliferation rates as percentages of Ki-67-positive cells. In addition, 68-week-old wild-type B6 mice received 150 µL of green fluorescent protein fat (from 69-week-old B6 mice) mixed with saline or 3 × 10 5 aged or young DsRed ASCs (N, A, and Y groups, respectively) on the scalp ( n = 6/group). After 8 weeks, graft volumes were evaluated using microcomputed tomography. Vessel densities were tracked by percentages of CD31 using immunofluorescence staining.</p><p><strong>Results: </strong>Young ASCs showed higher proliferation than aged ASCs (47.1% and 26.2%, respectively; P < 0.05). The Y group showed the highest graft retention (median: N, 41.0%; A, 52.2%; Y, 65.2%; P < 0.05) and percentage of blood vessels (median: N, 27.7%; A, 43.5%; Y, 54.7%; P < 0.05) among the 3 groups.</p><p><strong>Conclusions: </strong>Cell-assisted lipotransfer is effective with older recipients. Higher effect was observed by supplementation with younger ASCs because of higher angiogenesis stimulation. Further validation of safety, toxicity, and allogenic grafting is required.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"959-968"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505911","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":"Skin Graftless Dorsal Metacarpal Island VY Advancement Flap versus Dorsal Rectangular Flap with Skin Grafting in 213 Simple Syndactyly Releases.","authors":"Shaun D Mendenhall, Emily M Graham, Zoe E Belardo, Eliza Buttrick, Elizabeth B Card, Apurva S Shah, Benjamin Chang","doi":"10.1097/PRS.0000000000011925","DOIUrl":"10.1097/PRS.0000000000011925","url":null,"abstract":"<p><strong>Background: </strong>Simple syndactyly is a common congenital upper extremity difference. Traditional reconstructive approaches use skin grafts; however, recent studies suggest that skin graftless techniques may improve outcomes. The authors hypothesized that patients who underwent reconstruction with a skin graftless dorsal metacarpal island VY advancement flap would have fewer postoperative complications compared with those released with a dorsal rectangular flap with skin grafts.</p><p><strong>Methods: </strong>Patients aged 0 to 17 years presenting for primary reconstruction of simple syndactyly were analyzed retrospectively at a large pediatric hospital. Medical records were identified using International Classification of Diseases, Ninth Revision and Tenth Revision codes, CPT codes, and case logs from 6 hand surgeons. Outcomes of interest included early postoperative complications (within 30 days) such as infection, hematoma, seroma, wound healing issues, unplanned returns to the operating room, and digit loss. Late complications (>30 days) included web creep and development of pathologic scar formation.</p><p><strong>Results: </strong>In total, 213 syndactyly repairs from 153 patients were analyzed (rectangular, 94 webspaces and 58 patients; VY, 119 webspaces and 95 patients). The rectangular group had significantly more early complications ( P = 0.04). The rectangular group had significantly higher incidences of web creep and hypertrophic scarring (19.3% versus 1.8%, P < 0.001; 19.1% versus 5.9%, P = 0.003, respectively). The rectangular flap with skin grafts was the only variable predictive of web creep and hypertrophic scar formation on regression analysis ( P < 0.001 and P = 0.004, respectively). Subgroup analyses of syndromic and nonsyndromic cases and incomplete and complete cases mirrored overall cohort results.</p><p><strong>Conclusion: </strong>Simple syndactyly releases with the skin graftless technique produces fewer complications compared with the traditional approach with skin grafts.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"969-981"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838762","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":"Limb Salvage for Chronic Lower Extremity Wounds.","authors":"Rajiv P Parikh, Justin M Sacks","doi":"10.1097/PRS.0000000000012006","DOIUrl":"10.1097/PRS.0000000000012006","url":null,"abstract":"<p><strong>Learning objectives: </strong>After studying this article, the participant should be able to: 1. Describe perioperative management and a multidisciplinary approach to limb salvage and functional limb restoration. 2. Summarize preoperative strategies to optimize patients for limb salvage procedures. 3. Discuss the indications for limb salvage versus amputation. 4. Develop an operative plan for limb salvage that is patient and defect centered and emphasizes the goal of functional limb restoration. 5. Understand adjunct biomechanical procedures and technical considerations to optimize functional outcomes following limb salvage.</p><p><strong>Summary: </strong>This article highlights principles and evolving concepts in limb salvage for chronic lower extremity wounds. Limb salvage is an increasingly important topic, as chronic lower extremity wounds associated with diabetes and/or peripheral vascular disease increase morbidity and long-term mortality rates, decrease quality of life, and contribute to substantial health care costs. The goal of a contemporary reconstructive approach to limb salvage is functional limb restoration. This concept involves optimizing function and minimizing residual disability. In this article, the authors review key concepts in the multidisciplinary approach to patients with limb-threatening lower extremity wounds and introduce the concept of end-stage limb disease. The indications to guide surgical decision-making for limb salvage versus functional amputation are discussed. A patient- and defect-centered reconstructive approach is delineated, with representative case examples provided. Recent developments, such as supermicrosurgical techniques, are also highlighted. Finally, the authors detail important considerations to facilitate success in this complex and challenging patient population, including microvascular technique, adjunct biomechanical operations, flap selection, and recipient vessel selection.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1056e-1070e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161339","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105959/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}