Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Fusion Sling-Superficial Orbicularis Oris Nasalis Composite Flap: A Soft-tissue Suspension Technique for Columellar Base Augmentation in Asian Rhinoplasty.","authors":"Takamasa Nakai, Kazushi Sasaki, Junya Fukabori","doi":"10.1097/GOX.0000000000008078","DOIUrl":"10.1097/GOX.0000000000008078","url":null,"abstract":"<p><p>In Asian rhinoplasty, midfacial harmony often requires concurrent enhancement of the nasolabial angle and columellar base projection. Conventional structural grafts-columellar struts, septal extension grafts, and premaxillary grafts-provide reliable support but may increase tip rigidity or disturb the upper lip-columellar relationship. Recent anatomical work has identified the fusion sling and the superficial orbicularis oris nasalis (SOON) as key soft-tissue contributors to nasal tip dynamics. Between 2022 and 2025, the fusion sling-SOON composite flap (FSCF) was performed in 214 consecutive Asian rhinoplasty patients (179 primary; the remainder selected revision cases with preserved fusion sling-SOON continuity). Indications included an acute nasolabial angle with inadequate anterior nasal spine or premaxillary support. Through a sub-superficial musculoaponeurotic system approach, the fusion sling and SOON were elevated as an 8- to 10-mm fasciomuscular composite flap and stabilized with a caudal septal soft-hinge or septal extension graft suspension. Three-dimensional Vectra analysis was performed in 63 patients. Mean follow-up was 12.4 months (range, 6-24 mo). Mean nasolabial angle increased from 93.4-degree angle to 101.0-degree angle (+7.6-degree angle), and columellar base projection increased by 1.9 mm. Graded mild, moderate, and large changes were reproducibly achieved. No major complications, upper lip stiffness, animation deformities, or FSCF-related revisions occurred. The FSCF is a reproducible, anatomy-based dynamic technique that improves the nasolabial angle and columellar base while preserving upper lip mobility, offering a balanced alternative to rigid structural augmentation in Asian rhinoplasty.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8078"},"PeriodicalIF":1.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Surgical Waist: Defining the Zones of the Waist via Selective Liposuction or Fat Grafting to Improve the Female Silhouette.","authors":"Wilberto Cortes, Constantino Mendieta, Raúl Martín Manzaneda Cipriani, Melody Cortes, Tara Mather, John LoGiudice","doi":"10.1097/GOX.0000000000008112","DOIUrl":"10.1097/GOX.0000000000008112","url":null,"abstract":"<p><strong>Background: </strong>An \"hourglass\" waist is often valued as a sign of health and beauty. Despite this, methods to achieve the 3-dimensional anatomy and aesthetics of the waist remain underexplored. Selective liposuction or fat grafting of the waist transition aesthetic unit influences shape, depth, and proportions, regardless of adjunct surgical techniques to reduce the transverse plane of the waist. This study describes a technique using selective liposuction or fat grafting to refine the waist.</p><p><strong>Methods: </strong>The primary author's technique using selective liposuction or fat grafting is described. A retrospective study of patients treated between November 1, 2016, and January 30, 2025, was conducted to assess safety and efficacy. Medical records, photographs, and insurance claims were reviewed. Progress photographs were taken preoperatively and at postoperative time points. A photometric analysis was performed.</p><p><strong>Results: </strong>A total of 1999 consecutive cases were performed during the study period. The median age was 36 (interquartile range, 31-42) years, and the median body mass index was 29 (interquartile range, 26-32) kg/m². Complications included hematoma (4, 0.20%), pulmonary embolism or deep vein thrombosis (4, 0.20%), postoperative anemia requiring transfusion (11, 0.55%), and surgical site infection (24, 1.20%). Six patients required excision for skin necrosis (0.30%). Skin hyperemia occurred in 458 cases (22.91%), resolving in most but leading to permanent hyperpigmentation in less than 1%.</p><p><strong>Conclusions: </strong>Selective liposuction or fat grafting is a safe, reliable technique and serves as the first surgical intervention in our surgical protocol to enhance the waist. Addressing this area helps achieve a more balanced feminine profile.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8112"},"PeriodicalIF":1.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Periorbital Dynamic Rhytides on Surgical Outcomes of Lower Eyelid Blepharoplasty: A Clinical Efficacy Assessment.","authors":"Chi Liu, Junyan Wei, Chenyi Wen, Wenrong Gan, Zijin Liao, Chichi Li","doi":"10.1097/GOX.0000000000008104","DOIUrl":"10.1097/GOX.0000000000008104","url":null,"abstract":"<p><strong>Background: </strong>Lower eyelid bags and periorbital dynamic rhytides are common manifestations of periocular aging in middle-aged and older adult patients seeking aesthetic improvement. Although lower eyelid blepharoplasty corrects bag deformity, its interplay with preoperative dynamic rhytides remains understudied. This retrospective cohort study compares surgical outcomes following lower eyelid blepharoplasty in patients with varying severities of preoperative periorbital dynamic rhytides and to assess differences in treatment efficacy.</p><p><strong>Methods: </strong>This retrospective study analyzed 56 patients (112 eyes) undergoing transcutaneous lower eyelid blepharoplasty. Patients were stratified into group A (n = 32, severe dynamic rhytides) and group B (n = 24, mild dynamic rhytides) based on the preoperative Lemperle Wrinkle Scale. Postoperative outcomes were evaluated at 1-month and 1-year intervals using Barton and Hirmand grading systems to quantify infraorbital rejuvenation. Secondary endpoints included complication rates and patient satisfaction.</p><p><strong>Results: </strong>At 1-year follow-up, group A (severe rhytides) showed significantly less improvement in infraorbital contour than group B (mild rhytides) based on standardized grading systems (<i>P</i> < 0.05). Patient satisfaction was also lower in group A (<i>P</i> < 0.05). Complication rates did not differ between the groups (<i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>The severity of preoperative periorbital dynamic rhytides is associated with less favorable aesthetic outcomes in infraorbital contour after lower eyelid blepharoplasty and predicts lower patient satisfaction. However, it does not increase surgical risks. Preoperative assessment of wrinkle severity should be integrated into surgical planning and patient counseling to optimize expectations.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8104"},"PeriodicalIF":1.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Refractory Lymphedema of Perineum and Lower Limbs.","authors":"Chunchi Chuang, Honda Hsu","doi":"10.1097/GOX.0000000000008114","DOIUrl":"10.1097/GOX.0000000000008114","url":null,"abstract":"<p><p>Lymphedema is a chronic, progressive condition characterized by the accumulation of lymphatic fluid, followed by fat deposition and tissue fibrosis. It can also lead to local immune compromise and, in some cases, cutaneous malignancies. Here, we report a case of a patient with stage III combined perineal and lower limb lymphedema secondary to trauma. The patient was treated with lymphaticovenous anastomoses in the suprapubic region and both lower limbs, along with excision of excess skin and tissue in the perineal area. Optimal clinical improvement was achieved through this staged approach. This case emphasizes that although lymphaticovenous anastomosis effectively addresses extremity edema, radical excision remains essential for fibrotic genital elephantiasis. Comprehensive postoperative management is crucial for maintaining long-term results and minimizing recurrence.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8114"},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Healing of a Chronic Distal Toe Ulcer with Tendon Exposure Using the Topical Macrophage Regulator ON101.","authors":"Chao-Hsin Huang, I-Wen Lin, Yu-Ting Su, Shu-Hung Huang","doi":"10.1097/GOX.0000000000008115","DOIUrl":"10.1097/GOX.0000000000008115","url":null,"abstract":"<p><p>Diabetic foot ulcer (DFU) is one of the most challenging complications of diabetes mellitus. Chronic hyperglycemia contributes to impaired immune function, characterized by failure of macrophage polarization from the proinflammatory M1 to the prohealing M2 phenotype, together with increased release of inflammatory mediators. ON101 is a novel macrophage-regulating topical agent derived from botanical extracts, designed to suppress proinflammatory cytokines, restore M1/M2 macrophage balance, and promote collagen synthesis. We report the case of a 77-year-old man with diabetes mellitus who presented with a chronic, nonhealing ulcer of the right fifth toe with exposed tendon, persisting for 2 years despite conventional wound care and twice-daily Aquacel Ag⁺ extra dressing changes. The wound was accompanied by local inflammation, whereas angiographic evaluation suggested preserved distal runoff without evidence of critical macrovascular occlusion. ON101 topical therapy was initiated once daily under PolyMen dressing, leading to progressive granulation tissue formation, epithelial coverage of the tendon, and complete wound closure within 2 months. Notably, the total amount of ON101 used throughout the treatment course was less than 1 15-g tube. Given the chronicity of the wound, the presence of exposed tendon, and the difficulty of achieving durable healing in distal diabetic toe ulcers, this case suggests that ON101 may provide substantial therapeutic benefit in selected refractory cases.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8115"},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb Salvage Using Local Antibiotic Beads for Calcaneal Osteomyelitis With Multidrug-resistant Infection and Chronic Limb-threatening Ischemia.","authors":"Danah Alhunayan, Ahmed Alsaleh, Mahmood Makhdoomi, Salma Khuraibet, Ali Alnaser, Razzaq Alhunayan","doi":"10.1097/GOX.0000000000008117","DOIUrl":"10.1097/GOX.0000000000008117","url":null,"abstract":"<p><p>Calcaneal osteomyelitis in diabetic patients with chronic limb-threatening ischemia (CLTI) and multidrug-resistant (MDR) infection poses a significant reconstructive challenge. Limited perfusion, high plantar loading, and constrained antimicrobial delivery often narrow salvage options and increase the risk of major amputation. We report a case of recurrent calcaneal osteomyelitis in a 53-year-old man with type 2 diabetes, chronic kidney disease, peripheral vascular disease, CLTI, and polymicrobial MDR infection. Management included revascularization, serial debridement, culture-directed systemic therapy, negative-pressure wound therapy, hyperbaric oxygen therapy, structured offloading, and adjunctive local antibiotic delivery using calcium sulfate beads. Following recurrence, repeat calcaneal debridement and saucerization were performed, and vancomycin- and gentamicin-loaded calcium sulfate beads were placed individually into the calcaneal defect. The wound progressed with no recurrent infection or exposed bone. Complete epithelialization was achieved at 14 months, and the patient remained pain-free and independently ambulatory in offloading footwear. In recurrent calcaneal osteomyelitis complicated by CLTI and MDR infection, calcium sulfate antibiotic carriers may serve as a useful adjunct to staged multimodal limb salvage. By combining dead-space management with high local antibiotic delivery after repeat debridement, this approach may be considered in selected ischemic, infection-resistant presentations.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8117"},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Multinational Collaboration Supporting Reconstructive Surgery in Response to the 2023-2025 War in Gaza.","authors":"Sheila S Nazarian Mobin, Scot Bradley Glasberg, B Aviva Preminger, Mark D Epstein","doi":"10.1097/GOX.0000000000008177","DOIUrl":"10.1097/GOX.0000000000008177","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8177"},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donor-site Seroma in Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Pooled Analysis.","authors":"André S Alves, Jérôme Martineau, Matteo Scampa, Boran Tekdogan, Adriano Fabi, Gaëtan Kellerhals, Daniel F Kalbermatten, Axelle Serre","doi":"10.1097/GOX.0000000000008106","DOIUrl":"10.1097/GOX.0000000000008106","url":null,"abstract":"<p><strong>Background: </strong>Seroma at the abdominal donor site is a recognized complication following deep inferior epigastric perforator (DIEP) flap breast reconstruction. Reported incidences vary widely, reflecting differences in surgical technique, patient characteristics, and outcome reporting. Consequently, this proportional meta-analysis aims to estimate the pooled incidence of abdominal donor-site seroma and evaluate potential risk factors associated with its occurrence.</p><p><strong>Methods: </strong>A systematic literature review of PubMed, Web of Science, and the Cochrane Library was performed up to June 2025. Studies reporting abdominal donor-site seroma rates following DIEP flap reconstruction were included. Data were pooled using a random-effects model (DerSimonian-Laird), and heterogeneity was assessed using <i>I</i> ² and τ² statistics. Univariable meta-regression analyses explored associations of smoking status and diabetes with seroma occurrence.</p><p><strong>Results: </strong>The search identified 1345 unique records, of which 71 studies met the inclusion criteria, comprising 12,739 patients and 16,915 DIEP flaps. A total of 736 seromas were reported, yielding a pooled incidence of 6% (95% confidence interval, 4%-7%). Heterogeneity was substantial (<i>I</i> ² = 85.3%, τ² = 0.05, <i>P</i> < 0.001). The mean body mass index and age were 27.2 kg/m² and 50.4 years, respectively. Meta-regression showed no significant association between seroma occurrence and smoking (<i>P</i> = 0.57) or diabetes (<i>P</i> = 0.07).</p><p><strong>Conclusions: </strong>Donor-site seroma occurs in 6% of DIEP flap reconstructions. The absence of associations with smoking or diabetes in meta-regression suggests that seroma formation may be influenced by technical and perioperative factors rather than by comorbidities.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8106"},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Suggestion to Use \"Pedicle Reach\" Instead of \"Pedicle Length\" for Communication in Free Flap Surgery.","authors":"Steven Liben Zhang, Fu-Chan Wei","doi":"10.1097/GOX.0000000000008121","DOIUrl":"10.1097/GOX.0000000000008121","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8121"},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Antimicrobial-impregnated Sutures Reduce Surgical Site Infections in Plastic Surgery: A Systematic Review and Meta-analysis-Erratum.","authors":"Sarah Petrecca, Simran K Chandawarkar, Hassan ElHawary, Rawan Elabd, Jeffrey E Janis","doi":"10.1097/GOX.0000000000008142","DOIUrl":"10.1097/GOX.0000000000008142","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/GOX.0000000000007925.].</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 9","pages":"e8142"},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}