Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Oral Mucosa Remodeling Induced by Injecting New Cellular Treatment Factor (NCTF) and Human-derived Exosomes (ASCE & CellExosome).","authors":"Noury Adel, Jack Kolenda","doi":"10.1097/GOX.0000000000007587","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007587","url":null,"abstract":"<p><strong>Background: </strong>Exosomes mediate tissue regeneration by promoting angiogenesis, fibroblast activity, and extracellular matrix remodeling. New Cellular Treatment Factor (NCTF), cellular treatment factor solutions containing amino acids, vitamins, nucleotides, coenzymes, minerals, and hyaluronic acid, are used in regenerative medicine, but their combined effects with human-derived exosomes on the oral mucosa remain unclear. The aim of this study was to evaluate the histological and immunohistochemical changes in normal hamster oral mucosa following treatment with an NCTF solution enriched with 2 distinct human exosome formulations at different time points.</p><p><strong>Methods: </strong>Sixty-three male hamsters were randomized into 3 groups: saline-injected control, NCTF with cell-derived exosomes (CellExosome), and NCTF solution with adipose stem cell-derived exosomes (ASCEs). Injections were administered into the buccal mucosa, and tissues were harvested at baseline, day 3, and day 7. Hematoxylin-eosin, Masson trichrome, and Van Gieson staining were used to assess mucosal structure and collagen remodeling, whereas angiogenesis was quantified using CD34 immunohistochemistry.</p><p><strong>Results: </strong>Both exosome-treated groups demonstrated progressive increases in fibroblast proliferation, collagen organization, and microvessel density from day 3 to day 7 compared with controls. The NCTF + CellExosome group consistently exhibited the most pronounced effects, with significantly greater angiogenesis and extracellular matrix remodeling across all time points (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>In a hamster model, exosome-enriched biorevitalization solutions enhanced angiogenesis and collagen remodeling in normal oral mucosa in a time-dependent manner. The NCTF + CellExosome formulation demonstrated superior regenerative potential, supporting its potential translational relevance for future regenerative and aesthetic research.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7587"},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646286","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":"Strategies for Malar Implant Placement: A Review of Access, Planning, and Outcomes.","authors":"Martin Kauke-Navarro, Leonard Knoedler, Felix J Klimitz, Fortunay Diatta, Victoria Kong, Simon Bigus, Michael Alperovich, Alexandre G Lellouch, Ali-Farid Safi","doi":"10.1097/GOX.0000000000007554","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007554","url":null,"abstract":"<p><strong>Background: </strong>The absence of standardized planning and placement strategies for malar implants contributes to variable aesthetic outcomes.</p><p><strong>Methods: </strong>A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines searched PubMed/MEDLINE, Cochrane CENTRAL, and Google Scholar for clinical studies on aesthetic malar implantation. Surgical access, implant positioning, planning methods, and complications were extracted.</p><p><strong>Results: </strong>Fifteen studies including 796 patients were analyzed. Intraoral (n = 370) and preauricular (n = 350) approaches were most common, followed by subciliary (n = 54) and endonasal (n = 20). Intraoral access showed higher infection rates (2.0%), revisions (4.3%), removals (2.0%), and malposition (1.3%). Preauricular access was associated with asymmetry (20.3%) and contour irregularities. Subciliary and endonasal approaches showed few reported complications. Most implants were placed over the anterolateral zygoma to enhance malar projection. Only 3 studies used patient-specific implants, and 6 incorporated computed tomography or 3-dimensional planning.</p><p><strong>Conclusions: </strong>Intraoral access carries a higher infection risk. Targeting the central malar eminence may optimize projection while avoiding lateral overcorrection. Broader use of patient-specific implants and image-guided planning may improve precision and aesthetic outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7554"},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646325","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":"Negative Pressure Therapy With Instillation for Salvage of Infected Breast Prostheses: A Technique Video.","authors":"Jason C Llaneras, Garrison Leach, Luther Holton, Aladdin H Hasssanein, Devinder Singh, Chris M Reid","doi":"10.1097/GOX.0000000000007630","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007630","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7630"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646304","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":"Back External Quilting Suture in Massive Weight Loss Patients: A New Technique to Enhance Body Contouring.","authors":"Matilde de Garcia de la Vega, Anna Scarabosio, Damiano Tambasco, Etienne Rousson, Eric Watier, Benoit Lengelé, Yanis Berkane, Nicolas Bertheuil","doi":"10.1097/GOX.0000000000007607","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007607","url":null,"abstract":"<p><p>Despite its first descriptions in the previous decade, the use of the hemostatic net has experienced a recent resurgence of enthusiasm in cervicofacial rhytidectomy. Sizeable studies demonstrate a reduction of postoperative hematoma and better skin retraction thanks to external quilting suture techniques. Recent evidence supports this technique's safety for skin and soft tissue vascularization. We describe an innovative extension of transcutaneous suture indications to postbariatric and body-contouring surgery. By extending the hemostatic net, described for cervical and thoracic surgery, to postbariatric and body-contouring surgery, we aim to propose a safe, reproducible, and innovative technique to enhance contour shaping of the lumbar region. We present a series of 8 massive weight loss patients undergoing liposuction followed by hemostatic net sutures to improve contouring while minimizing scarring. Stitches were performed with 1/0 braided sutures and removed after 2 days. The follow-up ranged from 6 to 20 months. The average lipoaspirated volume was 1431 mL (range, 450-2300 mL). No complications were reported, and no subsequent procedures were needed. Lower back contouring improvement was evaluated using pre- and postoperative photograph comparisons by the patient and the surgeon. Skin marks partially faded at 6 months and disappeared at 12 months. This study primarily emphasized the safety and feasibility of external quilting sutures as an adjunct in postbariatric contouring rather than demonstrating definitive superiority over existing methods. This technique offered an additional option in the plastic surgeon's arsenal to address massive weight-loss sequelae despite poor skin tone.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7607"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646256","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":"Advancing Robotic-assisted Microsurgery for Access to Deep Anatomical Structures.","authors":"Andrea Weinzierl, Nicole Lindenblatt","doi":"10.1097/GOX.0000000000007668","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007668","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7668"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646213","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":"Late-Onset Upper Eyelid Edema Following Temporal Hollow Correction With Hyaluronic Acid.","authors":"Charbel El Feghaly, Pierre Tawa","doi":"10.1097/GOX.0000000000007612","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007612","url":null,"abstract":"<p><p>Hyaluronic acid (HA) fillers are widely used for facial rejuvenation, offering favorable safety outcomes. Although early-onset complications such as lower eyelid edema and tear trough Tyndall effect are well documented, late-onset manifestations-particularly upper eyelid edema occurring more than 6 months postinjection-remain poorly understood and often misdiagnosed. We report the case of a 51-year-old woman who presented with isolated, persistent, bilateral upper eyelid swelling. Imaging and laboratory workup, including thyroid function tests and orbital magnetic resonance imaging, were unremarkable. Given the inconclusive findings, upper blepharoplasty was performed for both therapeutic and diagnostic purposes. Histopathologic analysis revealed dermal basophilic deposits consistent with HA, with no inflammatory reaction. Only after surgery did the patient recall undergoing temporal filler injections 2 years earlier. This case illustrated the resilience and migration potential of HA fillers-especially when injected into avascular gliding planes such as the temporal region-and the capacity for remote complications. Unlike other documented cases involving direct periorbital injection and successful hyaluronidase resolution, our case required surgical intervention due to delayed diagnosis. Clinicians must maintain a high index of suspicion for HA-related complications, even when symptoms manifest far from the typical injection site and long after the procedure. Thorough aesthetic history-taking is essential to avoid misdiagnoses such as thyroid orbitopathy or Melkersson-Rosenthal syndrome. To our knowledge, this is the first reported case of chronic upper eyelid edema secondary to temporal HA filler injection, and we advocate for greater awareness of this presentation within the aesthetic and ophthalmologic communities.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7612"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646276","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 Use of Machine Learning to Enable Objective Assessment of Surgical Outcomes in Sagittal Craniosynostosis.","authors":"Saskia I H M Brulleman, Luke Smith, Alexander J Rickart, Lara S van de Lande, Noor Ul Owase Jeelani, David J Dunaway, Silvia Schievano, Simone Foti, Juling Ong","doi":"10.1097/GOX.0000000000007583","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007583","url":null,"abstract":"<p><strong>Background: </strong>Sagittal craniosynostosis (SC) is the most common type of isolated craniosynostosis, resulting in premature fusion of the sagittal suture and a scaphocephalic head shape. Surgical interventions, such as spring-assisted cranioplasty (SAC) and open calvarial vault remodeling (CVR), are often required to normalize skull morphology and improve functional outcomes. The Swap Disentangled Variational Autoencoder (SD-VAE) was used for the objective assessment of the SC phenotype and quantification of surgical outcomes after SAC and CVR, focusing on global and regional head shape relative to a healthy population.</p><p><strong>Methods: </strong>A dataset of computed tomography, magnetic resonance imaging, and 3-dimensional photographs was used to train the SD-VAE on preoperative SC patients and healthy controls. Paired pre- and postoperative scans were analyzed to evaluate surgical outcomes. Data augmentation addressed class imbalance, and linear and quadratic discriminant analyses were used to visualize, classify, and quantify head shape morphology relative to the healthy norm.</p><p><strong>Results: </strong>For training, scans of 108 healthy children and 239 preoperative SC patients were included, with 21 CVR and 37 SAC pre- and postoperative pairs for evaluating surgical outcomes. The SD-VAE accurately distinguished SC patients from healthy controls based on global and regional morphology. Both SAC and CVR resulted in head shape normalization, with region-specific differences in effectiveness.</p><p><strong>Conclusions: </strong>By providing objective, global, and region-specific analysis of head shape and surgical outcomes, the SD-VAE enhances understanding of the SC phenotype and supports standardized outcome assessment. Future work will explore predictive applications and integration into clinical workflows for patient counseling and surgical planning.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7583"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646301","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":"Effectiveness of the Implementation of a Bundle Protocol for the Reduction of Postmastectomy Reconstruction Failures.","authors":"Celeste M Guillén Rodríguez, Alberto Jiménez Puente, Francisco Rivas Ruiz, Alejandro J Rohde Calleja, Antonio Rueda Domínguez, Beatriz Sánchez Jiménez, José C Maañón Di Leo","doi":"10.1097/GOX.0000000000007604","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007604","url":null,"abstract":"<p><strong>Background: </strong>Immediate breast reconstruction with implants after mastectomy offers significant clinical and psychological benefits. However, implant loss due to infection or complications remains a major concern. Variability in surgical practices may contribute to this issue. This study aims to evaluate whether implementing a standardized protocol (bundle) of intra- and postoperative measures reduces the rate of reconstruction failures within 12 months of surgery.</p><p><strong>Methods: </strong>A retrospective observational cohort study was conducted at a single institution, including 102 patients who underwent 119 implant-based breast reconstructions between January 2022 and May 2024. Outcomes were compared before and after implementation of a surgical bundle designed to minimize infection and complications. The bundle included measures such as intraoperative sterility practices, implant handling protocols, and prolonged antibiotic prophylaxis. The primary endpoint was the rate of implant loss and moderate-to-major complications. Multivariate logistic regression was used to assess associations between bundle implementation and outcomes.</p><p><strong>Results: </strong>Patients in the postbundle group had significantly fewer moderate-to-major complications (6.8% versus 24.6%, <i>P</i> = 0.008) and lower rates of implant loss (3.4% versus 14.8%). Bundle implementation was associated with a 6.4-fold reduction in the odds of experiencing a moderate or major complication (odds ratio, 6.40; 95% confidence interval, 1.81-22.62). No significant differences were found in baseline clinical characteristics between groups.</p><p><strong>Conclusions: </strong>Implementing a standardized protocol significantly reduced complications and implant loss in immediate postmastectomy reconstruction. These findings support adopting surgical safety measures to improve reconstructive outcomes. Further multicenter studies are needed to confirm long-term effectiveness.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7604"},"PeriodicalIF":1.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634173","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":"Histomorphologic Assessment of Osteoregeneration in a Rabbit Femur Model With Xenograft, Bone Morphogenetic Protein-2, Platelet-Rich Plasma, and Denosumab.","authors":"Berik Tuleubayev, Yevgeniy Kamyshanskiy, Yerkin-Dauir Kurmangaliyev, Amina Koshanova, Ivan Avromidi, Yekaterina Kossilova, Daryn Darybayev","doi":"10.1097/GOX.0000000000007593","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007593","url":null,"abstract":"<p><strong>Background: </strong>This study investigated whether the combination of thermally processed bone xenograft (XG) and recombinant human bone morphogenetic protein-2 (rhBMP-2) with platelet-rich plasma (PRP) or Prolia (denosumab) can enhance bone regeneration in a rabbit femoral bone defect model.</p><p><strong>Methods: </strong>Seventy-two rabbits with created femoral bone defects (5 mm) were divided into 4 groups: (1) XG + rhBMP-2 + Prolia; (2) XG + rhBMP-2 + PRP; (3) XG + rhBMP-2; and (4) XG. At 14, 30, and 60 days after implantation, samples were prepared for histological and histomorphometric analysis.</p><p><strong>Results: </strong>Histomorphometrically, on day 30, there were no statistically significant differences between groups regarding the amount of newly formed bone (<i>P</i> = 0.2231), but a reduction in residual graft in the intramedullary space was observed in the PRP group. On day 60, more intense formation of new bone with reduced intragroup variation in the amount of newly formed bone was found in the XG + rhBMP-2 + PRP group (<i>P</i> < 0.001). At day 60, XG + rhBMP-2 + Prolia showed no cortical bone increase because of concurrent resorption.</p><p><strong>Conclusions: </strong>Combined therapy using thermally processed bone graft, rhBMP-2, and PRP improves bone healing in femoral defects in rabbits.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7593"},"PeriodicalIF":1.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634130","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":"Reflections From 2-week Visit at the Reconstructive Microsurgical Center of Chang Gung Memorial Hospital.","authors":"Hatan Mortada","doi":"10.1097/GOX.0000000000007632","DOIUrl":"https://doi.org/10.1097/GOX.0000000000007632","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 4","pages":"e7632"},"PeriodicalIF":1.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634183","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}