JPRAS Open最新文献

{"title":"Autologous fibroblast therapy for facial rejuvenation: A randomized open-label controlled study","authors":"Pietro Gentile","doi":"10.1016/j.jpra.2026.05.045","DOIUrl":"10.1016/j.jpra.2026.05.045","url":null,"abstract":"<div><h3>Background</h3><div>The aging process of the face is characterized by dermal thinning, loss of elasticity, and wrinkle formation. Injection of autologous micrografts containing fibroblasts (Am-FBs) has emerged as a promising regenerative technique.</div></div><div><h3>Objectives</h3><div>This trial aims to assess the efficacy and safety of Am-FBs for facial rejuvenation.</div></div><div><h3>Methods</h3><div>A randomized, open-label, controlled study was conducted. Forty patients presenting with mild to moderate dermal thinning, reduced elasticity, and wrinkles were divided into two groups: a study group (SG; n = 20) that received Am-FBs treatment and a control group (CG; n = 20) treated with a hyaluronic acid (HA)–based skin booster. Both groups received treatment at baseline (T0), at one month (T1), and at three months (T2). Clinical outcomes were evaluated at T1, T2, T3 (6 months), and T4 (12 months) through patient and physician evaluations, the Wrinkle Severity Rating Scale (WSRS), and objective skin elasticity metrics. <em>In vitro</em> evaluation of the Am-FBs and immunophenotypic characterization of the nucleated cell population contained in the Am-FBs suspension was performed.</div></div><div><h3>Results</h3><div>At T4, the SG showed significantly greater improvements in wrinkle depth, skin elasticity, and WSRS score than the CG (<em>p</em> &lt; 0.01). The physician’s evaluation showed scores ranging from 9 to 4 (<em>p</em> = 0.049), whereas patient self-assessments ranged from 9 to 5 (<em>p</em> = 0.039). Patient satisfaction was higher in the SG. The in vitro analysis documented 2.780.750 nucleated cells/ml in Am-FBs with a viability of 89.61% and immunophenotype: CD34%0.2, CD45%0.2, CD44%98.7, CD200%80.0, Cytokeratin 15%99.4.</div></div><div><h3>Conclusions</h3><div>Am-FBs significantly improve signs of facial aging and present a safe option for skin rejuvenation.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 632-644"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309866","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":"Response to correspondence on: “Neurolymphatic clearance in neurodegenerative disease: Emerging mechanisms and potential translational strategies”","authors":"Adriano Fabi,&nbsp;Raphael Guzman,&nbsp;Marc Aurel Busche,&nbsp;Elisabeth A. Kappos","doi":"10.1016/j.jpra.2026.03.036","DOIUrl":"10.1016/j.jpra.2026.03.036","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 718-719"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391883","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":"Effect of Pterygomasseteric sling shortening via mandibular angle resection on postoperative skeletal stability in skeletal class III malocclusions treated with mandibular setback surgery","authors":"Le Tan Hung,&nbsp;Pham Trinh Quoc Khanh,&nbsp;Le Duc Lanh,&nbsp;Tran Ai Khiem,&nbsp;Nguyen My Huyen,&nbsp;Vo Ke Dat","doi":"10.1016/j.jpra.2026.05.035","DOIUrl":"10.1016/j.jpra.2026.05.035","url":null,"abstract":"<div><div>Postoperative skeletal stability issues are frequently attributed to the tension exerted by the pterygomasseteric muscle sling following mandibular setback. This study investigated the hypothesis that simultaneous mandibular angle resection during Bilateral Sagittal Split Ramus Osteotomy (BSSRO) enhances skeletal stability by reducing this muscular tension.</div><div>A prospective randomised controlled study was conducted on 20 patients with Skeletal Class III malocclusion - characterised by mandibular prognathism. The study sample was equally divided into an experimental group <em>(4 males, 6 females; mean age 23.6</em> <em>±</em> <em>3.9 years)</em> undergoing the combined procedure (BSSRO with simultaneous mandibular angle ostectomy), and a control group <em>(5 males, 5 females; mean age 20.4</em> <em>±</em> <em>3.4 years)</em> receiving isolated ramus osteotomy (conventional BSSRO setback only). Lateral cephalometric tracings were utilised to quantify the horizontal and vertical positional changes of the mental region, specifically at Point B, Pogonion and Menton, during the 3-month postsurgical healing phase.</div><div>The results indicated a significant divergence in remodelling between the two groups. The control group characterised anterior relapse (B: +1.35 ± 1.50 mm; Pog: +0.81 ± 2.92 mm), whereas the experimental group demonstrated a stabilising posterior settling effect (Point B: -1.44 ± 1.93 mm; Pog: -1.14 ± 4.06 mm).</div><div>These findings substantiate that resecting the mandibular angle effectively shortens the pterygomasseteric sling, thereby alleviating the muscular tension responsible for skeletal rebound. Consequently, simultaneous angle ostectomy during Surgery-First Orthognathic Approach (SFOA) mandibular setback protocol is advocated not merely as an aesthetic contouring procedure for lower facial width reduction, but as a functional release of the pterygomasseteric sling that significantly improves early skeletal stability, suggesting a larger study with Class II malocclusions as well or other types of skeletal deformity</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 621-631"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309904","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":"Exosome therapy for flap and skin graft survival: A systematic review and meta-analysis of preclinical evidence","authors":"Alexander A.W. Perkasa-Hendropriyono,&nbsp;David S. Perdanakusuma,&nbsp;Dwikora N. Utomo,&nbsp;Budiman Budiman,&nbsp;Sepehr S. Lajevardi,&nbsp;Gazi Hussain,&nbsp;Anand K. Deva","doi":"10.1016/j.jpra.2026.05.042","DOIUrl":"10.1016/j.jpra.2026.05.042","url":null,"abstract":"<div><div>Flap necrosis and graft failure remain significant sources of morbidity in reconstructive and aesthetic surgery, yet no cell-free biological adjunct has been established to improve tissue survival after transfer. Exosomes are nano-sized extracellular vesicles capable of simultaneously modulating angiogenesis, inflammation, apoptosis, and oxidative stress, and have been investigated as candidate regenerative adjuncts in plastic surgery. This PROSPERO-registered systematic review and meta-analysis (CRD420251146650), conducted per PRISMA 2020, searched PubMed, OVID, Scopus, Web of Science, and Google Scholar through September 2025 and included 24 animal studies (19 flap; 5 skin graft). Flap and graft studies were analysed as separate populations. Random-effects meta-analysis suggested increased flap survival (<em>k</em> = 19; MD 35.54%; 95% CI 25.11–45.97; <em>p</em> &lt; 0.0001) and angiogenesis (<em>k</em> = 19; SMD 3.60; 95% CI 2.66–4.54; <em>p</em> &lt; 0.00001). However, heterogeneity was extreme (I² 76–97%), and funnel plot asymmetry with significant Egger's tests (both <em>p</em> &lt; 0.001) indicated substantial small-study effects; the true effect is likely considerably smaller than these pooled estimates suggest, which should therefore be interpreted with caution. Perfusion, VEGF expression, and apoptosis generally favoured exosomes in narrative synthesis. In skin graft models, 4 of 5 studies reported improved graft take by days 10–14, but certainty was low. Allocation concealment was unreported in all studies and blinding unclear in most, representing a major methodological limitation that may further inflate observed effects. Preclinical evidence provides a biological rationale, but findings remain exploratory and hypothesis-generating. Standardised preclinical replication is required before clinical translation can be considered.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 665-684"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353966","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":"Beyond the battlefield: The legacy of Archibald McIndoe and the Guinea Pig Club","authors":"Angelo Federico","doi":"10.1016/j.jpra.2026.05.043","DOIUrl":"10.1016/j.jpra.2026.05.043","url":null,"abstract":"<div><div>Originally founded in 1941 during the Second World War, the Guinea Pig Club was a group composed of airmen that sustained severe burn injuries during the war. During this time, the field of reconstructive surgery was still developing and available reconstructive options were extremely limited. Here, we explore the revolutionary advancements in burn care and reconstructive surgery pioneered by Sir Archibald McIndoe, as well as expand on the legacy of the Guinea Pig Club.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 617-620"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309832","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 open book abdominoplasty: a vertical scar technique for abdominal wall reconstruction in massive weight loss patients","authors":"Eddy Dona","doi":"10.1016/j.jpra.2026.05.044","DOIUrl":"10.1016/j.jpra.2026.05.044","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the Open Book Abdominoplasty, a form of vertical abdominoplasty used in selected massive weight loss patients, and to evaluate clinical outcomes.</div></div><div><h3>Methods</h3><div>A retrospective review was performed of all consecutive patients who underwent the Open Book Abdominoplasty between June 2021 and December 2024. All patients with a BMI under 35 were included in this study, with patient demographics, operative details, outcomes, and complications analysed.</div></div><div><h3>Results</h3><div>53 patients were identified for this study, with 27 patients having a BMI below and 30, and 26 with a BMI between 30 and 34.9. The mean patient age was 40.5 years. The mean preoperative weight loss was 43.5 kg, with 39 patients achieving weight loss following bariatric surgery. Fourteen patients underwent Open Book Abdominoplasty alone, while 39 underwent combined procedures, including breast surgery (n=27), bra lipectomy (n=14), and belt lipectomy (n=7). The mean resection weight was 4.3 kg. The overall complication rate was 9.4%, including seroma (3.8%), haematoma (1.9%), and wound complications with delayed healing (3.8%).</div></div><div><h3>Conclusions</h3><div>The Open Book Abdominoplasty is a vertical abdominoplasty technique incorporating a vertical scar for massive weight loss patients. It allows management of significant abdominal wall laxity and, when combined with adjunctive procedures, facilitates treatment of multidirectional circumferential torso excess with reproducible outcomes in appropriately selected patients.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 645-658"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333507","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":"Shoulder contouring with botulinum toxin and fillers","authors":"Kyu-Ho Yi,&nbsp;Isabella Rosellini,&nbsp;Kang Hoon Choi,&nbsp;Han Earl Lee","doi":"10.1016/j.jpra.2026.05.054","DOIUrl":"10.1016/j.jpra.2026.05.054","url":null,"abstract":"<div><h3>Background</h3><div>Interest in shoulder aesthetics has increased, with emphasis on clavicular definition and balanced shoulder contour. Minimally invasive approaches combining hyaluronic acid fillers and botulinum toxin type A (BoNT-A, Letibo, Hugel, Korea) have been proposed to address both structural and muscular components.</div></div><div><h3>Methods</h3><div>This technical note describes three patients who underwent combined acromial and clavicular filler injections with BoNT-A administered to the upper trapezius and deltoid regions for shoulder contour refinement. Filler volume was individualized according to baseline shoulder slope, clavicular/acromial projection deficiency, soft-tissue thickness, and the degree of asymmetry, with total volumes of 10, 12, and 15 cc. BoNT-A was administered as 25 units distributed across five anatomically defined injection points. Outcomes were assessed by standardized clinical photography, clinical follow-up, patient-reported satisfaction, and adverse-event grading using the Common Terminology Criteria for Adverse Events framework.</div></div><div><h3>Results</h3><div>All three patients demonstrated visible, qualitative improvement in shoulder contour, including enhanced clavicular definition and reduced trapezius prominence. Patient-reported satisfaction was favorable in all cases. No major complications were observed. Minor adverse events, including transient swelling and discomfort, were classified as mild CTCAE grade 1 events and resolved without intervention.</div></div><div><h3>Conclusions</h3><div>This three-case technical note illustrates a feasible anatomy-guided multimodal approach for shoulder contour refinement. Because of the very small sample size, lack of a control group, and predominantly qualitative outcome assessment, these observations should not be interpreted as evidence of efficacy, safety, or generalizability. Larger controlled studies with standardized morphometric measurements, validated patient-reported outcome instruments, and longer follow-up are required.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 712-717"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346606","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":"Free adipomuscular diagonal upper gracilis flap as volume replacement for reconstruction of partial breast defect in the medial upper quadrant","authors":"RJ Erdbrink Reinoud,&nbsp;J. Nick Brinkman","doi":"10.1016/j.jpra.2026.05.034","DOIUrl":"10.1016/j.jpra.2026.05.034","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of the gracilis flap has been extensively described for whole breast reconstruction, however its application as volume replacement for partial breast defects has only scarcely been described. This short communication covers two patient cases in which a free adipomuscular diagonal upper gracilis (DUG) flap is used as volume replacement for reconstruction of a partial breast defect in the medial upper quadrant of the breast following lumpectomy.</div></div><div><h3>Case introduction</h3><div>Both patients are healthy middle-aged women who presented themselves with a breast malignancy in the upper medial quadrant of the left breast. Because of the tumor location, their small-to-moderate breast size and nonptotic breasts a free flap reconstruction was selected using a free diagnonal upper gracilis flap.</div></div><div><h3>Methods/Surgery technique</h3><div>In both patients the flap was harvested conform current techniques.</div></div><div><h3>Results</h3><div>Both flaps were successful with no evidence of (partial) flap loss. In one patient a wound dehiscence of the donor site was reported, which healed over time by secondary intention. Scar revision surgery was performed to improve the aesthetic appearance of the donor site. Both patients reported high satisfaction with their reconstructions, though the second patient has not yet underwent radiotherapy of the operated breast.</div></div><div><h3>Conclusion</h3><div>The free adipomuscular gracilis flap represents a valuable option for volume replacement in partial breast reconstruction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 659-664"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353910","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":"Virtual surgical planning guided osteotomy in facial feminization surgery","authors":"Hester Elizabeth Lacey,&nbsp;Yi Min Khoong,&nbsp;Keith Altman","doi":"10.1016/j.jpra.2026.05.039","DOIUrl":"10.1016/j.jpra.2026.05.039","url":null,"abstract":"<div><h3>Background</h3><div>Osseous facial feminization surgery (FFS) requires precision to accurately modify craniofacial skeletal features and achieve optimal aesthetic and functional outcomes. Virtual surgical planning (VSP) has emerged as a tool to enhance preoperative planning and intraoperative accuracy in FFS. This systematic review aims to evaluate the role of VSP in guiding osteotomy during osseous FFS, assessing operative efficiency, accuracy, safety, and satisfaction, and describe potential future applications.</div></div><div><h3>Methods</h3><div>A systematic review was conducted in accordance with PRISMA guidelines and the Cochrane Handbook. MEDLINE, EMBASE, Global Health, Scopus, Web of Science, Cochrane Central Library, and grey literature sources were searched in April 2025. Eligible studies included adult transgender women undergoing osseous FFS procedures with VSP guidance. Outcomes assessed included planning time, operative time, accuracy, safety/complication rates, and patient-reported satisfaction or femininity perception. Meta-analysis was performed for operative time using standardised mean difference (SMD).</div></div><div><h3>Results</h3><div>Seven studies met inclusion criteria. Meta-analysis demonstrated significantly reduced operative time with VSP compared to conventional techniques (SMD = −0.72; 95 % CI −1.13 to −0.32; P &lt; 0.05). Planning time varied substantially across studies reporting this data (5–10, 145 ± 13.2 min), reflecting heterogeneity in outcome reporting, software platforms used and workflow integration. Accuracy outcomes favoured VSP, with one comparative study reporting 95.25 ± 4.09 % accuracy with VSP versus 78.25 ± 12.92 % without. Reported complication rates were low (0–1.77 %), though comparative safety data were limited. Patient satisfaction and cosmetic outcomes were consistently high, though assessed using heterogeneous tools precluding pooled analysis.</div></div><div><h3>Conclusions</h3><div>Current evidence suggests that VSP in osseous FFS is associated with reduced operative time, improved osteotomy accuracy, and favourable safety and patient-reported outcomes. Although methodological heterogeneity and limited comparative data constrain definitive conclusions, findings support an expanding role for VSP in precision-driven craniofacial gender-affirming surgery. Emerging integration of augmented reality (AR)-assisted intraoperative navigation may further enhance anatomical accuracy and surgical safety. Prospective comparative studies with standardised outcome measures and validated patient-reported instruments are required to define the long-term clinical and economic value of VSP and AR in FFS.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 699-711"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353936","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":"Response to ‘Correspondence On “Venous thromboembolism prophylaxis regimen for patients undergoing deep inferior epigastric perforator flap breast reconstruction”’","authors":"Taylor Kreul,&nbsp;Janelle Rodriguez,&nbsp;Michel Saint-Cyr","doi":"10.1016/j.jpra.2026.05.007","DOIUrl":"10.1016/j.jpra.2026.05.007","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 720-721"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391901","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}