Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Time to final breast reconstruction: Effect on quality of life and associated factors","authors":"Unser Jaffry ,&nbsp;Catherine Bienert ,&nbsp;Dennis G. Foster ,&nbsp;Charalampos Siotos ,&nbsp;Michele A. Manahan ,&nbsp;Samuel Sarmiento","doi":"10.1016/j.bjps.2025.05.029","DOIUrl":"10.1016/j.bjps.2025.05.029","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer patients often undergo prolonged periods of care due to chemotherapy, radiation, and multiple breast reconstruction procedures. The time to final reconstruction (TTFR) after mastectomy can span years, during which time patients may experience reduced quality of life (QoL). However, the relationship between prolonging this interval and long-term QoL is unclear.</div></div><div><h3>Methods</h3><div>We analyzed a prospectively collected registry of patients who received breast reconstruction at our institution. We obtained data for patients meeting the following criteria: received breast reconstruction between 2010 and 2015; had at least 12 months of Breast-Q follow-up; and for whom TTFR was available. Patients who received final breast reconstruction on the same day as mastectomy were excluded.</div></div><div><h3>Results</h3><div>We identified 198 female patients. The median time to final reconstruction was 199 days. Women with a BMI of ≥35 kg/m² experienced the longest interval (936 days; p=0.001). African-American women also experienced greater delays (mean: 527 days; p=0.05). Women undergoing autologous reconstruction experienced a significantly greater delay compared to implant-based or fat grafting (325 days; p=0.02). However, this did not hold in the adjusted model. Compared to staged, women undergoing delayed reconstruction waited the longest (mean: 1269 days; p&lt;0.001). Regarding QoL, a linear regression revealed reductions across all domains per each day of delay in final reconstruction.</div></div><div><h3>Conclusion</h3><div>A longer interval between mastectomy and final reconstruction may be associated with decreases in QoL outcomes. Factors including mastectomy type, reconstruction type, and patient demographics may impact this interval. These factors are worth considering when discussing reconstruction options.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 203-212"},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priced out of progress: The financial strain of plastic surgery conferences on medical students","authors":"John A. Toms ,&nbsp;Daniel Najafali ,&nbsp;Elizabeth S. O’Neill ,&nbsp;Shahood Fazal ,&nbsp;Jubril Adepoju","doi":"10.1016/j.bjps.2025.05.030","DOIUrl":"10.1016/j.bjps.2025.05.030","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 187-190"},"PeriodicalIF":2.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal technique of perineal reconstruction following extralevator abdominoperineal excision: A systematic review","authors":"Hamish Thomson ,&nbsp;Tharenya Uthayakumar ,&nbsp;Anirban Mandal","doi":"10.1016/j.bjps.2025.05.025","DOIUrl":"10.1016/j.bjps.2025.05.025","url":null,"abstract":"<div><div>The optimal method of perineal reconstruction following extralevator abdominoperineal excision (ELAPE) is a debated topic among plastic surgeons, with current options including direct closure, biological mesh, flaps or a combination. This systematic review was conducted in accordance with the PRISMA guidelines to evaluate the available medical literature on the optimal modality of perineal reconstruction. We hypothesised that the use of flaps is the superior method, with complex cases requiring the use of an additional flap or incorporation of a supporting biological mesh. The specific outcomes of each reconstruction modality assessed included the a) length of hospital stay, b) perineal complications, c) hernias, d) recurrence, e) mortality and f) functional outcomes. A comprehensive search of the MEDLINE and EMBASE databases yielded 1081 articles. Following independent screening using a PICOT framework-guided inclusion and exclusion criteria, and a subsequent quality assessment, 21 papers were incorporated into the review for qualitative analysis; Among the 21 papers, 15 were retrospective cohort studies, 4 were prospective cohort studies, 1 was an observational cohort study and 1 was a randomised control trial. The literature suggests that when used exclusively, flaps and biological meshes achieved a higher percentage of fully healed perineum without complications compared to flap–mesh or flap–flap hybrids. However, these findings are inconclusive and undermined by several critical limitations. Further long-term randomised control trials are required to determine the superior method for perineal reconstruction.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 223-233"},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast implant-associated malignancies: Do plastic surgeons have the awareness?","authors":"Thomas H. Jovic,&nbsp;Mohamed Abdelrazek,&nbsp;Amenah Dhannoon,&nbsp;Reza Arya","doi":"10.1016/j.bjps.2025.05.027","DOIUrl":"10.1016/j.bjps.2025.05.027","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 156-157"},"PeriodicalIF":2.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding: “Prevalence of contralateral lymphatic drainage patterns during sentinel lymph node biopsy for truncal melanoma: A retrospective, observational study”","authors":"Aurada Jitworawisut,&nbsp;Reiko Tsukuura","doi":"10.1016/j.bjps.2025.05.026","DOIUrl":"10.1016/j.bjps.2025.05.026","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 191-192"},"PeriodicalIF":2.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic representation in AI-generated faces: An exploratory analysis","authors":"Antoinette T. Nguyen ,&nbsp;Rena A. Li ,&nbsp;Emily D. Duckworth ,&nbsp;May X. Li ,&nbsp;Robert D. Galiano","doi":"10.1016/j.bjps.2025.05.021","DOIUrl":"10.1016/j.bjps.2025.05.021","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 160-163"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter comments on “Scarpa fascia preservation abdominoplasty combined with precise liposuction for postpregnancy abdomen: A 10-year experience” Refining abdominoplasty: The role of adjunctive technologies in enhancing aesthetic and vascular safety","authors":"Albanese Roberta,&nbsp;Tomaselli Federica,&nbsp;Tambasco Damiano","doi":"10.1016/j.bjps.2025.04.054","DOIUrl":"10.1016/j.bjps.2025.04.054","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 158-159"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of antibiotic-impregnated discs in breast reconstruction among the obese population: A retrospective propensity score-matched analysis","authors":"Christian Palacios ,&nbsp;Sophia Salingaros ,&nbsp;Devi Lakhlani ,&nbsp;Max Silverstein ,&nbsp;Tooba Riaz ,&nbsp;Kathryn Kamperman ,&nbsp;Brian Thornton ,&nbsp;Chris M. Reid ,&nbsp;Rahim Nazerali","doi":"10.1016/j.bjps.2025.05.020","DOIUrl":"10.1016/j.bjps.2025.05.020","url":null,"abstract":"<div><div>Two-stage breast reconstruction is a well-established post-mastectomy surgical technique. Unfortunately, periprosthetic infections in tissue expanders remain a prevalent concern. Antibiotic-impregnated polymethylmethacrylate (PMMA) plates for infection prophylaxis in TE–based reconstruction have been shown to lower infection rates. With the growing obesity epidemic in the US, this propensity-score matched retrospective study aimed to evaluate the impact of PMMA plates on the obese population. A retrospective chart review was performed for patients with a BMI of 30 and above to record patient demographics, complications, operative details, and post-operative details. One-to-one propensity score matching was used to match the intervention and control group on age, diabetes status, smoking status, neoadjuvant chemotherapy, prior radiation history, and laterality of breast reconstruction, resulting in 48 patients in each group. Chi-squared analysis, and Barnard exact tests assessed significant differences between groups and infection rates. T-tests compared the normally distributed continuous variables. Logistic regression controlled for confounders that have been reported in previously published literature. Chi-square analysis revealed a significant association between PMMA plate usage and infection rate (4.2% compared to 16.7%; p = 0.045). Logistic regression analysis found that the PMMA antibiotic plate group had a statistically significant decrease in infection rate (OR: 0.18 [0.033–0.962]; p = 0.045). Though antibiotic-impregnated PMMA plates have demonstrated effective infection prophylaxis in the general population, this study is the first to explore their use in the obese population. Within our cohort, placing an antibiotic plate resulted in a reduced infection rate.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 246-253"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social support holds protective value in breast reconstruction","authors":"Jacquelyn Roth,&nbsp;Bernice Z. Yu,&nbsp;Ethan Fung,&nbsp;Carol Wang,&nbsp;Maxwell Godek,&nbsp;Peter J. Taub","doi":"10.1016/j.bjps.2025.05.018","DOIUrl":"10.1016/j.bjps.2025.05.018","url":null,"abstract":"<div><h3>Background</h3><div>Social support is a recognized determinant of surgical outcomes, yet its specific impact on breast reconstruction remains unclear. The present study sought to evaluate the associations between relationship status, household composition, and the presence of support person(s) preoperatively on outcomes in breast reconstruction patients.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on breast reconstruction patients at a single institution from 2017 to 2023. The primary outcome assessed was post-operative complications. Univariable and multivariable regression analyses evaluated associations between social support characteristics and outcomes.</div></div><div><h3>Results</h3><div>Of the 1466 patients included in the study, 910 patients (62.1%) had a partner, while 556 patients (37.9%) did not; when stratified by living arrangement, 1254 patients (85.6%) lived with others, while 212 patients (14.4%) lived alone; when stratified by the presence of a support person, 1015 patients (69.2%) were accompanied at visits, while 451 (30.8%) patients were alone. Univariate regression showed that having a partner was associated with significantly reduced odds of any complication (OR: 0.712, p=0.002), dehiscence (OR: 0.480, p&lt;0.001), and necrosis (OR: 0.699, p=0.013). On multivariate analysis, controlling for patient demographics, procedure type and laterality, having a partner continued to predict any complication (aOR: 0.760, p=0.023) and dehiscence (aOR: 0.491, p&lt;0.001). Having a support person at visits and living arrangements were not predictive of any complications on regression analysis.</div></div><div><h3>Conclusion</h3><div>Having a partner predicts fewer complications following breast reconstruction, highlighting the role of social support in optimizing recovery. Incorporating social support assessments into preoperative care may reduce disparities and improve patient outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 213-220"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial reanimation in Moebius syndrome – 25-Year experience in treating bilateral facial paralysis","authors":"Paul Panzenbeck ,&nbsp;Cédric Zubler ,&nbsp;Edel de Buitleir ,&nbsp;Adriaan Ockert Grobbelaar ,&nbsp;Jonathan Ian Leckenby","doi":"10.1016/j.bjps.2025.05.013","DOIUrl":"10.1016/j.bjps.2025.05.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Moebius syndrome is a rare congenital neurological disorder characterised by bilateral facial (VII) and abducens (VI) nerve palsies, resulting in facial paralysis and impaired ocular abduction. Additional cranial nerve involvement and anomalies, such as limb deformities and neurodevelopmental abnormalities, complicate its presentation. Facial reanimation using a free functional muscle transfer is the gold standard for restoring movement and improving psychosocial outcomes. This study presents over 25 years of surgical experience in facial reanimation for Moebius syndrome management.</div></div><div><h3>Patients and methods</h3><div>A retrospective analysis of patients with Moebius syndrome who underwent bilateral facial reanimation between 1998 and 2023 was conducted. Outcomes were assessed using a surgeon’s score, independent panel scoring with the Hay’s rating scale and evaluation of spontaneous smile. We describe our surgical technique, key aspects of post-operative therapy and potential pitfalls.</div></div><div><h3>Results</h3><div>Overall, 56 patients (30 women and 26 men) underwent facial reanimation. Among them, 49 had complete Moebius syndrome. Partial latissimus dorsi muscle flaps were used in 93% of the cases, with the masseteric nerve as the neural input (91%). Facial symmetry and function were rated as excellent (n=43) or good (n=11) in 96% of the patients. A spontaneous smile was achieved in 59% of the cases, with the best outcomes in masseteric-innervated latissimus dorsi transfers.</div></div><div><h3>Conclusion</h3><div>Bilateral free functional muscle transfers are the gold standard for facial reanimation in Moebius syndrome management, yielding significant functional and aesthetic improvements, especially in children. We recommend performing bilateral facial reanimation as a single-stage procedure due to its physical and psychological benefits for this patient population.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 238-245"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}