Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"National trends and outcomes of same-day discharge after direct-to-implant breast reconstruction: A 15-year NSQIP analysis","authors":"Martin Kauke-Navarro ,&nbsp;Samuel Knoedler ,&nbsp;Felix J. Klimitz ,&nbsp;Juan Lizardi ,&nbsp;Omar Allam ,&nbsp;Fortunay Diatta ,&nbsp;Zachary Gala ,&nbsp;Elizabeth Berger ,&nbsp;Thomas Schaschinger ,&nbsp;Julius M. Wirtz ,&nbsp;Zvjezdana Milacak ,&nbsp;P. Niclas Broer ,&nbsp;Siba Haykal ,&nbsp;Bohdan Pomahac","doi":"10.1016/j.bjps.2025.09.002","DOIUrl":"10.1016/j.bjps.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Same-day discharge following direct-to-implant (DTI) breast reconstruction is increasingly common; however, large-scale outcome studies are scarce. This study evaluated the trends and postoperative outcomes in patients who were discharged on the same day following DTI.</div></div><div><h3>Methods</h3><div>We analyzed female patients with breast cancer who underwent DTI breast reconstruction from 2008–2023 using their data from the National Surgical Quality Improvement Program database. Patients were grouped by length of stay (LOS = 0 days (no overnight stay) vs. LOS &gt; 0 days (with overnight stay)). Primary outcomes included 30-day surgical and medical complications, reoperations, and readmissions. Propensity score matching and inverse probability of treatment weighting were used to adjust for baseline differences between the 2 cohorts.</div></div><div><h3>Results</h3><div>Among 11,505 cases, 2457 (21.4%) patients were discharged the same day. Compared to inpatients, same-day discharge patients were on an average younger (mean age 51.2 vs. 53.4 years, <em>p</em> &lt; 0.001) and had lower BMI (mean 26.9 vs. 28.1 kg/m², <em>p</em> &lt; 0.001). After statistical adjustment for baseline patient differences, same-day discharge was associated with lower odds of any complication (OR 0.79, 95% CI 0.72–0.87, <em>p</em> &lt; 0.001), reoperation (OR 0.72, 95% CI 0.63–0.82, <em>p</em> &lt; 0.001), and readmission (OR 0.70, 95% CI 0.61–0.81, <em>p</em> &lt; 0.001). There was no increase in surgical or medical complications in the same day discharge cohort.</div></div><div><h3>Conclusions</h3><div>Same-day discharge after DTI breast reconstruction was safe, with no increase in short-term complications, among appropriately selected patients based on clinical and demographic factors. These findings support same day discharge after DTI in selected patients.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 147-155"},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227684","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":"Late secondary alveolar bone grafting using autologous versus alloplastic material for treating patients with cleft lip and palate with one year follow-up—A retrospective comparative study","authors":"Amrit Thapa ,&nbsp;Saugat Ray ,&nbsp;B. Jayan ,&nbsp;S.S. Chopra ,&nbsp;B.S. Walia ,&nbsp;Abhijeet Kadu ,&nbsp;Kapil Tomar","doi":"10.1016/j.bjps.2025.09.003","DOIUrl":"10.1016/j.bjps.2025.09.003","url":null,"abstract":"<div><div>Cleft lip and palate (CLP) frequently require secondary alveolar bone grafting (SABG) to restore maxillary continuity and support orthodontic tooth movement. The choice of graft material influences the long-term outcomes, especially in late SABG cases. This retrospective study compared autogenous iliac crest bone grafts to a composite of demineralized freeze-dried bone allograft (DFDBA) and platelet-rich fibrin (PRF) in patients with unilateral CLP (UCLP) with residual alveolar clefts. Twenty-six patients (≥15 years) were divided equally into two groups: Group A (iliac crest autograft) and Group B (DFDBA + PRF). All patients underwent pre- and 12-month post-operative cone beam computed tomography (CBCT). Volumetric analysis were used to quantify the regenerated bone volume, and statistical comparisons were made using independent t-tests with p &lt; 0.05 considered significant.</div><div>Baseline cleft volumes were similar between the groups (4.53 ± 0.61 cm³ vs. 4.53 ± 0.68 cm³, p = 0.962). After 12 months, the mean residual cleft volumes were 2.92 ± 0.58 cm³ (autograft) and 2.95 ± 0.54 cm³ (DFDBA + PRF), with no significant intergroup difference (p = 0.668). Mean graft fill was 35.1% ± 10.8 (autograft) and 38.3% ± 8.7 (DFDBA + PRF), both achieving up to 57% regeneration of the initial defect. Inter- and intra-observer reliability for CBCT measurements was excellent (ICC = 0.89–0.93). Findings indicated that DFDBA + PRF achieved bone regeneration comparable to iliac crest autografts in late SABG for UCLP, while avoiding donor site morbidity and hospitalization. Therefore, DFDBA + PRF is a clinically viable, less invasive alternative for selected patients, though longer-term prospective studies are warranted to confirm its stability.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 35-44"},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214855","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":"3D-printed bioresorbable polycaprolactone-tricalcium phosphate implant for mandible reconstruction: A biomechanical in-vivo evaluation","authors":"Elijah Z. Cai ,&nbsp;Kwan Yi Yap ,&nbsp;Zhi Peng Lee ,&nbsp;Jocelyn YH Yeo ,&nbsp;Yu Liu ,&nbsp;Zhi Xian Ong ,&nbsp;Hung Chew Wong ,&nbsp;Victor KM Lee ,&nbsp;Thiam Chye Lim","doi":"10.1016/j.bjps.2025.08.035","DOIUrl":"10.1016/j.bjps.2025.08.035","url":null,"abstract":"<div><h3>Background</h3><div>Large mandibular critical-sized defects commonly require free vascularized bone flaps. However, this procedure is associated with donor site morbidities and complex microsurgical procedures. An implant-based technique that can achieve similar reconstructive outcomes would be a valuable addition in a reconstructive surgeon’s armamentarium. This preliminary study evaluated 3D-printed polycaprolactone-tricalcium phosphate implant for reconstructing mandibular critical-sized defects using a porcine model.</div></div><div><h3>Methods</h3><div>Seven mandibular body critical-sized defects were created in 5 male Yorkshire-Landrace pigs (3 unilateral and 2 bilateral defects). These defects were reconstructed using polycaprolactone-tricalcium phosphate implants. The study endpoint was at 3 months. The reconstructed mandibular specimens were resected for evaluation. Ossification was evaluated using computed tomography scans and histology. Biomechanical strength was evaluated using the three-point bend test. The contralateral unoperated sides served as the controls.</div></div><div><h3>Results</h3><div>The animals retained normal mastication. All implants demonstrated ossification on computed tomography scans with a median of 24.1% (range 13.6–27.2%). Histological examination (using hematoxylin and eosin and Masson’s Trichrome stains) demonstrated new bone formation. The three-point bend test demonstrated a borderline significant difference in the maximum flexural force between the reconstructed mandibles and controls (p = 0.059), with a mean difference of 426.62 N (95% CI −16.57 to 869.81).</div></div><div><h3>Conclusion</h3><div>Using polycaprolactone-tricalcium phosphate implants in reconstructing mandibular critical-sized defects is safe and reliable. Polycaprolactone-tricalcium phosphate is bioresorbable, osteo-conductive, and osteo-inductive. It provides immediate functional restoration and mechanical strength under load-bearing situations.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 18-26"},"PeriodicalIF":2.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190006","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":"Lymphatic drainage of the trunk: Radiation induced no flow zone of mastectomy skin flaps—A cross-sectional study","authors":"Shayan M. Sarrami ,&nbsp;Michael Mazarei ,&nbsp;Meeti Mehta ,&nbsp;Jordan Fishman ,&nbsp;Carolyn De La Cruz","doi":"10.1016/j.bjps.2025.08.028","DOIUrl":"10.1016/j.bjps.2025.08.028","url":null,"abstract":"<div><div>Changes in the lymphatic flow from the trunk following mastectomy, sentinel lymph node biopsy, axillary lymph node dissection, and radiotherapy remain understudied. We aimed to illustrate the altered lymphatic drainage pathways of the trunk following breast cancer treatment. We conducted a retrospective review of patients with breast cancer who underwent truncal lymphography between December 2014 and January 2024. Using a standardized imaging protocol, we recorded dermal backflow patterns, zones of absent lymphatic flow, and drainage pathways to the surrounding lymph node basins. Patients were grouped into radiated or non-radiated cohorts based on their treatment history and lymphatic drainage patterns from the chest wall were compared. Among the 173 hemi-trunks (95 patients), 73 (42%) received radiation therapy. Absence of lymphatic flow in the superior and inferior mastectomy flaps was observed in 66% of the cases. Multivariable regression analysis, accounting for radiation, mastectomy, axillary lymph node dissection, and chemotherapy, revealed that radiation was associated with a 142% increase in the odds of absent lymphatic flow to the inferior flap (OR 2.42, confidence interval, 1.05–5.55, p=0.038). Additionally, the radiation group demonstrated a significant increase in contralateral axillary lymph node drainage. This study highlights the impact of radiation therapy on the lymphatic anatomy of the trunk, inducing the no flow zone in mastectomy flaps. These findings are clinically significant for reconstructive surgeons, as lymphatic stasis in radiated flaps may compromise surgical outcomes. Lymphatic specialists can leverage this knowledge to optimize lymphatic drainage from the mastectomy flap using conservative and surgical approaches.</div></div><div><h3>Lay summary</h3><div>Radiation therapy for breast cancer treatment significantly damages the lymphatic pathways in the chest. We showed that radiation increases the incidence of no lymphatic flow zones within mastectomy flaps. This knowledge can help improve the management of lymphatic drainage after cancer treatment.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 60-68"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214778","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":"Impact of non-tobacco nicotine use on postoperative complications in breast reduction: A propensity score-matched analysis","authors":"Agustin N. Posso,&nbsp;Audrey Mustoe,&nbsp;Micaela Tobin,&nbsp;Mohammed Yamin,&nbsp;Morvarid Mehdizadeh,&nbsp;Tricia Raquepo,&nbsp;Maria J. Escobar-Domingo,&nbsp;Sarah J. Karinja,&nbsp;Ryan P. Cauley,&nbsp;Bernard T. Lee","doi":"10.1016/j.bjps.2025.08.030","DOIUrl":"10.1016/j.bjps.2025.08.030","url":null,"abstract":"<div><h3>Background</h3><div>Macromastia negatively affects the quality of life and has led to increased demand for breast reduction surgery. With the growing use of non-tobacco nicotine products, such as vapes, concerns have emerged about their potential impact on postoperative outcomes. This study aims to investigate whether non-tobacco nicotine dependence (NTND) is associated with an increased risk of postoperative complications following breast reduction.</div></div><div><h3>Methods</h3><div>The TriNetX database was queried to identify patients who underwent breast reduction. Patients were classified into 2 cohorts based on the diagnosis of NTND, excluding those with tobacco use or dependence. A propensity score-matching analysis was performed to adjust for risk factors associated with postoperative complications. The primary outcome was wound dehiscence, while secondary outcomes included surgical site infection, hematoma, seroma, opioid use, and emergency department visits. All outcomes were assessed at 30, 60, and 90 days following surgery.</div></div><div><h3>Results</h3><div>After matching, each group contained 2327 individuals. Patients with NTND had a significantly increased risk of wound dehiscence (risk ratio [RR] 1.97, p = 0.001), opioid use (RR 1.35, p &lt; 0.001), and emergency department visits (RR 1.39, p = 0.006) at 30 days after breast reduction, compared to patients without NTND. Similar increases in risk were observed at 60 and 90 days after surgery. No significant differences were observed between the groups for surgical site infection, hematoma, or seroma at any time point.</div></div><div><h3>Conclusion</h3><div>In this study, NTND is associated with an increased risk of wound dehiscence, emergency department visits, and opioid use following breast reduction surgery.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 80-88"},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214840","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":"The return of in-person plastic surgery interviews and its effect on applicant preferences","authors":"Sonia S. Patel ,&nbsp;Lawson E. Spence ,&nbsp;Rohun Gupta ,&nbsp;Peter K. Firouzbakht ,&nbsp;Michael L. Bernstein","doi":"10.1016/j.bjps.2025.08.026","DOIUrl":"10.1016/j.bjps.2025.08.026","url":null,"abstract":"<div><div>The 2023–2024 integrated plastic surgery resident selection cycle marked the reintroduction of in-person interviews since the onset of the COVID-19 pandemic. The shift back to in-person interviews, coupled with the recent transition to a pass/fail Step 1 outcome, presented a new landscape for medical students, with the literature displaying increasing trends in research involvement, away rotations, and residency application costs. We aimed to understand the factors influencing the applicants’ decisions to pursue in-person or virtual interviews and financial implications of applying to a plastic surgery residency program. A 24-question Qualtrics survey was distributed via standardized email to the applicants of Saint Louis University’s integrated plastic surgery residency program at the conclusion of the interview. The questions included a 5-point Likert scale or free-response form and assessed demographics, finances, and interview experience. Forty-five surveys were distributed and 37 responses were obtained (82.2% response rate). Data revealed a statistically significant difference in the mean cost for in-person interviews ($554.84) versus virtual interviews ($100). Furthermore, applicant race was significantly related to the need to borrow money toward interview expenses. Despite the rising financial burden of applying to residency, 95% of the applicants indicated a final preference for in-person interviews, thereby highlighting the importance of factors beyond cost in the program selection process. Moreover, distinct financing patterns among racial groups may reflect a disproportionate impact of rising costs. Thus, implementing new scholarships may aid in bridging socioeconomic gaps and attracting the most qualified and deserving applicants.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 76-79"},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214878","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":"Impact of topical analgesia on injection pain perception in facial botulinum toxin injections: A systematic review and meta-analysis","authors":"Galathea Van Hout ,&nbsp;Gino Vissers ,&nbsp;Thierry Tondu ,&nbsp;Filip Thiessen ,&nbsp;Veronique Verhoeven","doi":"10.1016/j.bjps.2025.08.024","DOIUrl":"10.1016/j.bjps.2025.08.024","url":null,"abstract":"<div><div>This systematic review compared the effect of various topical analgesics on botulinum toxin injection pain perception.</div><div>Data search was conducted in PubMed, Web of Science and the Cochrane Library up to 30 November 2024. Inclusion criteria were (1) research articles in English, Dutch, French or German; (2) study population with adults ≥ 18 years; (3) facial botulinum toxin injections for cosmetic and/or functional indications; (4) comparison of different types of topical analgesia or topical analgesia with no analgesia applied and (5) inclusion of injection pain measurement. Exclusion criteria included (1) articles comparing solvent variations; (2) systematic reviews and meta-analyses and (3) injection areas other than the face.</div><div>Eleven RCTs (randomised controlled trials) and 3 controlled, non-randomised studies with a total of 472 patients were included. An evidence profile table showed that the quality of the studies according to the grading of recommendations, assessment, development and evaluation guidelines was in the low and moderate categories. A forest plot was used to display the results of pooled VAS (Visual Analogue Scale) scores for comparison after topical analgesia versus no analgesia. A statistically significant reduction in pain scores was observed with an anaesthetic gel or spray, vibration stimulus and cooling compared to no analgesia or placebo. Results can be pooled to an overall effect size of −1.20 in favour of the intervention (CI: −1.69, −0.70).</div><div>This systematic review was limited owing to bias, indirectness, imprecision, clinical and methodological heterogeneity, small study groups and few studies comparing different types of topical analgesia. Further research is needed to determine the optimal type of analgesia prior to botulinum toxin injections.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 130-143"},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226569","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":"Comparison of hypoglossal nerve transfer and hypoglossal jump nerve graft techniques for facial reanimation: A systematic review","authors":"Raisa Chowdhury ,&nbsp;Sara B.A. Morel ,&nbsp;Rawan ElAbd ,&nbsp;Khoa D. Tran ,&nbsp;Sabrina Cugno ,&nbsp;Gregory H. Borschel","doi":"10.1016/j.bjps.2025.08.029","DOIUrl":"10.1016/j.bjps.2025.08.029","url":null,"abstract":"<div><h3>Background</h3><div>Facial paralysis significantly affects patient quality of life by impairing facial expression, speech, and swallowing. Hypoglossal nerve transfer (HNT) and hypoglossal jump nerve graft (HJG) are established surgical techniques for facial reanimation, each with distinct advantages and complications. This systematic review compares the functional outcomes and complications of HNT and HJG to guide optimal surgical decision making.</div></div><div><h3>Methods</h3><div>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was conducted across 7 databases. Studies comparing HNT (end-to-end [ETE] or end-to-side [ETS]) and HJG techniques in adults with facial paralysis were included. Primary outcomes included facial movement recovery assessed via the House-Brackmann (HB) scale, Sunnybrook grading system, FaCE survey, or Facial Disability Index. Secondary outcomes included complication rates, quality of life, and predictors of surgical success. Risk of bias was assessed using ROB-2, Newcastle-Ottawa Scale, and ROBINS-I tools.</div></div><div><h3>Results</h3><div>A total of 34 studies comprising 1008 patients were included. HNT (ETE) provided robust facial reanimation but was associated with high rates of tongue atrophy (73%) and speech/swallowing difficulties (57%). HNT (ETS) preserved partial hypoglossal function and reduced morbidity while maintaining favorable outcomes (HB II–III recovery in 78–86%). HJG minimized complications, with no severe tongue atrophy and HB II–III recovery in 62.5–91.6% of patients. Recovery was slower in patients who underwent HJG due to nerve grafting but resulted in improved long-term facial symmetry and reduced synkinesis.</div></div><div><h3>Conclusion</h3><div>Both HNT and HJG are effective for facial reanimation. HNT (ETE) offers faster recovery but has higher morbidity, while HJG minimizes complications and maintains functional outcomes. HNT (ETS) provides a balance between efficacy and morbidity. Future comparative studies using standardized outcome measures are needed to refine patient-specific surgical selection, guided by accumulated clinical experience and published outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 156-183"},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227685","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":"Preoperative use of serotonergic antidepressants is associated with increased rates of complications and surgical revision in autologous breast reconstruction","authors":"Matthew Q. Dao ,&nbsp;Jacquelyn M. Roth ,&nbsp;Bernice Z. Yu ,&nbsp;Keisha E. Montalmant ,&nbsp;Parul Rai ,&nbsp;Arjun Nanda ,&nbsp;Jasmin Wilson ,&nbsp;Peter W. Henderson","doi":"10.1016/j.bjps.2025.08.025","DOIUrl":"10.1016/j.bjps.2025.08.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Depression and anxiety are common among women with breast cancer scheduled for autologous breast reconstruction, with selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors serving as the first-line treatments. Although effective for mood disorders, perioperative use of these medications has been linked to impaired hemostasis and wound healing in recovering patients. We evaluated the association between preoperative serotonergic antidepressants and complications following reconstructive breast surgery.</div></div><div><h3>Methods</h3><div>Female patients were identified from the US collaborative network within TriNetX, a globally federated database. Adults (18 years and older) who underwent autologous breast reconstruction were stratified into 2 groups: those prescribed serotonergic antidepressants within 3 months preoperatively (n = 4434), and those without any documented use (n = 13,661). Propensity score matching controlled for demographics and comorbidities. Primary outcomes were postoperative complications within 90 days. Secondary outcomes included deformity of reconstructed breast and surgical revision at 1 and 2 years. Risk ratios (RR) were used to measure associations, with statistical significance set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>After matching, 3064 patients remained in each group. Patients who used serotonergic antidepressants before autologous breast reconstruction had significantly higher risks of developing complications, including sepsis (RR = 1.94, p = 0.004), seroma (RR = 1.58, p = 0.004), hematoma (RR = 1.29, p = 0.037), and surgical site infection (RR = 1.54, p &lt; 0.0001), within 90 days. At 1 and 2 years, the rates of breast deformity and revision were also significantly elevated (p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Preoperative serotonergic antidepressant use is associated with increased short- and long-term complications following autologous breast surgery.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 89-97"},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226567","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":"Impact of post-bariatric lipoabdominoplasty on knee and hip function: A biomechanical and symptomatic analysis","authors":"Damiano Tambasco ,&nbsp;Roberta Albanese ,&nbsp;Federica Tomaselli ,&nbsp;Michelle Dowsey ,&nbsp;Pier Camillo Parodi ,&nbsp;Peter F.M. Choong","doi":"10.1016/j.bjps.2025.08.027","DOIUrl":"10.1016/j.bjps.2025.08.027","url":null,"abstract":"<div><div>Massive weight loss after bariatric surgery frequently results in redundant abdominal skin that can compromise posture, gait, and joint biomechanics. This prospective study investigated the functional effects of circumferential lipoabdominoplasty in post-bariatric patients. Eighteen individuals (mean BMI 29.3 kg/m²), all weight-stable for at least 12 months, underwent 360° lipoabdominoplasty with removal of ≥4 kg of tissue. Hip and knee range of motion (ROM) was measured preoperatively, at 1 month, and at 12 months postoperatively. Patient-reported outcomes were assessed using the BODY-Q Physical Symptoms (PS) and Physical Function (PF) domains. At 12 months, mean hip flexion improved from 110° ± 8° to 120° ± 7°, and knee flexion from 130° ± 10° to 140° ± 9° (p &lt; 0.05). PS scores increased from 58 ± 10 to 80 ± 9, and PF from 60 ± 11 to 79 ± 8 (p &lt; 0.05). No significant correlation was observed between ROM gains and BODY-Q scores, suggesting that improvements are mediated by mechanical release, postural realignment, and psychosocial benefits rather than mobility alone. These findings indicate that lipoabdominoplasty, while traditionally performed for aesthetic purposes, may play a significant role in enhancing functional recovery and quality of life following massive weight loss.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 205-208"},"PeriodicalIF":2.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988181","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}