Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Resident participation in reduction mammaplasty: Safe, efficient, and equivalent in patient satisfaction","authors":"Stephen Goulliart ,&nbsp;Claudia Miszewska ,&nbsp;Giulio J. Jaber ,&nbsp;Carolina Pollio ,&nbsp;Roxana Matasa ,&nbsp;Socorro Ortiz","doi":"10.1016/j.bjps.2026.02.036","DOIUrl":"10.1016/j.bjps.2026.02.036","url":null,"abstract":"<div><h3>Background</h3><div>Breast reduction surgery is one of the most common procedures in plastic surgery and a cornerstone of resident training. While its safety and benefits are well established, the impact of resident participation on surgical outcomes and patient satisfaction remains underexplored.</div></div><div><h3>Methods</h3><div>A retrospective single-center study was conducted between January 2019 and January 2023, including 208 patients (416 breasts) who underwent bilateral reduction mammaplasty using an inverted-T technique. Procedures were performed either by a senior surgeon alone (S group, n = 56) or by a senior surgeon assisted by a resident (S+R group, n = 152). Perioperative outcomes, postoperative complications, and risk factors were analyzed. Patient-reported outcomes were assessed using the BREAST-Q Version 2.0 Reduction Module and compared to normative data.</div></div><div><h3>Results</h3><div>Resident participation significantly reduced operative time (134.9 ± 29.8 vs 158.2 ± 24.6 min; p &lt; 0.001) without increasing complication rates (35.5% vs 41.1%; p = 0.46) or wound dehiscence. Multivariate analysis identified only resection weight &gt;650 g as an independent predictor of complications (OR = 2.23; 95% CI [1.20–4.20]; p = 0.012). BREAST-Q scores were comparable between groups, with slightly higher values in the S+R group. Satisfaction with breasts was significantly higher than normative data in both groups (p = 0.0347 and p &lt; 0.001, respectively).</div></div><div><h3>Conclusions</h3><div>In a highly supervised academic setting involving intermediate-level residents, resident participation in breast reduction surgery is safe and efficient and preserves patient satisfaction. These findings support structured resident integration without suggesting a direct performance benefit attributable to resident participation.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"115 ","pages":"Pages 444-453"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370891","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":"Invited Commentary on “Resident participation in reduction mammaplasty: Safe, efficient, and equivalent in patient satisfaction”","authors":"Antonio Rampazzo","doi":"10.1016/j.bjps.2026.02.034","DOIUrl":"10.1016/j.bjps.2026.02.034","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"115 ","pages":"Pages 454-455"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380239","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":"Aesthetic outcomes and surgical complications of acellular dermal matrix in immediate direct-to-implant breast reconstruction: A meta-analysis of comparative studies","authors":"Omar ElSewify ,&nbsp;Rawan ElAbd ,&nbsp;Leen ElEter ,&nbsp;Natasha Barone ,&nbsp;Brea Willey ,&nbsp;Samuel J. Lin ,&nbsp;Joshua Vorstenbosch","doi":"10.1016/j.bjps.2025.12.040","DOIUrl":"10.1016/j.bjps.2025.12.040","url":null,"abstract":"<div><div>Acellular dermal matrix (ADM) is frequently used in implant-based breast reconstruction due to its perceived aesthetic superiority and reduction in postoperative complications. This meta-analysis aims to investigate the aesthetic outcomes and surgical complications of ADM in immediate direct-to-implant (DTI) breast reconstruction. A systematic literature review was conducted using Medline, EMBASE, and Cochrane databases up to November 25, 2024. Comparative studies analyzing aesthetic outcomes and surgical complications of DTI reconstruction with and without ADM were included. Ten articles were eligible, with 416 patients undergoing ADM DTI reconstruction and 339 undergoing immediate reconstruction without ADM. The mean follow-up duration was 25 months. The mean age for cases was 47 ± 6 years, comparable with controls (48 ± 6; <em>p</em> &gt; 0.1). The mean body mass index was similar (23.5 ± 2.7 kg/m²; <em>p</em> &gt; 0.1). Implant volume was comparable at 280 ± 65 versus 265 ± 79 cc; <em>p</em> &gt; 0.1. Drain removal timing (15 vs 13 days) and hospital stay (5 vs 6 days) were similar (<em>p</em> &gt; 0.1). Meta-analysis showed comparable rates of haematoma, capsular contraction, skin necrosis, and wound dehiscence. However, ADM was associated with a higher risk of infection (odds ratio, 3.15, <em>p</em> = 0.0005, <em>I</em>² = 0%). Results for seroma and implant loss should be interpreted with caution. Aesthetic outcomes, although variably measured, were mostly comparable. ADM use in DTI reconstruction offers more comfort with pocket coverage but appears to carry higher risks of infection, implant loss, and possibly seroma. This meta-analysis offers guidance regarding risks, benefits, and costs associated with ADM use in clinical practice.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 100-116"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080627","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":"Unequal burden: Inguinal sentinel lymph node biopsy and the disproportionate risk of infection in melanoma","authors":"Aleksandra Nowak ,&nbsp;Jessica Coyle ,&nbsp;Abigail Colletta ,&nbsp;Veronique Verhoeven ,&nbsp;Gino Vissers","doi":"10.1016/j.bjps.2025.12.039","DOIUrl":"10.1016/j.bjps.2025.12.039","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate surgical site-specific infection rates after sentinel lymph node biopsies (SLNB) for melanoma.</div></div><div><h3>Methods</h3><div>This single-centre retrospective analysis of prospectively collected data included 422 patients who underwent SLNB between January 2020 and January 2025. Negative post-operative outcomes within 31 days were recorded: infection, seroma, wound dehiscence, haematoma, lymphedema and other complications. Clinical variables included: demographics, SLNB site and result, comorbidity, prophylactic antibiotic use and American Joint Committee on Cancer stage. Multivariable logistic regression was used to identify predictors of infection. This study adheres to the STROBE guidelines (Supplementary Appendix).</div></div><div><h3>Results</h3><div>Across the 422 patients in the cohort (mean age 59.1 years, range 6–89 years), infection accounted for 55 cases (13%). Rates varied markedly by site: inguinal 23.9%, axilla 7.8%, knee 29.4% and head/neck 3.0%. All infections were managed with antibiotics, and none required re‑operation. Multivariable analysis revealed that inguinal site (OR 5.01, 95% CI 2.50–10.04, p &lt; 0.001) and male gender (OR 2.57, 95% CI 1.30–5.09, p = 0.007) independently predicted postoperative infection. Age and comorbidity were not associated with increased risk in our cohort.</div></div><div><h3>Conclusion</h3><div>Within this UK cohort, the SLNB anatomical site emerged as the strongest driver of postoperative infection, with inguinal procedures carrying the greatest increase in risk. Male patients were also at a higher risk of infection. These findings highlight the value of targeted prevention strategies and close postoperative surveillance for high-risk groups.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 14-22"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014055","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":"Optimizing outcomes in pediatric microvascular mandibular reconstruction: A 23-year institutional experience","authors":"Theodor B. Lenz,&nbsp;Dominic J. Romeo,&nbsp;Allison C. Hu,&nbsp;Jacob R. Thomas,&nbsp;Patrick Akarapimand,&nbsp;Scott P. Bartlett,&nbsp;Jesse A. Taylor,&nbsp;Eric J. Granquist,&nbsp;Cassandra A. Ligh,&nbsp;Jordan W. Swanson","doi":"10.1016/j.bjps.2025.12.030","DOIUrl":"10.1016/j.bjps.2025.12.030","url":null,"abstract":"<div><h3>Background</h3><div>The vascularized free fibula flap (VFFF) is a well-established technique for addressing critical-sized mandibular defects, including those in pediatric patients. However, surgical risk factors and impact on growth potential are not well understood, particularly in skeletally immature patients, nor are the methods to optimize growth and outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed children who underwent mandibular reconstruction using VFFF between 2001 and 2024 at our institution. Complications were classified using the Clavien–Dindo scale. Data were analyzed using Pearson’s r correlation, Fisher’s exact tests, and chi-squared analysis.</div></div><div><h3>Results</h3><div>Twenty-nine patients underwent 31 mandibular reconstructions using VFFFs at a median age of 14 years old (range: 3.5–18.9 years), most commonly after ameloblastoma resection (n=10, 32%). Twenty-nine (94%) flaps were successful, and 17 complication events transpired among 13 (42%) operations, most commonly hardware exposure (n=4, 24%). Complications decreased with increased institutional experience (after 2016, p=0.011) and with the use of two rather than one venous anastomosis (p=0.002). Recipient site complications were more common in patients under 12 years of age (p=0.026). Although flap viability was high; two flap failures occurred with single venous anastomosis, and none with two venous anastomoses. Hardware removal was planned on an average 15.7 months after nine operations (29%) to maintain growth potential; subsequent corrective orthognathic surgery was performed following four flaps (13%).</div></div><div><h3>Conclusion</h3><div>Pediatric mandibular reconstruction using VFFF is safe and effective, with the majority maintaining functional occlusion with growth. Complication rates are comparable to those in the adult population and may be mitigated via multiple vein anastomoses and institutional experience.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 32-42"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013975","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":"Closed-suction fat harvest using a drain bottle: A practical modification","authors":"Vasiliki Fesatidou ,&nbsp;Abdulla Ibrahim ,&nbsp;Kavan S Johal ,&nbsp;Pari-Naz Mohanna","doi":"10.1016/j.bjps.2026.01.033","DOIUrl":"10.1016/j.bjps.2026.01.033","url":null,"abstract":"<div><div>Autologous fat grafting is a well-established technique for tissue augmentation, with various methods having been reported. None of them, however, has demonstrated clear superiority. We describe a simple modification of a well-established technique using a standard liposuction cannula connected to a closed-suction drain bottle for fat harvesting. Connecting the closed-suction drain bottle to a surgical suction unit, rather than relying on its inherent vacuum, allows for continuous control of the suction pressure and reduces harvest time by preventing the loss of negative pressure when the cannula is removed. This simple adaptation is cost-effective, versatile, and is an operator-controlled method for fat harvesting utilising readily available equipment.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 253-255"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184008","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":"Corrigendum to “Effect of hydration time on the microstructure of a porcine acellular dermal matrix for breast reconstruction: a pilot study” [J Plast Reconstr Aesthet Surg 106 (2025) 319–328]","authors":"Claudia Di Santo ,&nbsp;Carlo Di Pietrantonj ,&nbsp;Stefania Crivellari ,&nbsp;Giuseppe Sanese ,&nbsp;Fausto Cella","doi":"10.1016/j.bjps.2026.01.036","DOIUrl":"10.1016/j.bjps.2026.01.036","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 282-283"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215159","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":"Patient satisfaction following scar revision: A systematic review and meta-analysis","authors":"Abdulaziz Almodumeegh ,&nbsp;Maha Alkharisi ,&nbsp;Ghaida Assiry ,&nbsp;Leen Almutairi ,&nbsp;Sara Alotaibi ,&nbsp;Nasser Alowaimer ,&nbsp;Alanoud Albalkhail ,&nbsp;Rawan Alotaibi ,&nbsp;Lana Turson ,&nbsp;Amjad Abdullah Aljulayyil ,&nbsp;Abdulaziz Alotaibi ,&nbsp;Alanood Almusaiteer ,&nbsp;Mona Talic","doi":"10.1016/j.bjps.2026.01.021","DOIUrl":"10.1016/j.bjps.2026.01.021","url":null,"abstract":"<div><h3>Background</h3><div>Scar revision aims to improve the esthetic appearance and functional impact of scars. However, evidence synthesizing patient-reported satisfaction following these procedures remains limited.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed/MEDLINE, EMBASE, and Google Scholar (2010–2024) for studies reporting patient satisfaction after scar revision in adults. The primary outcome was patient-reported satisfaction measured through validated patient-reported outcome measures (PROMs) or structured surveys. Secondary contextual outcomes included esthetic severity scores (patient and observer scar assessment scale (POSAS), observer scar assessment scale (OSAS), Vancouver scar scale (VSS)) and complication rates. Data were pooled using random-effects single-arm meta-analysis.</div></div><div><h3>Results</h3><div>Thirty studies involving 5230 patients met the inclusion criteria, including 8 RCTs, 5 systematic reviews (narrative only), and 17 observational studies. Surgical interventions demonstrated the most favorable POSAS scores (2.71, 95% CI 2.32–3.11), compared with non-surgical procedures (3.32, 95% CI 2.92–3.71). Across 25 studies (1432 patients), the pooled patient satisfaction rate was 78.6% (95% CI 74.3–82.8). Satisfaction was the highest among patients with traumatic scars (88.3%) and lower in those with burn scars (74.5%). Minor complications occurred in 8.6% of the patients, with higher rates in post-acne and post-surgical scars. No major complications were reported.</div></div><div><h3>Conclusions</h3><div>Scar revision is associated with high patient satisfaction, with surgical approaches generally producing superior patient-reported outcomes. Satisfaction varies according to scar etiology and follow-up duration, emphasizing the importance of expectation setting and ongoing assessment. Secondary outcomes support the overall safety and effectiveness of current techniques. Standardized PROMs and improved reporting of psychosocial and contextual factors are needed to strengthen future evidence and enhance patient-centered care.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 284-295"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260509","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":"Erratum to “Early detection of viable microorganisms in “sterile” periprosthetic fluids in implant-based breast reconstruction: A bioelectrochemical approach using screen-printed electrodes” [J Plast Reconstr Aesthet Surg 113 (2026) 353–361]","authors":"Marta Monari ,&nbsp;Stefano Vaccari ,&nbsp;Alessandro Marco Lupacchini ,&nbsp;Anna Parisi ,&nbsp;Nicki Zolesi ,&nbsp;Sara Beltrame ,&nbsp;Paola Petrillo ,&nbsp;Fabio Grizzi ,&nbsp;Mohamed Ahmed Ahmed Abdelaziz Hegazi ,&nbsp;Riccardo Di Giuli ,&nbsp;Francesco Klinger ,&nbsp;Roberto Rusconi ,&nbsp;Valeriano Vinci","doi":"10.1016/j.bjps.2026.01.009","DOIUrl":"10.1016/j.bjps.2026.01.009","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Page 43"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021076","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":"Rate of fistula repair following palatoplasty in patients with cleft lip and palate: A systematic review of the literature","authors":"Dylan G. Choi ,&nbsp;Alexander T. Plonkowski ,&nbsp;Marvee Turk ,&nbsp;Muhammad Daiem ,&nbsp;Francesca Calderon ,&nbsp;Laura Herrera Gomez ,&nbsp;Ghulam Qadir Fayyaz ,&nbsp;Caroline A. Yao ,&nbsp;Priyanka Naidu ,&nbsp;William P. Magee III","doi":"10.1016/j.bjps.2025.12.032","DOIUrl":"10.1016/j.bjps.2025.12.032","url":null,"abstract":"<div><h3>Background</h3><div>Oronasal fistulas are among the most common and burdensome complications of cleft palate repair. Despite exhaustive literature detailing the nature and incidence of palatal fistulas, the reported rates of surgical fistula repair remain contested. The aim of this study was to identify the rate of palatal fistula repair following primary palatoplasty for cleft lip and palate.</div></div><div><h3>Methods</h3><div>The PubMed, Scopus, and Cochrane databases were queried for studies that focused on the incidence of surgical fistula repair following primary palatoplasty. Studies that included submucous clefts or were written in non-English languages were excluded.</div></div><div><h3>Results</h3><div>A total of 47 studies met the inclusion criteria. The average reported rate of palatal fistula repair was 6.5±5.3% (range: 0–49%). Stratified by cleft phenotype, the rate of fistula repair was 3.2±3.8% for patients with isolated cleft palate, 4.2±3.3% for patients with unilateral cleft lip and palate (UCLP), and 17.2±12.3% for patients with bilateral cleft lip and palate (BCLP). The rates of fistula repair were significantly different between the UCLP and BCLP groups (p=0.02) as well as between the BCLP and ICP groups (p=0.03). The included studies reported a range of predictors of fistula repair, including palatoplasty timing and surgeon experience, but our meta-analysis did not find an association between timing and fistula repair (p=0.84) in the aggregated data.</div></div><div><h3>Conclusion</h3><div>Initial analysis demonstrated differences in fistula surgery rate when stratified by phenotype and technique. Standardization of outcomes reporting is necessary to drive more robust conclusions.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 256-265"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190137","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}