Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Nerve block for pain management in pediatric patients undergoing cleft lip and palate repair: A systematic review and network meta-analysis","authors":"Nawaf Alhindi ,&nbsp;Houriah Nukaly ,&nbsp;Lina Abdulrahman ,&nbsp;Sarah Alzolaibani ,&nbsp;Mousa Akkour ,&nbsp;Abdulaziz Abumelha ,&nbsp;Deemah Alhuraish ,&nbsp;Razan Albrahim ,&nbsp;Reemah AlQahtani ,&nbsp;Sami I. Alissa","doi":"10.1016/j.bjps.2025.03.036","DOIUrl":"10.1016/j.bjps.2025.03.036","url":null,"abstract":"<div><h3>Background</h3><div>Cleft lip and palate, a common congenital anomaly, occurs in approximately 1 in every 1000–1500 births. Effective postoperative pain management in pediatric patients undergoing repair for cleft lip and palate remains a challenge. Therefore, this systematic review and network meta-analysis aimed to assess the effectiveness of nerve block in controlling postoperative pain compared to other methods in pediatric patients who underwent cleft lip and palate repair.</div></div><div><h3>Methods</h3><div>This review adhered to the preferred reporting items for systematic reviews and meta-analysis guidelines. A comprehensive search was conducted across multiple databases, including Embase, MEDLINE, Cochrane, and SCOPUS, without time frame limitation.</div></div><div><h3>Results</h3><div>A total of 8 randomized controlled trials comprising 550 patients were included. The findings of the study indicate that dexmedetomidine provided longer duration of nerve block (incremental value = 6.33, CI 95%, 1.49: 11.16) compared to the control. Thus, the probability of dexmedetomidine achieving longer nerve block is 89.98%. This was followed by fentanyl and pethidine.</div></div><div><h3>Conclusion</h3><div>This study supports the efficacy and safety of nerve blocks, particularly with dexmedetomidine, for postoperative pain management in pediatric cleft lip and palate repair. Adjuvant-enhanced nerve blocks offer extended pain relief and reduce the reliance on opioids.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 55-64"},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791102","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":"Addressing economic disparities in plastic surgery education: Reply to \"The cost of plastic surgery conferences for medical students\"","authors":"Daniel Najafali ,&nbsp;John A. Toms","doi":"10.1016/j.bjps.2025.03.035","DOIUrl":"10.1016/j.bjps.2025.03.035","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 198-199"},"PeriodicalIF":2.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715090","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":"Immediate versus delayed contralateral symmetrisation in autologous breast reconstruction: A comparative study","authors":"Benedetta Peltristo ,&nbsp;Maria Chicco ,&nbsp;Alexandra Molina","doi":"10.1016/j.bjps.2025.03.028","DOIUrl":"10.1016/j.bjps.2025.03.028","url":null,"abstract":"<div><h3>Introduction</h3><div>The optimal timing for contralateral breast symmetrisation in autologous breast reconstruction remains a controversial and under-researched topic, even though approximately 50% of patients will undergo contralateral symmetrisation procedures at some point in their reconstructive journey.</div></div><div><h3>Methods</h3><div>We conducted a retrospective comparative study including patients who underwent unilateral autologous breast reconstruction with either immediate or delayed contralateral breast symmetrisation from January 2018 to December 2022 at the Queen Victoria Hospital. Data were collected on patient age, timing of breast reconstruction and symmetrisation, flap type, operative time of the reconstructive procedure, length of hospital stay, complications requiring return-to-theatre, total number of surgical procedures and length of the reconstructive journey.</div></div><div><h3>Results</h3><div>Overall, 417 patients were divided into two groups based on the timing of contralateral symmetrisation (Group 1: 299 patients with delayed symmetrisation and Group 2: 118 patients with immediate symmetrisation). The two groups were comparable in terms of age and surgical characteristics. Although immediate symmetrisation significantly increased the operative time of the reconstructive procedure, there was no increase in the rate of complications requiring return-to-theatre or in the length of hospital stay. Patients who underwent immediate symmetrisation had a significantly lower total number of surgical procedures with a shorter reconstructive journey.</div></div><div><h3>Conclusion</h3><div>Our study showed that immediate contralateral breast symmetrisation is safe, reduces the total number of surgical procedures and shortens the reconstructive journey for patients undergoing unilateral autologous breast reconstruction.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 321-327"},"PeriodicalIF":2.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734686","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":"Risk of myocardial infarction and stroke in patients with keloids: A nationwide population-based cohort study","authors":"Taehee Jo ,&nbsp;Woonhyeok Jeong ,&nbsp;Jeong Yeop Ryu","doi":"10.1016/j.bjps.2025.03.034","DOIUrl":"10.1016/j.bjps.2025.03.034","url":null,"abstract":"<div><h3>Background</h3><div>Keloids represent a form of benign fibroproliferative disorder. Prior studies have linked various fibroproliferative conditions to an increased cardiovascular disease risk; however, the relationship between keloids and major adverse cardiovascular events, such as myocardial infarction (MI) and stroke, remains inadequately explored. A comprehensive nationwide population-based cohort approach was used to examine the cardiovascular disease risk in patients with keloids.</div></div><div><h3>Methods</h3><div>The cohort comprised 554,501 patients with keloid and 1,109,002 matched controls. Primary measures included the incidence rates and incidence rate ratios of MI, ischemic stroke (IS), and hemorrhagic stroke (HS) compared to the matched controls. The study applied a stratified Cox regression hazard model to compute the relative hazards between patients with keloid and the controls.</div></div><div><h3>Results</h3><div>Incidence rate ratios for cardiovascular diseases in patients with keloid, relative to controls, were 1.08 (95% confidence interval [CI], 1.06–1.10) for MI, 1.06 (CI, 1.04–1.08) for IS, and 1.05 (CI, 1.01–1.08) for HS. After adjusting for additional cardiovascular risk factors, a persistent elevated risk for MI and IS was evident in patients with keloid with adjusted hazard ratios (HRs) of 1.04 (CI 1.01–1.07) for MI and 1.03 (CI 1.00–1.07) for IS. Stratified analyses by age, sex, body mass index, and smoking status revealed consistent risk elevations in older individuals (≥50 years), women, obese individuals, and nonsmokers.</div></div><div><h3>Conclusions</h3><div>Keloids are associated with a significant increase in MI and IS risk, independent of the traditional cardiovascular risk factors. This association is particularly prominent in older adults, women, obese individuals, and nonsmokers.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 65-74"},"PeriodicalIF":2.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800324","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: ‘International Observerships in Plastic Surgery: Key Insights and Recommendations for Success’","authors":"Vaibhav Sahni","doi":"10.1016/j.bjps.2025.03.032","DOIUrl":"10.1016/j.bjps.2025.03.032","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Page 123"},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680753","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":"A combination of fat grafting with inferior dermal flap in breast reconstruction following prophylactic mastectomy: A cohort study","authors":"Libor Streit ,&nbsp;Katsiaryna Abukhovich ,&nbsp;Adam Bajus ,&nbsp;Monika Schneiderová ,&nbsp;Tomáš Kubek ,&nbsp;Michaela Bohušová ,&nbsp;Luboš Dražan","doi":"10.1016/j.bjps.2025.03.020","DOIUrl":"10.1016/j.bjps.2025.03.020","url":null,"abstract":"<div><h3>Background</h3><div>Breast reconstruction following prophylactic mastectomy in women with ptotic or hypertrophic breasts often poses challenges. We describe a combined technique of large-volume fat grafting (&gt;100 mL) and an inferior dermal flap, aiming to improve aesthetic outcomes and patient satisfaction.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 21 patients undergoing immediate breast reconstruction with the described technique. All patients were asked to complete the BREAST-Q questionnaire preoperatively and at least 12 months postoperatively (median interval: 20 months). Statistical analysis (Wilcoxon signed-rank test) was used to assess changes in satisfaction and well-being; aesthetic outcomes were scored by an independent, multidisciplinary team.</div></div><div><h3>Results</h3><div>Among 13 patients with complete BREAST-Q data, satisfaction with the breasts increased significantly from a median score of 38–85 (p = 0.002), psychosocial well-being from 57–70 (p = 0.045), and physical well-being (chest) from 68 to 81 (p = 0.045). Sexual well-being rose from 47–63 (p = 0.023). Aesthetic evaluation by an independent panel showed notable improvements in breast symmetry, shape, and overall appearance. Minimal and asymptomatic fat necroses or oil liponecrotic pseudocysts were observed.</div></div><div><h3>Conclusions</h3><div>Combining large-volume fat grafting with an inferior dermal flap appears promising for women with ptotic breasts, yielding high satisfaction and low complication rates. Despite requiring multiple operative stages, this autologous reconstruction technique may offer a less invasive alternative for high-risk patients seeking natural outcomes without implants.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 231-244"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual perfusion superomedial pedicle in reduction mammaplasty – A prospective intraoperative radiographic study","authors":"Jake Moscarelli ,&nbsp;Martin J. Carney ,&nbsp;K. Lynn Zhao ,&nbsp;Brogan Evans ,&nbsp;Elizabeth B. Card ,&nbsp;Vikram G. Mookerjee ,&nbsp;David P. Alper ,&nbsp;Paris D. Butler","doi":"10.1016/j.bjps.2025.03.017","DOIUrl":"10.1016/j.bjps.2025.03.017","url":null,"abstract":"<div><div>This study uses intraoperative ultrasound to confirm dual perfusion to the nipple-areolar complex from internal mammary artery and intercostal artery perforators using a superomedial pedicle technique. Findings presented include color-Doppler ultrasound images, anatomical illustration, operative information, and postoperative outcomes. Dual blood supply may improve SMP safety in patients with extremely large and/or ptotic breasts.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 253-255"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715091","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":"Assessing the predictive accuracy of ChatGPT-based image analysis in forecasting long-term scar characteristics from 3-month assessments – A pilot study","authors":"Antoinette T. Nguyen ,&nbsp;Rena A. Li ,&nbsp;Robert D. Galiano","doi":"10.1016/j.bjps.2025.03.021","DOIUrl":"10.1016/j.bjps.2025.03.021","url":null,"abstract":"<div><h3>Introduction</h3><div>Scarring significantly impacts patient quality of life, yet traditional assessments often rely on subjective evaluations, resulting in variability in predictions. This study aimed to evaluate the predictive accuracy of a Smart Image Analysis ChatGPT model in forecasting scar characteristics.</div></div><div><h3>Methods</h3><div>This single-institution prospective cohort study included 40 patients who underwent plastic surgery. Scar images were captured at 3 and 12 months, assessing characteristics such as vascularity, pigmentation, height, and width. The ChatGPT model predicted binary outcomes (good vs. bad scars) and continuous outcomes. Predictive accuracy was measured using metrics including mean absolute error (MAE), mean squared error (MSE), root mean squared error (RMSE), and R-squared (R²).</div></div><div><h3>Results</h3><div>The model achieved an overall accuracy of 97.5% for binary classifications of scars. McNemar's test confirmed no significant differences between predicted and actual outcomes. For continuous outcomes, the MAE was 0.65, with an MSE of 0.9 and RMSE of 0.95, indicating moderate accuracy. Vascularity predictions yielded an R² of 0.234, whereas height and width showed stronger correlations with R² values of 0.857 and 0.956, respectively. Statistically significant differences in paired t-tests were observed for pigmentation (t = 4.356, p = 9.319e-05) and width (t = 2.896, p = 0.0062).</div></div><div><h3>Conclusion</h3><div>The Smart Image Analysis ChatGPT model demonstrates excellent predictive accuracy in binary scar classification and provides valuable insights for scar characteristics. Further refinement is necessary for improving predictions of dynamic features such as vascularity.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 200-208"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715074","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 V-Y inferior gluteal artery perforator flap in perineal reconstruction: Modifications to aid flap inset","authors":"O. Sharp,&nbsp;H. Shepherd,&nbsp;T. Nanidis","doi":"10.1016/j.bjps.2025.03.029","DOIUrl":"10.1016/j.bjps.2025.03.029","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 256-258"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715092","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 use of ultrasound imaging in aesthetic injectables: A modified Delphi consensus","authors":"P.J. Velthuis ,&nbsp;F. Alfageme ,&nbsp;H. Cartier ,&nbsp;D. Cassuto ,&nbsp;O. Catalano ,&nbsp;F. Cavallieri ,&nbsp;S. Desyatnikova ,&nbsp;C.P. Gonzalez Diaz ,&nbsp;J.S. Kim ,&nbsp;A. Mandava ,&nbsp;C. Mariluis ,&nbsp;L.S. Schelke ,&nbsp;S. Shah-Desai ,&nbsp;S. Weiner ,&nbsp;X. Wortsman","doi":"10.1016/j.bjps.2025.03.001","DOIUrl":"10.1016/j.bjps.2025.03.001","url":null,"abstract":"<div><div>A four-round modified Delphi consensus was held concerning the question, ‘What are the prerequisites for using ultrasound imaging in cosmetic filler injections’? Fifteen international experts in the field from seven different relevant medical specialties and 11 countries were included.</div><div>An extensive list of topics was discussed in rounds 1 and 2. Statements were drawn up for voting in rounds 3 and 4. Experts had a consensus (&gt;70% agreement) on most of the statements.</div><div>With regard to equipment, a minimum linear 15 MHz transducer (probe) is recommended for both learning and regular diagnostics. Hand-held devices can be used in both circumstances. B-mode, Color-Doppler, Spectral Doppler, and picture/video archiving are mandatory, Power-Doppler is recommended.</div><div>Experts find ultrasound imaging prior to injection mandatory in certain areas with high risk for vascular adverse events, as well as for the management of complications. It is recommended to identify prior fillers before injecting.</div><div>An ultrasound-guided injection is recommended in many parts of the face for fillers, toxin and injection lipolysis. A sterile probe cover and sterile gel are necessary in these cases. Ultrasound-guidance is necessary for precise intralesional injections, needed in filler complication treatment.</div><div>An extensive list of training and practice topics is given that should be learned before one can start using ultrasound imaging in cosmetic filler injection practice.</div><div>Ultrasound imaging for minimal invasive aesthetic procedures has met a significant surge in attention, both in publication numbers and in prominence at major conferences. For physicians and institutions exploring this field, many critical decisions must be made, particularly concerning the prerequisites for using ultrasound imaging in cosmetic filler injections. Guidelines from international experts addressing these topics would provide valuable insights and facilitate the adoption of ultrasound technology in this field.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 33-37"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642234","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}