Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Response to letter Re: “Medial epicondylectomy for cubital tunnel syndrome: Outcomes from an 8-year retrospective cohort study”","authors":"Abdus S. Burahee, Liron S. Duraku, Colin Shirley, Magdalena Nowak, Mark J.W. van der Oest, Michiel J. Zuidam, Dominic M. Power","doi":"10.1016/j.bjps.2025.08.007","DOIUrl":"10.1016/j.bjps.2025.08.007","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 243-244"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984143","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":"Increased instruction or decreased opportunity? How co-surgeons and fellows impact resident training in microsurgery","authors":"Annie M. Fritsch ,&nbsp;Brandon E. Alba ,&nbsp;Kelly Harmon ,&nbsp;Emma Theisen ,&nbsp;George Kokosis","doi":"10.1016/j.bjps.2025.08.016","DOIUrl":"10.1016/j.bjps.2025.08.016","url":null,"abstract":"<div><h3>Background</h3><div>Microsurgical reconstructions are incredibly demanding, and many plastic surgeons perform these procedures with a co-surgeon (CSM), or a microsurgical fellow (MSF). Although both the CSM and MSF have their benefits, there is currently a lack of understanding of how these additions impact the microsurgical training of residents.</div></div><div><h3>Methods</h3><div>An electronic survey of plastic surgical residents was sent via the American Council for Educators in Plastic Surgery (ACEP) distribution service. Questions included details regarding the level of training, program characteristics, and the use of the CSM/MSF at their institution. A 5-point Likert scale (Very Positive to Very Negative) was used to assess the impact of the CSM/MSF on microsurgical education.</div></div><div><h3>Results</h3><div>One hundred thirty-four residents with an average of 4 years (SD =1.95) of plastic surgery training completed the survey. The CSM was used at 95 (71%) and MSF at 37 (27%) programs. Residents felt the CSM was positive for their training (45% positive vs. 23% negative), while MSF was seen as more negative (15% positive vs. 57% negative). Residents at programs with the CSM and/or MSF had a significantly more positive outlook (53% CSM and 32% MSF) compared to those training at institutions without (24% CSM and 8% MSF) (p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Residents at programs utilizing these tools had a much more positive outlook compared to those without. As institutions adopt CSM or bring MSF into their program, they should consider resident concerns and ensure that the CSM and MSF are a help and not a hindrance to resident learning.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 130-133"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886179","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":"Response to Letter Re: 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.2025.08.010","DOIUrl":"10.1016/j.bjps.2025.08.010","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 247-248"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984197","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":"Commentary on “Trapeziectomy vs carpometacarpal prosthesis: Two techniques in an ‘in vivo’ side-by-side comparison”","authors":"John J. Faillace","doi":"10.1016/j.bjps.2025.08.011","DOIUrl":"10.1016/j.bjps.2025.08.011","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 231-232"},"PeriodicalIF":2.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984120","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":"Acute limb ischaemia secondary to fat embolism following lipoinjection","authors":"Diego Posada-Ríos ,&nbsp;Bárbara Dieck-Gutiérrez ,&nbsp;Eugenia López-Salazar ,&nbsp;Wilber Édison Peña-Niño ,&nbsp;Juan Carlos Gómez-Rodríguez ,&nbsp;Vanesa Vásquez-Sañudo ,&nbsp;Laura Botero-Ángel","doi":"10.1016/j.bjps.2025.08.012","DOIUrl":"10.1016/j.bjps.2025.08.012","url":null,"abstract":"<div><div>Peripheral arterial fat embolism is an exceptionally rare complication of autologous fat grafting. We report a 49-year-old woman who developed Rutherford grade IIB ischaemia of the left lower limb 90 min after combined liposuction and gluteo-femoral lipoinjection. Urgent thromboembolectomy 12 h later retrieved mature adipose fragments, yet progressive gangrene mandated transfemoral amputation. The case underscores the need for strict injection technique, intra-operative ultrasound guidance and prompt vascular referral when acute limb pain follows lipoinjection.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 134-136"},"PeriodicalIF":2.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886180","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":"Finite element analysis of donor site fracture risk after medial femoral condyle flap harvest: Implications for optimal harvest site and flap size","authors":"Walter Sobba ,&nbsp;Nicholas Parody ,&nbsp;Pengcheng Wang ,&nbsp;Rebecca Nicholas ,&nbsp;Jacques Hacquebord","doi":"10.1016/j.bjps.2025.08.005","DOIUrl":"10.1016/j.bjps.2025.08.005","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the risk of fracture with weight-bearing after medial femoral condyle (MFC) harvest with varying harvest size and location using finite element analysis (FEA).</div></div><div><h3>Methods</h3><div>FEA evaluated the potential impact of MFC harvest on donor femur strength. Donor flaps were modeled as cubes of corticocancellous defects within the descending genicular angiosome (DGA). Stress and safety factors were recorded during simulated single-leg stance as a function of harvest size and location within the DGA. An S-N curve was used to determine the number of cycles to failure due to stress.</div></div><div><h3>Results</h3><div>Among the 15 simulated harvest size and location combinations for each femur, the smallest (1x1x1 cm) corticocancellous flap centered 1 cm proximal to the medial epicondyle demonstrated the most favorable stress (34.95±9.81 MPa), safety factor (3.42±0.85), and fatigue (&gt;10⁶ cycles) profiles during single-leg stance, but saw notably increased stress and lower safety factors at larger sizes. Flaps centered at the medial epicondyle and shifted 0.5 cm proximally exhibited consistent stress and safety factor values. The largest (2x2x2 cm) and most proximally based flap (2 cm proximal) resulted in a precipitous increase in stress (92.23±21.19 MPa) and fatigue profile (10²–10³ cycles).</div></div><div><h3>Conclusions</h3><div>Our results suggest that small corticocancellous flaps centered no more than 0.5 cm proximal to the medial epicondyle are the most favorable for harvest, resulting in physiologically tolerable stress values on the donor femur during single-leg stance. Caution and potential weight-bearing restrictions should be considered when harvesting larger and more proximally based flaps.</div></div><div><h3>Level of evidence</h3><div>Biomechanical study</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 187-194"},"PeriodicalIF":2.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911811","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":"Inclusivity in plastic surgery – Insights, Recommendations, & Education (INSPIRE): A pilot identity-concordant mentorship programme for underrepresented students in plastic surgery","authors":"Umar Rehman ,&nbsp;Garikai Kungwengwe ,&nbsp;Shireen S. Gohari ,&nbsp;Elena Whiteman ,&nbsp;Cheuk Ying Kyleen Kiew ,&nbsp;Anna C. Corriero ,&nbsp;Simarjit Sandhar ,&nbsp;Ryan Faderani ,&nbsp;Mohammad S. Sarwar ,&nbsp;Ricky Ellis ,&nbsp;Sarah Al-Himdani ,&nbsp;Jana Torres-Grau ,&nbsp;Manaf Khatib ,&nbsp;Naveen Cavale ,&nbsp;Norma Timoney ,&nbsp;Peter A. Brennan ,&nbsp;Farah Bhatti ,&nbsp;Simon A. Filson","doi":"10.1016/j.bjps.2025.08.004","DOIUrl":"10.1016/j.bjps.2025.08.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Mentorship is integral to surgical training, yet access remains inequitable. Ethnic minority (EM) students, those from low-income households, and first-generation medical students face persistent barriers that hinder progression into competitive specialties like Plastic Surgery (PS). To address this, we piloted INSPIRE, a first-in-kind identity-concordant mentorship programme for UK undergraduates.</div></div><div><h3>Aim</h3><div>The aim was defined as achieving an 80% improvement over 12 months across three domains: research engagement, preparedness for surgical training, and career interest.</div></div><div><h3>Methodology</h3><div>Delivered as a Quality Improvement initiative, INSPIRE combined structured face-to-face teaching with longitudinal, identity-concordant research mentorship, using review-based projects aligned with national PS priorities. Outcomes were assessed pre- and post-intervention across research engagement, preparedness, and career interest.</div></div><div><h3>Results</h3><div>Of 22 mentees, 21 identified as EM and 15 had attended a state school. All mentors identified as being from one of the following groups: ethnic minorities, previously of low socio-economic status, or state school educated. Mentees showed full adherence to programme requirements, with 100% attending all teaching sessions and completing ≥3 mentorship meetings. At baseline, 21 had no publications or national presentations, and none had access to a PS mentor. Post-intervention, 18 had submitted or had prepared a publication (RD=77%, p&lt;0.001) and 59% had presented nationally (RD=55%, p&lt;0.001). Interest in academic surgery rose by 42% (p=0.004) and PS by 40% (p=0.004).</div></div><div><h3>Conclusion</h3><div>INSPIRE significantly improved research engagement and strengthened PS career interest among underrepresented students. These results highlight the value of identity-concordant mentorship.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 171-180"},"PeriodicalIF":2.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911831","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":"Do disease-modifying anti-rheumatic drugs affect implant-based breast reconstruction outcomes in patients with autoimmune connective tissue disease?","authors":"Ethan Fung,&nbsp;Jacquelyn M. Roth,&nbsp;Diana S. Shaari,&nbsp;Bernice Z. Yu,&nbsp;Peter J. Taub","doi":"10.1016/j.bjps.2025.07.042","DOIUrl":"10.1016/j.bjps.2025.07.042","url":null,"abstract":"<div><h3>Background</h3><div>As breast implants gain popularity, there remains concern over implant safety. Roughly 8% of the U.S population lives with an autoimmune disease, yet there is a paucity of literature comparing outcomes between patients taking disease-modifying anti-rheumatic drugs (DMARDs) and those not taking DMARDs undergoing implant-based breast reconstruction.</div></div><div><h3>Methods</h3><div>The TrinetX database identified 2 cohorts of 1262 patients each: those with an autoimmune connective tissue disease on a DMARD, and subsequently underwent implant-based breast reconstruction, and those with similar diagnoses undergoing the same procedure, without prior exposure to DMARDs. Demographics and comorbidities were matched via a 1:1 propensity-score analysis to identify predictors of postoperative outcomes within 90-days and 2-years.</div></div><div><h3>Results</h3><div>Within 90 days, DMARD patients had higher odds of necrosis (OR 1.86, P = 0.03) and surgical site pain (OR 1.43, P = 0.01). Within 2 years, DMARD patients had higher odds of postoperative infection (OR 1.35, P = 0.04), DVT (OR 1.76, P = 0.01), PE (OR 2.52, P = 0.001), emergency room (ER) visit (OR 1.21, P = 0.03), surgical site pain (OR 1.46, P = 0.001), and capsulectomy (OR 1.30, P = 0.04). Patients on conventional DMARDs were found to have increased odds of capsular contracture within 2 years compared to patients on biologic DMARDs (OR 3.29, P = 0.001).</div></div><div><h3>Conclusion</h3><div>Patients on DMARDs were more likely to experience negative postoperative outcomes within 90 days and 2 years, with increased capsular contracture risk in those taking conventional DMARDs. Plastic surgeons should be cognizant of these postoperative complications to improve patient outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 90-98"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840930","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":"Abnormal breast pathology after breast reduction surgery: A case-series and a 10-year retrospective chart review","authors":"Panthea Pouramin ,&nbsp;Krystal Stewart ,&nbsp;Anna Duncan ,&nbsp;Todd Dow ,&nbsp;Margaret Wheelock","doi":"10.1016/j.bjps.2025.08.001","DOIUrl":"10.1016/j.bjps.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Incidental abnormal breast pathology identified by histological analysis following breast reduction surgery is a rare complication. This may vary from benign and premalignant pathologies to invasive breast carcinoma. Such unexpected diagnoses can pose a challenge for plastic surgeons. Few studies have examined the treatment course for this patient population. We aimed to determine whether patients with incidental breast pathology following breast reduction mammoplasty were more likely to be treated conservatively or more aggressively through prophylactic mammoplasty.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted for all patients who underwent bilateral breast reduction surgery over a 10-year period. The anatomical pathology reports from all breast reduction specimens were reviewed for abnormal breast pathology findings. For patients identified with abnormal breast pathology, health records were further assessed to determine their individualized course of management.</div></div><div><h3>Results</h3><div>A total of 694 patients met the inclusion criteria. Overall, 22 patients (3.2%) showed incidental findings of abnormal breast pathology. The most common incidental pathologies were ADH (n=9, 40.9%), followed by ALH (n=6, 27.3%), and LCIS (n=5, 22.7%). There was a single case of DCIS (4.5%), and a single case of lobular microinvasive carcinoma in one breast, which was found to be ER and PR positive (4.5%). Most patients were treated conservatively, with only four of the 22 patients undergoing a prophylactic mastectomy.</div></div><div><h3>Conclusions</h3><div>The findings of this study suggest that prophylactic mastectomy is an uncommon intervention for abnormal breast pathology following breast reduction surgery. The majority of patients with low-grade breast lesions opted for a more conservative management plan.</div></div><div><h3>Level of evidence</h3><div>IV</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 68-75"},"PeriodicalIF":2.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831461","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 effect of sarcopenia on postoperative complications in autologous breast reconstruction: A systematic review and meta-analysis","authors":"Cian M. Hehir ,&nbsp;Gavin P. Dowling ,&nbsp;Gavin G. Calpin ,&nbsp;Gordon R. Daly ,&nbsp;Barry O’Sullivan ,&nbsp;James D. Martin-Smith ,&nbsp;Colin Morrison ,&nbsp;Roisin T. Dolan","doi":"10.1016/j.bjps.2025.08.002","DOIUrl":"10.1016/j.bjps.2025.08.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Sarcopenia refers to a loss of muscle mass combined with an associated loss of muscle function and has been demonstrated to predict post operative complications across a range of surgical procedures. The effect of sarcopenia on patient outcomes following autologous breast reconstruction (ABR) remains unknown. This systematic review and meta-analysis aims to assess the impact of sarcopenia on complications following ABR.</div></div><div><h3>Methods</h3><div>A systematic review of electronic databases was performed in conjunction with PRISMA guidelines. Studies reporting on postoperative complications in sarcopenic versus non-sarcopenic patients undergoing autologous breast reconstruction were included. Sarcopenia was identified in all included studies by objectively measuring psoas muscle index (PMI) or skeletal muscle index (SMI) on computed tomography (CT) scan.</div></div><div><h3>Results</h3><div>Six studies were included in this meta-analysis, which reported outcomes of 1315 patients undergoing ABR following mastectomy (407:908, Sarcopenic: Non-Sarcopenic). Sarcopenic patients had an increased risk of haematoma formation (OR= 1.84, 95% CI=1.06–3.18, p=0.03), but this was not associated with an increased risk of return to theatre due to haematoma (OR=1.11, 95% CI=0.36–3.38, p=0.86). There was no significant difference in risk of total flap loss, recipient site infection, recipient site seroma formation, donor site complications, risk of re-operation or wound dehiscence between sarcopenic and non-sarcopenic patients following ABR.</div></div><div><h3>Conclusion</h3><div>This study reports a higher haematoma risk in sarcopenic patients undergoing autologous breast reconstruction. Prospective studies reporting on BMI, PMI/SMI, radiographic muscle attenuation, and patient-reported return to function are required to comprehensively evaluate the potential impact of sarcopenia on post-mastectomy autologous breast reconstruction.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 116-127"},"PeriodicalIF":2.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866575","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}