Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Gender-affirming facial surgery in racially, ethnically, and socioeconomically diverse individuals: Variations and consistencies in procedures and outcomes in a large cohort","authors":"Nathan S. Ramrakhiani,&nbsp;Leon Sarpong,&nbsp;Angelica McDaniel,&nbsp;Israel Falade,&nbsp;Chelsea Yim,&nbsp;William Hoffman,&nbsp;Esther Kim,&nbsp;Jason H. Pomerantz","doi":"10.1016/j.bjps.2025.08.003","DOIUrl":"10.1016/j.bjps.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Gender-affirming facial surgery (GAFS) is an integral part of the gender-affirming care continuum, but access to surgery is limited, and only 7% of transgender women have undergone GAFS. The intersection of race/ethnicity and insurance coverage significantly impacts access to GAFS. Many insurance plans exclude GAFS, and a vast majority of GAFS operations in the United States have been performed on White patients. Accordingly, there are limited data on GAFS in diverse individuals.</div></div><div><h3>Methods</h3><div>A retrospective chart review identified transgender women who underwent GAFS at the University of California, San Francisco (UCSF) between 2019 and 2023. Data were collected via retrospective chart review, and statistical analyses were performed using R.</div></div><div><h3>Results</h3><div>168 transgender women had GAFS during the study period. The cohort was racially/ethnically diverse, with 39.9% Hispanic, 30.4% White, 6.5% Asian, 6% Black, and 17.3% Other/Multiple/Unknown. Insurance type was also diverse, with 71.9% MediCal, 12% Medicare, 11.4% Private, and 4.8% Other/Unknown.</div><div>The rate of medical complications was 11.3% and the rate of revisions was 22.6%, with no differences observed across different racial/ethnic groups. However, Black and Hispanic patients were more likely to undergo rhinoplasty and soft tissue procedures than other groups. Neither the total number of procedures nor the number of stages was found to be a significant predictor of medical complications or future revision operations.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that GAFS is safe and effective in racially, ethnically and socioeconomically diverse individuals, and that racial and ethnic background influences the specific GAFS procedures performed.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"110 ","pages":"Pages 98-105"},"PeriodicalIF":2.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214803","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":"Federated learning: Removing barriers to collaboration in AI-driven plastic surgery research","authors":"Berk B. Ozmen,&nbsp;Neel Vishwanath,&nbsp;Erin J. Kim,&nbsp;Graham S. Schwarz","doi":"10.1016/j.bjps.2025.07.036","DOIUrl":"10.1016/j.bjps.2025.07.036","url":null,"abstract":"<div><div>Plastic surgery research faces a fundamental challenge in the era of artificial intelligence; individual departments rarely possess sufficient case volumes to train robust machine learning models, particularly for specialized procedures or rare complications. This limitation constrains the development of evidence-based predictive tools that could significantly improve patient care. Federated learning emerges as a transformative solution, offering a privacy-preserving framework for collaborative model development across institutions without centralized data sharing. Unlike traditional multicenter studies requiring data pooling, federated learning transmits only model parameters between institutions, never raw patient information, addressing the tension between large-scale data analysis needs and stringent privacy regulations. Recent healthcare applications demonstrate significant improvements, with federated models showing better performance and increased generalizability compared to single-institution approaches. In plastic surgery, federated learning could enhance risk prediction for complex reconstructive procedures like free flap surgery, enable objective assessment of aesthetic outcomes through globally representative models, and facilitate rare complication surveillance, such as breast implant-associated anaplastic large cell lymphoma detection. Implementation requires attention to data standardization and technical infrastructure, but the distributed nature actually facilitates regulatory compliance with GDPR and HIPAA since patient data never leaves institutional boundaries. The convergence of federated learning with emerging technologies promises integration with surgical planning software for real-time outcome prediction and precision medicine approaches. International plastic surgery societies are uniquely positioned to coordinate specialty-specific federated learning networks, establishing governance structures and technical standards. Federated learning offers plastic surgery an unprecedented opportunity to harness collective global experience while maintaining patient privacy and institutional autonomy, addressing fundamental limitations in current research paradigms and enabling the development of robust predictive models that will define evidence-based practice for years to come.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 252-254"},"PeriodicalIF":2.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850204","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":"Psychological health status and influencing factors among aesthetic plastic surgery patients: A cross-sectional analysis","authors":"Na Liu ,&nbsp;Yingjie Wang ,&nbsp;Zihan Mi ,&nbsp;Chang Qu ,&nbsp;Rong Zhang ,&nbsp;Yongqian Wang","doi":"10.1016/j.bjps.2025.07.037","DOIUrl":"10.1016/j.bjps.2025.07.037","url":null,"abstract":"<div><h3>Objective</h3><div>This study explored psychological well-being and body image-related distress among patients undergoing aesthetic plastic surgery, and identified key demographic and clinical factors influencing their mental health and quality of life.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 403 outpatients and inpatients at a tertiary plastic surgery hospital. Participants completed a validated five-dimensional psychological assessment scale, comprising appearance concern, emotional distress, cognitive distress, behavioural distress, and body image inferiority. Demographic and clinical variables were collected. Independent group comparisons were performed using t-tests and ANOVA. Spearman’s correlation assessed associations between variables, and multiple linear regression identified independent predictors.</div></div><div><h3>Results</h3><div>The mean total psychological distress score was 43.43 ± 17.72. Subscale means were: appearance concern (17.37 ± 6.36), emotional distress (8.36 ± 4.93), cognitive distress (7.13 ± 4.68), behavioural distress (4.91 ± 3.34), and body image inferiority (4.89 ± 3.03). Psychological distress varied significantly by gender, age, income, and treatment frequency (<em>P</em> &lt; 0.05). Spearman’s analysis indicated associations with gender (r = −0.121), education (r = −0.100), income (r = −0.117), and treatment frequency (r = 0.112–0.115). Regression identified male gender, low income, and repeated procedures as significant predictors of heightened distress.</div></div><div><h3>Conclusion</h3><div>Psychological distress among aesthetic surgery patients is shaped by demographic and treatment-related factors. Male patients, those with lower income, and individuals undergoing multiple procedures exhibit greater vulnerability. These findings underscore the importance of routine psychological screening and targeted interventions to enhance patient-centred care and surgical outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 82-89"},"PeriodicalIF":2.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831462","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":"Reconsideration of the anatomical structure of the buccal fat pad","authors":"Yoshiaki Sakamoto ,&nbsp;Yuji Nakanishi ,&nbsp;Katsuya Tanaka ,&nbsp;Kenei Chin ,&nbsp;Yoshifumi Takatsume ,&nbsp;Nobuaki Imanishi","doi":"10.1016/j.bjps.2025.07.041","DOIUrl":"10.1016/j.bjps.2025.07.041","url":null,"abstract":"<div><h3>Background</h3><div>The buccal fat pad has gained attention because of its anatomical characteristics and functions; however, its morphology and relationship with surrounding tissues have been inconsistently described. This study aimed to reassess the anatomical morphology of the buccal fat pad.</div></div><div><h3>Methods</h3><div>Twelve human cadavers donated to Keio University School of Medicine were used during this study. A total of 24 dissections were performed, and the morphology of the buccal fat pad was analyzed using computed tomography. Arterial injection techniques were used to evaluate the vascular distribution and continuity.</div></div><div><h3>Results</h3><div>The buccal fat pad was located within the masticatory space and categorized as the main body, temporal extension, and pterygoid extension. A computed tomography analysis revealed that the fat pad encircled the anterior margin of the masseter muscle and extended to the temporal region. Dissection showed that the buccal fat pad was divided by the parotid duct in most cases. The vascular supply was classified into the following three regions: deep temporal artery, buccal artery, and posterior superior alveolar artery.</div></div><div><h3>Conclusions</h3><div>The buccal fat pad is intricately associated with the muscles of mastication, facial nerve, and parotid duct. This study provides detailed anatomical insights that can contribute to safer surgical manipulation of the buccal fat pad.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 76-81"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831508","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":"Magnetic resonance lymphangiography: Correlation with indocyanine green lymphangiography in lower limb lymphedema","authors":"Minge Zhang ,&nbsp;Liqi Yi ,&nbsp;Chong Liu ,&nbsp;Jinbiao Huang ,&nbsp;Yan Chen ,&nbsp;Jingjing Wang ,&nbsp;Runyu Tang ,&nbsp;Hai Yang","doi":"10.1016/j.bjps.2025.07.034","DOIUrl":"10.1016/j.bjps.2025.07.034","url":null,"abstract":"<div><h3>Background</h3><div>Indocyanine green (ICG) lymphography is considered the gold standard method for real-time imaging of the lymphatic vessels. Despite extensive literature on the effectiveness of different imaging modalities, research comparing the reliability of ICG lymphography and magnetic resonance lymphangiography (MRL) is limited. We retrospectively analyzed and compared the capability of MRL and ICG lymphangiography to detect lower limb lymphoedema abnormalities.</div></div><div><h3>Methods</h3><div>This monocentric cohort study included patients who had examinations and surgeries between September 2021 and December 2023. The assessment comprised scoring the severity levels of the drainage pattern, lymphatic vessel conspicuity, anatomic level of lymphatic vessel enhancement, contrast medium deposition in the foot, and the anatomic coverage of dermal backflow. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRL and ICG lymphangiography were calculated.</div></div><div><h3>Results</h3><div>A total of 89 patients with clinically proven moderate to severe lymphoedema (stages II–III) affecting 92 lower limbs were enrolled. Good to excellent agreement was determined between MRL and ICG lymphography in drainage pattern (k=0.710), contrast medium deposition in the foot (k=0.933), and anatomic coverage of dermal backflow (k=0.653). Anatomical level of lymphatic vessel enhancement was in moderate correlation (k=0.524), and the visualization of lymphatic vessels was correlated (k=0.330) between the two modalities. MRL demonstrated lower NPV (50% vs 100%) in lymphatic vessel conspicuity but better sensitivity (100% vs 98%) and NPV (100% vs 97.6%) of contrast medium deposition in the foot as compared to ICG lymphography.</div></div><div><h3>Conclusions</h3><div>MRL demonstrated better performance on the lymphatic vessel conspicuity when dermal backflow is obvious. For normal lymphatic vessels, ICG lymphography provided a better description.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 60-67"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831460","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":"Alveolar cleft repair: A 30-year follow-up","authors":"Rossella Elia,&nbsp;Giuseppe Giudice,&nbsp;MIchele Maruccia,&nbsp;Eleonora Nacchiero,&nbsp;Pasquale Tedeschi,&nbsp;Nicolò Mininni","doi":"10.1016/j.bjps.2025.07.040","DOIUrl":"10.1016/j.bjps.2025.07.040","url":null,"abstract":"<div><div>Secondary alveolar bone grafting (SABG) is a key surgical procedure in the management of patients with cleft lip and palate, aiming to restore maxillary continuity and support dental development. However, long-term outcomes beyond the first decade remain poorly documented. This study presents a 30-year longitudinal evaluation of SABG outcomes in patients with complete unilateral non-syndromic CLP, focusing on clinical, radiological, and patient-reported outcomes, and identifying predictive factors of surgical success. A retrospective cohort of 32 patients who underwent SABG between 1990 and 1994 was analyzed. Clinical assessment included dental and periodontal evaluation (DMFT index), while radiological success was assessed using Cone Beam CT scan and the Suomalainen Index. Patient-reported outcomes were evaluated using the validated CLEFT-Q questionnaire. Predictors of outcome were explored through uni- and multivariate regression analyses. After 30 years, 56.3% of patients achieved satisfactory radiological outcomes (Suomalainen Index ≥12). Autologous grafting, good oral health (lower DMFT), and compliance with orthodontic treatment were significantly associated with favorable outcomes. In multivariate analysis, only oral health and orthodontic treatment remained independent predictors. Patients with successful grafts reported significantly better quality of life across all CLEFT-Q domains. SABG can provide durable clinical and radiological benefits over three decades, especially when combined with proper orthodontic management and maintained oral health. Integration of PROMs reveals that long-term graft success correlates with improved patient satisfaction and psychosocial well-being.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 40-49"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827170","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 influence of cardiovascular disease on duration of admission after DIEP flap breast reconstruction: A retrospective cohort study","authors":"Dorien I. Schonebaum ,&nbsp;Jian H. Li ,&nbsp;Jade E. Smith ,&nbsp;Bernard T. Lee ,&nbsp;Samuel J. Lin","doi":"10.1016/j.bjps.2025.07.031","DOIUrl":"10.1016/j.bjps.2025.07.031","url":null,"abstract":"<div><h3>Objectives</h3><div>Deep Inferior Epigastric Perforator (DIEP) flaps are a preferred type of autologous breast reconstruction because of their relatively low rate of donor site complications. Comorbidities, such as cardiovascular disease (CVD) and hypertension (HTN), influence the rate of post-operative complications, leading to increased length of stay (LOS). The Nationwide Readmission Database (NRD) compiles readmission and LOS data in the USA. We aim to investigate the relationship between CVD and cardiovascular risk factors and the LOS after DIEP flap.</div></div><div><h3>Methods</h3><div>The NRD was queried from 2016 to 2020 using ICD-10 codes for DIEP flaps. The resulting dataset was analyzed for congestive heart failure (CHF), hypertension, obesity and diabetes. Multivariate regression analyses were performed to evaluate the influence of CVD on LOS.</div></div><div><h3>Results</h3><div>A total of 23,319 cases were identified; the average LOS without comorbidities was 4.15 days. Complicated HTN increased LOS by 1.17 days while uncomplicated HTN, CHF, complicated diabetes, morbid- and moderate obesity all significantly increased the length of stay by 0.09, 0.64, 0.40, 0.29 and 0.24 days, respectively (P&lt;0.05). Out of 20,423 patients, 872 were readmitted within 90 days (4.3%). Main reasons for readmission were infection (83.8%), vascular complications (12.7%) and seroma (8.3%). Flap failure occurred 6 times.</div></div><div><h3>Conclusion</h3><div>Results show that CVD increased the LOS after DIEP flap, with complicated HTN increasing LOS most by 1.17 days. This is clinically relevant due to the rising cost of healthcare and the shortage of healthcare workers.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"108 ","pages":"Pages 129-137"},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770750","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 Letter comments on “Scarpa fascia preservation abdominoplasty combined with precise liposuction for post pregnancy abdomen: A 10-year experience” Refining abdominoplasty: The role of adjunctive technologies in enhancing aesthetic and vascular safety [J Plast Reconstr Aesthet Surg 106C (2025) 158–159]","authors":"Roberta Albanese ,&nbsp;Federica Tomaselli ,&nbsp;Damiano Tambasco","doi":"10.1016/j.bjps.2025.07.015","DOIUrl":"10.1016/j.bjps.2025.07.015","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"108 ","pages":"Page 110"},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738488","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":"Photographs of non-melanoma skin tumours submitted by patients improve preoperative triage","authors":"Anne Sofie Krogh Holdam ,&nbsp;Vibeke Koudahl ,&nbsp;Hans B. Rahr ,&nbsp;Bekka Christensen","doi":"10.1016/j.bjps.2025.07.033","DOIUrl":"10.1016/j.bjps.2025.07.033","url":null,"abstract":"<div><div>The incidence of non-melanoma skin cancer is rapidly increasing, along with the demand for surgical treatments. Most lesions can be treated with same-day examination and simple surgery, while more complex cases require advanced procedures and a separate pre-surgical visit. However, referral letters often fail to convey case complexity accurately, resulting in unnecessary hospital surgical planning visits for cases that ultimately require only simple procedures. Efficient triaging is essential to direct patients to the appropriate treatment pathway. This study evaluates whether patient-submitted photographs can improve the efficiency and accuracy of surgical planning for non-melanoma skin cancer in a prospective cohort study. Patients were invited to submit photographs and complete a simple survey using the mobile application 'Mit Sygehus'. Data were extracted from electronic medical records and used to analyze triage patterns during a six-month baseline period, response rates to the study invitation over an 18-month study period, and differences between responders and non-responders using appropriate statistical tests. In the baseline group, 116 patients were triaged for surgical planning but ultimately underwent minor procedures without reconstructive surgery, suggesting they could have benefited from photo-assisted triage. In the study group, 201 patients were eligible for photo-assisted triage, as it was not clear from the referral letters which treatment would be appropiate. We had 95 patients responding to the invitation with 50 of these triaged directly to surgical treatment. Responders had shorter wait times to treatment compared to non-responders. In conclusion, patient involvement in telemedicine improves pre-surgical triage, reducing hospital visits and time to surgery for patients with non-melanoma skin cancer.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"108 ","pages":"Pages 138-146"},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770751","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 Regarding “Medial epicondylectomy for cubital tunnel syndrome: Outcomes from an 8-year retrospective cohort study”","authors":"Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1016/j.bjps.2025.07.028","DOIUrl":"10.1016/j.bjps.2025.07.028","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 241-242"},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765905","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}