Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Letter comments on: ‘Impact of Tranexamic Acid (TXA) on Post-Operative Complications and Bleeding in Facial Aesthetic Surgery: A Systematic Review and Meta-analysis’","authors":"Vaibhav Sahni","doi":"10.1016/j.bjps.2025.06.043","DOIUrl":"10.1016/j.bjps.2025.06.043","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 128-129"},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866580","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 free-style approach to selection of locoregional perforator flaps for unilateral breast restoration","authors":"Carolina Legarda,&nbsp;Nave Cohen,&nbsp;Roei Singolda,&nbsp;Ehab Madah,&nbsp;Yoav Barnea,&nbsp;Ehud Arad","doi":"10.1016/j.bjps.2025.06.040","DOIUrl":"10.1016/j.bjps.2025.06.040","url":null,"abstract":"<div><h3>Background</h3><div>Evolution in breast oncology has increased the use of breast-conserving therapy and expanded the role of locoregional autologous reconstruction. While bilateral reduction is common for patients with large, ptotic breasts, those with small to moderate symmetric breasts often prefer unilateral volume restoration. This study demonstrates a free-style approach to flap selection and design for partial and total breast reconstruction, emphasizing intraoperative decision-making and preservation of muscle and nerve function.</div></div><div><h3>Methods</h3><div>A retrospective review was performed on patients undergoing perforator flap reconstruction from 2016 to 2023. Demographic, oncologic, and operative data were analyzed. Flap type was chosen intraoperatively based on donor tissue availability, perforator quality, and defect characteristics and included thoracodorsal artery perforator flap (TDAP), muscle-sparing latissimus dorsi (ms-LD), lateral intercostal artery perforator (LICAP), and anterior intercostal artery perforator (AICAP) flaps.</div></div><div><h3>Results</h3><div>Twenty-three reconstructions were included: 18 following lumpectomy (78%) and 5 following mastectomy (22%). Reconstruction was immediate in 78% of cases. The average lumpectomy resection weight was 64 g, and the median operative time was 3.5 h. TDAP was the most frequently employed flap (52%), followed by ms-LD (21%), LICAP (13%), and AICAP (13%). Minor complications occurred in three patients, and only two patients experienced mastectomy skin flap necrosis requiring revision.</div></div><div><h3>Conclusions</h3><div>Locoregional perforator flaps provide reliable volume replacement with preservation of muscle function and minimal donor morbidity. The free-style intraoperative selection based on donor tissue quality offers versatile reconstruction without necessitating contralateral procedures.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"108 ","pages":"Pages 53-60"},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662208","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":"Recent trends in nipple reconstruction – A case series and social media analysis of patient preferences","authors":"Sumin Yang,&nbsp;Armin Edalatpour,&nbsp;Jacqueline Israel,&nbsp;Katherine Gast","doi":"10.1016/j.bjps.2025.06.042","DOIUrl":"10.1016/j.bjps.2025.06.042","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients undergoing mastectomies are often offered nipple reconstruction. Nipple areolar tattooing is also an option chosen by many. The purpose of this study is to highlight trends in nipple reconstruction over time and identify factors that may impact patient decision-making.</div></div><div><h3>Methods</h3><div>A retrospective review of gender affirming mastectomies performed at a single institution was performed. A Pearson Chi-Square test was run on categorical data while an independent sample t-test was run on continuous data. Existing literature and social media were used to supplement our primary findings.</div></div><div><h3>Results</h3><div>Four hundred and forty-three adult patients who underwent surgery between 2017 and 2023 were included. The proportion of patients who chose to have nipple grafts decreased from 91% in 2019 to 78% in 2022. Statistically significant factors in deciding to forego nipple grafts were patient’s gender identity, pronouns, and absence of prior testosterone therapy. Discussions held on Reddit forums demonstrated comparable themes for transgender and breast cancer patients when deciding to preserve their nipples or not during their mastectomies.</div></div><div><h3>Conclusions</h3><div>We have observed anecdotally and objectively that a higher proportion of patients undergoing mastectomies are opting not to pursue surgical nipple reconstruction. There are likely many individual factors that may be related to this decision, including gender identity, perception of added risk, desire to minimize the number of surgeries, and/or option of undergoing future nipple-areolar tattooing. Social media discussions regarding this topic highlight its relevance for patients undergoing both breast reconstruction and gender affirming surgery.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"108 ","pages":"Pages 1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632754","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":"Deep neck surgery in deep plane facelifts – learning from evidence and experience","authors":"Alexandre G. Lellouch ,&nbsp;Leonard Knoedler ,&nbsp;Michael Alfertshofer ,&nbsp;Jillian Dean ,&nbsp;Adriana C. Panayi ,&nbsp;Raffaele Aguglia ,&nbsp;Curtis L. Cetrulo Jr. ,&nbsp;Kevin Sadati","doi":"10.1016/j.bjps.2025.06.036","DOIUrl":"10.1016/j.bjps.2025.06.036","url":null,"abstract":"<div><div>Deep plane facelifts have gained popularity for their natural and long-lasting results, prompting increased focus on advanced neck rejuvenation techniques. Both clinical experience and literature support refined strategies to address platysmal laxity, glandular prominence, and fat distribution. Midline corset platysmaplasty and lateral platysma repositioning improve structural support and jawline definition. Novel plication methods, including purse-string, crisscross, and layered sutures, enhance durability and patient satisfaction. Submandibular gland reduction, subplatysmal fat excision, and selective myotomies targeting the digastric and sternocleidomastoid muscles further contribute to cervicomental contouring. Adjunctive procedures such as fasciotomies improve tissue mobility and complement deep-plane dissection. Collectively, these innovations yield high patient satisfaction and sustained aesthetic outcomes. As surgical precision and technology evolve, individualized, anatomy-driven approaches will remain central to optimizing neck rejuvenation.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 247-257"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632743","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":"Bilateral Cleft Lip Severity Index in primary cleft rhinoplasty: Correlation with anthropometric outcomes and layperson perception","authors":"Allison C. Hu,&nbsp;Jinggang J. Ng,&nbsp;Jonathan H. Sussman,&nbsp;Philip D. Tolley,&nbsp;Isabel A. Ryan,&nbsp;Nicholas A. Han,&nbsp;Scott P. Bartlett,&nbsp;Oksana A. Jackson,&nbsp;Jordan W. Swanson,&nbsp;Jesse A. Taylor","doi":"10.1016/j.bjps.2025.06.044","DOIUrl":"10.1016/j.bjps.2025.06.044","url":null,"abstract":"<div><h3>Background</h3><div>The Bilateral Cleft Lip Severity Index (BCLSI) was developed to predict outcomes among patients who underwent bilateral cleft lip (CL) repair. However, its utility among cleft patients undergoing bilateral repair with primary rhinoplasty (PR) has not been studied. Here, we assess whether the BCLSI predicts nasal anthropometric and aesthetic outcomes in patients who had PR at the time of bilateral CL repair.</div></div><div><h3>Methods</h3><div>A retrospective review was performed of all children who underwent bilateral CL repair from 2008 to 2023 at our institution. Preoperative photographs were graded using the BCLSI (grades 1–3, 1 being least severe) and anthropometric analyses performed. Crowdsourcing surveys utilized pairwise comparison or Likert scale ratings of nasal appearance.</div></div><div><h3>Results</h3><div>55 patients met inclusion criteria and were stratified by BCLSI severity: Grade 1, 11 (20.0%); Grade 2, 17 (30.9%); and Grade 3, 27 (49.1%). Postoperative columellar-labial angle (CLA) was 117.7°±8.8°, 127.3°±9.6°, 133.4°±12.4° in patients with BCLSI of 1, 2, and 3, respectively (<em>p</em>&lt;0.001). Patients with BCLSI 1 received the most favorable layperson evaluations, while those with BCLSI 3 received the least favorable assessments across pairwise rank-derived coefficients (<em>p</em>=0.017) and composite ratings (<em>p</em>=0.014) independent of age of surgery, history of nasoalveolar molding, and technique. Greater CLA correlated with less favorable pairwise ratings (<em>p</em>=0.018).</div></div><div><h3>Conclusions</h3><div>Among patients undergoing bilateral CL repair with PR, higher BCLSI was associated with greater columellar-labial angle and worse nasal appearance scores postoperatively. Overall, the BCLSI may be a clinically useful tool with prognostic relevance for patients undergoing bilateral cleft repair both with and without primary rhinoplasty.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 205-213"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595413","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":"Arteriogenesis mechanism of choke vessel remodelling in multiterritory perforator flap in rats","authors":"Ping Peng ,&nbsp;Zhonggen Dong ,&nbsp;Zhaobiao Luo ,&nbsp;Jianwei Wei ,&nbsp;Lingli Zhou","doi":"10.1016/j.bjps.2025.06.037","DOIUrl":"10.1016/j.bjps.2025.06.037","url":null,"abstract":"<div><h3>Background</h3><div>The remodelling of choke vessels within the multiterritory perforator flap (MPF) is intricately associated with the blood supply of the flap. The objective of this study was to elucidate the revascularization mechanism underlying the remodelling of these choke vessels.</div></div><div><h3>Methods</h3><div>Integument radiography and hematoxylin-eosin (HE) staining were utilised to qualitatively and quantitatively evaluate the microvascular morphology within the choke zones. The Evans blue dye was employed to quantify blood flow velocities in the choke arteries within choke zone I, while a laser Doppler blood flow imager was utilised to assess blood perfusion. Immunohistochemistry was also conducted to evaluate the expression of proteins associated with arteriogenesis mechanisms.</div></div><div><h3>Results</h3><div>In choke zone I, several true anastomotic arteries were observed in the 3d postoperation (PO) group. There was no significant increase in arteriolar density; however, the maximum calibre of arterioles in the 3 d, 5 d, and 7 d PO groups exceeded that of the control group (P&lt;0.05). HE staining showed a decrease in microvessel density and dilation of the microvasculature. The arterial blood flow velocity began to significantly increase at 6 h PO (P&lt;0.05) and reached its peak at 1 d PO. Blood perfusion was higher at 1 d PO than at 6 h PO (P&lt;0.05). The expression of the TRPV4, Ephrin B2, CD11b, MMP-9 and eNOS increased significantly (P&lt;0.05).</div></div><div><h3>Conclusions</h3><div>Arteriogenesis is likely the key revascularization mechanism involved in choke artery remodelling in choke zone I. Arteriogenesis and angiogenesis play similar roles in choke artery remodelling in choke zone II.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 184-191"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595411","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":"Long-term follow-up after DIEP flap breast reconstruction: Quality of life with a focus on donor-site morbidity","authors":"Reinier W.A.M. Wertenbroek ,&nbsp;Andrzej A. Piatkowski","doi":"10.1016/j.bjps.2025.06.035","DOIUrl":"10.1016/j.bjps.2025.06.035","url":null,"abstract":"<div><h3>Background</h3><div>The DIEP flap is widely used for breast reconstruction post-mastectomy, known for its superior aesthetic results. Given the variety of reconstruction options available, evaluation of donor site satisfaction is essential for informed patient counseling and decision-making. This study assesses the overall quality of life and long-term patient satisfaction with the abdominal donor site after DIEP flap breast reconstruction.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study at Maastricht University Medical Center identified patients who underwent DIEP flap breast reconstruction over the past 15 years. Data mining tools searched electronic medical records for relevant procedures. Eligible participants received an online questionnaire using validated Dutch translations of the BREAST-Q and BODY-Q to measure satisfaction and physical well-being of the abdomen. Statistical analyses were performed using SPSS 29.0, employing multiple linear regression to investigate associations between demographic and clinical variables and satisfaction scores.</div></div><div><h3>Results</h3><div>A total of 563 questionnaires were initiated, and 470 patients were included for further analysis. The mean age at surgery was 51.5 years, with a mean BMI of 26.8. Patients reported high aesthetic satisfaction but experienced functional discomfort. Significant correlations were found between BMI, age, comorbidities (diabetes, hypertension), and satisfaction scores.</div></div><div><h3>Conclusion</h3><div>This study on DIEP flap breast reconstruction highlights high aesthetic satisfaction despite functional discomfort, with satisfaction decreasing as BMI increases. It underscores the importance of pre-operative weight management, individualized patient counseling, and consideration of age and comorbidities to optimize post-surgical satisfaction. The unexpected positive correlations between diabetes, hypertension, and satisfaction scores warrant further investigation.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"108 ","pages":"Pages 34-42"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655336","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 missing conversation? Intimacy and sexuality in facial palsy patients","authors":"Christian J. Jacobs ,&nbsp;Martinus M. van Veen","doi":"10.1016/j.bjps.2025.06.039","DOIUrl":"10.1016/j.bjps.2025.06.039","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 182-183"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595551","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 lymphatic reconstruction for prevention of secondary lymphedema in cancer patients: A meta-analysis of 42 studies","authors":"Jianing Du,&nbsp;Ao Fu,&nbsp;Chunjun Liu","doi":"10.1016/j.bjps.2025.06.038","DOIUrl":"10.1016/j.bjps.2025.06.038","url":null,"abstract":"<div><h3>Background</h3><div>Secondary lymphedema, a common complication following lymph node dissection, affecting up to 53% of cancer survivors, imposes significant morbidity and reduced quality of life. Immediate lymphatic reconstruction (ILR) has emerged as a preventive strategy; however, its efficacy remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a PRISMA/AMSTAR-compliant systematic review and meta-analysis. A comprehensive search of PubMed, EMBASE, and Web of Science (2009–2024) identified studies evaluating ILR for lymphedema prevention. Random-effects models were used to calculate pooled odds ratios (ORs) for comparative studies and pooled incidence proportions for single-arm studies, each with 95% confidence intervals (CIs). Subgroup analyses examined extremity site, follow-up duration, BMI, and study design. Publication bias was assessed with funnel plots and Egger’s test.</div></div><div><h3>Results</h3><div>We included 42 studies with a total of 4539 patients. Among comparative studies, ILR was associated with roughly a 75% reduction in lymphedema risk (pooled OR = 0.25, 95% CI 0.17–0.36, p=0.004). A temporal decline in ILR’s protective effect was observed: OR 0.11 at &lt;1 year follow-up versus OR 0.41 at ≥2 years (p=0.003). Across 19 single-arm studies, the pooled lymphedema incidence after ILR was 7.34% (95% CI 4.97–10.71%), rising to ∼20% in studies with &gt;2 years of follow-up. Heterogeneity among studies was moderate (I² = 51%). Funnel plots indicated potential publication bias in comparative studies (Egger’s test: z=−2.14, p=0.032), but not in single-arm studies (p=0.105).</div></div><div><h3>Conclusion</h3><div>ILR reduces the risk of cancer-related secondary lymphedema, particularly for breast cancer patients in the early postoperative period. Standardized surgical protocols and prolonged follow-up are needed to optimize and confirm long-term benefits.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 214-227"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595550","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 rate of revision surgery for secondary deformities of the lip in cleft lip patients: A systematic review","authors":"Alexander T. Plonkowski ,&nbsp;Dylan G. Choi ,&nbsp;Marvee Turk ,&nbsp;Muhammad Daiem ,&nbsp;Francesca Calderon ,&nbsp;Priyanka Naidu ,&nbsp;William P. Magee III","doi":"10.1016/j.bjps.2025.06.016","DOIUrl":"10.1016/j.bjps.2025.06.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Secondary deformities following primary cleft lip repair require varying degrees of surgical intervention, from minor scar revision to complete takedown and repair. Revision surgery can itself necessitate multiple interventions, representing a considerable burden for both patients and the health system. In this study, we evaluate the reported rates of revision surgery for secondary deformities of the lip within the literature.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following PRISMA criteria. Pubmed, SCOPUS, and Cochrane databases were utilized. Studies reporting rates of lip revision surgery were included. Studies with non-cleft patients, not in English, or those with primary and revision surgery at two different institutions were excluded.</div></div><div><h3>Results</h3><div>Thirty-four studies were included. The overall revision rate was 21.2±14.6% (Range: 0–91.2%). Stratified by phenotype, revision rates were 32.3±18.9% for isolated unilateral cleft lip, 78.6±6.5% for isolated bilateral cleft lip, 29.6±24.4% for unilateral cleft lip and palate, and 36.7±21.6% for bilateral cleft lip and palate. No significant differences were found between phenotypic groups. Revision rates did not significantly differ between studies that used presurgical orthopedics (16.6±13.6%) and those that did not (25.3±9.5%) (p=0.06). With regards to surgical technique, revision rates were 27.3±19.0% for rotation advancement, 12.0±22.4% for straight line repair, and 8.1±0.5% for anatomic subunit approximation (p=0.63). The most common surgical indication was scar revision (26.2%).</div></div><div><h3>Conclusion</h3><div>Current literature reports a wide range of rates for revision surgery. The most common indication for secondary surgery is scar revision. Improved reporting of surgical technique is necessary to guide evidence-based protocols for primary lip repair.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"109 ","pages":"Pages 99-107"},"PeriodicalIF":2.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852512","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}