Journal of Plastic Reconstructive and Aesthetic Surgery最新文献_第8页

Post-excisional radiotherapy for keloid treatment: A systematic review and meta-analysis 瘢痕疙瘩切除后放射治疗：系统回顾和荟萃分析。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-14 DOI: 10.1016/j.bjps.2025.11.016

Ishith Seth , Damien Gibson , Gianluca Marcaccini , Paola Pentangelo , Yi Xie , Bryan Lim , Roberto Cuomo , Richard Khor , Warren M. Rozen , Sally Kiu-Huen Ng

Background

Keloids are aggressive fibroproliferative scars extending beyond wound margins, with high recurrence despite multiple treatment modalities. Combining surgical excision with radiotherapy reduces recurrence, but the optimal timing of radiotherapy remains controversial.

Aim

To evaluate the effectiveness and optimal timing of post-excisional radiotherapy in preventing keloid recurrence.

Methods

A systematic review was conducted using Scopus, Web of Science, PubMed, and Cochrane databases from inception to June 2024. Studies were included if they involved keloid patients treated with post-excisional radiotherapy (X-ray, brachytherapy, or electron beam), applied either early (≤ 24 h post-operation) or late (> 24 h). Studies without data on recurrence or complications were excluded. Outcomes were analysed using rate ratios (RR) with statistical significance set at p < 0.05.

Results

Of 3076 records identified, 2507 unique studies were screened, and 106 met the inclusion criteria. These studies involved 10,745 keloid lesions. The mean patient age was 35 years, with a nearly equal gender distribution. Recurrence rates were 18% (X-ray), 14% (brachytherapy), and 16% (electron beam). Complication rates were 9%, 18%, and 16%, respectively. No statistically significant difference in recurrence or complications was observed between radiotherapy modalities or between early and late radiotherapy application (p > 0.05 across all subgroups).

Conclusion

Post-excisional radiotherapy significantly reduces keloid recurrence, but recurrence and complication rates are comparable across X-ray, brachytherapy, and electron beam therapies. Early versus delayed radiotherapy timing does not significantly impact outcomes. These findings highlight that recurrence and complication rates are comparable across radiotherapy modalities and timing windows. Until controlled, standardised trials are available, treatment practice may reasonably reflect physician judgement and local treatment availability.

背景：瘢痕疙瘩是一种侵袭性的纤维增生性瘢痕，可扩展到伤口边缘以外，尽管采用多种治疗方法，但其复发率很高。手术切除联合放疗可减少复发，但最佳放疗时间仍有争议。目的：探讨术后放疗预防瘢痕疙瘩复发的效果及最佳时机。方法：对Scopus、Web of Science、PubMed、Cochrane等数据库进行系统评价。如果瘢痕疙瘩患者在手术后接受放疗（x射线、近距离放疗或电子束），早期（术后≤24小时）或晚期（术后≤24小时）应用，则纳入研究。没有复发或并发症数据的研究被排除在外。结果分析采用率比（RR）， p < 0.05为有统计学意义。结果：在确定的3076条记录中，筛选了2507项独特的研究，106项符合纳入标准。这些研究涉及10745个瘢痕疙瘩病变。患者平均年龄为35岁，性别分布几乎相等。复发率分别为18% （x线）、14%（近距离治疗）和16%（电子束治疗）。并发症发生率分别为9%、18%和16%。不同放疗方式、早期和晚期放疗的复发率和并发症无统计学差异（各亚组间p < 0.05）。结论：术后放疗可显著减少瘢痕疙瘩复发，但x线、近距离治疗和电子束治疗的复发率和并发症发生率相当。早期和延迟放疗时间对预后没有显著影响。这些发现强调了不同放疗方式和时间窗的复发率和并发症发生率具有可比性。在有对照的、标准化的试验之前，治疗实践可以合理地反映医生的判断和当地治疗的可用性。

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引用次数: 0

The impact of vascular endothelial growth factor containing collagen-binding domain on fat graft survival 含胶原结合结构域的血管内皮生长因子对脂肪移植存活的影响。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-14 DOI: 10.1016/j.bjps.2025.11.027

Fatih İçbudak , Dila Şener Akçora , Banu Taktak Karaca , Cemile Ceylan , Zeynep Deniz Akdeniz Doğan

Background

Fat grafting is widely used in esthetic and reconstructive surgery; however, graft survival and volume retention are often suboptimal, particularly in fibrotic tissues following radiotherapy (RT). Vascular endothelial growth factor (VEGF) enhances angiogenesis but has limited efficacy due to its short half-life. We evaluated a modified VEGF containing a collagen-binding domain (CBD-VEGF) for improving fat graft survival in irradiated fibrotic tissue.

Methods

Twenty-four Sprague-Dawley rats were randomly allocated into three groups (n=8). All received a single 10 Gy dose of RT to the dorsal region to induce fibrosis. After one month, Group 1 received fat graft only, Group 2 received fat graft + VEGF, and Group 3 received fat graft + CBD-VEGF. Two months postgrafting, the grafts were harvested for weight measurement and histological evaluation, which included fibrosis and necrosis scoring and immunohistochemical staining for CD31 (vascular density) and perilipin-1 (adipocyte viability).

Results

Group 3 (CBD-VEGF) demonstrated significantly higher graft weight compared to Groups 1 and 2 (p<0.01). Fibrosis and necrosis scores were significantly reduced in Group 3 (p<0.01 and p<0.05, respectively). CD31 and perilipin-1 expression levels were significantly elevated in Group 3 compared to both control and VEGF groups (p<0.01 and p<0.05).

Conclusion

CBD-VEGF significantly enhanced fat graft survival and improved tissue quality in irradiated fibrotic beds. Its application may represent a promising therapeutic strategy to optimize outcomes in fat grafting, particularly in previously irradiated tissues.

背景：脂肪移植在整形外科中应用广泛；然而，移植物的存活和体积保留通常不是最佳的，特别是在放疗（RT）后的纤维化组织中。血管内皮生长因子（Vascular endothelial growth factor， VEGF）能促进血管生成，但由于其半衰期短，其疗效有限。我们评估了含有胶原结合结构域（CBD-VEGF）的改良VEGF对改善辐照纤维化组织中脂肪移植存活的作用。方法：24只sd大鼠随机分为3组（n=8）。所有小鼠均接受单次10 Gy剂量的背区放射治疗以诱导纤维化。1个月后，组1只接受脂肪移植，组2接受脂肪移植+ VEGF，组3接受脂肪移植+ CBD-VEGF。移植2个月后，采集移植物进行重量测量和组织学评估，包括纤维化和坏死评分以及CD31（血管密度）和perilipin-1（脂肪细胞活力）的免疫组织化学染色。结果：与1组和2组相比，第3组（CBD-VEGF）的移植物重量显著增加(结论：CBD-VEGF显著提高了脂肪移植物的存活率，改善了辐照纤维化床的组织质量。它的应用可能代表了一种有前途的治疗策略，以优化脂肪移植的结果，特别是在以前辐照过的组织中。

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引用次数: 0

How well does quantitative measurements of the lip and panel ratings of the lip outcomes correlate in adults treated for unilateral cleft, lip, and palate with Skoog lip repair in childhood 在成人单侧唇裂、唇裂和腭裂治疗中，唇部的定量测量和唇部结果的小组评分与儿童期Skoog唇部修复的相关性有多好？

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-14 DOI: 10.1016/j.bjps.2025.11.023

Roshan Peroz , Alberto Falk-Delgado , Omar Al-hili , David Schwarz , Malin Hakelius , Maria Mani

Background

Little is known about the long-term lip symmetry after cleft repair and correlation between objective measures and subjective human ratings. Therefore, we examined long-term lip asymmetry among adults who were treated for unilateral cleft, lip, and palate (UCLP) with the Skoog’s lip repair in their infancy. Furthermore, we investigated the correlation between patient-reported scores of lip appearance and percentage of lip asymmetry as measured using SymNose.

Patients and methods

The symmetry of the lip was measured twice using SymNose by two users on frontal uncropped photographs of 74 UCLP-treated adults at a mean follow-up of 37 years postlip surgery. Previously collected self-assessment of lip appearance and panel ratings (from professionals, laypersons, and cleft panels) of these photographs were included in this study.

Results

The overall median lip asymmetry was relatively low at 18%. Men exhibited slightly higher asymmetry than women (P<0.05). There was no difference between SymNose measurements taken by the two users (P>0.05). Intrarater agreement of both users ranged from good to excellent (intraclass correlation coefficient 0.84–0.96). The interrater agreement was moderate, (intraclass correlation coefficient 0.52–0.66). No significant correlation was found between the human ratings: self-assessment and panel assessments to that of lip asymmetry (%) measured using SymNose.

Conclusion

Although SymNose is confirmed to be a reliable tool for quantifying asymmetry, it does not correlate with subjective human ratings. Thus, it should be complemented with subjective assessment and clinical findings to define lip outcomes among patients with UCLP.

背景：关于唇裂修复后的长期唇对称以及客观测量与人类主观评分之间的关系，我们所知甚少。因此，我们研究了在婴儿期接受Skoog唇修复治疗的单侧唇腭裂（UCLP）成人的长期唇不对称。此外，我们研究了患者报告的嘴唇外观分数与使用SymNose测量的嘴唇不对称百分比之间的相关性。患者和方法：74名接受过uclp治疗的成年人在唇部手术后平均随访37年，两名用户使用SymNose对其正面未裁剪的照片进行了两次测量。本研究包括先前收集的这些照片的唇形和面板评分的自我评估（来自专业人士，外行人和唇裂面板）。结果：整体中唇不对称相对较低，为18%。男性的不对称性略高于女性（P0.05）。两名用户的内部一致性从好到优不等（类内相关系数0.84-0.96）。组间一致性中等（组内相关系数0.52 ~ 0.66）。没有发现人类评分：自我评估和小组评估与使用SymNose测量的嘴唇不对称（%）之间有显著的相关性。结论：虽然SymNose被证实是量化不对称性的可靠工具，但它与人类的主观评分无关。因此，它应该与主观评估和临床结果相补充，以确定患者的唇部预后。

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引用次数: 0

The adverse effects of frontalis muscle hyperactivity on Asian upper blepharoplasty outcomes: A prospective randomized controlled trial 额肌过度活跃对亚洲上睑成形术结果的不良影响：一项前瞻性随机对照试验

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-14 DOI: 10.1016/j.bjps.2025.11.028

Jiaxi Liu , Zhaoxiang Zhang , Lei Guo , Peihui Yang , Qian Zhao , Baoqiang Song

Background

Common complications of upper blepharoplasty include significant changes in crease height and disappearance. These issues are frequently observed in patients with overactive frontalis muscles.

Objectives

This study aimed to evaluate the impact of frontalis muscle hyperactivity on surgical outcomes.

Methods

Crease height was categorized as apparent or true. In this prospective comparative study, 58 patients were randomly assigned to one of two groups: the experimental group received incisional upper blepharoplasty along with botulinum toxin injections into the frontalis muscle 2 weeks before and 6 months after surgery, while the control group underwent incision-based upper blepharoplasty alone. Relevant outcome indicators were assessed and compared between the two groups at 3, 6, and 12 months postoperatively.

Results

At 6 months postsurgery, significant differences were observed between the two groups in the variations of apparent crease height at the mid-pupil and true crease height at the lateral canthus. By 12 months, significant intergroup differences were also noted in the variations of true crease height at both the lateral and medial canthus and apparent crease height at the lateral canthus and mid-pupil, as well as in the rate of crease disappearance.

Conclusions

Hyperactive frontalis muscles adversely affect the outcome of upper blepharoplasty.

背景：上睑成形术的常见并发症包括皱褶高度的显著变化和消失。这些问题常见于额肌过度活跃的患者。目的探讨额肌多动对手术效果的影响。方法将切口高度分为明显高度和真实高度。在这项前瞻性比较研究中，58例患者被随机分为两组：实验组在术前2周和术后6个月分别行切口上睑成形术并在额肌注射肉毒杆菌毒素，对照组仅行切口上睑成形术。在术后3个月、6个月和12个月对两组的相关结局指标进行评估和比较。结果术后6个月，两组患者瞳孔中部视折痕高度和外眦真折痕高度变化差异有统计学意义。12个月时，两组间的外眦和内眦真折痕高度变化、外眦和瞳孔中部视折痕高度变化以及折痕消失率也有显著差异。结论额肌过活跃影响上睑成形术的效果。

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引用次数: 0

Impact of scroll reconstruction on nasal tip rotation and projection following primary open rhinoplasty 初开鼻成形术后螺旋形重建对鼻尖旋转和突出的影响

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-13 DOI: 10.1016/j.bjps.2025.11.024

Agah Yeniceri, Melih Cayonu

Nasal tip stability is a key determinant of long-term rhinoplasty outcomes, yet the role of scroll reconstruction in supporting this stability remains insufficiently studied. This study investigated the impact of scroll reconstruction on nasal tip stability in patients undergoing primary open rhinoplasty with cephalic resection of the lower lateral cartilage. This retrospective study included 69 patients who underwent primary open approach rhinoplasty between 2021 and 2024. The mean age of the patients was 25.18 ± 5.69 years. Standardized lateral photographs were used to assess nasal tip rotation (nasolabial angle) and projection (Goode ratio) preoperatively and at 1 week and 12 months postoperatively. The results revealed that the scroll reconstruction group exhibited significantly less loss of nasal tip rotation (6 degrees) compared with the control group (10 degrees) during long-term follow-up (p < 0.0001). Additionally, the scroll reconstruction group showed significantly less loss of nasal tip projection (0.029) compared with the control group (0.042) during the same period (p = 0.007). Correlation analysis indicated a weak but significant relationship between early postoperative changes and long-term outcomes (r = 0.302, p = 0.012). Our study suggested that scroll reconstruction may contribute to maintaining nasal tip stability by reducing postoperative changes in rotation and projection.

鼻尖的稳定性是长期鼻整形效果的关键决定因素，然而，在支持这种稳定性方面，滚动重建的作用仍然没有得到充分的研究。本研究探讨了涡旋重建对初次开放性鼻成形术伴有头侧切除下外侧软骨患者鼻尖稳定性的影响。这项回顾性研究包括了69名在2021年至2024年间接受了首次开放式鼻整形手术的患者。患者平均年龄25.18±5.69岁。术前、术后1周和12个月采用标准化侧位照片评估鼻尖旋转（鼻唇角）和突出（古德比）。结果显示，在长期随访中，卷轴重建组鼻尖旋转损失（6度）明显少于对照组（10度）（p < 0.0001）。与对照组（0.042）相比，滚动重建组在同一时期鼻尖突出损失（0.029）显著减少（p = 0.007）。相关分析显示，术后早期变化与远期预后之间存在较弱但显著的相关性（r = 0.302, p = 0.012）。我们的研究表明，通过减少术后旋转和突出的变化，滚动重建可能有助于维持鼻尖的稳定性。

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引用次数: 0

Long-term outcomes of dissection of the depressor labii inferioris muscle to enhance symmetry after free functional gracilis muscle transfer in patients with facial paralysis 面瘫患者游离功能性股薄肌转移术后，切除下唇降肌以增强对称性的远期疗效

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-13 DOI: 10.1016/j.bjps.2025.11.020

Mark Fricke, Branislav Kollar, Ayla A. Hohenstein, Nico Leibig, Steffen U. Eisenhardt, Jakob B.W. Weiss

Background

In unilateral facial paralysis, overactivity of the contralateral depressor labii inferioris muscle (DLI) often contributes to persistent lower lip asymmetry after free functional gracilis transfer (FFGT). This issue can be addressed through dissection of DLI. We objectively evaluated the long term effects of DLI dissection after FFGT.

Methods

Patients with unilateral facial paralysis who underwent smile reconstruction with FFGT and subsequent DLI dissection between 2014 and 2023 were retrospectively analyzed. Lower lip height deviation was measured at different time points after DLI dissection.

Results

Thirty patients were included with a mean follow-up of 8.41 months. For smiling with exposed teeth, the mean lower lip height deviation significantly decreased from 5.06 mm to 2.58 mm (p < 0.001) following DLI dissection. When first clinical follow-up was conducted within six months, lower lip height deviation was reduced to 2.00 mm (p = 0.0003), follow-ups beyond six months showed a nonsignificant reduction to 3.72 mm. Long-term evaluations revealed initial improvements, followed by a partial regression of results over time (4.83 mm preoperatively, 1.59 mm at 3–7 months [p < 0.01], 3.66 mm at 13–17 months, 2.54 mm at 26–30 months postoperatively). One patient required revision surgery due to a neuroma of the lower lip and two underwent a second DLI dissection.

Conclusions

Dissection of the DLI is a safe and effective technique for improving lower lip symmetry after FFGT in the short term. However, the diminishing effect over time highlights the need for patient education about the expected long-term outcomes.

背景：在单侧面瘫中，游离功能性股薄肌转移（FFGT）后，对侧下唇下降肌（DLI）的过度活动通常导致持续的下唇不对称。这个问题可以通过剖析DLI来解决。我们客观评价FFGT后DLI剥离的长期效果。方法回顾性分析2014 ~ 2023年单侧面瘫患者行FFGT微笑重建及DLI剥离术的临床资料。在DLI解剖后不同时间点测量下唇高度偏差。结果30例患者入组，平均随访8.41个月。对于露出牙齿的微笑，DLI剥离后的平均下唇高度偏差从5.06 mm显著降低到2.58 mm （p < 0.001）。首次临床随访6个月时，下唇高度偏差减小至2.00 mm (p = 0.0003)， 6个月后随访，下唇高度偏差减小至3.72 mm，差异无统计学意义。长期评估显示初步改善，随后随着时间的推移结果部分回归（术前4.83 mm， 3-7个月1.59 mm [p < 0.01]， 13-17个月3.66 mm，术后26-30个月2.54 mm）。一名患者因下唇神经瘤需要翻修手术，两名患者接受了第二次DLI夹层。结论游离下唇夹层是改善FFGT术后下唇对称性的一种安全、有效的方法。然而，随着时间的推移，效果逐渐减弱，这凸显了对患者进行预期长期结果教育的必要性。

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引用次数: 0

Combined transconjunctival and transcaruncular approach with multiple sheet implantation for three-dimensional reduction of concomitant medial and inferior orbital wall fracture 经结膜、经孔道联合多片植入术治疗伴发眶内、下壁骨折三维复位术。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-13 DOI: 10.1016/j.bjps.2025.11.021

Hidetaka Miyazaki , Makoto Ito , Muhammad Abumanhal , Jose Miguel Ambat , Yasuhiro Takahashi

The aim of this retrospective study was to present the technique for three-dimensional reduction of concomitant medial and inferior orbital wall fracture by placing multiple thin bioabsorbable sheet implants and to evaluate the surgical outcomes. Twenty-six patients (14 males and 12 females) were included in this study. Surgery was performed through separate transconjunctival and transcaruncular incisions, and 2 or 3 pieces of thin bioabsorbable sheet implants of hydroxyapatite and poly L-lactide composite were inserted through each. In 11 cases with inferomedial orbital strut fracture, these implants were in contact with the inferomedial orbit. Surgical outcomes were evaluated using a 5-point scale based on the binocular single vision field (BSV), area of field of BSV, and orbital volume measured on computed tomography. Consequently, three-dimensional reconstruction was successfully achieved in all cases with no complications. Postoperatively, the field of BSV scale (p < 0.001) and area of field of BSV (p < 0.035) were significantly improved. There was no significant difference in orbital volume between the repaired and unrepaired sides (p = 0.807). Based on these findings, the approach presented here is an effective technique for repairing concomitant inferior and medial orbital wall fractures.

本回顾性研究的目的是介绍通过放置多个生物可吸收薄片植入物来三维复位合并眶内、下壁骨折的技术，并评估手术效果。26例患者（男14例，女12例）纳入本研究。手术通过单独的经结膜和经孔道切口，分别置入2或3片羟基磷灰石和聚l -丙交酯复合材料的生物可吸收薄片植入物。在11例眶内侧支撑骨折中，植入物与眶内侧支撑接触。根据双眼单视野（BSV）、BSV视野面积和计算机断层扫描测量的眼眶体积，采用5分制评估手术效果。因此，所有病例均成功实现三维重建，无并发症。术后BSV量表范围（p < 0.001）和BSV视野面积（p < 0.035）均有显著改善。修复侧与未修复侧眼眶体积差异无统计学意义（p = 0.807）。基于这些发现，本文提出的入路是修复伴发的眶下壁和眶内壁骨折的有效方法。

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引用次数: 0

Beam me later: Prepectoral vs subpectoral breast reconstruction before postmastectomy radiotherapy - A systematic review and meta-analysis 稍后发送：乳房切除术放疗前胸前乳房重建vs胸下乳房重建-系统回顾和荟萃分析

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-13 DOI: 10.1016/j.bjps.2025.11.019

Regitze Størling , Rikke Johansen , Caroline Lilja , Tine Engberg Damsgaard

Aim

To compare postoperative complications between prepectoral and subpectoral immediate implant-based breast reconstruction (IBBR) in patients receiving postmastectomy radiotherapy.

Methods

This systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was conducted in Embase, PubMed, Cochrane Library, and ClinicalTrials.gov. The meta-analysis investigated the incidence of implant loss between prepectoral and subpectoral IBBR, and odds ratios (ORs) were used to compare the incidence of dehiscence, hematoma, seroma, infection, and necrosis. Capsular contracture rates were compared as well, and complication severity was evaluated using the Clavien–Dindo classification system.

Results

The literature search, conducted in June 2024, identified 1302 studies. Fourteen met the inclusion criteria. Seven studies were included in the meta-analysis at the breast level (334 prepectoral and 448 subpectoral), and eight in the patient-level analysis (417 and 744 patients, respectively). No significant difference in implant loss was observed (breast level: OR, 0.66; p=0.22 and patient level: OR, 1.00; p=0.99). Dehiscence, hematoma, seroma, and necrosis rates were also comparable. Infection initially appeared more common in the prepectoral group (OR, 1.46; p=0.05), but this was not confirmed in the sensitivity analysis. Severity and frequency of complications, assessed using the Clavien–Dindo system, were similar between groups. One study reported higher capsular contracture rates in the subpectoral group, while the other seven studies found no difference.

Conclusion

Prepectoral and subpectoral IBBR show comparable rates and severity of short- and long-term postoperative complications, suggesting similar safety profiles between approaches in selected patients receiving postmastectomy radiotherapy.

目的比较乳房切除术后放疗患者胸前与胸下即刻植入式乳房重建术（IBBR）的术后并发症。方法本系统评价和荟萃分析按照系统评价和荟萃分析指南的首选报告项目进行。在Embase、PubMed、Cochrane图书馆和ClinicalTrials.gov进行文献检索。该荟萃分析调查了胸前和胸下IBBR植入物丢失的发生率，并使用优势比（ORs）来比较裂开、血肿、血肿、感染和坏死的发生率。采用Clavien-Dindo分类系统比较两组患者囊膜挛缩率，并评估并发症严重程度。文献检索于2024年6月进行，确定了1302项研究。14例符合纳入标准。7项研究被纳入乳房水平的荟萃分析（334项胸前研究和448项胸下研究），8项研究被纳入患者水平的分析（分别为417例和744例患者）。两组植入物丢失无显著差异（乳房水平：OR， 0.66; p=0.22；患者水平：OR， 1.00; p=0.99）。裂开、血肿、血肿和坏死的发生率也具有可比性。感染最初在术前组更常见（OR, 1.46; p=0.05），但在敏感性分析中未得到证实。使用Clavien-Dindo系统评估并发症的严重程度和频率，两组之间相似。一项研究报告了胸下组的荚膜挛缩率较高，而其他七项研究没有发现差异。结论胸前和胸下IBBR的短期和长期术后并发症发生率和严重程度相当，表明在选定的接受乳房切除术后放疗的患者中，两种入路的安全性相似。

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引用次数: 0

Predictors of globe injuries in over 340,000 facial fracture patients: A National Trauma Data Bank study 超过340,000例面部骨折患者的全球损伤预测因素：一项国家创伤数据库研究

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-13 DOI: 10.1016/j.bjps.2025.11.018

Michael Edgar , Sam Jiang , Megan M. Perez , Daniel Paku , Justin Chang , Akriti Choudhary , Kelsey Green , Royce Park , Chad A. Purnell

引用次数: 0

Is there histological evidence supporting capsulectomy in patients with breast implant illness: A case-control study 是否有组织学证据支持乳房种植体疾病患者的荚膜切除术：病例对照研究

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-13 DOI: 10.1016/j.bjps.2025.11.026

Linda Regina Gudjonsdottir , Erik Eiler Frydshou Bak , Andreas Larsen , Tim Kongsmark Weltz , Mathias Ørholt , Jens Jørgen Elberg , Trine Foged Henriksen , Lisbet Rosenkrantz Hölmich , Mads Gustaf Jørgensen , Mikkel Herly

Background

Breast implant illness (BII) is a controversial and poorly understood condition reported by some patients with breast implants. We compared implant capsule histology from patients with BII versus a control group to identify potential markers of BII and assess the biological rationale for capsulectomy.

Methods

We performed a 1:10 matched case-control study using the Copenhagen Breast Implant biobank. Capsule biopsies from patients who reported BII symptoms were randomly matched with patients without BII by implant type, implantation time, age, body mass index, and Baker grade. Biopsies were stained with hematoxylin and eosin (H&E) and assessed using a validated histopathological scoring system to evaluate histological parameters associated with capsule fibrosis, inflammation, and foreign-body reaction.

Results

The study included 148 patients (198 capsules). Nine patients with BII contributed with 18 capsules which were matched with 180 capsules from 139 control patients. Median capsule thickness, synovial-like metaplasia, lymphocyte infiltration, multinucleated giant cells, fibroblast/macrophage density, collagen organization, stromal cellularity, vascularity, calcification, and quantified silicone volume did not differ between the groups (all P >.05).

Conclusions

Breast implant capsules from patients with BII were histologically similar to those from asymptomatic patients. These findings provide no histological justification for routine capsulectomy in patients with BII. Further research is needed to clarify the etiology of BII and its surgical management.

背景乳房植入物疾病（BII）是一些乳房植入物患者报告的一种有争议且知之甚少的疾病。我们比较了BII患者和对照组的种植体胶囊组织学，以确定BII的潜在标志物，并评估胶囊切除术的生物学依据。方法采用哥本哈根乳房植入物生物库进行1:10配对病例对照研究。对报告BII症状的患者进行胶囊活检，根据种植体类型、种植时间、年龄、体重指数和Baker分级随机匹配无BII患者。活检用苏木精和伊红（H&；E）染色，并使用经过验证的组织病理学评分系统评估与胶囊纤维化、炎症和异物反应相关的组织学参数。结果纳入148例患者（198粒胶囊）。9名BII患者提供18粒胶囊，与139名对照患者的180粒胶囊相匹配。中位囊厚度、滑膜样化生、淋巴细胞浸润、多核巨细胞、成纤维细胞/巨噬细胞密度、胶原组织、间质细胞、血管密度、钙化和定量硅胶体积在两组间无差异（均P >； 0.05）。结论BII患者的乳房植入胶囊在组织学上与无症状患者相似。这些发现没有提供对BII患者进行常规包膜切除术的组织学依据。需要进一步的研究来阐明BII的病因和手术治疗。

{"title":"Is there histological evidence supporting capsulectomy in patients with breast implant illness: A case-control study","authors":"Linda Regina Gudjonsdottir , Erik Eiler Frydshou Bak , Andreas Larsen , Tim Kongsmark Weltz , Mathias Ørholt , Jens Jørgen Elberg , Trine Foged Henriksen , Lisbet Rosenkrantz Hölmich , Mads Gustaf Jørgensen , Mikkel Herly","doi":"10.1016/j.bjps.2025.11.026","DOIUrl":"10.1016/j.bjps.2025.11.026","url":null,"abstract":"<div><h3>Background</h3><div>Breast implant illness (BII) is a controversial and poorly understood condition reported by some patients with breast implants. We compared implant capsule histology from patients with BII versus a control group to identify potential markers of BII and assess the biological rationale for capsulectomy.</div></div><div><h3>Methods</h3><div>We performed a 1:10 matched case-control study using the Copenhagen Breast Implant biobank. Capsule biopsies from patients who reported BII symptoms were randomly matched with patients without BII by implant type, implantation time, age, body mass index, and Baker grade. Biopsies were stained with hematoxylin and eosin (H&E) and assessed using a validated histopathological scoring system to evaluate histological parameters associated with capsule fibrosis, inflammation, and foreign-body reaction.</div></div><div><h3>Results</h3><div>The study included 148 patients (198 capsules). Nine patients with BII contributed with 18 capsules which were matched with 180 capsules from 139 control patients. Median capsule thickness, synovial-like metaplasia, lymphocyte infiltration, multinucleated giant cells, fibroblast/macrophage density, collagen organization, stromal cellularity, vascularity, calcification, and quantified silicone volume did not differ between the groups (all <em>P</em> >.05).</div></div><div><h3>Conclusions</h3><div>Breast implant capsules from patients with BII were histologically similar to those from asymptomatic patients. These findings provide no histological justification for routine capsulectomy in patients with BII. Further research is needed to clarify the etiology of BII and its surgical management.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"113 ","pages":"Pages 138-146"},"PeriodicalIF":2.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624703","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}

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