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Postoperative measures changes in patients with gigantomastia who underwent inverted-T reduction mammoplasty with or without dermo-adipo-glandular inferior-pedicled Ribeiro flap 术后测量巨乳症患者行内翻t型缩乳术伴或不伴真皮脂肪腺下蒂Ribeiro皮瓣的变化
IF 2.4 3区 医学 Q2 SURGERY
Journal of Plastic Reconstructive and Aesthetic Surgery
Pub Date : 2026-02-01 Epub Date: 2025-11-03 DOI: 10.1016/j.bjps.2025.10.041
Giovanni Francesco Marangi, Fara Desiree Romano, Marco Gratteri, Martina Pagnoni, Daniela Porso, Luigi Abate, Annalisa Cogliandro, Vito Toto, Angelo Faiola, Paolo Persichetti

Introduction

The Ribeiro flap was originally described to increase breast projection during breast surgery. The aim of the study was to evaluate the changes in breasts of patients with gigantomastia undergoing reduction mammaplasty with a Pitanguy-Ribeiro technique based on the Ribeiro flap and compare volume, sternal notch-nipple, sulcus-nipple distance, and projected sulcus-to-skin distance-sulcus with a control group (without the use of the aforementioned flap).

Materials and methods

The flap group was composed of 33 patients, while the no-flap group was composed of 52 patients. Photographs and measurements were taken preoperatively and after 3, 6, and 12 months. The estimated volume was calculated using BREAST-V.

Results

Groups were comparable for breast volume after surgery. The ANOVA test showed significant increases in outcome measurements between each time in each single group. The t-test didn’t demonstrate a statistically significant change for ΔT12–3 between the two groups for each outcome. The average T3 projection in the flap group was greater. A weak negative correlation between projection and ΔT0–3 volumes within the flap group was demonstrated.

Discussion

Authors may assume that for both groups, breasts tend to descend over time with no significant difference between the two groups. The flap allowed an increased breast projection, which can be influenced by tissue resection.

Conclusion

The use of the Ribeiro flap during reduction mammoplasty according to Pitanguy's technique seems not to affect the stability of the breast over time in patients with gigantomastia. The flap and extent of tissue resection appear to influence postoperative breast projection.
Ribeiro皮瓣最初被描述为在乳房手术中增加乳房投影。本研究的目的是评估巨乳症患者在接受基于Ribeiro皮瓣的Pitanguy-Ribeiro技术的缩乳成形术时乳房的变化，并与对照组（不使用上述皮瓣）比较体积、胸骨缺口-乳头、沟-乳头距离和沟-皮肤距离-沟的投影距离。材料与方法皮瓣组33例，无皮瓣组52例。术前、术后3、6、12个月分别拍照和测量。使用BREAST-V计算估计体积。结果两组术后乳房体积具有可比性。方差分析（ANOVA）检验显示，每一组每次的结果测量值显著增加。t检验没有证明两组之间ΔT12-3的每个结果有统计学上的显著变化。皮瓣组T3平均投影量较大。在皮瓣组内，投影与ΔT0-3体积呈弱负相关。作者可能会假设，对于两组，乳房随着时间的推移会下降，两组之间没有显著差异。皮瓣可以增加乳房投影，这可能受到组织切除的影响。结论应用Ribeiro皮瓣对巨乳症患者的缩乳术不影响乳房的长期稳定性。皮瓣和组织切除的程度似乎影响术后乳房投影。
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引用次数: 0
Can we “overcorrect” our way to normal appearance in metopic craniosynostosis? A single-center’s 33 year odyssey 异位性颅缝闭闭是否可以“矫枉过正”以达到正常的外观？一个单一中心的33年奥德赛。
IF 2.4 3区 医学 Q2 SURGERY
Journal of Plastic Reconstructive and Aesthetic Surgery
Pub Date : 2026-02-01 Epub Date: 2025-11-20 DOI: 10.1016/j.bjps.2025.11.041
Allison C. Hu, Carrie Z. Morales, Aaron T. Zhao, Philip D. Tolley, Nicholas A. Han, Isabel A. Ryan, Dominic J. Romeo, Jordan W. Swanson, Scott P. Bartlett, Jesse A. Taylor

Background

To better expand the anterior cranial fossa and account for growth and relapse after traditional fronto-orbital advancement (FOA), an intentional “overcorrection” technique was adopted by our institution in 2012. This study compared long-term clinical and aesthetic outcomes between traditional (T-FOA) and overcorrection (O-FOA) approaches.

Methods

A retrospective review was performed of all children who underwent FOA for isolated metopic craniosynostosis from 1987 to 2020. Patients with ≥4 years follow-up were included.

Results

Among the 270 patients who underwent FOA, 166 (61.5%) patients met the inclusion criteria (n=100 (60.2%) T-FOA and n=66 (39.8%) O-FOA). Mean age at surgery was 10.9±6.3 months with follow-up of 9.5±4.1 years. There were 13 (7.8%) surgical complications, and 40 (24.1%) patients underwent at least one secondary surgery, more commonly in the T-FOA cohort (35.0% vs. 7.6%, p<0.001). In the intermediate term, T-FOA patients had higher Whitaker scores (2.2±1.0 vs. 1.5±0.8, p<0.001) and were more likely to have palpable bony irregularities (64.0% vs. 21.2%, p<0.001), visible irregularity (68.0% vs 48.5%, p=0.012), and lateral orbital retrusion (48.0% vs. 15.2%, p<0.001) compared to O-FOA. However, in subgroup analysis of patients ≥10 years old postoperatively (n=85), aesthetic outcomes (Whitaker 2.1±1.0 vs. 2.4±1.0, p=0.167) and revisions (48.6 vs. 26.7%, p=0.122) were comparable between the cohorts.

Conclusion

FOA with overcorrection is a safe and effective approach for improving aesthetic outcomes in the intermediate term. Its association with aesthetic decline over time highlights the importance of long-term follow-up until skeletal maturity. Further research is needed to better understand the underlying causes of relapse.
背景：为了更好地扩大颅前窝，考虑传统额眶前进（FOA）术后的生长和复发，我院于2012年采用了一种有意的“过矫”技术。本研究比较了传统（T-FOA）和过度矫正（O-FOA）方法的长期临床和美学结果。方法：回顾性分析1987年至2020年所有接受FOA治疗孤立性异位颅缝闭锁的儿童。纳入随访≥4年的患者。结果：270例FOA患者中，166例（61.5%）患者符合纳入标准，其中T-FOA 100例（60.2%），O-FOA 66例（39.8%）。平均手术年龄10.9±6.3个月，随访9.5±4.1年。有13例（7.8%）手术并发症，40例（24.1%）患者至少接受了一次二次手术，在T-FOA队列中更为常见（35.0% vs. 7.6%）。结论：FOA过度矫正是一种安全有效的中期改善美学效果的方法。随着时间的推移，它与审美下降的关系突出了长期随访直到骨骼成熟的重要性。需要进一步的研究来更好地了解复发的潜在原因。
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引用次数: 0
Doppler ultrasound versus computed tomography angiography prior to deep inferior epigastric perforator flap breast reconstruction: An updated systematic review and meta-analysis 多普勒超声与腹部下穿支皮瓣乳房重建前的计算机断层血管造影：最新的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 : 2026-02-01 Epub Date: 2025-11-28 DOI: 10.1016/j.bjps.2025.11.053
Bernardo Gabriele Collaco , Raquel Nogueira , Pedro Lucas Machado Magalhães , Syed Ali Haider , Gabriel Cavalcante Lima Chagas , Amanda Rangel , Bruno Lins de Souza , Alessandra Marjorye Maia Leitão , Adekunle I. Elegbede

Background

Preoperative perforator mapping is essential for optimizing outcomes in deep inferior epigastric perforator (DIEP) flap breast reconstruction. Computed tomography angiography (CTA) and Doppler ultrasound (US) are widely used, but their relative effectiveness remains uncertain. Previous reviews were limited by small numbers of randomized trials and inconsistent outcome reporting.

Methods

PubMed, Embase, and Cochrane Library were searched through May 2025. Eligible studies compared CTA imaging with Doppler US, reporting flap loss, reoperation, or operative time. Risk of bias was assessed using RoB 2 and ROBINS-I. Subgroup and sensitivity analyses explored heterogeneity and study design effects.

Results

Twelve studies involving 1784 patients were included, incorporating two additional RCTs in comparison with previous meta-analyses. CTA was associated with lower flap loss (RR 0.37; 95% CI 0.18–0.78) and reoperation rates (RR 0.55; 95% CI 0.33–0.89), and shorter operative time (MD –65 min; 95% CI –101 to –29) compared to Doppler US. This review is the first to meta-analyze reoperation as an endpoint and provide comprehensive sensitivity analyses, confirming the robustness of the findings. Subgroup analyses revealed that observed benefits were driven largely by observational studies, whereas pooled RCTs did not show significant differences.

Conclusions

This expanded review strengthens prior evidence by including additional RCTs, analyzing reoperation as a key outcome, and applying more rigorous subgroup and sensitivity approaches. CTA appears to improve efficiency and reduce complications, but randomized evidence remains limited. CTA and Doppler US may be appropriate depending on surgeon expertise and institutional resources, highlighting the need for larger, high-quality RCTs.
背景：术前穿支定位是优化上腹部深下穿支（DIEP）皮瓣乳房重建效果的关键。计算机断层血管造影（CTA）和多普勒超声（US）被广泛使用，但它们的相对有效性仍不确定。先前的综述受到随机试验数量少和结果报告不一致的限制。方法：检索至2025年5月的PubMed、Embase和Cochrane图书馆。符合条件的研究比较了CTA成像与多普勒超声，报告皮瓣丢失、再手术或手术时间。使用rob2和ROBINS-I评估偏倚风险。亚组分析和敏感性分析探讨了异质性和研究设计效果。结果：纳入了12项研究，涉及1784例患者，与先前的荟萃分析相比，纳入了2项额外的rct。与多普勒超声相比，CTA与较低的皮瓣损失（RR 0.37; 95% CI 0.18-0.78）和再手术率（RR 0.55; 95% CI 0.33-0.89）以及较短的手术时间（MD -65分钟；95% CI -101至-29）相关。这篇综述首次以再手术为终点进行meta分析，并提供了全面的敏感性分析，证实了研究结果的稳健性。亚组分析显示，观察到的益处主要是由观察性研究驱动的，而合并的随机对照试验没有显示出显著差异。结论：通过纳入额外的随机对照试验，分析再手术作为关键结果，并采用更严格的亚组和敏感性方法，本扩展的综述加强了先前的证据。CTA似乎可以提高效率并减少并发症，但随机证据仍然有限。CTA和多普勒超声可能是合适的，这取决于外科医生的专业知识和机构资源，强调需要更大、高质量的随机对照试验。
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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 : 2026-02-01 Epub 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
Patient recruitment strategies of the Belgian plastic surgeon: A national anonymous survey 比利时整形外科医生的患者招募策略：一项全国匿名调查
IF 2.4 3区 医学 Q2 SURGERY
Journal of Plastic Reconstructive and Aesthetic Surgery
Pub Date : 2026-02-01 Epub Date: 2026-01-13 DOI: 10.1016/j.bjps.2026.01.001
Renee De Busser , Amélie Bouteille , Stefaan Callens , Margot Den Hondt , Moustapha Hamdi

Background

Patient recruitment strategies in plastic surgery are diverse, and no overview exists for Belgium. Internationally, word of mouth is the most common method, while social media usage grows.

Purpose

This study aimed to map recruitment methods among Belgian plastic surgeons and explore differences by age and professional location.

Methods

Plastic surgeons practicing in Belgium were included in a prospective survey. An anonymous online questionnaire (LimeSurvey) was distributed and data analysed using SPSS.

Results

Eighteen percent of all Belgian plastic surgeons participated. Referrals and word of mouth were the primary recruitment methods, followed by websites and social media. Referrals were mainly by gynaecologists, dermatologists and GPs. Intra-centre collaboration was most frequent in university and general hospitals (both 74%). Non-surgical and aesthetic procedures were proportionally more common in private clinics, while reconstructive procedures dominated university and general hospitals. Fifty-two percent treated international patients, an average of 15% of practice volume, predominantly aesthetic cases (68%). All surgeons used a website, and 54% were active on social media, primarily Instagram (60%) and Facebook (26%). Social media reached mainly 20- to 40-year-old patients (66%) with aesthetic concerns (62%).

Conclusion

Referrals and word of mouth are the most important recruitment strategies among Belgian plastic surgeons. Social media is increasingly relevant, particularly for younger, international patients and aesthetic surgery. Its growing use raises professional, legal, and ethical challenges, highlighting the need for clearer legislation, awareness, and enforcement strategies with patient safety as central priority.
背景：整形外科的患者招募策略是多种多样的，没有比利时的概述。在国际上，口口相传是最常见的方法，而社交媒体的使用也在增长。目的研究比利时整形外科医生的招募方法，探讨年龄和职业地区的差异。方法对在比利时执业的整形外科医生进行前瞻性调查。采用匿名在线问卷（limessurvey）进行调查，并使用SPSS软件对数据进行分析。结果18%的比利时整形外科医生参与了调查。推荐和口口相传是主要的招聘方式，其次是网站和社交媒体。转介者主要是妇科医生、皮肤科医生和全科医生。中心内合作在大学医院和综合医院最为常见（均为74%）。非手术和美容手术在私人诊所中更为常见，而重建手术在大学和综合医院中占主导地位。52%的人治疗国际患者，平均占业务量的15%，主要是美容病例（68%）。所有的外科医生都使用一个网站，54%的人活跃在社交媒体上，主要是Instagram（60%）和Facebook（26%）。社交媒体接触的主要是20- 40岁的患者（66%），他们关注审美（62%）。结论推荐和口碑是比利时整形外科医生最重要的招聘策略。社交媒体越来越重要，尤其是对年轻的国际患者和美容手术。它的使用日益增加，带来了专业、法律和道德方面的挑战，突出表明需要更明确的立法、意识和执法策略，以患者安全为中心优先事项。
{"title":"Patient recruitment strategies of the Belgian plastic surgeon: A national anonymous survey","authors":"Renee De Busser ,&nbsp;Amélie Bouteille ,&nbsp;Stefaan Callens ,&nbsp;Margot Den Hondt ,&nbsp;Moustapha Hamdi","doi":"10.1016/j.bjps.2026.01.001","DOIUrl":"10.1016/j.bjps.2026.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Patient recruitment strategies in plastic surgery are diverse, and no overview exists for Belgium. Internationally, word of mouth is the most common method, while social media usage grows.</div></div><div><h3>Purpose</h3><div>This study aimed to map recruitment methods among Belgian plastic surgeons and explore differences by age and professional location.</div></div><div><h3>Methods</h3><div>Plastic surgeons practicing in Belgium were included in a prospective survey. An anonymous online questionnaire (LimeSurvey) was distributed and data analysed using SPSS.</div></div><div><h3>Results</h3><div>Eighteen percent of all Belgian plastic surgeons participated. Referrals and word of mouth were the primary recruitment methods, followed by websites and social media. Referrals were mainly by gynaecologists, dermatologists and GPs. Intra-centre collaboration was most frequent in university and general hospitals (both 74%). Non-surgical and aesthetic procedures were proportionally more common in private clinics, while reconstructive procedures dominated university and general hospitals. Fifty-two percent treated international patients, an average of 15% of practice volume, predominantly aesthetic cases (68%). All surgeons used a website, and 54% were active on social media, primarily Instagram (60%) and Facebook (26%). Social media reached mainly 20- to 40-year-old patients (66%) with aesthetic concerns (62%).</div></div><div><h3>Conclusion</h3><div>Referrals and word of mouth are the most important recruitment strategies among Belgian plastic surgeons. Social media is increasingly relevant, particularly for younger, international patients and aesthetic surgery. Its growing use raises professional, legal, and ethical challenges, highlighting the need for clearer legislation, awareness, and enforcement strategies with patient safety as central priority.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"113 ","pages":"Pages 700-704"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976744","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}
引用次数: 0
Cholesteatoma in concha-type microtia 胆脂瘤见于甲壳型小鼠
IF 2.4 3区 医学 Q2 SURGERY
Journal of Plastic Reconstructive and Aesthetic Surgery
Pub Date : 2026-02-01 Epub Date: 2026-01-07 DOI: 10.1016/j.bjps.2025.12.036
Nobuyuki Mitsuhashi , Takatoshi Yotsuyanagi , Ken Yamashita , Shinji Kato , Ayaka Kitada , Minoru Sakuraba

Background

Concha-type microtia with congenital aural stenosis carries a risk of external auditory canal cholesteatoma, which may cause infection and lead to the loss of costal cartilage grafts during auricular reconstruction. However, awareness of this risk among plastic surgeons remains limited. We aimed to review cases of cholesteatoma in concha-type microtia and discuss optimal management strategies.

Methods

We conducted a single-center retrospective review of patients with concha-type or small concha-type microtia and congenital aural stenosis who underwent auricular reconstruction with costal cartilage grafting between January 2018 and December 2021. We identified patients who developed external auditory canal cholesteatoma and analyzed the timing of occurrence, treatment, postoperative complications, graft preservation or removal, and postoperative course (including recurrence).

Results

Among 278 patients with microtia (90 auricles), 83 had concha-type or small concha-type microtia. The mean age at surgery was 11.8 years (range 10 to 24 years; median 11 years), and the cohort comprised 53 males and 30 females. Congenital aural stenosis (<4 mm) was present in 60 auricles, with cholesteatoma occurring in 4 (6.7%). One cholesteatoma was diagnosed preoperatively, two were diagnosed shortly after reconstruction (one required graft removal), and two were diagnosed after reconstruction. All patients underwent cholesteatoma excision and canalplasty. During ≥2 years of follow-up, mild restenosis but no recurrence were observed.

Conclusion

Concha-type microtia with congenital aural stenosis carries a risk of cholesteatoma. Preoperative screening is essential, and excision should precede auricular reconstruction. Vigilance during and after reconstruction, and close collaboration with otolaryngologists, are essential to prevent complications.
先天性耳廓狭窄的耳甲型小耳症有外耳道胆脂瘤的风险，可能引起感染并导致耳廓重建时肋软骨移植物的丢失。然而，整形外科医生对这种风险的认识仍然有限。我们的目的是回顾胆脂瘤在耳甲型小耳蜗的病例，并讨论最佳的管理策略。方法对2018年1月至2021年12月行肋软骨移植耳廓重建术的耳廓型或小耳廓型小耳廓狭窄患者进行单中心回顾性分析。我们确定了发生外耳道胆脂瘤的患者，并分析了发生时间、治疗、术后并发症、移植物保存或切除以及术后病程（包括复发）。结果278例小耳廓（90耳）中，有83例为甲壳型或小甲壳型小耳廓。手术的平均年龄为11.8岁（范围10 - 24岁，中位数11岁），队列包括53名男性和30名女性。先天性耳廓狭窄（4mm） 60例，胆脂瘤4例（6.7%）。1例术前诊断为胆脂瘤，2例重建后不久诊断为胆脂瘤（1例需要移除移植物），2例重建后诊断为胆脂瘤。所有患者均行胆脂瘤切除术和胆管成形术。随访≥2年，轻度再狭窄，无复发。结论先天性耳廓狭窄伴耳甲型小耳有胆脂瘤的危险。术前筛查是必要的，切除应先于耳廓重建。重建期间和重建后保持警惕，并与耳鼻喉科医生密切合作，对预防并发症至关重要。
{"title":"Cholesteatoma in concha-type microtia","authors":"Nobuyuki Mitsuhashi ,&nbsp;Takatoshi Yotsuyanagi ,&nbsp;Ken Yamashita ,&nbsp;Shinji Kato ,&nbsp;Ayaka Kitada ,&nbsp;Minoru Sakuraba","doi":"10.1016/j.bjps.2025.12.036","DOIUrl":"10.1016/j.bjps.2025.12.036","url":null,"abstract":"<div><h3>Background</h3><div>Concha-type microtia with congenital aural stenosis carries a risk of external auditory canal cholesteatoma, which may cause infection and lead to the loss of costal cartilage grafts during auricular reconstruction. However, awareness of this risk among plastic surgeons remains limited. We aimed to review cases of cholesteatoma in concha-type microtia and discuss optimal management strategies.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective review of patients with concha-type or small concha-type microtia and congenital aural stenosis who underwent auricular reconstruction with costal cartilage grafting between January 2018 and December 2021. We identified patients who developed external auditory canal cholesteatoma and analyzed the timing of occurrence, treatment, postoperative complications, graft preservation or removal, and postoperative course (including recurrence).</div></div><div><h3>Results</h3><div>Among 278 patients with microtia (90 auricles), 83 had concha-type or small concha-type microtia. The mean age at surgery was 11.8 years (range 10 to 24 years; median 11 years), and the cohort comprised 53 males and 30 females. Congenital aural stenosis (&lt;4 mm) was present in 60 auricles, with cholesteatoma occurring in 4 (6.7%). One cholesteatoma was diagnosed preoperatively, two were diagnosed shortly after reconstruction (one required graft removal), and two were diagnosed after reconstruction. All patients underwent cholesteatoma excision and canalplasty. During ≥2 years of follow-up, mild restenosis but no recurrence were observed.</div></div><div><h3>Conclusion</h3><div>Concha-type microtia with congenital aural stenosis carries a risk of cholesteatoma. Preoperative screening is essential, and excision should precede auricular reconstruction. Vigilance during and after reconstruction, and close collaboration with otolaryngologists, are essential to prevent complications.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"113 ","pages":"Pages 705-712"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976861","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}
引用次数: 0
Correspondence on: Racial disparities in research productivity among integrated plastic surgery applicants 通信：在综合整形外科申请人的研究生产力的种族差异。
IF 2.4 3区 医学 Q2 SURGERY
Journal of Plastic Reconstructive and Aesthetic Surgery
Pub Date : 2026-02-01 Epub Date: 2025-11-29 DOI: 10.1016/j.bjps.2025.11.058
Lawrence O. Lin, Allyson L. Huttinger, Jeffrey E. Janis
{"title":"Correspondence on: Racial disparities in research productivity among integrated plastic surgery applicants","authors":"Lawrence O. Lin,&nbsp;Allyson L. Huttinger,&nbsp;Jeffrey E. Janis","doi":"10.1016/j.bjps.2025.11.058","DOIUrl":"10.1016/j.bjps.2025.11.058","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"113 ","pages":"Pages 273-274"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673302","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}
引用次数: 0
Novel technique for lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap 应用管状鼻粘膜膜瓣重建泪道的新技术
IF 2.4 3区 医学 Q2 SURGERY
Journal of Plastic Reconstructive and Aesthetic Surgery
Pub Date : 2026-02-01 Epub Date: 2025-11-12 DOI: 10.1016/j.bjps.2025.11.017
Ko Nakao , Masafumi Yamaga , Natsuki Kemuriyama , Eri Matoba , Hisashi Sakuma
The medial canthal region is a common site for skin cancers, and its resection often requires a concomitant lacrimal canaliculi resection. Although conventional reconstruction methods, such as dacryocystorhinostomy with placement of a Jones tube, autologous vascular grafting, and conjunctival flaps, have been used, each has notable drawbacks, including restenosis and conjunctivitis. Herein, we report a case of basal cell carcinoma of the lower eyelid in which the lower canaliculus was resected, followed by lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap. A bony window was created from the tumor resection site to the nasal bone. Subsequently, a pedicled nasomucoperiosteal flap was elevated, tubularized, and anastomosed to the lower eyelid conjunctiva, allowing direct drainage of tears into the nasal cavity. At 6 months postoperatively, no complications, such as epiphora or conjunctivitis, were observed. Dacryocystography confirmed satisfactory tear drainage from the conjunctiva into the nasal cavity. This technique enables the reconstruction of a stenosis-resistant lacrimal duct using a pedicled nasomucoperiosteal flap that possesses favorable vascularity, flexibility, and adequate thickness and strength.

Lay summary

This report describes a novel technique for lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap after canalicular resection for basal cell carcinoma. This method creates a durable tear drainage pathway, reducing restenosis and postoperative complications.
内眦区域是皮肤癌的常见部位，其切除通常需要同时切除泪小管。虽然传统的重建方法，如放置琼斯管的泪囊鼻腔造口术、自体血管移植和结膜瓣，已经被使用，但每种方法都有明显的缺点，包括再狭窄和结膜炎。在此，我们报告一个下眼睑基底细胞癌的病例，其中下小管被切除，然后用管状鼻黏膜瓣重建泪管。从肿瘤切除部位到鼻骨建立骨窗。随后，将带蒂鼻黏膜骨膜瓣抬高，管状化，与下睑结膜吻合，使泪液直接引流至鼻腔。术后6个月，无睑裂、结膜炎等并发症发生。泪囊造影证实泪液从结膜流入鼻腔。该技术可以使用带蒂的鼻黏膜骨膜瓣重建抗狭窄的泪管，该皮瓣具有良好的血管性、柔韧性和足够的厚度和强度。本报告描述了一种用于基底细胞癌小管切除后用管状鼻黏膜瓣重建泪管的新技术。这种方法创造了持久的泪液引流通道，减少了再狭窄和术后并发症。
{"title":"Novel technique for lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap","authors":"Ko Nakao ,&nbsp;Masafumi Yamaga ,&nbsp;Natsuki Kemuriyama ,&nbsp;Eri Matoba ,&nbsp;Hisashi Sakuma","doi":"10.1016/j.bjps.2025.11.017","DOIUrl":"10.1016/j.bjps.2025.11.017","url":null,"abstract":"<div><div>The medial canthal region is a common site for skin cancers, and its resection often requires a concomitant lacrimal canaliculi resection. Although conventional reconstruction methods, such as dacryocystorhinostomy with placement of a Jones tube, autologous vascular grafting, and conjunctival flaps, have been used, each has notable drawbacks, including restenosis and conjunctivitis. Herein, we report a case of basal cell carcinoma of the lower eyelid in which the lower canaliculus was resected, followed by lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap. A bony window was created from the tumor resection site to the nasal bone. Subsequently, a pedicled nasomucoperiosteal flap was elevated, tubularized, and anastomosed to the lower eyelid conjunctiva, allowing direct drainage of tears into the nasal cavity. At 6 months postoperatively, no complications, such as epiphora or conjunctivitis, were observed. Dacryocystography confirmed satisfactory tear drainage from the conjunctiva into the nasal cavity. This technique enables the reconstruction of a stenosis-resistant lacrimal duct using a pedicled nasomucoperiosteal flap that possesses favorable vascularity, flexibility, and adequate thickness and strength.</div></div><div><h3>Lay summary</h3><div>This report describes a novel technique for lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap after canalicular resection for basal cell carcinoma. This method creates a durable tear drainage pathway, reducing restenosis and postoperative complications.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"113 ","pages":"Pages 1-3"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555332","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}
引用次数: 0
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 : 2026-02-01 Epub 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。
{"title":"Post-excisional radiotherapy for keloid treatment: A systematic review and meta-analysis","authors":"Ishith Seth ,&nbsp;Damien Gibson ,&nbsp;Gianluca Marcaccini ,&nbsp;Paola Pentangelo ,&nbsp;Yi Xie ,&nbsp;Bryan Lim ,&nbsp;Roberto Cuomo ,&nbsp;Richard Khor ,&nbsp;Warren M. Rozen ,&nbsp;Sally Kiu-Huen Ng","doi":"10.1016/j.bjps.2025.11.016","DOIUrl":"10.1016/j.bjps.2025.11.016","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Aim</h3><div>To evaluate the effectiveness and optimal timing of post-excisional radiotherapy in preventing keloid recurrence.</div></div><div><h3>Methods</h3><div>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 (&gt; 24 h). Studies without data on recurrence or complications were excluded. Outcomes were analysed using rate ratios (RR) with statistical significance set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>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 (<em>p</em> &gt; 0.05 across all subgroups).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"113 ","pages":"Pages 459-531"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770285","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}
引用次数: 0
Correspondence on: ‘First experience from 200 cases with a new breast tissue expander for multi-stage pre-pectoral breast reconstruction after mastectomy’ 回复：“来自200例乳房切除术后使用新型乳腺组织扩张器进行多阶段胸前乳房重建的首次经验”。
IF 2.4 3区 医学 Q2 SURGERY
Journal of Plastic Reconstructive and Aesthetic Surgery
Pub Date : 2026-02-01 Epub Date: 2025-11-05 DOI: 10.1016/j.bjps.2025.09.035
O. Sharp, A.R. McKean, L. Spence, T. Nanidis
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