Journal of Plastic Reconstructive and Aesthetic Surgery最新文献_第9页

Lymphatic ultrasound detects more vessels than indocyanine green lymphography in lymphedematous limbs 淋巴超声在四肢淋巴水肿中比吲哚菁绿淋巴造影发现更多的血管

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-02-01 Epub Date: 2025-11-07 DOI: 10.1016/j.bjps.2025.11.005

Hisako Hara , Makoto Mihara

Background

Indocyanine green (ICG) lymphography is widely used for preoperative assessment in lymphaticovenous anastomosis; however, its limited imaging depth and inability to detect vessels with impaired flow may lead to underestimation of surgical targets. Lymphatic ultrasound is a noninvasive, contrast-free modality capable of visualizing deeper lymphatic vessels and providing structural assessment. This retrospective study compared lymphatic ultrasound and ICG lymphography for detecting lymphatic vessels in patients with lower limb lymphedema.

Methods

Thirteen female patients (26 limbs; 104 areas) underwent both ICG lymphography and lymphatic ultrasound preoperatively. Each limb was divided into four regions (lateral thigh, medial thigh, medial calf, and lateral calf). The number of lymphatic vessels identified by each modality was recorded per region, and analyses were stratified by dermal backflow (DB) status on ICG lymphography.

Results

Overall, lymphatic ultrasound identified significantly more lymphatic vessels than ICG lymphography (mean ± SD: 1.9 ± 1.5 vs. 0.6 ± 0.7 vessels per area, p < 0.01). In DB-positive areas, ultrasound detected more vessels (1.9 ± 1.5) than ICG (0.3 ± 0.5, p < 0.01). In DB-negative areas also, ultrasound identified more vessels (2.0 ± 1.5) than ICG (1.1 ± 0.9, p < 0.01), except in the DB-negative lateral calf, where ICG detected more vessels. Across all the International Society of Lymphology stages, ultrasound identified more vessels; in stage 3, no vessels were detected using ICG, whereas ultrasound detected an average of 2.4 vessels per area.

Conclusions

Lymphatic ultrasound detects more lymphatic vessels than ICG lymphography, particularly in DB-positive regions and advanced stages. Negative ICG findings did not necessarily indicate the absence of lymphatic vessels. The combined use of ultrasound and ICG lymphography may broaden lymphaticovenous anastomosis eligibility and enhance preoperative planning.

背景：ICG淋巴造影术广泛应用于淋巴-静脉吻合术的术前评估；然而，它的成像深度有限，无法检测到血流受损的血管，这可能导致对手术目标的低估。淋巴管超声是一种无创、无造影剂的检查方式，能够显示更深的淋巴管并提供结构评估。本回顾性研究比较了淋巴超声和ICG淋巴造影在下肢淋巴水肿患者中检测淋巴管的效果。方法13例女性患者（26条肢体，104个部位）术前行ICG淋巴造影和淋巴超声检查。每条肢体分为四个区域（大腿外侧、大腿内侧、小腿内侧和小腿外侧）。记录每个区域通过每种方式识别的淋巴管数量，并根据ICG淋巴造影上的真皮回流（DB）状态进行分层分析。结果总体而言，淋巴超声比ICG淋巴造影发现更多的淋巴管（平均±SD: 1.9±1.5 vs. 0.6±0.7,p < 0.01）。在db阳性区，超声检出的血管数（1.9±1.5）比ICG检出的血管数（0.3±0.5,p < 0.01）多。在db阴性区域，超声也比ICG（1.1±0.9,p < 0.01）发现更多的血管（2.0±1.5），但在db阴性的小腿外侧，ICG检测到更多的血管。在国际淋巴学会的所有阶段，超声检查发现了更多的血管；在第3阶段，ICG未检测到血管，而超声平均每个区域检测到2.4条血管。结论淋巴超声比ICG淋巴造影检出更多的淋巴管，特别是在db阳性区和晚期。ICG阴性结果并不一定表明没有淋巴管。超声和ICG淋巴造影的联合应用可以拓宽淋巴-静脉吻合术的资格，加强术前规划。

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引用次数: 0

Long-term cranial shape outcomes in metopic synostosis: A 12-year follow-up study using 3D photography 异位性骨膜闭锁的长期颅形结果：一项使用3D摄影技术的12年随访研究

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-02-01 Epub Date: 2025-12-09 DOI: 10.1016/j.bjps.2025.12.001

Nina Claessens , William Breakey , Anthony Penington , Peter Claes , Jonathan Burge

Background

Restoring a normal head shape is a key objective in surgery for metopic synostosis. Few studies have examined long-term results due to challenges in data collection and reliance on ionizing CT scans. Recent advances in 3D photography offer a promising, non-invasive method to accurately assess cranial shape and track outcomes over time.

Methods

We conducted a retrospective longitudinal cohort study using 3D analysis to assess cranial shape outcomes after surgery for metopic synostosis over a 12-year follow-up period. Using a craniofacial growth curve from a dataset of healthy controls, we objectively compared individual cases to their age- and sex-matched average. Using these features, we defined a data-driven metopic severity score (MSS) to accurately estimate the severity of the deformity at different timepoints.

Results

Immediate postoperative images indicated good correction of the head shape, reflected in a reduction in MSS. At 8 and 12 years, cranial shapes showed a significant recession of the forehead and an increase in vault height, with a high preoperative severity score correlating to more severe recession. However, MSS did not significantly change compared to postoperative levels, indicating that this does not represent a relapse to the preoperative phenotype.

Conclusion

We identified a consistent long-term head shape outcome for surgically corrected metopic synostosis, marked by a retrusion of the forehead and tendency toward a turricephalic vault rather than a relapse into trigonocephaly. These findings underscore the value of 3D shape analysis as a tool for assessing long-term cranial outcomes and informing surgical planning.

背景：恢复正常的头部形状是异位性结膜闭锁手术的关键目标。由于数据收集方面的挑战和对电离CT扫描的依赖，很少有研究检查长期结果。3D摄影的最新进展提供了一种有前途的非侵入性方法来准确评估颅骨形状并跟踪结果。方法我们进行了一项回顾性纵向队列研究，使用3D分析来评估异位性骨膜闭锁手术后12年随访期间的颅形结果。使用健康对照数据集的颅面生长曲线，我们客观地将个体病例与其年龄和性别匹配的平均值进行了比较。利用这些特征，我们定义了一个数据驱动的异位严重性评分（MSS）来准确估计不同时间点的畸形严重程度。结果术后立即图像显示头部形状得到了很好的矫正，反映在MSS的降低上。在8岁和12岁时，颅骨形状显示出明显的前额衰退和拱顶高度增加，术前严重程度评分高与更严重的衰退相关。然而，与术后水平相比，MSS没有显著变化，表明这并不代表术前表型的复发。结论：对于手术矫正的异位性骨膜闭锁，我们确定了一致的长期头部形状结果，其特征是前额向后缩，倾向于颅顶，而不是复发为三角头。这些发现强调了3D形状分析作为评估长期颅骨预后和告知手术计划的工具的价值。

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引用次数: 0

Is cubital tunnel obliteration a safe and effective procedure for cubital tunnel syndrome? A case series 肘管闭塞术是治疗肘管综合征安全有效的方法吗？一个案例系列。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-02-01 Epub Date: 2025-12-17 DOI: 10.1016/j.bjps.2025.12.019

Ji Sup Hwang, Yongwoo Kim, Jihyeung Kim

Background

Cubital tunnel obliteration aims to eliminate potential drawbacks associated with in situ decompression and anterior transposition of the ulnar nerve for treating cubital tunnel syndrome (CuTS). However, the safety of this technique has not been evaluated further, and no reports have focused specifically on its surgical outcomes. In this study, we evaluated patients who underwent cubital tunnel obliteration for established CuTS at a single institute. We asked: (1) What are the electrophysiological and clinical outcomes of cubital tunnel obliteration? (2) Which demographic and disease-related factors are associated with good electrophysiological outcomes?

Methods

Forty-three patients (mean age, 62 years) treated for CuTS between 2022 and 2023 were studied. We measured motor nerve conduction velocity (mNCV) and the Disabilities of the Arm, Shoulder, and Hand (DASH) scores four months and two years after surgery, respectively. We defined good electrophysiological outcome as normalization of the mNCV, for which we investigated the odds ratio (OR) with age, sex, body mass index, diabetes, etiology of CuTS (idiopathic vs. secondary), and preoperative mNCV as covariates.

Results

The average mNCV improved from 28.9 ± 11.2 to 38.1 ± 15.1 m/s and DASH score from 32.4 ± 18.7 to 11.7 ± 8.6. A good electrophysiological outcome was significantly associated with the absence of diabetes (adjusted OR = 0.04) and idiopathic CuTS (adjusted OR = 18.7), regardless of other factors.

Conclusions

Cubital tunnel obliteration seems to be a safe and reliable surgical option for treating CuTS and its short-term outcome was favorable for both idiopathic and secondary CuTS.

Level of evidence

Level IV (Therapeutic study).

背景：肘管闭塞术旨在消除与尺神经原位减压和前移位治疗肘管综合征（CuTS）相关的潜在缺陷。然而，这项技术的安全性尚未得到进一步的评估，也没有专门针对其手术结果的报道。在这项研究中，我们评估了在单一研究所接受肘管闭塞术治疗的患者。我们的问题是：(1)肘管闭塞术的电生理和临床结果是什么？(2)哪些人口统计学和疾病相关因素与良好的电生理结果相关？方法：对2022年至2023年期间43例（平均年龄62岁）治疗CuTS的患者进行研究。我们分别在手术后4个月和2年测量运动神经传导速度（mNCV）和手臂、肩膀和手的残疾（DASH）评分。我们将良好的电生理结果定义为mNCV的正常化，为此我们研究了年龄、性别、体重指数、糖尿病、CuTS病因（特发性与继发性）和术前mNCV作为协变量的比值比（OR）。结果：平均mNCV由28.9±11.2提高到38.1±15.1 m/s， DASH评分由32.4±18.7提高到11.7±8.6。无论其他因素如何，良好的电生理结果与无糖尿病（校正OR = 0.04）和特发性切口（校正OR = 18.7）显著相关。结论：肘管闭塞术是治疗切口的一种安全可靠的手术选择，其短期疗效对特发性和继发性切口均有利。证据等级：IV级（治疗性研究）。

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引用次数: 0

Severe cryptotia correction using an adjustable postauricular Z-skin flap combined with autologous conchal cartilage grafting: A retrospective study 应用可调节耳后z型皮瓣联合自体耳甲软骨移植术矫正严重隐隐症：回顾性研究。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-02-01 Epub Date: 2025-12-19 DOI: 10.1016/j.bjps.2025.12.020

Ning Wang, Jiajun Zhi, Yue Wang, Bingqing Wang, Tun Liu, Jin Qian

Objective

Cryptotia is a common congenital auricular deformity among Asian populations, often involving cartilage malformations in the upper third of the auricle. Existing surgical techniques frequently yield unsatisfactory outcomes due to inadequate skin coverage or insufficient cartilage correction. This study introduces a modified technique combining a postauricular Z-shaped skin flap with autologous conchal cartilage grafting to address these issues.

Methods

A retrospective analysis was conducted on 48 unilateral severe cryptotia cases treated between 2020 and 2023. All patients underwent corrective surgery using a postauricular Z-shaped skin flap with autologous conchal cartilage grafting. During the operation, the concha cartilage was transplanted to stretch the helix and support the antihelix, achieving a thorough and stable correction of the cartilage deformity. Surgical outcomes were evaluated using 3D scanning and visual analog scale (VAS) scores.

Results

The mean follow-up period was 17.67 ± 4.72 months. Significant improvements were observed in auricular perimeter, length, width, and vertical distance “D” between the highest point of the auricle and skull immediately postoperatively (P＜0.05), with no statistical differences compared to the contralateral ear (P＞0.05). These results remained stable and improved further at the final follow-up. VAS scores indicated high satisfaction among patients and their families.

Conclusion

This modified technique effectively restores auricular contour and symmetry in severe cryptotia. Short-term follow-up revealed stability of the operative result with minimal complications and concealed scarring. It represents a safe and efficient option for surgical correction of severe cryptotia.

目的：隐耳症是亚洲人群中常见的先天性耳廓畸形，常涉及耳廓上三分之一的软骨畸形。由于皮肤覆盖不足或软骨矫正不足，现有的手术技术经常产生不满意的结果。本研究介绍了一种改良技术，结合耳后z形皮瓣和自体耳甲软骨移植来解决这些问题。方法：回顾性分析2020 ~ 2023年收治的48例单侧严重隐症病例。所有患者都接受了耳后z形皮瓣和自体耳甲软骨移植的矫正手术。术中移植甲骨软骨拉伸螺旋并支撑反螺旋，实现软骨畸形的彻底、稳定矫正。采用三维扫描和视觉模拟评分（VAS）评估手术效果。结果：平均随访时间17.67±4.72个月。术后即刻耳廓周长、长度、宽度及耳廓最高点与颅骨垂直距离“D”均有显著改善（P<0.05），与对侧耳廓比较差异无统计学意义（P<0.05）。这些结果保持稳定，并在最后的随访中进一步改善。VAS评分显示患者及家属满意度较高。结论：该改良术能有效恢复重度隐隐症患者耳廓轮廓及对称性。短期随访显示手术结果稳定，并发症少，瘢痕隐蔽。它是一种安全有效的手术矫正严重隐症的方法。

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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 : 2026-02-01 Epub 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

Time well spent? The impact of operative time on breast reduction outcomes 时间花得好吗？手术时间对缩乳效果的影响

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-02-01 Epub Date: 2025-11-07 DOI: 10.1016/j.bjps.2025.11.007

Samuel Knoedler , Florian Falkner , Marina T. Dietrich , Sarah Friedrich , Stefan O.P. Hofer , Giuseppe Sofo , Thomas Schaschinger , Gabriel Hundeshagen , Christoph Heitmann , Stefano Pompei , Dennis P. Orgill , Adriana C. Panayi , Bong-Sung Kim

Background

Although extended operative duration increases risks in other surgeries, its impact on breast reduction outcomes remains unclear. This retrospective cohort study investigated the relationship between operative time and postoperative morbidity in breast reduction.

Methods

The ACS-NSQIP database (2008–2022) was queried to identify adult female patients who underwent elective breast reduction. Preoperative, intraoperative, and postoperative parameters, including 30-day complications, were assessed. Multivariable logistic regression was used to evaluate the impact of operative time on postoperative outcomes, analyzing it as both a continuous and dichotomous variable.

Results

A total of 45,143 patients were included. Overall complications occurred in 6.4% (n=2870), with reoperation required in 1.8% (n=825) and readmission in 1.1% (n=516). Surgical complications were observed in 4.3% (n=1930), primarily superficial incisional infections (n=1466, 3.2%). Multivariable analysis demonstrated a nuanced association between operative time and complications: For every 1-h increase in operative time, the risk of any complication and surgical complications decreased by 11.4% (OR=0.998, p<0.0001) and 17.4% (OR=0.997, p<0.0001), respectively, whereas the risk of medical complications increased by 19.2% (OR=1.003, p=0.0009). Threshold analyses revealed that operative times >145 min and >147 min were associated with a significantly lower risk of any (OR=0.792, p<0.0001) and surgical complication (OR 0.708, p<0.0001), respectively. Conversely, operative times >156 min correlated with significantly higher odds of medical complications (OR=1.473, p=0.005).

Conclusion

Operative time impacts postoperative outcomes in breast reduction surgery. Longer procedures are linked to lower surgical risks but higher medical complications. Further research is needed to validate these findings and explore the underlying mechanisms.

虽然延长手术时间会增加其他手术的风险，但其对缩胸效果的影响尚不清楚。本回顾性队列研究探讨了缩乳手术时间与术后发病率的关系。方法查询ACS-NSQIP数据库（2008-2022）中择期行缩乳手术的成年女性患者。评估术前、术中和术后参数，包括30天并发症。采用多变量logistic回归评估手术时间对术后预后的影响，将其作为连续变量和二分类变量进行分析。结果共纳入45143例患者。总并发症发生率为6.4% (n=2870)，再次手术发生率为1.8% (n=825)，再入院发生率为1.1% （n=516）。手术并发症发生率为4.3% (n=1930)，主要为浅表切口感染（n=1466, 3.2%）。多变量分析显示手术时间与并发症之间存在微妙的关联：手术时间每增加1小时，任何并发症和手术并发症的风险分别降低11.4% （OR=0.998, p= 0.0001）和17.4% (OR=0.997, p= 0.0001)，而内科并发症的风险增加19.2% （OR=1.003, p=0.0009）。阈值分析显示，手术时间145分钟和147分钟与任何手术并发症（OR=0.792, p<0.0001）和手术并发症（OR= 0.708, p<0.0001）的风险显著降低相关。相反，手术时间156 min与较高的并发症发生率相关（OR=1.473, p=0.005）。结论缩胸手术时间影响手术效果。手术时间越长，手术风险越低，但并发症也越多。需要进一步的研究来验证这些发现并探索潜在的机制。

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引用次数: 0

Patient-reported outcomes and complications of flexor tendon tenolysis following prior A1 pulley release: A cohort of 139 patients 先前A1滑轮释放后屈肌腱松解的患者报告的结果和并发症：139例患者队列。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-02-01 Epub Date: 2025-11-27 DOI: 10.1016/j.bjps.2025.11.057

Jaimy E. Koopman , Caroline A. Hundepool , Jeroen Smit , Robbert M. Wouters , Ruud W. Selles , J. Michiel Zuidam , Hand-Wrist Study Group

Background

Following surgical A1 pulley release, approximately 0.5% of patients require reoperation due to flexor tendon adhesions. However, literature evaluating outcomes following flexor tendon tenolysis is scarce.

Objective

This study assessed the effectiveness and safety of tenolysis following prior A1 pulley release.

Methods

This is a cohort study of patients who underwent tenolysis following A1 pulley release. We included patients who completed baseline questionnaires, the Michigan Hand outcomes Questionnaire (MHQ), and Satisfaction with the Treatment Result questionnaire at 3 months postoperatively. Additionally, we retrospectively reviewed medical records to identify postoperative complications.

Results

Our cohort of 139 patients demonstrated an improvement in self-reported hand function and pain from baseline to 3 months postoperatively, although individual outcomes varied considerably. For example, 60% of patients demonstrated an improvement exceeding the minimally important change, whereas 20% demonstrated a deterioration in MHQ scores. Furthermore, 10% of patients underwent reoperation, the majority of which were repeat tenolysis.

Discussion

This study shows that tenolysis, on an average, resulted in a clinically relevant improvement in hand function and pain in short- and long-term, although individual outcomes varied considerably. Additionally, 10% of patients underwent another reoperation, the majority of which were repeat tenolysis. These findings underscore the challenges associated with tenolysis procedures. Further insight into factors contributing to the failure of tenolysis procedures is needed to improve the selection of patients that may benefit from tenolysis following A1 pulley release.

Level of evidence

III

背景：手术解除A1滑轮后，大约0.5%的患者由于屈肌腱粘连需要再次手术。然而，评估屈肌腱松解后结果的文献很少。目的：本研究评估先前A1滑轮松解后肌腱松解的有效性和安全性。方法：这是一项针对A1滑轮释放后肌腱松解的患者的队列研究。我们纳入了在术后3个月完成基线问卷、密歇根手结局问卷（MHQ）和治疗结果满意度问卷的患者。此外，我们回顾了医疗记录，以确定术后并发症。结果：我们的139例患者队列显示，自基线到术后3个月，自我报告的手功能和疼痛有所改善，尽管个体结果差异很大。例如，60%的患者表现出的改善超过了最低限度的重要变化，而20%的患者表现出MHQ评分的恶化。此外，10%的患者再次手术，其中大多数是重复肌腱松解。讨论：本研究表明，平均而言，肌腱松解术可导致短期和长期手部功能和疼痛的临床相关改善，尽管个体结果差异很大。此外，10%的患者再次接受手术，其中大多数是重复肌腱松解。这些发现强调了与肌腱松解术相关的挑战。需要进一步了解导致肌腱松解手术失败的因素，以改进选择可能受益于A1滑轮释放后肌腱松解的患者。证据水平：III。

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引用次数: 0

Oral contraceptive pills and reduction mammoplasty: A retrospective cohort analysis 口服避孕药和乳房缩小术：回顾性队列分析

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-02-01 Epub Date: 2025-11-22 DOI: 10.1016/j.bjps.2025.11.037

Alyssa D. Reese , Chloe Cottone , Katherine Foote , Siderah Pryce , Jordan Frey

Background

Oral contraceptive pills (OCPs) are commonly utilized by women aged 15–40 years. Despite being associated with an increased risk of thromboembolism, their potential impact on surgical outcomes, particularly in reduction mammoplasty, remains unknown. We aimed to explore the association between OCP use and outcomes following reduction mammoplasty.

Methods

A retrospective cohort study was conducted. An OCP group was defined by those who were taking oral contraceptive pills at the time of reduction mammoplasty and those in control group were not taking OCPs. Propensity score matching was carried out for age, race, previous delivery, and body mass index. Mastodynia, ptosis, fat necrosis, deformity/disproportion of the breast, hematoma/hemorrhage, and embolism/thrombosis that occurred within 6 months of surgery were documented.

Results

Each cohort contained 8526 patients with a mean age of 31.7 years (SD: 11.5 years). Controls exhibited a 1.36-fold higher likelihood of hematoma/hemorrhage, with 195 (2.3%) cases. Controls experiencing the complication were compared to 143 (1.7%) individuals on OCPs (CI:1.10–1.68; p<0.01). However, the OCP group did not demonstrate an increased risk for developing an embolism or thrombosis, with 32 (.38%) experiencing the complication compared to 35 (.41%) controls (RR=.91; CI:.57–1.48; p=.71). No statistical difference was found in mastodynia (p=.10), ptosis (p=.15), fat necrosis (p=.54), or deformity or disproportion/reconstructed breast (p=.32).

Conclusion

Discontinuation of OCPs prior to reduction mammoplasty would not offer any discernible advantages in postoperative outcomes. The decision to continue or discontinue OCPs before reduction mammoplasty should be based on patient-specific factors, rather than on reducing the risks associated with the procedure.

背景口服避孕药（ocp）通常被15-40岁的女性使用。尽管与血栓栓塞的风险增加有关，但它们对手术结果的潜在影响，特别是在缩小乳房成形术中，仍然未知。我们的目的是探讨OCP的使用与缩小乳房成形术后的结果之间的关系。方法采用回顾性队列研究。OCP组是指在缩乳术时服用口服避孕药的患者和对照组不服用OCP的患者。对年龄、种族、既往分娩和体重指数进行倾向评分匹配。记录了手术后6个月内发生的乳突痛、下垂、脂肪坏死、乳房畸形/不成比例、血肿/出血和栓塞/血栓形成。结果每组8526例患者，平均年龄31.7岁（SD: 11.5岁）。对照组出现血肿/出血的可能性高1.36倍，有195例（2.3%）。对照组与使用ocp的143例（1.7%）患者进行比较（CI: 1.10-1.68; p<0.01）。然而，OCP组没有显示出栓塞或血栓形成的风险增加，32例（0.38%）出现并发症，而对照组35例（0.41%）出现并发症（RR= 0.91; CI: 0.57 - 1.48; p= 0.71）。在乳突痛（p= 0.10）、上睑下垂（p= 0.15）、脂肪坏死（p= 0.54）、乳房畸形或不成比例/重建（p= 0.32）方面无统计学差异。结论缩小乳房成形术前停用ocp对术后结果没有明显的优势。在缩小乳房成形术前继续或停止OCPs的决定应基于患者的具体因素，而不是减少与手术相关的风险。

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引用次数: 0

Commentary on: Plastic surgery training in the United Kingdom and Ireland in 2025: Results of the National Training Survey 评论：2025年英国和爱尔兰的整形外科培训：国家培训调查的结果。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-02-01 Epub Date: 2025-11-16 DOI: 10.1016/j.bjps.2025.11.030

Nick Wilson Jones , Chris Duff

引用次数: 0

Letter response to Sutcliffe et al. (“Re: Single modality indocyanine green is feasible for sentinel node detection in head and neck cutaneous melanoma: A prospective cohort study”) 对Sutcliffe等人的回复（“回复：单模态吲哚菁绿可用于头颈部皮肤黑色素瘤前哨淋巴结检测：一项前瞻性队列研究”）。

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.2025.11.015

Rini Vyas, Christopher Jones, Aenone Harper Machin

引用次数: 0