Plastic Surgery Weekly

Reconstruction leads with a Plast Reconstr Surg series on suzetrigine, a non-opioid NaV1.8 inhibitor added to multimodal analgesia: 90.9% of aesthetic and reconstructive patients needed no opioid rescue, 90.7% rated pain control good to excellent, and the few who did use opioids took a mean of 2.4 tablets over 2.0 days. The IDEAL BREAST cohort in the same journal finds immediate and delayed autologous reconstruction under postmastectomy radiotherapy produce comparable major complication rates (6.4% vs 3.5%, p=.29) and comparable BREAST-Q scores at a median 5.0 years. A multicentre Ann Surg Oncol RCT of da Vinci SP robotic versus open nipple-sparing mastectomy reports identical positive-margin counts, six patients each, but longer operative times, 141.6 versus 83.9 minutes. Robotics recur in a J Plast Reconstr Aesthet Surg review of early microsurgical adoption, most often for immediate lymphatic reconstruction (52.8%), again with longer anastomosis times that shorten along a learning curve. In J Reconstr Microsurg, intraoperative EMG puts cervical phrenic nerve variation at 63.3%, roughly double the 31.8% found by cadaveric dissection, with variant amplitudes reaching half the main nerve in 44.4% of recordable cases.