Plastic Surgery Weekly

Single-center cohort study of approximately 43 patients undergoing perineal reconstruction (2013–2023), comparing perforator-based versus non-perforator myocutaneous flaps for postoperative complications, donor-site morbidity, and patient-reported quality of life, most often after oncologic resection.

• Overall complication rates were identical at 50% in both groups, but donor-site morbidity was higher in the non-perforator group, with all such complications classified as Clavien-Dindo grade III.
• Patient satisfaction was higher in the non-perforator group (100% vs 66%), though this group also had substantially longer follow-up (4.14 vs 1.74 years), limiting interpretation.
• Quality-of-life scores were numerically higher in the perforator group, although this difference was exploratory and not statistically powered.

Retrospective cohort of 102 patients with secondary cleft lip deformities (21 Abbe flap, 81 non-Abbe) plus 36 healthy controls, using standardized anthropometry, cluster analysis, and ROC analysis to derive quantitative thresholds for Abbe flap indication and to identify predictors of optimal outcome.

• Optimal indication thresholds were an upper-to-lower lip projection ratio ≤0.700 and nasolabial angle ≥108°, with sensitivities of 100% and 95.24% and specificities of 97.26% and 93.15% respectively.
• The Abbe flap significantly improved all core morphological parameters, whereas conventional non-Abbe repair achieved minimal improvement in patients with marked upper-lip tissue deficiency.
• Abbe flap superiority was independent of initial cleft type, and preoperative lip height index and intercanthal-width-to-medial-upper-lip-height ratio independently predicted optimal outcomes.

Retrospective two-centre review of 16 patients with extremely wide cleft palate only (mean width 18 mm, palate index >0.8) undergoing two-stage repair, in which a polydioxanone sheet served as a first-stage scaffold before definitive Sommerlad intravelar veloplasty, with 12-month fistula rate as the primary outcome.

• Mean cleft width fell from 18.09 mm to a residual 3.3 mm at the second stage, a mean narrowing of 14.4 mm between stages.
• The first stage produced no postoperative complications, with the polydioxanone scaffold allowing soft-tissue bridging before definitive closure.
• After definitive closure, two patients (12.5%) developed fistulae and one (6.25%) required unplanned secondary speech surgery.

Retrospective case series of 22 free-flap reconstructions undergoing secondary debulking with a subunit-based intraflap technique, in which incisions placed along internal anatomical subunit borders excise central redundant skin and fat in cone-shaped fashion, with postoperative healing and complications assessed.

• Most cases were lower-extremity reconstructions, particularly of the foot, with the superficial circumflex iliac artery perforator flap most frequently used at the index operation.
• Debulking was performed a median of 10 months after reconstruction, with no postoperative complications including dehiscence, delayed healing, seroma, hematoma, or infection.
• Median time to complete healing was 14 days, and all patients reported satisfaction with the aesthetic result.

A retrospective single-center cohort of 247 patients undergoing mandibular continuity resection with preoperative lower-extremity CTA, examining whether CTA-derived vascular parameters (plaque, three-vessel run-off, bilateral anomaly score) were associated with fibula free flap selection and postoperative outcomes.

• A combined multivariable CTA-based model showed excellent discrimination for fibula flap selection (AUC 0.826), while absence of plaque (AUC 0.745) and the inverted bilateral vascular anomaly score (AUC 0.686) performed individually at a moderate level.
• No CTA-derived variable independently predicted postoperative complications such as revision surgery, flap loss, or length of stay.
• Fibula flaps were harvested in a small subset of patients despite absent three-vessel run-off, without an apparent increase in postoperative complications.

An ultrasound study of 54 inguinal regions in 27 healthy volunteers, comparing peak systolic velocity and resistance index across the superficial and deep branches of the superficial circumflex iliac artery (SCIA) and the superficial inferior epigastric artery (SIEA) to characterize hemodynamic variation in the groin.

• Peak systolic velocity differed significantly among the three arteries (p < 0.00001), driven mainly by higher flow in the SCIA branches than the SIEA.
• Three flow distribution patterns emerged: single-artery dominance (18.5%), a single underdeveloped artery with reduced flow (64.8%), and balanced flow across all three arteries (16.7%).
• No significant side-to-side differences were observed (all p > 0.75), supporting symmetric reference values for preoperative mapping.

A retrospective review of 630 ears (577 patients) undergoing costal cartilage grafting and 573 ears undergoing ear elevation, analyzing acute infection within one month and the risk factors and management associated with framework salvage.

• Infection and cartilage framework removal rates were significantly higher in the costal cartilage grafting group than the ear elevation group.
• On multivariate analysis, hematoma, secondary cases, and local wound complications were independent risk factors for infection after costal cartilage grafting.
• Early aggressive irrigation and debridement preserved the framework, and approximately 58% of these cases maintained an auricular contour comparable to baseline.

A retrospective case series of 15 consecutive patients with partial or subtotal internal nasal lining defects (oncologic in 10, traumatic in 5) reconstructed with unilateral or bilateral septal artery musculo-mucosal fornix (SAMM-F) flaps based on the septal branch of the superior labial artery.

• Flap survival was 100% with complete mucosalization in every patient and no flap necrosis.
• No cases of nasal deformity, valve obstruction, or scar contracture occurred, and donor-site morbidity was absent.
• Three patients had limited exposure of underlying cartilaginous grafts, all resolving within one month with conservative management.

A narrative literature review of lower extremity reconstruction covering timing of soft-tissue coverage, antibiotic management, limb-salvage decision-making, fracture management, and region-specific strategies for the thigh, leg, ankle, and foot.

• Early debridement followed by timely soft-tissue coverage is associated with improved outcomes, though delayed reconstruction can succeed when guided by clinical readiness and supported by negative-pressure wound therapy.
• Reconstructive selection ranges from local muscle and perforator flaps to free muscle and fasciocutaneous flaps, guided by defect location, zone of injury, and functional demands.
• In severe trauma, management may require individualized decisions regarding limb salvage versus amputation, skeletal stabilization, and bone grafting.

A retrospective comparative cohort of 46 patients with adult acquired buried penis, comparing the newly described Manta Ray technique against elliptical excision for postoperative complications, reoperation, recurrence, and operative time.

• Operative time was significantly shorter with Manta Ray than elliptical excision (mean 150.7 vs 207.4 minutes, P=0.0018).
• Multivariable analysis showed no significant association between technique and postoperative complications.
• Reoperation (16.7% vs 31.8%, P=0.307) and recurrence (4.2% vs 13.6%, P=0.336) were numerically lower but not significantly different in the Manta Ray group.

Systematic review of 118 articles covering 97 patients who underwent hand or upper-extremity transplantation (1998–2025), pooling motor, sensory, and psychosocial outcomes by postoperative year and stratifying by transplant level (proximal vs distal) and laterality (Therapeutic IV).

• Proximal transplants recovered less power grip than distal transplants (4.51 vs 7.33 kg), and transplant level also shaped Hand Transplantation Score System gains.
• Power grip and finger total active range of motion plateaued after the first postoperative year, whereas lateral grip, Kapandji opposition, composite score, and monofilament sensation continued improving for up to a decade, predominantly in distal transplants.
• Bilateral recipients reported higher SF-36 psychosocial scores than unilateral recipients across postoperative years 1–10, with no difference in DASH scores.

Retrospective case series of 338 patients with arthroscopically confirmed chronic Geissler grade 3C scapholunate ligament injuries treated with modified Viegas dorsal capsuloplasty (2007–2016), assessing long-term range of motion, pain, function, return to high-demand activity, and complications (Level IV).

• At long-term follow-up, patients retained preserved wrist range of motion alongside low residual pain and satisfactory functional scores.
• Most patients engaged in high-demand activities returned to their prior activity level with minimal limitations.
• Complications were infrequent, consisting mainly of isolated degenerative progression or revision surgery.

A prospective observational study of adults with thumb carpometacarpal osteoarthritis and passive MCP hyperextension of at least 10 degrees who underwent trapeziectomy with suspensionplasty without MCP stabilization, stratified by a 30 degree passive hyperextension threshold and followed for 12 months.

• No significant between-group difference was detected in the primary outcome of MCP joint position during key pinch, with most patients positioning the MCP in flexion.
• Secondary outcomes including grip and pinch strength, first-second metacarpal angle, trapezial space ratio, and DASH scores also showed no between-group difference over time.
• Dynamic measures of MCP behavior may complement static passive thresholds, since most patients functioned in flexion regardless of baseline hyperextension.

A prospective cohort of 81 patients with brachial plexus injury undergoing reconstruction, screening preoperative depression with the PHQ-9 (threshold of 9 or higher) and assessing functional elbow flexion recovery (MRC grade 3 or higher) over at least 24 months.

• Depression was identified in 30.8% of patients (25 of 81), and 42% of the cohort achieved functional motor recovery.
• Across the full cohort, no significant association was found between depression and functional recovery (P=0.22).
• In the partial ulnar nerve transfer subgroup, depression was significantly associated with suboptimal recovery (Fisher exact P=0.04).

A systematic review and meta-analysis of 885 patients (1279 supernumerary digits) across 14 studies compared suture ligation, excision under local anaesthesia, and excision under general anaesthesia for type B ulnar polydactyly, pooling parent-reported satisfaction and complication data.

• Excision under local anaesthesia yielded significantly greater parental satisfaction with both treatment outcome and aesthetic appearance than suture ligation or excision under general anaesthesia.
• Pooled complication rates were lowest for excision under local anaesthesia (0.01) and highest for suture ligation (0.16).
• Treatment choice was driven mainly by avoiding anaesthesia risk versus avoiding pain: parents choosing ligation or local anaesthesia prioritized risk and speed, while those choosing general anaesthesia prioritized pain avoidance.
• No parent-reported outcome data were available for vascular clip ligation.

A retrospective single-institution cohort of 106 patients undergoing thumb metacarpophalangeal arthrodesis (49 plate, 21 screw, 24 Kirschner wire with tension band, 12 Kirschner wire alone) for osteoarthritis or post-traumatic instability compared range of motion, pain, PROMIS scores, and complications across fixation techniques.

• Range of motion, postoperative PROMIS scores, and VAS pain scores were statistically similar across all four fixation techniques.
• Removal of fixation was most frequent after Kirschner wire with tension band (27%), a pattern that persisted in the pure-arthrodesis subcohort.
• Nonunion rates were low and did not differ by fixation technique.

A retrospective comparative study of 30 patients with Allen type I-III fingertip injuries reconstructed using multilayer dermal regeneration templates (Integra, n=12; Terudermis, n=18) at a Taiwanese tertiary center compared healing, cosmesis, sensory and functional recovery, and satisfaction at 6 months.

• Integra and Terudermis produced comparable outcomes across all measures (P > 0.05), with minimal differences in finger length (0.37 cm) and nail bed area (0.34 cm2).
• Mean static 2-point discrimination on the affected side was 5.83 mm, with hook nail in 13.4% of cases.
• Complete epithelialization occurred within 38.9 days, with mean distal interphalangeal range of motion of 79.0 degrees and patient satisfaction of 4.8 out of 5.

A retrospective cohort of 190 hands undergoing primary carpal tunnel release with pre- and postoperative Boston Carpal Tunnel Questionnaire data compared the Patient Acceptable Symptom State (PASS) against MCID attainment on the Symptom Severity and Functional Status scales.

• PASS and MCID agreed on 68.4% of hands for both subscales, with only moderate concordance (SSS kappa = 0.325; FSS kappa = 0.306).
• Among PASS-positive hands, roughly one third did not meet MCID (35.3% for symptoms, 34.0% for function), while few PASS-negative hands reached MCID.
• Lower baseline BCTQ scores were associated with PASS-positive/MCID-negative outcomes, reflecting a baseline-dependent ceiling effect.

A retrospective case series of 10 patients undergoing total proximal interphalangeal joint arthroplasty using costal osteochondral grafts assessed pain, motion, and the relationship between external fixation duration and residual extension deficit.

• The procedure significantly improved pain and joint motion across the cohort.
• Longer external fixation duration was associated with less residual extension deficit.

A case series of 30 free anterolateral thigh adipofascial flaps combined with immediate full-thickness skin grafting reconstructed complex cobra-bite hand defects with exposed tendons after debridement.

• The overall flap success rate was 97.7%, with one total flap failure and two partial skin graft losses.
• Reconstructed hands recovered to approximately two-thirds of normal range of motion.
• Flaps averaged 11 cm long and 5.6 cm wide (65.8 cm2) at 2-3 mm thickness, with no secondary defatting or donor-site complications and primarily direct donor closure.

Retrospective propensity-matched cohort of 84,478 burn patients drawn from the TriNetX database (2015–2025), comparing adults who received proton pump inhibitors within one month of burn injury with matched controls who did not, assessing infectious and wound outcomes at 90 days and 1 year.

• At 90 days, the proton pump inhibitor cohort had two- to threefold higher rates of pneumonia (RR=2.38), ventilator use (RR=2.13), sepsis (RR=2.91), and mortality (RR=1.95).
• Wound-healing outcomes were also worse in the proton pump inhibitor group, with roughly twofold increases in dehiscence (RR=2.05), wound infection (RR=2.68), hematoma (RR=2.61), and seroma (RR=2.10).
• All of these associations remained statistically significant at 1 year post-burn.

A double-blind randomized trial of 80 patients with second- or third-degree burns covering 30-50% of total body surface area compared silver sulfadiazine cream with povidone-iodine for healing rate, pain intensity, and dressing-change frequency.

• The povidone-iodine group required significantly more frequent dressing changes (P = 0.001) and reported higher pain intensity (P < 0.001).
• Healing rate, number of surgical interventions, and length of stay did not differ between groups (P > 0.05).
• On logistic regression, pain intensity was the only variable significantly associated with treatment assignment (P = 0.014).

A narrative review for burns and plastic surgeons covers blistering and desquamating skin diseases (including Stevens-Johnson syndrome, toxic epidermal necrolysis, pemphigus vulgaris, and staphylococcal scalded skin syndrome) that are increasingly referred owing to dermatology inpatient bed shortages.

• Initial assessment should include a full head-to-toe skin and mucous membrane examination, plus review and possible discontinuation of recent medications.
• Incision or punch biopsy sent for histology and immunofluorescence is identified as the single investigation of greatest diagnostic value, alongside a full blood panel including autoantibody screen.
• Management parallels burn care: antimicrobials and steroids initiated by dermatology, treatment of the underlying cause, supportive wound care, and multidisciplinary input.

In a preclinical in vitro and ex vivo study, two antimicrobial peptides (Nisin and cathelicidin LL-37) were co-coated onto the commercially available NovoSorb Biodegradable Temporising Matrix (BTM) and tested for antimicrobial, antibiofilm, and immunomodulatory activity against the antimicrobial matrix Endoform and uncoated controls.

• The peptide-coated matrix eradicated mature polymicrobial biofilms of common Gram-positive and Gram-negative pathogens, with direct contact kill efficacy comparable to the commercial antimicrobial matrix Endoform.
• In a bioluminescent ex vivo biofilm model, the coated matrix reduced metabolically active bacterial burden by more than 50% after 6 hours of treatment.
• The coating showed anti-inflammatory effects, reducing TNF-α and increasing macrophage phagocytic activity in vitro.

This case series of two patients describes severe inhalation injury after indoor e-bike lithium-ion battery fires, characterizing the pulmonary effects of hydrogen fluoride (HF) exposure alongside the accompanying thermal burns.

• The first patient sustained 32% TBSA burns and developed ARDS with radiological chemical pneumonitis, requiring prolonged mechanical ventilation and leaving persistent pulmonary impairment.
• The second patient sustained 44% TBSA burns with rapidly progressive respiratory failure disproportionate to smoke inhalation and died of pulmonary failure despite ECMO.
• Both injuries occurred in enclosed environments, where the authors emphasize monitoring for hydrofluoric acid exposure via biochemical indicators.

This PRISMA-guided systematic review and meta-analysis of 21 studies (2019–2024) compared negative pressure wound therapy (NPWT) with standard care dressings for chronic diabetic wound healing and reviewed supporting in vitro and animal mechanistic data.

• NPWT reduced hospitalisation time by 7.8 days versus standard dressings (95% CI -14.2 to -1.4, p = 0.017).
• NPWT significantly reduced complication rates, particularly major and minor amputations (95% CI -10.2 to -1.3, p = 0.01).
• Mechanistic studies indicated NPWT reduces local inflammation and oxidative stress while supporting angiogenesis and improving scarring.

This retrospective case series of four patients at a tertiary burns centre (2021–2024) evaluated aesthetic (decorative) tattooing for camouflage of mature burn or traumatic scars after prior conventional scar therapies, and proposes a management algorithm informed by a focused literature review.

• All four patients had mature scars previously treated with laser, scar revision, or skin grafting, with tattoos used to camouflage dyschromia, grafted skin, and extensive visible scarring.
• All patients reported high satisfaction and improved confidence, with perceived improvement in scar appearance.
• No tattoo-related complications were reported in the series.

This narrative review synthesizes preclinical and clinical literature from the past decade on botulinum toxin A (BoNT/A) for wound healing, pathological scar prevention, and chronic wounds, covering biological mechanisms and combination therapies.

• BoNT/A is described as reducing inflammatory mediators such as IL-6 and substance P and promoting angiogenesis via HIF-1α/VEGF and nitric oxide pathways.
• It modulates fibroblast activity by suppressing TGF-β1/Smad and ERK signaling, reducing abnormal collagen deposition.
• Combination therapy with steroids, lasers, or hyaluronic acid was reported to enhance efficacy in scarring and chronic wound treatment.

This retrospective multicenter study of 235 patients at two German centres compared emergency plastic surgery presentations, patient characteristics, and DRG-based costs on New Year's Day (private fireworks used) versus Easter Sunday (non-pyrotechnic control) across 2021–2025.

• New Year's Day had more emergency presentations and a younger, predominantly male cohort (mean age 37.5 vs 45.75 years, p = 0.058).
• Operative interventions, ICU admissions, length of stay, and costs were higher on New Year's Day, with mean cost per patient €14,484 vs €3,893 (p = 0.22).
• During the COVID-19 firework bans, the authors observed a marked reduction in firework-related injuries, injury severity, operations, ICU admissions, and costs.

This prospective observational study of 52 procedures at a UK regional burns centre quantified intraoperative carbon emissions (kg CO₂e) using published life-cycle assessment data and NHS emission factors, and used regression to identify the key drivers.

• Mean intraoperative footprint was 158 kg CO₂e per case (range 40–875), roughly equivalent to 800 miles of petrol vehicle travel.
• Emissions increased by 9 kg CO₂e per 1% rise in TBSA (R²=0.75, p<0.001).
• Consumables accounted for 67% of total emissions, followed by theatre energy (20%) and anaesthesia (13%).

Systematic review and meta-analysis of 9 randomized controlled trials evaluating autologous fat transfer as a stand-alone procedure for total breast reconstruction or augmentation, assessing oncologic and surgical safety, technique-dependent complications, fat retention, and patient satisfaction following PRISMA guidance.

• Compared with implant-based reconstruction, autologous fat transfer was associated with fewer surgical complications while oncologic safety appeared similar.
• Fat-specific complications such as oil cysts and fat necrosis occurred at similar rates across techniques, though fat sedimentation and retropectoral grafting were linked to fewer complications.
• All enriched techniques, including stromal vascular fraction and botulinum toxin, improved fat retention rates.

This retrospective cohort of 481 DIEP flaps by a single surgeon compared hybrid breast reconstruction (implant placement after DIEP, 20 flaps in 13 patients) with DIEP reconstruction alone over a 14-year period.

• Hybrid patients were younger (47 vs 52 years) and had lower BMI (29 vs 32) than DIEP-only patients.
• Mean implant size was 256 cm³ (range 150–340), with no significant complications after implant placement.
• Five of 13 hybrid patients (38%) later underwent implant exchange.

A retrospective single-centre cohort of 192 patients (235 DIEP flaps) undergoing immediate DIEP reconstruction after skin-sparing mastectomy between 2010 and 2023, evaluating long-term recurrence patterns and standard oncological outcomes.

• Isolated local recurrence occurred in 2.7% of patients, with a further 2.7% having local recurrence alongside distant metastasis and 8.4% isolated distant metastasis.
• Local recurrence presented at a median of 2.76 years from surgery.
• Isolated local recurrences were managed by surgical resection with flap conservation followed by adjuvant chemoradiation.

A retrospective review of 228 patients undergoing mastectomy with immediate DIEP flap or tissue expander reconstruction by a single surgeon, comparing breast cancer-related lymphedema incidence and progression with subgroup analysis of prepectoral versus subpectoral implant placement.

• Overall lymphedema incidence did not differ significantly between groups (DIEP 8.9%, prepectoral 14.8%, subpectoral 15.6%).
• Over 2-year follow-up, the subpectoral group showed faster progression and greater limb volume increase than the DIEP and prepectoral groups.
• Improvements in soft-tissue compliance were greatest in the DIEP group, followed by prepectoral, with the least improvement in the subpectoral group.

A retrospective single-institution review of 5,003 free flaps in 3,120 patients, comparing flaps undergoing intraoperative repeat anastomosis for vascular compromise (182 flaps) with those returning postoperatively for anastomosis revision (79 flaps).

• The intraoperative re-anastomosis cohort had significantly lower odds of surgical site infection, seroma, hematoma, skin necrosis, and flap loss due to vascular compromise on multivariate analysis.
• Overall flap loss across the series was 1.28%.
• Patient demographics, comorbidities, and flap types were not significantly different between the two groups.

A retrospective case series of 6 patients with positive internal mammary lymph nodes identified during autologous breast reconstruction, paired with a literature review of 20 studies and 4,887 patients, assessing stage migration and changes to oncologic management.

• Internal mammary node assessment influenced oncologic management in all 6 cases, although pathologic stage migration occurred in only 1 patient (16.7%) and preoperative imaging had flagged a suspicious node in just 1 patient.
• There were no biopsy-related complications.
• Across the 20 published studies, mean positive node detection was 5.7% per study, and 85% of studies advocated routine sampling of nodes encountered during vessel dissection.

A prospective single-center series of 87 patients (137 DIEP flaps) at a community hospital, comparing surgical outcomes and BREAST-Q patient-reported outcomes against published normative and multi-institutional data.

• Flap survival was 97.8%, with breast and donor-site complication rates (14.6% and 13.1%) lower than larger published series.
• Patient-reported outcomes were superior to multi-center data across most domains, except abdominal physical well-being.
• From pre- to post-operative assessment, satisfaction with breasts improved markedly (+39.1 points), while abdominal physical well-being declined (-12.8 points).

An exploratory mixed-methods study of 20 patients undergoing same-day discharge after post-mastectomy prepectoral implant-based reconstruction, combining the Surgical Satisfaction Questionnaire with semi-structured interviews analyzed by content analysis.

• All participants reported satisfaction with postoperative pain control, and nearly all felt safe and satisfied with same-day discharge.
• Satisfaction was lower for return to exercise than for return to daily and social activities.
• Qualitative analysis identified effective pain management and clear communication as success factors, alongside modifiable challenges in preparation and early recovery.

A controlled animal study of 30 rats randomized to control, systemic (intraperitoneal) tranexamic acid, or local peri-implant tranexamic acid infiltration after smooth mini-implant placement, with capsules assessed at 3 months by pressure, imaging, histology, and immunohistochemistry.

• Capsule thickness on ultrasound was highest in controls and lowest with local infiltration, with concordant intracapsular pressure findings.
• Histopathology likewise showed the thinnest capsules with local application, alongside lower inflammatory cell density.
• Local infiltration outperformed intraperitoneal administration in reducing capsular contracture.

An observational analysis of 36 TikTok videos on breast implant illness, drawn from the top 30 videos across 5 hashtags and rated by 4 reviewers using the DISCERN instrument, comparing healthcare professional and non-professional creators.

• Healthcare professional videos showed significantly higher DISCERN reliability (20.9 vs 16.4) and total scores (31.6 vs 27.8) than non-professional videos.
• Treatment quality scores did not differ between creator types.
• Among healthcare professionals, higher follower count was positively associated with DISCERN score.

This prospective single-cohort study of 65 transgender and nonbinary patients assessed facial satisfaction and psychosocial well-being with the FACE-Q before and serially after facial feminization surgery over a 4-year enrollment period.

• Satisfaction with overall facial appearance rose from a preoperative 34.3 to 92.2 out of 100 at 12 months (p<0.001), with significant gains already evident by 3 months.
• Domain-specific improvements reached at least 33, 34, and 23 points for the lips, lower face, and aging appearance, respectively (p<0.001).
• Psychosocial measures increased by at least 35 points for social function and 39 points for psychological function (p<0.001).
• The mean minimal important difference was estimated at 3 points for facial appearance and 4 points for psychosocial and satisfaction domains, well below the observed changes.

This PRISMA-ScR scoping review synthesized preclinical and clinical evidence on how GLP-1 receptor agonists (semaglutide, liraglutide, tirzepatide, retatrutide) affect adipocyte metabolism, adipose-derived stem cell function, and tissue revascularization relevant to fat graft take.

• The authors mapped several plausible interference points, including adipocyte browning with UCP1 upregulation and mitochondrial uncoupling that could raise the metabolic demands of grafted fat.
• Additional concerns included enhanced lipolysis through ATGL and HSL upregulation and suppression of white adipogenic differentiation in stem cells toward thermogenic beige lineages.
• Despite a strong mechanistic rationale, no clinical or preclinical study has directly examined fat graft outcomes in patients receiving incretin-based therapy.
• The proposed perioperative management considerations are explicitly framed as hypothesis-generating rather than evidence-based guidelines.

This multicenter retrospective cohort of 2000 randomly selected cases across 105 clinics evaluated complication incidence after polydioxanone thread-lift and developed a risk-scoring model using multivariable logistic regression and ROC analysis.

• The overall complication rate was 12.4%, most commonly skin retraction (6.35%), asymmetry (2.9%), and pain (1.75%).
• Independent predictors were thread count (OR 1.12 per thread) and older age, with risk rising up to OR 5.08 for patients aged 60 or older.
• A weighted risk score combining age and thread count showed an area under the curve of 0.747, with a 9-point cutoff giving 90.3% sensitivity and 46.9% specificity.

This observational cohort of 627 women undergoing primary bilateral augmentation received an opioid-free protocol of ultrasound-guided PECS I-II and parasternal blocks with sedation, with VAS pain tracked to 72 hours and compared across implant planes.

• Mean VAS fell below 2 in all groups by 72 hours, after peaking around 16 hours postoperatively.
• Early pain was highest with dual-plane placement (peak VAS 7.0, AUC 292 VAS·h) versus submuscular and pre-pectoral placement (both approximately 5.5).
• Implant volume correlated only weakly with pain (ρ = 0.20) and not at all within individual planes.
• No patient required rescue opioids and no major complications occurred, with most resuming normal activity within four days.

This prospective single-arm study of 100 female patients assessed the safety and aesthetic outcomes of full abdominoplasty combined with VASER ultrasound-assisted, perforator-preserving liposuction.

• No abdominal skin-flap necrosis occurred in any of the 100 patients.
• The overall local complication rate was 7%, all minor: seroma (2%), hematoma (1%), wound infection (3%), and delayed healing (1%), each managed conservatively.
• There were no cases of deep vein thrombosis, pulmonary embolism, hernia, or significant contour irregularity at 6-month follow-up.

This retrospective comparative cohort of 392 patients compared upper blepharoplasty outcomes between 100 patients on anticoagulant or antiplatelet therapy and 292 untreated controls at a single academic center.

• Overall complications did not differ significantly between the antithrombotic and control groups (6.0% vs 3.5%, p=0.380), with no major bleeding events.
• Ecchymosis requiring extended observation was rare and similar (1.0% vs 0.0%), while operative time, blood loss, and return to work were comparable between groups.
• On multivariable analysis no variable independently predicted complications, though hypertension carried the highest odds ratio (OR 2.9, 95% CI 0.29–28.56).

This comparative study of 40 patients (20 with interchondral joint preservation versus 20 without) evaluated donor-site pain after sixth costal cartilage harvest for rhinoplasty using serial VAS scores.

• Postoperative VAS was consistently lower with joint preservation, including 4.15 vs 5.10 on day 1 and 1.95 vs 2.85 on day 3.
• Harvested cartilage length was comparable between groups (33.2 vs 32.45 mm), indicating no compromise in graft yield.
• No hematoma, infection, or pneumothorax occurred at the donor site in either group.

This prospective case series of 73 patients evaluated subciliary surgical release of the tear trough ligament (with orbicularis retaining ligament release when indicated) across Barton grades I–III, with outcomes graded by independent surgeons.

• Excellent outcomes were achieved in 19 of 21 Grade I, 29 of 33 Grade II, and 14 of 19 Grade III cases, with no poor outcomes recorded.
• Patient-reported satisfaction was high across grades, with a trend toward lower satisfaction in more severe deformities.
• No major complications such as ectropion or lower eyelid malposition occurred over a mean 10-month follow-up.

This retrospective analysis of 145 female patients described a single senior surgeon's buttock lift technique using a sliding adipofascial flap for hip and upper buttock projection, with concomitant fat grafting of the central and lower buttocks in most cases, performed between 2015 and 2020.

• The complication rate for the buttock lift procedure alone was 8.3%, with an overall rate of 17.2% across all concurrently performed procedures.
• No instances of adipofascial flap necrosis were observed, supporting the vascular reliability of the broadly based sliding flap.
• Concomitant autologous fat grafting of the central and lower buttocks was used in 91% of patients (132/145), reserving hip-flank tissue for more proximal projection.

This prospective cohort of 20 women aged 18–40 with thoracic deformities underwent RibXcar costochondral remodeling (with rib conversion surgery where indicated), assessed at one year for waist circumference reduction, complications, and Body-Q satisfaction.

• Average waist circumference reduction was 10 cm at one year, with no complications recorded during follow-up.
• A new classification system was applied, with Type IIA the most common deformity (75%), followed by Types IIB, IB, and IC.
• Rib 11 was the most frequently affected (70% on the right and 25% on the left), followed by ribs 10 and 12.
• Body-Q assessment showed statistically significant improvement in patient satisfaction at one year.

This retrospective single-institution series of 8 patients treated for Campanacci grade III distal radius giant cell tumors (2017–2024) reported clinical, radiographic, and functional outcomes after en bloc resection and free fibula flap arthrodesis, including union, recurrence, and MSTS, DASH, and VAS scores.

• All patients achieved radiographic union (mean 7 months proximally and 11 months distally).
• Seven of eight patients (87.5%) remained disease-free at a median follow-up of 36 months; the single recurrence with pulmonary metastases was managed surgically with radiotherapy and remained disease-free at last follow-up.
• Mean scores indicated satisfactory limb function (MSTS 24.5, DASH 20.3) with minimal pain (VAS 2.3) and minimal donor-site morbidity.

This study presented SKELEX, a self-supervised foundation model trained on 1.2 million radiographs, evaluated against task-specific baselines on 12 downstream diagnostic tasks with external validation focused on bone tumor classification.

• The model outperformed task-specific baselines in fracture detection, osteoarthritis grading, and bone tumor classification across the 12 downstream tasks.
• Unsupervised, reconstruction-based anomaly localization produced error maps that identified pathologic regions without any task-specific training.
• A region-guided bone tumor classifier maintained robust performance on external datasets and was deployed as a publicly accessible web application.

This narrative literature review of PubMed and Web of Science articles examined the biological role of collagen in peripheral nerve regeneration and evaluated current collagen-based repair strategies.

• Collagen supports Schwann cell adhesion, migration, and alignment, organizing the extracellular framework required for axonal regrowth and remyelination.
• Dysregulated collagen deposition can drive fibrosis, scar formation, and neuroma development, impairing regeneration.
• Collagen-based conduits, hydrogels, scaffolds, and decellularized grafts show promise but remain limited in mechanical strength, degradation timing, and large-gap repair.

This experimental study in 30 Sprague-Dawley rats compared platelet-rich plasma versus plasma gel as adjuncts to autologous fat grafting under chronic cigarette smoke exposure, using the contralateral untreated side as an internal control and assessing graft retention and histology at six weeks.

• PRP increased graft retention to 64.9% versus 36.5% in untreated controls (p = 0.004), reduced necrosis, and increased viable adipose tissue.
• Plasma gel did not improve graft retention (p = 0.084) and was associated with greater fibrosis (p = 0.015).
• PRP-treated grafts showed greater retention than both the control and plasma gel groups (p < 0.001).

This mechanistic study using patient scar tissue and a mouse model tested whether MSC-derived exosomes attenuate hypertrophic scar by modulating Schwann cells, using co-culture, knockdown and rescue experiments, and a dual-luciferase reporter assay to define the pathway.

• In patient hypertrophic scar tissue, reduced miR-29a-3p was inversely correlated with upregulated PDGFRB.
• Exosome-delivered miR-29a-3p suppressed Schwann cell proliferation and migration, promoted apoptosis, and reduced NGF secretion, in turn limiting fibroblast migration and myofibroblast transformation, with effects reversed by miR-29a-3p knockdown.
• Rescue experiments confirmed signaling through the PDGFRB/PAK1 axis, as PDGFRB silencing abolished and the PAK1 activator FTY720 restored the phenotype.

This single-arm study of 6 patients (aged 8–41) with refractory anastomotic restenosis after surgery for congenital esophageal atresia or stenosis evaluated endoscopic transplantation of autologous oral mucosal epithelial cell sheets placed immediately after balloon dilatation, with follow-up for safety, patency, and dietary status.

• No serious adverse events occurred, supporting the safety of the transplantation procedure.
• Four of six patients achieved long-term patency without further balloon dilatation, with the longest recurrence-free period reaching five years, while one patient improved only temporarily and required surgical reconstruction.
• Two patients had concomitant eosinophilic esophagitis, suggesting that inflammation control may influence therapeutic outcomes.

A preclinical mouse study examining the role of Ras-related protein 2 (Rras2) in bone homeostasis, comparing Rras2-deficient mice with controls and testing whether AAV9-mediated Rras2 restoration could rescue osteoporotic bone loss.

• Rras2-deficient mice developed osteopenia and reduced bone strength with impaired osteogenesis, recapitulating the skeletal features seen in human Noonan syndrome.
• Rras2 sustains BMP signaling by blocking Smurf1-dependent degradation of BMPR2, while BMP signaling reciprocally enhances Rras2 transcription, forming a positive feedback loop.
• Osteoporotic mice showed markedly reduced Rras2 in bone, and AAV9-mediated Rras2 restoration rescued bone loss.

An in vitro degradation study of poly(p-dioxanone) (PPDO) cog threads fabricated by three techniques (injection molding, compression molding, and cutting), incubated in 37°C PBS for 32 weeks with periodic measurement of mass loss, inherent viscosity, tensile strength, and grasping force.

• All threads followed a two-stage degradation profile: slow mass loss with rapid viscosity decline over the first 8 weeks, then accelerated mass loss with near-complete tensile-strength loss afterward.
• Injection-molded threads, exposed to the highest processing temperature, degraded the fastest, compression-molded threads were intermediate, and unheated cut threads degraded slowest.
• Cut threads showed the slowest initial tensile-strength loss owing to absent thermal damage, though all three converged in later stages, while injection-molded threads lost grasping force faster than compression-molded ones.

A narrative review summarizing preclinical evidence on magnesium-based materials, including nanostructured and hydrogel/hybrid systems, for chronic wound repair, and the barriers blocking their clinical translation.

• Across preclinical models, magnesium materials remodel the wound immune microenvironment, with degradation-derived Mg2⁺ ions proposed to direct immune cell polarization, endothelial activity, and oxidative-stress relief.
• Inorganic, nanostructured, and hydrogel/hybrid magnesium platforms showed potential to integrate antibacterial, immunoregulatory, and tissue-regenerative functions in a single dressing.
• Clinical translation is constrained by poor control of Mg2⁺ release kinetics, safety risks from local pH elevation and hydrogen gas generation, scarce long-term toxicology, and absent standardized evaluation systems.

A preclinical in vitro and diabetic-mouse study evaluating a PF127 thermosensitive hydrogel carrying benzalkonium chloride-loaded selenium-doped mesoporous silica nanoparticles (Se-MSNs) for antibacterial, antioxidant, pro-angiogenic, and anti-inflammatory effects on diabetic wounds.

• In vitro, the hydrogel was antibacterial against S. aureus and E. coli, lowered intracellular reactive oxygen species, and promoted endothelial migration and tube formation.
• In diabetic mice, the hydrogel accelerated wound closure while enhancing collagen deposition and angiogenesis and reducing excessive inflammation.
• The authors attribute the benefit to restored redox homeostasis combined with coordinated inflammation resolution and vascular regeneration.