The latest medical research on Plastic Surgery

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about plastic surgery gathered by our medical AI research bot.

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Robotics vs Laparoscopy in Foregut Surgery: Systematic Review and Meta-Analysis Analyzing Hiatal Hernia Repair and Heller Myotomy.

Journal of the

Laparoscopic surgery remains the mainstay of treating foregut pathologies. Several studies have shown improved outcomes with the robotic approach. A systematic review and meta-analysis comparing outcomes of robotic and laparoscopic hiatal hernia repairs (HHR) and Heller myotomy (HM) repairs is needed.

PubMed, Embase and Scopus databases were searched for studies published between January 2010 and November 2022. The risk of bias was assessed using the Cochrane ROBINS-I tool. Assessed outcomes included intra- and post-operative outcomes. We pooled the dichotomous data using the Mantel-Haenszel random effects model to report odds ratio (OR) and 95% confidence intervals (95% CIs) and continuous data to report mean difference (MD) and 95% CIs.

Twenty-two comparative studies enrolling 196,339 patients were included. Thirteen (13,426 robotic, 168,335 laparoscopic patients) studies assessed HHR outcomes, while nine (2,384 robotic, 12,225 laparoscopic patients) assessed HM outcomes. Robotic HHR had a non-significantly shorter length of hospital stay (LOS) [MD -0.41 (95% CI -0.87, -0.05)], fewer conversions to open [OR 0.22 (95% CI 0.03, 1.49)], and lower morbidity rates [OR 0.76 (95% CI 0.47, 1.23)]. Robotic HM led to significantly fewer esophageal perforations [OR 0.36 (95% CI 0.15, 0.83)], reinterventions [OR 0.18 (95% CI 0.07, 0.47)] a non-significantly shorter LOS [MD -0.31 (95% CI -0.62, 0.00)]. Both robotic HM and HHR had significantly longer operative times.

Laparoscopic and robotic HHR and HM repairs have similar safety profiles and perioperative outcomes. Randomized controlled trials are warranted to compare the two methods, given the low to moderate quality of included studies.

Feasibility and Safety of Superomedial Pedicle for Breast Reduction in Geriatric Patients.

Aesthetic Plastic Surgery

 Historically, inferior breast reduction is more commonly performed overall and this applies to the elder population. No study to this date has compared whether there is any difference in complications and overall safety between when using superomedial pedicle and inferior pedicle in geriatric patients and furthermore whether the safety profile of superomedial pedicle differs when compared to general population.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Fifty-four women met the inclusion criteria for the study group and they were further broken down into two subgroups; inferior and superomedial pedicle groups with 25 and 29 patients into each group, respectively. The mean age at the time of the operation was 67.8 years. Geriatric group had more significant comorbidities (37% vs. 9%, p<0.05). Looking solely on patients undergone superomedial pedicle breast reduction, OR times were similar between two age groups and hospital stay was slightly longer in the geriatric population albeit statistically insignificant. The average weight of specimens resected from each breast was 592.4 gr in geriatric population and slightly higher in the younger population with an average weight of 624 grams (p=0.27). Two women in the geriatric group and  six women in the  non-geriatric group developed major complications where superomedial pedicle was utilized, no meaningful difference was seen when major complications were compared (p=0.24). On the other hand, minor complications were significantly higher in the geriatric population compared to the younger cohort regarding superomedial pedicle reductions (p=0.02). 'Satisfaction with breasts' scores of BreastQ from the superomedial breast reduction subgroup was slightly higher than inferior pedicle breast reduction subgroup in geriatric population and it was statistically significant (0.032).

Safety margins and satisfaction scores of superomedial pedicled breast reduction in geriatric patients seem similar to their younger counterparts. Furthermore, with similar complication rates and with its slightly higher 'Satisfaction with breasts'  scores  when compared to inferior pedicle, superomedial pedicled breast reduction technique can be utilized without reservation in geriatric candidates for breast reduction.

The "Keystone Angle": Geometry in Preservation Rhinoplasty.

Aesthetic Plastic Surgery

Rhinoplasty outcome may depend on different factors and bony dorsum shape has proven to significantly influence the lateral view result. The "Keyst...

Optimizing Postoperative Care in Rhinoplasty and Septoplasty: A Review of the Role of Nasal Packing and Alternatives in Complication Management.

Aesthetic Plastic Surgery

Rhinoplasty, a common surgical procedure for nose reshaping, demands meticulous preoperative evaluation and precise execution. When coupled with se...

Patient Comfort with Before and After Photography at Plastic Surgery Offices.

Aesthetic Plastic Surgery

Before and after (B&A) photographs are a sensitive part of patients' medical records, and the use of smartphones may pose risks to confidentiality and comfort. The purpose of this study was to assess patient comfort depending on the circumstances under which these photographs being taken.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

There were 411 respondents with an average age of 36.1 years old. Of them, 46% were female and the majority were White (90%) and non-Hispanic (64%). Nearly one-third had previously undergone plastic surgery, with 80% receiving B&A photography. Surgeons took these photographs 51% of the time with similar rates of smartphone cameras use (47%) versus professional cameras (52%). The public had similar levels of comfort when a nurse or a surgeon took the clinical photographs (p = 0.08). Patients were significantly less comfortable when non-medically trained office staff captured their photographs (p = 0.0041). The public had similar comfort levels with the use of smartphones and professional cameras when dressed but were significantly less comfortable with the use of a smartphone when unclothed (p = < 0.001).

To ensure the best patient experience, B&A photography should be taken by a medical professional. If photographs are to be taken when the patient is unclothed, the use of a professional-grade camera may help ease patient discomfort.

The TRICK-TIP Rhinoplasty: Tip of the Nose Preservation Using the Combined Synergy of Open and Closed Approaches.

Aesthetic Plastic Surgery

This study introduces and assesses the outcomes of a novel rhinoplasty technique, TRICK-TIP (Transcolumellar and Inter Cartilaginous Keystoning with Tip preservation), employing a combined open and closed approach with tip anatomy conservation and structured tip support.

The procedure involves a low stairstep columellar sectioning, followed by transmembranous and intercartilaginous incisions without skin dissection in the columella or tip. Elevating the entire mobile nose as a three-layered flap provides extensive access to the entire nasal pyramid and septum. Tip modifications, including retrograde cephalic cartilage resection and supratip skin thinning, are performed based on individual cases. A key columellar strut is frequently used, initially sutured in the interdomal space and then turned down for height adjustment and final fixation. Interdomal sutures, supratip sutures, and alar resection are implemented as needed.

One hundred twenty patients participated, with high satisfaction and a low frequency of adverse effects reported using four FACE-Q™ questionnaires. One hundred and two independent raters evaluated pre and postoperative photographs, scoring "overall nose result" as 3.6 out of 5, with minimal or absent nostril deformities (1.84), soft triangle deformities (1.73), and columellar external scar deformity/visibility (1.35) where 1 is the absence of the deformity and 5 is disfigurement. Complications were absent, and revisions were infrequent.

The combined benefits of the wide-open approach, shortened surgery duration, and nasal tip preservation contribute to outcome optimization. TRICK-TIP rhinoplasty is characterized by simplicity, enabling targeted modifications, preventing soft triangle and rim complications, and facilitating essential tip support while maintaining favorable results. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Locally Advanced Adenocarcinoma of the Esophagus: Is Esophagectomy Associated with Improved Overall Survival?

Journal of the

Esophagectomy in locally advanced esophageal adenocarcinoma is challenging and carries risk. The value of esophagectomy in locally advanced esophageal adenocarcinoma is not well-defined.

The National Cancer Database was used to identify patients with cT4 esophageal adenocarcinoma from 2004-2020. Multivariable regression was used to identify factors associated with use of esophagectomy. Cox modeling was used to identify factors associated with all-cause mortality. Patients undergoing esophagectomy were 1:1 propensity score-matched to patients treated non-surgically. Kaplan-Meier analysis was used to compare five-year overall survival (OS).

3,703 patients met inclusion criteria. 541 (15%) underwent esophagectomy, 3,162 (85%) did not. Age ≤ 65 (aOR 1.69, [1.33, 2.14]), white race (aOR 2.98, [2.24, 3.96]), treatment in academic centers (aOR 1.64, [1.33, 2.02]), private insurance (aOR 1.88, [1.50, 2.36]), and tumors <6cm (aOR 1.86, [1.44, 2.40]) were associated with use of esophagectomy. Government/lack of insurance (HR 1.23, [1.12, 1.35]), income <$46,000 (HR 1.11, [1.03, 1.20]), treatment in non-academic centers (HR 1.16, [1.07, 1.25]), CCI ≥ 1 (HR 1.22, [1.12, 1.32]), and tumors ≥ 6 cm (HR 1.20, [1.09, 1.32]) were associated with risk of all-cause mortality. Esophagectomy (HR 0.50, [0.44, 0.56]) and systemic therapy (HR 0.40, [0.37, 0.43]) were associated with decreased risk of all-cause mortality. Patients undergoing esophagectomy had higher rates of 5-year OS (27.4% vs 13.2%, p<0.0001) and longer median OS (24.71 vs. 10.09 months, p<0.0001). Among cT4b patients, those who underwent esophagectomy had higher rates of 5-year OS (24.5% vs 12.3%, p<0.0001) and longer median OS (25.53 vs. 11.01 months, p<0.0001).

In cT4 esophageal adenocarcinoma, esophagectomy is associated with improved rates of 5-year OS compared to non-surgical treatment.

TikTok Videos Related to Rhinoplasty in China: Characteristics and the Quality of the Information.

Aesthetic Plastic Surgery

There are numerous videos related to rhinoplasty on TikTok in China. The objective is to examine videos on Chinese TikTok regarding rhinoplasty surgery and evaluate the content quality of rhinoplasty-related videos on TikTok.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A total of 184 videos were included in the study. The sampled videos received approximately 4.8 million likes, 900,000 comments, and 300,000 favorites. Most of the videos (n = 130, 70.65%) were posted by certified plastic surgeons on the TikTok platform. This study found that 6 (3.26%) videos contained obvious errors or misleading information. Regarding the PEMAT-A/V, the median total score was 85.71 (n = 184, IQR = 78.57-92.45%). Videos created by plastic surgeons had the highest comprehension score (n = 130, median = 100%, IQR = 91.67-100%), while videos from news media (n = 16, median = 75%, IQR = 70.76-77.34%) had the lowest usability and PEMAT-A/V total scores. In terms of video content, the PEMAT-A/V total score for surgical risks/contraindications related content (n = 15, median = 92.86%, IQR = 83.48-92.86%) was the highest, while scores for complaint-related content (n = 20, median = 75, IQR = 71.43-78.57%) were the lowest.

This study is the first report in China to evaluate the quality of information in nose plastic surgery-related videos on TikTok. We found that the quality of videos created by plastic surgeons on the TikTok platform is generally high, while videos provided by news media have lower quality. We encourage healthcare professionals to share more high-quality information on TikTok and educate patients on how to properly handle misinformation.

Simultaneous Vertical Mastopexy During Aquafilling Removal: An Effective Way to Reshape the Breast with Ptosis.

Aesthetic Plastic Surgery

Aquafilling was used to be a popular breast filler and was banned due to increasing reports of complications. Debridement surgery is the only available approach to treat complications caused by gel fillers, but it often leads to breast deformity and skin laxity. This study aims to present a new surgical strategy to reshape the breast immediately after Aquafilling removal.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The age range of the 12 patients was 41-56 years. Although the duration of surgery in group I was longer than that in group II (p = 0.011), the drainage duration and postoperative hospitalization between the two groups were comparable. All patients recovered well. Scarring was the only complication in group I, but there was no difference compared to group II (p = 0.711). Group II had a significantly higher incidence of postoperative depression deformity than group I (p = 0.008). Regarding satisfaction, patients in group I had significantly higher scores in satisfaction with breasts, psychosocial well-being and sexual well-being than those in group II.

Combining Aquafilling removal with vertical mastopexy is an effective method of reshaping the shape of the ptotic breasts, offering superior esthetic outcomes without delaying postoperative recovery or increasing the risk of complications.

Clinical Relevance of the Variability of the Infraorbital Arterial Anatomy Evaluated by Three-Dimensional Computed Tomography.

Aesthetic Plastic Surgery

Knowledge of the anatomy of the infraorbital artery (IOA) is crucial for the rejuvenation of the anterior medial aspect of the midface; however, studies adequately describing the anatomy of the IOA branches are lacking, and their connection with the ophthalmic artery branches remains unclear.

This study aims to elucidate the anatomical characteristics of the IOA in its deployment within the lower eyelid using three-dimensional (3D) technology, thereby offering an anatomical foundation for clinical surgical procedures.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The prevalence of type I IOA was observed at 38.6% (51/132), while Type II IOA was found in 61.4% (81/132) of cases. A 7.6% incidence (10/132) of IOA directly anastomosing with the angular artery was noted. The presence of palpebral branches (PIOA) was identified in 57.6% (76/132) of instances. In the lower eyelid, four distinct distribution patterns of IOA were discerned: The likelihood of Type I PIOA was 5.3%, whereas for Types IIA, IIB, and IIC PIOA, the probabilities were 8.3%, 32.6%, and 11.4%, respectively. The occurrence of the orbital branch of IOA was recorded at 41.7% (55/132).

3D technology can map IOA variants and identify the deployment patterns of IOA branches in the lower eyelid vascular vesicles at high resolution as a guide in clinical practice.

Four-Layer Wound Closure Technique with Barbed Sutures for Inframammary Fold in Mastopexy Augmentation.

Aesthetic Plastic Surgery

The inframammary fold (IMF) is an important landmark in breast aesthetic surgery. In augmentation mastopexy procedures, secure and accurate placement of the IMF is essential to aesthetic outcomes and to allow the new IMF to heal in the correct position without displacement. The authors present a simple and efficient four-layer wound closure technique using barbed sutures for closure of the repositioned IMF in augmentation mastopexy procedures. This method was previously described by the first author for reset of the IMF in breast augmentation surgery and has been adapted to the longer IMF incision in augmentation mastopexy procedures.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

There were no cases of complications related to wound healing or wound dehiscence. One patient required explantation for an infected implant.

The four-layer wound closure technique with barbed sutures provides a quick and efficient method for accurate closure of the newly reset IMF, with positive outcomes related to wound healing. Secure and accurate placement of the inframammary fold is crucial in augmentation mastopexy procedures. The use of a four-layer wound closure technique with barbed sutures provides an efficient method for accurate closure of the newly reset inframammary fold. This method was previously described by the first author for reset of the IMF in breast augmentation surgery and has been adapted to the longer IMF incision in augmentation mastopexy procedures.

Reply to: "Invited Discussion on: Video Assisted Septo-Rhinoplasty, the Future of Endonasal Rhinoplasty-a Technical Note".

Aesthetic Plastic Surgery

We respond to Gryskiewic and Alameddine's commentary on our recent study regarding endoscopic use in rhinoplasty. Highlighting the context-dependen...