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Plastic and Reconstructive Surgery: Clinical Advances and Future Opportunities

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: 15 September 2026 | Viewed by 1729

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Dr. Rami S Kantar

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Guest Editor

Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY 10016, USA
Interests: plastic & reconstructive surgery; value-based surgery; facial transplantation; vascularized

Special Issue Information

Dear Colleagues,

Plastic and reconstructive surgery is experiencing unprecedented transformation, propelled by technological innovations, shifting patient needs, and an enhanced focus on comprehensive patient care. This Special Issue seeks to examine the integrated strategies essential for overcoming contemporary challenges in the specialty. Surgeons routinely manage complex cases spanning congenital defect correction (cleft lips and/or palates), post-traumatic reconstruction, aesthetic enhancement, and functional rehabilitation all requiring close interdisciplinary cooperation.

Minimally invasive procedures, robotic-assisted surgery, and improved microsurgical methods have enhanced precision and patient outcomes. While these technological leaps forward offer remarkable benefits, they simultaneously emphasize persistent concerns regarding sustainable functional outcomes, patient-centered satisfaction metrics, and the psychological dimensions of surgical interventions.

In this Special Issue, we welcome authors to submit manuscripts that address the current treatment of Plastic and reconstructive surgery, as well as future directions in the field. This collection will serve as a platform for medical professionals to share solutions.

Dr. Rami S Kantar
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

plastic surgery
reconstructive surgery
cleft lips
palates
post-traumatic reconstruction
facial transplantation
craniofacial surgery
cleft surgery

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Published Papers (4 papers)

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11 pages, 1038 KB

Open AccessArticle

The Potential Role of Microsurgical Training in Robotic Surgery Education: A Prospective Simulation-Based Study

by Alberto Bolletta, Mirco Pozzi, Davide Di Seclì, Alfredo Dente, Luigi Bonat Guarini, Stefano Bacchini, Luigi Losco and Emanuele Cigna

J. Clin. Med. 2026, 15(7), 2598; https://doi.org/10.3390/jcm15072598 - 29 Mar 2026

Viewed by 261

Abstract

Background/Objectives: Simulation has become an integral part of contemporary surgical training, allowing safe acquisition of technical skills with objective performance assessment. Microsurgery and robotic surgery share several technical features, including fine bimanual coordination, precise instrument control, and stereoscopic vision. This study aimed to evaluate whether a structured microsurgical course is associated with improved performance on a robotic surgical simulator and to explore its potential role within robotic training pathways. Methods: A prospective study was conducted between October 2022 and November 2025 at a single academic center, including 56 participants divided into three groups. Group A consisted of surgical residents attending a 3-day Basic Microsurgery Course; Group B included residents who did not undergo training during the same period; and Group C comprised experienced microsurgeons. Groups A and B performed two robotic simulation tasks at baseline (T0) and after three days (T1). Group C was assessed at T1 only as a reference benchmark. Performance was evaluated using simulator-derived metrics. Statistical analysis was performed using paired and unpaired t-tests. Results: Group A showed significant improvement across several performance parameters following training, whereas no comparable changes were observed in Group B. At T1, Group A demonstrated better performance than Group B in multiple metrics. Group C achieved the highest scores and was considered a reference group. Conclusions: Structured microsurgical training was associated with improved performance in a robotic simulation setting. These findings suggest that microsurgical skills may be transferable to robotic tasks and may contribute to the early phases of robotic skill acquisition. Further studies are required to assess their impact in clinical practice. Full article

(This article belongs to the Special Issue Plastic and Reconstructive Surgery: Clinical Advances and Future Opportunities)

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13 pages, 413 KB

Open AccessArticle

Exploring the Balance Between Artificial Intelligence and Human Expertise in Shaping Breast Reconstruction Outcomes: A Comparative Reflection Study

by Ioan Constantin Pop, Maximilian Vlad Muntean, Vlad Alexandru Gata, Radu Alexandru Ilies, Delia Nicoara, Claudiu Ioan Filip, Vasile Pop and Patriciu Andrei Achimas-Cadariu

J. Clin. Med. 2026, 15(3), 1170; https://doi.org/10.3390/jcm15031170 - 2 Feb 2026

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Abstract

Background/Objectives: Artificial intelligence (AI) has shown potential in patient education and integration into clinical decision support systems. However, its performance in counseling patients on breast reconstruction currently remains underexplored. This study’s objective is to compare AI-generated answers with expert surgeon responses to common patient questions (derived from clinical scenarios) in domains like oncological justification, reconstructive options, and postoperative care. Methods: We realized an observer-blinded study using five real-world clinical scenarios in the field of oncologic and reconstructive surgery of the breast. Both ChatGPT-5 (October 2025 version) and a senior board-certified plastic surgeon responded to frequently asked questions, which were split into three domains: (1) oncological and surgical justification; (2) reconstruction options and outcomes, respectively; and (3) postoperative period. The answers were evaluated by another senior plastic surgeon using a four-grade ordinal scoring system (1 = unsatisfactory, 4 = excellent), which assessed accuracy, completeness, safety, nuance, and alignment with the current guidelines. Results: Across a total of 40 questions, the average AI response score was 3.1 ± 0.6. Domain-specific items scored lowest values for oncological justification (2.8 ± 0.7) and higher values for reconstruction options/outcomes and postoperative care (both 3.2 ± 0.4). No AI response was graded as unsatisfactory (score 1). Responses graded 4 (15%) were considered comprehensive, accurate, and patient-friendly. Conclusions: Globally, ChatGPT-5 provides satisfactory, readable, and medically accurate answers to basic patient questions on breast reconstruction, with a few limitations in nuanced oncological justification. Full article

(This article belongs to the Special Issue Plastic and Reconstructive Surgery: Clinical Advances and Future Opportunities)

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14 pages, 2442 KB

Open AccessArticle

Clinical Salvage Approaches for Surgical Site Infection After Autologous Microtia Reconstruction

by Kap Sung Oh, Wonseok Cho, Junekyu Kim and Kyu Nam Kim

J. Clin. Med. 2026, 15(3), 1064; https://doi.org/10.3390/jcm15031064 - 29 Jan 2026

Viewed by 397

Abstract

Background/Objectives: Surgical site infection (SSI) after autologous rib cartilage microtia reconstruction is an uncommon but potentially devastating complication, as infection of the avascular cartilage framework can rapidly lead to partial or complete framework loss. Traditional management often favored aggressive debridement or framework removal, resulting in significant deformity. This study aimed to evaluate salvage-oriented management strategies and to propose a structured treatment algorithm for SSI following microtia reconstruction. Methods: A retrospective case series was conducted of patients who developed SSI after autologous rib cartilage microtia reconstruction between March 2021 and November 2025. SSI was defined by clinical and surveillance criteria requiring intervention beyond routine postoperative care. Nine patients were included. Management strategies were analyzed with respect to infection control, framework preservation, and wound healing outcomes. Results: SSI occurred at variable time points, ranging from early postoperative infection to delayed and late-onset presentations. Identified pathogens included Gram-positive cocci and multidrug-resistant Gram-negative organisms. Negative-pressure wound therapy (NPWT) was applied in all cases with wound dehiscence, persistent drainage, or cartilage exposure. Conservative staged debridement was performed only after clear demarcation of nonviable tissue. Overall auricular framework preservation was achieved in 100% of patients, with no cases requiring complete framework removal, although limited cartilage loss occurred in select cases. These outcomes demonstrate the clinical feasibility and effectiveness of salvage-oriented management across heterogeneous infection scenarios. Conclusions: SSI following autologous microtia reconstruction can be effectively salvaged without routine framework removal through a structured, timing-based algorithm emphasizing early culture-guided antimicrobial therapy, NPWT, and conservative staged intervention. This salvage-oriented approach provides a clinically relevant and reproducible framework for preserving auricular structure while minimizing morbidity, even in infections involving multidrug-resistant organisms. Full article

(This article belongs to the Special Issue Plastic and Reconstructive Surgery: Clinical Advances and Future Opportunities)

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17 pages, 822 KB

Open AccessSystematic Review

Safety and Efficacy of Octyl 2-Cyanoacrylate (Dermabond) in Breast Surgery: A Systematic Review

by Maciej Rybicki, Marta Fijałkowska and Anna Kasielska-Trojan

J. Clin. Med. 2026, 15(6), 2462; https://doi.org/10.3390/jcm15062462 - 23 Mar 2026

Viewed by 369

Abstract

Background/Objectives: Effective wound closure in breast surgery achieves a compromise between safety and aesthetic outcomes. This systematic review evaluates the effect of 2-octyl cyanoacrylate (2-OCA) tissue adhesive (Dermabond) as a primary means of skin closure compared with traditional sutures. Methods: The study protocol was registered in PROSPERO (CRD42023420595). A systematic search of PubMed, Embase, and Web of Science databases identified ten studies (n = 1870) comparing 2-OCA with standard suturing techniques in breast reduction, reconstruction, and oncological procedures. The methodological quality was assessed using Cochrane RoB 2.0 and the Newcastle–Ottawa Scale. Results: Using the Synthesis Without Meta-analysis (SWiM) framework, the results indicate that 2-OCA offers a safety profile comparable to sutures in terms of the incidence of infection and hematoma. Although a higher incidence of wound dehiscence was observed with glue, 2-OCA showed better operative efficacy and greater patient satisfaction, which is attributed to its immediate water resistance and elimination of the need for suture removal. Conclusions: The analysis suggests that 2-OCA is a feasible structural alternative to skin sutures in appropriately selected patients, with the proper management of deep skin layer tension. Full article

(This article belongs to the Special Issue Plastic and Reconstructive Surgery: Clinical Advances and Future Opportunities)

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