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Trends in Plastic and Reconstructive Surgery
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Trends in Plastic and Reconstructive Surgery

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: closed (30 May 2025) | Viewed by 9980

Special Issue Editors

Dr. Eduardo D. Rodriguez

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Guest Editor
Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY, USA
Interests: vascularized composite allotransplantation; face transplant; microsurgery; facial trauma; craniofacial abnormalities; facial feminization
Dr. Carter J. Boyd

E-Mail
Guest Editor
Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY, USA
Interests: plastic surgery; innovation; aesthetics; aesthetic breast surgery; breast reconstruction; facial aesthetics; body contouring
Dr. Oriana D. Cohen

E-Mail Website
Guest Editor
Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY, USA
Interests: breast reconstruction; microsurgery; autologous breast reconstruction; implant-based breast reconstruction; gender-affirming surgery

Special Issue Information

Dear Colleagues,

The field of plastic and reconstructive surgery has perpetually been on the cusp of innovation. Persisently presented with complex problems, the role of plastic and reconstructive surgeons remains two-fold. This objective invovles restoration or improvement in function while simultaneously optimizing the aesthetic form. The pursuit of these dual goals has propelled researchers within the field to think critically and develop creative solutions that foster continual improvement. An improved understanding of anatomy and technological advancements has equipped plastic and reconstructive surgeons with a diverse toolbox. As new techniques and devices emerge, a critical scientific inquiry into surgical outcomes remains an important tenent of the field in order to assess for complications and the longevity of outcomes. In this Special Issue, we welcome authors to submit manuscripts that deal with recent trends within various focus areas of plastic and reconstructive surgery.   

Dr. Eduardo D. Rodriguez
Dr. Carter J. Boyd
Dr. Oriana D. Cohen
Guest Editors

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 100 words) can be sent to the Editorial Office for announcement on this website.

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
  • innovation
  • breast surgery
  • microsurgery
  • craniofacial surgery
  • hand surgery
  • body contouring

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Published Papers (6 papers)

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Research

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13 pages, 1189 KB  
Article
The Role of Biodegradable Temporizing Matrix in Paediatric Reconstructive Surgery
by Aikaterini Bini, Michael Ndukwe, Christina Lipede, Ramesh Vidyadharan, Yvonne Wilson and Andrea Jester
J. Clin. Med. 2025, 14(15), 5427; https://doi.org/10.3390/jcm14155427 - 1 Aug 2025
Viewed by 711
Abstract
Introduction: Biodegradable Temporizing Matrix (BTM) is a new synthetic dermal substitute suitable for wound closure and tissue regeneration. The data in paediatric population remain limited. The study purpose is to review the indications for BTM application in paediatric patients, evaluate the short-term and [...] Read more.
Introduction: Biodegradable Temporizing Matrix (BTM) is a new synthetic dermal substitute suitable for wound closure and tissue regeneration. The data in paediatric population remain limited. The study purpose is to review the indications for BTM application in paediatric patients, evaluate the short-term and long-term results, including complications and functional outcomes, as well as to share some unique observations regarding the use of BTM in paediatric population. Patients and Methods: Patients undergoing reconstructive surgery and BTM application during the last three years were included. Data collected included patient demographics, primary diagnosis, previous surgical management, post-operative complications and final outcomes. BTM was used in 32 patients. The indications varied including epidermolysis bullosa (n = 6), burns (n = 4), trauma (n = 7), infection (n = 4), ischemia or necrosis (n = 11). Results: The results were satisfying with acceptable aesthetic and functional outcomes. Complications included haematoma underneath the BTM leading to BTM removal and re-application (n = 1), BTM infection (n = 1) and split-thickness skin graft failure on top of BTM requiring re-grafting (n = 2). Conclusions: BTM can be a good alternative to large skin grafts, locoregional flaps or even free flaps. The big advantages over other dermal substitutes or skin grafts are that BTM is less prone to infection and offers excellent scarring by preserving the normal skin architecture. Specifically in children, BTM might not require grafting, resulting in spontaneous healing with good scarring. In critically ill patients, BTM reduces the operation time and there is no donor site morbidity. BTM should be considered in the reconstructive ladder when discussing defect coverage options in children and young people. Full article
(This article belongs to the Special Issue Trends in Plastic and Reconstructive Surgery)
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11 pages, 224 KB  
Article
Who’s on Call? Mandibular Fracture Management at a Level I Trauma Center
by Allyson R. Alfonso, Maxime M. Wang, Alexis K. Gursky, Hailey P. Wyatt, Jonathan M. Bekisz, Karl Bruckman, Spiros G. Frangos and Pierre B. Saadeh
J. Clin. Med. 2025, 14(13), 4707; https://doi.org/10.3390/jcm14134707 - 3 Jul 2025
Viewed by 528
Abstract
Background: Facial trauma is one of the few surgical conditions that is routinely managed by three distinct disciplines, including Oral and Maxillofacial Surgery (OMS), Plastic and Reconstructive Surgery (PRS), and Otolaryngology (ENT). This study aims to evaluate mandibular trauma management strategies and [...] Read more.
Background: Facial trauma is one of the few surgical conditions that is routinely managed by three distinct disciplines, including Oral and Maxillofacial Surgery (OMS), Plastic and Reconstructive Surgery (PRS), and Otolaryngology (ENT). This study aims to evaluate mandibular trauma management strategies and clinical outcomes among three operating services. Methods: An IRB-approved, retrospective chart review was performed over a ten-year period (2007–2016) at a major, urban, Level I trauma center for all patients treated for an isolated mandibular injury determined by ICD-9 codes. Of the 2299 patients evaluated for traumatic facial injuries, 191 met the inclusion criteria and 137 had longitudinal data. Patient, fracture, and management characteristics and clinical outcomes were compared among three surgical services. Results: Most patients were male (95.3%), and assaults were the most common etiology of injury (79.1%). The angle/ramus was the most common single location (31.4%), and 47.6% of patients had multiple fractures. There was a statistically significant difference between specialties when assessing the use of operative versus non-operative approaches to fracture management (p < 0.001), and within operative management, for the use of open reduction-internal fixation (ORIF) alone versus ORIF with maxillomandibular fixation (MMF) (p = 0.002). There was no significant difference in the overall complications between specialties (p = 0.227). Conclusions: Services differ in their decision to pursue operative versus non-operative management, as well as the decision for postoperative MMF, though these differences in decision-making were not associated with a significant difference in the overall complications. Full article
(This article belongs to the Special Issue Trends in Plastic and Reconstructive Surgery)
10 pages, 959 KB  
Article
Power-Assisted Liposuction of the Superomedial Pedicle in Primary Wise-Pattern Reduction Mammoplasties
by Ines Ana Ederer, Shadi Najaf Zadeh, Jonas Walber, Florian Johannes Jung, Abdul Rahman Jandali and Alberto Franchi
J. Clin. Med. 2025, 14(13), 4475; https://doi.org/10.3390/jcm14134475 - 24 Jun 2025
Viewed by 517
Abstract
Background: Superomedial pedicle breast reduction is a widely performed procedure in plastic surgery. However, in cases of massive ptosis and excessively large breasts, achieving adequate pedicle reduction can be challenging. Direct excision of the tissue bulk may compromise blood supply while insufficient reduction [...] Read more.
Background: Superomedial pedicle breast reduction is a widely performed procedure in plastic surgery. However, in cases of massive ptosis and excessively large breasts, achieving adequate pedicle reduction can be challenging. Direct excision of the tissue bulk may compromise blood supply while insufficient reduction can hinder proper pedicle positioning or result in strangulation when forcefully placed in the keyhole area. This study investigates the application of power-assisted liposuction (PAL) to the superomedial pedicle, aiming to achieve volume reduction while preserving its vascular integrity. Methods: Patients who underwent reduction mammaplasty with concomitant PAL were retrospectively reviewed. Parenchymal resection was performed first, followed by PAL, which was selectively applied to the pedicle. Eligibility for liposuction was made intraoperatively based on breast morphology and the ease of pedicle insetting. Results: The mean lipoaspirate per breast was 243.0 mL (SD 131.3) following a mean resection weight of 1261.7 g (SD 356.9). In 76.7% of cases, more than 150 mL was aspirated. The smallest volume per breast was 50 mL, while the highest reached 500 mL. A strong correlation was observed between the aspirated volume and resection weight. The overall complication rate was 3.3%, with one patient requiring hematoma evacuation. No cases of NAC necrosis occurred. All patients reported satisfactory breast shape and size. Conclusions: Power-assisted liposuction of the superomedial pedicle is a reliable and efficient technique for reshaping and reducing the pedicle while maintaining a low risk of complications. Full article
(This article belongs to the Special Issue Trends in Plastic and Reconstructive Surgery)
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Review

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11 pages, 2692 KB  
Review
Transoral Robotic Surgery (TORS) in Head and Neck Reconstruction
by Sophia Sijia Song, Z-Hye Lee and Jessie Zexi Yu
J. Clin. Med. 2025, 14(16), 5775; https://doi.org/10.3390/jcm14165775 - 15 Aug 2025
Viewed by 758
Abstract
Background/Objectives: Transoral robotic surgery (TORS) has advanced treatment for complex oropharyngeal cancers (OPC) by offering minimally invasive, precise approaches, initially for ablative and now for reconstructive procedures. This review examines TORS in OPC reconstruction, comparing it to traditional methods and presenting a TORS [...] Read more.
Background/Objectives: Transoral robotic surgery (TORS) has advanced treatment for complex oropharyngeal cancers (OPC) by offering minimally invasive, precise approaches, initially for ablative and now for reconstructive procedures. This review examines TORS in OPC reconstruction, comparing it to traditional methods and presenting a TORS case with free flap reconstruction in recurrent OPC. Methods: A PubMed review assessed TORS-based reconstruction outcomes, technical challenges, and innovations. Additionally, a recurrent OPC case was treated with TORS resection and lateral arm free flap. Surgical techniques and outcomes were detailed. Results: TORS is associated with reduced morbidity and length of hospitalization, and showed positive functional outcomes in primary, salvage, and post-radiation cases. Our case achieved favorable oncologic and functional outcomes, such as preserved speech and swallowing. Conclusions: TORS-based reconstruction represents a major advancement in minimally invasive head and neck oncology, providing comparable oncologic outcomes to open surgery with fewer complications. Although technically demanding, TORS is promising for complex reconstructions, warranting further research to refine techniques and standardize protocols. Full article
(This article belongs to the Special Issue Trends in Plastic and Reconstructive Surgery)
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10 pages, 228 KB  
Review
The Evolution of Implant-Based Breast Reconstruction: Innovations, Trends, and Future Directions
by Chris Amro, Thomas J. Sorenson, Carter J. Boyd, Kshipra Hemal, Nicholas A. Vernice, Jenn J. Park, Oriana D. Cohen, Mihye Choi and Nolan S. Karp
J. Clin. Med. 2024, 13(23), 7407; https://doi.org/10.3390/jcm13237407 - 5 Dec 2024
Cited by 8 | Viewed by 3237
Abstract
Background/Objectives: Implant-based breast reconstruction has been essential since the 1960s, offering a faster and less invasive alternative to autologous reconstruction. Recent innovations—including direct-to-implant (DTI) reconstruction, advancements in surgical planes, synthetic meshes, and nipple-areolar complex (NAC) neurotization—have improved patient outcomes. This review explores these [...] Read more.
Background/Objectives: Implant-based breast reconstruction has been essential since the 1960s, offering a faster and less invasive alternative to autologous reconstruction. Recent innovations—including direct-to-implant (DTI) reconstruction, advancements in surgical planes, synthetic meshes, and nipple-areolar complex (NAC) neurotization—have improved patient outcomes. This review explores these developments, analyzing their impact on breast reconstruction over the past two decades. Methods: A comprehensive literature review was conducted using PubMed, Google Scholar, and Cochrane Library databases, focusing on peer-reviewed studies published up to 2024. Articles were selected based on relevance, quality, and documentation of clinical outcomes and patient satisfaction. Results: Findings indicate that DTI reconstruction reduces the need for multiple surgeries, especially in cases with sufficient mastectomy flap quality. Prepectoral placement showed benefits in postoperative comfort and recovery speed compared to subpectoral placement, but had specific risks, such as implant rippling. Synthetic meshes improved implant support and reduced complication rates, while neurotization has shown potential in restoring sensation to the nipple-areolar complex (NAC), addressing quality-of-life concerns. Conclusions: Innovations like DTI, prepectoral techniques, and adjunctive mesh and neurotization strategies are advancing patient outcomes. Future research should refine these methods, aiming to expand applicability and further improve aesthetic and sensory outcomes for breast cancer survivors. Full article
(This article belongs to the Special Issue Trends in Plastic and Reconstructive Surgery)
21 pages, 20030 KB  
Review
Ultrasound in Microsurgery: Current Applications and New Frontiers
by Rachel Cowan, Gursimran Mann and Ara A. Salibian
J. Clin. Med. 2024, 13(12), 3412; https://doi.org/10.3390/jcm13123412 - 11 Jun 2024
Cited by 4 | Viewed by 2959
Abstract
Ultrasound has revolutionized reconstructive microsurgery, offering real-time imaging and enhanced precision allowing for preoperative flap planning, recipient vessel identification and selection, postoperative flap monitoring, and lymphatic surgery. This narrative review of the literature provides an updated evidence-based overlook on the current applications and [...] Read more.
Ultrasound has revolutionized reconstructive microsurgery, offering real-time imaging and enhanced precision allowing for preoperative flap planning, recipient vessel identification and selection, postoperative flap monitoring, and lymphatic surgery. This narrative review of the literature provides an updated evidence-based overlook on the current applications and emerging frontiers of ultrasound in microsurgery, focusing on free tissue transfer and lymphatic surgery. Color duplex ultrasound (CDU) plays a pivotal role in preoperative flap planning and design, providing real-time imaging that enables detailed perforator mapping, perforator suitability assessment, blood flow velocity measurement, and, ultimately, flap design optimization. Ultrasound also aids in recipient vessel selection by providing assessment of caliber, patency, location, and flow velocity of recipient vessels. Postoperatively, ultrasound enables real-time monitoring of flap perfusion, providing early detection of potential flap compromise and improved flap survival rates. In lymphatic surgery, ultra-high frequency ultrasound (UHFUS) offers precise mapping and evaluation of lymphatic vessels, improving efficacy and efficiency by targeting larger dilated vessels. Integrating ultrasound into reconstructive microsurgery represents a significant advancement in the utilization of imaging in the field. With growing accessibility of devices, improved training, and technological advancements, using ultrasound as a key imaging tool offers substantial potential for the evolution of reconstructive microsurgery. Full article
(This article belongs to the Special Issue Trends in Plastic and Reconstructive Surgery)
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