New Developments in Plastic Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 10 June 2025 | Viewed by 5133

Special Issue Editors

Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
Interests: hand surgery; medical education; aesthetic surgery; cosmetic surgery; applied artificial intelligence

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Guest Editor
Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia
Interests: microsurgery; oculoplastic surgery; medical education; breast surgery; applied artificial intelligence; hand surgery
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Guest Editor
Department of Plastic, Reconstructive and Hand Surgery, Peninsula Campus, Central Clinical School, Monash University, Frankston, VIC 3199, Australia
Interests: skin cancer; hand surgery; breast reconstruction; vascular imaging; peripheral nerve surgery; abdominoplasty
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue, entitled "New Developments in Plastic Surgery", aims to highlight the latest advancements and innovations within the field of plastic surgery. We invite researchers and practitioners to contribute original research articles, comprehensive reviews, and insightful case reports that explore cutting-edge techniques, technologies, and methodologies in plastic surgery. The Special Issue seeks to provide a platform for discussing emerging trends, clinical practices, and the integration of artificial intelligence and other novel approaches into surgical procedures and patient care. By gathering contributions from experts worldwide, we aim to offer a comprehensive overview of the current state and future directions of plastic surgery, ultimately enhancing clinical outcomes and patient satisfaction. This Special Issue serves as an essential resource for professionals looking to stay abreast of the latest developments and enhance their practice with evidence-based insights.

Dr. Bryan Lim
Dr. Ishith Seth
Prof. Dr. Warren M. Rozen
Guest Editors

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Keywords

  • hand surgery
  • microsurgery
  • breast reconstruction
  • artificial intelligence
  • rhinoplasty
  • blepharoplasty
  • aesthetic surgery
  • surgical anatomy
  • 3D printing

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Published Papers (3 papers)

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Research

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8 pages, 2828 KiB  
Article
A Novel Reconstruction Approach After Skin Cancer Ablation Using Lateral Arm Free Flap: A Serial Case Report
by Soyeon Jung, Seungjun Lee and Seokchan Eun
Medicina 2024, 60(12), 2082; https://doi.org/10.3390/medicina60122082 - 19 Dec 2024
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Abstract
Background and Objectives: The lateral arm flap has been a very useful choice for the reconstruction of small to medium-sized defects, such as in the hands, extremities, and oral head and neck area. Its versatile characteristics and surgical feasibility allow this flap [...] Read more.
Background and Objectives: The lateral arm flap has been a very useful choice for the reconstruction of small to medium-sized defects, such as in the hands, extremities, and oral head and neck area. Its versatile characteristics and surgical feasibility allow this flap to be widely applied, but its reconstructive potential in the facial subunit after tumor ablation procedures has never been reported. In this study, we aimed to utilize the advantages of this flap to carry out facial temple subunit defect reconstruction. Materials and Methods: Between 2020 and 2023, 12 patients underwent temple reconstruction with lateral arm free flaps after wide malignant tumor excisions. There were seven women and five men, and the mean patient age was 60.6 years. Among the patients with cancer, six had squamous cell carcinoma, five had basal cell carcinoma, and one had myxofibrosarcoma. All flaps were elevated under general anesthesia. Alprostadil (PGE1, Eglandin®, Mitsubishi Tanabe Korea, Seoul, Republic of Korea) was administered postoperatively. Results: All flaps were the fasciocutaneous type, with sizes that varied from 3 cm × 4 cm to 5 cm × 7 cm (average size: 22.7 cm2). The average pedicle length was 6.1 cm. The versatility of the lateral arm flap enabled successful coverage in all cases, with no specific complications. Good functional outcomes and good ranges of motion in the donor arms were observed after surgery. Conclusions: The authors successfully verified the advantages of lateral arm flaps in the treatment of medium-sized facial temple subunit defects. Full article
(This article belongs to the Special Issue New Developments in Plastic Surgery)
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8 pages, 467 KiB  
Article
Perforator Selection with Computed Tomography Angiography for Unilateral Breast Reconstruction: A Clinical Multicentre Analysis
by Ishith Seth, Bryan Lim, Robert Phan, Yi Xie, Peter Sinkjær Kenney, William E. Bukret, Jørn Bo Thomsen, Roberto Cuomo, Richard J. Ross, Sally Kiu-Huen Ng and Warren M. Rozen
Medicina 2024, 60(9), 1500; https://doi.org/10.3390/medicina60091500 - 14 Sep 2024
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Abstract
Background and Objectives: Despite CTAs being critical for preoperative planning in autologous breast reconstruction, experienced plastic surgeons may have differing preferences for which side of the abdomen to use for unilateral breast reconstruction. Large language models (LLMs) have the potential to assist [...] Read more.
Background and Objectives: Despite CTAs being critical for preoperative planning in autologous breast reconstruction, experienced plastic surgeons may have differing preferences for which side of the abdomen to use for unilateral breast reconstruction. Large language models (LLMs) have the potential to assist medical imaging interpretation. This study compares the perforator selection preferences of experienced plastic surgeons with four popular LLMs based on CTA images for breast reconstruction. Materials and Methods: Six experienced plastic surgeons from Australia, the US, Italy, Denmark, and Argentina reviewed ten CTA images, indicated their preferred side of the abdomen for unilateral breast reconstruction and recommended the type of autologous reconstruction. The LLMs were prompted to do the same. The average decisions were calculated, recorded in suitable tables, and compared. Results: The six consultants predominantly recommend the DIEP procedure (83%). This suggests experienced surgeons feel more comfortable raising DIEP than TRAM flaps, which they recommended only 3% of the time. They also favoured MS TRAM and SIEA less frequently (11% and 2%, respectively). Three LLMs—ChatGPT-4o, ChatGPT-4, and Bing CoPilot—exclusively recommended DIEP (100%), while Claude suggested DIEP 90% and MS TRAM 10%. Despite minor variations in side recommendations, consultants and AI models clearly preferred DIEP. Conclusions: Consultants and LLMs consistently preferred DIEP procedures, indicating strong confidence among experienced surgeons, though LLMs occasionally deviated in recommendations, highlighting limitations in their image interpretation capabilities. This emphasises the need for ongoing refinement of AI-assisted decision support systems to ensure they align more closely with expert clinical judgment and enhance their reliability in clinical practice. Full article
(This article belongs to the Special Issue New Developments in Plastic Surgery)
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Review

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8 pages, 2073 KiB  
Review
Exploring Reverse Sural Flap Necrosis in Lupus-like Syndrome: Challenges and Strategies in Lower Limb Reconstruction—A Case Presentation
by Alessandra Ceccaroni, Roberto Cuomo, Paola Pentangelo, Antonioenrico Gentile, Caterina Marra, Warren Matthew Rozen, Ishith Seth, Bryan Lim and Carmine Alfano
Medicina 2024, 60(12), 2053; https://doi.org/10.3390/medicina60122053 - 13 Dec 2024
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Abstract
Soft tissue reconstruction in the lower limbs presents a significant challenge, particularly when addressing defects in the distal third of the leg, ankle, and foot. The reverse sural flap reliant on the perforating branches of the peroneal artery has emerged as a versatile [...] Read more.
Soft tissue reconstruction in the lower limbs presents a significant challenge, particularly when addressing defects in the distal third of the leg, ankle, and foot. The reverse sural flap reliant on the perforating branches of the peroneal artery has emerged as a versatile option, offering a solution for patients for whom microsurgical techniques are not feasible. Despite its advantages, the procedure carries inherent risks, especially in populations with underlying conditions, such as venous insufficiency, cardiovascular disease, and diabetes, as well as in elderly patients, where the likelihood of flap necrosis is elevated. This report details a case of reverse sural flap necrosis in a patient with lupus-like syndrome, a complex scenario that underscores the need for meticulous preoperative assessment and planning. The case illustrates not only the technical considerations and challenges associated with the reverse sural flap but also the broader implications of systemic autoimmune disorders on postoperative outcomes. Through a comprehensive review of the literature, we explore the relationship between vascularization, autoimmune profiles, and the success of reverse sural flap procedures. We highlight the critical need for surgeons to adopt a holistic approach to patient evaluation, considering both local and systemic factors that may influence the viability of the flap and the overall reconstructive success. Full article
(This article belongs to the Special Issue New Developments in Plastic Surgery)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Current Clinical Evidence of Bioengineered Materials including 3D-Printing in Plastic and Reconstructive Surgery
Authors: Anthony Ojochonu [1], Li Siew Lim [1], Ishith Seth [2], Marcel Chua [1]
Affiliation: 1. Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia 3168 2. Department of Plastic and Reconstructive Surgery, Peninsula Health, Victoria, Australia 3199
Abstract: /

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