Search Results (29)

Facial aesthetic surgery has evolved from early reconstructive efforts to highly refined, technology-driven practice. This educational review explores the historical development of key procedures, including rhinoplasty, blepharoplasty, and facelifts, and connects these milestones to modern innovations including artificial intelligence, virtual reality, and three-dimensional planning. By linking past techniques to current approaches, this work highlights how foundational surgical principles continue to guide safe, precise, and patient-centered aesthetic care. Full article

Background/Objectives: Immortality and anti-aging research is accelerating, with implications across medicine. This narrative review explores the biological principles, translational innovations, and ethical considerations at the intersection of aging and plastic surgery, reframed for a broad clinical audience. Methods: A narrative review of the literature from PubMed, clinical trials, and translational studies was conducted, with emphasis on regenerative medicine, stem cells, tissue engineering, gene editing, and longevity pharmacologics within the field of plastic and reconstructive surgery. Results: Key themes include (1) the biology of aging and epigenetic reprogramming, (2) esthetic and regenerative innovations with broader clinical significance, (3) emerging genetic and pharmacologic longevity strategies, (4) ethical and regulatory challenges, and (5) future directions such as nanotechnology, artificial intelligence, and digital immortality. Conclusions: Immortality remains an aspirational frontier, but innovations in regenerative science and longevity research offer opportunities for improving healthspans. Medicine as a whole must balance innovation with ethics, equity, and safety in translating these discoveries to patient care. Full article

As the fields of plastic surgery and dermatology advance, regenerative medicine is positioned to play a transformative role in both aesthetic and reconstructive procedures. This narrative review examines current and emerging applications of biologic therapies, including exosomes, platelet-rich plasma (PRP), and adipose-derived stem cells (ASCs) with an emphasis on their mechanisms of action, clinical efficacy, and regulatory considerations. We also explore synergistic strategies, such as the combined use of biologics with laser-based technologies, which may enhance therapeutic outcomes. Looking forward, we highlight promising developments in mitochondrial-based therapies, microRNA-based therapies, synthetic exosome mimetics, and AI-assisted biologic design, offering a framework for personalized, precision-driven interventions. By synthesizing existing clinical data alongside scientific and ethical challenges, this narrative review provides a comprehensive perspective on how regenerative therapies are transforming the landscape of aesthetics. Ultimately, successful integration of these innovations will require rigorous validation, ethical responsibility, and a patient-centered approach by plastic surgeons and dermatologists to ensure both safety and accessibility in mainstream practice. Full article

Cancer continues to pose a significant challenge to global health, resulting in millions of deaths annually despite advancements in treatments like surgery, chemotherapy, and radiotherapy. A key factor complicating successful outcomes is the presence of cancer stem cells (CSCs), which possess distinctive features that facilitate tumor initiation and progression as well as resistance to therapies. These cells are adept at evading conventional treatments and can hinder the effectiveness of immunotherapy, often manipulating the tumor microenvironment to suppress immune responses. This review delves into the complex interplay between CSCs and immune cells, emphasizing their contributions to tumor heterogeneity and therapeutic resistance. By investigating the CSC niche in which these cells thrive and their complex interactions with the immune system, we aim to reveal new therapeutic avenues that could enhance patient outcomes and minimize the risk of recurrence. CSCs are characterized by remarkable self-renewal and plasticity, allowing them to transition between stem-like and differentiated states in response to various stimuli. Their existence within the CSC niche confers immune protection and maintains stem-like properties while promoting immune evasion. Activating key signaling pathways and specific surface markers is crucial in developing CSC traits, pointing to potential strategies for effective tumor eradication. Conventional therapies often fail to eliminate CSCs, which can lead to tumor recurrence. Therefore, innovative immunotherapeutic strategies such as dendritic cell vaccines (DC vaccines), chimeric antigen receptor (CAR) engineered T cells, and immune checkpoint inhibitors (ICIs) are under examination. This review sheds light on CSC’s roles across different malignancies, highlighting the necessity for innovative targeted approaches in cancer treatment. Full article

(1) Burn injuries demand multidisciplinary, evidence-based care, yet the extensive literature complicates timely decision making. Retrieval-augmented generation (RAG) synthesizes research while addressing inaccuracies in pretrained models. However, citation bias in sourcing for RAG often prioritizes highly cited studies, overlooking less-cited but valuable research. This study examines RAG’s performance in burn management, comparing citation levels to enhance evidence synthesis, reduce selection bias, and guide decisions. (2) Two burn management datasets were assembled: 30 highly cited (mean: 303) and 30 less-cited (mean: 21). The Gemini-1.0-Pro-002 RAG model addressed 30 questions, ranging from foundational principles to advanced surgical approaches. Responses were evaluated for accuracy (5-point scale), readability (Flesch–Kincaid metrics), and response time with Wilcoxon rank sum tests (p < 0.05). (3) RAG achieved comparable accuracy (4.6 vs. 4.2, p = 0.49), readability (Flesch Reading Ease: 42.8 vs. 46.5, p = 0.26; Grade Level: 9.9 vs. 9.5, p = 0.29), and response time (2.8 vs. 2.5 s, p = 0.39) for the highly and less-cited datasets. (4) Less-cited research performed similarly to highly cited sources. This equivalence broadens clinicians’ access to novel, diverse insights without sacrificing quality. As plastic surgery evolves, RAG’s inclusive approach fosters innovation, improves patient care, and reduces cognitive burden by integrating underutilized studies. Embracing RAG could propel the field toward dynamic, forward-thinking care. Full article

We present our experience of using the UROLASE+ surgical system, based on thulium laser technology, in the context of plastic surgery. Our work with the thulium fiber laser for soft tissue dissection in vitro, ex vivo, and in vivo is described, and the positive outcomes of using the thulium fiber laser, which has not previously been employed in aesthetic surgery of the face and body, are demonstrated in this study. Integration of the thulium fiber laser may enhance safety and facilitate tissue dissection through more precise interventions, reduced blood loss, and improved clinical outcomes. This is particularly relevant for patients who have undergone cosmetic procedures leading to fibrotic changes in soft tissues, which complicate inter-tissue dissection when using traditional methods. Full article

Background/Objectives: Robotic systems offer enhanced precision, dexterity, and visualization, which are essential in addressing the complex nature of plastic surgery procedures. Despite widespread adoption in other surgical specialties, such as urology and gynecology, their application in plastic surgery remains underexplored. This review examines the use of robotic systems in plastic and reconstructive surgery with a focus on clinical outcomes. Methods: A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. Search terms included (“robotic surgery” OR “surgical robots”) AND (“plastic surgery” OR “reconstructive surgery”). Studies on clinical outcomes and biomimetic innovations published between 1980 and 2024 were included, while non-English, cadaver-based, and animal studies were excluded. Data were systematically extracted using Covidence and analyzed. Results: Twenty-nine studies were identified that evaluated the clinical outcomes of robotics in areas including breast reconstruction, microsurgery, and craniofacial procedures. Robotic systems like the Da Vinci and Symani platforms offer motion scaling, tremor elimination, and enhanced depth perception. In nipple-sparing mastectomies, they reduced skin necrosis rates from 8% to 2%, while in DIEP flap reconstruction, they enabled smaller fascial incisions (2.67 ± 1.13 cm vs. 8.14 ± 1.69 cm) and faster recovery with fewer complications. In microsurgery, they achieved 100% patency for vessels under 0.3 mm and a 25.2% limb volume reduction in lymphedema patients in 3 months. Conclusions: Robotic systems show significant promise, particularly in procedures such as nipple-sparing mastectomies, and have the potential to overcome challenges including surgeon fatigue. However, challenges such as longer operating times, high costs, and limited haptic feedback remain barriers to their adoption. Full article

This study addresses a significant gap in the clinical validation and standardization of exosome-based applications within the domains of cosmetics and regenerative medicine. Despite offering a thorough overview of the potential therapeutic benefits and underlying mechanisms of exosomes, the manuscript underscores several unresolved challenges, including the paucity of clinical evidence, regulatory barriers, inconsistencies in standardization, and incomplete mechanistic understanding. The primary aim of this research is to conduct a systematic and comprehensive review of existing studies on the applications of exosomes in cosmetics and skincare. To achieve this, a systematic literature review was performed, drawing on the major medical database PubMed. This approach facilitated the collection and meta-analysis of relevant data, ensuring a rigorous assessment of recent advancements in exosome research. The main outcomes of the study highlight the multifaceted roles of exosomes in promoting skin rejuvenation and mitigating signs of aging. Specific applications discussed include pigmentation correction, wound healing, tissue repair, and innovative delivery mechanisms. Moreover, the study examines the emerging potential of exosomes in plastic surgery and regenerative medicine. Challenges and limitations, such as regulatory constraints, standardization hurdles, and the need for further clinical validation, are critically analyzed, providing a framework for future research directions. Full article

Background/Objectives: Spino-plastic surgery describes a specialized, multidisciplinary approach to addressing various spinal pathologies. The field is the innovative product of a multidisciplinary collaboration between plastic and reconstructive, orthopedic, and neurosurgery. Over the last few decades, this collaboration has borne promising surgical techniques and treatment plans geared toward restoring form, function, and aesthetics in patients with a variety of spinal conditions, including failed fusions, pseudoarthrosis, and the need for oncologic reconstruction. This paper explores the application of spino-plastic surgery in the context of post-sarcoma resection reconstructions, focusing on the efficacy in addressing the unique challenges posed by extensive tissue loss and structural deformities. Methods: Our study reviews a series of cases wherein spino-plastic techniques were utilized in patients with sarcomas of the spine and adjacent structures. We also discuss the technical considerations, including preoperative planning, intraoperative challenges, and overall patient care, that are crucial for the success of spino-plastic procedures. Results: The outcomes demonstrate significant improvements in patient mobility, pain reduction, and overall quality of life. Most notably, spino-plastic surgical techniques help facilitate the restoration of functional anatomy by leveraging vascularized bone grafts and muscle flaps, thereby enhancing long-term stability and reducing the risk of complications such as nonunion or infection. Conclusions: Spino-plastic collaboration represents a pivotal advancement in oncologic treatment, spinal care, and reconstructive surgery, offering new hope for patients undergoing post-sarcoma reconstruction. Further research and refinement of the techniques will only expand their application and improve outcomes for a broader range of patients in the future. Full article

Background: Since laparoscopic surgery became the gold standard for colorectal procedures, specific skills are required to achieve good outcomes. The best way to acquire basic and advanced skills and reach the learning curve plateau is by using dedicated simulators: box-trainers, video-trainers and virtual reality simulators. Laparoscopic skills training outside the operating room is cost-beneficial, faster and safer, and does not harm the patient. When compared to box-trainers, virtual reality simulators and cadaver models have no additional benefits. Several laparoscopic trainers available on the market as well as homemade box and video-trainers, most of them using plastic boxes and standard webcams, were described in the literature. The majority of them involve training on a flat surface without any anatomical environment. In addition to their demonstrated benefits, box-trainers which add anatomic details can improve the training quality and skills development of surgeons. Methods: We created a 3D-printed anatomic pelvi-trainer which offers a real-size narrow pelvic space environment for training. The model was created starting with a CT-scan performed on a female pelvis from the Anatomy Museum (Cluj-Napoca University of Medicine and Pharmacy, Romania), using Invesalius 3 software (Centro de Tecnologia da informação Renato Archer CTI, InVesalius open-source software, Campinas, Brazil) for segmentation, Fusion 360 with Netfabb software (Autodesk software company, Fusion 360 with Netfabb, San Francisco, CA, USA) for 3D modeling and a FDM technology 3D printer (Stratasys 3D printing company, Fortus 380mc 3D printer, Minneapolis, MN, USA). In addition, a metal mold for casting silicone valves was made for camera and endoscopic instruments ports. The trainer was tested and compared using a laparoscopic camera, a standard full HD webcam and “V-Box” (INTECH—Innovative Training Technologies, Milano, Italia), a dedicated hard paper box. The pelvi-trainer was tested by 33 surgeons with different qualifications and expertise. Results: We made a complete box-trainer with a versatile 3D-printed pelvi-trainer inside, designed for a wide range of basic and advanced laparoscopic skills training in the narrow pelvic space. We assessed the feedback of 33 surgeons regarding their experience using the anatomic 3D-printed pelvi-trainer for laparoscopic surgery training in the narrow pelvic space. Each surgeon tested the pelvi-trainer in three different setups: using a laparoscopic camera, using a webcam connected to a laptop and a “V-BOX” hard paper box. In the experiments that were performed, each participant completed a questionnaire regarding his/her experience using the pelvi-trainer. The results were positive, validating the device as a valid tool for training. Conclusions: We validated the anatomic pelvi-trainer designed by our team as a valuable alternative for basic and advanced laparoscopic surgery training outside the operating room for pelvic organs procedures, proving that it supports a much faster learning curve for colorectal procedures without harming the patients. Full article

Background/Objectives: Microsurgery employs techniques requiring optical magnification and specialized instruments to operate on small anatomical structures, including small vessels. These methods are integral to plastic surgery, enabling procedures such as free tissue transfer, nerve reconstruction, replantation, and lymphatic surgery. This paper explores the historical development, advancements, and current applications of microsurgery in plastic surgery. Methods: The databases MEDLINE (via PubMed) and Web of Science were selectively searched with the term “(((microsurgery) OR (advances)) OR (robotic)) OR (AI)) AND (((lymphatic surgery) OR (peripheral nerve surgery)) OR (allotransplantation))” and manually checked for relevance. Additionally, a supplementary search among the references of all publications included was performed. Articles were included that were published in English or German up to June 2024. Results: Modern microsurgical techniques have revolutionized plastic surgery, enabling precise tissue transfers, improved nerve reconstruction, and effective lymphedema treatments. The evolution of robotic-assisted surgery, with systems like da Vinci and MUSA, has enhanced precision and reduced operative times. Innovations in imaging, such as magnetic resonance (MR) lymphography and near-infrared fluorescence, have significantly improved surgical planning and outcomes. Conclusions: The continuous advancements in microsurgery, including supermicrosurgical techniques and robotic assistance, have significantly enhanced the capabilities and outcomes of plastic surgery. Future developments in AI and robotics promise further improvements in precision and efficiency, while new imaging modalities and surgical techniques expand the scope and success of microsurgical interventions. Full article

Breast reconstruction surgery is continualladvancing, significantly enhancing patient well-being. Current surgical techniques prioritize minimizing donor site morbidity while achieving a more natural breast appearance. Increasing patient preferences for avoiding prosthetic materials in reconstruction, along with advancements in oncological safety and heightened aesthetic expectations, are driving the exploration and development of innovative approaches. Today’s reconstructive options range from straightforward oncoplastic glandular remodeling to intricate microsurgical procedures. This narrative review, titled “Breast reconstruction: the oncoplastic approach,” provides a comprehensive overview of contemporary trends in breast-conserving treatment. It evaluates the indications for these techniques and offers guidance to plastic surgeons in crafting personalized treatment plans. This approach presents a valuable single-stage alternative or adjunct to traditional prosthetic or microsurgical reconstruction methods. Full article

Artificial intelligence (AI) is revolutionizing plastic surgery through its remarkable advancements in various domains such as image analysis, robotic assistance, predictive analytics, and augmented reality. Predictive analytics, powered by AI, harnesses patient data to predict surgical outcomes, minimize risks, and tailor treatment plans, thereby optimizing patient care and safety. Augmented reality and virtual reality technology are also reshaping the cosmetic surgery landscape, providing immersive experiences for preoperative imaging, intraoperative guidance, and advanced skills through simulation. Looking ahead, the future of AI in plastic surgery holds great promise, including personalized medicine, bioprinting of tissues and organs, and continuous learning through iterative improvement algorithms based on real-world surgical experience. However, amid these transformational advances, ethical considerations and regulatory frameworks must evolve to ensure the responsible deployment of AI, protect patient privacy, minimize errors and algorithmic deviation, and uphold standards of fairness and transparency. Our study aims to explore the role of AI in the field of plastic surgery with the potential for the future in mind. In summary, AI is considered a beacon of innovation in plastic surgery, enhancing surgical precision, enhancing patient outcomes, and heralding a future where interventions rely on personalized technology that will redefine the boundaries of aesthetic and regenerative medicine. Full article

Abdominal wall reconstruction is a common and necessary surgery, two factors that drive innovation. This review article examines recent developments in ventral hernia repair including primary fascial closure, mesh selection between biologic, permanent synthetic, and biosynthetic meshes, component separation, and functional abdominal wall reconstruction from a plastic surgery perspective, exploring the full range of hernia repair’s own reconstructive ladder. New materials and techniques are examined to explore the ever-increasing options available to surgeons who work within the sphere of ventral hernia repair and provide updates for evolving trends in the field. Full article