Plastic Surgery

Biofabricated scaffolds aim to overcome capsular contracture and volume loss in breast reconstruction

This review summarizes bio-fabrication strategies to address capsular contracture, volume loss, and infection in breast reconstruction after mastectomy. Engineered scaffolds combining biomaterials, bioactive agents, and 3D printing seek to better replicate the breast microenvironment than current implants. Key goals include promoting vascularization, adipogenesis, and soft-tissue integration while modulating fibrosis and infection via tailored implant surface modifications. The authors highlight integrating antitumor functions into reconstructive materials to support oncologic safety alongside aesthetic restoration. They outline research priorities for personalized, biocompatible scaffolds that provide durable volume and fewer complications than current implant or autologous options. 1

Prepectoral versus subpectoral reconstruction: similar complications, no delay in adjuvant therapy

This retrospective series of 622 mastectomy patients compared prepectoral with subpectoral implant-based reconstruction over a 10-year period. Overall complication rates were similar between subpectoral and prepectoral techniques (23.8% vs 20.2%). Prepectoral reconstruction had more delayed wound healing but less postoperative bleeding and significantly shorter operative time. Time to adjuvant treatment was not affected by reconstructive plane; instead, skin-reducing mastectomy, smoking, and diabetes predicted delays. These data support prepectoral reconstruction as an oncologically compatible option when patient comorbidities and skin flaps are carefully assessed. 2

CaHA-modified PLGA microspheres show long-lasting soft-tissue support and collagen regeneration

This preclinical study developed mossy-textured hydroxyapatite-modified PLGA microspheres as a soft-tissue filler targeting collagen loss with aging. The 30–60 μm CaHA/PLGA particles had porous surfaces, enhanced protein adsorption, delayed degradation, and low inflammatory response. Compared with commercial PLLA, CaHA/PLGA provided stable tissue support for at least 12 weeks and significantly increased collagen network formation in vivo. Transcriptomics in adipose-derived stem cells implicated calcium/TGF-β and chemokine pathways in driving migration, cytokine production, and collagen deposition. Findings suggest a next-generation biostimulatory filler with potentially longer persistence and more robust neocollagenesis than existing PLLA products. 3

Global Delphi consensus defines and guides management of lipedema

Experts from 19 countries used a Delphi process to establish international consensus on lipedema definition and management. Fifty-nine of 62 statements reached agreement across eight domains spanning diagnosis, staging, and conservative and interventional treatment. The consensus emphasizes recognizing painful, disproportionate adipose tissue in predominantly women and distinguishes lipedema from obesity and lymphedema. Recommendations provide a standardized framework that can inform surgical decision-making, outcome measures, and patient counseling in plastic surgery clinics. The authors stress substantial evidence gaps, underscoring the need for prospective data and harmonized reporting in future lipedema surgery studies. 4