All Issues

Issue No. 21

Dr. Gupta's Plastic Surgery
Intelligence Briefing

28 articles · 7 sections

Axillary Surgery · Minimally Invasive

Optimizing the Surgical Paradigm for Axillary Osmidrosis: A Retrospective Cohort Study Integrating Tumescent Suction-Curettage and Direct-Vision Trimming

This newly accepted retrospective cohort study compares a tumescent suction-curettage approach with direct-vision trimming for axillary osmidrosis. The technique pairing is designed to balance complete removal of odor-producing tissue against the wound and scar burden associated with more extensive excision.

Breast Reconstruction · ERAS

The 24-hour DIEP challenge: How ERAS redefines recovery in microsurgical breast reconstruction

This study evaluates an enhanced-recovery pathway aimed at compressing recovery after deep inferior epigastric perforator flap reconstruction into a 24-hour framework. Its practical focus is on perioperative standardization and earlier discharge while maintaining the safety requirements of microsurgical monitoring.

Abdominal Wall · Reconstructive Planning

Abdominal Wall Reconstruction: A Literature Review

This review surveys contemporary strategies for abdominal wall reconstruction, spanning primary closure, mesh reinforcement, component separation, and flap-based approaches. The key planning issue is matching the reconstructive method to defect size, tissue quality, contamination, and the need to restore durable abdominal-wall function.

Brow Reconstruction · Tissue Engineering

The evolving landscape of eyebrow reconstruction

This review frames eyebrow reconstruction as a field moving beyond conventional hair transplantation toward cell-based therapies and tissue engineering. It highlights the continuing challenge of recreating a three-dimensional, directionally oriented brow with durable growth and a natural aesthetic result.

Burn Wounds · Procedural Analgesia

Oral ketamine adjunct for wound care in patients with burn injuries

This newly published burn-care study evaluates oral ketamine as an adjunct during wound-care procedures. The approach is clinically relevant because it seeks to improve analgesia and procedural tolerance while limiting the monitoring burden and opioid exposure associated with deeper intravenous sedation.

Chronic Wounds · Photobiomodulation

Photobiomodulation therapy in the management of chronic wounds: From molecular mechanisms to translational clinical evidence

This review connects photobiomodulation’s molecular effects with the clinical evidence for chronic-wound treatment. It positions wavelength, dose, and delivery parameters as central variables for translating a promising light-based modality into reproducible wound-care protocols.

Diabetic Wounds · Mechanisms

Diabetes and Delayed Wound Healing: Molecular Mechanisms and Dermatological Interventions

This review explains how diabetes disrupts multiple stages of wound repair and then surveys dermatological interventions intended to address those deficits. The clinical implication is a coordinated strategy that considers inflammation, infection, perfusion, and tissue remodeling rather than relying on a single topical treatment.

Chronic Wounds · Oxygen Therapy

Clinical Efficacy and Safety of Portable Continuous Topical Oxygen Therapy for Chronic Wound Management: A Randomised Controlled Trial

This randomized controlled trial tests portable continuous topical oxygen as an adjunct for chronic wound management. Its importance is practical: a portable delivery model could extend oxygen-based therapy beyond specialized facilities, provided healing gains and safety remain consistent in routine care.

Tissue Engineering · Skin Substitutes

Advances in stem cell-based tissue-engineered skin substitutes for wound healing

This review examines stem-cell-based skin substitutes intended to improve coverage and regeneration when conventional autograft supply is limited. It emphasizes the translational gap between promising engineered constructs and dependable clinical products, including vascularization, manufacturing, and long-term integration.

3D Bioprinting · Skin Equivalents

3D bioprinting of skin equivalents: Towards functional wound healing

This review surveys 3D bioprinted skin equivalents designed to reproduce the organization and function of native skin. The field is moving from printable geometry toward functional constructs that can vascularize, integrate, and support durable wound closure.

Bioprinted Skin · Clinical Translation

Bioprinted skin: from lab bench to clinic, what matters now and what is next

This perspective places bioprinted skin at the intersection of tissue engineering and reconstructive surgery. It argues that clinical progress will depend not only on printing resolution, but also on bioink performance, vascular integration, regulatory readiness, scalable manufacturing, and meaningful patient outcomes.

ADM · Diabetic Wounds

Human cell-derived dermal-specific interwoven extracellular matrix for diabetic wound healing

This study develops a dermal-specific interwoven extracellular-matrix scaffold derived from human cells for diabetic wound repair. The design aims to provide a more physiologic regenerative substrate than a generic dressing, with matrix architecture and biologic signaling treated as linked therapeutic variables.

Exosomes · Skin Wounds

Application of stem cell-derived exosomes in skin wound healing: mechanisms, prospects, and challenges

This review describes mesenchymal-stem-cell-derived exosomes as nanoscale carriers of proteins, RNAs, and lipids that can reproduce part of the parent cell’s regenerative signaling without delivering whole cells. It emphasizes the remaining translational barriers—manufacturing consistency, dosing, delivery, and clinical validation—before routine wound-care use.

Exosomes · Cell-Free Therapy

The use of therapeutic exosomes for in vivo wound healing

This review evaluates therapeutic exosomes as cell-free agents for wound healing in living models. It focuses on how extracellular-vesicle cargo can influence inflammation, angiogenesis, and matrix remodeling while underscoring the need for standardized preparations and better clinical evidence.

Stem Cells · Mechanically Conditioned Scaffolds

Mechanical stretch loading of BMSCs-PLCL composite scaffolds accelerate diabetic wound healing by protecting endothelial cells and promoting angiogenesis

This preclinical study combines bone-marrow mesenchymal stem cells with a PLCL nanofiber scaffold and applies cyclic mechanical stretch before treatment. The engineered construct is intended to protect endothelial cells and amplify angiogenesis, illustrating how physical conditioning may improve a cell-scaffold therapy for diabetic wounds.

Exosomes · Scarless Healing

Mesenchymal Stem Cells-Derived Exosomes: Next-Generation Nanomedicines Toward Scarless Wound Healing

This review considers mesenchymal-stem-cell-derived exosomes as a next-generation, cell-free strategy for improving wound repair and limiting scar formation. The opportunity lies in targeted delivery of regenerative signals; the challenge is converting mechanistic and preclinical promise into controlled, reproducible clinical products.

RF Microneedling · Device Safety

Analysis of US Food and Drug Administration Data on Adverse Events Associated With Radiofrequency Microneedling

This analysis reviews FDA MAUDE reports associated with radiofrequency microneedling, with attention to treatment locations and reported adverse events. The signal is a reminder that device safety depends on anatomy, energy settings, technique, and informed consent—not only on the label “minimally invasive.”

Laser · Skin Rejuvenation

Repositioning Non-Ablative Fractional Lasers - Molecular and Histological Insights from a scoping review

This scoping review reassesses non-ablative fractional lasers for rejuvenation and scar treatment through molecular and histologic evidence. The authors’ framing supports parameter-specific treatment selection, linking controlled dermal injury to collagen remodeling while keeping downtime and skin phenotype in view.

Lasers · Comparative Effectiveness

Comparative Efficacy and Safety of Laser Versus Chemical Peels for Skin Rejuvenation

This comparative review evaluates laser resurfacing against chemical peels for skin rejuvenation across efficacy and safety outcomes. The evidence supports improvement with both modalities, but choice should be individualized to the target condition, skin type, depth of treatment, and tolerance for recovery.

RF Microneedling · Evidence Synthesis

Effectiveness of Radiofrequency Microneedling in the Treatment of Dermatological Conditions: A Systematic Review

This systematic review synthesizes the clinical literature on radiofrequency microneedling across dermatologic indications. Its value is in separating platform-level enthusiasm from indication-specific evidence and in highlighting the importance of treatment parameters, comparator choice, and standardized endpoints.

Breast Reconstruction · Staged Flaps

The FAST Protocol: A Novel Approach for Staged Autologous Breast Reconstruction

This Plastic and Reconstructive Surgery article introduces a staged protocol for autologous breast reconstruction, addressing the persistent debate over ideal timing and sequencing. The approach may give teams more control over tissue preparation and patient recovery, but its value will depend on reproducibility beyond the originating practice.

Breast Reconstruction · Radiotherapy

Postmastectomy Radiotherapy in Immediate Autologous Breast Reconstruction: A Patient-Reported and Clinical Outcomes Study

This patient-reported and clinical outcomes study examines immediate autologous reconstruction in the setting of postmastectomy radiotherapy. It adds decision-relevant evidence to counseling about satisfaction, complications, and the trade-offs of proceeding with reconstruction before adjuvant treatment is complete.

Breast Reconstruction · Thigh Flaps

Beyond the DIEP Flap: Thigh-Based Autologous Breast Reconstruction

This review examines thigh-based donor sites as alternatives when abdominal tissue is unavailable or unsuitable for autologous breast reconstruction. It supports a broader donor-site algorithm that includes profunda artery perforator and related thigh flaps, while acknowledging the planning and patient-selection constraints of each option.

Fat Grafting · Cell Enrichment

Adipose-Derived Stem Cell-Enhanced versus Conventional Fat Grafting for Breast Reconstruction: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis compares adipose-derived stem-cell-enhanced fat grafting with conventional fat grafting for breast reconstruction. The central question is whether cellular enrichment improves retention and safety enough to justify added processing complexity and unresolved translational concerns.

AI · Clinical Governance

From Innovation to Integration: Responsible Integration of Artificial Intelligence in Plastic Surgery

This perspective shifts the AI conversation from novelty to responsible integration in plastic surgery. It highlights the practical requirements for deployment—validated datasets, bias monitoring, transparent performance limits, clinician oversight, and workflow design that keeps accountability with the care team.

AI · Robotics · Cosmetic Practice

Technological Integration in Aesthetic Practice: A Systematic Review of Artificial Intelligence, Augmented Reality and Robotics in Cosmetic Procedures

This systematic review screened 12,316 studies and included 55 clinical papers on AI, augmented reality, and robotics in cosmetic procedures. Most studies used AI for skin assessment, volumetric planning, or communication; fewer addressed risk prediction, and the overall evidence quality for robotics and augmented reality remained low to moderate.

3D Bioprinting · Wound Care

Clinical trials on 3D bioprinted scaffolds for lower extremity vascular, diabetic and pressure ulcers: A systematic review

This systematic review identified eight human studies of 3D-bioprinted scaffolds for lower-limb ulcers, including two randomized trials and six single-arm studies involving 139 patients. The reported epithelialization gains and absence of treatment-related serious adverse events are encouraging, but small samples, short follow-up, and variable methods still limit confidence.

Intraoperative Bioprinting · Vascularization

Coupling intraoperative bioprinting and surgical micropuncture for synergistic scaffold vascularization

This Biomaterials study couples intraoperative bioprinting with surgical micropuncture to address vascularization of printed scaffolds. The concept moves bioprinting toward the operating field, where defect-specific fabrication and deliberate vessel access could improve integration, though translation remains dependent on reliable bioinks and surgical workflow.