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Precision Medicine in Plastic Surgery and Reconstruction
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Precision Medicine in Plastic Surgery and Reconstruction

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Regenerative Medicine and Therapeutics".

Deadline for manuscript submissions: 15 February 2025 | Viewed by 9502

Special Issue Editors

Dr. Sebastian P. Nischwitz

E-Mail Website
Guest Editor
Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036 Graz, Austria
Interests: plastic surgery; aesthetic surgery; regenerative medicine; rejuvenation; tissue engineering; rhinoplasty; face surgery; leadership and management; professional policies
Dr. Thomas Rappl

E-Mail Website
Guest Editor
Joanneum Research Forschungsgesellschaft mbH, Graz, Austria
Interests: plastic surgery; aesthetic surgery; reconstructive surgery

Special Issue Information

Dear Colleagues,

Advancements in the field of precision medicine have revolutionized various medical disciplines, including plastic surgery and reconstruction. The integration of personalized treatment approaches, molecular diagnostics, genomics, and advanced imaging techniques has significantly enhanced the accuracy, outcomes, and patient satisfaction in plastic surgery procedures. This Special Issue aims to explore the exciting developments and potential applications of precision medicine in plastic, aesthetic, and reconstructive surgery.

The issue will feature cutting-edge research and clinical studies that highlight the utility of precision medicine in the diagnosis, treatment planning, and execution of plastic surgery interventions. Contributions focusing on the application of genetic profiling, biomarkers, and targeted therapies in aesthetic and reconstructive procedures will be particularly welcomed. Furthermore, the potential role of emerging technologies, such as 3D printing, virtual surgical planning, and robotics, in enabling personalized surgical interventions will be explored.

The issue will also delve into the integration of artificial intelligence and machine learning algorithms in plastic surgery, enabling precise patient selection, prediction of surgical outcomes, and optimization of treatment strategies. The ethical considerations, challenges, and future directions pertaining to the implementation of precision medicine in plastic surgery will be addressed.

We invite fellow scientists and clinicians to submit original research articles, reviews, case studies, and perspectives that contribute to the evolving field of precision medicine in plastic surgery and reconstruction. This Special Issue aims to foster interdisciplinary collaborations and encourage the translation of innovative research findings into clinical practice. Together, we can shape the future of plastic surgery by leveraging the power of precision medicine to deliver personalized, effective, and safe treatments for patients.

Dr. Sebastian P. Nischwitz
Dr. Thomas Rappl
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 Personalized Medicine is an international peer-reviewed open access monthly 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
  • reconstruction
  • aesthetic surgery
  • virtual surgery
  • artificial intelligence
  • precision medicine

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Published Papers (6 papers)

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12 pages, 1289 KiB  
Article
Ulnar Nerve Management in Complex Elbow Dislocations: A Retrospective Monocentric Study
by Carlotta Faccenda, Elisa Dutto, Francesco Bosco, Alessandro Dario Lavia and Bruno Battiston
J. Pers. Med. 2024, 14(11), 1076; https://doi.org/10.3390/jpm14111076 - 26 Oct 2024
Viewed by 431
Abstract
Background/Objectives: The ulnar nerve’s unique anatomy makes it vulnerable to complex elbow dislocations. Depending on the nature of the injury, the clinical treatment and outcomes related to the nerve may vary. Unfortunately, the current literature provides limited and fragmented information on managing the [...] Read more.
Background/Objectives: The ulnar nerve’s unique anatomy makes it vulnerable to complex elbow dislocations. Depending on the nature of the injury, the clinical treatment and outcomes related to the nerve may vary. Unfortunately, the current literature provides limited and fragmented information on managing the ulnar nerve and the incidence of neuropathy in complex elbow dislocations. This study aimed to determine the occurrence of ulnar nerve pain and its relationship with transposition. Methods: A retrospective evaluation was conducted on a consecutive series of 44 patients who underwent surgery for complex elbow dislocations. The average follow-up period was 29 months. Patients were categorized based on their condition (trans-olecranon fracture–dislocation, Terrible Triad, Monteggia-like lesions, and injuries not falling into the previous categories). The study assessed whether the ulnar nerve was released from the cubital tunnel and underwent transposition. Additionally, the study examined the number of patients experiencing ulnar pain in the postoperative period and its duration over time. All patients were also evaluated using the Mayo Elbow Performance Score (MEPS), Disabilities of Arm, Shoulder, and Hand (DASH) score, and Oxford Elbow Score (OES). Results: Patients who underwent simultaneous ulnar nerve transposition surgery with complex elbow dislocation showed a higher incidence of neuropathy. In these patients, the symptoms were less severe but lasted longer. MEPS, DASH, and OES did not show statistically significant differences between the two groups; however, they were slightly better for the group without ulnar nerve transposition. Conclusions: Surgeons should refrain from routinely transposing the ulnar nerve in complex elbow dislocations. However, further studies involving larger populations are necessary. Full article
(This article belongs to the Special Issue Precision Medicine in Plastic Surgery and Reconstruction)
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11 pages, 5292 KiB  
Article
Breast Vascularization and Its Implication in Breast Reduction and Mastopexy Surgery: Anatomical Study
by Ainhoa Salas-López, Carolina Morgado-Águila, Carlos López-de-Celis, Jacobo Rodríguez-Sanz, Sara Ortiz-Miguel and Albert Pérez-Bellmunt
J. Pers. Med. 2024, 14(5), 536; https://doi.org/10.3390/jpm14050536 - 17 May 2024
Viewed by 1091
Abstract
(1) Background: Breast reduction is one of the most frequently performed plastic surgeries in women worldwide. The Wise pattern breast reduction is one of the most frequent skin designs for this surgery. One key point of the surgery is to preserve a well-vascularized [...] Read more.
(1) Background: Breast reduction is one of the most frequently performed plastic surgeries in women worldwide. The Wise pattern breast reduction is one of the most frequent skin designs for this surgery. One key point of the surgery is to preserve a well-vascularized NAC by using different surgical pedicles. This study aims to test and update the anatomical knowledge of breast vascularization, the topographic and anatomical basis of the different surgical vascular pedicles, and the differences between the right and left sides. (2) Methods: A descriptive observational anatomical study was carried out on 15 breasts from 10 cryopreserved body donors. A dissection was performed by quadrants to know the affected arteries’ origin in the different patterns. (3) Results: The largest and most frequently dissected internal mammary perforator artery was in the second intercostal space. A total of 44.9% of the dissected perforators are located in the upper inner quadrant, compared to 53.5% in the lower quadrants. (4) Conclusions: The upper inner quadrant alone has the most arterial perforators. In contrast, the sum of the two lower quadrants represents the greatest vascularization of the breast, with a small difference between both. Full article
(This article belongs to the Special Issue Precision Medicine in Plastic Surgery and Reconstruction)
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10 pages, 2634 KiB  
Article
Double Lateral Osteotomy: Not Only the Correction of Crooked Noses but a Relevant Aesthetical Refinement in Structural Rhinoplasty
by Roberto Bracaglia, Maria Servillo, Regina Fortunato, Anna Amelia Caretto and Stefano Gentileschi
J. Pers. Med. 2023, 13(11), 1619; https://doi.org/10.3390/jpm13111619 - 19 Nov 2023
Cited by 1 | Viewed by 2150
Abstract
Background: Osteotomy represents a crucial step in structural rhinoplasty; however, there is not a unique approach accepted. Double lateral osteotomy has proven to be effective in the long-term correction of a deviated nose. In this series, we evaluated its aesthetic value also in [...] Read more.
Background: Osteotomy represents a crucial step in structural rhinoplasty; however, there is not a unique approach accepted. Double lateral osteotomy has proven to be effective in the long-term correction of a deviated nose. In this series, we evaluated its aesthetic value also in non-deviated cases. Materials and Methods: 864 patients who underwent primary structural rhinoplasty from 2012 to 2020 were divided into four groups. Group A and B included patients with a crooked nose treated with asymmetrical double osteotomy and bilateral double osteotomy, respectively. Patients who did not present nasal deviation were divided into group C, including cases treated with bilateral single osteotomy, and group D, including patients who underwent bilateral double osteotomy. Postoperative evaluations were performed by three independent plastic surgeons blinded to the surgical technique. Patient’s satisfaction was assessed through the FACE-Q rhinoplasty module. Results: FACE-Q scores reported a satisfaction rate higher than 30% for every item in all groups; however, group B and group D showed statistically higher satisfaction (p < 0.01). According to the evaluations performed by physicians, group B and group D showed the most satisfactory outcomes (p < 0.01). Conclusions: bilateral double osteotomies represent a significant aesthetic refinement in structural rhinoplasty, not only in crooked noses but also in non-deviated cases, since the reduction in the width of the nose is an aesthetical aspect very appreciated by patients. Full article
(This article belongs to the Special Issue Precision Medicine in Plastic Surgery and Reconstruction)
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11 pages, 2221 KiB  
Article
Evaluation of Intraoperative Volumetric Assessment of Breast Volume Using 3D Handheld Stereo Photogrammetric Device
by Rafael Loucas, Marios Loucas, Sebastian Leitsch, Katarina Danuser, Gabriela Reichard, Omar Haroon, Julius Michael Mayer, Konstantin Koban and Thomas Holzbach
J. Pers. Med. 2023, 13(8), 1262; https://doi.org/10.3390/jpm13081262 - 15 Aug 2023
Cited by 2 | Viewed by 1469
Abstract
Methods for assessing three-dimensional (3D) breast volume are becoming increasingly popular in breast surgery. However, the precision of intraoperative volumetric assessment is still unclear. Until now, only non-validated scanning systems have been used for intraoperative volumetric analyses. This study aimed to assess the [...] Read more.
Methods for assessing three-dimensional (3D) breast volume are becoming increasingly popular in breast surgery. However, the precision of intraoperative volumetric assessment is still unclear. Until now, only non-validated scanning systems have been used for intraoperative volumetric analyses. This study aimed to assess the feasibility, handling, and accuracy of a commercially available, validated, and portable device for intraoperative 3D volumetric evaluation. All patients who underwent breast surgery from 2020 to 2022 were identified from our institutional database. Intraoperative 3D volumetric assessments of 103 patients were included in this study. Standardized 3D volumetric measurements were obtained 3 months postoperatively to compare the intraoperatively generated volumetric assessment. All of the study participants were women with a mean age of 48.3 ± 14.7 years (range: 20–89). The mean time for intraoperative volumetric assessment was 8.7 ± 2.6 min. The postoperative 3D volumetric assessment, with a mean volume of 507.11 ± 206.29 cc, showed no significant difference from the intraoperative volumetric measurements of 504.24 ± 276.61 cc (p = 0.68). The mean absolute volume difference between the intraoperative simulations and postoperative results was 27.1 cc. Intraoperative 3D volumetric assessment using the VECTRA H2 imaging system seems to be a feasible, reliable, and accurate method for measuring breast volume. Based on this finding, we plan to investigate whether volumetric objective evaluations will help to improve breast symmetry in the future. Full article
(This article belongs to the Special Issue Precision Medicine in Plastic Surgery and Reconstruction)
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10 pages, 887 KiB  
Article
Do Sex-Specific Factors Influence the Surgical Treatment of Facial Skin Cancer?
by Sarah Victoria Wünscher, Stephan Spendel, Sebastian P. Nischwitz, Alessandro Gualdi, Alexander Avian, Lars-Peter Kamolz and Janos Cambiaso-Daniel
J. Pers. Med. 2023, 13(8), 1193; https://doi.org/10.3390/jpm13081193 - 27 Jul 2023
Viewed by 1868
Abstract
Facial skin cancer (FSC) is prone to incomplete excision due to the sophisticated anatomy and the aesthetic importance of the face. In this study, we sought to investigate to what extent sex-specific differences and other operation-, patient-, and cancer-specific factors influence the re-resection [...] Read more.
Facial skin cancer (FSC) is prone to incomplete excision due to the sophisticated anatomy and the aesthetic importance of the face. In this study, we sought to investigate to what extent sex-specific differences and other operation-, patient-, and cancer-specific factors influence the re-resection rate in FSC surgery, in order to provide personalized treatment strategies to patients. In this retrospective study, patients (>18 years) undergoing surgical excision of an FSC were enrolled. Each patient’s demographic data, cancer location, the surgical team, primary and secondary surgeries were analyzed. Overall, 469 patients (819 surgeries) were included. The mean age was 69 ± 15 years. No significant association between sex-specific factors (surgeon’s sex (OR: 1.09, 95% CI: 0.76–1.56) or patient’s sex (OR: 0.85, 95% CI: 0.62–1.17), surgeon–patient sex concordance and discordance) and the likelihood of secondary surgery were found. However, healing by secondary intention (OR: 4.28; 95% CI: 1.94–9.45) and cancer location showed an increased re-resection rate. In conclusion, FSC surgery is a safe method unaffected by sex-specific factors, which had no impact on the re-resection rate. However, in further analysis, the likelihood of a re-resection was influenced by other factors such as healing by secondary intention and cancer location. This knowledge might be useful to provide an algorithm for personalized treatment strategies in the future. Full article
(This article belongs to the Special Issue Precision Medicine in Plastic Surgery and Reconstruction)
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9 pages, 1862 KiB  
Case Report
Feet Salvage Using Anterolateral Thigh Flaps after Severe Frostbite Injury: A Case Report
by Krešimir Martić, Borna Vojvodić, Božo Gorjanc, Ivan Budimir, Hrvoje Tucaković, Doroteja Caktaš, Rado Žic and Josip Jaman
J. Pers. Med. 2024, 14(4), 389; https://doi.org/10.3390/jpm14040389 - 5 Apr 2024
Viewed by 1435
Abstract
Background: Frostbite is a severe injury characterized by tissue damage due to exposure to freezing temperatures. It often necessitates prompt medical intervention to prevent further complications such as necrosis and amputation. This case report explores the successful use of bilateral anterolateral thigh (ALT) [...] Read more.
Background: Frostbite is a severe injury characterized by tissue damage due to exposure to freezing temperatures. It often necessitates prompt medical intervention to prevent further complications such as necrosis and amputation. This case report explores the successful use of bilateral anterolateral thigh (ALT) free flaps for feet salvage in a 19-year-old male refugee from Gambia who suffered severe frostbite injuries. Case Report: The patient, found after six days in freezing conditions, exhibited necrosis on multiple toes. Initial management included stabilization, intravenous fluids, and rewarming. Subsequent necrectomy and amputation revealed exposed metatarsal bones, necessitating a meticulous reconstructive strategy. Bilateral ALT flaps were chosen to preserve walking function, with a staged reconstruction involving multiple operations. The patient’s progress, from inpatient care to outpatient follow-ups, is detailed, emphasizing the challenges and decisions in managing severe frostbite injuries. Results: The surgical intervention utilizing bilateral ALT flaps successfully salvaged the patient’s feet. Throughout the postoperative period, wound care, rehabilitation, and outpatient monitoring contributed to positive outcomes. Despite challenges associated with the patient’s ethnic background and nutritional status, the staged reconstruction facilitated effective healing and functional recovery. The use of ALT flaps provided a reliable solution with minimal donor site morbidity. Conclusion: This case highlights the efficacy of bilateral ALT flap reconstruction in salvaging feet following severe frostbite injury. The successful restoration of foot function underscores the importance of early intervention and tailored reconstructive approaches in frostbite management. Despite patient-specific challenges, including nutritional status and limited healthcare resources, the use of ALT flaps facilitated optimal recovery and functional outcomes. Importantly, this report is unique as it describes a novel case of feet salvage using bilateral ALT flaps in severe frostbite injury, with only one similar case previously reported in the literature. This emphasizes the rarity and significance of this specific surgical approach in frostbite management. Full article
(This article belongs to the Special Issue Precision Medicine in Plastic Surgery and Reconstruction)
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