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Study Type: Experimental perception study (3D modelling/survey-based)

Key Question: Which facial region — periocular, perioral, midface-lower face, or neck-jawline — contributes most to perceived youth when rejuvenated in isolation?

Key Findings:

• Neck-jawline rejuvenation was most frequently ranked as appearing youngest (54/101 participants); perioral rejuvenation was most often ranked oldest (71/101)
• Mean perceived-youth rankings: neck-jawline 1.8, midface-lower face 2.2, periocular 2.6, perioral 3.6 (P<0.001)
• Periocular and midface-lower face regions did not differ significantly from each other (P=0.4)

Clinical Relevance: When resource, recovery, or patient preference limits comprehensive facial rejuvenation, these findings support prioritising jawline/neck procedures — relevant to NHS and private practice treatment planning conversations.

Limitations: Participants assessed a single digitally sculpted female model, limiting generalisability across ages, ethnicities, and sexes.

Study Type: Retrospective within-subject controlled study

Key Question: Does intramuscular autologous fat grafting (PRIME-GRAFT technique) induce measurable biological changes in recipient muscle tissue?

Key Findings:

• Treated pectoralis major showed reduced fibrosis and collagen deposition alongside elevated glycogen content compared to untreated vastus lateralis at one year
• Transcriptomic profiling identified 70 differentially expressed genes (51 upregulated, 19 downregulated), with upregulated genes clustering around muscle structure, ECM remodelling, energy metabolism, and stem cell activity
• Findings suggest a regenerative and anabolic transcriptional shift in grafted muscle, beyond purely aesthetic outcomes

Clinical Relevance: For UK surgeons performing intramuscular fat transfer, this provides preliminary biological rationale that the procedure may confer tissue-level regenerative benefit, potentially relevant to reconstructive as well as aesthetic applications.

Limitations: Extremely small sample size (n=7 males) with cross-muscle rather than within-muscle comparison, introducing significant confounding from baseline tissue heterogeneity.

Study Type: Retrospective cohort analysis

Key Question: Does preoperative biologic or immune-modulating therapy increase postoperative complication rates following breast reconstruction or augmentation?

Key Findings:

• Following 1:1 propensity score matching (n=3,980 per group), complication rates were comparable between biologic-exposed and unexposed patients at 30 days, 90 days, and 6 months (all p>0.05)
• No significant difference in wound dehiscence, infection, seroma/haematoma, implant revision, or hospital readmission
• Findings held across TNF-α, IL, JAK, mTOR, and calcineurin inhibitor classes

Clinical Relevance: Many UK plastic surgery patients on biologics for rheumatoid arthritis, psoriasis, or IBD require breast reconstruction or augmentation; this supports continuing therapy perioperatively rather than interrupting immunomodulation unnecessarily.

Limitations: Retrospective database methodology risks residual confounding, and TriNetX data may lack granularity on dosing, timing of last dose, and disease severity.

Study Type: Scoping review

Key Question: What is the extent and quality of evidence supporting intraoperative ultrasound as a safety tool during gluteal fat grafting?

Key Findings:

• Only 9 studies (2018–2025) met inclusion criteria across 6 databases; evidence base is predominantly observational case series plus one systematic review with meta-analysis — no RCTs identified
• No cases of fat embolism or procedure-related mortality were reported across included studies, though absence of comparative controls limits causal inference
• Ultrasound use was primarily for real-time cannula positioning and subcutaneous plane confirmation, but verification methods were not standardised across studies

Clinical Relevance: Brazilian Butt Lift carries recognised mortality risk; UK clinicians and regulators need robust evidence before mandating intraoperative ultrasound as standard of care, and this review confirms that evidence base does not yet exist.

Limitations: The predominantly non-comparative, low-quality study designs preclude any conclusions about whether ultrasound independently reduces complication rates.

Study Type: Retrospective cohort study with supplementary systematic literature review

Key Question: Do Becker expander implants produce different complication profiles compared to fixed-volume implants in reconstructive or corrective breast surgery?

Key Findings:

• Overall complication rates were comparable between Becker and fixed-volume groups (31.25% vs. 32.59%, p≥0.05) over a median follow-up of 5.87 years
• Major complications resulting in implant loss were significantly higher with Becker expanders (9.73% vs. 2.21%, p<0.05), though subgroup analysis failed to identify which specific patient cohort drove this difference
• Both groups demonstrated lower overall complication rates than comparable series reported in the literature

Clinical Relevance: For UK reconstructive surgeons offering single-stage implant-based breast reconstruction, this supports cautious use of Becker expanders where volume adjustability is a priority, but highlights a meaningful implant loss risk requiring frank consent discussions.

Limitations: Single-surgeon retrospective design limits generalisability and introduces potential selection bias between implant groups.

Study Type: Cadaveric anatomical study combined with prospective clinical cohort study

Key Question: Does venous injury to the nipple-areolar complex (NAC) contribute to clinically significant necrosis following nipple-sparing mastectomy with immediate implant-based reconstruction?

Key Findings:

• Significant NAC necrosis occurred in 15.4% (19/123 breasts); vein branch loss (VBL), mastectomy weight, BMI, and diabetes were independent predictors on multivariable analysis
• A VBL-based prediction model demonstrated strong discriminatory performance (AUROC 0.902; 95% CI 0.82–0.98)
• NIR venous mapping identified a low-risk subgroup within breasts showing poor ICG angiography perfusion, in whom no significant necrosis occurred

Clinical Relevance: For UK breast reconstruction surgeons, adjunctive NIR venous assessment could refine perioperative risk stratification beyond ICG angiography alone, potentially guiding intraoperative decision-making to reduce NAC necrosis rates.

Limitations: Single-centre prospective cohort with modest sample size (123 breasts) limits generalisability and external validation of the prediction model.

Study Type: Randomised controlled animal experimental study (rat model)

Key Question: Does LigaSure vessel-sealing cause less histological tissue damage than bipolar electrocautery when used during submandibular gland surgery?

Key Findings:

• Both energy modalities caused significantly greater tissue injury than cold dissection controls (p<0.05)
• Bipolar electrocautery produced significantly more inflammation, oedema, haemorrhage, and necrosis than LigaSure (p<0.05)
• LigaSure caused significantly greater ductal narrowing than bipolar electrocautery (p<0.05), raising potential concerns regarding salivary outflow obstruction

Clinical Relevance: As submandibular gland reduction gains traction in cervicofacial rejuvenation and contouring procedures, this study provides experimental evidence to inform energy device selection — relevant to UK surgeons incorporating glandular surgery into facelifts or isolated neck procedures.

Limitations: Findings are limited to a rat model with short-term histological endpoints, restricting direct translation to human clinical outcomes.

Study Type: Retrospective cohort study with instrument development and preliminary validation

Key Question: What are the five-year patient-reported outcomes following primary breast augmentation with polyurethane-coated implants, and can a device-specific PRO instrument reliably capture them?

Key Findings:

• High satisfaction at mean 5.2 years: domain scores 81.3 (Perception), 84.5 (Satisfaction), and 78.2 (Postoperative Experience) out of 100; no revision surgeries during follow-up
• The PU-PRO instrument demonstrated good internal consistency (Cronbach's α 0.84–0.91) and high test-retest reliability (ICC 0.88–0.93)
• Complication rates were low: 1% clinically evident rippling; capsular contracture rates not explicitly reported

Clinical Relevance: For UK surgeons considering polyurethane-coated implants, this provides preliminary long-term PRO data supporting their use, though the instrument requires validation against established measures before clinical adoption.

Limitations: Single-centre retrospective design without a comparator group limits generalisability and precludes conclusions about superiority over standard implants.