Plastic Surgery

Pre-pectoral vs sub-pectoral implants: similar complications and no delay in adjuvant therapy

In this 10-year single-center series of 622 immediate implant reconstructions, overall complication rates were similar for sub-pectoral and pre-pectoral placement. Pre-pectoral reconstruction had more delayed wound healing, whereas sub-pectoral placement showed more postoperative bleeding. Despite differing complication profiles, the reconstruction plane did not independently delay initiation of adjuvant therapy on multivariate analysis. Smoking, diabetes, and skin-reducing mastectomy predicted delayed adjuvant treatment, not implant position. Pre-pectoral reconstruction also reduced operative time compared with sub-pectoral techniques. 1

Next-generation craniomaxillofacial implants emphasize the “3Bs” and patient-specific design

This narrative review synthesizes advances in craniomaxillofacial implants focusing on biomechanics, biocompatibility, and bioactivity. Emerging materials such as bioresorbable polymers, magnesium alloys, and ceramic composites enable safer, more functional, patient-specific devices. Triply periodic minimal surface architectures and additive manufacturing allow tailored mechanical performance and enhanced tissue integration. The authors highlight AI-driven design, real-time monitored 3D printing, and advanced biological testing as key future directions. Clinical translation will depend on tight collaboration between surgeons, materials scientists, and computational engineers. 2

Bioactive peptide–hyaluronic acid scaffolds enhance bone ingrowth into 3D-printed titanium

This preclinical study couples porous 3D-printed titanium with a nanofibrillar peptide–hyaluronic acid scaffold for critical-size calvarial defects in rabbits. The scaffold improved in vitro osteoblast-like cell adhesion and enzymatic stability compared with unmodified titanium surfaces. In vivo, scaffold-integrated implants significantly increased inner bone volume and improved trabecular architecture versus inert titanium controls. Hydrogel-delivered scaffold nearly doubled inner bone volume, with histology showing better bone–implant integration and active periosteum. The acellular, growth factor–free design offers a potentially translatable strategy for personalized craniofacial bone reconstruction. 3

Decellularized engineered human cartilage graft fully repairs rat femoral defects

This study presents engineered human cartilage that is subsequently decellularized to create an extracellular matrix–only graft. In immunocompetent and immunocompromised animals, ectopic implantation preserved the graft’s osteoinductive properties, guided by macrophage polarization kinetics. In vitro allogeneic coculture assays showed the decellularized cartilage suppressed macrophage and dendritic cell maturation and reduced T cell activation. In a rat orthotopic critical-sized femoral defect model, the graft achieved full morphological and mechanical restoration. These data suggest an off-the-shelf, immunosuppressive cartilage-derived graft platform ready for first-in-human skeletal repair trials. 4