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Plastic surgery

Monthly plastic surgery bulletin — November 2, 2026

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This issue covers October 17 through November 2, 2026, the interval since the October 16 issue, and also includes one October 6 trial not covered in the previous issue. It was a short, quiet period: six verifiable items, weighted toward neuromodulators, body contouring, and editorial integrity. We found no verifiable publications in breast reconstruction and microsurgery, burns and lymphedema, or craniofacial surgery during these two weeks, and we have not padded those sections. Only two items come from outside North America and Western Europe (India and the Dominican Republic).

Breast reconstruction and microsurgery

No verifiable items in this period. The Dominican congress, devoted to breast surgery, appears under Cross-cutting.

Hand, peripheral nerve, and extremities

1. Ultrasound-guided median nerve hydrodissection for carpal tunnel syndrome: randomized trial

[Clinical trial] [India] [Outside the period: October 6]

A prospective randomized trial in Radiology enrolled 63 patients with confirmed carpal tunnel syndrome who had not responded to conventional treatment, divided into three equal groups: ultrasound-guided hydrodissection with saline, hydrodissection with saline plus corticosteroid, or ultrasound-guided corticosteroid injection alone. All three groups improved at 4 weeks, but at 12 and 24 weeks only the hydrodissection groups sustained improvement, while the steroid-only group relapsed. Median nerve cross-sectional area decreased by about 43% to 45% with hydrodissection versus about 15% with steroid alone; adding steroid to the injectate provided no significant additional benefit. The procedure took about 15 minutes on average, with no significant immediate or delayed complications.

Why it matters: a small trial with six months of follow-up and no surgical-release comparator; it does not change the indication for surgery in established carpal tunnel syndrome, but it offers an outpatient option, without anesthesia or hospitalization according to the RSNA release, for patients who do not respond to conservative care or are awaiting surgery.

Sources

Burns, wounds, and lymphedema

No verifiable items in this period.

Craniofacial, head and neck

No verifiable items in this period.

Facial and body aesthetics

2. TrenibotulinumtoxinE: pivotal phase 3 results for glabellar lines

[Clinical trial] [USA, Canada, Germany, Hungary, Poland]

A multicenter phase 3, double-blind, placebo-controlled trial (NCT05248867, study M21-500), funded by AbbVie, randomized 638 adults with moderate to severe glabellar lines 3:1 to an initial treatment with trenibotulinumtoxinE (serotype E) or placebo, in a 43-day double-blind period followed by an open-label phase. The primary endpoint required none or mild glabellar lines with at least a two-grade improvement at maximum frown by both investigator and participant assessments on day 7; response was 60.0% versus 0.6%. Improvement was observed from 8 hours and peaked on day 7; line severity returned to moderate or severe around day 21. Adverse events were mostly mild and, according to the manufacturer, similar to placebo, with no serious treatment-related events.

Why it matters: it confirms onset within hours and a duration of two to three weeks, useful for toxin-naive patients or before an event; the study is manufacturer-funded. In the United States, AbbVie announced on April 23, 2026 an FDA complete response letter requesting information on manufacturing processes, which according to the company raised no safety or efficacy concerns; in the European Union the product (Boey) received a positive CHMP opinion on May 21 and marketing authorisation on July 15, 2026. Availability in Latin America remains uncertain.

Sources

3. Botulinum toxin type A and patient-reported outcomes: meta-analysis of 65 controlled trials

[Meta-analysis] [International]

A systematic review and meta-analysis in the Aesthetic Surgery Journal, published October 19, included 65 placebo-controlled randomized trials (18,581 participants) of botulinum toxin type A in facial aesthetics. All four pooled responder analyses favored toxin, with risk ratios of 5.53 to 14.74 and no heterogeneity (I² 0%). GRADE certainty was moderate for satisfaction, global aesthetic improvement, line severity, and perceived youthfulness; low for appearance-related psychological well-being; and very low for overall quality of life and self-esteem.

Why it matters: it solidly supports patient-perceived benefit but cautions against promotional claims of improved self-esteem or quality of life, which lack robust evidence; useful for informed consent.

Sources

4. Advanced practice provider first visit for body contouring

[Publication] [USA]

A study from The Ohio State University Wexner Medical Center in the November issue of Plastic and Reconstructive Surgery, publicized by ASPS on October 28, describes a body contouring clinic in which a physician assistant or nurse practitioner sees patients before the surgeon consultation. About half of patients were surgical candidates at the first visit; the rest received an optimization plan (nicotine cessation, weight stabilization, control of conditions such as diabetes) with reassessment at three to six months. The authors report higher satisfaction and more patients ultimately undergoing surgery; the press release provides no figures.

Why it matters: relevant to the wave of patients losing weight on GLP-1 receptor agonists, but quantitative data are only in the full article, and the model depends on a professional role that is underdeveloped in the Dominican Republic.

Sources

Cross-cutting

5. Editorial integrity: conflicts of interest and retractions around PRS Global Open

[Publication] [USA]

On October 21 (updated October 24), Retraction Watch published an investigation into PRS Global Open: a March 2026 trial of a human platelet-derived hair serum from the company Rion did not disclose the journal founder's consulting relationship with the company (he called it an oversight he will correct), and experts, including a biostatistician, criticized the design, in which only 8 of 39 participants received placebo. The journal had promoted on social media a study of an exosome product for chronic wounds that was later retracted, and its revised version in JPRAS Open was also retracted. In September, Plastic and Reconstructive Surgery retracted another paper for unreliable results.

Why it matters: exosome products are reaching Latin American practices with these papers as support; check conflicts of interest, placebo allocation, and retraction status before adopting or recommending them.

Sources

6. 23rd Dominican Congress of Plastic Surgery: breast surgery and new leadership

[Congress] [Dominican Republic]

SODOCIPRE held its 23rd congress October 15 to 18 in Punta Cana, themed "Current approach to breast surgery," with faculty from Brazil, Bolivia, Colombia, Cuba, Ecuador, Spain, the United States, Guatemala, Peru, and Venezuela. The meeting reported on the 2nd FILACP Ibero-Latin American Congress of Residents and Young Specialists, held in Santo Domingo in September 2025 with 318 participants. It also recalled coverage under the Family Health Insurance of reduction mammoplasty for gigantomastia, symptomatic breast hypertrophy, and gynecomastia, subject to the criteria in CNSS Resolution 624-02 of October 31, 2025; gynecomastia eligibility includes men aged 16 to 30 with grade III or IV and documented psychological impact. The president of the new 2026-2028 board is Dr. Asmín Aquino Rodríguez.

Why it matters: coverage of functional breast reduction, in force since the October 2025 resolution, is not universal; thorough documentation of symptoms and of the resolution's criteria will keep authorizations from becoming the bottleneck.

Sources

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