Start the Year Reading: SESPRS January 2026 Journal Picks

Must-read articles chosen by the Southeastern Society of Plastic and Reconstructive Surgeons January 2026:

Risk of Radiation-Induced Capsular Contracture following Subpectoral or Prepectoral Implant-Based Breast Reconstruction

Shammas, Ronnie L. MD; Levy, Jacob MD; Boe, Lillian A. PhD, et. Al.

Plastic and Reconstructive Surgery;157(1), Pages 6e-14e, January 2026.

A review was performed of 585 patients who underwent 2-stage tissue expander to implant breast reconstruction with radiation to the tissue expander over a 14-year period.  Implant placement weas prepectoral in 116 patients and submuscular in 469.  The estimated 48-month cumulative incidence of capsular contracture was 61% for submuscular and 35% for prepectoral reconstruction.  Patients with submuscular implant placement were found to have a risk of capsular contracture over time three times that of patients with prepectoral placement.  These results go against conventional wisdom about retropectoral implant placement and capsular contracture risk.  The authors emphasize the need for thorough patient counseling regarding the risks of capsular contracture and the importance of individualized reconstructive planning to optimize outcomes in patients undergoing radiation treatment.

https://journals.lww.com/plasreconsurg/fulltext/2026/01000/risk_of_radiation_induced_capsular_contracture.4.aspx

Evaluating the Safety of Rhinoplasty in Smokers

Tugertimur, Buğra MD; Datta, Shaishav MD; Goote, Paige MD, et. Al.

Plastic and Reconstructive Surgery 157(1):p 43-52, January 2026

The authors performed a retrospective review of 1884 rhinoplasty cases between 2014 and 2022, of whom 80 were active smokers, and 39 former smokers.  Average follow-up was 23.8 months. The overall revision rate was 3.3%, with 3.8% in smokers and 3.3% in nonsmokers; 3.8% of smokers required additional antibiotics for cellulitis compared with 1.6% of nonsmokers; all cases resolved without long-term complications. There were no significant differences between smoker and nonsmoker rhinoplasty patients in rates of revision, postoperative infection, or wound complications. The authors conclude that smoking does not appear to be a strict contraindication for rhinoplasty. This study reinforces the need to counsel patients who smoke appropriately about the risks of each procedure, rather than taking a blanket approach, as the risks vary greatly among procedures.https://journals.lww.com/plasreconsurg/fulltext/2026/01000/evaluating_the_safety_of_rhinoplasty_in_smokers.10.aspx

Fat Graft Replacement for Reducing Implant Size May Decrease Radiotherapy-Related Complications in Prepectoral Expander-to-Implant Breast Reconstruction.

Munur Selcuk Kendir, MD , Majid Ismayilzade, MD

Aesthetic Surgery Journal, Volume 46, Issue 1, January 2026, Pages 49–56

The authors aimed to decrease radiation-related complcations in two stage tissue expander to implant breast reconstruction by staged fat grafting prior to implant exchange.  64 patients were included in the study, of whom 31 underwent fat grafting. In the fat graft group, two sessions of fat grafting were performed after radiotherapy, with 50-100cc of fat being injected. The fat graft group demonstrated a statistically significant lower incidence of wound dehiscence, skin necrosis, infection, implant loss, rippling, and capsular contracture compared to the no fat graft group (P < .05), despite similar baseline characteristics and reconstructive protocols.  The authors concluded that autologous fat grafting before implant exchange was associated with a substantial reduction in complications compared to standard implant exchange without fat grafting in prepectoral breast reconstruction.

https://academic.oup.com/asj/article/46/1/49/8238217