In this week's edition
- ✍️ Letter from P'Fella
Who won Best PRS Articles 2025? - 🤓 The Sunday Quiz
How well do you know blepahroplasty? - 🖼️ Image of the Week
Intra-op lower eyelid bleph. - 🚑 Technique Tip
How to mark for upper lid blepharoplasty. - 📘 Foundations Textbook
In the printer! - 🎓 The Fellow's Corner
Meet the team behind foundations. - 🎓 JPRAS Journal Club
Early oral feeding following head and neck mucosal free flap recon. - 🔥 Articles of the Week
Blepharoplasty outcomes, why the Asian bleph is different, & 5-step bleph: With 1-sentence summaries. - 💕 Feedback
Suggest ideas & give feedback!
A Letter from P'Fella
Who won best PRS awards in 2025?
👋
Let’s be honest — most journal awards are a bit part merit, part politics, and occasionally a surprise hit. But the PRS Best Paper Awards 2025 just dropped, and there’s a lot we can learn from what topped the charts this year.
What Got the Nod
Across 14 categories, the big winners leaned heavily on systematic reviews, anatomical deep-dives, and patient-safety angles. A few standouts:
- Best Breast Paper: Prepectoral vs. Subpectoral Reconstruction for complication prevention. Yet another meta-analysis proving that sometimes, the simplest surgical question still needs answering.
- Best Cosmetic Surgery Paper: The Superficial Musculoaponeurotic System: Does It Really Exist? — my personal pick of the year. Mendelson & co. tackle the SMAS controversy head-on, dissecting (literally) decades of dogma.
- Best Experimental Paper: Vascularized adipose tissue engineering with sustained-release adipokines — the kind of lab magic that sounds like science fiction until it’s in your OR.
- Best Hand/Peripheral Nerve Paper: Targeted muscle reinnervation reducing symptomatic neuromas — a practical win for amputees and anyone managing nerve pain.
- Best Special Topic: The global macroeconomic burden of burns — a sobering reminder that reconstructive surgery is as much public health as it is operative craft.
My Take
If you strip the PR gloss, these awards tell us two things:
- Evidence still sells — systematic reviews and meta-analyses dominated.
- Anatomy isn’t dead — when done well, foundational anatomical work can still make waves.
It’s refreshing to see a mix of high-tech experimental work and gritty, clinically relevant topics
Hit reply — let’s compile our own “real” best paper list for 2025.
With love,
P’Fella ❤️
The Sunday Quiz
How Well Do You Know Blepharoplasty?
Ready to climb the leaderboard?
Join The Weekly Quiz in each edition of thePlasticsPaper. This is the final round of seven rounds!
The top scorer wins one of the first print Foundations at a discount once it's released!
Join The Weekly Quiz in each edition of thePlasticsPaper. This is the final round of seven rounds!
The top scorer wins one of the first print Foundations at a discount once it's released!
Image of the Week
Intra-op Lower Eyelid Bleph
🖼️
Image of the Week
This week’s image captures an intraoperative view of a transconjunctival lower eyelid blepharoplasty, highlighting fat pad exposure beneath the orbicularis and lower lid retractor. This is important for recognising key anatomy and the surgical approach from the conjunctival side.
This week’s image captures an intraoperative view of a transconjunctival lower eyelid blepharoplasty, highlighting fat pad exposure beneath the orbicularis and lower lid retractor. This is important for recognising key anatomy and the surgical approach from the conjunctival side.
Technique Tip
How to Mark for Upper Lid Blepharoplasty
🚑
Technique Tip of the Week
This week’s tip features a clear, step-by-step demonstration of how to mark the skin before performing an upper eyelid blepharoplasty, shared by Mr Richard Caesar.
Watch the visual guide below👇
This week’s tip features a clear, step-by-step demonstration of how to mark the skin before performing an upper eyelid blepharoplasty, shared by Mr Richard Caesar.
Watch the visual guide below👇
Foundations Textbook
In the Printer!
📘
It’s official — Foundations is now with the printer!
We expect the earliest deliveries to begin within 10 days, although this may vary slightly depending on your location. Keep an eye on your inbox for any shipping updates!
We expect the earliest deliveries to begin within 10 days, although this may vary slightly depending on your location. Keep an eye on your inbox for any shipping updates!
the Fellows' Corner
Meet the Team Behind Foundations
🎓
the Fellows' Corner
A huge thank you to the incredible team that brought Foundations to life. This textbook was built by a truly international crew of fellows, advisors, trainees, creatives, and students — each contributing greatly to bring Foundations to your hands.
Core Team
Ryan Sugrue
Tara Wickramasinghe
Michael Edgar
Waruguru Wanjau
Kurt Lee Chircop
Benedetta Agnelli
Hatan Mortada
External Authors
Carissa J. Jacobs
Robert Browne
Justin Wormald
Suraya Yusuf
Mustafa Qais Al-Khafaji
Trainee Reviewers and Authors
Conor Cudden (Melbourne, Australia)
Ryan Leon (Perth, Australia)
Himani Murdeshwar (Nottingham, UK)
Student Reviewers and Authors
Parul Rai (Chicago, USA)
Laryssa Kemp (Ottawa, Canada)
Luanne Lai (Nottingham, UK)
Adebusola Olabiran (London, UK)
Creative Visuals
Barbara Borko
A huge thank you to the incredible team that brought Foundations to life. This textbook was built by a truly international crew of fellows, advisors, trainees, creatives, and students — each contributing greatly to bring Foundations to your hands.
Core Team
Ryan Sugrue
Tara Wickramasinghe
Michael Edgar
Waruguru Wanjau
Kurt Lee Chircop
Benedetta Agnelli
Hatan Mortada
External Authors
Carissa J. Jacobs
Robert Browne
Justin Wormald
Suraya Yusuf
Mustafa Qais Al-Khafaji
Trainee Reviewers and Authors
Conor Cudden (Melbourne, Australia)
Ryan Leon (Perth, Australia)
Himani Murdeshwar (Nottingham, UK)
Student Reviewers and Authors
Parul Rai (Chicago, USA)
Laryssa Kemp (Ottawa, Canada)
Luanne Lai (Nottingham, UK)
Adebusola Olabiran (London, UK)
Creative Visuals
Barbara Borko
JPRAS Journal Club
Early Oral Feeding Following Head and Neck Mucosal Free Flap Recon
👄
Early Oral Feeding After Head & Neck Free Flaps
This week’s feature looks at a systematic review of 13 studies (1,657 patients) evaluating when to resume oral feeding following head and neck mucosal free flap reconstruction.
Key Takeaway: Starting oral intake within 5 days post-op was associated with lower fistula rates (3.7% vs 11.4%), fewer pneumonias, and a shorter hospital stay (9.85 vs 13.11 days) — all without compromising flap safety.
The findings question the traditional nil-by-mouth approach, supporting the inclusion of early oral intake in ERAS protocols for carefully selected patients.
Flap failure rates remained consistent (~3%) regardless of feeding timing, and no increase in wound complications was observed. While protocol variability limits generalisation, this review offers strong support for a shift toward more proactive recovery planning.
This week’s feature looks at a systematic review of 13 studies (1,657 patients) evaluating when to resume oral feeding following head and neck mucosal free flap reconstruction.
Key Takeaway: Starting oral intake within 5 days post-op was associated with lower fistula rates (3.7% vs 11.4%), fewer pneumonias, and a shorter hospital stay (9.85 vs 13.11 days) — all without compromising flap safety.
The findings question the traditional nil-by-mouth approach, supporting the inclusion of early oral intake in ERAS protocols for carefully selected patients.
Flap failure rates remained consistent (~3%) regardless of feeding timing, and no increase in wound complications was observed. While protocol variability limits generalisation, this review offers strong support for a shift toward more proactive recovery planning.
Articles of the Week
3 Interesting Articles with One-Sentence Summaries
✅
Muscle-Sparing Upper Blepharoplasty May Reduce Dry Eye (Todorov, 2025)
Skin-only upper blepharoplasty significantly improves dry eye symptoms, while preserving orbicularis muscle reduces the risk of lagophthalmos without compromising aesthetic outcomes.
Skin-only upper blepharoplasty significantly improves dry eye symptoms, while preserving orbicularis muscle reduces the risk of lagophthalmos without compromising aesthetic outcomes.
✅
Does Short-Incision Technique in Asian Blepharoplasty Minimize Downtime? (Kruavit, 2009)
A short central incision with selective anchoring created stable suprapalpebral folds in over 6200 patients, with minimal swelling and a 3.8% complication rate over 18 years.
A short central incision with selective anchoring created stable suprapalpebral folds in over 6200 patients, with minimal swelling and a 3.8% complication rate over 18 years.
✅
Five-Step Lower Blepharoplasty for Minimizing Risk (Rohrich, 2020)
A structured five-step lower blepharoplasty approach, including fat repositioning, canthopexy, and orbicularis ligament release, achieves natural rejuvenation while reducing lid malposition risk.
A structured five-step lower blepharoplasty approach, including fat repositioning, canthopexy, and orbicularis ligament release, achieves natural rejuvenation while reducing lid malposition risk.
