Roberto Cuomo

• MD
• Professor at University of Siena

Background/Objectives: Mycobacterium ulcerans causes Buruli ulcers, typically manifesting as a single progressive necrotizing skin lesion. Rarely, non-contiguous “skip lesions” occur, complicating diagnosis and management. This report describes an atypical case and reviews similar presentations to emphasize early recognition and combined therapeuti...

Background Post-bariatric abdominoplasty is a standard procedure to improve body contour and quality of life following massive weight loss. However, perioperative bleeding remains a concern, particularly in the context of thromboprophylaxis and pre-existing comorbidities. This study investigates the risk factors for bleeding, including hypertension...

Background: Myopericytoma is a rare benign vascular tumour characterised by concentric spindle cell proliferation around blood vessels, often misdiagnosed due to its resemblance to other soft tissue masses. Dupuytren’s disease (DD), a fibroproliferative disorder of the palmar fascia, causes progressive contractures, typically affecting the ring and...

Background: Burn injuries require accurate assessment for effective management, and artificial intelligence (AI) is gaining attention in burn care for diagnosis, treatment planning, and decision support. This study compares the effectiveness of AI-driven models with experienced plastic surgeons in burn assessment and management. Methods: Ten anonym...

Background: Large language models (LLMs), such as ChatGPT have revolutionised patient education by offering accessible, reasonable, and empathetic guidance. This study evaluates ChatGPT's role in supporting patient inquiries regarding four key plastic surgery procedures: mastopexy, breast augmentation, breast reduction, and breast reconstruction. T...

Large language models (LLMs) have demonstrated transformative potential in health care. They can enhance clinical and academic medicine by facilitating accurate diagnoses, interpreting laboratory results, and automating documentation processes. This study evaluates the efficacy of LLMs in generating surgical operation reports and discharge summarie...

Background: Artificial intelligence (AI) and large language models (LLMs) are increasingly used in healthcare, with applications in clinical decision-making and workflow optimization. In head and neck surgery, postoperative rehabilitation is a complex, multidisciplinary process requiring personalized care. This study evaluates the feasibility of us...

The authors respond to the Commentary on “Can AI Answer My Questions? Utilizing Artificial Intelligence in the Perioperative Assessment for Abdominoplasty Patients” by analyzing the insights proposed by the authors. AI is already being utilized in various surgical aspects, including patient assessment, surgical planning, and intraoperative decision...

Background: Hand fracture management requires precise diagnostic accuracy and complex decision-making. Advances in artificial intelligence (AI) suggest that large language models (LLMs) may assist or even rival traditional clinical approaches. This study evaluates the effectiveness of ChatGPT-4o, DeepSeek-V3, and Gemini 1.5 in diagnosing and recomm...

BACKGROUND and OBJECTIVE Carboxytherapy (CXT) is a minimally invasive procedure based on percutaneous or subcutaneous microinjections of carbon dioxide. Due to the Bohr effect, it influences the hemoglobin dissociation curve, improving tissue oxygenation, angiogenesis, facilitating vascular perfusion, and lymphatic drainage. Recent evidence suggest...

Background: Dupuytren’s fibroproliferative disease affecting the hand’s palmar fascia leads to progressive finger contractures and functional limitations. Management of this condition relies heavily on the expertise of hand surgeons, who tailor interventions based on clinical assessment. With the growing interest in artificial intelligence (AI) in...

Background: Breast cancer is one of the most prevalent oncological diseases worldwide, with mastectomy often necessary for treatment. Post-mastectomy breast reconstruction is essential for restoring physical integrity and improving patients' quality of life, especially in high-risk individuals with advanced age, obesity, diabetes, smoking habits,...

Minimally invasive treatments for Dupuytren’s disease (DD), such as percutaneous needle fasciotomy (PNF) and collagenase clostridium histolyticum (CCH), have become alternatives to open surgeries. This meta-analysis compared these treatments in terms of complications, patient satisfaction, clinical outcomes, and recurrence. Relevant studies up to J...

Background Ethnic nose rhinoplasty is one of the most technically and conceptually challenging plastic surgery procedures due to the complex nasal anatomy and aesthetic preferences. The procedure aims to reshape and project the nasal tip, enhance and strengthen the dorsum, and reduce the size of the alar base, approaching Western beauty standards....

Aim: In the digital age, artificial intelligence (AI) platforms have gradually replaced traditional manual techniques for information retrieval. However, their effectiveness in conducting academic literature searches remains unclear, necessitating a comparative assessment. This study examined the efficacy of AI search engines (Elicit, Consensus, Ch...

Non-surgical alternatives to rhinoplasty are gaining interest but, despite its popularity, research on the long-term psychological impact and post-rhinofiller patients’ satisfaction is limited. This study evaluates patient-reported satisfaction and quality of life immediately after and 6 months post-non-surgical rhinoplasty using the FACE-Q questio...

Background/Objectives: Digital twin technology, initially developed for engineering and manufacturing, has entered healthcare. In plastic surgery, digital twins (DTs) have the potential to enhance surgical precision, personalise treatment plans, and improve patient outcomes. This systematic review aims to explore the current use of DTs in plastic s...

Soft tissue reconstruction in the lower limbs presents a significant challenge, particularly when addressing defects in the distal third of the leg, ankle, and foot. The reverse sural flap reliant on the perforating branches of the peroneal artery has emerged as a versatile option, offering a solution for patients for whom microsurgical techniques...

Authors discuss the paper titled “Artificial Intelligence: Enhancing Scientific Presentations in Aesthetic Surgery,” which explores how AI can improve the delivery and effectiveness of scientific presentations. They argue that the integration of AI in aesthetic surgery heralds significant possibilities for both academic and clinical applications. C...

Background. In alloplastic breast reconstruction, the choice of implant positioning and the selection of periprosthetic devices is a critical and challenging decision. Surgeons must navigate between various biologic and synthetic meshes, including acellular dermal matrices (ADM). This study aimed to propose a simple selection tool for periprostheti...

The integration of artificial intelligence (AI) into plastic surgery is transforming the field by enhancing precision in preoperative planning, diagnostic accuracy, intraoperative assistance, and postoperative care. AI encompasses machine learning, natural language processing, computer vision, and artificial neural networks, each offering unique ad...

The introduction of generative artificial intelligence (AI) has revolutionized healthcare and education. These AI systems, trained on vast datasets using advanced machine learning (ML) techniques and large language models (LLMs), can generate text, images, and videos, offering new avenues for enhancing surgical education. Their ability to produce i...

Background The COVID-19 pandemic necessitated a reassessment of healthcare delivery, emphasizing on strategies to reduce hospital visits without compromising patient care. In response, plastic surgery units explored innovative approaches to ensure high-quality care and enhanced protection for vulnerable groups, such as oncologic patients undergoing...

Background The inframammary incision appears promising in nipple-areola-sparing mastectomies (NASM). The Golden Ratio principles may standardize the extension and position of this incision, placing it in the lateral 2/3 of the fold. The authors explored the inframammary approach within the Golden Ratio concepts, to standardize its usage. Methods T...

Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a potentially life-threatening autoimmune disorder which is strongly associated with ovarian teratomas in young female patients. The primary aim is to highlight the importance of considering NMDAR encephalitis in the differential diagnosis of young female patients presenting with...

Background: Deep inferior epigastric perforator (DIEP) flap breast reconstruction is an increasingly popular technique, but controversy exists regarding the optimal use of closed suction drains (CSD) at the abdominal donor site. This narrative review synthesizes current evidence on CSD application, criteria for placement/removal, and complications...

Pelvic organ prolapse in pregnancy is uncommon. It poses unique maternal and foetal risks which must be carefully managed in the antepartum, intrapartum, and post-partum period. This case series and literature review discusses two cases of young female patients without significant risk factors presenting in their third trimester of pregnancy with s...

Background/Objectives: Abdominoplasties are prevalent surgical procedures for improving lower abdominal contours, necessitating effective pain management. Insufficient management can increase opioid usage, dependency risks, and adverse effects. This review investigates various strategies in abdominoplasty pain management, aiming to reduce opioid de...

Background: Tumescent local anesthesia (TLA) is widely used in esthetic surgery due to its ability to reduce complications, eliminate the need for general anesthesia, provide effective pain control, and shorten hospitalization times. Methods: This study evaluates the use of TLA in 80 patients who underwent augmentation mastopexy between 2010 and 20...

Background and Objectives: Despite CTAs being critical for preoperative planning in autologous breast reconstruction, experienced plastic surgeons may have differing preferences for which side of the abdomen to use for unilateral breast reconstruction. Large language models (LLMs) have the potential to assist medical imaging interpretation. This st...

Background: Inguinal hernia repair is a common surgical procedure, with more than 20 million cases yearly. Choice between mesh types varies in clinical practice. To compare light-weight polypropylene (LW-PP, 34-36 g/m2) and heavyweight polypropylene (HW-PP, 95 g/m2) meshes. Methods: Data from patients who underwent open inguinal hernia repair betwe...

Background: The regulatory landscape for plastic and cosmetic surgery across the country plays a crucial role in shaping the practices within its premises, ensuring patient safety, and maintaining ethical standards in the medical community. This review examines the distinct regulatory frameworks that govern Australia, United Kingdom (UK), and Italy...

Mycobacterium ulcerans (M Ulcerans) infection leads to the debilitating Buruli ulcer (BU), characterized by necrotizing skin and soft tissue lesions. Conventional treatment primarily focuses on an antibiotic regimen, but wound management remains paramount to patient recovery. This literature review aims to evaluate the efficacy and benefits of Vacu...

The integration of neck liposuction with FaceTite Manipulus Radiofrequency (RF) technology and buccal fat pad excision for enhanced neck rejuvenation promise heightened precision and efficacy in sculpting the neck and jawline. Neck liposuction, coupled with RF technology, provides controlled thermal energy for adipose tissue treatment and collagen...

The increasing adoption and widespread acceptance of negative pressure wound therapy (NPWT) have paralleled the expansion of its indications in clinical practice. The spectrum of indications for NPWT now extends to encompass soft tissue defects arising from trauma, infection, surgical wound care, and soft tissue grafting procedures. Recent advancem...

Fournier’s gangrene (FG) is a rare form of necrotizing fasciitis of the perineal, genital, or perianal region. It is characterized by an aggressive course and high mortality rate, over 20%. FG demands immediate treatment including resuscitation maneuvers, intravenous antibiotic therapy and early surgical debridement. Background/Objectives: The gold...

Background: Abdominoplasty is a critical aesthetic and functional procedure for individuals who have undergone massive weight loss. Numerous techniques have been proposed to optimize aesthetic results while minimizing complications. Methods: This prospective study examined 500 patients who underwent abdominoplasty during body-contouring procedures...

Background Abdominoplasty is a common operation, used for a range of cosmetic and functional issues, often in the context of divarication of recti, significant weight loss, and after pregnancy. Despite this, patient–surgeon communication gaps can hinder informed decision-making. The integration of large language models (LLMs) in healthcare offers p...

Eyelid melanoma (EM) is a malignant neoplasm accounting for around 1% of eyelid malignancies. Because of its rarity, most of our knowledge of EM is currently based on studies of cutaneous melanomas located elsewhere. Accordingly, this study aimed to specifically evaluate EM characteristics, management strategies, and prognosis. A retrospective stud...

Purpose The integration of artificial intelligence and machine learning technologies into the medical field has brought about remarkable advancements, particularly in the domain of clinical decision support systems. However, it is uncertain how they will perform as clinical decision-makers. Methods This prospective cohort study evaluates the poten...

Clear cell acanthoma (CCA) and squamous cell carcinoma (SCC) represent distinct entities within dermatological oncology, each posing unique diagnostic and therapeutic challenges. CCA is a rare, benign epidermal growth, often not associated with human papillomavirus (HPV) infection, whereas SCC, a more aggressive form of skin cancer, has been linked...

Background In Italy, with a cohort of 6.3 million morbidly obese patients, panniculectomy is often necessary both in relation to bariatric surgery and as the sole treatment to reduce excess lower abdominal tissues. At first glance, the procedure could be misjudged as technically simple; however, when considering patients with Extreme obesity or wor...

Background: Atrophic scarring is a severe form disfiguring sequela of acne which can lead to negative effect on patients’ life. Fractional microplasma radiofrequency (RF) has emerged as a promising modality, leveraging dermal fibroblast remodeling to enhance aesthetic results for scars and hyperpigmentation. This study evaluates the efficacy and sa...

Background Artificial intelligence (AI) has the potential to transform preoperative planning for breast reconstruction by enhancing the efficiency, accuracy, and reliability of radiology reporting through automatic interpretation and perforator identification. Large language models (LLMs) have recently advanced significantly in medicine. This study...

Introduction: Augmentation rhinoplasty traditionally represents a serious challenge for plastic surgeons. The association with centrofacial lipofilling is a great approach to achieve harmonious, aesthetic results. The aim of this article is to describe our personal association between Augmentation Rhinoplasty and Centrofacial Lipofilling (ARCL) in...

Background: Artificial intelligence (AI) has emerged as a powerful tool in various medical fields, including plastic surgery. This study aims to evaluate the performance of ChatGPT, an AI language model, in elucidating historical aspects of plastic surgery and identifying potential avenues for innovation. Methods: A comprehensive analysis of ChatG...

Objective Included foreign bodies of a metallic nature are commonly found. They are often small, asymptomatic, with few or non‐visible scars or even clinically invisible. Sometimes the patient does not remember their existence. The condition is benign and does not require special attention, unless a magnetic resonance imaging scan is necessary. Ind...

Introduction The use of the dorsal hamate as a free osteochondral bone graft or vascularized bone flap has become the mainstay for large, comminuted middle phalanx volar lip fractures. To date, few studies have been conducted in the assessment of donor site morbidity for the hemi-hamate graft or flap, and none have discussed modes of repair or reco...

Background. Breast cancer with about 2.3 million diagnoses and 685,000 deaths globally is the most frequent malignancy in the female population. Continuous research has led to oncological and reconstructive advances in the management of breast cancer, thus improving outcomes and decreasing patient morbidity. Nowadays, the submuscular expander and p...

Background and Objective: In the face of advancing technologies and a greater understanding of human physiology and psychology, preoperative care is on the cusp of a paradigm shift. Healthcare is moving towards an emphasis on holistic care and technologies such as those of artificial intelligence (AI) are being implemented rapidly. This review aime...

Periocular sebaceous carcinoma (PSC) is a rare, aggressive, and potentially metastatic adnexal malignancy. Due to the ability of PSC to resemble several benign and malignant conditions, diagnosis is often delayed or mistaken. In addition, even with a known diagnosis, choosing the right treatment is still an open debate. For this reason, we decided...

Introduction rhinoplasty traditionally represents a difficult challenge for plastic surgeons. The aim of this article is to describe our personal new graft ABLG (Alar base lining graft) in augmentation rhinoplasty, to treat and prevent alar retraction. Materials and Methods in this study, we retrospectively reviewed patients treated with ABLG at o...

Background: The integration of artificial intelligence in healthcare has led to the development of large language models that can address various medical queries, including intraoperatively. This study investigates the potential of ChatGPT in addressing intraoperative questions during the deep inferior epigastric perforator flap procedure. Methods:...

Background The advancement of artificial intelligence (AI), specifically Generative Adversarial Networks (GANs), offers exciting possibilities for the enhancement of medical education, with its image-generation capabilities becoming a topic of interest. This novel study evaluates the aptitude of combining a large language model, ChatGPT, with GANs...

Background: While current wound treatment strategies often focus on antimicrobials and topical agents, the role of nutrition in wound healing and aesthetic outcomes is crucial but frequently overlooked. This review assesses the impact of specific nutrients and preoperative nutritional status on surgical outcomes. Methods: A comprehensive search was...

Breast cancer-related lymphedema (BCRL) affects approximately 20% of women after breast cancer therapy. Advances in treatment have increased the life expectancy; thus, the prevalence of BCRL will continue to rise with the number of cancer survivors, hence the need to develop strategies to prevent this condition. We provide a systematic review of th...

Keywords: Rhinoplasty - Augmentation rhinoplasty - Open rhinoplasty - Facial rejuvenation – Centrofacial lipofilling.

Abdominal elephantiasis (AE) is a rare, deforming and chronical skin disease related to massive obesity. Up to date, there are only 16 cases described in the literature, but the disease is definitely underreported. AE is caused by chronic terminal dysfunction of the lymphatic system and recurrent infections of the abdominal soft tissues. Lipectomy...

Obesity is a chronic disease with significant health implications. Bariatric surgery is an effective treatment for obesity-related conditions. However, the timing of post-bariatric body contouring surgery remains uncertain. We conducted a retrospective study of 1336 patients who underwent bariatric surgery. We analyzed weight trends and variations...

Breast cancer-related lymphedema (BCRL) affects approximately 20% of women after breast cancer therapy. Advances in treatment have increased life expectancy, thus the prevalence of BCRL will continue to rise with the number of cancer survivors. Hence the need to develop strategies to prevent this condition. We provide a systematic review of the lit...

The increasing integration of artificial intelligence (AI) into domains like medicine, surgery, and research, has brought unparal- leled advancements, and changed how doctors, particularly sur- geons, are perceived.1–9 The advent of AI-generated images using generative adversarial networks (GANs) and increased reliance on large language models (LLM...

Artificial intelligence (AI), notably Generative Adversarial Networks, has the potential to transform medical and patient education. Leveraging GANs in medical fields, especially cosmetic surgery, provides a plethora of benefits, including upholding patient confidentiality, ensuring broad exposure to diverse patient scenarios, and democratizing med...

Background and Objectives: The use of oncoplastic techniques has spread widely in the last decade, with an expansion of the indications and demonstration of excellent oncological safety profiles. A potential downside may be the increased complication rates, which could influence the timing of adjuvant therapy. To date, there is increasing evidence...

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, d...

Unlabelled: Capsular contracture (CC) is the most relevant complication of both aesthetic and reconstructive breast implant surgery. For many years, experimental and clinical trials have attempted to analyze CC risk factors, clinical features, and appropriate management strategies. It is commonly accepted that a multifactorial etiology promotes CC...

Background With the recent safety communication issued by The Food and Drug Administration, squamous cell carcinoma breast-implant associated (BIA-SCC) has become part of the breast implant capsule related conditions. In the present paper, we review all cases of BIA-SCC currently reported in the literature. Methods From October 2022 to February 20...

Authors comment on the paper “An Original Approach to Massive Weight Loss Deformities in the Lower Thigh: A Retrospective Assessment of Results and Patients” written by Dr. Pierfranco Simone et al. Although the authors present excellent results on medial tight lift, we express some considerations about the proposed follow-up and hope in new researc...

The use of hyaluronic acid (HA)-based aesthetic therapies is growing steadily, and according to the International Society of Aesthetic Plastic Surgery, more than 4.3 million aesthetic procedures using HA were performed in 2019, an increase of 15.7% than 2018. More people are offering these types of services, often without proper training or qualifi...

(1) Introduction: Erdheim–Chester disease (ECD) is a life-threatening condition and often a diagnostic challenge. It has recently been classified as a hematopoietic tumour, and the cases of ECD reported in the literature has dramatically increased during the last 15 years. (2) Methods: We describe the case of a 57-year-old male patient with severe...

(1) Background: The role of the umbilical scar and its repositioning remains one of the most important surgical steps in the execution of any type of abdominoplasty, including those involving “inverted-t” or “fleur de lys” incisions. A consequence of this is a surgeon’s Hamletic dilemma: to keep or not to keep the original umbilical scar? (2) Metho...

Introduction: The timing of contralateral symmetrisation in patients with large and ptotic breasts undergoing a unilateral skin-reducing mastectomy (SRM) is one of the most debated topics in the reconstructive field. There is no evidence to support the advantage of immediate or delayed symmetrisation to help surgeons with this decision. The aim of...

(1) Background: The increase in the number of bariatric surgery procedures has led plastic surgeons to look for new approaches to improve outcomes of body-contouring surgeries. A major concern in brachioplasty is the scarring process. Here, we propose a novel technique to minimize the incidence of pathological or unsatisfactory scars from brachiopl...

The use of acellular dermal matrix (ADM) implants has enhanced breast reconstruction. ADM is a biotechnologically designed human tissue of bovine or porcine origin in which tissue processing removes cellular antigens. In this case report, we describe the use of ADM in one-stage prepectoral breast reconstruction. Skin-reduction breast reconstruction...

Due to the increased prevalence of obesity in the last decades, bariatric surgery has been on the rise in recent years. Bariatric surgery is a compelling option for weight loss in obese patients with severe obesity-related comorbidities or for whom lifestyle modifications have proven ineffective. Redundant skin following significant weight loss is...

Lymphedema is a chronic disabling condition affecting a growing number of patients worldwide. Although lymphedema is not life-threatening, several reports underlined detrimental consequences in terms of distress, pain, functional impairment, and infections with a relevant decrease in quality of life. Currently, there is no cure, and the therapeutic...

Introduction: in a historical moment where there is an increasing use of beauty center, we report a case of necrotizing fasciitis occurred after a pedicure, with the aim of clarifying the safety of these aesthetic treatments. Case report: we discuss a case of left foot necrotizing fasciitis as consequence of removing a plantar callus. The patien...

See the Original Article here. We read with great interest the article entitled “Labiaplasty: Analysis of the National Surgical Quality Improvement Program Database” by Wells et al.¹ The authors evaluated the complication profiles of labiaplasties for both cosmetic and pathologic etiologies, analyzing the 2005 to 2017 National Surgical Quality Impr...

Background: Breast ptosis is characterized by severe volumetric deficiency of the upper pole, excess of skin in the lower pole and descent of the nipple-areola complex (NAC). Mastopexy, also known as breast lifting, is the surgical operation aimed to reshape the ptotic breast. Recurrence of breast ptosis after mastopexy is common but to the best o...