December 2025 Edition
- thestitchprs
- Dec 1
- 4 min read
Welcome to the December edition of The Stitch! We are back with a new executive board and writing team! We appreciate your continued support and readership.
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Wishing everyone a happy holidays,
The Stitch Editorial Board
Introduction to Flaps
Article by Joyce Zhu, University of South Florida
Medical students interested in plastic surgery will inevitably encounter “flaps” in both research settings and the operating room. But what exactly are flaps, and how can we talk about them? In short, flaps are sections of tissue, commonly harvested from the back, abdomen, arm, or thigh, that are transferred to new sites for reconstruction. They differ from grafts which do not have their own blood supply.
Flaps can be described by several features. These include their tissue composition, their attachments, and their location relative to the recipient site (local, regional, free). Local flaps are adjacent to the recipient site and can be moved without disconnecting its vascular supply. While regional flaps are slightly farther away from the recipient site, they are also close enough that their blood supply does not need to be disconnected. Free flaps are completely detached along with their vascular supply, and reattached at the recipient site.
Flaps are further characterized by their blood supply (perforator based, axial pattern, random pattern) and by their movement. The four major patterns of movement are advancement, rotation, transposition, and interpolation.
Overall, an understanding of flap classification lays the groundwork for clinical decision making: what advantages and disadvantages accompany each design, and when is one type preferred over another? These are useful questions for medical students to consider when learning about the versatility of flaps and practicing how to apply this knowledge on a case-by-case basis.
Plastic Surgery by the Numbers: The Trends of Aesthetic Procedures in 2024
Article by Carson Bair, University of South Florida
Each year, the American Society of Plastic Surgeons publishes a report on the demographics and number of plastic surgery procedures performed by ASPS members. The 2024 ASPS Procedural Statistics Release reported that over 1.5 million patients underwent cosmetic procedures, with liposuction representing 22% of all procedures. Breast augmentation, abdominoplasty, breast lifts, and blepharoplasty were the next most common procedures.
The report highlights the increasing use of GLP-1 agonists, and the ASPS predicts increased demand for body contouring procedures. In a survey of GLP-1 patients, 39% indicated interest in cosmetic procedures and 20% had undergone one.
Regarding patient demographics, 94% were female. However, men had a 3.4% increase in procedures compared to 2023, most commonly breast reduction, liposuction, and blepharoplasty. Most patients (36%) were in the 40-54 age range, followed by 24% aged 55-69, and 23% aged 30-39. Younger patients most often pursued breast augmentation, while older generations underwent more lower body lifts and facial aesthetic procedures.
The 2024 data reinforce patients’ interest in aesthetic plastic surgery and the impact of these procedures on patient’s physical and mental wellbeing. Surgeons may anticipate future trends including increased body contouring and use these data to help educate patients.
Citation: 2024 ASPS Procedural Statistics Release. Plastic and Reconstructive Surgery 156(2S):p 1-44, August 2025. | DOI: 10.1097/01.prs.0001125128.08298.ca
Scars of Conflict, Seeds of Hope: The Future of Humanitarian Reconstruction
Article by Colton Brown, University of Florida
Plastic and reconstructive surgery continues to maintain a critical role in humanitarian aid where there exist traumatic, congenital, and disease-related deformities that severely impact quality of life associated with disability and societal stigma. Reestablishing form and function is a defining characteristic of this specialty that provides for such. It largely emerged with need of facial and limb reconstruction among injured soldiers in the World Wars, with pioneer surgeons like Sir Harold Gillies in skin grafting and flap surgeries. These innovations influenced humanitarian missions, as needs in civilian populations were realized globally. Surgeons began to travel to low-resource countries initially as short-term, charity-driven campaigns focused on addressing congenital anomalies (e.g. cleft lips and palates). These efforts paved the way for an institutionalization of humanitarian plastic surgery with the development of organizations like Operation Smile and ReSurge International.
Continued attempts at expanding the scope of missions to envelop burn contracture release, oncologic care, and trauma reconstruction, led to the modern era of capacity-building programs focused on sustainability with the empowerment of locally trained surgeons. Conflict zones witness higher rates of burn, blast, and facial trauma increasing disability. Lower resource settings often prevent treatment of congenital cleft and craniofacial conditions reducing quality of life with speech, feeding, social integration, and development impairments. The psychosocial impact of conditions like these goes without saying. Restoring form and function improves personal mental health, social acceptance, and economic productivity, an especially important notion for women and children facing additional stigma due to visible deformation.
Disaster response and war injury management with recent crises underscores the current indispensability of continued plastic surgical efforts. Global health partnerships provide opportunities for education and infrastructure development with integration of long-term care in low-resource environments. Notably, the Ukrainian conflict beginning in 2022 sees deployment of groups like Médecins Sans Frontières and the International Committee of the Red Cross to address blast injuries, facial traumas, and limb salvage cases using microsurgical reconstruction and flap coverage, invaluable for civilians and soldiers with complex wounds. In Gaza, plastic surgeons have completed similar endeavors managing complex wounds and limb salvage for civilians suffering from airstrike injuries.
Unfortunately, the extent of resource limitations impedes care. Challenges exist with lack of equipment for microsurgery and anesthesia, follow-up care restraints of transient missions, and ethical considerations to ensure informed consent and continuity of care. The future of PRS in humanitarian aid lies in a continued expansion towards sustainable, locally empowered care. As global health challenges persist, with continued civil conflicts, natural disasters, and congenital anomalies abroad, the demand for reconstructive expertise will only increase.
Plastic surgeons are uniquely positioned to restore form and function, dignity, and hope in these vulnerable populations. Continued campaigns in training, resource development, and international collaboration are imperative. It is our moral imperative as global citizens to realize our very clear responsibility to ensure equitable access to reconstructive care, strengthen surgical capacity in underserved regions both domestically and internationally, and advocate for a world where no one is denied the chance to heal and thrive.
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