(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) Methods: A retrospective observational study was conducted on all patients undergoing “T-inverted” abdominoplasty at the Department of Plastic Surgery of the Santa Maria alle Scotte University Hospital, Siena, between January 2018 and December 2020. Twelve months after the surgery we submitted to all patients the U-score questionnaire about their feelings about their umbilicus’s appearance. Patients could assign a score from 1 (very dissatisfied) to 4 (very satisfied) to each of the five items of the score. (3) Results: The average of the scores attributed by the nine patients in whom the navel was preserved is 13 (Range 10–17), while in patients on whom a navel reconstruction was performed, the mean score is 16.8 (Range 12–20). The mean score of patients with a reconstructed umbilicus is, therefore, statistically higher than that of the other group of patients (t-value = 3.88, p = 0.000374) with an average increase of 3.8 points. (4) Conclusions: We can state that the reconstruction of a new navel is the right answer to the Hamletic dilemma in patients having undergone vertical or anchor abdominoplasty.

(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 gynecomastia, with a detailed description of his diagnostic iter and consequent surgical operation. We provide the first systematic review of the literature of breast involvement in ECD, following PRISMA guidelines, including 13 studies and 16 patients. (3) Results: Our report resulted to be the first case of gynecomastia as a single clinical and imaging feature of ECD described in English literature. A total of 81.3% of patients included were female. Among them, 76.9% had unilateral and nodular presentation, while male patients presented bilateral heterogeneous breast enlargement. Globally, 87.5% expressed breast alterations as their first manifestations of ECD. Only 50% presented skeletal involvement. (4) Conclusion: The reported case represents a unique addition to the literature. We found two different patterns in ECD-related breast involvement between male and female patients, an unusual M/F ratio, and a lower rate of bone involvement. Breast involvement is frequently the first clinical feature; therefore, breast caregivers should be aware of this dangerous and most likely underestimated condition.

Medical laser hair removal is a common treatment for both aesthetic and pathological conditions, permitting the reduction of dark and thick terminal hairs and increasing the number of vellus hairs. This study aims to present the clinical outcomes and safety of a new approach for hair removal, combining Nd: YAG (1064 nm), diode (808–810 nm), and Alexandrite (755 nm) lasers in a rotational regimen. From January 2022 to December 2023, 60 patients underwent a complete course of hair removal treatment, which included three sessions with Nd: YAG (1064 nm), diode (808–810 nm), and Alexandrite (755 nm) lasers in a rotational regimen. Follow-up visits were conducted three and six months after the last treatment session to assess the results. Across all treated body areas, the hair reduction at six months was 75.07%, with a significant reduction in hair thickness and an increase in vellus hairs. Additionally, the treatment was well-tolerated, with patients reporting only slight discomfort during laser irradiation, reflected by average pain scores of 2/4. No long-term adverse effects were observed, and transient side effects, such as erythema and perifollicular edema, resolved within days. This new rotational regimen for laser hair removal has proven to be effective, safe, and satisfactory for patients. The tailored approach enhances the treatment’s efficacy and ensures comprehensive targeting of various hair types and colors. This protocol promises a significant advancement in the field of laser hair removal, offering a reliable and patient-friendly solution for long-term hair reduction.

Background/Objectives: Simulation has become an integral part of contemporary surgical training, allowing safe acquisition of technical skills with objective performance assessment. Microsurgery and robotic surgery share several technical features, including fine bimanual coordination, precise instrument control, and stereoscopic vision. This study aimed to evaluate whether a structured microsurgical course is associated with improved performance on a robotic surgical simulator and to explore its potential role within robotic training pathways. Methods: A prospective study was conducted between October 2022 and November 2025 at a single academic center, including 56 participants divided into three groups. Group A consisted of surgical residents attending a 3-day Basic Microsurgery Course; Group B included residents who did not undergo training during the same period; and Group C comprised experienced microsurgeons. Groups A and B performed two robotic simulation tasks at baseline (T0) and after three days (T1). Group C was assessed at T1 only as a reference benchmark. Performance was evaluated using simulator-derived metrics. Statistical analysis was performed using paired and unpaired t-tests. Results: Group A showed significant improvement across several performance parameters following training, whereas no comparable changes were observed in Group B. At T1, Group A demonstrated better performance than Group B in multiple metrics. Group C achieved the highest scores and was considered a reference group. Conclusions: Structured microsurgical training was associated with improved performance in a robotic simulation setting. These findings suggest that microsurgical skills may be transferable to robotic tasks and may contribute to the early phases of robotic skill acquisition. Further studies are required to assess their impact in clinical practice.

Background/Objectives: The fibula osteoseptocutaneous flap is an established option for head and neck reconstruction. Preoperative planning requires assessment of donor-limb arterial anatomy and localization of cutaneous perforators. This study describes a structured surgeon-performed Conventional High-Frequency Ultrasound (CHFUS) protocol and evaluates its correlation with intraoperative findings. Methods: This retrospective study included patients undergoing reconstruction with a fibula osteoseptocutaneous free flap between January 2024 and December 2025. A standardized two-phase CHFUS workflow was used to assess infrapopliteal arterial anatomy and identify, characterize, and mark perforators at their deep fascial emergence. Preoperative findings were compared with intraoperative anatomy. Results: Ten patients underwent fibula flap reconstruction. Eighteen perforators were mapped, with a mean of 1.80 ± 0.63 per patient. The most common Kim–Lippert vascular pattern was type I (90%). Mean peroneal artery diameter at its origin was 2.83 ± 0.15 mm, and mean dominant perforator diameter at deep fascial emergence was 1.04 ± 0.14 mm. All 10 patients met the predefined anatomical agreement threshold of ≤1 cm (100%; exact two-sided 95% confidence interval, 69.2–100%). No flap required intraoperative redesign because of perforator anatomy. All flaps survived, without partial skin-paddle necrosis, donor-site ischemia, or vascular complications. Conclusions: This structured surgeon-performed CHFUS protocol was feasible and useful for fibula osteoseptocutaneous flap planning, enabling assessment of arterial anatomy, reliable perforator localization, and translation of preoperative findings into skin-paddle design. CHFUS should be considered complementary to CT angiography. Larger prospective studies are required to evaluate interoperator reproducibility and the diagnostic performance of CHFUS for clinically relevant arterial variants.