Background/Objectives: High-energy trauma to the lower limb often results in extensive soft tissue loss with exposure of critical structures, posing a serious threat to limb viability. Early and effective coverage is crucial to prevent infection, promote bone healing, and preserve function. This report presents the use of a latissimus dorsi free flap for circumferential soft tissue reconstruction following a severe crush injury. Methods: We describe the case of a young female patient who sustained a high-energy crush trauma with a comminuted, displaced fracture of the middle and distal third of the tibia and complete circumferential soft tissue loss. Due to the extent and location of the defect, a latissimus dorsi free flap was selected for reconstruction. The surgical technique, microsurgical anastomosis, postoperative care, and rehabilitation protocol are detailed. Results: The latissimus dorsi flap provided reliable coverage of the entire defect, protected the underlying bone and hardware, and promoted wound healing. No major complications were observed. Functional recovery was satisfactory, with progressive weight-bearing and joint mobility achieved during follow-up. Conclusions: In complex lower limb injuries with extensive soft tissue damage, free flap transfer remains a key strategy for limb salvage. The latissimus dorsi flap, due to its size, reliability, and versatility, represents a valuable option for circumferential coverage and restoration of limb function following high-energy trauma.

Background: Demand for anesthesia-sparing body contouring techniques is rising. This study assessed the feasibility, safety, and outcomes of medial thigh lift performed exclusively under tumescent local anesthesia (TLA) in an outpatient setting. Methods: A retrospective review was conducted that included 43 female patients (mean age of 41.6 years; BMI of 27.6 kg/m²) treated from November 2019 to June 2023. All procedures used pure TLA without sedation; a horizontal excision alone or combined with liposuction was chosen according to preoperative evaluation. The end-points were operative time, intra-operative pain (four-point scale), complications, and 12-month patient satisfaction. Results: Surgery was completed under TLA in every case, with no conversion to general anesthesia. The median operative time was 30 min for excision-only procedures and 50 min when combined with liposuction. Intra-operative comfort was rated “excellent” (86.0%) or “good” (14.0%); no opioids were required postoperatively. The overall complication rate was 23.2% (10/43), limited to minor wound dehiscence (9.3%), dog-ear deformity (7.0%), and scar displacement/hypertrophy (7.0%). No seroma, hematoma, infection, thromboembolic events, sensory deficits, or hospital readmissions occurred. All patients were discharged after 4 h and resumed ambulation within 24 h. At 12 months, 97.7% reported being “very satisfied” or “satisfied.” Conclusions: Medial thigh lift under pure TLA provides reliable anesthesia and hemostasis, minimizes perioperative morbidity, and enables same-day discharge, with high patient satisfaction. The low incidence of only minor complications supports TLA as a safe, effective, and resource-efficient alternative to general anesthesia for selected patients with mild-to-moderate thigh laxity. Further comparative and long-term studies are warranted.

Background: In recent years, prepectoral implant-based breast reconstruction supported by acellular dermal matrices (ADMs) has become an increasingly adopted alternative to submuscular techniques. Although this approach can improve patient comfort and aesthetic outcomes, fluid accumulation around the implant remains one of the most frequent and clinically relevant complications. Our unit progressively modified the handling and wrapping of the Braxon^® ADM with the aim of optimizing pocket configuration and reducing seroma formation. Methods: We performed a retrospective analysis of consecutive patients who underwent immediate prepectoral, direct-to-implant breast reconstruction with Braxon^® ADM at our institution between October 2019 and January 2025. Two techniques were compared: a standard full-wrap configuration and a modified approach in which the posterior ADM sheet is trimmed and only anterior coverage is maintained, with fenestrations created in the anterior wall. Clinical data and postoperative complications, including seroma rates, were recorded and compared between groups. Categorical variables were summarized as counts and percentages, and continuous variables as means and standard deviations. The primary comparison between techniques was performed on the presence of at least one postoperative complication using Fisher’s exact test, and odds ratios (OR) with 95% confidence intervals (CI) were calculated where appropriate. A p-value <0.05 was considered statistically significant. Results: A total of 138 direct-to-implant prepectoral reconstructions were included, 90 performed with the standard full-wrap technique and 48 with the modified wrapping approach. The overall complication rate was 27.8% (25/90) in the standard group and 10.4% (5/48) in the new-technique group. Seroma occurred in 8 patients (8.9%) in the standard group and in 1 patient (2.1%) in the modified-technique group. Fisher’s exact test demonstrated a significantly lower overall complication rate in the modified-technique cohort (10.4% vs. 27.8%; p = 0.02; OR 3.31; 95% CI 1.18–9.31), indicating that patients treated with the standard technique had approximately 3.3-fold higher odds of developing at least one complication than those treated with the modified technique. Conclusions: Anterior-only ADM coverage with selective trimming of the posterior sheet and fenestration of the anterior wall appears to reduce complications, particularly seroma, in ADM-assisted prepectoral breast reconstruction. Small technical refinements in ADM handling and pocket configuration, combined with a structured drainage protocol, may substantially improve postoperative outcomes in this setting.

Background and Clinical Significance: Facial aging is a multifactorial process involving the skin, subcutaneous tissues, facial fat compartments, muscles, ligaments, and skeletal structures. Integrated minimally invasive protocols are increasingly used to improve facial harmony and skin quality while preserving natural expression. The PATH (Profundity, Action, Timing, and Home care) protocol combines chemical peeling, hyaluronic acid–succinate filler, intradermal biorevitalization, and post-procedural homecare in a sequential and individualized approach to facial rejuvenation; Case Presentation: Three female patients aged 52–58 years with clinical signs of facial aging were treated according to the PATH protocol. Assessments were performed at baseline and after 60 days using standardized photography, OBSERV 520^®, Antera 3D PRO^®, and QuantifiCare LifeViz^® Infinity Pro. No serious adverse events or systemic complications were reported during the 60-day follow-up period. Mild edema, erythema, and ecchymosis resolved spontaneously within 48–72 h. At 60 days, all patients showed natural improvement in facial appearance, with better midface and lower-face balance, increased skin brightness, improved texture, and no overcorrection or alteration of facial expression. Instrumental evaluations supported the clinical findings, showing improvements in skin regularity, chromatic uniformity, microrelief, and soft-tissue distribution; Conclusions: This preliminary case series suggests that the PATH protocol may represent a coherent multimodal strategy for integrated facial rejuvenation. The main clinical lesson is that a sequential, depth-oriented, and individualized approach may achieve natural aesthetic improvement. No serious adverse events were reported in the three patients during the 60-day follow-up period; however, the limited sample size and short follow-up do not allow definitive conclusions regarding safety. Further controlled studies with larger samples and longer follow-up are needed to confirm these exploratory findings.