Prehabilitation represents a proactive, multimodal strategy to enhance patient resilience prior to plastic and reconstructive surgery, building on the success of Enhanced Recovery After Surgery (ERAS) pathways. This narrative review synthesizes the conceptual framework of prehabilitation—encompassing exercise training, nutritional optimization, risk factor modification, and psychological preparation—and examines its current application within plastic surgery. While evidence from selected randomized trials and systematic reviews in orthopedic and colorectal surgery suggests potential reductions in complications (often in the range of 20–40% in higher-risk populations), the results remain heterogeneous and context-dependent. To date, there have been no randomized controlled trials on plastic surgery, despite unique patient populations facing modifiable risks, including smoking, obesity, and malnutrition. This review proposes a risk-stratified prehabilitation framework tailored to key plastic surgery domains: breast reconstruction, head-and-neck microsurgery, post-bariatric body contouring, and major esthetic procedures. Practical implementation strategies address timelines, multidisciplinary teams, and digital delivery tools. By positioning prehabilitation as a structured preoperative component within ERAS pathways, plastic surgeons may support better perioperative readiness, potentially influencing complications, recovery, and patient experience. This review proposes conceptual frameworks intended to guide structured evaluation and future clinical research in plastic surgery.

Introduction/Objective. The most important etiologic factors for both, capsular contracture (CC) and breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is subclinical infection, defined as a response of an organism on presence of biofilm on the implant surface. The aim of this research was to examine the possibility of biofilm formation of four different bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa and Ralstonia picketti) on three differently textured silicone breast implants (Siltex, Mentor, pore size 70-150 μm; MESMO®sensitive, Polytech, pore size 50-900 μm; and SilkSurface, Motiva pores 13 μm) in vitro. Methods. Samples of silicone breast implant capsules (sized 1 × 1 cm) were divided into three groups according to texture. After sterilization, 30 samples in every group were contaminated with 100 μl of examined bacterial broth, followed by incubation which led to biofilm formation. For testing the capability of biofilm formation, modified technique with microtitar plates described by Stepanović was used. Results. All four examined bacteria (S. epidermidis, S. aureus, P. aeruginosa and Ralstonia pickettii) form more biofilm on implants with pore sizes 50-900 μm compared to implants with pore size 70-150 μm and those with 13 μm. Statistical significance was found in biofilm formation on implants with pores 70-150 μm compared to implants with pores 13 μm. The only exception was P. aeuruginosa which did not show significant difference in biofilm formation on implants 70-150 μm and 13 μm. Conclusion Silicone breast implants with micro and nanotexture should be chosen in order to prevent biofilm formation and possible consequent complications.