Arm remodeling surgery is becoming increasingly popular due to the high impact of this anatomical unit in terms of life relationships, non-verbal language, and aesthetic concern. When referring to the post-bariatric brachioplasty (PBB), plenty of techniques have been proposed. However, PBB is challenging due to technical factors and patient’s comorbidities, the evidence is limited, and there is a debate on the appropriate treatment choice. The present paper, through a systematic review, introduces a new classification system for PBB procedures, aiming to improve the management of post-bariatric patients. A systematic review was carried according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement by searching the PubMed (MEDLINE) database from December 2004 to December 2024 using the keywords ‘‘brachioplasty OR arm contouring OR postbariatric brachioplasty OR (arm contouring AND weight loss) OR (arm contouring AND liposuction)”. Original studies discussing PBB with a minimum of three clinical cases were eligible for inclusion. The final synthesis included 39 papers and 1972 patients from articles published in the last 20 years. Various PBB surgical strategies and technical measures were evidenced. The proposed classification allows a comprehensive assessment PBB techniques, possibly facilitating the treatment choice based on a patient’s individual needs. Liposuction-assisted traditional PBB with the scar at the bicipital groove is effective for most post-bariatric patients. However, selected candidates may benefit from a more invasive treatment as suggested by this simple and intuitive surgical algorithm. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Whether ventral or incisional hernias should be repaired during abdominoplasty remains disputed. A PROSPERO-registered PRISMA-2020 systematic review searched PubMed, Scopus, and Cochrane on June 15, 2025. Twenty-four studies (2 randomised trials, 2 propensity-matched registry analyses, 19 cohort series and 1 case report) encompassed 3142 adults, 1456 of whom underwent a single-stage repair, were included. Primary outcomes analysed were surgical-site occurrence (SSO), hernia recurrence, reoperation and patient-reported measures. Median SSO after combined repair was 20 www.springer.com/00266 .

Abdominoplasty is one of the most popular body contouring procedures. However, complications are common, particularly in post-bariatric patients, and surgical safety is a topic of growing interest. Among the significant steps, Osvaldo Saldanha first introduced the concept of lipo-abdominoplasty in 2001. Following an aggressive liposuction, the extensive dissections of traditional techniques are avoided, reducing complications. Furthermore, in 2014, Francisco Villegas advanced the TULUA technique. The latter introduces a transverse plication of rectus muscles, avoiding supraumbilical undermining, further improving safety. With the present study, we aim to introduce the TULUANHA: the modified TULUA and Saldanha lipo-abdominoplasty, a new technique electively designed for post-bariatric patients.Methods A retrospective study was conducted on post-bariatric patients who underwent TULUANHA between January 2019 and January 2021. The TULUANHA involved a bipolar radiofrequency scalpel assisted abdominoplasty with transverse plication of rectus muscles, umbilical preservation, and extensive liposuction.Results Twelve post-bariatric patients matched the selection criteria and were included in the study. Minor complications occurred in 1 of 12 patients (8.3%), consisting of a seroma. No major complications were reported. According to the Salles score, all included patients revealed satisfactory aesthetic outcomes.Conclusions The TULUANHA, by combining the principles of the TULUA and the lipo-abdominoplasty, a minimal supraumbilical undermining, and innovative technologies for surgical dissections, represents an innovative abdominoplasty technique. Potential benefits include enhanced vascular safety and reduced complications. Moreover, the TULUANHA allows for umbilical preservation, which is instead removed and reconstructed in the original technique. By avoiding any extensive supraumbilical dissection and related devascularization risks, the TULUANHA seems a promising technique for post-bariatric patients, and future research is expected.Level of Evidence Level V, retrospective study.

Background/Objectives: Surgical debridement and early excision of burned areas followed by skin autograft is the gold standard of treatment for partial and full-thickness pediatric burns. However, skin autografting might be unfeasible or unlikely to succeed due limited availability of skin donor areas or inadequate conditions. In these circumstances, alternative treatment is required, and Skin Substitutes (SS) cold play a role. Recently, Biological Skin Substitutes (BSS) and Tissue Engineered Skin Substitutes (TESS) are emerging as alternative treatment options, but strong evidence is missing. This review investigates the current literature focusing on BSS and TESS, aiming to improve the medical and surgical management of pediatric patients. Methods: A systematic review was performed in accordance with the PRISMA 2020 guidelines and registered in the PROSPERO database (CRD42024627569). A comprehensive search was conducted in PubMed (MEDLINE) from 2000 to 2024 using Boolean logic and PICO-based inclusion criteria. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists according to study design. Results: Twenty-nine articles and 2676 pediatric patients undergoing surgical reconstruction by BSS or TESS for burns were included. The methodological quality was generally moderate, with most studies being observational or case series. Several strategies were critically analyzed and possibly discussed. Conclusions: While BSS and TESS are safe and effective reconstructive options, the overall level of evidence remains low to moderate. A schematic classification of SS for pediatric burns is presented. Further prospective trials are needed to define standardized algorithms for pediatric burn reconstruction.

Background: Local flaps are a cornerstone of reconstructive plastic surgery for oncological skin defects, ensuring functional recovery and aesthetic integration. Their selection, however, varies with surgeon experience. Generative artificial intelligence has emerged as a potential decision-support tool, although its clinical role remains uncertain. Methods: We evaluated three generative AI platforms (ChatGPT-5 by OpenAI, Grok by xAI, and Gemini by Google DeepMind) in their free-access versions available in September 2025. Ten preoperative photographs of suspected cutaneous neoplastic lesions from diverse facial and limb sites were submitted to each platform in a two-step task: concise description of site, size, and tissue involvement, followed by the single most suitable local flap for reconstruction. Outputs were compared with the unanimous consensus of experienced plastic surgeons. Results: Performance differed across models. ChatGPT-5 consistently described lesion size accurately and achieved complete concordance with surgeons in flap selection. Grok showed intermediate performance, tending to recognise tissue planes better than lesion size and proposing flaps that were often acceptable but not always the preferred choice. Gemini estimated size well, yet was inconsistent for anatomical site, tissue involvement, and flap recommendation. When partially correct answers were considered acceptable, differences narrowed but the overall ranking remained unchanged. Conclusion: Generative AI can support reconstructive reasoning from clinical images with variable reliability. In this series, ChatGPT-5 was the most dependable for local flap planning, suggesting a potential role in education and preliminary decision-making. Larger studies using standardised image acquisition and explicit uncertainty reporting are needed to confirm clinical applicability and safety.

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, or a history of radiotherapy. Traditional submuscular reconstruction techniques are effective but often associated with higher rates of complications in this patient population. This study aimed to evaluate the efficacy and safety of a novel video-assisted procedure (VAP) for submuscular breast reconstruction, focusing on its ability to reduce complications and enhance outcomes. Methods:A retrospective analysis compared 17 high-risk patients who underwent VAP with 127 patients treated using traditional non-video-assisted procedures (NVAP) between September 2022 and June 2024. Both groups were comparable in age, body mass index (BMI), and risk factors. Data on postoperative complications, including bleeding, wound dehiscence, and infections, were collected and analyzed. Statistical significance was determined using appropriate tests, with a P value <0.05 considered significant. Results:The VAP group demonstrated significant reductions in complications compared to the NVAP group. No cases of postoperative bleeding were reported in the VAP group, while 8.66% of NVAP patients experienced bleeding. Wound dehiscence rates were also lower in the VAP group (5.88%) compared to the NVAP group (10.24%). The minimally invasive nature of VAP allowed for precise dissection and reduced tissue trauma without prolonging surgical times. Conclusions:The findings suggest that VAP is a safer and more effective alternative for high-risk patients requiring submuscular breast reconstruction. By minimizing complications and enhancing both functional and aesthetic outcomes, VAP offers a promising innovation in reconstructive surgery. Larger, randomized trials are necessary to validate these results and establish VAP as a standard of care in diverse clinical settings.

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

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. The study highlights its potential as a supplemental tool in patient education by assessing its performance across relevance, accuracy, clarity, and empathy criteria. Methods:The study collected frequently asked questions from patients about the selected procedures during pre- and post-operative consultations. Responses were generated by ChatGPT and evaluated by a panel of Plastic Surgery experts. Scores from 1 to 5 were assigned to four criteria: relevance, accuracy, clarity, and empathy. Statistical analyses, including means, standard deviations, and Kruskal-Wallis tests, were conducted to evaluate differences in the scores assigned to responses across criteria and procedures. Results:ChatGPT demonstrated high performance across all evaluation criteria, with clarity emerging as the strongest attribute, reflecting the model's ability to simplify complex medical concepts effectively. Accuracy, while slightly lower, remained reliable, aligning well with medical standards. Among the procedures, breast reconstruction appeared to perform particularly well, followed closely by mastopexy and breast augmentation. The analysis revealed no significant differences across the criteria, indicating consistent performance. Conclusions:ChatGPT demonstrated remarkable capability in addressing patient concerns and offering clear, empathetic, and relevant responses. However, limitations include the lack of personalised advice and potential patient misinterpretations, emphasising the need for professional oversight. ChatGPT is a valuable adjunct to professional medical consultations, enhancing patient education and engagement. Future research should focus on improving personalisation and evaluating its real-world application in clinical settings.

Background:While radiotherapy is a fundamental component of breast-conserving therapy for early breast cancer, it can complicate subsequent reconstructive procedures due to its impact on tissue quality. Despite the growing use of implant-based reconstruction, limited data are available on its safety and aesthetic outcomes in patients previously treated with radiotherapy. This study aims to evaluate the effectiveness and safety of heterologous breast reconstruction using tissue expanders and implants in irradiated patients compared to non-irradiated controls. Methods:This retrospective comparative cohort study included patients who underwent mastectomy with heterologous reconstruction between January 2020 and December 2023. Patients were divided into two groups: those with prior radiotherapy following breast-conserving surgery for local recurrence (PRS group) and those without prior radiotherapy (NPRS group). All irradiated patients received a standardized regimen of 50 Gy in 25 fractions. Reconstructions were performed using either prepectoral or subpectoral techniques, with Ti-Loop® mesh used in all prepectoral cases. Only patients who completed the reconstructive process were included. Follow-up focused on early postoperative outcomes within 120 days. Complications and aesthetic results were evaluated, with the latter assessed by an independent plastic surgeon. Results:A total of 175 patients were included: 15 in the PRS group and 160 in the NPRS group. No statistically significant differences were found in postoperative complication rates, including hematoma (13% PRS vs. 5.6% NPRS, P=0.28), infection (6.6% vs. 5.6%, P>0.99), and wound dehiscence (6.6% vs. 5.6%, P>0.99). Most patients were discharged on the first postoperative day in both groups (80% PRS vs. 81.9% NPRS). Aesthetic scores ≥4 were achieved in 86.7% of PRS and 88% of NPRS patients. Conclusions:Implant-based breast reconstruction appears to be a viable option for patients with prior radiotherapy when performed with careful planning and standardized protocols. However, due to the small sample size of the irradiated group and limited follow-up duration, larger and longer-term studies are needed to validate these findings and assess long-term complications.

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 suggests unconventional applications in dermatologic surgery and aesthetic medicine; these are focused with the present review. METHODS:A systematic review was conducted by searching the PubMed library from January 2018 to July 2023, using the terms "Dermatologic Surgery, Aging, Rejuvenation, Scars, Cellulite, Alopecia, AND Carboxy therapy." Eligibility criteria included original studies aimed at discussing CXT in dermatologic surgery and aesthetic medicine. RESULTS:The final synthesis included 41 articles distinguished by topic into studies on the role of CXT in facial rejuvenation ( n .14), in cellulite, scars and fat deposits treatment ( n .17), and other pathologic conditions ( n .10). Overall, CXT is an effective antiaging treatment. Furthermore, CXT may play a role in several pathologic conditions including alopecia, lichen planopilaris, vitiligo, chronic diabetic wounds, temporomandibular arthralgia, and lipedema. CONCLUSION:CXT, by promoting tissue oxygenation and microvascular and vascular perfusion, appears to have promising indications for several aesthetic and pathologic conditions, potentially offering satisfactory results with a minimally invasive, safe, and well-tolerated treatment.

Background: The treatment of burns is a socio-economic challenge for both patients and the National Health Service. Early debridement and skin graft reduces the risk of local and systemic complications. However, when skin autografting is unfeasible or contraindicated, alternative options are required. Recent research has introduced new potential tools: fish skin grafts (FSGs). This systematic review focuses on FSGs with the aim of improving the management of burn patients. Methods: A systematic search on articles concerning FSG for the treatment of burns was performed by searching PubMed, Web of Science and Embase according to the PRISMA statement. Clinical trials, retrospective studies, case series and case reports were included. Results: A total of 36 studies were identified through the search strategy and imported for screening. After duplicate removal, 26 studies were considered. Based on predetermined criteria, 20 full texts were assessed for eligibility, leaving 18 articles to be included in the systematic review. Conclusions: By virtue of the safety and effectiveness of FSGs, including low risk of zoonosis transmission and valuable outcomes even in austere environments, FSGs could represent a new alternative for the treatment of burns.

Background: Breast-conserving surgery (BCS) combined with radiotherapy achieves oncologic outcomes comparable to mastectomy while preserving breast integrity. However, resections of more than 20% of breast volume or those in challenging quadrants may compromise cosmetic results. Level II oncoplastic techniques using volume replacement flaps aim to address this. The lateral intercostal artery perforator (LICAP) flap is a reliable, muscle-sparing option for lateral and central–lateral breast defects. This study reports our initial experience with LICAP in Level II oncoplastic breast reconstruction. Methods: A retrospective review was conducted of women undergoing BCS with LICAP reconstruction between March 2024 and March 2025. The primary outcome was flap-related complications within 90 days. Secondary outcomes included operative time, hospital stay, donor-site morbidity, and six-month aesthetic results using the Harvard scale and BREAST-Q® module. Results: Nine women underwent LICAP reconstruction. All tumours were ≤pT2 with negative margins. Mean operative time was 128 min, and the median hospital stay was 2 days. One minor flap-related complication (seroma, 11%) occurred, which was managed conservatively without re-operation or delay in adjuvant therapy. At six months, all patients achieved good or excellent Harvard scores. The mean BREAST-Q® satisfaction score was 79 ± 12. Conclusions: LICAP reconstruction is safe, efficient, and provides reliable early aesthetic and patient-reported outcomes. Its low complication rate, high satisfaction, and minimal morbidity support its broader adoption, while larger prospective studies are needed to assess long-term results and refine indications. These findings also underline the role of LICAP reconstruction as part of a personalized surgical strategy, where the choice of technique is tailored to individual anatomy and expectations.

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 worse (BMI > 40 kg/m2), the surgical risks increase significantly, patients are often inoperable, and few studies are available in the literature. Most surgeons actually avoid this job and related risks. Recent research has highlighted a potential role of the Bipolar Radiofrequency Scalpel (BRS) in various fields as a promising tool to reduce surgical complications. With this paper, the authors report their experience in the management of panniculectomy in Extreme (BMI > 40 kg/m2) and Super (BMI > 50 kg/m2) obese patients through the technique of BRS assisted panniculectomy. A retrospective study was conducted on Extreme / Super obese patients who underwent BRS assisted panniculectomy between June 2013—June 2022. The panniculectomy involved lower abdomen excess skin and soft tissues removal, assisted by BRS, minimal undermining, and eventual abdominal hernia repair. Surgical procedures, and complications rate are discussed. Fourteen patients matched the selection criteria and were included in the study. Minor and major complications occurred in 28,6

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 non-Caucasian patients. Materials and Methods: In this study, we retrospectively reviewed patients treated with ARCL at our institution between January 2019 and December 2023. We described our personal approach and technique. At a minimum follow-up time of one year, post-operative pictures were taken, and patients were reassessed, evaluating aspects such as global symmetry, shape and contour of the nose, and facial harmony and rejuvenation; finally, patients’ satisfaction was investigated according to the ROE questionnaire and the modified S-GAIS. Results: A total of 307 patients were included in the study. They reported a significant satisfactory aesthetic result in nasal image and facial harmony, as the mean postoperative ROE and S-GAIS score show. None of the grafts extruded or collapsed. Wounds healed without reported major infection. Conclusions: This study has demonstrated that ARCL is a safe approach that contributes to improve functional and aesthetic outcomes, has a high patient satisfaction rate, and limited post-operative complications.

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-standard treatment for FG is surgical reconstruction. However, up to date, no precise guidelines exist. Thus, we decided to systematically review the literature, focusing on FG contemporary approaches to reconstructive surgery, aiming to analyze the various reconstructive strategies and their specific indications. Methods: A systematic review was carried out according to the PRISMA statement by searching various databases from April 2014 to April 2024, using the terms ‘‘Fournier Gangrene OR Fournier Gangrene Reconstruction OR Fournier Gangrene Treatment OR Fournier Gangrene Plastic Surgery OR Necrotizing Fasciitis OR Necrotizing Fasciitis AND Reconstruction”. The eligibility criteria included original studies aimed at discussing FG reconstruction with at least three clinical cases. Results: The final synthesis included 38 articles, and 576 reconstructions were described. Of these, 77.6% were minimally invasive strategies (direct closure, secondary healing, grafts, and local random flaps), while more invasive reconstructions (loco-regional flaps based on known vascular anatomy) were adopted in 22.4%. No free flaps were reported. Conclusions: FG requires immediate medical interventions including broad-spectrum antibiotic therapy, surgical debridement, adjuvant therapies, and reconstructive surgeries. Taking into account the anatomical characteristics of the inguinal-crural region, skin grafts and local random flaps could offer versatile and effective reconstructions for most FG cases, while the more invasive strategies should be reserved for very few cases. Future research is warranted to define an FG dedicated reconstruction protocol.

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 study was carried out on patients diagnosed with EM at Careggi University Hospital, Florence between May 2012 and May 2022. In addition, a systematic review of relevant literature was conducted, encompassing studies published from 2013 to 2023. Clinical, histopathological, therapeutical, and prognostic data were analyzed to assess the metastasis rate and the 5-year survival rate of patients with EM. Separate data were extracted for in situ and invasive disease. Our original study included 19 patients diagnosed with EM with a 5-year survival rate of 100% for in situ and 83.3% for invasive EM. The literature review identified five poorly detailed large database reviews and 14 original studies on EM with an overall 5-year survival rate of 79.7%. The present research indicates that EM is a challenging malignancy, but has a relatively better prognosis and easier management than other melanomas of the head and neck region. These are probably related to the anatomical location which leads to early diagnosis. Therefore, EM should be considered as a specific disease requiring dedicated treatment. Based on the personal authors’ experience and comprehensive overview of the current knowledge, a dedicated protocol is proposed.

ObjectiveIncluded 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. Indeed, magnetic field interactions could pose significant risks, and the procedure is typically contraindicated unless the ferromagnetic foreign body (FFB) has been previously removed. For such purposes, the magnet that is commonly used in breast and plastic surgery units for breast expanders port injection site identification could represent a time-saving and cost-effective solution.MethodologyThis paper presents an alternative technique based on off-label application of the breast expander magnet to localize FFBs.ResultsBetween April 2023 and June 2023, the breast expander magnet allowed successful pre-operative localisation and intra-operative guidance for removal of FFBs in four clinical cases. The post-operative ultrasound confirmed the absence of metal residues after the procedure in all cases.ConclusionOff-label application of the breast expander magnet allows for FFB pre-operative localisation and safe intra-operative surgical guidance, thus representing a promising off-label application of the device. After surgical removal of FFBs, the magnetic resonance imaging is allowed without any risk.

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 prosthesis (E/P) implant-based breast reconstruction (IBR) accounts for 73% of all reconstructions. Despite its widely accepted efficacy, the technique is not free from complications and up to 28% of cases require revision surgery for mechanical complications such as capsular contracture, implant displacement/rotation, and implant rupture. With this study, the authors report their experience in the management of E/P IBR revision surgery through the technique of Selective Capsulotomies (SCs) and Partial Capsulectomy (PC). Methods. A retrospective study was conducted on patients who had previously undergone E/P IBR and presented for revision reconstruction between January 2013 and May 2023 at the Department of Plastic Surgery of the University of Siena, Italy. Reasons for revision included capsular contracture, implant displacement/rotation, and implant rupture. Revision reconstructions involved SC and PC with implant replacement. Fat grafting was also considered. The complication rate was evaluated by analysis of patients’ medical records. Patients’ satisfaction with the treatment was assessed through a specific questionnaire. Results. 32 patients underwent revision surgeries. No early complication occurred. Recurrence rate was assessed at 19% with average follow-up of 59 months (range: 13–114 months). The average time between revision surgery and recurrence was 3 years (range: 1–6 years). 23 patients answered the questionnaire and were overall satisfied with the treatments (8.29/10). Conclusions. SC possibly associated to PC is a valuable option for E/P IBR revision surgery with minimal complications, reduced surgical trauma, short operating time, and relatively low recurrence risk. In addition, treated patients are overall satisfied with the results over time.

Background Thigh lift, first described by Lewis in 1957, consists of thigh recontouring by various strategies. When considering the Post-Bariatric Thighs Lift (PBTL) the technical details become fundamental due to both patients’ comorbidities and increased risk of complications. Moreover, post-bariatric weight loss affects the thighs resulting in significant tissue redundancy, inner excess, lower thigh deformity, later excess and buttocks ptosis. With this paper, PBTL procedures are reviewed and a comprehensive classification system is proposed aiming to improve their medical and surgical management. Methods A PRISMA systematic review was carried out by searching the PubMed (MEDLINE) library from May 2004 to May 2024 using the keywords ‘‘thighplasty OR thigh lift OR postbariatric thighplasty OR (thigh lift AND weight loss) OR (thigh lift AND liposuction)”. Eligibility criteria included original studies discussing PBTL with a minimum of 3 clinical cases. Results The final synthesis included 17 articles and 496 patients from articles published in the last 20 years. Several papers revealed significant PBTL surgical strategies and technical measures. Conclusions PBTL is challenging due to both technical factors and complex comorbidities of post-bariatric patients. A comprehensive assessment of PBTL may help choosing the appropriate treatment, based on patient’s individual needs. Liposuction assisted inner thigh lifts with combined horizontal-vertical scars and skin-only excision is effective and versatile for most patients. However, selected cases may benefit of alternative and more invasive strategies. Artificial Intelligence (AI) is a topic of growing interest and it will probably become increasingly relevant in PBTL. Future research is expected.