Plastic and Reconstructive Surgery in Sports Medicine: Interdisciplinary Intersections, Clinical Management, and Optimization of Return to Play (RTP) - a narrative review
DOI:
https://doi.org/10.12775/QS.2026.78.76644Keywords
facial trauma sports, craniomaxillofacial injuries athletes, reduction mammaplasty physical fitness, breast reduction exercise tolerance, hand injuries athletes plastic surgery, sagittal band rupturę athlete, orthoplastic approach lower extremity trauma, jersey finger repair, gynecomastia anabolic-androgenic steroids, gynecomastia bodybuildersAbstract
Background: Modern high-velocity athletics and collision disciplines have increased the incidence of complex trauma and biomechanical dysfunctions. Beyond conventional orthopediccare, plastic and reconstructive surgery plays an essential role: restoring anatomy after injury and optimizing body mechanics for performance.
Aim: To summarize current evidence on plastic, aesthetic, and reconstructive surgery in athletes, emphasizing functional biomechanics, exercise performance, and safe return to play (RTP).
Material and methods: A structured literature search of major databases (PubMed, Scopus, Cochrane Library, Google Scholar; prioritizing 2016–2026) was performed using MeSH terms related to plastic surgery, sports trauma, and athletic performance.
Results: Patient-specific 3D-printed carbon-fiber orthoses for craniomaxillofacial fractures expedite safe and full RTP in rugby players, from 8-12 weeks to 2–3 weeks post-fixation. Early orthoplastic microvascular flap coverage and anatomical tendon re-anchoring (e.g., flexor digitorum profundus avulsion repair within 7–10 days) preserve joint kinematics and lower complication rates. Functionally, reduction mammaplasty provides significant gains in VO2max, running economy, and spinal posture alignment. Subfascial, subpectoral or dual-plane pocket method of breast augmentation are preserving pectoralis major strength, however subfascial approach prevents animation deformities. In bodybuilders with AAS-induced gynecomastia, open intra-areolar adenectomy with liposuction effectively removes dense fibrotic parenchyma, though elevated bleeding risks require strict perioperative care. Functional labiaplasty resolves saddle-induced chafing in 86,2% of female participants.
Conclusions: Plastic surgery provides essential anatomical restoration and functional optimization in sports medicine. Individualized, criterion-based RTP protocols minimize complications and expedite safe clearance.
References
1. Ardern CL, Glasgow P, Schneiders A, Witvrouw E, Clarsen B, Cools A, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med. 2016;50(14):853-864. https://doi.org/10.1136/bjsports-2016-096278
2. Audlin J, Tipirneni K, Ryan J. Facial Trauma Patterns Among Young Athletes. Cranimaxillofac Trauma Reconstr. 2021;14(3):218–223. https://doi.org/10.1177/1943387520966424
3. Beniwal M, Singh K, Singh P, Sharma A, Beniwal S. The Burden of Anabolic Androgenic Steroid-Induced Gynecomastia. Indian J Plast Surgery. 2023;56(4):338-343. https://doi.org/10.1055/s-0043-1771293
4. Boffano P, Roccia F, Zavattero E, Dediol E, Uglešić V, Kovačič Ž, et al. European Maxillofacial Trauma (EURMAT): a multicenter and prospective study. J Craniomaxillofac Surg. 2015;43(1):62-70. https://doi.org/10.1016/j.jcms.2014.10.011
5. Bolijanovic S, Axelsson CK, Elberg JJ. Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy. Scand J Surg. 2003;92(2):160-2. https://doi.org/10.1177/145749690309200209
6. Bumbasirevic Matić S, Palibrk T, Glišović Jovanović I, Mitković M, Lesić A. Mangled extremity- Modern concepts in treatment. Injury. 2021;52(12):3555-3560. https://doi.org/10.1016/j.injury.2021.03.028
7. Cohen M, ed. Mastery of Plastic and Reconstructive Surgery. Boston: Little, Brown and Company; 1994. ISBN:0316149993 https://books.google.pl/books?id=UFtsAAAAMAAJ&hl=pl&source=gbs_slider_cls_metadata_9_mylibrary&redir_esc=y
8. Coltman CE, Steele JR, McGhee DE. Does breast size affect how women participate in physical activity? J Sci Med Sport. 2019;22(3):324-329. https://doi.org/10.1016/j.jsams.2018.09.226
9. DiPalma AD, Zia H, Goodwin B, Al-Shehab U, et al. Efficacy of absorbable vs. non-absorbable patient-specific, 3D-printed implants for the treatment of facial bone fractures: a systematic review and meta-analysis. Oral Maxillofac Surg. 2025;13;29(1):30. https://doi.org/10.1007/s10006-024-01327-x
10. Gilmer G, Xu E, Franklin E, Adams N, Rizzone K. The Impact of Breasts and Bras on Physical Activity Amongst Women and Girls: A Systematic Review and Meta-Analysis. Journal od Women’s Sports Medicine. 2024;4(1):39-54. https://doi.org/10.53646/cdp9k364
11. Goodrum JM, Nair VS, Crouch AK, Eichner D, Miller GD. Evaluating the Testosterone-to-Luteinizing Hormone Ratio in Male Anti-Doping Serum Samples: Results From a Transdermal Testosterone Administration Trial and Field Collected Samples. Drug Test Anal. 2026;18(1):9-15. https://doi.org/10.1002/dta.3959
12. Greywoode JD, Pribitkin EA Krein H. Management of auricular hematoma and the cauliflower ear. Facial Plast Surg. Clin North Am. 2010;26(6):451-455. https://doi.org/10.1055/s-0030-1267719
13. Guliyeva G, Cheung JY, Avila FR, Huayllani MT, Boczar D, Broer PN, Forte AJ. Effect of Reduction Mammoplasty on Pulmonary Function Tests: A Systematic Review. Ann Plast Surg. 2021;87(6):694-698. https://doi.org/10.1097/SAP.0000000000002834
14. Hada S, Seto H, Kaketa T, Nagayama M, Kawasaki T, et al. Accelerated Return to Play for Professional Rugby Players After Facial Fractures. J Craniofac Surg. 2019;30(4):1121-1124. https://doi.org/10.1097/SCS.0000000000005138
15. Hamori CA, Banwell PE, Alinsod R, eds. Female Cosmetic Genital Surgery. New York: Thieme; 2017. https://doi.org/10.1055/b-0037-144677
16. Jurat D, Wenzel D. Breast Augmentation in Athletic Women: A Retrospective Survey Assessing Pectoral Muscle Function and Implant Aesthetics Post-Augmentation. Aesthetic Plast Surg. 2022;46(3):1075-1081. https://doi.org/10.1007/s00266-021-02692-8
17. Mahajan M, Rhemrev SJ. Rupture of the ulnar collateral ligament of the thumb: a review. Int J Emerg Med. 2013;12;6:31. https://doi.org/10.1186/1865-1380-6-31
18. Mansour AM, Jacobs A, Raj MS, et al Lower Extremity Soft Tissue Reconstruction Review Article. Orthop Clin North Am. 2022;53(3):287-296. https://doi.org/10.1016/j.ocl.2022.03.003
19. McGhee DE, Steele JR. Biomechanics of Breast Support for Active Women. Exerc Sport Sci Rev. 2020;48(3):99-109. https://doi.org/10.1249/JES.0000000000000221
20. Oranges CM, Sisti A, Sisti G. Labia minora reduction techniques: a comprehensive literature review. Aesthet Surg J. 2015;35(4):419-31. https://doi.org/10.1093/asj/sjv023
21. Rosenbaum YA, Awan HM. Acute hand injuries in athletes. Phys Sportsmed. 2017;45(2):151-158. https://doi.org/10.1080/00913847.2017.1306420
22. Ryan L, Doody O. The treatment, outcomes and management of hand, wrist, finger, and thumb injuries in the professional/amateur contact sport athletes: A scoping review. Int J Orthop Trauma Nurs. 2024:54:101108. https://doi.org/10.1016/j.ijotn.2024.101108
23. Sarbak JM, Baker JL Jr. Effects of breast augmentation on pectoralis major muscle function in athletic woman. Aesthet Surg J. 2004;24(3):224-8. https://doi.org/10.1016/j.asj.2004.02.005
24. Sharp G, Tiggemann M, Mattiske J. Psychological Outcomes of Labiaplasty: A Prospective Study. Plast Reconst Surg. 2016;138(6):1202-1209 https://doi.org/10.1097/PRS.0000000000002751
25. Singh KA, Losken A. Additional Benefits of Reduction Mammaplasty: a Systematic Review of the Literature. Plast Reconstr Surg. 2012;129(3):562-570. https://doi.org/10.1097/PRS.0b013e31824129ee
26. Thorne CH, Chung KC, Gosain AK, Gurtner GC, Mehrara BJ, Rubin JP, Spear SL, eds. Grabb and Smith's Plastic Surgery. 8th ed. Philadelphia: Wolters Kluwer; 2020. ISBN:1496388259 https://books.google.de/books?id=4SaWDwAAQBAJ&redir_esc=y&hl=pl
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Copyright (c) 2026 Filip Lenartowicz, Maciej Mariusz Lesiczka, Jarosław Józef Kucharski, Zuzanna Zofia Cecot, Oliwia Gałczyńska, Dawid Oskar Mazurek, Alicja Martyna Lewczuk, Katarzyna Kuklińska, Anna Magdalena Maciaszczyk, Julia Weronika Duszejko
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