Moreira, Andréa

Abstract While the launch of the da Vinci Surgical System catalyzed the expansion of robotic surgery across disciplines, adoption in plastic surgery remains modest. To explore this disconnect, this study surveys plastic surgeons to gauge interest, utilization, and perceived barriers to robotic surgery adoption. A 15-question survey on training, access, interest, and barriers to robotic procedures was developed on Qualtrics and distributed via email to members of the American Society of Plastic Surgeons (ASPS) in May 2024. Descriptive statistics were used to summarize responses. About 123 responses were collected among 3,512 survey recipients. Among respondents, 84.6% reported having access to a surgical robot; however, only 13.8% had training on robotic systems during residency, and only 12.2% utilized the technology for plastic surgery procedures. Interest in robotics was noted among 47.9% of respondents, particularly for deep inferior epigastric perforator (DIEP) flap procedures (65.5%), rectus/Vertical Rectus Abdominis Myocutaneous (VRAM) flap (58.2%), and hernia repairs (27.3%). Key barriers to adoption included training requirements (63.9%), lack of demand (60.2%), increased operative time (54.6%), and financial concerns (26.9%). Additional obstacles cited were credentialing difficulties and skepticism about the necessity of robotics in plastic surgery. The present survey identified inadequate training, high costs, and limited demand as key barriers to the adoption of robotics in plastic surgery, reflecting the current lack of robotic integration into residency curricula, as well as the substantial investment and maintenance costs associated with robotic systems. Nevertheless, the strong interest in robotics highlights the need for expanded training programs, promotion of clinical benefits, and research quantifying potential downstream savings to overcome these barriers.

Background/Objectives: Immortality and anti-aging research is accelerating, with implications across medicine. This narrative review explores the biological principles, translational innovations, and ethical considerations at the intersection of aging and plastic surgery, reframed for a broad clinical audience. Methods: A narrative review of the literature from PubMed, clinical trials, and translational studies was conducted, with emphasis on regenerative medicine, stem cells, tissue engineering, gene editing, and longevity pharmacologics within the field of plastic and reconstructive surgery. Results: Key themes include (1) the biology of aging and epigenetic reprogramming, (2) esthetic and regenerative innovations with broader clinical significance, (3) emerging genetic and pharmacologic longevity strategies, (4) ethical and regulatory challenges, and (5) future directions such as nanotechnology, artificial intelligence, and digital immortality. Conclusions: Immortality remains an aspirational frontier, but innovations in regenerative science and longevity research offer opportunities for improving healthspans. Medicine as a whole must balance innovation with ethics, equity, and safety in translating these discoveries to patient care.