No abstract available
Thu Jul 30, 2020 10:29
Background: Occult breast carcinoma is occasionally found in breast reduction specimens. Although its incidence varies widely, there is a trend toward an increased incidence for women with a history of breast cancer. The authors performed a systematic review and meta-analysis of occult carcinoma incidence in breast reduction specimens. Methods: The MEDLINE and Embase databases were searched for peer-reviewed studies with no language restrictions for studies that recorded the incidence of...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Preoperative planning of microsurgical perforator free flaps continues to be a discussion topic among microsurgeons. The purpose of this study was to compare the ability of three methods of preoperative vascular mapping—hand-held Doppler imaging, color Doppler ultrasonography, and computed tomographic angiography—to detect perforators and their concordance with surgical findings. Methods: A prospective study was performed to evaluate the sensitivity, specificity, and accuracy...
Thu Jul 30, 2020 10:29
Summary: The coronavirus disease 2019 (COVID-19) pandemic has confronted the U.S. health care system with unprecedented challenges amidst a tenuous economic environment. As inpatient hospitals across the country prepare for an overwhelming influx of highly contagious COVID-19 cases, many nonemergent procedures have been cancelled or indefinitely postponed without guidance regarding eventual safe accommodation of these procedures in the future. Given the potentially prolonged impact of the COVID-19...
Thu Jul 30, 2020 10:29
Background: Antifibrinolytic medications, such as tranexamic acid, have recently garnered increased attention. Despite its ability to mitigate intraoperative blood loss and need for blood transfusion, there remains a paucity of research in breast reconstruction. The authors investigate whether intravenous tranexamic acid safely reduces the risk of hematoma following implant-based breast reconstruction. Methods: A single-center retrospective cohort study was performed to analyze all consecutive...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Reduction mammaplasty is the standard of care for symptomatic macromastia. The process of requesting insurance coverage for reduction mammaplasty is cumbersome and potentially controversial, and insurance policies vary significantly. The goal of our analysis is to identify trends in insurance coverage rates, assess for the presence of disparities, and propose ways to increase chances of successful preauthorization. Methods: The authors performed a retrospective review of preauthorizations...
Thu Jul 30, 2020 10:29
Background: Abdominally based free tissue transfer (FTT) and latissimus dorsi and immediate fat transfer (LIFT) procedures are both fully autologous options for breast reconstruction. The former is specialized and requires comfort with microsurgical technique, whereas LIFT combines a common set of techniques familiar to all plastic surgeons. Comparing the two methods for clinical effectiveness and complications for equivalency in outcomes may help elucidate and enhance patient decision-making. ...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Summary: The concept of sensate autologous breast reconstruction is not novel, and prior literature has focused mainly on sensate abdominally based breast reconstruction. The goal of this article is to present the authors’ results with a novel technique performing sensate implant-based reconstruction. A database was prospectively maintained for patients who underwent implant-based sensate breast reconstruction. The anterior branch of the lateral fourth intercostal is identified and preserved during...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: The Poly Implant Prothèse incident and breast implant-associated anaplastic large cell lymphoma have pointed to the need for uniform registries for breast implants as key features to monitoring the outcomes of breast implant surgeries internationally. The purpose of this study was to identify and harmonize common data elements collected by breast implant registries across the International Collaboration of Breast Registry Activities (ICOBRA) global consortium. Methods: The authors...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: The tumescent face lift uses the concept of subcutaneous cannula lipodissection of the neck, as opposed to wide skin undermining. Lipodissection mobilizes soft tissue while preserving perforating neurovascular branches. The purpose of this study is two-fold: (1) to compare the skin recruitment with subcutaneous lipodissection of the neck alone versus wide undermining and (2) to examine the effect of superiorly oriented superficial musculoaponeurotic system (SMAS) movement on jowl excursion...
Thu Jul 30, 2020 10:29
Background: Despite the widespread use of the Cottle maneuver as a finding to define nasal valve collapse, no studies have confirmed the association between a positive Cottle maneuver and need for nasal valve repair. This study demonstrates the low construct validity of the Cottle maneuver. Methods: One hundred healthy volunteer students and employees at Boston Medical Center were recruited for this study. Participants were asked to evaluate their breathing on a 10-point scale, rating their...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: As one of the most commonly used soft-tissue fillers, hyaluronic acid is generally considered safe and efficacious. However, evident bone resorption in mentum was observed. In this study, the authors analyzed the impact of hyaluronic acid on bone resorption in mentum and the influencing factors. Methods: The authors retrospectively compared the computed tomographic scans of patients with or without mentum augmentation using hyaluronic acid. The body mass index– and sex-matched...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Gluteal prominence is a unique characteristic that is widely acknowledged in female contouring but ignored in the male population. This study focuses on male gluteal aesthetics based on a muscular anatomical approach. Methods: A retrospective review of gluteal contouring in men from January of 2012 to September of 2019 was conducted. Male body sculpting surgery in the gluteal area was performed in most cases. Patients were included according to preoperative assessment and the...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Scarpa fascia preservation during abdominoplasty has been shown to reduce complications associated with the traditional technique. As an extension of a previously published randomized controlled trial, this study aims to clarify whether preservation of Scarpa fascia during abdominoplasty has an influence on scar quality or sensibility recovery. Methods: This was a single-center clinical trial, involving 160 patients randomly assigned to one of two surgical procedures: classic...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Summary: Optimizing patient safety and outcomes remains at the forefront of cosmetic surgery today. The five most commonly performed procedures are breast augmentation, liposuction, rhinoplasty, blepharoplasty, and abdominoplasty. Safety of all cosmetic surgery is a necessity for its successful, continued practice. This article seeks to elucidate the current literature detailing the major and minor complication profiles of the five most practiced areas in cosmetic surgery.
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Infections are challenging complications of implant-based breast reconstruction and augmentation. They pose a clinical challenge, with significant economic implications. One proposed solution is implant irrigation at the time of placement. There is no consensus on the optimal irrigant solution. Methods: The authors tested the relative efficacy of 10% povidone-iodine, Clorpactin, Prontosan, triple-antibiotic solution, or normal saline (negative control) against two strains each...
Thu Jul 30, 2020 10:29
Background: Adipose-derived stem cells are considered as candidate cells for regenerative plastic surgery. Measures to influence cellular properties and thereby direct their regenerative potential remain elusive. Hyperbaric oxygen therapy—the exposure to 100% oxygen at an increased atmospheric pressure—has been propagated as a noninvasive treatment for a multitude of indications and presents a potential option to condition cells for tissue-engineering purposes. The present study evaluates the...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Shoulder release and tendon transfer is frequently performed to address persistent weakness from neonatal brachial plexus palsy. Although postoperative improvements in motion are well described, associated deficits are poorly documented, and functional assessments are lacking. Loss of ability to reach midline can occur with surgery and may result in impairment. The purpose of this study was to comprehensively assess the gains, losses, functional changes, and patient-reported outcome...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Local health care facilities are often unequipped to treat complex upper extremity injuries, and patients are therefore transferred to designated trauma centers. This study describes the characteristics of patients transferred to a Level I trauma center for hand and upper extremity injuries and to investigate the accuracy of the provided diagnosis at the time of referral. Methods: Adult patients transferred from outside facilities to the authors’ Level I trauma center by means...
Thu Jul 30, 2020 10:29
Background: Autologous fat grafting is a useful adjunct following breast reconstruction. The impact of autologous fat grafting on oncologic safety and surveillance remains questionable, particularly following breast conservation therapy. Methods: The authors performed a retrospective review of patients who underwent delayed fat grafting following breast conservation therapy between 2006 and 2016. A control group of conservatively managed patients without grafting was matched for cancer stage,...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Summary: Plastic surgeons have the unique perspective of working with all types of patients and care teams from almost all specialties in surgery and medicine, which creates unique challenges in times of distress. As the initial epicenter of coronavirus disease 2019 cases in the United States, the University of Washington program was required to rapidly develop strategies to deal with the escalating crisis. All aspects of the program were affected, including the need to triage the urgency of plastic...
Thu Jul 30, 2020 10:29
Background: Trigger finger, or stenosing tenosynovitis, is one of the most common conditions affecting the hand, yet its pathophysiology remains poorly understood, and genetic association studies of trigger finger are lacking. The purpose of this study was to identify single-nucleotide polymorphisms associated with trigger finger through a genomewide approach. Methods: The authors performed a case-control genomewide association study in the Partners HealthCare Biobank. Single-nucleotide polymorphism–...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Evidence-based practices in medicine are linked with a higher quality of care and lower health care cost. For trigger finger, identifying patient factors associated with nonadherence to evidence-based practices will aid physicians in treatment decisions. The objectives were to (1) determine patient factors associated with treatment nonadherence, (2) examine the success rates of steroid injections, and (3) evaluate the economic consequences of nonadherence to treatment recommendations. ...
Thu Jul 30, 2020 10:29
Summary: Routine measurement of outcome of clinical care is increasingly considered important, but implementation in practice is challenging. This article describes (1) how the authors created and implemented a routine outcome measurement cohort of patients with hand and wrist conditions and (2) how these data are used to improve the quality of care and facilitate scientific research. Starting in 2011, routine outcome measurement was implemented at all practice sites (currently 22) of a specialized...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Craniosynostosis is one of the most common craniofacial malformations demanding surgical treatment in infancy. Data on overall psychiatric morbidity among children with nonsyndromic craniosynostosis remain limited. This study investigated the risk of psychiatric disorders in nonsyndromic craniosynostosis. Methods: The authors reviewed a register-based cohort of all individuals born with nonsyndromic craniosynostosis in Sweden between 1973 to 1986 and 1997 to 2012 (n = 1238). The...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Summary: Computed tomographic scans are frequently obtained following craniomaxillofacial fracture reconstruction. The additive radiation from such scans is not trivial; cumulative radiation exposure poses stochastic health risks. In this article, the authors postulate that a low-dose computed tomography protocol provides adequate image quality for postoperative evaluation of reconstructed craniomaxillofacial fractures. This study included patients for whom a computed tomographic scan was indicated...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: As a component of the Maintenance of Certification process from 2003 to 2019, the American Board of Plastic Surgery tracked 20 common plastic surgery operations. By evaluating the data collected over 16 years, the authors are able to examine the practice patterns of pediatric/craniofacial surgeons in the United States. Methods: Cumulative tracer data for cleft palate repair was reviewed as of April of 2014 and September of 2019. Evidence-based medicine articles were reviewed....
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Patients undergoing trigger-site deactivation surgery for headaches report a high prevalence (approximately 37 percent) of prior head or neck injury. Traditional medical treatment often fails to treat these posttraumatic patients. It is unclear whether surgery mirrors these poor outcomes. This study aims to describe the characteristics of posttraumatic headache surgery patients and compare their postoperative results to those of patients without a history of head or neck injury. Methods:...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Recent clinical experience with migraine surgery has demonstrated both the safety and the efficacy of operative decompression of the peripheral nerves in the face, head, and neck for the alleviation of migraine symptoms. Because of the perceived novelty of these procedures, and the paranoia surrounding a theoretical loss of clinical territory, neurologists have condemned the field of migraine surgery. The Patient Safety Subcommittee of the American Society of Plastic Surgeons ventured...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
Background: Panniculectomies are associated with high complication rates (43 to 70 percent), particularly in patients with obesity, smoking, and diabetes mellitus. Closed-incision negative-pressure therapy can be used postoperatively to support healing by promoting angiogenesis and decreasing tension. The authors hypothesized that using it with panniculectomies would minimize complications, and that a longer duration of therapy would not increase the incidence of complications. The authors also...
Thu Jul 30, 2020 10:29
No abstract available
Thu Jul 30, 2020 10:29
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