The Language of Implant-based Breast Reconstruction: Can We Do Better?
The management of breast cancer has experienced tremendous changes in the last half-century. In today’s multimodal approach to breast cancer, patients have the prospect of achieving a sense of normalcy after mastectomy thanks to advancements in oncology and breast reconstruction. Although the oncologic management of breast cancer has evolved over multiple centuries, implant-based breast reconstruction (IBBR) has only been around since the 1960s. The last half century has seen the conception of multiple techniques, novel devices, and new possibilities in hopes of achieving outcomes that are similar to or even better than ...
Source: Plastic and Reconstructive Surgery – Global Open - August 1, 2022 Category: Cosmetic Surgery Tags: Breast: Special Topic Source Type: research
Bipedicled SIEA Flap with Deep Inferior Epigastric Artery and Vein Grafts for Breast Reconstruction
Summary:
A superficial inferior epigastric artery (SIEA) flap can be an alternative to a deep inferior epigastric artery perforator (DIEAP) flap in cases where SIEAs are relatively well developed. Although an SIEA flap is less invasive than a DIEAP flap, the pedicles of the former are anatomically shorter, making it more difficult to choose recipient vessels when bilateral SIEAs are necessary. A 45-year-old female diagnosed with cancer of the left breast underwent mastectomy (specimen weight: 750 g) and immediate two-stage breast reconstruction using a free abdominal flap with bilateral pedicles was planned. Preoperati...
Source: Plastic and Reconstructive Surgery – Global Open - August 1, 2022 Category: Cosmetic Surgery Tags: Breast: Case Report Source Type: research
Two Independent Capsules Surrounding a Single Textured Implant in Ehlers-Danlos Syndrome
Summary:
Textured breast implants are associated with prolonged inflammation leading to increased risk for complications such as the development of anaplastic large cell lymphoma. The underlying molecular mechanisms that drive increased inflammation toward textured implants (compared with smooth implants) remain poorly understood. Here, we present the first known case of a patient with Ehlers-Danlos syndrome (EDS) who developed two independent fibrotic capsules around a single textured silicone implant. The patient was found to have one internal capsule tightly adherent to the implant and a second external capsule that...
Source: Plastic and Reconstructive Surgery – Global Open - August 1, 2022 Category: Cosmetic Surgery Tags: Breast: Case Report Source Type: research
Comparison of Breast Reconstruction Outcomes Using Oxychlorosene versus Triple Antibiotic Solution for Pocket Irrigation
Conclusions:
Oxychlorosene and TAS have similar surgical site infection rates in prosthetic breast reconstruction. Ease of preparation and cost make oxychlorosene a more favorable option for antibiotic irrigation in reconstructive breast surgery with prosthetic devices. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - August 1, 2022 Category: Cosmetic Surgery Tags: Breast: Original Article Source Type: research
Does a Latissimus Dorsi Flap Improve Surgical Outcomes of Implant-based Breast Reconstruction following Infected Device Explantation?
Conclusion:
Following a failed primary breast reconstruction due to infection, it may be appropriate to offer a secondary reconstruction. For patients with a history of radiotherapy, combining an LD flap with IBR may provide benefits over IBR alone. Although not statistically different, this outcome may have clinical significance, considering the magnitude of the effect, and may result in decreased complication rates and a higher chance of reconstructive success. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - August 1, 2022 Category: Cosmetic Surgery Tags: Breast: Original Article Source Type: research
Guideline Awareness Disparities in Plastic Surgery: A Survey of American Society of Plastic Surgeons
Conclusions:
Guideline awareness in plastic surgery varies by practice composition and geography. These findings can be used to help inform more targeted educational and implementation strategies in breast reconstruction.
Clinical Question/Level of Evidence:
Quality Improvement/Level IV (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - August 1, 2022 Category: Cosmetic Surgery Tags: Breast: Original Article Source Type: research
Fingertip Injuries Outcome Score: Erratum
No abstract available (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Erratum Source Type: research
Is the Impact Breast Implants with RFID Have on MRI Quality Investigated Thoroughly Enough?
No abstract available (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Letter to the Editor Source Type: research
Harnessing the Power of Artificial Intelligence to Teach Cleft Lip Surgery
Conclusions:
We successfully developed an AI algorithm that can identify the 21 surgically important anatomic landmarks of the unilateral cleft lip. This model can be used alone or integrated with surface projection to guide various cleft lip/nose repairs. Having demonstrated the feasibility of creating such a model on the complex three-dimensional surface of the lip and nose, it is easy to envision expanding the use of AI models to understand all of human surface anatomy—the full territory and playground of plastic surgeons. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Technology: Original Article Source Type: research
Radiation-induced Sarcoma in the Head and Neck: Clinical, Imaging, Histopathological, and Therapeutic Characterization
Summary:
Radiation-induced head and neck sarcoma (RIHNS) is a rare and serious long-term complication of radiotherapy (RT), with poor prognosis and high morbidity and mortality. Diagnosis is based on immunohistochemistry and molecular biomarker analysis, and therapy is usually surgical. Other adjuvant therapies might be considered. This case report aimed to describe the clinical, imaging, histopathological, and therapeutic characteristics of a rare case of RIHNS in the mandible after 21 years of RT. A 68-year-old male patient underwent a partial left parotidectomy in 1995, was diagnosed with pleomorphic adenoma, and af...
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Reconstructive: Case Report Source Type: research
Reconstruction of Chopart’s Amputation Stump with the Osteomusculocutaneous Latissimus Dorsi-Rib Flap
We present an original technique for reconstruction of the right forefoot after Chopart’s amputation. The case report was of a 20-year-old man who was a nonsmoker without comorbidities. He was referred to our department because of equinus deformity, pain, and prominence of the cuboid under the skin, leading to chronic ulceration at the stump. We performed flow through free latissimus dorsi flap including the eighth and tenth ribs to reconstruct the stump. Results were assessed at 18 months after operation, showing good stability and normal functional outcome of the foot. The patient is satisfied with the results achieved...
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Reconstructive: Case Report Source Type: research
Chimeric Anterolateral Thigh Flap for One-stage Reconstruction after Cervical Exenteration with Anterior Mediastinal Tracheostomy
We report a case involving a 60-year-old woman with recurrent medullary thyroid cancer who developed dyspnea and dysphagia. Salvage cervical exenteration and anterior mediastinal tracheostomy were complicated by tissue fibrosis caused by previous surgical and radiation therapies, resulting in complex defects with segmental loss of the esophagus, a short stump of trachea incapable of tracheocutaneous anastomosis, and great-vessel exposure. We used a chimeric anterolateral thigh flap consisting of a tubed skin flap for pharyngoesophageal reconstruction, a fenestrated skin flap for tracheostomy and neck coverage, and a vastus...
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Reconstructive: Ideas and Innovations Source Type: research
Complex Nasal Reconstruction in a Wide-awake Ambulatory Setting: A Study of Efficacy and Perioperative Patient Experience
Conclusion:
Our study demonstrated that complex nasal reconstruction performed under local anesthetic in a minor procedure setting is a feasible and safe option with good patient-reported outcomes. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Reconstructive: Original Article Source Type: research
Comprehensive Treatment and Reconstructive Algorithm for Functional Restoration after Ballistic Facial Injury
Conclusions:
Based on our findings, we describe a novel algorithm for function restoration and aesthetic revisions based on injury location. Underlying principles include avoiding early use of reconstruction plates, establishing occlusion early, and aligning bony segments using external fixation. An algorithmic approach to these injuries can improve outcomes. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Reconstructive: Original Article Source Type: research
Medial Canthus Reconstruction with the Paramedian Forehead Flap
Conclusions:
Utilization of the paramedian forehead flap leads to successful medial canthal repair with adequate coverage. Although the paramedian forehead flap requires three stages to complete, the procedure leaves patients with aesthetically pleasing results. In addition, the paramedian forehead flap has limited cases of ectropion. With the right expertise and patient population, the paramedian forehead flap can be highly successful in the repair of medial canthal defects. (Source: Plastic and Reconstructive Surgery – Global Open)
Source: Plastic and Reconstructive Surgery – Global Open - July 1, 2022 Category: Cosmetic Surgery Tags: Reconstructive: Original Article Source Type: research
