Body Mass Index and Complication Rates Among Patients Undergoing Gender-Affirming Surgeries: An Analysis of the National Surgical Quality Improvement Project Database.

Purpose: To determine the relationship between body mass index (BMI) and complication rates among patients undergoing gender-affirming surgeries (GAS).

Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried from 2015 to 2021. Patients who underwent a GAS were identified using International Classification of Diseases Ninth (ICD-9) and Tenth (ICD-10) codes.

Three Parameters Impact the Perception of Smile Asymmetry in Patients with Facial Paralysis.

The ability to smile is impaired in patients with facial palsy, and objective parameters assessing smile symmetry to guide treatment are not well elucidated. This study seeks to identify objective facial measurements that relate smile recognition, perception of smile asymmetry, and perceived emotions from photographs of individuals with asymmetrical smiles compared with control photographs of individuals without smile asymmetry as measured by a photograph analysis application. Fifty-six photographs of smiles were categorized using objective perioral morphometric measurements (Emotrics).

Determinants of Public Opinion Toward Gender-Affirming Surgery in the United States.

Purpose: National polling data indicate that Americans support the right of transgender persons to undergo gender-affirming surgery (GAS). It remains unknown whether public perceptions of GAS differ depending on patient subpopulations, anatomical site, or insurance coverage and whether the public widely believes that transgender people will regret GAS.

Methods: We built a Qualtrics™ survey derived from an online validated 2017 Ipsos survey and distributed it to American adults through Amazon Mechanical Turk.

Interpretation of Data from Translational Rodent Nerve Injury and Repair Models.

This article highlights the use of rodents as preclinical models to evaluate the management of nerve injuries, describing the pitfalls and value from rodent nerve injury and regeneration outcomes, as well as treatments derived from these rodent models. The anatomic structure, size, and cellular and molecular differences and similarities between rodent and human nerves are summarized. Specific examples of success and failure when assessing outcome metrics are presented for context.

Preference Signaling and the Integrated Plastic Surgery Match: A National Survey Study.

Objective: Rooted in economics market strategies, preference signaling was introduced to the Plastic Surgery Common Application (PSCA) in 2022 for integrated plastic surgery residency applicants. This study surveyed program and applicant experience with preference signaling and assessed how preference signals influenced likelihood of interview invitations.

Design: Two online surveys were designed and distributed to all program directors and 2022-2023 applicants to integrated plastic surgery.

Impact of Neighborhood Deprivation and Social Vulnerability on Outcomes and Interventions in Patients with Cleft Palate.

Objective: To examine whether neighborhood disadvantage impacts length of follow-up, interventions, and outcomes for patients with cleft palate.

Design: Retrospective cohort.

Setting: Cleft Palate Craniofacial Institute Database at St.

Multidisciplinary Optimal Outcomes Reporting and Team Clinic Retention in Isolated Nonsyndromic Cleft Palate.

Objective: Optimal Outcomes Reporting was recently introduced to categorize outcomes after cleft palate repair. We seek to propose an expanded version of Optimal Outcomes Reporting and to determine if correlation exists between the expanded outcomes and persistence with team care follow-up through age 9.

Design: Retrospective cohort study.

Buccal Myomucosal Flap Repair for Velopharyngeal Dysfunction.

Background: Velopharyngeal dysfunction (VPD) is the incomplete separation of the nasal and oral cavities during speech sound production that can persist following primary palatoplasty. Surgical technique used in management of VPD (palatal re-repair versus pharyngeal flap or sphincter pharyngoplasty) is often dictated by the preoperative velar closing ratio and closure pattern. Recently, buccal flaps have increased in popularity in management of VPD.

A feasibility study transplanting macrophages to a segmental nerve injury.

Introduction/aims: Promoting regeneration after segmental nerve injury repair is a challenge, but improving angiogenesis could be beneficial. Macrophages facilitate regeneration after injury by promoting angiogenesis. Our aim in this study was to evaluate the feasibility and effects of transplanting exogenous macrophages to a segmental nerve injury.

What do patients want to know about gender-affirming surgery? Analysis of common patient concerns and online health materials.

Purpose: Patients considering gender-affirming surgery often utilize online health materials to obtain information about procedures. However, the distribution of patient concerns and content of online resources for gender-affirming surgery have not been examined. We aimed to quantify and comprehensively analyze the most searched questions of patients seeking gender-affirming surgery and to examine the quality and readability of associated websites providing the answers.

Improving the Care of Our Patients: Twenty-Three Years of the James Barrett Brown Resident Research Day.

Background: James Barrett Brown was one of the founders of Plastic and Reconstructive Surgery as a specialty in the United States. Susan Mackinnon started the James Barrett Brown Resident Research Day in 1997 in his honor to serve as an annual opportunity for trainees to present their research to the Division and a visiting contemporary leader in plastic surgery. We sought to determine the proportion of Resident Research Day projects that have progressed to publication.

Terminal Schwann Cells Are Essential for Neuromuscular Junction Function and Recovery after Nerve Injury.

Background: Terminal Schwann cells (tSCs), nonmyelinating glial cells at the neuromuscular junction (NMJ), are integral to NMJ development, function, remodeling, and response to injury. It is essential to understand their requirement for NMJ function. In this study, the authors assessed consequences of immune-mediated tSC ablation in adult S100 -GFP mice of both sexes in homeostasis and after nerve injury.

Loss of Gata1 decreased eosinophils, macrophages, and type 2 cytokines in regenerating nerve and delayed axon regeneration after a segmental nerve injury.

The immune system has garnered attention for its role in peripheral nerve regeneration, particularly as it pertains to regeneration across segmental injuries. Previous work demonstrated that eosinophils are recruited to regenerating nerve and express interleukin-4, amongst potential cytokines. These results suggest a direct role for eosinophils in promoting nerve regeneration.

Electrical stimulation or tacrolimus (FK506) alone enhances nerve regeneration and recovery after nerve surgery, while dual use reduces variance and combines strengths of each in promoting enhanced outcomes.

Introduction/aims: Repaired nerve injuries can fail to achieve functional recovery. Therapeutic options beyond surgery, such as systemic tacrolimus (FK506) and electrical stimulation (E-stim), can improve recovery. We tested whether dual administration of FK506 and E-stim enhances regeneration and recovery more than either therapeutic alone.

Effect of Veau Class on Levator Veli Palatini Muscle Composition.

Objective: To examine levator veli palatini muscle composition in patients with nonsyndromic cleft palate and investigate the impact of Veau class.

Design: Prospective cohort study.

Setting: Tertiary care academic hospital.

Porous Polyethylene Versus Autologous Costochondral Reconstruction for Microtia: Incidence and Analysis of Secondary Procedures.

Objective: To examine the frequency of autologous and alloplastic ear reconstructions for patients with microtia in the United States, and describe post-index procedure rates associated with each method.

Design: Retrospective cohort study.

Setting: Claims data from 500 + hospitals from IBM® MarketScan® Commercial and Multi-State Medicaid databases.

Incidence and Management of Facial Paralysis After Skull Base Trauma, an Administrative Database Study.

Objective: Report the incidence of and treatment patterns for facial nerve palsy after skull base fracture.

Study Design: Retrospective cohort study.

Setting: IBM MarketScan Commercial Database (2006-2019).

Dispose with dish soap: A simple and convenient method to increase proper opioid disposal in postoperative pediatric patients.

Background: The opioid abuse crisis is rampant in the United States. Children and adolescents are unique risk groups in this crisis; age-specific concerns include accidental ingestion and association with high-risk behaviors. Studies aimed at disposal are limited in pediatric patients.

Impact of a Palatal Fistula After Cleft Palate Repair on Velopharyngeal Closure.

Purpose: A palatal fistula is an adverse outcome of cleft palate repair. It is unknown if a palatal fistula will influence velopharyngeal closure, even after repair of the fistula. This study determines the effect of a soft palate fistula on the risk of developing velopharyngeal insufficiency.

Variability and Excess in Opioid Prescribing Patterns After Cleft and Craniosynostosis Repairs.

Objective: To critically analyze pediatric opioid prescription patterns after cleft and craniosynostosis repairs.

Design: Observational study 1) retrospectively reviewing pediatric opioid prescriptions from July 2018 to June 2019 and 2) prospectively surveying patients about actual opioid use from August 2019 to February 2020.

Setting: Academic tertiary care pediatric hospital.

Factors contributing to delay or absence of alveolar bone grafting.

Introduction: Alveolar bone grafting (ABG) delay can lead to suboptimal outcomes. This study seeks to categorize reasons patients with cleft lip and palate have no record of ABG or who underwent later than typical ABG (≥13 years).

Methods: At a single tertiary care center, a retrospective review was performed of all patients with unilateral, complete cleft lip and palate, born 1998-2005.

Short-Duration, Pulsatile, Electrical Stimulation Therapy Accelerates Axon Regeneration and Recovery following Tibial Nerve Injury and Repair in Rats.

Background: Repair of nerve injuries can fail to achieve adequate functional recovery. Electrical stimulation applied at the time of nerve repair can accelerate axon regeneration, which may improve the likelihood of recovery. However, widespread use of electrical stimulation may be limited by treatment protocols that increase operative time and complexity.

IL-4 expressing cells are recruited to nerve after injury and promote regeneration.

Interleukin-4 (IL-4) has garnered interest as a cytokine that mediates regeneration across multiple tissues including peripheral nerve. Within nerve, we previously showed endogenous IL-4 was critical to regeneration across nerve gaps. Here, we determined a generalizable role of IL-4 in nerve injury and regeneration.

Brief Electrical Stimulation Accelerates Axon Regeneration and Promotes Recovery Following Nerve Transection and Repair in Mice.

Background: Clinical outcomes following nerve injury repair can be inadequate. Pulsed-current electrical stimulation (ES) is a therapeutic method that facilitates functional recovery by accelerating axon regeneration. However, current clinical ES protocols involve the application of ES for 60 minutes during surgery, which can increase operative complexity and time.