Comparison of preoperative quality of life in breast reconstruction, breast aesthetic and non-breast plastic surgery patients: A cross-sectional study.

A breast cancer diagnosis imposes significant emotional and psychological duress. The purpose of this study is to assess the baseline quality of life (QOL) of immediate, delayed, and secondary breast reconstruction patients, comparing these results with QOL in women seeking plastic surgery for cosmetic breast, and non-breast procedures. From 2012 through 2013, immediate (group 1), delayed (group 2), and secondary (Group 3) reconstruction patients, aesthetic breast (group 4) and non-breast plastic surgery patients (group 5) answered Breast-Q questionnaires.

Complications Following Abdominal-Based Free Flap Breast Reconstruction: Is a 30 days Complication Rate Representative?

Purpose: The purpose of this study was to analyze timing and frequency of complications following free tissue autologous reconstruction in a single tertiary care institution.

Methods: From August 2012 to December 2013, all patients operated on for abdominal-based free flap breast reconstruction at a single institution were included. Complications were identified and risk factors associated with them were analyzed using SPSS software.

Considerations surrounding reconstruction after resection of musculoskeletal sarcomas.

The defects left by resection of bone and soft-tissue sarcomas often require reconstructive surgery to provide adequate wound coverage, preserve limb function, and optimize cosmetic results. Immediate reconstruction should always be considered after resection with a negative margin, and should be attempted whenever possible. The choice of reconstructive method and tissue flap depends on multiple factors, including body site, donor site morbidity, functional requirements, size of the vascular pedicle, and aesthetics.

A survey of cosmetic surgery training in plastic surgery programs in the United States.

Background: Aesthetic surgery is evolving rapidly, both technologically and conceptually. It is critical for the specialty that aesthetic surgery training keep pace with this rapid evolution. To shed more light on this issue, a survey was sent to all program directors and senior plastic surgery residents to record their impressions of the quality of cosmetic surgery resident training.

Follow-up: orthognathic surgery. Is there a future? A national survey.

Background: The authors recently documented a significant decrease in orthognathic surgical cases performed by both plastic and oral surgeons in Ohio over a recent 5-year period. The main reason noted was related to third-party reimbursement. This is a potentially serious issue that may affect the quality of health care for patients with dentofacial deformities.

Repairing critical-sized rat calvarial defects with a periosteal cell-seeded small intestinal submucosal layer.

Background: Small intestinal submucosa was evaluated as a bioscaffold candidate for periosteum-derived osteoblasts, and its suitability as a bone replacement material for cranial defects was investigated.

Methods: In the in vitro phase, osteoblasts were expanded in osteogenic medium and were then seeded onto small intestinal submucosa. To confirm osteoblast phenotype, they were tested for alkaline phosphatase, collagen type 1, and calcium expression.

Biomechanical and histologic evaluation of the Norian craniofacial repair system and Norian Craniofacial Repair System Fast Set Putty in the long-term reconstruction of full-thickness skull defects in a sheep model.

Background: The purpose of this study was to investigate the long-term (12 months) strength and osteoconductive properties of two forms of carbonated calcium phosphate cements (i.e., the Norian Craniofacial Repair System and Norian Craniofacial Repair System Fast Set Putty) and to compare these two bone cement forms to an autogenous cranial bone graft in a full-thickness skull defect adult sheep model.

Self-reported outcome after diode laser hair removal.

Background: Laser-assisted photoepilation has become the procedure of choice for permanent hair reduction. Our purpose was to evaluate patient satisfaction with the procedure using a diode-laser system.

Method: A self-administered survey was mailed to 220 patients who underwent treatment between 2000 and 2004.

Multicenter study of wound healing in neurofibromatosis and neurofibroma.

Based on clinical experience, the senior author has become convinced that wounds produced to correct the deformities of patients with neurofibromatosis (NF-1) have produced remarkably good scars, the interesting feature being that progression to keloid or hypertrophic scar is rare. The other point noted was that this situation did not change, no matter the patient's race or skin color. There have been few reports describing or discussing this hypothesis.

Use of calcium-based bone cements in the repair of large, full-thickness cranial defects: a caution.

Background: Calcium-based bone cements have increased in popularity for the correction of craniofacial contour defects. The authors' experience with them in more than 120 patients has resulted in the establishment of strict criteria for their use. Although the authors' overall complication rate with these cements has been low, certain patient groups have an unacceptably high complication rate.

An alternative method for harvest and processing fat grafts: an in vitro study of cell viability and survival.

Background: Adipocyte viability has been emphasized as essential for fat graft survival. There is no universal agreement on the methodology for handling fat grafts.

Objective: Two different methods of fat harvesting and techniques of tissue processing were compared by assessing cell viability, damage, and growth in vitro.

Effects of fresh versus banked blood transfusions on microcirculatory hemodynamics and tissue oxygenation in the rat cremaster model.

Background: Blood transfusion is recommended to prevent the harmful effects of tissue hypoxia. Whether transfusion alleviates hypoxia at the microcirculatory level is unknown. The objective of this study was to determine whether the effects of fresh blood transfusion on microcirculatory hemodynamics after blood loss are preferable to the effects of banked blood transfusion.

Cosmetic procedures for the aging face.

As the United States' population continues to age and as cosmetic procedures have become more accepted, adults from all age groups and socioeconomic brackets are seeking improvement in facial aging. Ideal correction includes improvement in the quality of skin, improvement in wrinkles, correction of soft tissue descent, removal of skin excess, and volume restoration. The physiologic rather than the chronologic age is the most important factor in determining the advisability of cosmetic surgery in elderly people.

Calvarial thickness and its relation to cranial bone harvest.

Background: The purpose of this study was to define the variability in skull thickness from location to location and from individual to individual in a large number of human skulls.

Method: Skull thickness was measured in multiple areas of the calvaria in 281 dry skulls from the Hamman-Todd osteological collection (Cleveland Museum of Natural History, Cleveland, Ohio). A total of 40 points were determined over the frontal, occipital, and parietal bones, with a higher number of points concentrated on the latter.

Orthognathic surgery: is there a future?

Background: Despite significant clinical advances in orthognathic surgery, a perceived decrease in recent years in the number of orthognathic cases was noted at the authors' institution. Word of mouth suggested that this phenomenon was region-wide. To explore this possible dichotomy, a one-page questionnaire was designed and sent to all plastic surgeons in the American Society of Maxillofacial Surgeons and to all active practicing oral surgeons and orthodontists in the state of Ohio.

Hypertelorism: the importance of three-dimensional imaging and trends in the surgical correction by facial bipartition.

Background: The technique of facial bipartition has been considered a great advance in achieving a more natural appearance in hypertelorism correction.

Methods: Fourteen patients who had undergone hypertelorism correction by facial bipartition were retrospectively studied to analyze the role of three-dimensional computed tomographic reconstruction in the evaluation of the deformity and preoperative planning. The procedure and surgical details that can improve the outcome were described.

Skull base tumors: a comprehensive review of transfacial swing osteotomy approaches.

Numerous techniques have been proposed for the resection of skull base tumors, each one unique with regard to the region exposed and degree of technical complexity. This study describes the use of transfacial swing osteotomies in accessing lesions located at various levels of the cranial base. Eight patients who underwent transfacial swings for exposure and resection of cranial base lesions between 1996 and 2002 were studied.

Evaluation of 45S5 bioactive glass combined as a bone substitute in the reconstruction of critical size calvarial defects in rabbits.

Biomaterial research and tissue engineering have guided new developments in bone replacement. In this study, the osteoconductive and osteoinductive properties of 45S5 Bioglass (Novabone-C/M, Porex Surg., Newnan, GA), granules as a bone replacement material for large calvarial defects were evaluated.

Medial canthopexy: a proven technique.

The medial canthus comprises three limbs and functions to maintain the shape of the eye and to assist in drainage of the lacrimal sac. Repair of the medial canthal tendon is often complicated by canthal drift, extrusion of wires or sutures, and in-fracture of the contralateral orbital bones from pressure by transnasal wires. A technique used successfully for more than 25 years with a low rate of complications is described in a stepwise manner.

The buccal flap--a useful technique in cleft palate repair?

Objective: To evaluate speech quality and oronasal fistula after primary palate repair using a buccal mucosal flap.

Design: Retrospective study cohort of patients with cleft palate.

Setting: Primary care center for treatment of craniofacial congenital anomalies.

Vascular iliac crest with inner table of the ilium as an option in maxillary reconstruction.

Reconstruction of large maxillary defects has been a long-standing challenge to the reconstructive surgeon. Total maxillary reconstruction is desirable but often not possible; ideally, this would provide all the anatomical structural support, function, and esthetics missing because of the defect. A case is presented in which all the criteria for total maxillary reconstruction have been fulfilled.

Augmentation of the craniomaxillofacial region using porous hydroxyapatite granules.

Augmentation of the craniomaxillofacial region is required for many aesthetic and reconstructive procedures. A variety of different materials and techniques have been used. Coralline hydroxyapatite has proved to have biocompatible properties as a bone graft substitute.

Clinical outcome in cranioplasty: critical review in long-term follow-up.

Various materials have been proposed for cranial reconstruction. Bone autograft and alloplasts such as polymethylmethacrylate (PMMA) and hydroxyapatite (HA) cement are most commonly used at the present time. Patients submitted for cranioplasty were evaluated.

Nasal augmentation with Surgicel-wrapped diced cartilage: a review of 67 consecutive cases.

Cartilage grafting has been used extensively to correct both the functional and aesthetic aspects of the nasal framework. The technique described by Erol ( 105: 2229, 2000) uses Surgicel-wrapped diced cartilage grafts in rhinoplasties. The advantages include its ease of preparation, the large volume of graft substrate available for use, and the avoidance of contour irregularities in the areas of placement.