Module Creation Within the TOPS Registry: An Opportunity for Longitudinal Collection of Procedure-specific Clinical Outcomes.

The Tracking Operations and Outcomes for Plastic Surgeons (TOPS) data registry, first launched in 2002 by the American Society of Plastic Surgeons (ASPS) in collaboration with the Plastic Surgery Foundation (PSF), was designed to avoid the perceived shortcomings of other national data registries as they pertain to interests of the plastic surgery community. Given the diversity of plastic surgery practice, the ASPS and PSF sought to ensure that the TOPS registry platform would support detailed collection of data useful to plastic surgeons practicing in all subspecialties. Therefore, a key design element of the TOPS registry is its ability to incorporate custom-made modules that allow for focused collection of topic/procedure-specific information.

Prenatal Spina Bifida Repair: A Survey of Current Practice in the United States.

Background: Prenatal myelomeningocele (MMC) repair offers significant benefits over traditional postnatal repair, as demonstrated by the Management of Myelomeningocele Study trial. We characterize the current specialist involvement in prenatal and postnatal MMC repair.

Methods: The top 50 US News Children's Hospitals for Neonatology and Neurology/Neurosurgery were queried, resulting in 67 unique hospitals.

Quantifying Plastic and Reconstructive Surgery Engagement in the Evolution of ICD-10 Codes.

Background: International Classification of Diseases (ICD)-10 code specificity is important for detailed diagnostic documentation. Insufficient coding granularity in plastic surgery may hinder accurate clinical documentation, impacting education, research, and patient care. This study examines ICD-10 code modification efforts by plastic surgeons and plastic surgery organizations within the last decade, subsequently detailing the formal proposal process and highlighting potential areas where coding modifications may be explored.

Clinical Practice Patterns and Evidence-Based Medicine in Blepharoplasty: A 15-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery.

Introduction: The American Board of Plastic Surgery (ABPS) Continuous Certification tracer data on blepharoplasty offers valuable information on national trends in clinical practice. The present study was performed to analyze evolving trends in blepharoplasty and compare practice patterns to Evidence-Based Medicine (EBM) publications within the same timeframe.

Methods: Tracer data for blepharoplasty procedures performed by ABPS-certified surgeons between 2005 and 2020 was analyzed.

Numerical investigation of new rete ridge formation in a multi-layer model of skin subjected to tissue expansion.

The skin is a multilayered organ with microstructural and antomical heterogeneities that contribute to its unique mechanophysiology. Between the epidermis layer at the top and the dermis layer below, the basal keratinocytes form an interface with sinusoidal-like geometry termed rete ridges. In previous computational work we showed that the rete ridges contribute to lower delamination risk by increasing surface area and reducing the stress jump across the interface.

Regulatory elements in (7q21.3) locus contribute to genetic control of coronal nonsyndromic craniosynostosis and bone density-related traits.

Purpose: The etiopathogenesis of coronal nonsyndromic craniosynostosis (cNCS), a congenital condition defined by premature fusion of 1 or both coronal sutures, remains largely unknown.

Methods: We conducted the largest genome-wide association study of cNCS followed by replication, fine mapping, and functional validation of the most significant region using zebrafish animal model.

Results: Genome-wide association study identified 6 independent genome-wide-significant risk alleles, 4 on chromosome 7q21.

Tissue expansion mitigates radiation-induced skin fibrosis in a porcine model.

Tissue expansion (TE) is the primary method for breast reconstruction after mastectomy. In many cases, mastectomy patients undergo radiation treatment (XR). Radiation is known to induce skin fibrosis and is one of the main causes for complications during post-mastectomy breast reconstruction.

Timing of Pediatric Breast Reduction and Insurance Coverage: Single-institution Retrospective Study.

Background: Although long-term benefits of reduction mammaplasty have been proven, the appropriate age for adolescent reduction mammaplasty has been highly debated due to possible need for revision surgery. Practitioners often delay offering breast reduction to adolescents below age 18 based on presumed insurance denial. We reviewed trends in insurance denial at a single children's hospital to analyze whether age and/or insurance carriers have a significant impact on coverage of breast reduction.

A Sustainable Solution for Reducing Draping Waste in Cleft Surgeries.

Objective: This study aims to reduce the waste generated from primary cleft lip and/or palate (CL/P) repair.

Design: A retrospective chart review examined a single surgeon's experience with CL/P repair using standard draping technique and reduced draping technique. Fisher's exact tests were performed comparing complication rates between techniques.

Identifying Independent Predictors of Short-Term Postoperative Morbidity in Patients Undergoing Cranioplasty.

Background: The present study intends to identify independent predictors of short-term postoperative complications and health utilization in patients undergoing cranioplasty.

Methods: Demographic, clinical, and intraoperative characteristics were collected for each patient undergoing cranioplasty in the National Surgery Quality Improvement Program database from 2011 to 2020. The 30-day outcomes analyzed were medical complications, wound complications, return to the operating room, extended hospital stay, and non-home discharge.

Students Matriculating into Integrated Plastic Surgery: Are all Medical Schools Equal?

Introduction: Becoming a craniofacial/pediatric plastic surgeon depends on completing a plastic surgery (PS) residency. As medical school curricula for PS exposure are highly inconsistent, the authors investigated whether there was an association between the presence of PS elective rotations and/or home programs in medical schools with the proportion of students matriculating into integrated PS residency.

Methods: A list of 198 medical schools was compiled from the Association for American Medical Colleges and the American Association of Colleges of Osteopathic Medicine.

Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis.

Background: Although career choices are often shaped by training and mentors, it is not clear how training backgrounds have influenced whether plastic surgeons pursue leadership positions. Analysis of these training pathways can serve as a key component of career planning for future leaders.

Methods: The American Board of Plastic Surgery's annual was used to collate surgeons receiving board certification between 2002 and 2013.

The impact of surgical elective exposure during medical school upon residency match rates.

Objective: This study aims to investigate potential differences in surgical subspecialty match rates between medical schools with and without elective rotations in the respective surgical subspecialties.

Design: Data on duration of surgical rotations were retrieved from each school's public website. Fisher exact tests were performed to identify any statistically significant differences in surgical specialty match rates by allopathic versus osteopathic and elective clinical exposure.

Visibility of International Rotations on Plastic Surgery Program Websites.

Plastic surgery residency programs are offering increasing opportunities for international rotations, recognizing the importance of early exposure and the need to promote better capacity building in host countries. While a greater number of residency programs are offering international opportunities, it is not clear whether applicants are aware of these opportunities based on program websites. The purpose of this study was to determine the availability and ease of access to international rotation information on plastic surgery residency websites.

Predictors of Plastic Surgery Applicant Success: An Analysis of the Texas STAR Database.

Introduction: Integrated plastic surgery residency is one of the most competitive medical specialties. Although previous studies have surveyed integrated plastic surgery residency program directors regarding desired applicant characteristics, there is a paucity of literature assessing detailed application characteristics and reported match outcomes from applicants in recent application cycles. This study examines application characteristics associated with matching into integrated plastic surgery residency from 2017 to 2023.

Coverage of Congenital Anomalies: Ensuring Lasting Smiles Act in Legislation.

The Ensuring Lasting Smiles Act (ELSA) is a federal bill that would require all health federally regulated insurance products to cover the full treatment of a congenital anomaly or congenital disability until complete restoration of normal function or appearance. ELSA has been a key federal priority for the Legislative Advocacy Committee of the American Society of Plastic Surgeons since the 115th Congress in 2018. Although it has gained momentum, particularly in the 117th Congress, the bill remains stalled.

The Price of Productivity: Evaluating the Cost of a Research Year.

Objective: Research years during medical school are becoming increasingly common amongst applicants to competitive residency programs. As many of these positions are unpaid, it is important to consider the financial implications of these experiences and the feasibility of participation from students of all backgrounds. This study aims to quantify the cost of a research year during medical school.

Scalp Closure in Midline Cutis Aplasia-An Absolute Indication for Preoperative Imaging.

The ideal evaluation and treatment of aplasia cutis congenita remains disputed. We present a case of midline scalp cutis aplasia that healed by secondary intention, leaving an area of residual alopecia. There were no clinical indicators of an underlying calvarial defect.

Exploring uncertainty in hyper-viscoelastic properties of scalp skin through patient-specific finite element models for reconstructive surgery.

Understanding skin responses to external forces is crucial for post-cutaneous flap wound healing. However, the viscoelastic behavior of scalp skin remains poorly understood. Personalized virtual surgery simulations offer a way to study tissue responses in relevant 3D geometries.

Clinical Practice Patterns in Facelift Surgery: A 15-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery.

Background: This study evaluates change in practice patterns in facelift surgery based on a 15-year review of tracer data collected by the American Board of Plastic Surgery as part of the Continuous Certification process.

Methods: Tracer data for facelift was reviewed from 2006 to 2021. The 15-year collection period was divided into an "early cohort (EC)" from 2006 to 2014 and a "recent cohort (RC)" from 2015 to 2021.

12-Year Trends of Orofacial Clefts in the United States: Highlighting Racial/Ethnic Differences in Prevalence of Cleft Lip and Cleft Palate.

Objective: Discrepancies in prevalence among infants with orofacial clefts are public health research priorities. Our objective was to calculate updated estimated prevalence of orofacial clefts in the United States, with sub-analyses by racial/ethnic group.

Design: The National Birth Defect Prevention Network database was used to evaluate trends in cases with orofacial cleft in the United States from 2006 to 2018.