Defining Internal Tissue Closure: High-Resolution Ultrasound Evaluation of Interi-A Novel Internal Tissue Closure System.

Background: Seroma remains a leading postsurgical complication in plastic surgery. Conventional drains are ineffective in clearing blood and fluid and closing down surgical spaces. The Interi (Internal Closure System, IC Surgical, Grand Rapids, MI) is comprised of a novel branching internal manifold attached to a self-contained portable pump with a higher, consistent, continuous negative pressure, may reduce this long-standing issue.

Various Properties of Silicone Breast Implant Surfaces and Multimodal Techniques for the Functional Surface Modification.

"Silicone breast implants are the most widely used medical devices for breast reconstruction and augmentation, and revision, but even after more than 60 years of use they are associated with multiple continued complications. Using advancement in current technologies, researchers are attempting to create an optimal implant surface for patients. Through these efforts, plastic surgeons and material researchers have made great progress in the field of implant research.

The Nomenclature, Terminology and Lexicon of Breast Surgery: Are We Really Saying the Same Thing?

This study investigated inconsistencies in the use of descriptors in breast surgery and recommends a novel nomenclature that will be adopted and standardized among plastic surgeons. The study used a modified Delphi methodology to first identify redundant descriptors or those with multiple interpretations, and then achieve consensus on ideal recommended nomenclature in breast surgery. The Delphi panel agreed that there was misuse of and lack of a clear definition for several terms, and recommended removal of these subjective terms.

Why Do We Need Anatomical Implants? the Science and Rationale for Maintaining Their Availability and Use in Breast Surgery.

The choice between anatomical and round implants is an important decision in breast augmentation surgery; however, both have their place and the decision between them that should be made on a patient-by-patient basis, taking into account the patient's desires, anatomy, and surgical history. In some individuals, there are clear indications for using either anatomical or round devices, and there is good evidence that aesthetic outcomes are better with anatomical implants in some instances. When both types are an option, anatomical devices may offer increased flexibility and, despite a longer learning curve needed to properly manage them, they are associated with positive long-term outcomes and high levels of patient satisfaction.

Physical Properties of Silicone Gel Breast Implants.

Background: Surgical applications using breast implants are individualized operations to fill and shape the breast. Physical properties beyond shape, size, and surface texture are important considerations during implant selection.

Objectives: Compare form stability, gel material properties, and shell thickness of textured shaped, textured round, and smooth round breast implants from 4 manufacturers: Allergan, Mentor, Sientra, and Establishment Labs, through bench testing.

Clinical Applications of Barbed Suture in Aesthetic Breast Surgery.

The breadth of literature regarding barbed suture applications in plastic surgical procedures and of importance to this article, barbed suture applications in breast surgery, is growing dramatically as surgical practitioners are becoming more familiar with the advantages of this new suture technology. Barbed suture devices were first implemented by plastic surgeons for the use in various minimally invasive techniques for facial rejuvenation, but have now surpassed these applications and are now much more commonly used in Breast and Body closures.

Weight Measurement and Volumetric Displacement of Breast Implants and Tissue Expanders: Why Port and Shell Volumes Matter in Breast Reconstruction, Augmentation, and Revision.

There are significant differences in weight and volumetric characteristics between silicone and saline breast implants of which most plastic surgeons are unaware. Phase I of this study was a weight measurement focused on recording differences in the weight of saline volumes instilled versus recorded weights of saline implants and expanders. Phase II compared displaced volume differences of tissue expanders with instilled volumes.

The Laminated Nature of the Pectoralis Major Muscle and the Redefinition of the Inframammary Fold: Clinical Implications in Aesthetic and Reconstructive Breast Surgery.

The breast is appreciated aesthetically and clinically for its shape, projection, and volume. Surgical techniques have evolved to manipulate the breast skin envelope, soft tissues, and chest wall anatomy, with and without prosthetic devices. The pectoralis major specifically is altered for pocket dissection and implant coverage.

The Standardization of Bra Cup Measurements: Redefining Bra Sizing Language.

There are many challenges in developing a standardized bra cup system, the most significant being that bra cup sizes are a continuum. Women's breasts occur as a fluid range of shapes, sizes, and volumes. Patients have specific expectations regarding bra cup size, and failure to achieve expectations remains the leading cause of patient dissatisfaction.

The development of SERI® Surgical Scaffold, an engineered biological scaffold.

The primary goal of reconstructive and revision surgery is to restore, repair, rebuild, and support damaged, weakened, or absent tissue. There are numerous approaches for soft tissue support and repair, including the use of autologous tissue, human- or animal-derived acellular dermal matrices, absorbable or permanent synthetic mesh, and, now, a new class of bioresorbable protein scaffold. Although many factors influence the choice of surgical approach and the specific product used for soft tissue support and repair, the goal is to improve long-term outcomes while minimizing complications and recurrences requiring further revisional surgery.

Ten-year results from the Natrelle 410 anatomical form-stable silicone breast implant core study.

Background: Silicone breast implants have long been used for breast augmentation and reconstruction. During this time, these medical devices have gone through a number of modifications to improve their safety, quality, and clinical outcome performance.

Objectives: The authors conducted a 10-year study to determine the safety and effectiveness of Natrelle 410 silicone breast implants.

Clinical application of a silk fibroin protein biologic scaffold for abdominal wall fascial reinforcement.

Background: Preclinical studies have demonstrated that macroporous silk fibroin protein scaffolds are capable of promoting physiologically durable supportive tissue, which favors application of these engineered tissues for clinical implantation. The safety and effectiveness of a long-lasting, transitory, 510(k)-cleared purified silk fibroin biologic scaffold (SBS) are investigated for soft-tissue support and repair of the abdominal wall.

Methods: We conducted a multicenter retrospective review of all consecutive patients who underwent abdominal wall soft-tissue reinforcement with an SBS device between 2011 and 2013.

Acellular dermal matrices in secondary aesthetic breast surgery: indications, techniques, and outcomes.

Acellular dermal matrices are integrally involved in the majority of expander-implant reconstructions and complex hernia repairs today, and they are now making their way into secondary aesthetic breast surgery. The number of revisional breast surgery cases has continued to increase as the materials and repair techniques have improved. The aesthetic outcome bar is constantly being raised, and the complexity of patient deformities often requires additional tissues to achieve a successful repair.

Natrelle style 410 form-stable silicone breast implants: core study results at 6 years.

Background: The Natrelle Style 410 shaped, form-stable silicone gel implant (Allergan, Inc; Irvine, California) has been the subject of a pivotal study that supports potential US Food and Drug Administration approval of the device. The 3-year results of this study were reported previously.

Objectives: The authors update the safety and effectiveness findings for the Natrelle Style 410 implants through 6 years of study.

Emerging applications for acellular dermal matrices in mastopexy.

This article explores whether some new acellular dermal matrices (ADMs) can be applied to breast augmentation or reconstruction revision, and particularly whether they can withstand the centripetal pull and prevent recurrent stretch deformities following periareolar mastopexy. Acellular dermis use in breast reconstruction and aesthetic breast revision is a fortuitous development, because their original purpose was for burn reconstruction. Although level 1 evidence remains lacking, ADMs have become integral adjuncts in breast reconstruction, complex hernia, and aesthetic breast revision.