BREAST-Q Measurement of the Patient Perspective in Oncoplastic Breast Surgery: A Systematic Review.

Background: Since BREAST-Q was developed in 2009, it has been widely used by clinicians and researchers to capture information regarding health-related quality of life (HRQoL) and patient satisfaction related to breast surgery. Yet clinical guidelines regarding the use of BREAST-Q for assessment of success of surgery in women with breast cancer remain limited. To maximize the benefits of using BREAST-Q to inform clinical decision making, this systematic review aimed to identify and appraise current evidence on patient-reported outcomes (PROs) assessed by BREAST-Q associated with breast oncoplastic surgery.

Adipose-Derived Stem Cells in Aesthetic Surgery: A Mixed Methods Evaluation of the Current Clinical Trial, Intellectual Property, and Regulatory Landscape.

Background: Adipose tissue, which can be readily harvested via a number of liposuction techniques, offers an easily accessible and abundant source of adipose-derived stem cells (ASCs). Consequently, ASCs have become an increasingly popular reconstructive option and a novel means of aesthetic soft tissue augmentation.

Objectives: This paper examines recent advances in the aesthetic surgery field, extending beyond traditional review formats to incorporate a comprehensive analysis of current clinical trials, adoption status, and the commercialization pathway.

Cell assisted lipotransfer in breast augmentation and reconstruction: A systematic review of safety, efficacy, use of patient reported outcomes and study quality.

Background: Cell assisted lipotransfer serves as a novel technique for both breast reconstruction and breast augmentation. This systematic review assesses the efficacy, safety and use of patient reported outcome measures in studies involving cell assisted lipotransfer. We also carry out an objective assessment of study quality focussing on recruitment, follow-up and provide an up-to-date clinical trial landscaping analysis.

The iBRA (implant breast reconstruction evaluation) study: protocol for a prospective multi-centre cohort study to inform the feasibility, design and conduct of a pragmatic randomised clinical trial comparing new techniques of implant-based breast reconstruction.

Background: Implant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure in the UK. The introduction of techniques to augment the subpectoral pocket has revolutionised the procedure, but there is a lack of high-quality outcome data to describe the safety or effectiveness of these techniques. Randomised controlled trials (RCTs) are the best way of comparing treatments, but surgical RCTs are challenging.

#PlasticSurgery.

Background: Social media use is growing inexorably, and there is public appetite for evidence-based information. Little is known about engagement by plastic surgeons with social media. The aim of this study was to examine posting about plastic surgery on Twitter, to best inform how board-certified plastic surgeons could use the hashtag #PlasticSurgery as a tool to educate patients and the public.

The evidence for natural therapeutics as potential anti-scarring agents in burn-related scarring.

Though survival rate following severe thermal injuries has improved, the incidence and treatment of scarring have not improved at the same speed. This review discusses the formation of scars and in particular the formation of hypertrophic scars. Further, though there is as yet no gold standard treatment for the prevention or treatment of scarring, a brief overview is included.

Design for Natural Breast Augmentation: The ICE Principle.

Background: The authors' published studies have helped define breast beauty in outlining key parameters that contribute to breast attractiveness. The "ICE" principle puts design into practice. It is a simplified formula for inframammary fold incision planning as part of the process for determining implant selection and placement to reproduce the 45:55 ratio previously described as fundamental to natural breast appearance.

Shapes, Proportions, and Variations in Breast Aesthetic Ideals: The Definition of Breast Beauty, Analysis, and Surgical Practice.

There are few objective analyses in the plastic surgical literature to define an aesthetically pleasing template for breast shape and proportion. The authors previously identified key objective parameters that define breast aesthetic ideals in 2 studies: an observational analysis of 100 models with natural breasts, and a population analysis with 1315 respondents. From these data a simple yet reproducible formula for surgical planning in breast augmentation has been developed to consistently achieve beautiful breasts, namely the ICE principle.

PET-CT imaging in patients with chronic sternal wound infections prior to reconstructive surgery: A case series.

Late presenting and recurrent sternal wound infections post-sternotomy are difficult to treat, with the clinical picture not necessarily reflecting the underlying problem. As a result of our experience, we suggest that these chronic cases should be managed using a different algorithm to acute sternal wound infection. Positron emission tomography combined with computerized tomography (PET-CT) imaging may be potentially useful in enabling accurate localization of disease sites, which guides adequate debridement prior to definitive reconstruction.

Role of reconstructive surgery in the management of head and neck cancer: a national outcomes analysis of 11,841 reconstructions.

Background: The quality of head and neck cancer reconstruction in England is not known. Hospital administrative data provides details of treatment within the English National Health Service and may be used for national outcomes analysis.

Methods: An algorithm for identifying head and neck surgery with flap-based reconstruction from administrative data was constructed and validated against information from three cancer units.

Population analysis of the perfect breast: a morphometric analysis.

Background: The authors previously identified key objective parameters that define the aesthetic ideal of the breast in a study of 100 models with natural breasts. In this follow-up article, the opinion of the general public on ideal breast proportions was surveyed.

Methods: One thousand three hundred fifteen respondents were asked to rank the attractiveness of images of four women with varying breast sizes.

The growth factors involved in flexor tendon repair and adhesion formation.

Flexor tendon injuries remain a significant clinical problem, owing to the formation of adhesions or tendon rupture. A number of strategies have been tried to improve outcomes, but as yet none are routinely used in clinical practice. Understanding the role that growth factors play in tendon repair should enable a more targeted approach to be developed to improve the results of flexor tendon repair.

Subfascial harvest of the extended latissimus dorsi myocutaneous flap in breast reconstruction: a comparative analysis of two techniques.

Background: Widespread adoption of the extended latissimus dorsi myocutaneous flap in breast reconstruction has been limited by donor-site complications. The dissection plane may be either above or below the superficial layer of the thoracolumbar fascia, which may be transferred with the flap or retained on the back skin flaps. The aim of this study was to investigate whether varying the plane of dissection improves donor-site morbidity and complications.

Survival of a pedicled latissimus dorsi flap in breast reconstruction without a thoracodorsal pedicle.

The latissimus dorsi flap, first performed by Tansini in 1892, was popularised for use by Olivari in 1976. The successful transfer of a latissimus dorsi flap during breast reconstruction has previously been thought to be dependent on having an intact thoracodorsal pedicle to ensure flap survival. It is well documented that the flap may also survive on the serratus branch in thoracodorsal pedicle division.

Delayed repair in a case of forearm fascial muscle herniation using non-cross-linked acellular porcine dermal matrix.

The options for treatment of symptomatic muscle herniation in the limbs traditionally include fasciotomy, direct repair, tendon weave graft (palmaris longus), fascial graft (tensor fascia lata), and synthetic mesh (prolene). A recent case report has described the use of acellular cadaveric dermal matrix to reconstruct fascial defects in 2 cases. We describe the use of Strattice, a non-cross-linked acellular porcine dermal matrix, as a fascial underlay graft in a case of symptomatic upper limb muscle herniation.

iGuide to plastic surgery: iPhone apps, the plastic surgeon, and the health care environment.

The growth in the adoption of smartphones among clinicians has been phenomenal. The demand for medical applications, or "apps," downloaded by smartphone users has led to the development of practical and educational apps for clinicians, medical students, and patients. In addition to being a valuable resource for the clinician, mobile technologies are revolutionizing the nature and delivery of health care services.