Updates on Breast Reconstruction: Surgical Techniques, Challenges, and Future Directions.

The increasing global incidence of breast cancer underscores the significance of breast reconstruction in enhancing patients' quality of life. Breast reconstruction primarily falls into two categories: implant-based techniques and autologous tissue transfers. In this study, we present a comprehensive review of various aspects of implant-based reconstruction, including different types of implants, surgical techniques, and their respective advantages and disadvantages.

Science-Based Mobile Apps for Reducing Anxiety: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis examines the effectiveness of science-based mobile apps for reducing anxiety. A systematic review was employed to identify experimental studies on science-based mobile applications developed anxiety disorders. International databases such as PubMed, Web of Science, SCOPUS and ProQuest were searched to locate relevant articles.

Seroma After Breast Reconstruction With Tissue Expanders: Outcomes and Management.

Background: Seroma is a relatively common complication after breast reconstruction with tissue expanders. The main risk in the presence of seroma is development of periprosthetic infection, which can lead to implant loss. Our goals were to identify risk factors for seroma, and to describe our protocol for managing fluid accumulation.

Broad-Spectrum Antibiotics for Breast Expander/Implant Infection: Treatment-Related Adverse Events and Outcomes.

Background: Despite best practices, infection remains the most common complication after breast reconstruction with expanders and implants, ranging from 2% to 29%. Empiric broad-spectrum antibiotics are frequently used in nonsurgical treatment of implant-associated infections in an effort to salvage the reconstruction. Pitfalls of antibiotherapy include adverse events, vascular access site complications, and drug resistance.

Bilateral immediate two-stage breast reconstruction in patients with unilateral breast cancer: Outcomes analysis and risk assessment.

Introduction: Contralateral prophylactic mastectomy has the potential to decrease the occurrence of cancer and reduce psychological burden. However, it is known that complications after bilateral mastectomy are higher compared with unilateral mastectomy. Our goal was to evaluate outcomes of immediate breast reconstruction in patients undergoing bilateral mastectomy and to compare complication rates between therapeutic and prophylactic sides.

Management of Expander- and Implant-Associated Infections in Breast Reconstruction.

Background: Periprosthetic infection remains the most common complication after implant-based breast reconstruction. Objectives of the study were to (1) describe our clinical approach and treatment protocol for managing patients with suspected periprosthetic infection, (2) identify the microorganisms causing periprosthetic infections at our institute, and (3) report on outcomes of implant salvage versus explantation.

Methods: A retrospective chart review of patients who were treated with parenteral antibiotics for periprosthetic infection was carried out.

Plastic Surgery and the COVID-19 Pandemic: A Review of Clinical Guidelines.

Background: A novel coronavirus disease (COVID-19) was first reported in December 2019 in China and was soon declared a pandemic by the World Health Organization. Many elective and nonessential surgeries were postponed worldwide in an effort to minimize spread of disease, as well as to conserve resources. Our goal with this article is to review current practice guidelines in setting of the COVID-19 pandemic, based on available data and literature.

Expander/Implant Removal After Breast Reconstruction: Analysis of Risk Factors and Timeline.

Introduction: Removal of tissue expanders (TE) or implants is a dire consequence of breast reconstruction, and has the potential to halt the reconstructive efforts. Our goals were to characterize a cohort of patients with TE/implant removal, to perform a time-based analysis, and to review the bacteriology associated with explanted devices.

Materials And Methods: Review of a prospectively maintained database was performed to identify patients who underwent TE/implant removal.

Role of tissue expansion in abdominal wall reconstruction: A systematic evidence-based review.

Background: Tissue expanders (TEs) can be used to assist primary closure of complicated hernias and large abdominal wall defects. However, there is no consensus regarding the optimal technique, use, or associated risk of TE in abdominal wall reconstruction.

Methods: A systematic search of PubMed and Embase databases was conducted to identify articles reporting abdominal wall reconstruction with TE techniques.

Combined submuscular tissue expansion and anterior component separation technique for abdominal wall reconstruction: Long-term outcome analysis.

Background: We report the long-term outcome analysis of 12 patients who underwent two-stage abdominal wall reconstruction using combined submuscular tissue expansion and anterior components separation (CS) technique.

Methods: Outcome measures were (1) the patients were assessed for the presence or absence of recurrence; (2) patient-reported outcomes on physical functioning in relation with the abdominal wall reconstruction were evaluated using the SF 36-item health survey.

Results: The mean age, average expansion volume, and mean time expansion were 37.

Free vascularized lymph node transfer for treatment of lymphedema: A systematic evidence based review.

Background: Free vascularized lymph node transfer (VLNT) is a relatively novel technique for treatment of lymphedema. The purpose of this systematic review was to evaluate the current evidence on VLNT and to determine if there is objective data concerning improved outcomes.

Methods: A literature search of PubMed, EMBASE and CENTRAL electronic databases was conducted to identify articles written in the English language on VLNT for treatment of lymphedema.

Treatment of Foot Degloving Injury With Aid of Negative Pressure Wound Therapy and Dermal Regeneration Template.

Degloving injury of the foot continues to be a challenging condition to treat. Despite current advancements in reconstructive options, most of these injuries can result in amputations, causing physical and emotional impairment. Few reports have been published on the management of these complex traumatic injuries.

The relationship of the marginal mandibular nerve to the mandibular osseocutaneous ligament and lesser ligaments of the lower face.

Background: An in-depth understanding of the nuances of facial anatomy is the best means of preventing complications during facelift surgery. An appreciation of the operative details is complicated not only by the complexity of the anatomy but also by the variability in the nomenclature used.

Objectives: The authors have attempted to clarify these issues by detailing the relationships of the ligaments of the lower face both to each other and to the marginal mandibular nerve.

Skin sterility after application of a vapocoolant spray.

Background: Refrigerant sprays have been widely used to reduce pain in the office setting. However, more recently, their use has been limited by both concern regarding flammability and questions of bacterial contamination.

Objective: We investigated the microbiological effect of 1,1,1,3,3 pentafluoropropane and 1,1,1,2-tetrafluoroethane when sprayed after povidone-iodine application in 50 volunteers.

An Analysis of Current Techniques Used for Intraoperative Flap Evaluation.

Background: Over the last decade, microsurgeons have used a greater variety of more complex flaps. At the same time, microsurgeons have also become more interested in technology, such as indocyanine green (ICG) angiography, dynamic infrared thermography (DIRT), and photospectrometry, for preoperative planning and postoperative monitoring. These technologies are now migrating into the operating room, and are used to optimize flap design and to identify areas of hypoperfusion or problems with the anastomoses.

Variables affecting postoperative tissue perfusion monitoring in free flap breast reconstruction.

Postoperative flap monitoring is a key component for successful free tissue transfer. Tissue oxygen saturation measurement (TOx) with near-infrared spectrophotometry (NIRS) is a method used for this purpose. The aim of this study was to identify external variables that can affect TOx.

Predicting skin flap viability using a new intraoperative tissue oximetry sensor: a feasibility study in pigs.

Background:  Operations for soft-tissue reconstruction, orthopedic, vascular, and other types of surgery can be complicated by unexpected skin flap necrosis. At present, surgeons utilize subjective clinical judgment and physical findings to estimate the potential for tissue compromise. As the validity of these subjective methods is questionable, there is a need for objective, quantitative tools to determine the risk of flap necrosis during surgery.

Defining the fat compartments in the neck: a cadaver study.

Background: Cervicoplasty is an important component of aesthetic facial and neck surgery, but the fat content in this area has not been described.

Objectives: The authors identify anatomic compartments of fat in the neck (specifically the areas relevant to surgical management), quantify the fat in each compartment, and describe the relationships between each compartment and the submandibular glands.

Methods: The skin was removed from 10 fresh cadaver heads.

Feasibility of using external jugular vein and its branches as Y- and X-shaped vein grafts for bridging of arterial defects and providing additional arterial sources for free flap applications in rat model.

Background: Venous grafting has been widely used in microsurgical training. Different types of vascular grafts have been described in experimental models. In this study we describe for the first time the Y- and X-shaped vein grafts (YVG, XVG) with accompanying drain-out branches as a new tool for the microsurgical training and free flap applications in rats.

Achieving patient satisfaction in abdominally based free flap breast reconstruction: correlation with body mass index subgroups and weight loss.

Background: The goal of this study was to evaluate the relationship between body mass index, preoperative weight loss, and patient satisfaction in breast reconstruction with abdominally based free flaps.

Methods: A custom survey with overall, breast, and abdomen questions was sent to patients who underwent abdominally based free flap breast reconstruction over the past 4 years. Clinical data were collected for patients who returned surveys.

A failsafe method to avoid injury to the great auricular nerve.

Background: The great auricular nerve (GAN) is the most commonly injured nerve during facelift surgery. Although rare, injury can result in long-term sequelae.

Objectives: Previous reports have described the nerve's location at the midbelly of the sternocleidomastoid muscle (SCM) or at its emergence from underneath the SCM.

Outcomes assessment of combination face lift and perioral phenol-croton oil peel.

Background: Face-lift surgery when combined with perioral phenol-croton oil peel is an underappreciated tool for face rejuvenation. The procedure results in significant central face skin tightening and wrinkle reduction.

Methods: A retrospective review of 47 consecutive patients who underwent simultaneous face lift and perioral peel was performed.

Dentition, bone loss, and the aging of the mandible.

Background: Facial aging is a dynamic process with impact on both the soft tissues and the bones. Despite a growing body of evidence, controversy still exists regarding absolute characteristics of the aging facial skeleton.

Objective: The purpose of this study was to investigate various mandibular measurements in different age groups and to delineate the relation of the dentition to these parameters.

Complications following injection of soft-tissue fillers.

Background: Soft-tissue filler injection is a very common procedure in the United States. Although the safety profile is favorable, adverse events (AE) can occur, ranging from mild to severe in intensity.

Objectives: The authors performed a literature search to identify the facial sites most prone to severe complications.

Breast reconstruction with abdominal-based free flaps in high body mass index population: postoperative complications and impact of weight loss.

Obesity, which is becoming endemic in the United States, causes a significant challenge for reconstructive surgeons. This study evaluates postoperative complications and impact of weight loss in the high body mass index (BMI) population undergoing breast reconstruction with abdominal free flaps. A retrospective review of 182 consecutive patients was performed.