Fine tuning lipoaspirate viability for fat grafting.

Background: The efficient harvest of abundant viable adipocytes for grafting is of considerable interest. Hand aspiration, low-g-force, short-duration centrifugation, and harvest of the lower sublayer of fat centrifugate maximize viable adiopocytes, but this process is cumbersome with conventional equipment. The Lipose Corporation (Greenwich, Conn.

Risk factors and complications in reduction mammaplasty: novel associations and preoperative assessment.

Background: Although risk factors for complications following reduction mammaplasty are well known, it is difficult to assess risk for specific complications among patients with multiple factors or varying gradations of a single factor. The purpose of this study was to identify all associations between patient characteristics and specific complications and to quantify the risk attributable to these factors, to assess a prospective patient's individualized risk.

Methods: Patient characteristics and complications were identified through retrospective chart review of a consecutive series of patients who underwent Wise-pattern, inferior-pedicle reduction mammaplasty performed by the senior author (C.

A prospective, randomized, double-blind, controlled trial of continuous local anesthetic infusion in cosmetic breast augmentation.

Background: Narcotic pain medications are a significant component of most postoperative pain control regimens. Although they are usually effective, they produce several untoward side effects and sometimes provide inadequate analgesia. The continuous infusion of local anesthetic agents (via pain pump) has been used to supplement narcotic analgesics after various surgical procedures.

Safety and aesthetic improvement using the omega pattern reduction mammaplasty after breast conservation surgery and radiation therapy.

Background: With the continued popularity of lumpectomy and radiation therapy for many early-stage breast cancer patients, a considerable number of large-breasted patients are being identified who are unhappy with subsequent asymmetry and cosmetic distortion and symptoms related to their macromastia. Bilateral reduction mammaplasty is the most direct means of achieving size balance, improving cosmesis, and relieving symptoms related to macromastia. However, most plastic surgeons are fearful of reduction of the irradiated breast using traditional pedicle techniques for nipple transfer.

The effect of herbal medicines on platelet function: an in vivo experiment and review of the literature.

Background: Herbal medicines are used by a considerable number of surgical patients. An increased risk of bleeding, substantiated by anecdotal reports, has been attributed to the use of certain herbs, and numerous in vitro experiments have identified some herbal extracts as platelet inhibitors. The purpose of this investigation was to determine whether standard commercial preparations of commonly used herbal medicines have an effect on platelet function in vivo and, by extension, to provide clinical scientific evidence of the safety of their use in the perioperative period.

The effect of tirofiban on microvascular thrombosis: crush model.

Background: Microvascular anastomotic thrombosis is a significant clinical problem, particularly in crush and avulsion injuries. Platelet deposition plays a particularly important role in the initiation and propagation of microvascular thrombosis, whereas thrombin has little effect in the acute phase of thrombus formation. Nevertheless, heparin (a specific thrombin inhibitor) remains the most widely used microvascular irrigant.

Mitochondrial DNA mutations in breast cancer tissue and in matched nipple aspirate fluid.

Unlike nuclear (n)DNA, of which there is one paired copy per cell, there are many copies of mitochondrial (mt)DNA per cell, making PCR amplification of mtDNA easier in samples of limited cellularity. The aims of this study were to (i) determine the mutation patterns of breast cancers through a comprehensive screen of mtDNA mutations, and (ii) assess if mutations in the cancers are also detectable in breast nipple aspirate fluid (NAF), a physiologic fluid which contains shed ductal epithelial cells. Fifteen breast cancers, matched benign tissues and NAF were collected.

Analysis of freshwater pathogens: a guide to rational empiric antibiotic coverage.

Fresh water injuries are often contaminated with bacteria that are not typically encountered in other wounds. Their treatment should include empiric administration of appropriate antibiotics. This study identifies the most common pathogens found in the Lake of the Ozarks and their antibiotic sensitivity.

Intraoperative tissue expansion in rhytidectomy revisited.

Intraoperative tissue expansion is an adjunct that has been used during rhytidectomy to rejuvenate the face and neck. This technique has been thought to allow for additional skin resection and, thus, increased skin tightening during rhytidectomy. The stretch of the skin by expansion should allow for additional skin resection before closure.

Analysis of lipocyte viability after liposuction.

Free fat grafts from liposuction aspirate can be used as donor material for soft-tissue augmentation. The purpose of this study was to attempt to identify a subpopulation of adipose cells within liposuction aspirate with the greatest viability and, it is hoped, a greater chance for increased survival after transplantation. Liposuction samples were obtained from 20 individuals (16 women, four men; age range, 27 to 49 years).