Prepectoral Two-Stage Implant-Based Breast Reconstruction with Poly-4-Hydroxybutyrate for Pocket Control without the Use of Acellular Dermal Matrix: A 4-Year Review.

Background: Absorbable mesh has been used to mitigate the potential drawbacks of acellular dermal matrix (ADM)-based breast reconstruction. Poly-4-hydroxybutyrate (P4HB) has been demonstrated to be a lower-cost, safe, and effective alternative to ADM in subpectoral breast reconstruction. In this study, the authors used P4HB for pocket control and implant support in immediate two-stage prepectoral breast reconstruction, examining nonintegration, capsular contracture, implant malposition, patient comorbidities, and risk factors.

The "Smile Mastopexy": A Novel Technique to Aesthetically Address the Excess Skin Envelope in Large, Ptotic Breasts While Preserving Nipple Areolar Complex During Prosthetic Breast Reconstruction.

Background: Classically large, ptotic breasts have been a contraindication for nipple preservation during breast reconstruction. We present a technique of "smile mastopexy" (SM) to reduce the excess skin in both vertical and transverse directions, avoid a T-junction, preserve the nipple areolar complex, and add thickness to the upper pole of the breast at the time of mastectomy.

Objectives: The authors sought to demonstrate the safety and reliability of a novel technique that addresses the excess skin envelope during breast reconstruction while preserving the nipple-areola complex in large, ptotic breasts.

Periprosthetic Fluid Analysis in the Diagnosis of Breast Implant Infections Using Cell Count and Differential.

Background: One of the most devastating complications following implant-based breast reconstruction is periprosthetic infection. Making a prompt and accurate diagnosis has been a challenge as plastic surgeons are limited by nonspecific systemic markers of infection, clinical examination findings, or imaging modalities.

Objectives: The aim of this study is to evaluate the use of periprosthetic fluid using cell count and differential as an aid in the diagnosis of infection.

Inadvertent Rupture of a Silicone Breast Implant during Fat Grafting: Surgical and Radiological Findings.

Autologous fat grafting is a common, relatively safe procedure for breast augmentation and reconstruction. The most commonly reported complications tend to be fat necrosis and oil cysts. The incidence of rare events, such as breast implant rupture, is likely underreported.

Infectious Flexor Tenosynovitis Following Trigger Finger Release: Incidence and Risk Factors.

Trigger finger release (TFR) is one of the most commonly performed hand procedures and typically results in restoration of normal finger function. However, uncommon postoperative complications such as deep infection can have devastating consequences. The goal of this study was to evaluate the incidence, risk factors, and characteristics of infectious flexor tenosynovitis occurring after TFR.

Validation of the "Wisconsin Criteria" for Obtaining Dedicated Facial Imaging and Its Financial Impact at a Level 1 Trauma Center.

Introduction: According to national trauma databases, 25% of all people injured have some type of facial injury. The gold standard for diagnosing bony trauma of the facial skeleton has been computed tomography (CT) scan. In 2011, the "Wisconsin criteria" were established and subsequently validated as a method to predict which patients truly have a facial fracture and warrant further imaging.

Transfusion-Free Cranial Vault Remodeling: A Novel, Multifaceted Approach.

Background: Approximately one in 2000 babies are born with craniosynostosis, and primary open repair is typically performed before 1 year of age. Historically, the procedure has been associated with nearly 100 percent transfusion rates. To decrease the rates of transfusion, the authors' center has developed a novel multimodal blood conservation protocol.