Patient Satisfaction Using BREAST-Q and Breast Implant Illness after Breast Reconstruction in Transwomen.

Background: Gender-affirming breast augmentation comprises an increasing portion of breast augmentations performed by plastic surgeons. Satisfaction and breast implant illness (BII) symptoms in this population have not been well studied. This study aimed to evaluate satisfaction and BII symptoms in transwomen who received nontextured implants as part of their breast reconstruction.

Sixteen hundred years of increasing tree cover prior to modern deforestation in Southern Amazon and Central Brazilian savannas.

Tropical ecosystems are under increasing pressure from land-use change and deforestation. Changes in tropical forest cover are expected to affect carbon and water cycling with important implications for climatic stability at global scales. A major roadblock for predicting how tropical deforestation affects climate is the lack of baseline conditions (i.

Vascular Perfusion of the Facial Skin: Implications in Allotransplantation of Facial Aesthetic Subunits.

Background: As the field of face transplantation develops, it may be possible to transplant segments of facial skin to replace facial aesthetic subunits in selected cases. The aim of this study was to identify the more reliable vascular pedicles of each facial aesthetic subunit for its use in transplantation METHODS:: Six full facial soft-tissue flaps were harvested, and the external carotid artery was identified and cannulated proximal to the facial artery. Next, radiopaque contrast was injected through the facial artery into three of the facial flaps and through the superficial temporal artery in the other three facial flaps.

Accuracy of Visual Estimates of Partial Flexor Tendon Lacerations.

Purpose: To determine whether hand surgeons could accurately and consistently estimate the size of partial flexor tendon lacerations.

Materials And Methods: Thirty-two partial flexor tendon lacerations were made in the flexor digitorum profundus tendons of a fresh-frozen cadaveric hand. Four hand surgeons and 5 residents estimated the size of the lacerations.

The Profunda Artery Perforator Flap: Investigating the Perforasome Using Three-Dimensional Computed Tomographic Angiography.

Background: The profunda artery perforator flap has been emerging as an alternative method of autologous breast reconstruction. This flap uses upper posterior thigh tissue. The profunda artery perforator perforasome is investigated using three-dimensional computed tomographic angiography.

Influence of using a single facial vein as outflow in full-face transplantation: A three-dimensional computed tomographic study.

Background: The aim of this study was to evaluate the contribution of a single unilateral facial vein in the venous outflow of total-face allograft using three-dimensional computed tomographic imaging techniques to further elucidate the mechanisms of venous complications following total-face transplant.

Methods: Full-face soft-tissue flaps were harvested from fresh adult human cadavers. A single facial vein was identified and injected distally to the submandibular gland with a radiopaque contrast (barium sulfate/gelatin mixture) in every specimen.

Mastopexy and reduction mammoplasty pedicles and skin resection patterns.

Mastopexy and reduction mammoplasty share techniques of pedicle formation and skin excision patterns, with the main difference being the amount of breast tissue resected. Various types of excision patterns and orientation of pedicles were developed throughout the years, each with flares of popularity at different times. This article reviews the multiple techniques of pedicle orientation and skin excision patterns separately and gives the advantages and disadvantages of each.

Lumbar and thoracic perforators: vascular anatomy and clinical implications.

Background: Pedicled perforator flaps in the thoracic and lumbar regions allow reconstruction of the posterior trunk. They enable reconstruction of various local defects without microvascular anastomoses and with minimal donor-site morbidity and excellent cosmesis. The authors examined the locations of perforators in the lumbar and thoracic regions.

Proximal peroneal perforator in dual-skin paddle configuration of fibula free flap for composite oral reconstruction.

Background: Composite defects of the oral cavity are often the result of trauma or advanced-stage tumor extirpation. The resultant deformity frequently requires a three-dimensional reconstruction of bone and soft-tissue. The fibula free flap is the preferred method of reconstruction, with various modifications focused on providing supplemental soft-tissue coverage.

Does empiric antibiotic therapy change MRSA [corrected] hand infection outcomes? Cost analysis of a randomized prospective trial in a county hospital.

Background: The incidence of community-acquired methicillin-resistant Staphylococcus aureus infections is rising at an alarming pace. Effective treatment has historically involved early débridement and antibiotic administration. This study was designed to prospectively determine the effectiveness of empiric therapy in treating hand infections.

Obturator nerve anatomy and relevance to one-stage facial reanimation: limitations of a retroperitoneal approach.

Background: Single-stage facial reanimation with a partial gracilis muscle coapted to the contralateral facial nerve seems an optimal surgical solution yet has not supplanted the two-stage approach. Insufficient obturator nerve length may limit reach to sizable contralateral facial nerve branches (possibly necessitating interposition nerve grafting), compromise optimal muscle positioning, or risk nerve coaptation under tension. This study evaluates whether retroperitoneal obturator nerve dissection would effectively lengthen the nerve, thus obviating the aforementioned limitations.

Nerve transfers for facial transplantation: a cadaveric study for motor and sensory restoration.

Background: Restoration of facial animation and sensation is highly important for the outcome after facial allotransplantation. The identification of healthy nerves for neurotization is of particular importance for successful nerve regeneration within the allograft. However, because of the severity of the initial injury and resultant scar formation, a lack of healthy nerve stumps in the recipient is a commonly encountered problem.

Free tissue transfers and replantation.

Learning Objectives: After studying this article, the participant should be able to: 1. Describe the indications and contraindications for free flap reconstruction. 2.

The free descending branch muscle-sparing latissimus dorsi flap: vascular anatomy and clinical applications.

Background: Increasing focus on reducing morbidity from latissimus dorsi flaps has led to the evolution of muscle-sparing variants and perforator-based flaps. This study aimed to investigate the vascular anatomy of the muscle-sparing variant and to describe its application as a free flap based on the descending branch of the thoracodorsal artery.

Methods: Twelve fresh cadavers underwent anatomical dissection and angiographic injection studies of the thoracodorsal arterial system.

Subcutaneous fat tissue engineering using autologous adipose-derived stem cells seeded onto a collagen scaffold.

Background: This pilot study examined the efficacy of 5-bromo-2-deoxyuridine-labeled autologous adipose-derived stem cells seeded onto collagen scaffolds to augment and/or regenerate the fat-enriched hypodermal tissue in an acute porcine wound model.

Methods: Porcine autologous adipose-derived stem cells were isolated and cultured. At passage 2, the cells were labeled with 5-bromo-2-deoxyuridine, seeded onto a three-dimensional collagen scaffold, and cultured for 10 days.

Modifications to extend the transverse upper gracilis flap in breast reconstruction: clinical series and results.

Background: The transverse myocutaneous gracilis flap has traditionally been used to reconstruct smaller breasts. The authors have been performing autologous breast reconstruction utilizing the flap with two types of modifications to increase flap volume: an extended and a vertical extended flap. In this article, they discuss the different operative techniques and present a clinical series of both flap types.

The low transverse extended latissimus dorsi flap based on fat compartments of the back for breast reconstruction: anatomical study and clinical results.

Background: Despite many modifications to the extended latissimus dorsi flap, its use in autologous breast reconstruction remains limited because of insufficient volume and donor-site morbidity. Through a detailed analysis of the deposition of back fat, this study describes a low transverse extended latissimus dorsi flap harvest technique that increases flap volumes and improves donor-site aesthetics.

Methods: Eight fresh cadaver hemibacks were used to identify the anatomical location of the fat compartments.

Dermolipectomy of the lateral thoracic fat compartment in secondary breast reconstruction revision: Anatomical and clinical results.

Unlabelled: Fullness in the lateral thoracic area following breast reconstruction can be a source of concern for patients. This redundant tissue creates disharmony between the newly reconstructed breast, the lateral mammary fold, and the lateral thoracic compartment. In this article we present the results of our anatomical/histological study, discuss the operative technique and present a clinical series of patients who underwent this procedure.

Aesthetic subunit of the breast: an analysis of women's preference and clinical implications.

Patient satisfaction in breast surgery is dependent on achieving a balance among all aesthetic subunits. The purpose of this study is to identify which subunit of the breast women consider important and correlate this clinically to improve patient satisfaction following breast surgery. A total of 313 subjects (ages, 20-80) were surveyed using a 25-point survey instrument collected via a telemedicine form.

Latissimus dorsi donor-site morbidity: the combination of quilting and fibrin sealant reduce length of drain placement and seroma rate.

Seroma formation has been shown to be a multifactorial process in part due to dead space and the formation of raw surfaces, which produce large quantities of serous exudate. The purpose of this study is to evaluate the effect of quilting/progressive tension sutures (to reduce dead space) and fibrin sealant (to seal the raw surface) in combination on the seroma rate and length of drain placement in patients undergoing latissimus dorsi breast reconstruction. A retrospective review of 43 patients undergoing latissimus dorsi flap breast reconstruction was performed.

Dorsal percutaneous cannulated screw fixation for delayed union and nonunion of the scaphoid.

Background: Percutaneous fixation of fractures of the scaphoid is well documented in the acute setting by both dorsal and volar methods. What is not commonly discussed is the use of this method for delayed unions and nonunions of the scaphoid. The authors present their case series of patients who underwent dorsal percutaneous fixation for delayed union or nonunion of the scaphoid.