Publications by authors named "David Alper"

Background: Brassiere (bra) size is commonly used when patients and plastic surgeons discuss breast procedures. Variations in sizing between manufacturers can affect patient-surgeon communication and postoperative satisfaction. This study quantifies bra cup volume across alphanumeric sizes and manufacturers to describe variance and improve preoperative communication for shared decision-making.

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Purpose: Facial feminization surgery (FFS) is associated with improved psychological outcomes in transgender patients. We aimed to evaluate the impact of FFS on patient satisfaction with facial appearance using validated, patient-reported outcome tools.

Methods: Patients were recruited to complete a FACE-Q survey at least 6 months after their FFS.

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Background: Dermal filler injections pose serious risks when administered by untrained individuals or when food and drug administration (FDA) guidelines are not adhered to. This issue may potentially be compounded by a growing reliance on social media platforms for health information.

Objective: Our objective was to analyze the quality of health information in videos published on dermal filler on TikTok.

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Introduction: With the recent transition to smooth tissue expanders (TEs), functional differences between TE subtypes have not been fully elucidated. This study evaluated the differences in TE characteristics and complications between 2 commonly used Mentor smooth TE models, Artoura and CPX4.

Methods: A retrospective review of patients who received either smooth Mentor Artoura or CPX4 TE from 2012 to 2022 was conducted.

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Virtual surgical planning (VSP) has benefits in craniofacial surgery with growing popularity. However, while specific use cases are highlighted in the literature, no studies exist providing an overview of VSP use among craniofacial surgeons, and little is known about the extent of exposure to VSP during plastic surgery training. This study surveyed members of The American Society of Maxillofacial Surgeons (ASMS) to better characterize both the landscape of VSP use among practicing craniofacial surgeons and the extent of exposure to VSP throughout surgical training.

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Background: Children with metopic synostosis have been found to have more neurocognitive and behavioral difficulties. The variables that may affect future neurodevelopmental outcomes, including presenting morphologic severity, have not been fully studied. In the largest study to date, we aimed to assess what portends worse neurocognitive and behavioral outcomes at school age.

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Objective: Previous work identified an association between genetics and neurodevelopmental delays in patients with nonsyndromic craniosynostosis. The authors investigated the role of genetic mutations on behavioral outcomes of patients with treated sagittal synostosis.

Methods: Parents of children aged 6-18 years with surgically corrected sagittal synostosis were recruited to complete the Child Behavioral Checklist (overall behavioral problems), Conners 3rd Edition-Parent (attention-deficit/hyperactivity disorder), Social Responsiveness Scale 2nd Edition (autism spectrum disorder [ASD]), and Behavior Rating Inventory of Executive Function 2nd Edition (executive function).

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Purpose: Children with surgically corrected nonsyndromic craniosynostosis have been previously found to have neurocognitive and behavioral difficulties. Children with metopic synostosis have been described to have more difficulties than children with sagittal synostosis. This study aims to characterize the behavioral differences between children with metopic and sagittal synostosis.

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Background: Favorable behavioral interactions are critical for academic and interpersonal success. An association between metopic synostosis and behavioral impairments has not been fully elucidated. Behavioral dysfunction in school-age children with surgically corrected metopic synostosis was evaluated using targeted testing to detect the most common behavioral abnormalities in this population.

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Background: Rhinoplasty is one of the most commonly performed facial gender-affirming surgeries (FGASs) for transgender females, but well-established morphometric parameters describing feminizing nasal changes do not exist.

Objectives: Describe the author's technique for feminization rhinoplasty, analyze the changes in 3-dimensional nasal anthropomorphic parameters, and describe patient-reported outcomes.

Methods: Three-dimensional photogrammetric evaluation was performed both preoperatively and postoperatively in transgender female patients who underwent FGAS.

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Facial feminization surgery (FFS) is characterized by a series of relatively diverse procedures aimed at aligning skeletal and soft tissue facial appearance with one's experienced feminine gender. Although there are several well-described outcomes from surgical techniques, there is no standardized methodology to provide reliable analyses of postoperative FFS outcomes. This paper describes the first reliable and reproducible technique to accurately and consistently measure post-FFS changes to guide surgical planning to optimize patient outcomes.

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Background: Facial feminization surgery (FFS) has been associated with improving gender dysphoria in transgender patients. This study aimed to quantify the impact of surgery on patient facial satisfaction, using the FACE-Q and a quality-of-life (QoL) survey.

Methods: Transgender female patients were recruited to complete the FACE-Q and the World Health Organization's QoL Scale-Short Form (WHOQOL-BREF) if they were planning to or had undergone FFS at our institution.

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Background: Control of nasal tip position is critical to final rhinoplasty outcomes. Two frequent methods of exerting tip control are columellar strut and caudal septal extension graft (SEG). Past work has demonstrated that SEG are better able to preserve tip position.

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Measures of success for facial feminization surgery (FFS) have previously included improved rates of external gender perception as female and patient-reported outcome measures. In this study, we used artificial intelligence facial recognition software to objectively evaluate the effects of FFS on both perceived gender and age among male-to-female transgender patients, as well as their relationship with patient facial satisfaction. Standardized frontal preoperative and postoperative images of 27 transgender women undergoing FFS were analyzed by Amazon's AI facial recognition software to determine gender, femininity confidence score, and perceived age.

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Cranial vault remodeling (CVR) with and without frontal orbital advancement remodels the skull in craniosynostosis. Virtual surgical planning (VSP) for preoperative planning has been previously shown to be effective in CVR. In this study, the authors aimed to evaluate the impact of VSP on operative and perioperative efficiency for craniosynostosis surgery.

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Article Synopsis
  • This study investigates how the severity of metopic synostosis, measured by artificial intelligence, impacts long-term neurocognitive outcomes in children.
  • Results show that greater severity correlates with lower reading comprehension and that older age at surgery is linked to poorer visuomotor integration scores.
  • The findings suggest that timely surgical correction might help address neurodevelopmental challenges associated with the condition.
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Introduction: Ear molding is a safe, non-surgical approach to treat newborns with congenital ear anomalies. In this study, we aimed to investigate long-term aesthetic outcomes and caretaker satisfaction from ear molding therapy.

Methods: A retrospective chart review from 2018 to 2020 was conducted for infants who underwent ear molding treatment at our institution.

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Background: A comprehensive comparison of surgical, aesthetic, and quality of life outcomes by reduction mammaplasty technique does not exist. We sought to ascertain the effect of technique on clinical, aesthetic, and patient-reported outcomes.

Methods: Patients with symptomatic macromastia undergoing a superomedial or inferior pedicle reduction mammoplasty by a single surgeon were identified.

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Article Synopsis
  • * A retrospective review compared outcomes between 12 patients using Vicryl mesh and 34 patients using traditional acellular dermal matrices, focusing on complications, operative time, and costs.
  • * The Vicryl group showed low complication rates and required significantly less surgical time (35.7 min vs. 68.0 min), resulting in a cost savings of $8,273 per breast compared to the acellular dermal matrix method.
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Article Synopsis
  • - The study evaluates the quality and readability of online resources about Facial Feminization Surgery (FFS), aiming to improve patient understanding and outcomes.
  • - Analyzing 120 websites revealed that the average readability was at an 11.68 grade level, with most sites rated poorly on important quality metrics, such as clarity and support resources.
  • - Community-based websites tended to provide clearer descriptions of FFS processes and benefits, but academic sites were less biased and offered more support information.
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Article Synopsis
  • Tranexamic acid (TXA) is often used in surgeries like facial feminization but raises concerns about potential venous thromboembolic events (VTE) due to its prothrombotic nature.
  • A study reviewed 79 facial feminization surgeries conducted between 2015 and 2022, focusing on patients' demographics, surgical procedures, and outcomes related to TXA usage and anticoagulation.
  • The findings indicated no significant increase in VTE rates or other complications between patients who received TXA and those who didn't, suggesting it may be safe for use in patients with a history of estrogen supplementation.
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Article Synopsis
  • The study investigates cognitive outcomes in children aged 6-18 who underwent surgery for non-syndromic craniosynostosis, focusing on different types such as sagittal, metopic, and unicoronal synostosis.
  • A total of 204 children were tested, with results indicating that those with sagittal synostosis performed better in various cognitive measures, including verbal IQ and visuomotor integration, compared to those with metopic synostosis.
  • The findings suggest that even after surgical correction for craniosynostosis, some cognitive deficits may persist, particularly in children with metopic and unicoronal synostosis due to potential effects on brain structure.
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