Artificial Intelligence Analysis of Periorbital Rejuvenation.

Background: Periorbital rejuvenation surgery aims to restore a youthful appearance to the face. Despite the popularity of these procedures, few objective measurements exist to evaluate their impact on perceived facial aging.

Objectives: This study aims to quantify the impact of brow lift and blepharoplasty on age as perceived by convolutional neural network (CNN) algorithms.

Novel Use of Wound Matrix in Mastopexy Complicated by Pyoderma Gangrenosum.

Pyoderma gangrenosum (PG) is a relatively uncommon inflammatory skin disorder that is characterized by rapid onset, ulcerative lesions, and often triggered by trauma or surgery. Although rare, PG of the breast has been well described in the plastic surgery literature, most often reported following breast reductions and reconstructions. The authors present a case of PG that developed in a 56-year-old patient, with a history of essential thrombocytosis, following mastopexy.

Transconjunctival Lower Lid Blepharoplasty with and Without Fat Preservation and Skin Resurfacing.

Transconjunctival lower lid blepharoplasty is a safe and effective procedure with a low complication rate. Success with this procedure depends on proper patient analysis and selection. The lower lid periorbital fat can be resected, or preserved, and draped over the orbital rim or used as free fat grafts, depending on the clinical presentation.

Fondaparinux Significantly Reduces Postoperative Venous Thromboembolism After Body Contouring Procedures Without an Increase in Bleeding Complications.

Background: It is well established that abdominoplasty confers a uniquely high risk of venous thromboembolism (VTE) complications. However, chemoprophylaxis is not routinely utilized due to the risk of bleeding complications. Fondaparinux, a factor Xa inhibitor FDA approved in 2001 for postoperative VTE prophylaxis, has emerged as a safe option for preventing VTE complications after high-risk surgeries.

Do Patterns of Reconstruction Choices After Mohs Surgery Vary by Specialty? A Pilot Study of Mohs Surgeons and Facial Plastic Surgeons.

Background: Differences in approach to repair a specified defect after Mohs micrographic surgery (MMS) between specialties have not been previously examined.

Objective: To assess the difference in frequency of which reconstruction repairs are selected after MMS, among Mohs surgeons and facial plastic surgeons (FPS), and evaluate whether the level of satisfaction with the final repair outcome differed between specialties.

Materials And Methods: The study was approved by the Saint Louis University Institutional Review Board.

Radioprotection With Amifostine Enhances Bone Strength and Regeneration and Bony Union in a Rat Model of Mandibular Distraction Osteogenesis.

Background: Using distraction osteogenesis (DO) to regenerate robust endogenous bone could greatly enhance postoncologic reconstruction of head and neck cancer. However, radiation (XRT) corrosive effects still preclude DO's immense potential. We posit that adjunctive pretreatment with the radioprotectant amifostine (AMF) can optimize wound healing and allow for successful DO with quantifiable enhancements in bony union and strength despite previous surgical bed irradiation.

Deferoxamine enhances bone regeneration in mandibular distraction osteogenesis.

Background: Distraction osteogenesis is a powerful reconstructive technique for bone growth and repair. An angiogenic means of enhancing the efficacy of this metabolically demanding procedure would be beneficial in expanding its therapeutic potential. The authors posit that the angiogenic effect of deferoxamine, an iron chelator that has been shown to increase angiogenesis, will improve bone regeneration by means of augmentations in quality and quantity of bone and bone-producing cells.

Amifostine protects vascularity and improves union in a model of irradiated mandibular fracture healing.

Background: Pathologic fractures of the mandible can be devastating to cancer patients and are due in large part to the pernicious effects of irradiation on bone vascularity. The authors' aim was to ascertain whether amifostine, a radioprotective drug, will preserve vascularity and improve bone healing in a murine model of irradiated mandibular fracture repair.

Methods: Rats were randomized into three groups: nonirradiated fracture (n = 9), irradiation/fracture (n = 5), and amifostine/irradiation/fracture (n = 7).

The effect of Amifostine prophylaxis on bone densitometry, biomechanical strength and union in mandibular pathologic fracture repair.

Background: Pathologic fractures (Fx) of the mandibles are severely debilitating consequences of radiation (XRT) in the treatment of craniofacial malignancy. We have previously demonstrated Amifostine's effect (AMF) in the remediation of radiation-induced cellular damage. We posit that AMF prophylaxis will preserve bone strength and drastically reverse radiotherapy-induced non-union in a murine mandibular model of pathologic fracture repair.

Parathyroid hormone therapy mollifies radiation-induced biomechanical degradation in murine distraction osteogenesis.

Objective: Descriptions of mandibular distraction osteogenesis for tissue replacement after oncologic resection or for defects caused by osteoradionecrosis have been limited. Previous work demonstrated radiation decreases union formation, cellularity and mineral density in mandibular distraction osteogenesis. The authors posit that intermittent systemic administration of parathyroid hormone will serve as a stimulant to cellular function, reversing radiation-induced damage and enhancing bone regeneration.

An isogenic model of murine mandibular distraction osteogenesis.

The advent of stem cell-based therapies makes current models of mandibular distraction osteogenesis unwieldy. We thereby designed an isogenic model of distraction osteogenesis whose purpose was to allow for the free transfer of cells and components between rats. As immune response plays a significant role in healing and prevention of infection, an immune-competent mode is desirable rather than an athymic rat/xenograft model.

Role of parathyroid hormone therapy in reversing radiation-induced nonunion and normalization of radiomorphometrics in a murine mandibular model of distraction osteogenesis.

Background: The use of mandibular distraction osteogenesis (MDO) for tissue replacement after oncologic resection or for defects caused by osteoradionecrosis has been described but, in fact, has seen limited clinical utility. Previous laboratory work has shown that radiation (XRT) causes decreased union formation, decreased cellularity, and decreased mineral density in an animal model of MDO. Our global hypothesis is that radiation-induced bone damage is partly driven by the pathologic depletion of both the number and function of osteogenic cells.

Stem cell therapy remediates reconstruction of the craniofacial skeleton after radiation therapy.

This study utilized transplanted bone marrow stromal cells (BMSCs) as a cellular replacement therapy to remedy radiation-induced injury and restore impaired new bone formation during distraction osteogenesis (DO). BMSC therapy brought about the successful generation of new bone and significantly improved both the rate and quality of a bony union of irradiated, distracted [X-ray radiation therapy (XRT)/DO] murine mandibles to the level of nonirradiated DO animals. The bone mineral density and bone volume fraction were also significantly improved by the BMSC replacement therapy showing no difference when compared to nonirradiated animals.

Localized deferoxamine injection augments vascularity and improves bony union in pathologic fracture healing after radiotherapy.

Background: Medically based efforts and alternative treatment strategies to prevent or remediate the corrosive effects of radiotherapy on pathologic fracture healing have failed to produce clear and convincing evidence of success. Establishing an effective pharmacologic option to prevent or treat the development of non-unions in this setting could have immense therapeutic potential. Experimental studies have shown that deferoxamine (DFO), an iron-chelating agent, bolsters vascularity and subsequently enhances normal fracture healing when injected locally into a fracture callus in long bone animal models.

Raman spectroscopy demonstrates Amifostine induced preservation of bone mineralization patterns in the irradiated murine mandible.

Purpose: Adjuvant radiotherapy in the management of head and neck cancer remains severely debilitating. Fortunately, newly developed agents aimed at decreasing radiation-induced damage have shown great promise. Amifostine (AMF) is a compound, which confers radio-protection to the exposed normal tissues, such as bone.

Quantitative histologic evidence of amifostine-induced cytoprotection in an irradiated murine model of mandibular distraction osteogenesis.

Background: Head and neck cancer management requires adjuvant radiotherapy. The authors have previously demonstrated the damaging effect of a human equivalent dose of radiation on a murine mandibular model of distraction osteogenesis. Using quantitative histomorphometry, the authors' specific aim was to objectively measure amifostine radioprotection of the cellular integrity and tissue quality of an irradiated and distracted regenerate.

Amifostine remediates the degenerative effects of radiation on the mineralization capacity of the murine mandible.

Background: Radiotherapy, a cornerstone of head and neck cancer treatment, causes substantial morbidity to normal adjoining bone. The authors assessed the radioprotective effect of amifostine therapy on the mineralization of the mandible using micro-computed tomography. They hypothesized that amifostine would safeguard the mandible from radiation-induced disruption of the mineralization process and the associated failure of new bone creation.