Gender-Affirming Mastectomy: Psychosocial and Surgical Outcomes in Transgender Adults.

Background: Limited literature exists examining the effects of gender-affirming mastectomy on transmasculine and nonbinary patients that is prospective and uses validated survey instruments.

Study Design: The psychosocial functioning of transmasculine and nonbinary patients was compared between patients who underwent gender-affirming mastectomy and those who had not yet undergone surgery. Participants were enrolled in a single-site, combined study of surgical and psychosocial outcomes, including a cross-sectional cohort of preoperative and postoperative patients, as well as separate prospective cohort.

The challenging patient in autologous breast reconstruction: obesity, breast ptosis and beyond.

Autologous breast reconstruction has consistently demonstrated excellent patient satisfaction, ideal aesthetic results, and a low risk of complications. With the increasing incidence of breast cancer diagnoses and higher reconstruction rates, surgeons encounter a broader spectrum of patients. Obese patients undergoing breast reconstruction are more likely to experience a surgical complication.

Volumetric Assessment of the Anterior Digastric Muscles: A Deeper Understanding of the Volumetric Changes With Aging.

Background: Targeting the deeper, subplatysmal structures in the neck has recently grown in popularity. In particular, interventions targeting the "bulky" anterior digastric (AD) muscle have been described with excellent results. However, much remains to be understood about the deep anatomy of the neck and the age-associated changes of the AD.

The Pocket Flap: A Pericranial Galeal-Frontalis Flap for Lining and Graft Coverage in Nasal Reconstruction.

Complex nasal defects can necessitate nasal lining, bone and cartilage, and skin reconstruction. Defects requiring lining and structural support without the need for skin resurfacing are relatively uncommon. The following case report describes in detail a pericranial galeal-frontalis flap that is used to both reconstruct the nasal lining and provide adequate cartilage graft coverage.

The Central Mound Pedicle: A Safe and Effective Technique for Reduction Mammaplasty.

Background: The central mound technique offers a relatively less common approach for breast reduction. This study evaluated the expected safety and efficacy outcomes using this technique in a large patient series.

Methods: A retrospective review of all patients undergoing central mound breast reduction at the authors' institution between June of 1999 and November of 2018 was performed.

Contact Cooling of Random-Pattern Cutaneous Flaps: Does it Increase Necrosis?

Background: Cooling after surgery reduces pain, swelling and ecchymosis. However, the fear of adverse effects of vasoconstriction caused by cooling may prevent its use when the skin is undermined extensively, for example, after rhytidectomy. The purpose of this study is to determine whether the contact cooling of random-pattern skin flaps increases the area of necrosis observed.

Postnatal Pancraniosynostosis in a Patient With Infantile Hypophosphatasia.

Hypophosphatasia is a rare metabolic bone disorder that predisposes patients to craniosynostosis. Typically, patients born with hypophosphatasia will exhibit fused cranial sutures at birth. This is the first reported case of delayed onset of pancraniosynostosis in a patient with infantile hypophosphatasia.

Neurotoxins: Expanding Uses of Neuromodulators in Medicine--Headache.

Over the course of the past 17 years, since the initial discovery of the association between botulinum toxin-A (BT-A) and the reduction of headache symptoms, the use of this neurotoxin has greatly evolved. BT-A has emerged as an alternative to prophylactic pharmacological therapies in the prevention of chronic migraine headaches, with an excellent safety profile and proven efficacy, and is Food and Drug Administration-approved for on-label use since October 2010. The mechanism of BT-A involves its effect at the neuromuscular junction, inhibition of neuropeptide and neurotransmitter release in peripheral sensory neurons, and retrograde axonal transport allowing for its direct effect on inhibiting central sensitization.

The Current Means for Detection of Migraine Headache Trigger Sites.

The authors' 15-year experience with migraine surgery has led them to believe that the most common reasons for incomplete response are failure to detect all of the trigger sites or, on rare occasions, inadequate surgery on the trigger sites. Thus, accurate identification of trigger sites is essential. The purpose of this article is to share the authors' current stepwise algorithm for accurately detecting the migraine trigger sites, which has evolved through surgery on nearly 1000 patients.

A retrospective review of the outcomes of migraine surgery in the adolescent population.

Background: Migraine surgery has been studied extensively in adult patients with refractory headaches. The purpose of this study was to review a single surgeon's outcomes following migraine surgery in an adolescent population.

Methods: A retrospective review of all patients operated on by the senior author (B.