Is Iatrogenic Implant Contamination Preventable Using a 16-Step No-Touch Protocol?

Background: Intraoperative contamination of the surgical field during aesthetic breast augmentation may lead to implant infection with devastating consequences. This study covers a period of 30 years and is divided into 2 phases: a retrospective phase from 1992-2004 when a standard approach was used and a prospective phase from 2004-2022 when a no-touch approach was implemented to avoid contamination.

Methods: Patients in the standard and no-touch groups underwent aesthetic breast augmentation by the same senior surgeon (FDP) in the same outpatient surgical facility during the 30-year period of the study.

Review of Early Signs of Breast Implant Infection.

Background: Breast implant infection remains a problem despite various prevention methods. Common pathogens such as staphylococcus aureus typically present acutely with fever, erythema, swelling, and pain. However, with the increasing occurrence of mycobacterial infections, associated early signs and symptoms are typically absent, making early detection difficult.

Do Gloves Provide Adequate Protection Against Infection?

In the early 1800s gloves were a foreign concept to surgeons, as a result, patient care suffered, and mortality was high due to poor sanitary conditions in the operating room. This all changed in 1889, where the introduction of the surgical glove completely revolutionized surgical aseptic ideals. Through the work of William Halsted and his desire to help his nurse, Caroline Hampton, who was from suffering contact dermatitis, the first pair of rubber gloves were created.

Effect of Preoperative Patient Education on Opioid Consumption and Well-Being in Breast Augmentation.

Background: Perioperative use of opioids is common in surgical practice and frequently results in troublesome opioid-related side effects that often lead to suboptimal postsurgical outcomes. As such, multiple studies have sought to identify alternatives that may reduce reliance on opioid-based perioperative pain management. Recently, it has been shown that patient education and patient involvement in care positively impact surgical outcomes.

The First Confirmed Case of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Hawai'i.

A 78-year-old woman within 3 years of of bilateral silicone gel breast implants for breast reconstruction due to breast cancer presented with heaviness and swelling in her right breast. Cytology of the aspirated fluid confirmed breast implant associated anaplastic large cell lymphoma (BIA-ALCL), and the patient underwent removal of implant and total capsulectomy. Breast implantassociated anaplastic large cell lymphoma is a rare entity, but if diagnosed early is a curable condition.

Povidone-Iodine versus antibiotic irrigation in breast implant surgery: Revival of the ideal solution.

The use of povidone-iodine alone has been advocated by several authors who continued to utilize it for pocket irrigation despite the US Food and Drug Administration (FDA)'s prohibition of 2000. However, in 2017, the FDA removed the ban against povidone-iodine use in breast augmentation. In the practice of breast augmentation, pocket irrigation with various solutions has been advocated in preventing infection and capsular contraction.

Case of late hematoma after breast augmentation.

We present a case report of a patient who experienced a late, spontaneous breast hematoma 26 years after primary breast augmentation. Late hematomas are a rare complication of breast augmentation with uncertain etiology. In this case, there was no trauma, calcifications, or implant rupture.

An Improved Humanized Mouse Model for Excisional Wound Healing Using Double Transgenic Mice.

Splinting full-thickness cutaneous wounds in mice has allowed for a humanized model of wound healing. Delineating the epithelial edge and assessing time to closure of these healing wounds via macroscopic visualization have remained a challenge. Double transgenic mice were created by crossbreeding K14-Cre and ROSA reporter mice.

Bilateral Breast Reduction Without Opioid Analgesics: A Comparative Study.

Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction.

Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids.

A Modified, Direct Neck Lift Technique: The Cervical Wave-Plasty.

Background: Major problems with cervicoplasty by direct skin excision include the subjective nature of skin markings preoperatively and the confusing array of procedures offered. This technique incorporates curved incisions, resulting in a wave-like scar, which is why the procedure is called a "wave-plasty".

Methods: This prospective study includes 37 patients who underwent wave-plasty procedures from 2004 to 2015.

Avoiding Opioids and Their Harmful Side Effects in the Postoperative Patient: Exogenous Opioids, Endogenous Endorphins, Wellness, Mood, and Their Relation to Postoperative Pain.

Prescribed opioids are routinely used for many postoperative patients. However, these medications have daunting adverse effects on the body's innate pain management system--the action of the beta-endorphins. The prescribed opioids not only severely impair the function of the mu-opioid receptors, but also inhibit the release of beta-endorphin.

Polyurethane-coated breast implants revisited: a 30-year follow-up.

Background: Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture.

Methods: This study evaluates the senior surgeon's (F.

Muscle-sparing blepharoplasty: a prospective left-right comparative study.

Background: Standard upper blepharoplasty involves removal of both the skin and a portion of the underlying orbicularis oculi muscle. The senior author had observed sluggishness of eyelid closure, lagophthalmos as well as varying degrees of eye irritation in certain patients during the early postoperative period. He postulated that these findings could be due to orbicularis muscle excision.

Dry eye syndrome due to botulinum toxin type-A injection: guideline for prevention.

Dry eye syndrome is a potential complication of botulinum toxin type-A injection (BTX-A) into the lateral canthal rhytids (crow's feet). The early manifestations of this syndrome are subtle and are rarely reported to the treating physician. A guideline for early detection of dry-eye state is proposed, in order to avoid more troublesome adverse effects that may develop with repeated injections of BTX-A into the crow's feet region.