Defining the Ideal Reduction Mammaplasty: A Crowdsourcing Study.

Background: Reduction mammaplasty relieves macromastia symptoms while improving breast aesthetics, although the ideal breast aesthetically has been shown to differ culturally in previous crowdsourcing studies. Better understanding these differences can aid in setting postoperative expectations.

Objectives: The aim of this study was to characterize the ideal reduction mammaplasty according to demographics such as gender, ethnicity, socioeconomic status, and education.

Oncoplastic reconstruction with breast-conserving treatment versus breast-conserving treatment alone in the elderly.

Background/objectives: Oncoplastic reconstruction (IOR) performed in conjunction with breast conserving therapy (BCT) has been found to improve psychosocial well-being, reduce hospitalization time, and reduce cost burden. Few studies have looked at the safety profile, complication rates, and overall outcomes in patients ages 65 years and older undergoing IOR versus BCT alone.

Methods: A retrospective, cross-sectional, single-institution medical record review was conducted of women diagnosed with breast cancer age 65 years or older who received IOR or BCT alone.

Safe Reproducible Breast Reduction.

Breast reduction is a common operation performed by plastic surgeons. Patients can have significant improvement in physical symptoms in addition to increased self-esteem, body image, and quality of life as a result. The authors describe common techniques for breast reduction and provide representative photographs and videos of these techniques.

A Clinical Guide to the Treatment of Cellulite and Comprehensive Review of the Etiology, Pathophysiology, and Utility of Intervention.

Introduction: Cellulite is a common esthetic concern affecting most women. Despite its prevalence, there is no consensus on the optimal treatment approach for cellulite, partly due to the complex and multifactorial nature of its pathophysiology. Understanding the underlying biological processes along with available treatment options is important to be able to effectively counsel patients on effective management of this condition.

Preoperative Glucose Predicts Postoperative Complications After Complex Abdominal Wall Reconstruction.

Background: Despite advances in surgical methods, complication rates after complex abdominal wall reconstruction (CAWR) remain high. Identification of preoperative risk factors can assist surgeons with risk stratification and patient counseling. The deleterious effects of hyperglycemia on wound healing are well established.

Modern Approaches to Oncoplastic Surgical Treatment.

Partial breast reconstruction using oncoplastic techniques is performed at the time of lumpectomy and includes volume replacement techniques such as flaps and volume displacement techniques such as reduction and mastopexy. These techniques are used to preserve breast shape, contour, size, symmetry, inframammary fold position, and position of the nipple-areolar complex. Newer techniques such as auto-augmentation flaps and perforator flaps continue to broaden options and newer radiation therapy protocols will hopefully reduce side effects.

Evaluating resources required to evaluate child outcomes following indirect services in early childhood education centres: A scoping review.

Issue Addressed: Speech-language pathologists (SLPs) may provide indirect services focusing on the promotion of rich communication environments in early childhood education centres. Evaluating children's outcomes following SLP-led professional development in early childhood education centres is challenging. The aim of this scoping review was to identify how child outcomes were measured in studies exploring SLP professional development in early childhood education.

The Psychological Impact of Aesthetic Surgery: A Mini-Review.

The purpose of this summary is to outline the available research on the psychological factors associated with aesthetic surgery. Aesthetic procedures such as abdominoplasty, breast augmentation, face lift, and rhinoplasty are shown to have unique preoperative and postoperative psychological factors. Depression and anxiety may occur after aesthetic procedures with an increased incidence in patients with certain depression prone personality traits.

Evaluating the Effect of Socioeconomic Status on Complex Abdominal Wall Reconstruction Outcomes.

Background: In complex abdominal wall reconstruction, maintenance and follow-up are vital to effective long-term patient care. This can present a challenge for individuals from a low-income household who may have less ability to afford time away from work or caring for dependents as well as challenges with transportation to and from follow-up appointments. Given the expenses and high complication rate in abdominal wall reconstruction, we elected to determine whether socioeconomic status had an impact on patient outcomes.

Does An ERAS Protocol Reduce Postoperative Opiate Prescribing in Plastic Surgery?

Background: Enhanced recovery after surgery (ERAS) protocols are effective at reducing inpatient opiate use. There is a paucity of studies on the effects of an ERAS protocol on outpatient opiate prescriptions. The aim of this study was to determine whether an ERAS protocol for plastic and reconstructive surgery would reduce opiate use in the outpatient postoperative setting.

The safety of performing breast reconstruction during the COVID-19 pandemic.

Purpose: Elective operations including surgeries for breast cancer were significantly reduced during the height of the surge of COVID-19 cases in Massachusetts. The safety of performing breast reconstruction during the pandemic was unknown. This study aims to review the safety of performing mastectomy with immediate breast reconstruction during the first COVID-19 surge in Massachusetts.

Nipple-Sparing Mastectomy versus Skin-Sparing Mastectomy: Does Saving the Nipple Impact Short- and Long-Term Patient Satisfaction?

Background: Nipple-sparing mastectomy (NSM) is an oncologically safe alternative to skin-sparing mastectomy (SSM). This study evaluated whether NSM patients were more satisfied than SSM patients in short- and long-term follow-up.

Methods: Women who underwent NSM or SSM between 2009 and 2019 completed a postoperative BREAST-Q survey at least 1 year after surgery and patient characteristics were compared.

Enhanced Recovery After Surgery Patients Are Prescribed Fewer Opioids at Discharge: A Propensity-score Matched Analysis.

Objective: We aimed to compare discharge opioid prescriptions pre- and post-ERAS implementation.

Summary Of Background Data: ERAS programs decrease inpatient opioid use, but their relationship with postdischarge opioids remains unclear.

Methods: All patients undergoing hysterectomy between October 2016 and November 2020 and pancreatectomy or hepatectomy between April 2017 and November 2020 at 1 tertiary care center were included.

An Algorithm for Management of Cosmetic and Reconstructive Patients with Textured Implants: An Institutional Experience.

Textured anatomic silicone gel breast implants have advantages of gel cohesivity and a natural slope between the upper and lower poles of the breast; however, they have fallen out of favor secondary to their risk of breast implant-associated anaplastic large cell lymphoma. For patients who choose to keep their textured devices, there remains controversy over the best long-term follow-up. This article presents an algorithm from plastic surgery, surgical oncology, and radiology at the Massachusetts General Hospital for management of these patients.

The Use of Absorbable Mesh in Implant-Based Breast Reconstruction: A 7-Year Review.

Background: Breast reconstruction is most frequently performed using implants or expanders. Adjunctive materials such as acellular dermal matrix and synthetic meshes are used to support the implant or expander. A paucity of large studies exist on the use of synthetic mesh for breast reconstruction.

Prepectoral Direct-to-Implant Breast Reconstruction: Safety Outcome Endpoints and Delineation of Risk Factors.

Background: Continued evolution of implant-based breast reconstruction involves immediate placement of the implant above the pectoralis muscle. The shift to prepectoral breast reconstruction is driven by goals of decreasing morbidity such as breast animation deformity, range-of-motion problems, and pain, and is made possible by improvements in mastectomy skin flap viability. To define clinical factors to guide patient selection for direct-to-implant prepectoral implant reconstruction, this study compares safety endpoints and risk factors between prepectoral and subpectoral direct-to-implant breast reconstruction cohorts.

Atypical ductal hyperplasia in men with gynecomastia: what is their breast cancer risk?

Purpose: Atypical ductal hyperplasia (ADH) significantly increases the risk of breast cancer in women. However, little is known about the implications of ADH in men.

Methods: Review of 932 males with breast pathology was performed to identify cases of ADH.

Ability to Cope with Pain Puts Migraine Surgery Patients in Perspective.

Background: Candidates for migraine surgery are chronic pain patients with significant disability. Currently, migraine-specific questionnaires are used to evaluate these patients. Analysis tools widely used in evaluation of better understood pain conditions are not typically applied.

The Effect of Reduction Mammaplasty on Quality of Life in Adolescents With Macromastia.

Objectives: To measure changes in health-related quality of life and breast-related symptoms after reduction mammaplasty in adolescents.

Methods: In this longitudinal cohort study, we administered the Short-Form 36v2 (SF-36), Rosenberg Self-Esteem Scale (RSES), Breast-Related Symptoms Questionnaire (BRSQ), and Eating Attitudes Test-26 to 102 adolescents with macromastia and 84 female controls, aged 12 to 21 years. Patients with macromastia completed surveys preoperatively and after reduction mammaplasty at 6 months and 1, 3, and 5 years.

Long-term Outcomes After Flap Reconstruction in Pediatric Pressure Ulcers.

Background: Pressure ulcers refractory to nonoperative management may undergo flap reconstruction. This study aims to evaluate the long-term outcomes and recurrence rates of flap reconstruction for pediatric pressure ulcers.

Methods: We reviewed the records of patients who underwent flap reconstruction for pressure ulcer(s) from 1995 to 2013.

Thermal Injury to Reconstructed Breasts from Commonly Used Warming Devices: A Risk for Reconstructive Failure.

Background: Sensation is decreased or absent after breast reconstruction. This leaves reconstructed breasts vulnerable to injury from common household thermal sources such as heating pads and hot water bottles. We sought to categorize these injuries, provide a treatment plan, and prevent these injuries in the future.

Psychological impact of breast asymmetry on adolescents: a prospective cohort study.

Background: This study measures the impact of adolescent breast asymmetry compared with macromastia and female controls.

Methods: The following surveys were given to patients with breast asymmetry, macromastia, and controls aged 12 to 21 years: Short Form Health Survey, Version 2 (Short Form-36), the Rosenberg Self-Esteem Scale, and the Eating Attitudes Test. Demographics were compared, and linear regression models, adjusted for body mass index category and age, were fit to determine the effect of case status on survey score.