A Modified 270 Degree Closure Technique to Address the Prominent or Locked-Out Premaxilla in Bilateral Cleft Palate Repair.

The bilateral cleft deformity with a prominent or 'locked-out' premaxilla presents one of the most challenging repairs in cleft surgery. Despite its relative frequency, traditional hard palate repair techniques fail to fully address this deformity and expose surgeons to the risk of development of a large anterior fistula when flaps cannot approximate the premaxilla. This greatly increases morbidity for the patient and creates unnecessary challenges during fistula repair or alveolar cleft bone graft later in childhood.

Influenced: Exploring the Effect of Social Media on Medical Students' Perceptions of Plastic Surgery.

Background: Medical students rarely receive dedicated education in plastic surgery, exposing them to influence from the internet or television programming that is frequently skewed toward cosmetic procedures. Additionally, social media posts from board-certified plastic surgeons make up a small portion of available content. These biased representations may impact students' perceptions, narrowing the scope of referrals and limiting career exploration.

Medical Student Exposure to Plastic Surgery and the Impact of a Home Training Program.

Background: Contemporary medical education devotes little time to plastic surgery topics. This deficiency is potentially greater at institutions without a dedicated plastic surgery training program. Lack of exposure to plastic surgery results in many medical students developing limited awareness to the full scope of the field.

Longitudinal Experience Using Pedicled Buccal Fat Pad Flaps in Cleft Palatoplasty: Mitigating Velopharyngeal Insufficiency Risk and Severity.

Background: Cleft palatoplasty commonly results in denuded maxillary bone in the lateral gutters and a posterior void between oral and nasal closures. Bony exposure of the anterior palate subjects the maxilla to scarring and growth restriction; scar contracture of the posterior void may result in velopharyngeal insufficiency and fistula formation. Use of the buccal fat pad flap (BFPF) at the time of palatoplasty provides vascularized tissue over these critical areas, thereby reducing the rate of secondary surgery for speech and fistula revision.

Technical Precision with Autologous Fat Grafting for Facial Rejuvenation: A Review of the Evolving Science.

The scientific study of facial aging has transformed modern facial rejuvenation. As people age, fat loss in specific fat compartments is a major contributor to structural aging of the face. Autologous fat grafting is safe, abundant, readily available, and completely biocompatible, which makes it the preferred soft-tissue filler in the correction of facial atrophy.

Surgical Decision-Making in Microvascular Reconstruction of Composite Scalp and Skull Defects.

Objectives: Microvascular reconstruction of composite scalp and skull defects requires careful planning of both cranial bone and soft-tissue coverage. The current body of literature has yet to identify a "best practice" approach to achieve these goals.

Methods: A retrospective chart review was performed.

Anterior Approach to the Neck: Long-Term Follow-Up.

Background: The anterior or submental necklift has been well described. Long-term results have been demonstrated in patients with minimal, mild, and moderate skin excess. It relies on the skin's unique ability to contract once separated from its attachments and further enhances the surgical result with treatment of the intermediate layer- subplatysmal fat, anterior digastric, submandibular gland, and platysma.

Happiness in Plastic Surgery: A Cross-Sectional Analysis of 595 Practicing Plastic Surgeons, Fellows, Residents, and Medical Students.

Background: Despite a heightened appreciation for wellness in medicine, there exists little information specific to plastic surgery. The purpose of this research was to assess happiness within the field of plastic surgery.

Methods: A cross-sectional study was conducted in July of 2017 by distributing an American Society of Plastic Surgeons sponsored survey to a random cohort of current practicing American Society of Plastic Surgeons members, residents and fellows.

Smartphone Applications in Plastic Surgery: A Cross-Sectional Survey of 577 Plastic Surgeons, Fellows, Residents, and Medical Students.

Background: There are now over 2.2 million mobile applications (apps) in existence, with more than 250 identifiable by searching "plastic surgery." Unfortunately, only 30% of these are academically relevant, which makes finding useful plastic surgery apps both challenging and inefficient.

Identification and Management of Cranial Anomalies in Perinatology.

Neonatal skull and head shape anomalies are rare. The most common cranial malformations encountered include craniosynostosis, deformational plagiocephaly, cutis aplasia, and encephalocele. Improved prenatal imaging can diagnose morphologic changes as early as the second trimester.

Classification and Microvascular Flap Selection for Anterior Cranial Fossa Reconstruction.

Background:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects.

Parameters for Ordering Blood Cultures in Major Burn Injury Patients: Improving Clinical Assessment.

Hypermetabolic and catabolic states in large TBSA burns lead to higher basal body temperature and tachycardia. These metabolic changes complicate the diagnosis of bacteremia and sepsis. Current indications for obtaining blood cultures (BCs) in this population are poorly described and nonstandardized.

Component Separation Technique for Repair of Massive Abdominal Wall Defects at a Pediatric Hospital.

Background: Massive defects of the abdominal wall are commonly repaired with the component separation technique (CST) when insufficient tissue exists to close the defect primarily. Although the utility of CST has been documented in cases of large ventral hernias in adults, its application to congenital and acquired defects in pediatric patients has been largely unreported. This study is a retrospective case series discussing the success of CST at a large pediatric hospital.

Modified Genioglossal Advancement for Isolated Treatment of Obstructive Sleep Apnea.

Introduction: Genioglossal advancement is a surgical procedure for obstructive sleep apnea (OSA) that has lost favor as a primary treatment strategy. The authors describe utilization of a modified genioglossal advancement (MGA), combining a geniotubercle advancement via sliding genioplasty and a glossopexy.

Methods: A retrospective review was performed.

Deep Pyriform Space: Anatomical Clarifications and Clinical Implications.

Background: The purpose of this study was to define the anatomical boundaries, transformation in the aging face, and clinical implications of the Ristow space. The authors propose a title of deep pyriform space for anatomical continuity.

Methods: The deep pyriform space was dissected in 12 hemifacial fresh cadaver dissections.

Inset of Unilateral Dual Microvascular Breast Reconstruction Using Nonabdominal Free Tissue Transfer.

Background: Large breasted patients are difficult to reconstruct using free tissue transfer after mastectomy when abdominal tissue is inadequate. For these, two unilateral free flaps may be required. This study reviews the authors' experience using transverse upper gracilis and profunda artery perforator flaps.