Domestic and International Cosmetic Tourism Complications Presenting to a US Tertiary Hospital.

Background: Cosmetic surgery tourism has become a significant global industry. Often patients who develop postoperative complications present for care in their US home state.

Objectives: In this study we evaluated patients who either traveled abroad or to other states within the United States for cosmetic surgeries and later came with complications for treatment at the authors' center.

Obesity Portends Increasing Rates of Superficial Surgical Site Infection Following Pediatric Reduction Mammoplasty: A National Surgical Database Analysis.

Introduction: Pediatric reduction mammoplasty has become increasingly common due to the obesity epidemic. While obesity remains the leading cause of macromastia leading to surgery, it may also be a risk factor for postoperative complications. This study examines the safety of pediatric reduction mammoplasty and the risk of obesity for complications following this procedure.

Alpha Defensin-1 Biomarker Outperforms Culture in Diagnosing Breast Implant-Related Infection: Results from a Multicenter Prospective Study.

Background: Prompt diagnosis of breast implant infection is critical to reducing morbidity. A high incidence of false-negative microbial culture mandates superior testing modalities. Alpha defensin-1 (AD-1), an infection biomarker, has outperformed culture in diagnosing periprosthetic joint infection with sensitivity/specificity of 97%.

Evaluation of Xenograft Efficacy in Immediate Prosthesis-based Breast Reconstruction.

Unlabelled: The advent of acellular dermal matrix (ADM) has revolutionized prosthesis-based breast reconstruction. However, paucity of human cadaveric tissue has resulted in limitation of supply and increased associated costs, prompting concerted effort to identify xenograft alternatives. Although studies have examined the safety of Artia, a porcine-derived ADM, few have evaluated its clinical efficacy as soft tissue reinforcement.

Evaluating the Inaccuracy of the National Surgical Quality Improvement Project Surgical Risk Calculator in Plastic Surgery: A Meta-analysis of Short-Term Predicted Complications.

Background: Preoperative surgical risk assessment is a major component of clinical decision making. The ability to provide accurate, individualized risk estimates has become critical because of growing emphasis on quality metrics benchmarks. The American College of Surgeons National Surgical Quality Improvement Project (NSQIP) Surgical Risk Calculator (SRC) was designed to quantify patient-specific risk across various surgeries.

Improved Diagnostic Accuracy of Periprosthetic Breast Infection: Novel Application of the Alpha Defensin-1 Biomarker.

Unlabelled: Prompt, accurate diagnosis of breast implant infection is critical to minimizing patient morbidity. Bacterial culture false negative rate approaches 25%-30%, and better costeffective testing modalities are needed. Alpha defensin-1 (AD-1) is a neutrophil-mediated biomarker for microbial infection.

Severe burn injuries caused by bioethanol-design fireplaces-an overview on recreational fire threats.

Commercially available bioethanol-fueled fireplaces have become increasingly popular additions for interior home decoration in Europe and more recently in the United States. These fireplaces are advertised as smokeless, ecologically friendly, and do not require professional installation, formal gas lines, or venting. Although manufacturers and businesses promote their safety, recent presentations of injuries have alerted the authors to the relevant danger bioethanol fireplaces can pose for the incautious user.

Mastopexy techniques after massive weight loss: an algorithmic approach and review of the literature.

Mastopexy after massive weight loss (MWL) poses unique challenges that may not be successfully addressed with traditional mastopexy procedures. Several novel techniques have been proposed to improve esthetic outcomes; however, little data exists to guide the plastic surgeon on choice of technique for individual patients. A literature review revealed 10 articles with specific emphasis on mastopexy techniques in MWL patients.

Immediate breast tissue expander-implant reconstruction with inferolateral AlloDerm hammock and postoperative radiation: a preliminary report.

Objective: To preserve the mastectomy skin envelope in select patients destined to receive radiation following mastectomy, we performed immediate tissue expander-implant reconstruction with a subpectoral tissue expander and an inferolateral AlloDerm hammock for complete implant coverage. We hypothesized that the AlloDerm hammock may allow greater intraoperative volume expansion and potentially avoid the need for an autologous construct.

Methods: Tissue expanders were filled to 75%-85% capacity intraoperatively and 85%-100% prior to radiation therapy.

Improving shape and symmetry in mastopexy with autologous or cadaveric dermal slings.

Mastopexy and reduction mammaplasty reshape breast parenchyma and restore youthful contour in women with ptotic breasts. However, recurrent ptosis and breast base widening are common. We have been using internal autologous or cadaveric (AlloDerm) dermal slings to circumferentially support and shape the breasts for symmetry or rejuvenation.

Inferolateral AlloDerm hammock for implant coverage in breast reconstruction.

Purpose: Implant reconstruction is commonly performed to reconstruct mastectomy defects or to correct breast hypoplasia. We have been using an inferolateral AlloDerm hammock as an inferior extension of the pectoralis major muscle to provide a mechanical barrier between the implant and skin and to control implant position.

Methods: The inferior border of the AlloDerm hammock is attached inferiorly to the rectus abdominis fascia and laterally to the serratus anterior fascia to create the borders of the implant pocket.

Silver-impregnated vacuum-assisted closure in the treatment of recalcitrant venous stasis ulcers.

Vacuum-assisted closure (VAC) has made a significant contribution to the treatment of acute and chronic wounds. Microdeformational forces from the VAC device accelerate granulation tissue formation when compared with moist saline dressing changes. We present 2 patients with multiple comorbid conditions and complex venous stasis ulcers that had persistent purulent drainage after conventional treatment modalities.

Immediate bilateral breast reconstruction with implants and inferolateral AlloDerm slings.

To shorten the reconstructive process, improve results, and provide additional options for women seeking mastectomy, we used an acellular cryopreserved dermal matrix (AlloDerm) sling to reestablish the lower pole of the pectoralis major muscle. This technique creates a subpectoral-sub-AlloDerm pocket that completely encloses the breast implant. By tailoring the width of the AlloDerm, we can precisely control the degree of lower-pole fullness.

Early experience using low-frequency ultrasound in chronic wounds.

Periodic wound debridement promotes healing in chronic wounds. Low-frequency ultrasonic debridement (LFUD) is a promising adjunct to wound care, which offers relatively painless debridement and bacterial biofilm destruction. We performed LFUD on 17 patients over 8 months, with a minimum follow-up of 3 months.

Occult breast carcinoma in reduction mammaplasty specimens: 14-year experience.

Reduction mammaplasty is commonly performed for bilateral macromastia, congenital asymmetry, or as a contralateral symmetry procedure in breast reconstruction following mastectomy for cancer. Occult carcinoma has been detected in 0.06 percent to 0.