The Alar Equalization Suture for Nasal Tip Refinement.

Anatomic subtleties of the nasal tip have a dramatic impact on the overall appearance of the nose. Creation of the ideal nasal tip in rhinoplasty requires straight lower lateral cartilages, everted lateral crura, a higher caudal edge of the lower lateral cartilages relative to the cephalic margin, and a diamond-shaped tip. In this article, the authors describe the alar equalization suture, a suture technique that further refines nasal tip shaping after traditional maneuvers have been performed.

Screening Tests in the Era of COVID-19: Implications for the Plastic Surgeon.

The novel coronavirus, severe acute respiratory syndrome coronavirus 2, responsible for the coronavirus disease of 2019 (COVID-19) pandemic, has claimed over 2 million lives to date and brought the global economy to a halt, including elective surgery. As the authors emerge from lockdown, new protocols must be implemented to minimize risk by means of appropriate screening of their patients, surgical adjustments to reduce viral transmission in case of undiagnosed infection, and the development of accurate severe acute respiratory syndrome coronavirus 2 tests while awaiting the distribution of an effective vaccine. Many serology and molecular tests have received emergency use authorization from the U.

Social Media Guidelines for Young Plastic Surgeons and Plastic Surgery Training Programs.

Social media are a powerful tool that creates a unique opportunity for the young plastic surgeon and trainee to share content, brand oneself, educate the public, and develop one's own professional voice early. The majority of all plastic surgery programs and particularly those that are highly ranked have social media opportunities for their residents, yet clear rules to guide implementation of social media programming in residency have remained unspecified. These guidelines and pitfalls can be used to inform a productive and professional entry into plastic surgery social media use for the resident and young plastic surgeon.

How to Maximize Aesthetics in Autologous Breast Reconstruction.

With continuous technical and functional advances in the field of breast reconstruction, there is now a greater focus on the artistry and aesthetic aspects of autologous reconstruction. Whereas once surgeons were most concerned with flap survival and vessel patency, they are now dedicated to reconstructing a similarly or even more aesthetically pleasing breast than before tumor resection. We discuss the approach to shaping the breast through the footprint, conus, and skin envelope.

Supraorbital Neuralgia Associated With Thyroid Eye Disease.

Purpose: To identify the relationship between thyroid eye disease (TED) and supraorbital neuralgia (SON) and establish a reliable approach to the diagnosis and management of TED-associated SON.

Methods: This retrospective study included 1,126 patients. Demographics, active and inactive phase status and duration, and reactivation rate were noted.

2020 special issue: Twenty years of breast reconstruction: Past, present, and future.

Breast reconstruction has evolved in the last 25 years to provide women with better autologous and implant-based options. The general trends of breast reconstruction have shifted to skin and nipple-areolar complex preservation, resulting in improved aesthetics and patient satisfaction. Autologous reconstruction has made a dramatic movement toward microsurgical reconstruction by free tissue transfer and has addressed lymphedema and breast sensation.

Tissue Expansion in Children.

Tissue expansion is a well-established surgical method that has been creatively applied to the management of many congenital and acquired pediatric conditions, including the removal of giant congenital melanocytic nevi and the separation of conjoined twins. Careful preoperative planning and patient follow-up are required to achieve the proper results and minimize complications. Special considerations for pediatric patients are present during each step of the process, from patient selection to postoperative care.

Soft-Tissue Surgery for Camptodactyly Corrects Skeletal Changes.

Background: This study demonstrates the potential for radiographic and clinical improvement with surgical correction of camptodactyly. Although historically these radiographic changes have been held to be permanent, the authors encourage surgical intervention for digits with severe flexion contracture or progressive radiographic changes before skeletal maturity is reached.

Methods: The authors assessed 18 consecutively operated fingers in nine skeletally immature patients in whom advanced radiographic articular changes had occurred.

Severe camptodactyly: A systematic surgeon and therapist collaboration.

Introduction: Although common, the treatment of camptodactyly is controversial.

Purpose: Our purpose is to delineate a logical stepwise treatment plan based on corresponding components of the pre-operative and intraoperative evaluation of camptodactyly. In addition, describe structure rehabilitation plan utilizing the same stepwise evaluation.

Evaluation of a stepwise surgical approach to camptodactyly.

Background: Camptodactyly is common, but its treatment remains controversial. Multiple deforming forces have been implicated in its pathogenesis. This study evaluates a logical clinical assessment and corresponding stepwise surgical plan.

Repair of combined cheek and nose defects: categorization and utilization.

Combined cheek and nose soft tissue defects can represent a formidable challenge to the reconstructive surgeon. It is important for the surgeon to think of these defects as four separate categories: cheek with nasal sidewall, cheek with nasal sidewall and exposed bone, cheek with nasal sidewall plus ala, and cheek with simple posterior ala defect. This categorization will help the surgeon plan the repair and provide a successful aesthetic outcome.

Multidigit camptodactyly of the hands and feet: A case study.

A clinical case of a 12-year-old boy who presented with multidigit, nonsyndromal, progressive camptodactyly is discussed. While bilateral little finger camptodactyly is well described, there is no documentation of camptodactyly involving all fingers and many toes as well as both proximal (PIP) and distal interphalangeal (DIP) joints. This patient responded well to surgery, which was performed on four toes and seven fingers, despite having established radiographic changes of camptodactyly in the PIP joints as well as two DIP joints.

Comparison of magnification in primary digital nerve repair: literature review, survey of practice trends, and assessment of 90 cadaveric repairs.

Purpose: To review published clinical outcomes and current practice trends and to assess the quality of cadaveric digital nerve repairs using either loupe or microscopic magnification.

Methods: Published clinical outcomes of digital nerve repair accounting for magnification level were reviewed. Members of the American Society for Surgery of the Hand were surveyed regarding their current surgical practices.

Functional outcomes of children with index pollicizations for thumb deficiency.

Purpose: To gain a comprehensive perspective on outcomes by performing an array of tests on patients who had undergone index pollicization for isolated thumb aplasia or severe hypoplasia in the absence of clinical radial dysplasia; this led us to create a graphical snapshot for future comparison. Another purpose was to compare the function of the contralateral hand and to compare parent and patient perspectives.

Methods: We evaluated 22 hands (18 patients) by grip as well as lateral and tripod pinch strength tests; the pegboard Functional Dexterity Test (FDT); the Jebsen Hand Function Test (JHFT); and a parent/patient questionnaire.

Interphalangeal joint salvage arthrodesis using the lister tubercle as bone graft.

Treating failed interphalangeal joint arthroplasty is challenging. After an implant or surgical device has been removed, minimal cortical bone remains, and cancellous bone is largely absent from the medullary canals. Several surgical techniques exist for athrodesis of these joints, which render the operated digit unnaturally straight and shortened.