Mastectomy Incision Choice in Ptotic Patients Undergoing Immediate Implant-Based Reconstruction: A Comparison of Wise-Pattern and Oblique-Elliptical Incisions.

Breast ptosis presents challenges for implant-based reconstruction due to the large skin envelope. Skin-reducing mastectomy reduces the envelope but must consider many other factors including complications. Limited data exist on incision impact on outcomes.

Postoperative pain and opioid use after breast reduction with or without preoperative nerve block.

Background: Physician-prescribed opioids have been implicated as key contributing factors in the current opioid epidemic in the United States. Breast reduction mammoplasty is one of the most commonly performed procedures in plastic surgery and patients are often prescribed large amounts of postoperative opioids. Here we investigate the effects of erector spinae nerve blocks on postoperative pain, opioid consumption, and quality of life after breast reduction.

Do larger reductions yield larger returns? patient-reported outcomes as a function of specimen weight in bilateral reduction mammoplasty.

Background: Patients undergoing breast reduction mammoplasty for symptomatic macromastia have a significantly improved quality of life postoperatively. However, there are no data that examine the effect of reduction mammoplasty on quality of life as a function of the weight of tissue removed. Because the process by which insurance providers consider patients' candidacy for this breast reduction mammoplasty is most often based on the proposed weight of tissue to be removed, this gap in our understanding is particularly glaring.

Analysis of Immediate versus Delayed Sternal Reconstruction with Pectoralis Major Advancement Versus Turnover Muscle Flaps.

Background:  The pectoralis major muscle flap is a versatile reconstructive option for deep sternal wound infections (DSWI). The timing and surgical technique of bilateral pectoralis major muscle advancement flaps versus unilateral pectoralis major muscle turnover and unilateral pectoralis major muscle advancement flap on patient outcomes remain to be elucidated. The purpose of this investigation was to compare timing, immediate versus delayed reconstruction, and the surgical technique in patients with deep sternal wounds infections on patient outcomes.

Population Health Implications of Medical Tourism.

Background: Fifteen million U.S. patients each year seek medical care abroad; however, there are no data on outcomes and follow-up of these procedures.

Do acellularized dermal matrices change the rationale for immediate versus delayed breast reconstruction?

This article focuses on the contribution of acellular dermal matrices (ADMs) to immediate breast reconstruction. The current literature on ADMs is reviewed and the potential advantages and disadvantages of their use are highlighted. Technical considerations on how to effectively use these materials is presented.

Successful non-operative management of an iatrogenic recto-urethral fistula in a 13-year-old boy.

Here we present a case of successful non-operative management of an iatrogenic recto-urethral fistula in a 13-year-old boy. The fistula was created when urethroscopic repair of a urethral stricture was attempted. Due to the anatomy of the lesion and previous urinary diversion, it was deemed possible to spare this patient diverting colostomy or surgical repair of the fistula.

Lower lid deformity secondary to autogenous fat transfer: a cautionary tale.

Although autogenous fat grafting is performed with increasing frequency, its safety around the periorbital area remains ill defined. This article presents the case of a young woman whose tear troughs were treated using autogenous fat transfer (AFT), with resultant bilateral lower lid deformities. Secondary correction of this aesthetic deformity caused by AFT to the tear trough proved extremely difficult and resulted in a temporary lower lid ectropion.

Routine use of microvascular coupling device for arterial anastomosis in breast reconstruction.

Background: Although microvascular coupling devices are used routinely and successfully for venous anastomosis, there are few published reports demonstrating their efficacy for performing arterial anastomosis. It has been the senior author's (C.Y.

Nipple-areola reconstruction following chest-wall irradiation for breast cancer: is it safe?

Radiation therapy (RT) is considered by some to be a contraindication to nipple-areola reconstruction (NAR) particularly in patients with breast implant reconstruction. In this retrospective chart review, all patients who underwent breast reconstruction with tissue expanders and implants from 1997-2003 were reviewed. A subset of patients with a history of radiation therapy (pre- or postoperative) was identified.