Novel Strategies for Evaluating and Improving Plastic Surgery Applicant Selection.

Residency applicant evaluation and selection is a critical part of developing and maintaining a high-quality plastic surgery residency program. Currently, many programs rely on objective measures such as the United States Medical Licensing Exam scores, number of research publications, grade point average, Alpha Omega Alpha Honor Medical Society status, or a combination of these objective metrics. However, there is a growing body of literature suggesting that the current means of residency applicant evaluation and selection may not be the best predictive factors of future resident success.

The "RealSelf Effect": Can Patient Reviews on Social Media Impact Clinic Volume?

Background: Whether patient driven or surgeon driven, social media can serve as a strong marketing tool to attract plastic surgery patients. At many training programs, chief residents have the opportunity to run an independent clinic, in which patients are evaluated for aesthetic and reconstructive procedures. In this study, the authors sought to investigate the downstream effect of a single positive review on a major social review site on cosmetic surgery volume.

Fat Grafting to Improve Results of Facelift: Systematic Review of Safety and Effectiveness of Current Treatment Paradigms.

Background: Autologous fat grafting is a helpful supplement to facelift surgery that helps to combat age-related volume loss of facial structures. Despite the widespread prevalence of combined facelift and fat-grafting, significant procedural variation exists between providers.

Objectives: The primary purpose of this systematic review was to study the efficacy and complication rates of facelift with lipofilling compared with facelift alone.

Review of Endoscopic Repair of Mandible Fractures.

Introduction: Fractures of the mandibular condyle represent more than 30% of all mandible fractures. If required, reduction has been performed using either a closed or an open technique with similar outcomes. Endoscopic fracture repair is a minimally invasive approach for open reduction, but there is limited data regarding indications and outcomes.

Solving Congestion in the Plastic Surgery Match: A Game Theory Analysis.

Plastic and reconstructive surgery is among the most competitive specialties in the residency match. Applicants seeking to maximize their chances of a successful match often submit numerous applications to the National Residency Matching Program. It is not uncommon for those applying to plastic and reconstructive surgery to apply to every program.

Plastic Surgery Resident-Run Cosmetic Clinics: A Survey of Current Practices.

Background: The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the Accreditation Council for Graduate Medical Education highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics.

Liposomal Bupivacaine in Implant-Based Breast Reconstruction.

Purpose: This study evaluates the role of liposomal bupivacaine in implant-based breast reconstruction.

Methods: A prospective, randomized, single-blind trial of liposomal bupivacaine in implant-based breast reconstruction was performed. Patients in the control arm were treated with 20 mL 0.

Use of antibiotic beads to salvage infected breast implants.

Purpose: When an implant becomes infected, implant salvage is often performed where the implant is removed, capsulectomy is performed, and a new implant is inserted. The patient is discharged with a PICC line and 6-8 weeks of intravenous (IV) antibiotics. This method has variable success and subjects the patient to long-term systemic antibiotics.

Risk Factors Leading to Free Flap Failure: Analysis From the National Surgical Quality Improvement Program Database.

Background: The objective of this study was to identify risk factors for free flap failure among various anatomically based free flap subgroups.

Methods: The 2005 to 2012 American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing microvascular free tissue transfer based on current procedural terminology codes. Univariate analysis was performed to identify any association between flap failure and the following factors: age, gender, race, body mass index (BMI), diabetes, smoking, alcohol use, hypertension, intraoperative transfusion, functional health status, American Society of Anesthesiologists class, operative time, and flap location.

Flap Failure and Wound Complications in Autologous Breast Reconstruction: A National Perspective.

Purpose: There are many options for breast reconstruction following a mastectomy, and data on outcomes are greatly needed for both the patient and the care provider. This study aims to identify the prevalence and predictors of adverse outcomes in autologous breast reconstruction in order to better inform patients and surgeons when choosing a surgical technique.

Methods: This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified each autologous breast reconstruction performed between 2005 and 2012.

A Comparison of Postoperative Outcomes in Immediate Versus Delayed Reconstruction After Mastectomy.

Objective: The objective of this study was to evaluate the frequency of various postoperative complications in patients undergoing either immediate or delayed breast reconstruction after mastectomy for malignancy.

Methods: The ACS-NSQIP 2005-2012 database was queried for patients who underwent mastectomy for the treatment of breast malignancy. These mastectomy cases were then stratified, generating "mastectomy alone" and "mastectomy with immediate reconstruction" cohorts.

Outcomes and Safety of the Combined Abdominoplasty-Hysterectomy: A Preliminary Study.

Background: Abdominoplasty (ABP) at the time of hysterectomy (HYS) has been described in the literature since 1986 and is being increasingly requested by patients. However, outcomes of the combined procedure have not been thoroughly explored.

Methods: The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program database and identified each ABP, HYS, and combined ABP-HYS performed between 2005 and 2012.

Cryolipolysis for fat reduction and body contouring: safety and efficacy of current treatment paradigms.

Background: Cryolipolysis is a nonsurgical technique for localized fat reduction. With the increased risk of complications from more invasive methods such as liposuction, cryolipolysis presents a promising method for nonsurgical body contouring. This study presents a systematic review of the available clinical data, with an emphasis on the efficacy, methods, safety, and complications of cryolipolysis.

Vaginal labiaplasty: current practices and a simplified classification system for labial protrusion.

Background: Vaginal labiaplasty has been described for the management of functional and aesthetic problems associated with protrusion of the labia minora. Despite increasing numbers of procedures performed, there is a paucity of data to guide treatment paradigms. This systematic review aims to establish a simple, unifying classification scheme for labial protrusion and summarize current labiaplasty techniques and practices.

Does the application of incisional negative pressure therapy to high-risk wounds prevent surgical site complications? A systematic review.

Purpose: The application of incisional negative pressure wound therapy (INPWT) to clean, closed surgical incisions is a growing clinical practice. A systematic review was conducted to evaluate the effect of INPWT on surgical sites healing by primary intention. The primary outcomes of interest are incidence of complications (infection, dehiscence, seroma, hematoma, skin necrosis, or blistering).

Internal fixation of the distal humerus: a comprehensive biomechanical study evaluating current fixation techniques.

Objectives: The purpose of this study was to evaluate current fixation techniques in the operative fixation of distal humerus fractures, both with conventional and locked plating in both parallel and orthogonal orientation.

Methods: Twenty-eight upper extremities from 14 cadavers were prepared to create 4 implant testing constructs: Synthes locking plates (IMP1) (medial and posterolateral with lateral flange), Acumed parallel locking plates (IMP2), Smith & Nephew orthogonal locking plates (IMP3), and Synthes orthogonal 3.5-reconstruction plating (IMP4) (1 posterolateral and 1 medial).

A survey of patient comprehension of readily accessible online educational material regarding plastic surgery procedures.

Purpose: When an elective procedure is under consideration, the Internet may often be the first resource utilized by a patient.

Objectives: The goal of the present study was to examine the comprehension of readily available online educational material by the patient population in a single plastic surgery clinic.

Methods: Two 5-question surveys were constructed: 1 for breast augmentation and 1 for rhinoplasty, each based on explanatory passages from patient education sections of the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) websites.