The "Culture" of Organs: A Holistic Theory on the Origins of the Cancer Tissue Environment.

For over a century, the somatic gene mutation theory of cancer has been a scientific orthodoxy. The recent failures of causal explanations using this theory and the lack of significant progress in addressing the cancer problem medically have led to a new competition of ideas about just what cancer is. This essay presents an alternative view of cancer as a developmental process gone wrong.

Absorbable Biosynthetic Scaffolds in Place of Silicone for Breast Reconstruction: A 9-Year Experience with 53 Patients.

Background: Few series report on using fat grafting as the primary form of breast reconstruction. A 9-year experience with absorbable biosynthetic scaffolds, used in place of silicone implants, for breast reconstruction is reviewed.

Methods: A clinical quality improvement approach was used to evaluate real-world data on a single plastic surgeon's experience treating breast reconstruction patients over a 7-year period.

Clinical Implications of the Fascial System: A Commentary on One Surgeon's Journey.

A review of the most important concepts of the last 100 years on the topic of fascia and its fundamental importance to tissue and organ structure and function is provided as a basis for the author's commentary on the self-organizing nature of fascia. Implications for clinical applications in medicine, in both pathophysiology and the treatment of disease, follow from these anatomic insights. Organizing principles of nature put forth by D'Arcy Thompson, Buckminster Fuller, Benoit Mandelbrot, and Adrian Bejan set the stage for understanding tissue and fascial form.

Implant-based Prepectoral Breast Reconstruction: The Importance of Oncoplastic Plane, its Blood Supply and Assessment Methods.

With the recent rise in prepectoral breast reconstruction, partly due to the improvement in implants and the aesthetic results but, more so, due to the perseveration of the pectoralis major, it is of great importance to have an appreciation of the clinical anatomy with regards to the breast and its blood supply for the practice of prepectoral breast reconstruction. The preservation of the mastectomy flap vasculature together with meticulous surgical technique minimizes complications, notoriously of skin flap necrosis. We aimed to describe the anatomy of the oncoplastic plane (for the prepectoral technique), its vasculature, and relevant assessment methods.

Breast Reconstruction Using a Three-Dimensional Absorbable Mesh Scaffold and Autologous Fat Grafting: A Composite Strategy Based on Tissue-Engineering Principles.

Breast reconstruction remains an important field in plastic surgery, with most procedures using implants and/or autologous tissue. Few series report on experience with fat grafting as the primary form of breast reconstruction. The present article describes a new method of breast reconstruction using a three-dimensional absorbable mesh construct-or Lotus scaffold-and autologous fat grafting.

Anatomy of the Superficial Fascia System of the Breast: A Comprehensive Theory of Breast Fascial Anatomy.

Background: It has been two centuries since Petrus Camper identified superficial fascia and over 175 years since Sir Astley Cooper wrote his book on the anatomy of the breast. In the 1990s, Ted Lockwood taught us the importance of the superficial fascia layers in body contouring procedures he pioneered. These descriptions, however, fail to explain the three-dimensional fascial system in the breast.

Endoscopic surgery of the upper extremity.

Endoscopic techniques for surgery of the upper extremity show great promise based on recent discoveries of anatomic tissue planes. These planes can be dissected using new technology consisting of endoscopic balloons that create optical cavities that permit "incisionless" surgery. This article contains a review of the anatomic principles, new surgical technology, and development of endoscopic tools, as well as an example of endoscopic tissue expansion placement for soft-tissue augmentation in the upper extremity.