Standardized Pre-clinical Surgical Animal Model Protocol to Investigate the Cellular and Molecular Mechanisms of Ischemic Flap Healing.

Background: Some of the most complex surgical interventions to treat trauma and cancer include the use of locoregional pedicled and free autologous tissue transfer flaps. While the techniques used for these reconstructive surgery procedures have improved over time, flap complications and even failure remain a significant clinical challenge. Animal models are useful in studying the pathophysiology of ischemic flaps, but when repeatability is a primary focus of a study, conventional in-vivo designs, where one randomized subset of animals serves as a treatment group while a second subset serves as a control, are at a disadvantage instigated by greater subject-to-subject variability.

Rate of Fat Graft Volume Loss After Parotidectomy.

Background: Reconstruction after parotidectomy can include fat grafting, which allows for symmetry, but grafts have demonstrated volume loss over time.

Objectives: To provide quantitative evidence for the rate of volume loss of fat grafts.

Methods: Patients who received parotidectomy with fat graft reconstruction at a single institution from August 2016 to October 2020 were identified.

Sonic Rhinoplasty: Review and Updated Uses.

The ultrasonic bone aspirator (UBA) allows for precision and provides ease of use in multiple steps of cosmetic and functional rhinoplasties. Its use has previously been described; however, since the publication of many studies the UBA has been improved and its applications for rhinoplasty have been modified and expanded. Both bony and cartilaginous modifications to the nose can be aided with the use of the UBA.

Natural History and Consequences of Nonunion in Mandibular and Maxillary Free Flaps.

Objective: To describe the natural history of bone segment union in head and neck free flap procedures and detail the association of poor segment union with postoperative complications.

Study Design: Case series with chart review.

Setting: Single tertiary care referral center.

Long-Term Complications of Osteocutaneous Free Flaps in Head and Neck Reconstruction.

Objective: To determine the frequency at which patients with osteocutaneous free flap reconstruction of the head and neck develop long-term complications and identify predisposing perioperative factors.

Study Design: A prospectively maintained database of free flaps performed at a single institution over a 10-year period was queried.

Setting: Single tertiary care referral center.

Virtual Surgical Planning in Subscapular System Free Flap Reconstruction of Midface Defects.

Objectives: Reconstruction of the midface has many inherent challenges, including orbital support, skull base reconstruction, optimizing midface projection, separation of the nasal cavity and dental rehabilitation. Subscapular system free flaps (SF) have sufficient bone stock to support complex reconstruction and the option of separate soft tissue components. This study analyzes the effect of virtual surgical planning (VSP) in SF for midface on subsite reconstruction, bone segment contact and anatomic position.

Safety of Concurrent Endoscopic Browlift and Blepharoplasty.

The objective of the study was to evaluate the clinical safety of endoscopic browlift alone or in combination with blepharoplasty as a treatment for the aging face. This is a retrospective comparative study from 2007 to 2016 at a single tertiary care center. A consecutive sample of patients undergoing surgery for aging of the upper face was included in the study.

Thermistor-controlled subdermal skin tightening for the aging face: Clinical outcomes and efficacy.

Objective: Patients are increasingly seeking nonsurgical treatment for the aging face. The purpose of this study was to evaluate the clinical efficacy and outcomes of a thermistor-controlled subdermal skin tightening device (ThermiTight) as a treatment modality for the aging face.

Methods: A retrospective analysis of 12 patients was completed on patients having undergone ThermiTight for midface and neck skin tightening.

The Role of Free Tissue Transfer in the Management of Chronic Frontal Sinus Osteomyelitis.

Objectives/hypothesis: Chronic frontal sinus infection is managed with a combination of medical and surgical interventions. Frontal bone osteomyelitis due to recurrent infection following trauma or prior open surgery may require more significant debridement. Free tissue transfer may allow for extensive debridement with replacement of tissue, and definitive eradication of osteomyelitis.

Evaluating New Technology.

There are multiple complex issues to consider when evaluating any new technology. First evaluate the efficacy of the device. Then considering your patient population decide whether this technology brings an added benefit to your patients.

Naso- or Orbitocutaneous Fistulas after Free Flap Reconstruction of Orbital Exenteration Defects: Retrospective Study, Systematic Review, and Meta-Analysis.

 Naso- or orbitocutaneous fistula (NOF) is a challenging complication of orbital exenteration, and it often requires surgical repair. We sought to identify the incidence and risk factors for NOF after orbital exenteration.  Retrospective chart review, systematic review, meta-analysis.

Postoperative cerebrospinal fluid leak after microvascular reconstruction of craniofacial defects with orbital exenteration.

Objectives: To assess risk factors for cerebrospinal fluid (CSF) leak and complications after microvascular reconstruction of cranio-orbitofacial resection with orbital exenteration (CFOE).

Study Design: Retrospective case series.

Methods: Seventy consecutive patients at a tertiary hospital underwent 76 procedures with microvascular reconstruction of CFOE defects.

Aging effects on pedicled fasciocutaneous flap survival in rats.

Background: Poorer surgical outcomes in older patients undergoing locoregional head and neck reconstruction have raised questions about tolerance of aging tissue to iatrogenic ischemic insults.

Methods: We examined the effects of aging on viability of pedicled composite flaps in 2-month and 6-month old Sprague-Dawley male rats and correlated flap survival with vascular endogenous growth factor (VEGF) and VEGF receptor 2-mediated signaling events. Flap segments were assessed for gross/cellular necrosis by optical microscopy and for proangiogenic, apoptotic, and proliferative protein-marker content.

Subcutaneous vs intramuscular botulinum toxin: split-face randomized study.

IMPORTANCE Much has been published regarding rejuvenation of the upper face with botulinum toxin A injection; however, the optimal target tissue layer has not been specifically examined. OBJECTIVE To seek a difference between subcutaneous (SC) and intramuscular (IM) administration. DESIGN, SETTING, AND PARTICIPANTS Prospective, randomized study at a tertiary care university facial plastic surgery practice.

A preliminary report of percutaneous craniofacial osteoplasty in a rat calvarium.

Objectives/hypothesis: To evaluate the potential for injectable, permanent bone augmentation by assessing the biocompatability and bioactivity of subperiosteal hydroxylapatite (Radiesse) deposition in a rat model.

Study Design: Randomized controlled animal model.

Methods: Fourteen adult Sprague Dawley rats were injected in the parietal skull with 0.

Incidence and management of rhinosinusitis after complex orbitofacial reconstruction.

Objectives/hypothesis: To examine the sinus-related sequelae of free flap reconstruction for complex orbitofacial defects.

Study Design: Retrospective chart review.

Methods: Demographic, clinical, and radiographic data on a series of 55 patients who had undergone free tissue transfer for orbitofacial reconstruction was retrospectively reviewed.

Photoaging.

Treatments for photoaging are commonly requested by cosmetic patients. Laser resurfacing treatment addresses the myriad aspects of photoaging, including fine rhytides, dyspigmentation, and abnormal texture. Recent developments in laser medicine--such as fractional resurfacing in both ablative and non-ablative wavelengths--have improved the safety and side effect profile of laser resurfacing.

Laser treatment of skin texture and fine line etching.

Modern cosmetic medicine requires accurate recognition of all types of rhytids and their molecular causes such that treatments may be tailored for improving skin appearance for each unique patient. This article examines the causes and treatment of fine rhytids. Laser rejuvenation therapies that affect the epidermis, dermis or both and induce neocollagenesis and dermal remodeling can be effective against the stigmata of mature skin.

Management of traumatic facial nerve injuries.

Management of facial nerve injuries requires knowledge and skills that should be in every facial plastic surgeon's armamentarium. This article will briefly review the anatomy of the facial nerve, discuss the assessment of facial nerve injury, and describe the management of facial nerve injury after soft tissue trauma.

Management of bite wounds in the head and neck.

An estimated 50% of people in the United States will incur an animal or human bite wound at least once in their lifetimes. Although the majority of these individuals do not seek medical attention, bite wounds to the head and neck are a common reason for emergency department visits. Facial bites are complex injuries due to the functional and cosmetic nature of the area, as well as the unique polymicrobial infection potential that exists.

Assessment of microvascular anastomosis training in otolaryngology residencies: survey of United States program directors.

Objective: To assess current microvascular training strategies in otolaryngology residency programs.

Study Design: Cross-sectional study.

Setting: U.

Recombinant human tissue factor pathway inhibitor prevents thrombosis in a venous tuck model.

Objectives/hypothesis: Microvascular free tissue transfer has become a mainstay of reconstruction after resections for head and neck cancer. With current techniques, free flap failure is typically low; however, failure rates have been reported as high as 10%. Most thrombotic failures occur within the first few days postoperatively and tend to involve the venous anastomoses.

Reconstruction of the radial forearm free flap donor site using integra artificial dermis.

Autologous skin grafting to the donor site in patients who undergo radial forearm free flap reconstruction (RFFF) is associated with cosmetic and functional morbidity. Integra artificial dermis (Integra Lifesciences, Plainsboro, NJ) is a bovine collagen based dermal substitute that can be used as an alternative to primary autologous skin transplantation of the donor site. We describe a staged reconstruction using Integra followed by ultrathin skin grafting that results in highly aesthetic and functional outcomes for these defects.