Evidence-Based Practices in Cleft Palate Surgery.

Learning Objectives: After studying this article, the participant should be able to: (1) Understand the embryologic origins, cause, and incidence of cleft palate. (2) Review the anatomy and common classifications of cleft palate and associated defects. (3) Describe surgical techniques for palatoplasty and understand their respective indications.

Racial Disparities Following Reconstructive Flap Procedures.

Background: Prior reports have highlighted disparities in healthcare access, environmental conditions, and food insecurity between Black and White populations in the United States. However, limited studies have explored racial disparities in postoperative complications, particularly reconstructive flap surgeries.

Methods: Cases of flap reconstruction based on named vascular pedicles were identified in the American College of Surgeons National Surgical Quality Improvement Program database and grouped into 3 time periods: 2005 to 2009, 2010 to 2014, and 2015 to 2019.

Acellular Dermal Matrix Cover Improves Skin Growth during Tissue Expansion by Affecting Distribution of Mechanical Forces.

Background: Biological cover over tissue expander prostheses has been introduced to provide soft-tissue support for tissue expanders during breast reconstruction. However, its impact on mechanically induced skin growth remains unknown. This study investigates the hypothesis that covering the tissue expander with acellular dermal matrix (ADM) affects mechanotransduction without compromising the efficacy of tissue expansion.

Practice Patterns in Primary Breast Augmentation: A 16-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery.

Background: As part of the continuous certification process, the American Board of Plastic Surgery collects case data for specific tracer procedures in aesthetic surgery to assess practice improvement by the diplomates. These case-based data provide valuable information on national trends in clinical practice. The current study was performed to analyze practice patterns in aesthetic primary breast augmentation.

Changes in Subspecialty Interest of Plastic Surgery Residents With Progression of Training: Impact on Academic Attrition.

Background: Plastic surgery residency applicants often express interest in academic subspecialties, but only a small percentage of graduating residents pursue academic careers. Identifying reasons for academic attrition may help training programs address this discrepancy.

Methods: A survey was sent to plastic surgery residents through the American Society of Plastic Surgeons Resident Council to assess interest in 6 plastic surgery subspecialties during junior and senior years of training.

The Quality and Readability of Online Patient Information on Positional Head Shape Conditions.

Objective: Families increasingly use online resources to acquire medical information about their child's condition with little understanding of the legitimacy of the source of information or of the information itself. We evaluate the quality and readability of online information related to positional head shape conditions and identify unmet needs for healthcare providers to improve online patient education.

Design: The search terms "flat head baby," "brachycephaly," and "plagiocephaly" were queried on the Google search engine and the first 20 websites for each were reviewed.

Secondary Cleft Rhinoplasty: A National Survey of Surgical Practice by Accredited Cleft Palate Teams.

Unlabelled: Patients with cleft lip often undergo a primary rhinoplasty at the time of lip repair, and further surgical correction with secondary cleft rhinoplasty (SCR) is often warranted for improved form and function. The purpose of this study was to better elucidate current practice patterns and trends for how SCR is performed in the United States.

Methods: We administered a survey to team surgeons affiliated with cleft lip and palate care teams approved by the American Cleft Palate Craniofacial Association (ACPA).

Biological Cover Mitigates Disruption of the Dermal Structure in Mechanically Expanded Skin in a Porcine Model.

Tissue expansion is an integral procedure of the vast majority of breast reconstruction and has a significant impact on the final clinical outcomes. Therefore, technological advances leading to a fewer number of unfavorable outcomes and a decrease in complication rates are imperative. In this study, using a porcine model, we investigated an effect of acellular dermal matrix (ADM) used as a tissue expander cover on the dermal changes induced by mechanical forces during tissue expansion.

Genital Self-Image and Esthetic Genital Surgery.

Genital self-image describes the perception of one's genital appearance as being "normal" or "abnormal," and a disharmonious image leads to an increasing number of women seeking esthetic genital surgery each year. The concept of what constitutes "normal" is strongly influenced by the media, cultural norms, and sexual relations. In reality, the extent of normalcy is highly variable and overall patient education regarding extremes of size and shape should be provided to all patients considering surgery.

Competency-Based Education: Will This be the New Training Paradigm in Plastic Surgery?

The Accreditation Council for Graduate Medical Education created the "Next Accreditation System" in 2013 requiring residents to meet educational milestones based on core competencies over the course of their training. The 6 core competencies include patient care and technical skills, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. Since the traditional time-based model requires a predetermined length of training irrespective of learning style, pace, or activity, a competency-based model is appealing because it refocuses education on deliberate and relevant skills acquisition and retention.

The Impact of Dedicated Research Years During Residency Upon Continued Academic Productivity of Plastic Surgeons.

Background: This study explored the impact of dedicated research year(s) on long-term research productivity and career choices of plastic surgeons as academicians.

Methods: Scopus and Web of Science were accessed in September 2020 to collate publications and H indexes of alumni who graduated from integrated plastic surgery residency programs from 2011 to 2020. Public profiles were utilized to determine academic status.

The financial implications of telemedicine practice patterns across pediatric surgical specialties.

Background: Telemedicine has played an increasingly important role in surgical care during the coronavirus disease 2019 (COVID-19) pandemic, yet little is known about its usage and correlation to cost both within and across surgical specialties during the pandemic.

Study Design: We collected data on telehealth encounters from April 2020 to June 2021 for all surgical specialties at a pediatric academic institution. The percent of total encounters that were telemedicine vs.

How Important Are Dedicated Research Years and Global Health to Applicants in Plastic Surgery?

Unlabelled: Applicant preferences for required research and global surgery experiences during plastic surgery training have not been previously studied.

Methods: An anonymous survey was sent to integrated plastic surgery applicants from consecutive residency application cycles (2018-2020). Research and global health experiences before residency were elicited, along with the interest to continue these activities.

Routes to Residency: A National Survey Demonstrating the Pathways to Become a Plastic Surgeon.

Unlabelled: Plastic and reconstructive surgery (PRS) residency training can be completed through multiple pathways. Current residents' experiences regarding these different routes have not been previously described. The objective of the present study was to describe the educational pathways taken by current PRS residents in the United States.

Do Dedicated Research Years during Medical School Predict Academic Productivity during Residency?

Background: Evidence regarding whether medical school research portends resident research is limited. This information will provide program directors with data that may be useful for selecting applicants with a commitment to continued academic productivity.

Methods: A questionnaire distributed via the American Society of Plastic Surgeons Resident Council to residents in 44 plastic surgery training programs in May 2020 assessed participation in dedicated research years during medical school, the number of publications completed before residency, and the total number of publications by each resident at the time of the survey.

Improving Medical Student Recruitment into Plastic Surgery: A Survey of Orphaned Medical Students.

Objectives: This study was undertaken to measure the concerns of students whose medical schools do not have a plastic surgery training program to help educators better understand their perspectives. This is essential to improve plastic surgery education for almost 50% of students in the United States at institutions without a residency program.

Design: An anonymous survey was distributed to the clerkship directors of the applicable medical schools.

Depressor Anguli Oris Function in Oral Macrostomia.

Unilateral oral macrostomia can present in isolation or conjunction with other craniofacial abnormalities. Common associations include cartilaginous tags and accessory tragi, while the facial nerve is rarely involved. Our work is the first of its kind to report depressor anguli oris paralysis in the setting of oral macrostomia.