Bioabsorbable Polydioxanone Mesh for Soft Tissue Reinforcement in Revisional Breast Surgery.

Background: The need for revision procedures after breast implant surgery often arises from the failure of soft tissues to provide a stable implant pocket. Meshes or dermal matrices have been used to reinforce the implant's soft tissue support. Durasorb (Surgical Innovation Associates, Chicago, IL) is a resorbable polydioxanone (PDO) mesh indicated for soft tissue reinforcement.

Wealth Management and Retirement.

The purpose of this publication is to introduce basic financial planning concepts and highlight their use in creating a retirement savings plan. These tools may help young surgeons set their financial targets and create a plan to meet them, whereas surgeons later in their careers may reflect on their choices and implement adjustments, or be inspired to pass on the lessons they learned to the next generation. This publication is limited by design and should be thought of as a primer, not a comprehensive treatise.

Bayesian calibration of a computational model of tissue expansion based on a porcine animal model.

Tissue expansion is a technique used clinically to grow skin in situ to correct large defects. Despite its enormous potential, lack of fundamental knowledge of skin adaptation to mechanical cues, and lack of predictive computational models limit the broader adoption and efficacy of tissue expansion. In our previous work, we introduced a finite element model of tissue expansion that predicted key patterns of strain and growth which were then confirmed by our porcine animal model.

Photographic Misrepresentation on Instagram After Facial Cosmetic Surgery: Is Increased Photography Bias Associated With Greater User Engagement?

Background: Before-and-after images are commonly used on Instagram (Menlo Park, CA) to advertise aesthetic surgical treatments and are a powerful means of engaging prospective patients. Consistency between before-and-after images accurately demonstrating the postoperative result on Instagram, however, has not been systematically assessed.

Objectives: The aim of this study was to systematically assess facial cosmetic surgery before-and-after photography bias on Instagram.

Modeling Tissue Expansion with Isogeometric Analysis: Skin Growth and Tissue Level Changes in the Porcine Model.

Background: Tissue expansion relies on the ability of skin to grow in response to sustained mechanical strain. This study focuses on correlation of cellular and histologic changes with skin growth and deformation during tissue expansion.

Methods: Tissue expanders were placed underneath the skin of five Yucatan minipigs and inflated with one fill of 60 cc of saline 1 hour, 24 hours, 3 days, and 7 days before the animals were killed, or two fills of either 30 cc or 60 cc at 10 and 3 days or 14 and 7 days before the animals were killed.

Anterior and Posterior Commissuroplasty: Taking Labiaplasty to the Next Level.

As the popularity of female cosmetic genital surgery has grown, so has the number of publications detailing surgical techniques, particularly regarding labiaplasty. As a nascent surgical field, much room remains for finesse and exploration of new techniques to optimize outcomes and patient satisfaction. We present the techniques for anterior and posterior commissuroplasty the senior author (O.

Personalized Computational Models of Tissue-Rearrangement in the Scalp Predict the Mechanical Stress Signature of Rotation Flaps.

Objective: To elucidate the mechanics of scalp rotation flaps through 3D imaging and computational modeling. Excessive tension near a wound or sutured region can delay wound healing or trigger complications. Measuring tension in the operating room is challenging, instead, noninvasive methods to improve surgical planning are needed.

Novel Passage of Dermis-Fat Graft for Augmentation of Vermilion Deficiency Following Cleft Lip Repair.

Despite timely repair of cleft lip, secondary deformities such as vermilion notching or "whistle deformity" often require further surgical treatment. The use of dermis-fat graft for soft tissue augmentation of the upper lip is an established technique. We propose an innovation on this technique, by which the dermis-fat graft can be placed reliably and with minimal dissection by use of a soft red rubber sheath to protect the Keith needle while delivering the graft through the submucosal pocket in the dry vermilion, thereby avoiding the needle inadvertently catching soft tissue inside the pocket.

Incidence of Obstetric Lacerations and Episiotomy Following Labiaplasty.

Background: A significant proportion of patients seeking labiaplasty are nulliparous and may experience later changes to their labia following vaginal delivery.

Objectives: In the present study, the authors reported the long-term outcomes of a single surgeon's patient cohort who had vaginal delivery after labiaplasty.

Methods: A retrospective chart review of the senior author's database was conducted.

Utilization of Intraparotid Segments of Superficial Temporal Vessels for Head and Scalp Free Flap Microanastomosis: A Clinical, Histological, and Cadaveric Study.

Background:  The superficial temporal vessels (STV) are an underutilized target for head and neck microvascular reconstruction. Most surgeons regard the dissection as difficult, unreliable, and the anastomosis prone to vasospasm. The intraparotid course of the STV may provide more reliable flow without accompanying morbidity.

Gluteal Vein Anatomy: Location, Caliber, Impact of Patient Positioning, and Implications for Fat Grafting.

Background: Deaths in gluteal autografting occur due to gluteal vein injuries, but data are lacking on the precise location and caliber of these veins.

Objectives: The authors sought to present the first in vivo study of gluteal vein anatomy utilizing magnetic resonance imaging.

Methods: Magnetic resonance imaging venography of 16 volunteer hemi-sections was conducted in the supine, prone, prone with a bump (jack-knife), and left and right decubitus positions in 1 session after a single contrast administration.

A Quantitative Analysis of Online Plastic Surgeon Reviews for Abdominoplasty.

Background: Online reviews increasingly influence patients' decision-making. This is the first systematic, quantitative analysis of online reviews for abdominoplasty.

Methods: Reviews for abdominoplasty were sampled from RealSelf, Yelp, and Google for six major metropolitan areas.

Fibrous Dysplasia and Juvenile Psammomatoid Ossifying Fibroma: A Case of Mistaken Identity.

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare benign osseous tumor, usually presenting in the midface. There are many similarities in location, presentation, and radiographic appearance between fibrous dysplasia (FD) and JPOF. Awareness of this entity is important for craniofacial surgeons, as surgical timing and intraoperative management differ between these tumors.

Volumetric Changes of the Mid and Lower Face with Animation and the Standardization of Three-Dimensional Facial Imaging.

Background: The objective of this study was to quantify volumetric changes of the mid and lower face caused by facial expression to understand how procedural results measured by three-dimensional imaging can be influenced by lack of standardization. Secondarily, the study identified soft-tissue surface landmarks that can be used to ensure the standardization of three-dimensional images.

Methods: Three-dimensional facial images of subjects performing 22 facial expressions or changes in head position were captured.

Major Complications and 30-Day Morbidity for Single Jaw Versus Bimaxillary Orthognathic Surgery as Reported by NSQIP.

Objective: Acute complications in orthognathic surgery are reported in single-institution studies with small sample sizes. We aimed to analyze risk factors for acute complications using a national data set to better inform surgical decision-making.

Methods: 2005-2015 National Surgical Quality Improvement Program (NSQIP) data sets were analyzed for patients undergoing Le Fort 1 and/or bilateral sagittal split osteotomies (BSSO) for nontraumatic indications.

Google Ranking of Plastic Surgeons Values Social Media Presence Over Academic Pedigree and Experience.

Background: Patients increasingly rely on online resources to make healthcare decisions. Google dominates the search engine market; first-page results receive most of the web traffic and therefore serve as an important indicator of consumer reach.

Objectives: Our objective was to analyze the respective importance of physician academic pedigree, experience, and social media presence on plastic surgeon Google first-page search result placement.