Insurance Coverage of Prophylactic Mastectomies: A National Review of the United States.

Background: Breast cancer is associated with a multitude of risk factors, such as genetic predisposition and mutations, family history, personal medical history, or previous radiotherapy. A prophylactic mastectomy (PM) may be considered a suitable risk-reducing procedure in some cases. However, there are significant discrepancies between national society recommendations and insurance company requirements for PM.

Contralateral prophylactic mastectomy in the setting of breast cancer diagnosis and their insurance coverage in the United States.

Background: Contralateral prophylactic mastectomy (CPM) is more common in the United States than the rest of the world. However, the benefit of this procedure is still under question in many breast cancer scenarios. CPM utilization in the United States is in part dependent on a patient's health insurance coverage of breast oncology surgery and any desired reconstruction.

Resident experiences with virtual education during the COVID-19 crisis.

Background: Residency education has adapted to current social distancing recommendations by relying heavily on videoconferences. There is concern however, that this new paradigm may lead to over-saturation or burnout.

Methods: A 12-question survey investigating resident experiences with educational videoconferences was distributed to University of Washington plastic surgery residents.

Breast Reduction: Surgical Techniques with an Emphasis on Evidence-Based Practice and Outcomes.

Learning Objectives: After studying this article, the participant should be able to: 1. Understand the relevant anatomy involved in breast reduction. 2.

Implantable Cook-Swartz Doppler probe versus Synovis Flow Coupler for the post-operative monitoring of free flap breast reconstruction.

Background: The Cook-Swartz Doppler has long been a trusted tool for close monitoring of blood flow after microvascular reconstruction; however, device implantation requires additional operating time. Synovis Life Technologies, Inc. received FDA approval in 2010 for the Flow Coupler, which combines an end-to-end anastomotic coupler with a removable 20 MHz Doppler, allowing both procedures to be performed simultaneously.

Free tissue transfers and replantation.

Learning Objectives: After studying this article, the participant should be able to: 1. Describe the indications and contraindications for free flap reconstruction. 2.

The free descending branch muscle-sparing latissimus dorsi flap: vascular anatomy and clinical applications.

Background: Increasing focus on reducing morbidity from latissimus dorsi flaps has led to the evolution of muscle-sparing variants and perforator-based flaps. This study aimed to investigate the vascular anatomy of the muscle-sparing variant and to describe its application as a free flap based on the descending branch of the thoracodorsal artery.

Methods: Twelve fresh cadavers underwent anatomical dissection and angiographic injection studies of the thoracodorsal arterial system.

The short- and ultrashort-pedicle deep inferior epigastric artery perforator flap in breast reconstruction.

Background: Breast reconstruction using the deep inferior epigastric perforator (DIEP) flap is becoming more common and can help reduce donor site morbidity. The authors proposed that dissection of the deep inferior epigastric artery (DIEA) and vein (DIEV) to their external iliac source may not be required for safe flap transfer.

Methods: Sixteen whole fresh cadaveric hemiabdomens were used to dissect transverse abdominal-based flaps.

The low transverse extended latissimus dorsi flap based on fat compartments of the back for breast reconstruction: anatomical study and clinical results.

Background: Despite many modifications to the extended latissimus dorsi flap, its use in autologous breast reconstruction remains limited because of insufficient volume and donor-site morbidity. Through a detailed analysis of the deposition of back fat, this study describes a low transverse extended latissimus dorsi flap harvest technique that increases flap volumes and improves donor-site aesthetics.

Methods: Eight fresh cadaver hemibacks were used to identify the anatomical location of the fat compartments.

Secondary techniques in breast reconstruction refinement: the periareolar advancement flap.

Background: Techniques in breast reconstruction have vastly improved with natural feeling, aesthetically pleasing breasts created through transfer of free or pedicled tissue. Traditional flap designs incorporate a skin paddle that leaves a "patch," which can be fairly large on the nouveau breast, clearly delineating the boundaries between the reconstruction and the native skin. In this article, the authors discuss the operative technique and present a clinical series of patients undergoing the periareolar advancement flap procedure.

Dermolipectomy of the lateral thoracic fat compartment in secondary breast reconstruction revision: Anatomical and clinical results.

Unlabelled: Fullness in the lateral thoracic area following breast reconstruction can be a source of concern for patients. This redundant tissue creates disharmony between the newly reconstructed breast, the lateral mammary fold, and the lateral thoracic compartment. In this article we present the results of our anatomical/histological study, discuss the operative technique and present a clinical series of patients who underwent this procedure.

The role of fat grafting in reconstructive and cosmetic breast surgery: a review of the literature.

The technique of autologous fat transplantation has been dramatically improved since its first introduction in 1893. This surgical approach has more recently been used in both the reconstructive and cosmetic setting, and has subsequently been the subject of much controversy. We sought to compose a detailed and systematic literature review of recent literature on the topic in order to provide surgeons with the data in an organized and easily accessible manner.

Predicting prognosis in thermal burns with associated inhalational injury: a systematic review of prognostic factors in adult burn victims.

Burn injuries are a significant problem with high associated morbidity and mortality. Those associated with inhalational trauma (IHT) may be associated with higher mortality, but studies on prognosis are small and underpowered. This study was designed to identify prognostic factors that increase the risk of death, to quantify this risk, and to identify existing prognostic models.

Practice profiles in breast reduction: a survey among Canadian plastic surgeons.

Background: Breast reduction is an increasingly common procedure performed by Canadian plastic surgeons. Recent studies in the United States show that use of the inferior/central pedicle inverted T scar method is predominant. However, it is unknown what the practice preferences are among Canadian plastic surgeons.

Multivariate analysis of technical variables in pancreaticoduodenectomy: the effect of pylorus preservation and retromesenteric jejunal position on early outcome.

Background: To evaluate the effect of technical modifications to pancreaticoduodenectomy (PD) on postoperative outcome, we established a register of all patients undergoing PD at Victoria General Hospital (Queen Elizabeth II Health Sciences Centre), a tertiary care, university-affiliated hospital.

Patients And Method: Data from 78 consecutive patients who underwent PD from January 1998 through November 2000 were collected for univariate and multivariate analyses of clinical and technical factors on early outcome after PD, including duration of gastric stasis, development of complications and length of hospital stay.

Results: Two patients (2.