Allogeneic and Alloplastic Augmentation Grafts in Nipple-Areola Complex Reconstruction: A Systematic Review and Pooled Outcomes Analysis of Complications and Aesthetic Outcomes.

Background: With advancements in materials engineering, many plastic surgeons have looked to allogeneic tissue and alloplastic materials as a possible source of structure for long-lasting nipple-areola complex reconstruction. Furthermore, in light of the recent mandate from the Food and Drug Administration restricting the marketing and direct indication of acellular dermal matrices (ADMs) in breast reconstruction, we sought to highlight the overall safety and efficacy demonstrated in the existing literature surrounding all alloplastic materials in nipple-areola complex reconstruction. In this study, the authors conduct a systematic review and pooled outcomes analysis on allogenic and alloplastic implant materials utilized to achieve long-lasting nipple projection stratified by specific material used and respective outcomes.

Nonsurgical Adjuncts Following Facelift to Achieve Optimal Aesthetic Outcomes: "Icing on the Cake".

This article discusses the various nonsurgical treatments that can be performed in combination with facelift surgery to provide patients with a more complete facial rejuvenation. Nonsurgical adjuncts focus on facial volume enhancement, skin resurfacing, intense pulsed light for pigmentary changes, neuromodulators, and skin care in addition to the surgical techniques used to combat facial aging. Several options exist for skin resurfacing, including dermabrasion, chemical peels, and lasers; the advantages and limitations of each are discussed.

Flap Reconstruction of Gastrointestinal-to-Genitourinary Fistulas: A 20-Year Experience.

Background:  Gastrointestinal-to-genitourinary fistulas may occur secondary to obstetric complications, radiation therapy, cancer without radiation, inflammatory bowel disease, or previous surgery. Flap reconstruction is useful for complex cases refractory to standard techniques, separating the fistula tracts to aid healing. The purpose of this study was to investigate outcomes and risk factors for complications in flap reconstruction of fistulas from several different etiologies performed over a 20-year period.

The Ideal Thigh: A Crowdsourcing-Based Assessment of Ideal Thigh Aesthetic and Implications for Gluteal Fat Grafting.

Background: As the popularity of aesthetic gluteoplasty continues to grow, there is renewed focus on defining the ideal buttocks. However, the literature lacks studies characterizing an ideal thigh, despite the impact of thigh contour on overall gluteal aesthetic.

Objectives: The authors performed the first population analysis of the characteristics of perception of attractive thighs, to identify a role for fat grafting of the thigh in gluteoplasty.

Endobronchial-Guided Vascularized Tissue Flaps for a Bronchopleural Fistula.

The management of bronchopleural fistulas can be challenging. The initial treatment is usually conservative, but operative intervention with transposition of vascularized pedicled flaps may be required in refractory cases. We present the case of a 67-year-old man with stage IIIa squamous cell carcinoma of the lung who underwent a lower and middle bilobectomy after receiving neoadjuvant chemoradiation.

Desmoid tumor following abdominally-based free flap breast reconstruction.

Desmoid tumors are fibroblastic connective tissue tumors that most commonly develop within the anterior abdominal wall. The etiology of desmoid tumors has not been well defined; however, hereditary, hormonal, traumatic, and surgery-related causes have been implicated. Desmoid tumors are believed to arise from musculoaponeurotic structures.

The "Independent" Plastic Surgery Match: Analysis of Changes in Recent Years and Applicant Preferences.

Background: The number of surgical applicants to "independent" plastic surgery programs has drastically decreased. However, the competitiveness of recent applicants relative to previous years has not been assessed. The purpose of this study was to analyze the characteristics of recent "independent" applicants and to obtain their preferences regarding the match.

Ear Lobule Rejuvenation in Face-Lifting: The Role of Fat Augmentation.

Background: Ear lobule ptosis and deflation are characteristics of facial aging. A rhytidectomy without rejuvenation of a deflated ear lobule may fail to address all aspects of facial aging. Fillers have been used to treat ear lobule deflation; however, autologous fat transfer has never been utilized for ear lobule rejuvenation.

Management of temporomandibular joint Coccidioidomycosis.

Purpose: The aim of this report was to present the first known case of coccidioidomycosis involving the temporomandibular joint, review the literature regarding dissemination to the mandible, and to provide treatment recommendations for this challenging condition.

Methods: Coccidioidomycosis of the mandibular condyle was identified in a 30-year-old Somali male residing in Arizona. Due to the difficulty of surgical access and the anticipated temporomandibular joint morbidity of radical condylar debridement, primary medical management was performed.

Rectovaginal fistula repair using a gracilis muscle flap.

Introduction And Hypothesis: This video demonstrates a technique for using a pedicled gracilis muscle flap to repair rectovaginal fistula.

Methods: We present the case of a 48-year-old woman diagnosed with rectal cancer 2 years earlier. She underwent neoadjuvant chemoradiation followed by ultralow anterior resection.

Seromuscular Colonic Flap for Intrapelvic Soft-Tissue Coverage: A Reconstructive Option for Plastic Surgeons When Traditionally Used Flaps Are Not Available.

Background. Reconstruction of intrapelvic defects can be a challenging problem in patients with limited regional muscle flap options and previously resected omentum. In such situations, alternative methods of mobilizing vascularized tissue may be required.

Split latissimus dorsi muscle flap repair of acquired, nonmalignant, intrathoracic tracheoesophageal and bronchoesophageal fistulas.

The development of a fistula between the tracheobronchial tree and oesophagus due to nonmalignant causes is uncommon. Division of the fistula with muscle flap interposition eliminates contact between the tracheobronchial segment and the oesophagus, theoretically decreasing the chance of recurrence as well as providing a robust blood supply to aid in healing. The split latissimus dorsi muscle flap is a well-suited flap for such repairs because of the ability to simultaneously cover two separate apertures (tracheobronchial and oesophageal).

The diagnostic and surgical challenges of massive localized lymphedema.

Background: Massive localized lymphedema (MLL) is a rare entity first described in 1998 in patients with morbid obesity; the incidence is rising with the increased prevalence of morbid obesity. This report defines the clinical presentation and surgical challenges in 6 patients with MLL.

Methods: The MLL in 6 patients with morbid obesity (weight range 270 to 585 lbs) involved the thigh in 3 patients, the calf in 1 patient, and the abdomen in 2 patients.

Mandibular gunshot wound with bullet aspiration.

Urban violence continues to be an important source of penetrating craniofacial injuries in major trauma centers. Gunshot wounds to the mandible are a commonly treated condition by craniofacial surgeons. Some gunshot wounds are through-and-through injuries, but in many patients, the bullet enters with no visible exit wound.