Soft-Tissue Filler for Secondary Nasal Deformities.

One common indication for soft-tissue filler in the nose, or liquid rhinoplasty, is the temporary treatment of secondary nasal deformities after rhinoplasty. Multiple aspects of the patient evaluation, timing with respect to the previous rhinoplasty and planned revision, and procedural principles and steps must be carefully considered. When appropriately implemented, the procedure can help avoid unnecessary patient angst and displeasure before a formal revision rhinoplasty.

Neuromodulator Finesse for Masseter Hypertrophy and Bruxism.

A particularly prominent mandibular angle or a hypertrophied masseter muscle can result in an excessively wide facial appearance, which some individuals may find less aesthetically pleasing. Although normally a benign condition and strictly an aesthetic concern, a hypertrophied masseter can also cause pain, bruxism, and headaches. Neuromodulator for masseter reduction and treatment of bruxism has become first-line treatment.

Beyond Alar Base Resection: Contouring of the Alar Rim and Base.

Summary: Alar base surgery is approached with hesitancy and is often avoided by many surgeons because of inexperience and a lack of understanding. However, with a thorough knowledge of the anatomy and dynamic nature of the lower third of the nose, alar base resection can achieve favorable and reproducible results. Beyond correcting alar flare, an appropriately diagnosed and performed alar base procedure serves to contour both the alar rim and the alar base.

Lip Lifting: The Missing Link in Central Facial Rejuvenation.

The lip lift is a powerful yet finesse operation in the realm of facial rejuvenation. In an era of increased popularity of nonsurgical lip augmentation, the astute plastic surgeon must identify which patients will end up with an unnatural appearance should they receive volume enhancement alone in pursuit of central facial and perioral rejuvenation. In this article, the authors review the ideal youthful lip appearance, characteristics of the aged lip appearance, and indications for lifting.

The 10-7 Facial Analysis Method for Face Lifting and Facial Rejuvenation.

Proper facial analysis is the first step toward delivering an excellent result in any face lifting or facial rejuvenating operation or procedure. Every case should be approached in a systematic and comprehensive manner, ensuring proper assessment of specific anatomic regions contributing to facial aging as well as the global facial aesthetic. Failure to do so may result in an unnatural or partially rejuvenated face.

Differential Fat Grafting to Address Facial Asymmetry in Face Lifting.

The modern face lift is a complex operation involving the repositioning of tissues and the refilling of volume atrophy. Preoperative analysis is key to the successful diagnosis of aging changes. Facial asymmetry is universal, and must be recognized and incorporated into surgical planning.

Three-dimensional Analysis of Facial Asymmetry in Unilateral Lambdoid Craniosynostosis.

Objective: Unilateral lambdoid synostosis (ULS) is characterized by occipital flattening, mastoid bulging, and contralateral parietal bossing. Anterior craniofacial features are less well-defined. This study utilizes volumetric, craniometric, and composite heat maps of three-dimensional (3D) rendered CT scans to analyze anterior craniofacial asymmetry in ULS and compared to controls.

Neuromodulator Injection for Gummy Smile.

Neuromodulators have become a treatment of choice for the management of excess gingival show, or "gummy smile." There have been many proposed algorithms for the optimal placement and dosage of neuromodulator to inject in these locations. The authors aim to clarify these points and provide surgeons with a reliable way to manage the gummy smile that results from hyperactive muscles of the midface.

Technical Precision with Autologous Fat Grafting for Facial Rejuvenation: A Review of the Evolving Science.

The scientific study of facial aging has transformed modern facial rejuvenation. As people age, fat loss in specific fat compartments is a major contributor to structural aging of the face. Autologous fat grafting is safe, abundant, readily available, and completely biocompatible, which makes it the preferred soft-tissue filler in the correction of facial atrophy.

Characteristics and Outcomes of Surgical Treatment for Bronchial Anomalies.

Objectives: Bronchial anomalies are rare but challenging conditions to treat in children, encompassing a variety of structural abnormalities that could compromise airway patency. This includes complete rings, absent cartilage, traumatic avulsions, bronchoesophageal fistulas, and cartilaginous sleeves. The objective of this study is to describe the characteristics and outcomes of a series of pediatric cases of bronchial anomalies that were treated by slide tracheobronchoplasty.

Reduction in Seroma Rate Following Deep Inferior Epigastric Perforator Flap with Umbilectomy Utilizing Progressive Tension Sutures.

Background:  Umbilectomy has been implemented in both abdominoplasties and deep inferior epigastric perforator (DIEP) flaps to improve abdominal wound healing and better control the location of the neoumbilicus; however, seroma rates are increased. The objective of this study is to compare the seroma rate following DIEP flap reconstruction with umbilectomy when progressive tension sutures (PTS) are implemented.

Methods:  A retrospective chart review was performed to evaluate postoperative seroma rates in patients undergoing DIEP flap breast reconstruction at a single academic institution between January 2015 and September 2022.

Characterizing expression changes in noncoding RNAs during aging and heterochronic parabiosis across mouse tissues.

Molecular mechanisms of organismal and cell aging remain incompletely understood. We, therefore, generated a body-wide map of noncoding RNA (ncRNA) expression in aging (16 organs at ten timepoints from 1 to 27 months) and rejuvenated mice. We found molecular aging trajectories are largely tissue-specific except for eight broadly deregulated microRNAs (miRNAs).

Worse Itch and Fatigue in Racial and Ethnic Minorities: A Burn Model System Study.

Racial and ethnic minority patients experience worse hypertrophic scars after burn injury than White patients. Subsequently, minority patients encounter differences in scar-related recovery domains such as itch and fatigue. This study examines disparities regarding postburn injury itch and fatigue in minority patients to better inform counseling and treatment considerations.

Alar Asymmetry in Patients with Unilateral Cleft Lip: Implications for Secondary Rhinoplasty.

Objective: Alar asymmetry in unilateral cleft lip (UCL) nasal deformity is a well-recognized clinical feature. However, there is a lack of comprehensive quantitative analysis of this asymmetry. This study compares the shape, volume, and axis rotation between the cleft and non-cleft ala in skeletally mature patients with UCL.

Three-dimensional Anthropometric Analysis of Racial and Ethnic Differences in Unilateral and Bilateral Cleft Nasal Deformity.

Objective: This study used three-dimensional measurements to provide a nasolabial analysis of patients with unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), and controls across different races and ethnicities.

Design: A retrospective comparative study.

Setting: Tertiary care pediatric institution.

Matching into competitive surgical residencies: predictors of success.

Evidence-informed data may help students matching into competitive residency programs guide curricular activities, extracurricular activities, and residency career choices. We aimed to examine the characteristics of students applying to competitive surgical residencies and identify predictors of matching success. We identified the five lowest match rates for the surgical subspecialities listed in the 2020 National Resident Matching Program report to define a surgical residency as competitive.

Sclerotherapy of lower limb veins: Indications, contraindications and treatment strategies to prevent complications - A consensus document of the International Union of Phlebology-2023.

Background: Sclerotherapy is a non-invasive procedure commonly used to treat superficial venous disease, vascular malformations and other ectatic vascular lesions. While extremely rare, sclerotherapy may be complicated by serious adverse events.

Objectives: To categorise contraindications to sclerotherapy based on the available scientific evidence.

Early experience and recommendations for the use of an automated estimator of solution volume for negative pressure wound therapy with instillation.

Introduction: NPWTi is a device that combines the benefits of traditional NPWT with periodic irrigation. This automated device allows for preprogrammed cycles of dwelling of a solution and negative pressure onto the wound surface. Its adoption has been hampered by the perceived difficulty of estimating the volume of solution needed per dwell cycle.

Systematic Review of Capsular Contracture Management following Breast Augmentation: An Update.

Background: Capsular contracture is one of the most frequent indications for revision following breast augmentation. Management goals focus on restoring breast aesthetics and minimizing subsequent recurrence of capsular contracture. As new data emerge, close review of the data are merited to build evidence-based clinical guidelines to inform surgical practice and management of capsular contracture.

Revision Rhinoplasty Finesse with Digital Osteotomies.

Revision rhinoplasty is a finesse procedure requiring careful consideration of all of its requisite steps. Lateral osteotomies are required in many cases and, in the setting of prior lateral osteotomies, can often be recreated with digital pressure alone, without the use of an osteotome. The advantages of doing so include decreased dead-space creation and preservation of attachments between the skeleton and overlying soft tissue.

Techniques in Facial Fat Grafting: Optimal Results Based on the Science of Facial Aging.

A thorough understanding of the science of facial aging is imperative to the precise and natural restoration of a youthful appearance. A hallmark of the aging process is fat atrophy. For this reason, fat grafting has become a keystone of the modern face lift.

PAs and NPs in employee health during the COVID-19 pandemic.

COVID-19 created unprecedented occupational health challenges for hospitals. To meet these demands at a large county safety-net hospital, a COVID-19 employee response team led by PAs and NPs was created. From April 2020 through February 2022, this team managed more than 14,000 discrete employee contacts related to COVID-19 employee concerns.

Static and Dynamic Stabilization of the Shoulder After Total Scapulectomy in an Electric Burn Patient.

An otherwise healthy 49-year-old man experienced a high-voltage electrical injury to the left shoulder resulting in total scapulectomy, partial calviculectomy, and a substantial soft tissue defect. The majority of the muscles around his shoulder were debrided because of necrosis, with only the pectoralis and latissimus dorsi muscles remaining attached to the humerus. Surprisingly, the patient's brachial plexus remained intact, and his left elbow, wrist, and hand function were preserved.