Evidence-Based Medicine in Plastic Surgery: From Then to Now.

Evidence-based medicine, as described by Dr. Sackett, is defined as the "conscientious, explicit, and judicious use of current best evidence, combined with individual clinical expertise and patient preferences and values, in making decisions about the care of individual patients." In the late 2000s, seminal articles in Clinics in Plastic Surgery and Plastic and Reconstructive Surgery introduced evidence-based medicine's role in plastic surgery and redefined varying levels of evidence.

Screening Tests in the Era of COVID-19: Implications for the Plastic Surgeon.

The novel coronavirus, severe acute respiratory syndrome coronavirus 2, responsible for the coronavirus disease of 2019 (COVID-19) pandemic, has claimed over 2 million lives to date and brought the global economy to a halt, including elective surgery. As the authors emerge from lockdown, new protocols must be implemented to minimize risk by means of appropriate screening of their patients, surgical adjustments to reduce viral transmission in case of undiagnosed infection, and the development of accurate severe acute respiratory syndrome coronavirus 2 tests while awaiting the distribution of an effective vaccine. Many serology and molecular tests have received emergency use authorization from the U.

Social Media Guidelines for Young Plastic Surgeons and Plastic Surgery Training Programs.

Social media are a powerful tool that creates a unique opportunity for the young plastic surgeon and trainee to share content, brand oneself, educate the public, and develop one's own professional voice early. The majority of all plastic surgery programs and particularly those that are highly ranked have social media opportunities for their residents, yet clear rules to guide implementation of social media programming in residency have remained unspecified. These guidelines and pitfalls can be used to inform a productive and professional entry into plastic surgery social media use for the resident and young plastic surgeon.

The Role of the Buccal Fat Pad in Facial Aesthetic Surgery.

Social media have triggered a buccal fat pad excision frenzy. Not surprisingly, there is tremendous appeal of having a slimmer lower face and more defined jawline after undergoing a small intraoral procedure under local anesthesia. Although this procedure is great for social media and seemingly beneficial for jawline aesthetics, the evidence remains limited as to whether or not this is an effective long-term solution.

Revisiting Primary Otoplasty: Surgical Approach to the Prominent Ear.

Prominent ears and other ear deformities are some of the most common congenital deformities of the head, affecting over 10 percent of the general population. In 2018, more than 10,000 otoplasties were performed in the United States, with over one-third performed on men. The goal of primary otoplasty is creation of a normal-appearing ear without evidence of surgical intervention.

Secondary Rhinoplasty for Unilateral Cleft Nasal Deformity.

Background: Secondary cleft rhinoplasty presents some of the most challenging cases of both cosmetic and functional nasal deformities. Understanding the anatomy and growth abnormality seen with the cleft nasal deformity helps to tailor surgical management. This article seeks to expand on the application of current concepts in secondary rhinoplasty for unilateral cleft lip nasal deformity.

Perioperative Approach to Reducing Hematoma during Rhytidectomy: What Does the Evidence Show?

Background: Postoperative hematoma remains the most common complication in rhytidectomy, prompting surgeons to use a multitude of adjunctive measures to prevent its occurrence. The goal of this systematic review was to determine which of these measures are supported by strong evidence, and to highlight those that remain unsubstantiated and require further investigation.

Methods: A systematic search was performed of the PubMed and Embase databases for English literature from 1975 to March of 2020 containing designated keywords, and focusing specifically on adjunctive measures aimed at preventing hematoma in rhytidectomy.

Rhinosurgery during and after the COVID-19 Pandemic: International Consensus Conference Statement on Preliminary Perioperative Safety Measures.

Background: The coronavirus disease of 2019 (COVID-19) pandemic has widely affected rhinosurgery, given the high risk of contagion and the elective nature of the aesthetic procedure, generating many questions on how to ensure safety. The Science and Research Committee of the Rhinoplasty Society of Europe aimed at preparing consensus recommendations on safe rhinosurgery in general during the COVID-19 pandemic by appointing an international panel of experts also including delegates of The Rhinoplasty Society.

Methods: A Zoom meeting was performed with a panel of 14 international leading experts in rhinosurgery.

Management of Patients with Textured Surface Breast Implants.

The purpose of this special topic article is to present an evidence-based approach and provide recommendations for the management of both asymptomatic and symptomatic patients with textured surface breast implants. There are currently no scientific data to support complete removal of a benign capsule. When unnecessary capsulectomies are performed, the patient is at higher risk for developing postoperative complications.

Not All Breast Explants Are Equal: Contemporary Strategies in Breast Explantation Surgery.

Breast implant removal and replacement has been a common secondary breast procedure in the long-term maintenance of breast augmentation, but more recently growing concerns about silicone-related systemic illness, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), and changing perceptions of aesthetic beauty have seen breast implant removal without replacement become increasingly requested by patients. Explantation can be challenging, especially when performed with a total capsulectomy. Currently, there is no evidence regarding whether a partial or total capsulectomy has any effect on BIA-ALCL risk mitigation in patients that have textured implants without disease.

Four-Step Spreader Flap: The Pull-Twist-Turn Technique.

The spreader (or autospreader) flap offers an alternative to the traditional spreader graft in reconstructing the dorsal midvault and preserving internal valve function. This is of particular importance after an aggressive dorsal hump reduction, which has the potential to result in an inverted-V deformity, dorsal narrowing, or saddle-nose deformity. In this article, the authors describe a four-step spreader flap technique that offers a simple, reproducible method of shaping the dorsal midvault while preserving internal valve function.

Platelet-Rich Plasma: Evolving Role in Plastic Surgery.

Background: The use of platelet-rich plasma has emerged as one of the most desired nonsurgical treatments for facial rejuvenation and hair restoration. It has grown to encompass a wide variety of applications within the field of plastic surgery, including its use in combination with microneedling, laser, and fat-grafting procedures.

Methods: In this article, the authors aim to (1) describe the preparation process of platelet-rich plasma; (2) discuss the proposed science behind platelet-rich plasma with regard to its evolving role in hair restoration and facial rejuvenation; and (3) highlight the recent literature examining its widespread use.

Prediction of Facial Aging Using the Facial Fat Compartments.

Facial aging is a multifactorial process governed by both intrinsic and extrinsic factors that impart a change to each component of the facial anatomy. Our understanding of the science of aging has evolved over the years. A recent and valuable addition to our understanding is the knowledge of both the superficial and deep facial fat compartments.

Evidence-Based Performance Measures for Rhinoplasty: A Multidisciplinary Performance Measure Set.

The American Society of Plastic Surgeons, the American Academy of Otolaryngology-Head and Neck Surgery, and the American Academy of Facial Plastic and Reconstructive Surgery commissioned the multidisciplinary Rhinoplasty Performance Measure Development Work Group to identify and draft quality measures for the care of patients undergoing both functional and aesthetic rhinoplasty. One outcome measure and three process measures were identified. The outcome looked at patient satisfaction with rhinoplasty procedures.