Wood, Shannon M. B.S.; Cichocki, Meghan N.; Chung, Kevin C. M.D., M.S.
doi : 10.1097/PRS.0000000000008691
January 2022 - Volume 149 - Issue 1 - p 1-6
Salzman, Marc J. M.D.
doi : 10.1097/PRS.0000000000008632
January 2022 - Volume 149 - Issue 1 - p 7-14
Patient compliance has been low for U.S. Food and Drug Administration–recommended magnetic resonance imaging scans to screen silicone gel breast implants for silent rupture. High-resolution ultrasound scans are a convenient, in-office alternative that may improve screening compliance; however, women’s attitudes and feelings about silent rupture and their desire for rupture screening are unknown.
Oskar, Sabine Ph.D.; Nelson, Jonas A. M.D., M.P.H.; Hicks, Madeleine E. V. B.S.; Seier, M.S., Kenneth P.; Tan, Kay See Ph.D.; Chu, Jacqueline J. B.A.; West, Scott M.P.H.; Allen, Robert J. Jr. M.D.; Barrio, Andrea V. M.D.; Matros, Evan M.D., M.M.Sc., M.P.H.; Afonso, Anoushka M. M.D.
doi : 10.1097/PRS.0000000000008633
January 2022 - Volume 149 - Issue 1 - p 15-27
Racial disparities are evident in multiple aspects of the perioperative care of breast cancer patients, but data examining whether such differences translate to clinical and patient-reported outcomes are limited. This study examined the impact of race on perioperative outcomes in autologous breast reconstruction.
Duncan, Anna M. M.D.; Al Youha, Sarah M.D., Ph.D.; Joukhadar, Nadim M.D.; Konder, Ricarda B.Sc.; Stecco, Carla M.D.; Wheelock, Margaret E. M.D.
doi : 10.1097/PRS.0000000000008671
January 2022 - Volume 149 - Issue 1 - p 28-40
Understanding the anatomy of the fascial and ligamentous structures of the breast is important in both aesthetic and reconstructive breast surgery. Several structures have been identified that play a significant role in the aesthetic qualities and support of the breast warranting consideration in the context of breast reconstruction.
Magno-Pardon, David A. M.D.; Luo, Jessica B.S.; Carter, Gentry C. B.S.; Agarwal, Jayant P. M.D.; Kwok, Alvin C. M.D.
doi : 10.1097/PRS.0000000000008634
January 2022 - Volume 149 - Issue 1 - p 41-47
The modified five-item frailty index is a validated and effective tool for assessing risk in surgical candidates. The authors sought to compare the predictive ability of the modified five-item frailty index to established risk factors for complications in free flap breast reconstruction.
Rubenstein, Robyn N. M.D.; Allen, Robert J. Jr. M.D.; Nelson, Jonas A. M.D., M.P.H.
doi : 10.1097/PRS.0000000000008693
January 2022 - Volume 149 - Issue 1 - p 48-50
Naoum, George E. M.D., M.M.S.C.I.; Ho, Alice Y. M.D.; Shui, Amy M.S.; Salama, Laura M.D.; Goldberg, Saveli M.S.; Arafat, Waleed M.D., Ph.D.; Winograd, Jonathan M.D.; Colwell, Amy M.D.; Smith, Barbara L. M.D., Ph.D.; Taghian, Alphonse G. M.D., Ph.D.
doi : 10.1097/PRS.0000000000008635
January 2022 - Volume 149 - Issue 1 - p 1e-12e
The purpose of this study was to create a nomogram using machine learning models predicting risk of breast reconstruction complications with or without postmastectomy radiation therapy.
Lesniak, David M. M.D., Ph.D.; Sarfati, Isabelle M.D.; Meredith, Ineke M.B.Ch.B.; Millochau, Jenny M.D.; Wang, Kuan-Chi M.D.; Nos, Claude M.D.; Clough, Krishna B. M.D.
doi : 10.1097/PRS.0000000000008672
January 2022 - Volume 149 - Issue 1 - p 52-56
The majority of patients undergoing bilateral prophylactic mastectomy request immediate implant-based breast reconstruction. Some patients, especially those with prior radiotherapy, are at increased risk of early cutaneous complications and implant loss. The authors developed the technique of primary fat grafting before delayed prophylactic mastectomy to minimize early complications for selective high-risk patients. They have completed 21 cases in 14 patients, 10 of whom had previous lumpectomy and radiation treatment for breast cancer. A single session of fat grafting, with a median injection volume of 250 ml (interquartile range, 200 to 300 ml), was performed a median period of 19 weeks (interquartile range, 16 to 28 weeks) before prophylactic mastectomy. All cases were direct-to-implant reconstruction using textured silicone implants. The median implant volume was 410 ml (interquartile range, 318 to 450 ml). A minor early complication developed in 14 percent of cases (three of 21), with no early implant loss. At a median follow-up of 9 months (interquartile range, 5 to 27 months), the authors found no cases of implant loss and an excellent or good aesthetic outcome (score of 5 or 4) in 16 of 21 cases (76 percent). Fat grafting before prophylactic mastectomy is a novel strategy to minimize early complications and avoid implant loss in patients at high risk of postoperative complications.?
Morante, Lea M.D.; El Hajj, Houssein M.D.; Delecourt, Camille M.D.; Sabiani, Laura M.D.; Bannier, Marie M.D.; Rua, Sandrine M.D.; Barrou, Julien M.D.; Lambaudie, Eric M.D., Ph.D.; Houvenaeghel, Gilles M.D., Ph.D.; Cohen, Monique M.D.
doi : 10.1097/PRS.0000000000008696
January 2022 - Volume 149 - Issue 1 - p 13e-17e
Oncoplastic breast surgery is an evolving field combining both breast aesthetic surgery and oncologic breast surgery. It aims to optimize cosmetic outcomes without interfering with oncologic safety. The superior hemimastectomy is a technique that can be considered for large upper-quadrant breast tumors or multifocal and multicentric breast tumors localized in the upper quadrants. As with mastectomy, axillary procedures can be performed through the same incision. The nipple-areola complex can be preserved and reimplanted. Superior hemimastectomy allows wide excision of the breast tissue, but its main disadvantage is the increased risk of necrosis of the free grafted nipple-areola complex. In this article, the authors present the surgical technique of superior hemimastectomy with an inferior pedicle nipple-bearing flap. This technique is presented as a simple five-step algorithm. A modified superior hemimastectomy with nipple-areola complex preservation using an inferior pedicle nipple-bearing flap is an alternative to the classic superior hemimastectomy technique. This modified technique decreases the risk of nipple-areola complex necrosis and preserves better nipple-areola complex sensitivity.
Wong, Chin-Ho M.Med.(Surg.), F.A.M.S.(Plast.Surg.); Hsieh, Michael Ku Hung M.D., M.R.C.S.(Ed.), M.Med.(Surg.); Mendelson, Bryan F.R.C.S.(Ed.), F.R.A.C.S., F.A.C.S.
doi : 10.1097/PRS.0000000000008686
January 2022 - Volume 149 - Issue 1 - p 59-69
The composite face lift is becoming increasingly popular following recent advances in understanding of facial anatomy that enable safe sub-superficial musculoaponeurotic system (SMAS) dissection. This article presents the authors’ technique for composite face lift in Asian patients and reviews their experience and outcome with this procedure.
Hammond, Dennis C. M.D.; Kim, Kuylhee M.D.; Bageris, Matthew H. B.S.; Chaudhry, Arif M.D.
doi : 10.1097/PRS.0000000000008682
January 2022 - Volume 149 - Issue 1 - p 70-79
In breast augmentation, breast base diameter has been recognized as an important variable in implant selection. However, breast implant volume also has a tremendous impact on the final result. Previous methods of preoperative volume determination have been limited to external devices in a bra. Computer-based three-dimensional simulation technology now allows the physician to effectively communicate with the patient preoperatively regarding volume.
Bajaj, Anureet K. M.D., M.B.A.
doi : 10.1097/PRS.0000000000008687
January 2022 - Volume 149 - Issue 1 - p 80-81
Basile, Filipe V. M.D.; Oliveira, Thais S. M.D.
doi : 10.1097/PRS.0000000000008676
January 2022 - Volume 149 - Issue 1 - p 18e-24e
There are limited scientific data regarding the impact of exercise after breast augmentation surgery. Recommendations range from a few weeks to a few months of physical activity avoidance. To decide whether early exercise after breast augmentation is safe, a prospective randomized trial was designed to measure complications, scar quality, and patient-reported outcomes in this setting.
Aljerian, Albaraa M.D., M.Sc.; Abi-Rafeh, Jad M.D., M.Sc.; Ramirez-GarciaLuna, José M.D., Ph.D.; Hemmerling, Thomas M.D., M.Sc., D.E.A.A.; Gilardino, Mirko S. M.D., M.Sc.
doi : 10.1097/PRS.0000000000008652
January 2022 - Volume 149 - Issue 1 - p 83-95
Brachioplasty procedures have experienced a surge in popularity over the past decade, mirroring the rise in bariatric procedures and growing population of massive weight loss patients. The authors estimated the incidence of associated complications and identify possible patient- or procedure-related predictive factors.
Babaitis, Ricardo M.D.; Villegas, Francisco J. M.D.; Hoyos, Alfredo E. M.D.; Perez, Mauricio M.D.; Mogollon, Ivan R. M.D.
doi : 10.1097/PRS.0000000000008680
January 2022 - Volume 149 - Issue 1 - p 96-104
Abdominoplasty is a surgical technique for body contouring that has been shown to improve the patient’s quality of life. It has become more common among male patients, so clear differences between procedures for men and women have to be stated. The authors present their experience with high-definition lipoabdominoplasty with transverse plication in men.
Hurwitz, Dennis J. M.D.; Davila, Armando A. M.D.
doi : 10.1097/PRS.0000000000008681
January 2022 - Volume 149 - Issue 1 - p 105-106
Rochlin, Danielle H. M.D.; Morrison, Shane D. M.D., M.S.; Harirah, Muhammad B.A.; Rohrich, Rod J. M.D.; Satterwhite, Thomas M.D.
doi : 10.1097/PRS.0000000000008654
January 2022 - Volume 149 - Issue 1 - p 107-115
Iatrogenic jowling can be an unintended consequence of facial feminization surgery. Reduction of the mandible and chin without overlying changes to the soft tissue can lead to a redundant and deflated soft-tissue envelope, requiring a face lift to address jowling, cervicofacial laxity, and/or lower facial rhytids. Prospective quality-of-life outcomes data support this hypothesis, as patients who underwent mandible contouring with or without angle osteotomies were significantly more likely to express interest in face lift following facial feminization surgery on univariable analysis (90.0 percent versus 10.0 percent, p = 0.038). Patients with inherent skin laxity are at particularly high risk, such as those with advancing age, extrinsic skin damage (e.g., sun exposure, cigarette smoke), and history of massive weight loss. Before facial feminization surgery, the authors recommend comprehensive patient counseling that includes a discussion of the possible future need for a face lift, preferably around 1 year after facial feminization surgery. When performing a face lift after facial feminization surgery, technical considerations include those related to sequelae of prior facial surgery, anatomical differences between cismale and cisfemale facial soft tissue, and the mechanism of jowling after facial feminization surgery versus normal facial aging. The authors believe that these considerations can set more realistic expectations for facial feminization surgery patients, improve surgeons’ ability to skillfully execute this procedure, and ultimately contribute to ongoing quality-of-life improvements in facial feminization surgery patients.
Rohrich, Rod J. M.D.; Avashia, Yash J. M.D.; Savetsky, Ira L. M.D.
doi : 10.1097/PRS.0000000000008677
January 2022 - Volume 149 - Issue 1 - p 25e-27e
The bulbous and box tips are two common morphologies encountered in rhinoplasty. Nasal tip reshaping is a challenging aspect of rhinoplasty. Understanding the classifications of nasal tip morphologies aids when performing a nasal-facial analysis. The management algorithm for both tip morphologies shares various techniques. These techniques include but are not limited to cephalic trim, transdomal sutures, and interdomal sutures. A graduated approach to managing the variations in bulbous and boxy tips will help in achieving consistent results. New concepts applied to the management include supporting alar rims with alar contour grafts, closing dead space through a series of techniques, and managing the soft-tissue envelope, which is often in excess.
Than, Peter A. M.D.; Davis, Christopher R. B.Sc., Ph.D., M.B., Ch.B.; Rennert, Robert C. M.D.; Morrison, Shane D. M.D., M.S.; Findlay, Michael W. M.D., Ph.D.; Kay, Mark A. M.D., Ph.D.; Gurtner, Geoffrey C. M.D.
doi : 10.1097/PRS.0000000000008630
January 2022 - Volume 149 - Issue 1 - p 117-129
Gene therapy is a promising treatment for protein deficiency disorders such as hemophilia B. However, low tissue selectivity and efficacy are limitations of systemic vector delivery. The authors hypothesized that selective transfection of rat superficial inferior epigastric artery flaps could provide systemic delivery of coagulation factor IX, preventing the need for systemic vector administration.
Johnson, Anna Rose M.D., M.P.H.; Tétrault, Marc-André Ph.D.; Bravo, Miguel G. M.D.; Girouard, Vincent B.S.; Laurence, Rita B.S.; Lee, Bernard T. M.D., M.B.A., M.P.H.; Soo Choi, Hak Ph.D.; Singhal, Dhruv M.D.
doi : 10.1097/PRS.0000000000008631
January 2022 - Volume 149 - Issue 1 - p 130-141
The real-time quantification of lymphatic flow remains elusive. Efforts to provide a metric of direct lymphatic function are not clinically translatable and lack reproducibility. Early reports demonstrate the promise of immediate lymphatic reconstruction (immediate lymphovenous bypass after lymphadenectomy) to reduce the risk of lymphedema development. However, there remains a heightened need to appraise this technique in a clinically translatable large-animal model. The aim of the authors’ experiment was to evaluate the role of molecular imaging in the quantification of real-time lymphatic flow after lymphadenectomy, and lymphadenectomy with lymphovenous bypass using novel fluorophores in a swine model.
Nuri, Takashi M.D., Ph.D.; Ota, Masato D.D.S., Ph.D.; Ueda, Koichi M.D., Ph.D.; Iseki, Sachiko D.D.S., Ph.D.
doi : 10.1097/PRS.0000000000008665
January 2022 - Volume 149 - Issue 1 - p 28e-37e
The haploinsufficiency in the TWIST1 gene encoding a basic helix-loop-helix transcription factor is a cause of one of the craniosynostosis syndromes, Saethre-Chotzen syndrome. Patients with craniosynostosis usually require operative release of affected sutures, which makes it difficult to observe the long-term consequence of suture fusion on craniofacial growth.
Huang, Hui-Fu M.D.; Matschke, Jan
doi : 10.1097/PRS.0000000000008609
January 2022 - Volume 149 - Issue 1 - p 143-149
Digit replantation under wide-awake local anesthesia is a challenging method, and there are only a few works of literature on this procedure. This article describes the authors’ clinical experience in finger replantation under wide-awake local anesthesia compared to general anesthesia.
Hu, Ching-Wei M.D.; Chang, Tommy Nai-Jen M.D.; Chen, Yi-Chieh M.D.; Hu, Ching-Hsuan M.D., Ph.D.
doi : 10.1097/PRS.0000000000008628
January 2022 - Volume 149 - Issue 1 - p 38e-47e
Fingertip replantation is technically challenging. Venous congestion is one of the most common causes of replantation failure. Therefore, various venous drainage procedures and salvage techniques have been used in venous congestion. Negative-pressure wound therapy has proven beneficial in limb injuries, yet limited studies of fingertip replantation exist. This study aims to analyze risk factors in fingertip replantation and to evaluate the feasibility and clinical benefits of negative-pressure wound therapy compared with other salvage techniques.
van Mulken, Tom J. M. M.D.; Wolfs, Joost A. G. N. M.D.; Qiu, Shan S. M.D., Ph.D.; Scharmga, Andrea M. J. Ph.D.; Schols, Rutger M. M.D., Ph.D.; Spiekerman van Weezelenburg, Merel A. M.D.; Cau, Raimondo Ph.D.; van der Hulst, Rene R. W. J. M.D., Ph.D.; MicroSurgical Robot Research Group
doi : 10.1097/PRS.0000000000008670
January 2022 - Volume 149 - Issue 1 - p 151-161
Lymphaticovenous anastomosis, a supermicrosurgical technique, creates bypasses between the lymphatic and venous systems. The quality of lymphaticovenous anastomosis depends on the surgeon’s dexterity and precision, and is subject to imperfections caused by the physiologic tremor of the human hand. A dedicated robot for microsurgery has been created to overcome these limitations (MUSA, MicroSure, Eindhoven, The Netherlands). This study describes 1-year clinical outcomes of the first-in-human trial of robot-assisted and manual lymphaticovenous anastomosis in patients with breast cancer–related lymphedema.
Landau, Andrew J. M.D.; Parameswaran, Priyanka B.A.; Fresco, Rabiah B.S.; Simon, Laura M.L.I.S.; Dy, Christopher J. M.D., M.P.H.; Brogan, David M. M.D., M.Sc.
doi : 10.1097/PRS.0000000000008627
January 2022 - Volume 149 - Issue 1 - p 48e-56e
Power Doppler ultrasonography has been used as an adjunct in the diagnosis of peripheral nerve compression neuropathy. To better characterize its sensitivity and specificity, the authors performed a systematic review of its use in carpal and cubital tunnel syndrome diagnosis.
Claro, Gilles M.D.; Zelenski, Nicole A. M.D.; Balaguer, Thierry M.D., Ph.D.; Chaput, Benoit M.D., Ph.D.; Isola, Nicolas M.D.; Baqué, Patrick M.D., Ph.D.; Bronsard, Nicolas M.D., Ph.D.; Camuzard, Olivier M.D., Ph.D.
doi : 10.1097/PRS.0000000000008629
January 2022 - Volume 149 - Issue 1 - p 163-167
Digital neurovascular bundle defects are often encountered during crush or avulsion injuries and require complex reconstruction. Use of an arterialized nerve graft (neurovascular graft) serving both as an interpositional arterial conduit and as a nerve graft could be a reconstructive option in these cases. In this anatomical study, the authors aimed to describe a neurovascular graft of the posterior interosseous nerve and a branch of the anterior interosseous artery for neurovascular bundle reconstruction of the fingers.
Sood, Ravi F. M.D., M.S.; Irwin, Timothy J. M.D.; Taghinia, Amir H. M.D., M.P.H., M.B.A.
doi : 10.1097/PRS.0000000000008689
January 2022 - Volume 149 - Issue 1 - p 57e-59e
Syndactyly is one of the most common congenital differences treated by hand surgeons. Although dozens of techniques for syndactyly release have been described, a reliable method is based on a dorsal rectangular flap for commissure construction and a combination of interdigitating zigzag flaps and skin grafts for digital coverage. In this article, the authors present a detailed description of syndactyly release emphasizing principles integral to successful outcomes.
Vu, Giap H. B.A.; Warden, Clara B.A.; Zimmerman, Carrie E. B.S.; Kalmar, Christopher L. M.D., M.B.A.; Humphries, Laura S. M.D.; McDonald-McGinn, Donna M. M.S.; Jackson, Oksana A. M.D.; Low, David W. M.D.; Taylor, Jesse A. M.D.; Swanson, Jordan W. M.D., M.Sc.
doi : 10.1097/PRS.0000000000008636
January 2022 - Volume 149 - Issue 1 - p 169-182
The relationship between poverty and incidence of cleft lip and cleft palate remains unclear. The authors investigated the association between socioeconomic status and cleft lip with or without cleft palate and cleft palate only in the United States after controlling for demographic and environmental risk factors.
McGuire, Connor M.D., M.H.Sc.; Boudreau, Colton M.Sc.; Prabhu, Neetin B.Sc.; Hong, Paul F.R.C.S.C.; Bezuhly, Michael F.R.C.S.C.
doi : 10.1097/PRS.0000000000008645
January 2022 - Volume 149 - Issue 1 - p 183-195
Despite its increasing use in craniofacial surgery, the evidence for piezosurgery over conventional bone-cutting techniques has not been critically appraised. The purpose of this systematic review and meta-analysis was to identify and assess the evidence that exists for the use of piezosurgery in craniofacial surgery.
Hu, Allison C. M.D.; Jain, Nirbhay S. M.D.; Chan, Candace H. B.S.; Malapati, Sri Harshini B.S.; Dang, Brian N. M.D.; Bertrand, Anthony A. M.D., M.B.A.; Squitieri, Lee M.D., Ph.D.; Wilson, Libby F. M.D.; Lee, Justine C. M.D., Ph.D.
doi : 10.1097/PRS.0000000000008646
January 2022 - Volume 149 - Issue 1 - p 60e-67e
Late childhood (8 to 10 years of age) has emerged as a vulnerable period in children with cleft and craniofacial anomalies such that increased interventions during this period are associated with worse long-term patient-reported anxiety and depressive symptoms. These findings suggest that one possible practice change may be to consider changes in timing for surgical treatment algorithms. In this work, the authors investigated outcomes in altering the timing of the most common operation in late childhood for cleft lip and palate patients, alveolar bone grafting.
Carlson, Anna R. M.D.; Taylor, Jesse A. M.D.
doi : 10.1097/PRS.0000000000008647
January 2022 - Volume 149 - Issue 1 - p 68e-69e
Denadai, Rafael M.D.; Lo, Lun-Jou M.D.
doi : 10.1097/PRS.0000000000008648
January 2022 - Volume 149 - Issue 1 - p 197-201
Encouraging results have been described for the use of pedicled buccal fat pad flap in primary cleft palate repair. This retrospective study describes the surgical technique and early results of a technical innovation utilizing the split buccal fat flaps in modified Furlow palatoplasty with small double-opposing Z-plasty. This technique introduces buccal fat tissue for coverage of lateral denuded palate surfaces to reduce the bone exposure and scar formation to potentially attenuate maxillary growth interference and for reinforcement of the palatal areas of high tension or with incomplete closure to decrease the risk of postoperative dehiscence and oronasal fistula formation. Consecutive nonsyndromic patients (n = 56) with cleft palate were treated with this method, all of whom demonstrated fast mucosalization of lateral palatal recipient regions within 3 weeks postoperatively and showed no fistula with 12 months’ follow-up. Of 19 patients (33.9 percent) who underwent auditory-perceptual assessment, 15 (78.9 percent) had normal resonance. Surgeons could add this alternative surgical maneuver to their armamentarium during the primary palatoplasty, in which coverage of lateral surfaces and reinforcement with fat tissue in the anterior soft palate space are of paramount relevance.
Parsaei, Yassmin D.M.D.; Chandler, Ludmilla B.S.; Smetona, John T. M.D.; Lopez, Joseph M.D., M.B.A.; Steinbacher, Derek M.D., D.M.D.
doi : 10.1097/PRS.0000000000008688
January 2022 - Volume 149 - Issue 1 - p 70e-73e
Surgical management of unilateral cleft lip is challenging. Correction requires a comprehensive approach to ensure optimal aesthetic outcomes. Various techniques have been proposed for the repair of cleft lip. This article and video vignette highlight the senior author’s (D.S.) preferred method for repair of a unilateral cleft lip using a modified inferior triangle technique, a Noordhoff triangular flap for vermillion augmentation, orbicularis oris chemodenervation to reduce tension at the repair site, and autologous fat grafting for lip sculpting.
Schoenbrunner, Anna M.D., M.A.S.; Konschake, Marko M.D.; Zwierzina, Marit M.D.; Egro, Francesco M. M.B.Ch.B., M.Sc.; Moriggl, Bernhard M.D.; Janis, Jeffrey E. M.D.
doi : 10.1097/PRS.0000000000008673
January 2022 - Volume 149 - Issue 1 - p 203-211
Peripheral nerve decompression surgery can effectively address headache pain caused by compression of peripheral nerves of the head and neck. Despite decompression of known trigger sites, there are a subset of patients with trigger sites centered over the postauricular area coursing. The authors hypothesize that these patients experience primary or residual pain caused by compression of the great auricular nerve.
Coon, Devin M.D., M.S.E.; Berli, Jens M.D.; Oles, Norah B.S.; Mundinger, Sol M.D., M.B.A.; Thomas, Kate Ph.D.; Meltzer, Toby M.D.; Houssock, Carrie M.D.; Satterwhite, Thomas M.D.; Morrison, Shane M.D., M.S.; Bailón, Carlos M.D.; Tenório, Thiago M.D.; Simon, Daniel D.M.D.; Capitán-Cañadas, Fermín Ph.D.; Capitán, Luis M.D., Ph.D.
doi : 10.1097/PRS.0000000000008668
January 2022 - Volume 149 - Issue 1 - p 212-224
Increasing societal acceptance of transgender people has led to broader availability of gender surgery and rapid growth in transition-related operations. Facial gender surgery aims to modify patients’ facial features to be more congruent with their physical expression of gender, reducing gender dysphoria and improving quality of life. Growth in research and technique evolution has not kept pace with growth in clinical volume. Therefore, the first International Facial Gender Symposium was held at Johns Hopkins University in 2019, convening surgeons who perform facial gender surgery to share ideas and assess the state of clinical evidence.
Dayani, Fara M.D.; Sheckter, Clifford C. M.D.; Rochlin, Danielle H. M.D.; Nazerali, Rahim S. M.D., M.H.S.
doi : 10.1097/PRS.0000000000008661
January 2022 - Volume 149 - Issue 1 - p 225-232
Reconstruction following abdominoperineal resection improves outcomes by reducing wound-related complications, particularly in irradiated patients. Little is known regarding system-level factors that impact patients’ access to reconstructive surgery following abdominoperineal resection. This study aimed to identify barriers to undergoing reconstruction following abdominoperineal resection.
Kapur, Sahil K. M.D.; Butler, Charles E. M.D.
doi : 10.1097/PRS.0000000000008664
January 2022 - Volume 149 - Issue 1 - p 233-234
Bauder, Andrew M.D.; Othman, Sammy M.D.; Asaad, Malke M.D.; Butler, Charles E. M.D.; Kovach, Stephen J. M.D.
doi : 10.1097/PRS.0000000000008669
January 2022 - Volume 149 - Issue 1 - p 74e-78e
Patients with significant loss of abdominal wall soft tissue represent a reconstructive challenge. The purpose of this study was to describe the authors’ experience using microvascular free tissue transfer to repair complex abdominal wall defects with insufficient overlying soft tissue. In this report, the authors highlight their techniques and experiences in performing microvascular free tissue transfer to the abdominal wall for these massive, complex defects. In total, 14 patients who underwent 16 free-flap reconstructions were included in the series. The patients’ mean age was 50 ± 14 years, and mean body mass index was 27 ± 5 kg/m2. The mean hernia defect size was 412 ± 149 cm2. Ten flaps were fasciocutaneous anterolateral thigh flaps, one myocutaneous anterolateral thigh flap, two subtotal thigh flaps, one myocutaneous latissimus dorsi flap, one parascapular/latissimus dorsi flap, and one free filet of the lower leg. Five cases (36 percent) developed hernia recurrence, and seven developed surgical site complications. All flaps survived, with no total flap loss. This report highlights that microsurgical free tissue transfer in combination with mesh repair is a safe and reliable method for restoring complex, large, full-thickness abdominal wall defects. This case series illustrates a number of techniques and considerations that are of importance to achieve a favorable outcome when faced with these complex defects.
Ogawa, Rei M.D., Ph.D.
doi : 10.1097/PRS.0000000000008667
January 2022 - Volume 149 - Issue 1 - p 79e-94e
In 2010, this Journal published my comprehensive review of the literature on hypertrophic scars and keloids. In that article, I presented evidence-based algorithms for the prevention and treatment of these refractory pathologic scars. In the ensuing decade, substantial progress has been made in the field, including many new randomized controlled trials. To reflect this, I have updated my review.
Yang, Johnson Chia-Shen M.D.; Wu, Shao-Chun M.D.; Hayashi, Akitatsu M.D.; Lin, Wei-Che M.D.; Wang, Yu-Ming M.D.; Luo, Sheng-Dean M.D.; Chiang, Min-Hsien M.D.; Hsieh, Ching-Hua M.D.
doi : 10.1097/PRS.0000000000008674
January 2022 - Volume 149 - Issue 1 - p 237-246
Functional lymphatic vessels are essential for supermicrosurgical lymphaticovenous anastomosis. Theoretically, the larger the lymphatic vessel, the better the flow. However, large lymphatic vessels are not readily available. Since the introduction of lymphaticovenous anastomosis, no guidelines have been set as to how small a lymphatic vessel is still worthwhile for anastomosis.
Chang, Edward I. M.D.
doi : 10.1097/PRS.0000000000008675
January 2022 - Volume 149 - Issue 1 - p 247-248
Mishu, Mark D. B.A.; Zolper, Elizabeth G. B.S.; Dekker, Paige K. B.A.; Fleury, Christopher M. M.D.; Bekeny, Jenna C. B.A.; Fan, Kenneth L. M.D.; Attinger, Christopher E. M.D.; Evans, Karen K. M.D.
doi : 10.1097/PRS.0000000000008666
January 2022 - Volume 149 - Issue 1 - p 95e-103e
Antiplatelet agents are typically withheld perioperatively because of bleeding concerns. Dual antiplatelet therapy, such as aspirin and clopidogrel, has significant morbidity and mortality benefits in patients with ischemic heart disease or peripheral vascular disease. This study aims to evaluate the impact of perioperative dual antiplatelet therapy in the lower extremity free tissue transfer population.
Pereira, Nicolás M.D., M.Sc.; Kufeke, Matías M.D.; Roa, Ricardo M.D.
doi : 10.1097/PRS.0000000000008690
January 2022 - Volume 149 - Issue 1 - p 104e-107e
Technology is advancing in benefit to solving complex problems. Preoperative planning is essential in any reconstructive process given the importance of achieving good results. New technologies facilitate the process to anticipate intraoperative findings. Virtual surgical planning has contributed in the evolution of craniomaxillofacial surgery. However, limited reports have been published regarding its usefulness in extremity reconstruction. The aim of this study was to push the limits and evaluate the use of virtual surgical planning with three-dimensional images for reconstruction of complex extremity defects using a free, open-source software. Patient candidates for upper or lower extremity microsurgical reconstruction with multiple defects or defects requiring reconstruction of various tissue components were included. Computed tomography angiography images were analyzed for virtual surgical planning using Horos software (Horos, Annapolis, Md.). Two upper and eight lower extremities were reconstructed with free flaps using virtual surgical planning; six cases had multiple defects, and four cases underwent different tissue components reconstruction. The postoperative period was uneventful, and there was no flap failure. A didactic video of the process and examples of some cases are presented. Virtual surgical planning is a powerful planning method, and the authors propose its use in complex extremity defects reconstruction.
Wu, Kitty Yuechuan M.D.; Gillis, Joshua A. M.D.; Moran, Steven L. M.D.
doi : 10.1097/PRS.0000000000008692
January 2022 - Volume 149 - Issue 1 - p 108e-120e
After studying this article, the participant should be able to: 1. Understand the indications and management options for secondary flexor tendon reconstruction, including tenolysis, tendon grafting, and tendon transfers. 2. Understand the reconstructive options for pulley reconstruction. 3. Understand the options for management of isolated flexor digitorum profundus injuries.
Isbester, Kelsey A. M.D.; Boas, Samuel R. B.S.; Wee, Corinne M.D.; Summerville, Lesley B.S., Sc.M.; Kumar, Anand R. M.D.
doi : 10.1097/PRS.0000000000008678
January 2022 - Volume 149 - Issue 1 - p 253-261
The Open Payments database was created to increase transparency of industry payment relationships within medicine. The current literature often examines only 1 year of the database. In this study, the authors use 5 years of data to show trends among industry payments to plastic surgeons from 2014 to 2018. In addition, the authors lay out the basics of conflict-of-interest reporting for the new plastic surgeon. Finally, the authors suggest an algorithm for the responsible management of industry relationships.
Tanna, Neil M.D., M.B.A.; Clappier, Mona B.A.; Kasabian, Armen K. M.D.
doi : 10.1097/PRS.0000000000008679
January 2022 - Volume 149 - Issue 1 - p 262-263
Singerman, Kyle W. B.S.; Moore, Meredith G. B.S.; Kortlever, Joost T. P. M.D.; Gobble, Ryan M. M.D.
doi : 10.1097/PRS.0000000000008683
January 2022 - Volume 149 - Issue 1 - p 264-274
The Physician Payments Sunshine Act of 2010 mandated that all industry payments to physicians be publicly disclosed. To date, industry support of plastic surgeons has not been longitudinally characterized. The authors seek to evaluate payment trends from 2013 to 2018 and characteristics across plastic surgeon recipients of industry payments.
Luce, Edward A. M.D.
doi : 10.1097/PRS.0000000000008684
January 2022 - Volume 149 - Issue 1 - p 275-276
Agrawal, Nikhil A. M.D.; Hillier, Kirsty M.D.; Kumar, Riten M.D., M.Sc.; Izaddoost, Shayan A. M.D., Ph.D.; Rohrich, Rod J. M.D.
doi : 10.1097/PRS.0000000000008663
January 2022 - Volume 149 - Issue 1 - p 121e-129e
Venous thromboembolism is a significant cause of postoperative death and morbidity. While prophylactic and treatment regimens exist, they usually come with some risk of clinically relevant bleeding and, thus, must be considered carefully for each individual patient.
Shah, Jinesh M.D.; Zhao, Ruya M.D.; Yi, Joseph B.A.; Otterburn, David M.D.; Patel, Ashit M.B.Ch.B.; Szpalski, Caroline M.D., Ph.D.; Tanna, Neil M.D., M.B.A.; Taub, Peter J. M.D., M.S.; Weichman, Katie E. M.D.; Ricci, Joseph A. M.D.
doi : 10.1097/PRS.0000000000008649
January 2022 - Volume 149 - Issue 1 - p 130e-138e
Since the first documented case of coronavirus disease of 2019 (COVID-19), the greater New York City area quickly became the epicenter of the global pandemic, with over 500,000 cases and 50,000 deaths. This unprecedented crisis affected all aspects of health care, including plastic surgery residency training. The purpose of this study was to understand the specific impact of the COVID-19 pandemic on plastic surgery residencies.
Chung, Kevin C. M.D., M.S.
doi : 10.1097/PRS.0000000000008638
January 2022 - Volume 149 - Issue 1 - p 279-280
Bailey, Chad M. M.D.
doi : 10.1097/PRS.0000000000008695
January 2022 - Volume 149 - Issue 1 - p 281-282
Phillips, Brett T. M.D., M.B.A.; Boczar, Daniel M.D.; Boyd, Carter J. M.D., M.B.A.; Escandón, Joseph M. M.D.; Halani, Sameer H. M.D., M.Sc.; Karamanos, Efstathios M.D.; Lu, Karen B. M.D.; Lupon, Elise M.D., M.Sc.; Mazurek, Maciej J. M.D., Ph.D.; Sergesketter, Amanda R. M.D.; Shah, Harsh R. M.B.B.S., D.N.B.; Singh, Amiteshwar M.S.; Gosain, Arun K. M.D.
doi : 10.1097/PRS.0000000000008694
January 2022 - Volume 149 - Issue 1 - p 283-286
Albanese, Roberta M.D.; Zingaretti, Nicola M.D.; Almesberger, Daria M.D.; Parodi, Pier Camillo M.D.
doi : 10.1097/PRS.0000000000008610
January 2022 - Volume 149 - Issue 1 - p 139e-140e
Liu, Jing M.D.
doi : 10.1097/PRS.0000000000008611
January 2022 - Volume 149 - Issue 1 - p 140e
Ahn, Tae Hwan M.D., Ph.D.; Lee, Won M.D.; Yang, Eun-Jung M.D., Ph.D.
doi : 10.1097/PRS.0000000000008612
January 2022 - Volume 149 - Issue 1 - p 140e-141e
Hah, Wilbur M.D., M.B.A.; On behalf of the American Board of Cosmetic Surgery Trustees
doi : 10.1097/PRS.0000000000008613
January 2022 - Volume 149 - Issue 1 - p 141e-142e
Drolet, Brian C. M.D.; Gabrick, Kyle M.D.; Janis, Jeffrey E. M.D.; Perdikis, Galen M.D.
doi : 10.1097/PRS.0000000000008614
January 2022 - Volume 149 - Issue 1 - p 142e-143e
Mitchell, David B.S.; Laffoon, Allison M.D.; Rajesh, Aashish M.B.B.S.
doi : 10.1097/PRS.0000000000008615
January 2022 - Volume 149 - Issue 1 - p 143e-144e
Drinane, James J. D.O.; Eberlin, Kyle R. M.D.
doi : 10.1097/PRS.0000000000008616
January 2022 - Volume 149 - Issue 1 - p 144e-145e
Zeng, Lei M.D.; Yu, Fang M.D.; Tang, Juyu M.D.
doi : 10.1097/PRS.0000000000008617
January 2022 - Volume 149 - Issue 1 - p 145e-146e
Uygur, Safak M.D.; Konofaos, Petros M.D., Ph.D.
doi : 10.1097/PRS.0000000000008639
January 2022 - Volume 149 - Issue 1 - p 146e-147e
Rozen, Shai M. M.D.
doi : 10.1097/PRS.0000000000008640
January 2022 - Volume 149 - Issue 1 - p 146e-148e
Gill, Parneet M.B.Ch.B., M.Sc.; Henry, Angela B.Sc.; Hassan, Zahid B.M., M.D., Dip.HandSurg.(Br.),; McArthur, Paul M.B., B.S., Ph.D.,
doi : 10.1097/PRS.0000000000008641
January 2022 - Volume 149 - Issue 1 - p 147e-148e
Hallock, Geoffrey G. M.D.
doi : 10.1097/PRS.0000000000008642
January 2022 - Volume 149 - Issue 1 - p 148e-149e
Tsao, Chung-Kan M.D.; AL Deek, Nidal F. M.D.; Hsieh, Frank F.R.A.C.S.(Plast.)
doi : 10.1097/PRS.0000000000008643
January 2022 - Volume 149 - Issue 1 - p 149e-150e
Karczewski, Alison M. B.S.; Dingle, Aaron M. Ph.D.; Poore, Samuel O. M.D., Ph.D.
doi : 10.1097/PRS.0000000000008644
January 2022 - Volume 149 - Issue 1 - p 150e-151e
Knudson, Sean A. B.S.A.; DeLeon, Ashley Pharm.D., M.D.; Crane, Curtis N. M.D.; Santucci, Richard A. M.D.
doi : 10.1097/PRS.0000000000008618
January 2022 - Volume 149 - Issue 1 - p 152e-153e
Drost, Joshua P. Ph.D.; Clarkson, James M.D.; Bush, Tamara Reid Ph.D.
doi : 10.1097/PRS.0000000000008651
January 2022 - Volume 149 - Issue 1 - p 153e-155e
Katabi, Leila J. M.A.; Ascha, Mona M.D.; Wu-Fienberg, Yuewei M.D.; Todd Bafus, Blaine M.D.; Chepla, Kyle J. M.D.
doi : 10.1097/PRS.0000000000008619
January 2022 - Volume 149 - Issue 1 - p 155e-156e
Shahzad, Farooq M.B.B.S., M.S.; Kiwanuka, Elizabeth M.D., Ph.D.; Marano, Andrew M.D.; Boyle, Jay M.D.; Matros, Evan M.D., M.M.Sc.
doi : 10.1097/PRS.0000000000008620
January 2022 - Volume 149 - Issue 1 - p 157e-158e
Lai, Chung-Sheng M.D., Ph.D., E.M.B.A.,; Lee, Chia-Chen M.D.
doi : 10.1097/PRS.0000000000008621
January 2022 - Volume 149 - Issue 1 - p 158e-159e
Teven, Chad M. M.D.; Goulding, Krista M.D., M.P.H.; Rebecca, Alanna M. M.D., M.B.A.
doi : 10.1097/PRS.0000000000008622
January 2022 - Volume 149 - Issue 1 - p 160e-161e
Nigro, Lauren C. M.D.; Blanchet, Nadia M.D.
doi : 10.1097/PRS.0000000000008623
January 2022 - Volume 149 - Issue 1 - p 161e-162e
Akiki, Ronald K. M.D.; Rao, Vinay M.D., M.P.H.; Borrelli, Mimi R. M.D.; Beqiri, Dardan M.D.; Liu, Paul Y. M.D.
doi : 10.1097/PRS.0000000000008624
January 2022 - Volume 149 - Issue 1 - p 162e-164e
Egro, Francesco M. M.B.Ch.B., M.Sc., M.R.C.S.; Bustos, Samyd S. M.D.; Rubin, J. Peter M.D.; Goldstein, Jesse A. M.D.; Losee, Joseph E. M.D.; Nguyen, Vu T. M.D.
doi : 10.1097/PRS.0000000000008650
January 2022 - Volume 149 - Issue 1 - p 164e-166e
Kokosis, George M.D.; Gould, Adam M.D.; Darrach, Halley B.S.; Chopra, Karan M.D.; Hollenbeck, Scott T. M.D.; Lee, Bernard T. M.D., M.B.A., M.P.H.; Coon, Devin M.D., M.S.E.
doi : 10.1097/PRS.0000000000008655
January 2022 - Volume 149 - Issue 1 - p 166e-168e
Gasteratos, Konstantinos M.D., M.Sc.; Suess, Larry D.O., Ph.D.; Del Corral, Gabriel M.D.
doi : 10.1097/PRS.0000000000008656
January 2022 - Volume 149 - Issue 1 - p 168e-169e
Ma, Irene T. M.D.; Dayani, Fara B.S.; Yesantharao, Pooja B.S., M.S.; Chang, James M.D.; Hawn, Mary T. M.D., M.P.H.; Wald, Samuel M.D., M.B.A.; Lee, Gordon K. M.D.; Nazerali, Rahim M.D.
doi : 10.1097/PRS.0000000000008657
January 2022 - Volume 149 - Issue 1 - p 169e-171e
Singh, Nikhi P. B.S.; Ananthasekar, Shivani B.S.; Nocera, Alex P. B.S.; Boyd, Carter J. M.D., M.B.A.; Rais-Bahrami, Soroush M.D.,,; King, Timothy W. M.D., Ph.D.,,
doi : 10.1097/PRS.0000000000008844
January 2022 - Volume 149 - Issue 1 - p 171e-173e
Ferry, Andrew M. B.S.,; Chang, Andrew B.S.,; Dibbs, Rami P. B.A.,; Reece, Edward M. M.D., M.B.A.,; Vorstenbosch, Joshua M.D., Ph.D.; Winocour, Sebastian J. M.D., M.Sc.
doi : 10.1097/PRS.0000000000008658
January 2022 - Volume 149 - Issue 1 - p 173e-174e
Makhoul, Alan T. B.A.; Jackson, Kianna R. M.D.; Drolet, Brian C. M.D.,,,; Perdikis, Galen M.D.,
doi : 10.1097/PRS.0000000000008659
January 2022 - Volume 149 - Issue 1 - p 174e-175e
Guidry, Brad B.S.; Makhoul, Alan T. B.A.; Kelly, Patrick D. M.D., M.S.C.I.; Drolet, Brian C. M.D.,,
doi : 10.1097/PRS.0000000000008660
January 2022 - Volume 149 - Issue 1 - p 176e
Gupta, Arunesh M.S.(Gen.Surg.), M.Ch.(Plast.Surg.); Suresh, Aneesh M.S.(Gen.Surg.), M.Ch.(Plast.Surg.); Kumar, Vineet M.S.(Gen.Surg.), M.Ch.(Plast.Surg.); Anudeep, Talagavadi Channaiah M.S.(Gen.Surg.), M.Ch.(Plast.Surg.)
doi : 10.1097/PRS.0000000000008662
January 2022 - Volume 149 - Issue 1 - p 176e-179e
Khetpal, Sumun B.S., B.A.; Pourtaheri, Navid M.D., Ph.D.; Lopez, Joseph M.D., M.B.A.; Alperovich, Michael M.D., M.Sc.
doi : 10.1097/PRS.0000000000008653
January 2022 - Volume 149 - Issue 1 - p 179e-180e
Wheeler, Dakota Russell; Oldani, Silvia M.D.; Montagna, Licia M.D.; Vinci, Valeriano M.D.
doi : 10.1097/PRS.0000000000008637
January 2022 - Volume 149 - Issue 1 - p 180e-181e
doi : 10.1097/01.prs.0000812856.04231.d9
January 2022 - Volume 149 - Issue 1 - p 182e
doi : 10.1097/01.prs.0000812860.55722.a7
January 2022 - Volume 149 - Issue 1 - p 182e-184e
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