Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006342
Kevin Chen, Stephen M. Lu, R. Cheng, M. Fisher, Ben H. Zhang, Marcelo Ruben Di Maggio, J. Bradley
BACKGROUND Male-to-female (MtF) transgender patients desire to be identified and treated as female, not only with partners but also in public and social settings. Facial Feminization Surgery (FFS) entails a combination of highly visible changes in facial features which may affect social "first impressions." No study to date has evaluated the impact of FFS on how MtF patients are gender-typed. To study the effectiveness of FFS, we investigated preoperative/postoperative gender-typing using facial recognition neural networks. METHODS In this study, standardized frontal and lateral view preoperative and postoperative images of twenty MtF patients who completed hard and soft tissue FFS procedures were used, along with control images of unoperated cisgender men and women (n=120 images). Four large, public neural networks trained to identify gender based on facial features analyzed the images. Correct gender-typing, improvement in gender-typing (Preop to Postop), and confidence in femininity were analyzed. RESULTS Cisgender Male and Female control frontal images were correctly identified 100% and 98% of the time. Preoperative FFS images, were misgendered 47% of the time (recognized as male) and only correctly identified as female 53% of the time. Postoperative FFS images were gendered correctly 98% of the time; this was an improvement of 45%. Confidence in femininity also improved from a mean Preop FFS of 0.27 to Postop FFS of 0.87. CONCLUSIONS In the first study of its kind, facial recognition neural networks showed improved gender-typing of transgender women from Preop FFS to Postop FFS. This demonstrated the effectiveness of FFS by artificial intelligence methods.
{"title":"Facial Recognition Neural Networks Confirm Success of Facial Feminization Surgery.","authors":"Kevin Chen, Stephen M. Lu, R. Cheng, M. Fisher, Ben H. Zhang, Marcelo Ruben Di Maggio, J. Bradley","doi":"10.1097/PRS.0000000000006342","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006342","url":null,"abstract":"BACKGROUND\u0000Male-to-female (MtF) transgender patients desire to be identified and treated as female, not only with partners but also in public and social settings. Facial Feminization Surgery (FFS) entails a combination of highly visible changes in facial features which may affect social \"first impressions.\" No study to date has evaluated the impact of FFS on how MtF patients are gender-typed. To study the effectiveness of FFS, we investigated preoperative/postoperative gender-typing using facial recognition neural networks.\u0000\u0000\u0000METHODS\u0000In this study, standardized frontal and lateral view preoperative and postoperative images of twenty MtF patients who completed hard and soft tissue FFS procedures were used, along with control images of unoperated cisgender men and women (n=120 images). Four large, public neural networks trained to identify gender based on facial features analyzed the images. Correct gender-typing, improvement in gender-typing (Preop to Postop), and confidence in femininity were analyzed.\u0000\u0000\u0000RESULTS\u0000Cisgender Male and Female control frontal images were correctly identified 100% and 98% of the time. Preoperative FFS images, were misgendered 47% of the time (recognized as male) and only correctly identified as female 53% of the time. Postoperative FFS images were gendered correctly 98% of the time; this was an improvement of 45%. Confidence in femininity also improved from a mean Preop FFS of 0.27 to Postop FFS of 0.87.\u0000\u0000\u0000CONCLUSIONS\u0000In the first study of its kind, facial recognition neural networks showed improved gender-typing of transgender women from Preop FFS to Postop FFS. This demonstrated the effectiveness of FFS by artificial intelligence methods.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91218474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006386
L. Dvoracek, Jonathan Y. Lee, A. Ayyash, J. Losee, J. Goldstein
Replacement of the autologous bone flap after decompressive craniectomy can be complicated by significant osteolysis or infection with large defects over scarred dura. Demineralized bone matrix (DBM) is an alternative to autologous reconstruction, effective when reconstructing large defects using a resorbable mesh bilaminate technique in primary cranioplasty, but this technique has not been studied for revision cranioplasty and the setting of scarred dura.Retrospective review was performed of patients receiving DBM and resorbable mesh bilaminate (DRMB) cranioplasty for post-decompressive craniectomy defects. Seven patients (mean age 4.2 years) were identified with mean follow up of 4.0 years. Computed tomography before the DRMB cranioplasty and at least one year postoperative were compared. Defects were characterized and need for revision were assessed.All patients had craniectomy with associated hemi-dural scarring. Five patients had autologous bone flap cranioplasty associated with near-total osteolysis and two patients had deferral of bone flap prior to DRMB cranioplasty. DRMB cranioplasty demonstrated unpredictable and poor ossification with bony coverage unchanged at post-operative follow-up. All patients required major revision cranioplasty at mean time 2.5 years. Porous polyethylene was successfully utilized in six of the revisions while exchange cranioplasty was used in the remaining patient, with mean follow up of 1.4 years.Although DBM and resorbable mesh bilaminate is appropriate for primary cranioplasty, it should be avoided in the setting of scarred or infected dura in favor of synthetic materials or exchange cranioplasty.
{"title":"\"Demineralized Bone Matrix and Resorbable Mesh Bilaminate Cranioplasty is Ineffective for Secondary Reconstruction of Large Pediatric Cranial Defects\".","authors":"L. Dvoracek, Jonathan Y. Lee, A. Ayyash, J. Losee, J. Goldstein","doi":"10.1097/PRS.0000000000006386","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006386","url":null,"abstract":"Replacement of the autologous bone flap after decompressive craniectomy can be complicated by significant osteolysis or infection with large defects over scarred dura. Demineralized bone matrix (DBM) is an alternative to autologous reconstruction, effective when reconstructing large defects using a resorbable mesh bilaminate technique in primary cranioplasty, but this technique has not been studied for revision cranioplasty and the setting of scarred dura.Retrospective review was performed of patients receiving DBM and resorbable mesh bilaminate (DRMB) cranioplasty for post-decompressive craniectomy defects. Seven patients (mean age 4.2 years) were identified with mean follow up of 4.0 years. Computed tomography before the DRMB cranioplasty and at least one year postoperative were compared. Defects were characterized and need for revision were assessed.All patients had craniectomy with associated hemi-dural scarring. Five patients had autologous bone flap cranioplasty associated with near-total osteolysis and two patients had deferral of bone flap prior to DRMB cranioplasty. DRMB cranioplasty demonstrated unpredictable and poor ossification with bony coverage unchanged at post-operative follow-up. All patients required major revision cranioplasty at mean time 2.5 years. Porous polyethylene was successfully utilized in six of the revisions while exchange cranioplasty was used in the remaining patient, with mean follow up of 1.4 years.Although DBM and resorbable mesh bilaminate is appropriate for primary cranioplasty, it should be avoided in the setting of scarred or infected dura in favor of synthetic materials or exchange cranioplasty.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82459002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006326
Alfred P Yoon, Surinder Kaur, Ching-Han Chou, K. Chung
PURPOSE This study investigates the psychometric properties of patient-reported outcomes (PROs) instruments for assessing outcomes in post-surgical traumatic digit amputation patients. We hypothesize the MHQ(Michigan Hand Outcomes Questionnaire) and DASH(Disabilities of the Arm, Shoulder, and Hand Questionnaire) are the most valid and reliable instruments. METHODS We studied traumatic digit amputation patients as part of the Finger Replantation ANd amputation CHallenges in assessing Impairment, Satisfaction, and Effectiveness(FRANCHISE) study initiated by the Plastic Surgery Foundation. MHQ, DASH, Patient-Reported Outcomes Measurement Information System (PROMIS), and SF-36 were used to assess patients at least one year postoperatively. Internal consistency was measured by Cronbach's alpha(α) and criterion validity with Pearson's correlation coefficient(r). Construct validity was tested with four predefined hypotheses. Discriminant validity was analyzed by receiver operating characteristic curves. RESULTS 168 replantation and 74 revision amputation patients met the inclusion criteria. All instruments demonstrated fair to good internal consistency in both cohorts(0.70.60) in both cohorts. SF-36 had moderate to weak correlation with the remaining instruments, and its mental component had poor discriminant validity(area under the curve 0.64 - 0.67). MHQ, DASH, and PROMIS demonstrated good construct validity confirming 75-100% of predefined hypotheses, whereas SF-36 only confirmed 25%. CONCLUSIONS We recommend using MHQ or DASH when assessing PROs in digit amputation patients based on good internal consistency and validity. PROMIS has fair validity and reliability but should be an adjunct instrument. SF-36 should not be used as a primary assessment tool, but as an adjunct to assess overall quality of life.
{"title":"Reliability and Validity of Upper Extremity Patient-Reported Outcomes Measures in Assessing Traumatic Finger Amputation Management.","authors":"Alfred P Yoon, Surinder Kaur, Ching-Han Chou, K. Chung","doi":"10.1097/PRS.0000000000006326","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006326","url":null,"abstract":"PURPOSE\u0000This study investigates the psychometric properties of patient-reported outcomes (PROs) instruments for assessing outcomes in post-surgical traumatic digit amputation patients. We hypothesize the MHQ(Michigan Hand Outcomes Questionnaire) and DASH(Disabilities of the Arm, Shoulder, and Hand Questionnaire) are the most valid and reliable instruments.\u0000\u0000\u0000METHODS\u0000We studied traumatic digit amputation patients as part of the Finger Replantation ANd amputation CHallenges in assessing Impairment, Satisfaction, and Effectiveness(FRANCHISE) study initiated by the Plastic Surgery Foundation. MHQ, DASH, Patient-Reported Outcomes Measurement Information System (PROMIS), and SF-36 were used to assess patients at least one year postoperatively. Internal consistency was measured by Cronbach's alpha(α) and criterion validity with Pearson's correlation coefficient(r). Construct validity was tested with four predefined hypotheses. Discriminant validity was analyzed by receiver operating characteristic curves.\u0000\u0000\u0000RESULTS\u0000168 replantation and 74 revision amputation patients met the inclusion criteria. All instruments demonstrated fair to good internal consistency in both cohorts(0.70.60) in both cohorts. SF-36 had moderate to weak correlation with the remaining instruments, and its mental component had poor discriminant validity(area under the curve 0.64 - 0.67). MHQ, DASH, and PROMIS demonstrated good construct validity confirming 75-100% of predefined hypotheses, whereas SF-36 only confirmed 25%.\u0000\u0000\u0000CONCLUSIONS\u0000We recommend using MHQ or DASH when assessing PROs in digit amputation patients based on good internal consistency and validity. PROMIS has fair validity and reliability but should be an adjunct instrument. SF-36 should not be used as a primary assessment tool, but as an adjunct to assess overall quality of life.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80079961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006365
Daisuke Mito, M. Kurita, S. Miyamoto, M. Okazaki
{"title":"Miniaturization of Indocyanine Green Fluorescence Imaging Device Utilizing Smartphone.","authors":"Daisuke Mito, M. Kurita, S. Miyamoto, M. Okazaki","doi":"10.1097/PRS.0000000000006365","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006365","url":null,"abstract":"","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88286091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006364
Apinut Wongkietkachorn, Palakorn Surakunprapha, K. Winaikosol, Nuttapone Wongkietkachorn, Supawich Wongkietkachorn
{"title":"Precise Marking for Burn Excision by Using Indocyanine Green Angiography.","authors":"Apinut Wongkietkachorn, Palakorn Surakunprapha, K. Winaikosol, Nuttapone Wongkietkachorn, Supawich Wongkietkachorn","doi":"10.1097/PRS.0000000000006364","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006364","url":null,"abstract":"","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"193 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77299920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006335
Nneamaka Agochukwu-Nwubah, H. Mentz
one ampoule per liter up to a total of three ampoules per patient.3 The fat treated with either of the two technologies, laser-assisted or ultrasound-assisted lipoplasty, is reused as fat grafts in different body areas according to the patient’s demands, indications, and gender. The most frequent associations in my practice in men are gynecomastia treatment, gluteal filling, pectoral filling, and deltoid filling. In women, the most commonly used associations are lipoaspirations of neighboring areas, gluteal filling, and breast surgery. DOI: 10.1097/PRS.0000000000006460
{"title":"Abdominal Etching: Surgical Technique and Outcomes.","authors":"Nneamaka Agochukwu-Nwubah, H. Mentz","doi":"10.1097/PRS.0000000000006335","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006335","url":null,"abstract":"one ampoule per liter up to a total of three ampoules per patient.3 The fat treated with either of the two technologies, laser-assisted or ultrasound-assisted lipoplasty, is reused as fat grafts in different body areas according to the patient’s demands, indications, and gender. The most frequent associations in my practice in men are gynecomastia treatment, gluteal filling, pectoral filling, and deltoid filling. In women, the most commonly used associations are lipoaspirations of neighboring areas, gluteal filling, and breast surgery. DOI: 10.1097/PRS.0000000000006460","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85829703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006406
Maxime Abellan Lopez, B. Bertrand, F. Kober, M. Boucekine, Marc De Fromont De Bouailles, Marie Vogtensperger, M. Bernard, D. Casanova, J. Magalon, F. Sabatier
INTRODUCTION Platelet-rich plasma (PRP) improves engraftment after fat transfer. However, the effects of platelet dose have never been investigated. We used magnetic resonance imaging (MRI) to compare surviving graft volumes in mice after administration of four different formulations (microfat alone, and three PRP-enriched microfat mixes). METHOD We used a random, double-blinded, fat transfer protocol employing three different platelet levels: 1 (low-dose; LD), 500 (medium-dose; MD), and 1,000 million (high-dose; HD) platelets/mL, and fat alone (control; Cx). We grafted 0.4 mL of the 70/30 PRP-enriched microfat mixtures (0.4, 200 and 400 million platelets per 0.12 mL for the LD, MD and HD mixtures respectively) or 0.4 mL of microfat alone into 22 nude mice and monitored surviving graft volumes every month for 3 months. Then we histologically analyzed all grafts to assess neo-angiogenesis status and fat integrity RESULTS:: Three-dimensional MRI showed that the median surviving graft volumes at 3 months were 9.5 [0;25]% (p=0.003) (HD), 4.1 [0;18]% (p=0.001) (MD), and 18 [8;38]% (p= 0.41) (LD) compared to 36 [28;53]% for the Cx value. The histological integrity of microfat-alone grafts was significantly better than those of the other grafts, although the HD and LD grafts exhibited higher levels of neo-angiogenesis. CONCLUSION Higher platelet levels in microfat grafts were associated with poor graft survival in nude mice; a clinical review would be appropriate.
{"title":"The use of higher proportions of platelet-rich plasma to enrich microfat has negative effects: A pre-clinical study.","authors":"Maxime Abellan Lopez, B. Bertrand, F. Kober, M. Boucekine, Marc De Fromont De Bouailles, Marie Vogtensperger, M. Bernard, D. Casanova, J. Magalon, F. Sabatier","doi":"10.1097/PRS.0000000000006406","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006406","url":null,"abstract":"INTRODUCTION\u0000Platelet-rich plasma (PRP) improves engraftment after fat transfer. However, the effects of platelet dose have never been investigated. We used magnetic resonance imaging (MRI) to compare surviving graft volumes in mice after administration of four different formulations (microfat alone, and three PRP-enriched microfat mixes).\u0000\u0000\u0000METHOD\u0000We used a random, double-blinded, fat transfer protocol employing three different platelet levels: 1 (low-dose; LD), 500 (medium-dose; MD), and 1,000 million (high-dose; HD) platelets/mL, and fat alone (control; Cx). We grafted 0.4 mL of the 70/30 PRP-enriched microfat mixtures (0.4, 200 and 400 million platelets per 0.12 mL for the LD, MD and HD mixtures respectively) or 0.4 mL of microfat alone into 22 nude mice and monitored surviving graft volumes every month for 3 months. Then we histologically analyzed all grafts to assess neo-angiogenesis status and fat integrity RESULTS:: Three-dimensional MRI showed that the median surviving graft volumes at 3 months were 9.5 [0;25]% (p=0.003) (HD), 4.1 [0;18]% (p=0.001) (MD), and 18 [8;38]% (p= 0.41) (LD) compared to 36 [28;53]% for the Cx value. The histological integrity of microfat-alone grafts was significantly better than those of the other grafts, although the HD and LD grafts exhibited higher levels of neo-angiogenesis.\u0000\u0000\u0000CONCLUSION\u0000Higher platelet levels in microfat grafts were associated with poor graft survival in nude mice; a clinical review would be appropriate.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"176 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76611606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006389
R. Tse, R. Knight, Makinna Oestreich, Mica Rosser, E. Mercan
BACKGROUND Objective assessment of the unilateral cleft lip nasal deformity and the longitudinal changes with treatment is critical to optimizing cleft care. We used 3D images to evaluate nasal base morphology. METHODS Consecutive patients undergoing cleft lip repair and foundation-based rhinoplasty were included (N=102). 3D images pre-op, post-op, and at 5 years of age were assessed and compared to age-matched controls. Images were normalized to standard horizontal, cranio-caudal, and antero-posterior axes. RESULTS Cleft subalare was similar in position relative to controls but was 1.6 mm retrodisplaced. Subnasale was deviated 4.6 mm lateral to midline and had the greatest displacement of any landmark. Non-cleft subalare was 2.3 mm laterally displaced. Regression analysis with deviation of subnasale from midline as dependent variable revealed progressive lateral displacement of non-cleft subalare, narrowing of non-cleft nostril, and intercanthal widening. Surgery corrected nasal base displacements along all axes resulting in landmark positions similar to controls. The symmetry of nasal base correction persisted at 5-year follow-up with no recurrent cleft alar base retrusion, regardless of initial cleft type. CONCLUSIONS Unilateral cleft lip nasal deformity may be 'driven' by displacement of anterior nasal spine and caudal septum. The cleft alar base is normal in position but retruded whereas the non-cleft alar base is displaced lateral. Changes with surgery involve anterior movement of cleft alar base but also include medial movement of non-cleft alar base and columella. Symmetry of correction, including alar base retrusion, was stable over time and did not rely upon alveolar bone grafting.
{"title":"Unilateral cleft lip nasal deformity: 3D analysis of the primary deformity and longitudinal changes following primary correction of the nasal foundation.","authors":"R. Tse, R. Knight, Makinna Oestreich, Mica Rosser, E. Mercan","doi":"10.1097/PRS.0000000000006389","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006389","url":null,"abstract":"BACKGROUND\u0000Objective assessment of the unilateral cleft lip nasal deformity and the longitudinal changes with treatment is critical to optimizing cleft care. We used 3D images to evaluate nasal base morphology.\u0000\u0000\u0000METHODS\u0000Consecutive patients undergoing cleft lip repair and foundation-based rhinoplasty were included (N=102). 3D images pre-op, post-op, and at 5 years of age were assessed and compared to age-matched controls. Images were normalized to standard horizontal, cranio-caudal, and antero-posterior axes.\u0000\u0000\u0000RESULTS\u0000Cleft subalare was similar in position relative to controls but was 1.6 mm retrodisplaced. Subnasale was deviated 4.6 mm lateral to midline and had the greatest displacement of any landmark. Non-cleft subalare was 2.3 mm laterally displaced. Regression analysis with deviation of subnasale from midline as dependent variable revealed progressive lateral displacement of non-cleft subalare, narrowing of non-cleft nostril, and intercanthal widening. Surgery corrected nasal base displacements along all axes resulting in landmark positions similar to controls. The symmetry of nasal base correction persisted at 5-year follow-up with no recurrent cleft alar base retrusion, regardless of initial cleft type.\u0000\u0000\u0000CONCLUSIONS\u0000Unilateral cleft lip nasal deformity may be 'driven' by displacement of anterior nasal spine and caudal septum. The cleft alar base is normal in position but retruded whereas the non-cleft alar base is displaced lateral. Changes with surgery involve anterior movement of cleft alar base but also include medial movement of non-cleft alar base and columella. Symmetry of correction, including alar base retrusion, was stable over time and did not rely upon alveolar bone grafting.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79208004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/PRS.0000000000006352
Panxi Yu, Xiaonan Yang, Zuoliang Qi
211e 3. Park E, Lewis K, Alghoul MS. Comparison of efficacy and complications among various spacer grafts in the treatment of lower eyelid retraction: A systematic review. Aesthet Surg J. 2017;37:743–754. 4. Sullivan SA, Dailey RA. Graft contraction: A comparison of acellular dermis versus hard palate mucosa in lower eyelid surgery. Ophthalmic Plast Reconstr Surg. 2003;19:14–24. 5. Yoon MK, McCulley TJ. Autologous dermal grafts as posterior lamellar spacers in the management of lower eyelid retraction. Ophthalmic Plast Reconstr Surg. 2014;30:64–68.
211 e 3。Park E, Lewis K, Alghoul MS.不同间隔片移植治疗下眼睑挛缩的疗效及并发症的比较:系统回顾。中华美容外科杂志，2017;37:743-754。4. Sullivan SA, Dailey RA。移植物收缩:下眼睑手术中脱细胞真皮与硬腭粘膜的比较。眼科整形外科2003;19:14-24。5. Yoon MK, McCulley TJ。自体真皮移植物作为后板间垫治疗下睑挛缩。眼科整形外科，2014;30:64-68。
{"title":"The Use of Botulinum Toxin Type A in the Healing of Thyroidectomy Wounds: A Randomized, Prospective, Placebo-Controlled Study.","authors":"Panxi Yu, Xiaonan Yang, Zuoliang Qi","doi":"10.1097/PRS.0000000000006352","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006352","url":null,"abstract":"211e 3. Park E, Lewis K, Alghoul MS. Comparison of efficacy and complications among various spacer grafts in the treatment of lower eyelid retraction: A systematic review. Aesthet Surg J. 2017;37:743–754. 4. Sullivan SA, Dailey RA. Graft contraction: A comparison of acellular dermis versus hard palate mucosa in lower eyelid surgery. Ophthalmic Plast Reconstr Surg. 2003;19:14–24. 5. Yoon MK, McCulley TJ. Autologous dermal grafts as posterior lamellar spacers in the management of lower eyelid retraction. Ophthalmic Plast Reconstr Surg. 2014;30:64–68.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73735282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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