Pub Date : 2024-09-23DOI: 10.1177/22925503241281935
Michael J Stein
{"title":"Commentary: Scrolling for Answers About Breast Implant Illness: Application of Validated Tools to Assess the Quality of Content on YouTube and TikTok.","authors":"Michael J Stein","doi":"10.1177/22925503241281935","DOIUrl":"10.1177/22925503241281935","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503241281935"},"PeriodicalIF":0.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1177/22925503241276544
Kathryn Uhlman, Isabella Churchill, Robert Dydynsky, Stepfanie Johnston, Cameron Leveille, Mark McRae, Matthew McRae
Introduction: The COVID-19 pandemic has decreased the number of surgeries performed in North America. The purpose of this study was to compare the number of elective hand surgeries performed during the pandemic to a corresponding pre-pandemic time period and to quantify the impact to the surgical backlog in hand surgery. Methods: Patient health records for individuals who underwent surgical management of carpal tunnel syndrome (CTS), Dupuytren's disease (DD) or stenosing tenosynovitis (time periods: March 11, 2018 to July 1, 2019 [pre-pandemic] and March 11, 2020 to July 1, 2021 [pandemic]) were retrieved from two academic institutions. The primary outcome was number of surgeries performed in each time period. Secondary outcomes included wait times for each time period; and variables as predictors of wait times, including a) age; b) gender; c) socioeconomic status; d) geographic location; and, e) comorbidities. Results: Seven-hundred-and-fifteen cases were included (447 CTR cases, 135 fasciotomy/subtotal palmar fasciectomy cases and 133 pulley release/tendon release cases). Two-hundred-and-sixty-four elective hand procedures were performed during the COVID-19 time period, compared to 451 in the pre-pandemic time period (n = 187 surgeries, 41.5%). Mean surgical wait times decreased for CTS and DD and increased for stenosing tenosynovitis during the pandemic compared to the corresponding pre-pandemic time period. No association or variation in wait times was found in regard to the aforementioned variables. Conclusions: During the pandemic, a decreased total number of elective hand surgeries were performed when compared to the corresponding pre-pandemic period. This contributes to a backlog of elective surgical procedures.
{"title":"The Impact of the COVID-19 Pandemic on Case Volume and Wait Times of Elective Hand Procedures: A Retrospective Chart Review Study","authors":"Kathryn Uhlman, Isabella Churchill, Robert Dydynsky, Stepfanie Johnston, Cameron Leveille, Mark McRae, Matthew McRae","doi":"10.1177/22925503241276544","DOIUrl":"https://doi.org/10.1177/22925503241276544","url":null,"abstract":"Introduction: The COVID-19 pandemic has decreased the number of surgeries performed in North America. The purpose of this study was to compare the number of elective hand surgeries performed during the pandemic to a corresponding pre-pandemic time period and to quantify the impact to the surgical backlog in hand surgery. Methods: Patient health records for individuals who underwent surgical management of carpal tunnel syndrome (CTS), Dupuytren's disease (DD) or stenosing tenosynovitis (time periods: March 11, 2018 to July 1, 2019 [pre-pandemic] and March 11, 2020 to July 1, 2021 [pandemic]) were retrieved from two academic institutions. The primary outcome was number of surgeries performed in each time period. Secondary outcomes included wait times for each time period; and variables as predictors of wait times, including a) age; b) gender; c) socioeconomic status; d) geographic location; and, e) comorbidities. Results: Seven-hundred-and-fifteen cases were included (447 CTR cases, 135 fasciotomy/subtotal palmar fasciectomy cases and 133 pulley release/tendon release cases). Two-hundred-and-sixty-four elective hand procedures were performed during the COVID-19 time period, compared to 451 in the pre-pandemic time period (n = 187 surgeries, 41.5%). Mean surgical wait times decreased for CTS and DD and increased for stenosing tenosynovitis during the pandemic compared to the corresponding pre-pandemic time period. No association or variation in wait times was found in regard to the aforementioned variables. Conclusions: During the pandemic, a decreased total number of elective hand surgeries were performed when compared to the corresponding pre-pandemic period. This contributes to a backlog of elective surgical procedures.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":"18 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1177/22925503241276548
Kevin W. Dowling, Christopher G. Landis, George H. Landis
Introduction: “Flow states”, characterized by intense focus during complex tasks, are proposed as common to the practice of reconstructive microsurgery. Existing literature establishes close relationships between the experience of flow and key aspects of mental health. Taking a holistic approach, the paper defines flow and establishes its relevance to both microsurgical practice and to the life and well-being of microsurgeons. Means of cultivating and enhancing flow are offered with important acknowledgement of the benefits and potential pitfalls involved. Methods: The paper is based on an extensive literature review. Numerous sources are critically evaluated for research design, methodology, and consistency of results with existing literature before being synthesized for relevance to microsurgical practice. Results: Existing literature defines flow with precision by way of environmental preconditions and experiential characteristics. The relationship of flow to more general psychological health is also well-established. The effects of flow on performance and how to optimally utilize and balance flow are burgeoning topics of study. Conclusion: Microsurgeons may benefit from the explicit recognition of flow states and the application of strategies that foster and balance flow within microsurgery. Techniques such as mental visualization, mindfulness practices, and attention training are tools that may potentially enhance flow experiences, reduce stress, improve performance, and mitigate burnout. Overemphasizing flow within surgery at the expense of finding flow in life more broadly, however, can lead to negative consequences. The paper highlights the potential benefits of integrating flow states into reconstructive microsurgery, offers suggestions for finding flow effectively, and underscores the importance of harnessing flow not only within surgery but also across different life spheres to ensure a well-rounded, sustainable, and fulfilling professional and personal existence.
{"title":"Reconstructive Microsurgery and the Flow State","authors":"Kevin W. Dowling, Christopher G. Landis, George H. Landis","doi":"10.1177/22925503241276548","DOIUrl":"https://doi.org/10.1177/22925503241276548","url":null,"abstract":"Introduction: “Flow states”, characterized by intense focus during complex tasks, are proposed as common to the practice of reconstructive microsurgery. Existing literature establishes close relationships between the experience of flow and key aspects of mental health. Taking a holistic approach, the paper defines flow and establishes its relevance to both microsurgical practice and to the life and well-being of microsurgeons. Means of cultivating and enhancing flow are offered with important acknowledgement of the benefits and potential pitfalls involved. Methods: The paper is based on an extensive literature review. Numerous sources are critically evaluated for research design, methodology, and consistency of results with existing literature before being synthesized for relevance to microsurgical practice. Results: Existing literature defines flow with precision by way of environmental preconditions and experiential characteristics. The relationship of flow to more general psychological health is also well-established. The effects of flow on performance and how to optimally utilize and balance flow are burgeoning topics of study. Conclusion: Microsurgeons may benefit from the explicit recognition of flow states and the application of strategies that foster and balance flow within microsurgery. Techniques such as mental visualization, mindfulness practices, and attention training are tools that may potentially enhance flow experiences, reduce stress, improve performance, and mitigate burnout. Overemphasizing flow within surgery at the expense of finding flow in life more broadly, however, can lead to negative consequences. The paper highlights the potential benefits of integrating flow states into reconstructive microsurgery, offers suggestions for finding flow effectively, and underscores the importance of harnessing flow not only within surgery but also across different life spheres to ensure a well-rounded, sustainable, and fulfilling professional and personal existence.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":"34 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1177/22925503241276541
Jaimie L. Bryan, Kyle M. Ockerman, Lisa R. Spiguel, Elizabeth A. Cox, Sabrina H. Han, Nhan Trieu, Mario Blondin Fernandez, Frederick Heath, Sarah Sorice-Virk
Background: Post-mastectomy implant-based reconstruction can be performed as direct-to-implant (DTI) or two-staged reconstruction (TSR). Rigorous studies have explored postoperative complications between TSR or DTI, yet few have stratified outcomes by relevant populations, pre-operative findings, mastectomy characteristics, or plane of implant placement. We sought to compare the outcomes between these cohorts at our institution. Methods: All patients who underwent skin- or nipple-sparing mastectomy followed by DTI or TSR from 2011 to 2021 at a large academic medical center were included. Data included demographics, ADM use, mastectomy weight, plane of implant placement, and postoperative complications. Results: 295 patients were included. 271 (91.9%) received TSR, and 24 (8.1%) underwent DTI. Compared to TSR, DTI had a higher rate of NAC necrosis ( P = .007) and dehiscence ( P = .016). There was no difference in rate of other complications. Regardless of procedure, higher BMI ( P = .002), higher grade ptosis ( P = .01), and larger mastectomy weights ( P = .022) were associated with increased risk of complication. Pre-pectoral placement was not associated with risk of NAC or mastectomy skin necrosis. Prior tobacco use was associated with higher risk of infection ( P = .036) and dehiscence ( P = .025). Neoadjuvant and adjuvant chemotherapy was associated with increased risk of capsular contracture( P = .009). Conclusions: Our study suggests that TSR may be preferred to minimize risk of NAC necrosis and wound dehiscence, especially in high-risk patients. Pre-pectoral placement did not significantly affect risk of mastectomy or NAC necrosis and should be considered in all cases to minimize morbidity. Higher risk conditions for alloplastic reconstruction include higher degrees of ptosis, history of tobacco use, and higher BMIs.
背景：乳房切除术后以植入物为基础的重建可以直接植入（DTI）或两阶段重建（TSR）的方式进行。已有严格的研究探讨了 TSR 或 DTI 的术后并发症，但很少有研究根据相关人群、术前检查结果、乳房切除特征或植入物放置平面对结果进行分层。我们试图比较本机构这些组群之间的结果。方法：纳入2011年至2021年期间在一家大型学术医疗中心接受皮肤或乳头保留乳房切除术，然后进行DTI或TSR的所有患者。数据包括人口统计学、ADM使用情况、乳房切除体重、植入物放置平面和术后并发症。结果：共纳入 295 名患者。271人（91.9%）接受了TSR，24人（8.1%）接受了DTI。与 TSR 相比，DTI 的 NAC 坏死率（P = .007）和开裂率（P = .016）更高。其他并发症的发生率没有差异。无论采用哪种手术，体重指数越高 ( P = .002)、上睑下垂程度越高 ( P = .01)、乳房切除重量越大 ( P = .022)，并发症风险越高。胸大肌前置入与NAC或乳房切除皮肤坏死的风险无关。之前吸烟与感染（P = 0.036）和开裂（P = 0.025）风险较高有关。新辅助化疗和辅助化疗与囊膜挛缩风险增加有关 ( P = .009)。结论：我们的研究表明，TSR可能是将NAC坏死和伤口开裂风险降至最低的首选，尤其是在高风险患者中。胸大肌前放置对乳房切除或NAC坏死的风险没有明显影响，所有病例都应考虑使用，以最大限度地降低发病率。上睑下垂程度较高、有吸烟史和体重指数（BMI）较高的患者接受异体重建的风险较高。
{"title":"Postoperative Complications of Direct-to-Implant and Two-Staged Breast Reconstruction: A Stratified Analysis","authors":"Jaimie L. Bryan, Kyle M. Ockerman, Lisa R. Spiguel, Elizabeth A. Cox, Sabrina H. Han, Nhan Trieu, Mario Blondin Fernandez, Frederick Heath, Sarah Sorice-Virk","doi":"10.1177/22925503241276541","DOIUrl":"https://doi.org/10.1177/22925503241276541","url":null,"abstract":"Background: Post-mastectomy implant-based reconstruction can be performed as direct-to-implant (DTI) or two-staged reconstruction (TSR). Rigorous studies have explored postoperative complications between TSR or DTI, yet few have stratified outcomes by relevant populations, pre-operative findings, mastectomy characteristics, or plane of implant placement. We sought to compare the outcomes between these cohorts at our institution. Methods: All patients who underwent skin- or nipple-sparing mastectomy followed by DTI or TSR from 2011 to 2021 at a large academic medical center were included. Data included demographics, ADM use, mastectomy weight, plane of implant placement, and postoperative complications. Results: 295 patients were included. 271 (91.9%) received TSR, and 24 (8.1%) underwent DTI. Compared to TSR, DTI had a higher rate of NAC necrosis ( P = .007) and dehiscence ( P = .016). There was no difference in rate of other complications. Regardless of procedure, higher BMI ( P = .002), higher grade ptosis ( P = .01), and larger mastectomy weights ( P = .022) were associated with increased risk of complication. Pre-pectoral placement was not associated with risk of NAC or mastectomy skin necrosis. Prior tobacco use was associated with higher risk of infection ( P = .036) and dehiscence ( P = .025). Neoadjuvant and adjuvant chemotherapy was associated with increased risk of capsular contracture( P = .009). Conclusions: Our study suggests that TSR may be preferred to minimize risk of NAC necrosis and wound dehiscence, especially in high-risk patients. Pre-pectoral placement did not significantly affect risk of mastectomy or NAC necrosis and should be considered in all cases to minimize morbidity. Higher risk conditions for alloplastic reconstruction include higher degrees of ptosis, history of tobacco use, and higher BMIs.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":"274 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1177/22925503241276549
Peter E. Shamamian, Daniel Y. Kwon, Olachi Oleru, Nargiz Seyidova, Esther Kim, Simeret Genet, Abena Gyasi, Carol Y. Wang, Peter W. Henderson
Introduction: The characteristics, complications, and postoperative analgesic needs of patients with a recent or active history of recreational cannabis use have not been explored explicitly in plastic surgery. In this study, the characteristics, complications, and postoperative analgesic needs within a population of breast reduction patients who use and do not use recreational cannabis were compared. Methods: A retrospective cohort study was carried out on patients who underwent breast reduction between 2019 and 2023. Demographics, comorbidities, recreational cannabis use, postoperative opioid use, and postoperative complications were collected. Patients with a recent history (<1 month since last cannabis use) or current cannabis use were then compared to patients with no history of cannabis use. Results: In total, 340 patients were included, 88 (26%) patients had a history of cannabis use and 252 (74%) did not. Patients in the cannabis-using group were significantly younger than in the non-cannabis-using group (28 years vs 40 years, P < .01), and significantly more patients in the non-cannabis group had hypertension (20% vs 6% P < .01). More patients in the cannabis-using group had hematomas (5% vs 1%, P = .041) and fewer had t-point breakdown (4% vs 0%, P = .046), but these figures lost statistical significance on multiple logistic regression analysis after controlling for possible confounding factors including demographics and comorbidities ( P > .05). There were no significant differences in proportions of opioid use or by doses of opioids, even when converted to oral morphine equivalents ( P > .05). Conclusion: The analgesic needs, postoperative pain levels, and complications between cannabis-using and non-cannabis-using cohorts were similar. Counseling on substance use preoperatively should still be encouraged, especially in younger patients seeking reduction mammaplasty.
{"title":"The Use of Recreational Cannabis Among Breast Reduction Patients: Characteristics, Complications, and Immediate Postoperative Analgesic Needs","authors":"Peter E. Shamamian, Daniel Y. Kwon, Olachi Oleru, Nargiz Seyidova, Esther Kim, Simeret Genet, Abena Gyasi, Carol Y. Wang, Peter W. Henderson","doi":"10.1177/22925503241276549","DOIUrl":"https://doi.org/10.1177/22925503241276549","url":null,"abstract":"Introduction: The characteristics, complications, and postoperative analgesic needs of patients with a recent or active history of recreational cannabis use have not been explored explicitly in plastic surgery. In this study, the characteristics, complications, and postoperative analgesic needs within a population of breast reduction patients who use and do not use recreational cannabis were compared. Methods: A retrospective cohort study was carried out on patients who underwent breast reduction between 2019 and 2023. Demographics, comorbidities, recreational cannabis use, postoperative opioid use, and postoperative complications were collected. Patients with a recent history (<1 month since last cannabis use) or current cannabis use were then compared to patients with no history of cannabis use. Results: In total, 340 patients were included, 88 (26%) patients had a history of cannabis use and 252 (74%) did not. Patients in the cannabis-using group were significantly younger than in the non-cannabis-using group (28 years vs 40 years, P < .01), and significantly more patients in the non-cannabis group had hypertension (20% vs 6% P < .01). More patients in the cannabis-using group had hematomas (5% vs 1%, P = .041) and fewer had t-point breakdown (4% vs 0%, P = .046), but these figures lost statistical significance on multiple logistic regression analysis after controlling for possible confounding factors including demographics and comorbidities ( P > .05). There were no significant differences in proportions of opioid use or by doses of opioids, even when converted to oral morphine equivalents ( P > .05). Conclusion: The analgesic needs, postoperative pain levels, and complications between cannabis-using and non-cannabis-using cohorts were similar. Counseling on substance use preoperatively should still be encouraged, especially in younger patients seeking reduction mammaplasty.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":"417 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1177/22925503241268883
Brett Ponich, Alexander Platt, Madison Turk, Maleka Ramji, Aaron Knox
Field sterility and Wide Awake Local Anesthesia No Tourniquet (WALANT) technique is a commonly used operative technique for many hand and wrist pathologies. We present a case of a successful proximal row carpectomy using WALANT and field sterility in a minor surgery operating theatre setting. These techniques can be applied in appropriate patients to reduce the overall cost of surgery, anesthetic complications, and prolonged hospital stay.
{"title":"WALANT Proximal Row Carpectomy Under Field Sterility: A Case Report and Description of Technique","authors":"Brett Ponich, Alexander Platt, Madison Turk, Maleka Ramji, Aaron Knox","doi":"10.1177/22925503241268883","DOIUrl":"https://doi.org/10.1177/22925503241268883","url":null,"abstract":"Field sterility and Wide Awake Local Anesthesia No Tourniquet (WALANT) technique is a commonly used operative technique for many hand and wrist pathologies. We present a case of a successful proximal row carpectomy using WALANT and field sterility in a minor surgery operating theatre setting. These techniques can be applied in appropriate patients to reduce the overall cost of surgery, anesthetic complications, and prolonged hospital stay.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":"38 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16DOI: 10.1177/22925503241268886
Lucila M. Olivera Whyte, Patricia E. Ahualli, Gustavo E. Prezzavento
Background: Disproportionately large nipples with respect to the areola and the breast can result in physical and psychological problems for the patient. When a breast augmentation is performed, the nipple is projected forward by the implant, creating an optical appearance of being more projected and bigger in size with respect to the areola. A successful nipple reduction should be able to reduce its diameter and projection to achieve a good esthetic result, preserving its sensitive and lactation functions simultaneously. Objectives: The purpose of this study is to describe our technique and results of nipple reduction in context of breast augmentation. Methods: We carried out a retrospective cohort of patients in which a simultaneous breast augmentation and nipple reduction was performed by the Plastic and Reconstructive surgery Department of the German Hospital (Deutsches Hospital), in Buenos Aires, Argentina, between January 2016 and June 2022. Our technique consisted of a circumferential resection of skin at the base of the nipple followed by a wedge resection of the inferior portion of the nipple. The results were evaluated by comparing preoperative and postoperative photographs. Results: We included 17 patients. No patient presented nipple necrosis, wound dehiscence, hypertrophic scarring or permanent loss of sensation. Lactation could not be evaluated in the postoperative follow-up. Esthetic results were satisfactory in all patients. Conclusions: We described our surgical technique, which allows the treatment of the hypertrophic nipple addressing the anteroposterior projection and diameter independently. In turn, it preserves the sensory. The implantation of the scars at the base of the nipple and its inferior surface achieved discreet scars and a good esthetic result with high satisfaction rates in our patients. Level of evidence: Level IV, retrospective cohort.
{"title":"Treatment of the Hypertrophic Nipple in Breast Augmentation","authors":"Lucila M. Olivera Whyte, Patricia E. Ahualli, Gustavo E. Prezzavento","doi":"10.1177/22925503241268886","DOIUrl":"https://doi.org/10.1177/22925503241268886","url":null,"abstract":"Background: Disproportionately large nipples with respect to the areola and the breast can result in physical and psychological problems for the patient. When a breast augmentation is performed, the nipple is projected forward by the implant, creating an optical appearance of being more projected and bigger in size with respect to the areola. A successful nipple reduction should be able to reduce its diameter and projection to achieve a good esthetic result, preserving its sensitive and lactation functions simultaneously. Objectives: The purpose of this study is to describe our technique and results of nipple reduction in context of breast augmentation. Methods: We carried out a retrospective cohort of patients in which a simultaneous breast augmentation and nipple reduction was performed by the Plastic and Reconstructive surgery Department of the German Hospital (Deutsches Hospital), in Buenos Aires, Argentina, between January 2016 and June 2022. Our technique consisted of a circumferential resection of skin at the base of the nipple followed by a wedge resection of the inferior portion of the nipple. The results were evaluated by comparing preoperative and postoperative photographs. Results: We included 17 patients. No patient presented nipple necrosis, wound dehiscence, hypertrophic scarring or permanent loss of sensation. Lactation could not be evaluated in the postoperative follow-up. Esthetic results were satisfactory in all patients. Conclusions: We described our surgical technique, which allows the treatment of the hypertrophic nipple addressing the anteroposterior projection and diameter independently. In turn, it preserves the sensory. The implantation of the scars at the base of the nipple and its inferior surface achieved discreet scars and a good esthetic result with high satisfaction rates in our patients. Level of evidence: Level IV, retrospective cohort.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":"8 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1177/22925503241268878
Duncan Nickerson
{"title":"Commentary: A 10-Year Retrospective Review of Patient-to-Patient Transmitted Pathogens in Culture-Positive Burn Wounds at a Tertiary Burn Center","authors":"Duncan Nickerson","doi":"10.1177/22925503241268878","DOIUrl":"https://doi.org/10.1177/22925503241268878","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":"182 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141881634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1177/22925503241268888
Cameron F. Leveille, Brian Chin, Christopher J. Coroneos
{"title":"ERASing Confounders: Measuring Differences in Post Operative Pathways","authors":"Cameron F. Leveille, Brian Chin, Christopher J. Coroneos","doi":"10.1177/22925503241268888","DOIUrl":"https://doi.org/10.1177/22925503241268888","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":"14 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141881647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2022-10-17DOI: 10.1177/22925503221128986
Erica M Bien, Matthew D Rich, Pedram Zargari, Thomas J Sorenson, Ruth J Barta
Introduction: Reduction mammoplasty is becoming more commonly performed in the pediatric population yet the risk factors for complications have not been well-studied. The purpose of this study was to assess the relationship between preoperative patient characteristics and postoperative complications in a large population of pediatric patients undergoing reduction mammoplasty. Methods: Pediatric patients undergoing reduction mammoplasty were identified within the 2012 to 2019 National Surgical Quality Improvement Program database for cross-sectional study. The predictor variables were age, body mass index (BMI), diabetes, chronic steroid use, time under anesthesia, and operative time, and the primary outcome was a 30-day postoperative surgical site-related complication. Multivariate logistic regression was performed to identify a relationship between predictor variable and primary outcome. Results: A total of 1216 pediatric patients were identified with a mean age of 16.6 years and mean BMI of 30.8 kg/m2. The incidence of overall postoperative complications was 4.6%. Superficial surgical site infection (SSI) was the most common complication (29/1216; 2.4%). BMI was significantly associated with superficial SSI (odds ratio: 1.03, 95% confidence interval: 1.00-1.05, P = .02). Sixteen patients (1.32%) underwent a second operation, most commonly to address hematoma/seroma (7/16; 43.8%). Conclusion: In a large series of patients, pediatric reduction mammoplasty is a safe procedure with a low complication rate. BMI was significantly associated with the incidence of superficial SSIs with the most common cause for reoperation being a hematoma/seroma. This study can help guide the discussion between physicians and patients regarding potential risks associated with pediatric reduction mammoplasty.
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