Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2024.11.056
Qiang Yue, Zilong Cao, Yunzhang Wang, Shu Rui, Jiayue Liu, Tiran Zhang, Liqiang Liu
Objectives
To introduce a novel technique using the buried-guided suture method for suspending the alar crus to correct nostril exposure in East Asians and to investigate its safety and efficacy.
Methods
Patients with ptotic alar crus and nostril exposure at our clinic were enrolled between December 2011 and December 2023. Via an intranasal incision, the excess skin on the inner side of the nostrils was excised. The alar crus was suspended to the periosteum of the piriform aperture using non-absorbable sutures. Changes in the exposed area of the nostrils and distance of alar crus elevation were statistically analyzed before and after surgery. Satisfaction rate was assessed using a four-point visual analog scale.
Results
A total of 35 patients were included, with an average follow-up duration of 15 ± 6 months. Post-operatively, the mean exposed area of the nostrils was significantly reduced compared to the preoperative area (9.14 ± 1.93 mm² vs. 20.97 ± 2.64 mm², P < 0.05). The mean height of the alar crus relative to the base of the columella showed significant improvement post-operatively (+1.08 ± 0.32 mm vs. −1.82 ± 0.32 mm, P < 0.05). Overall, 91.4% (32/35) patients expressed satisfaction with the outcomes.
Conclusions
The buried-guided suture method for suspending the alar crus combined with excision of the inner nasal skin is a safe and effective surgical procedure for correcting nostril exposure.
目的：介绍一种新的埋置引导下鼻翼脚悬吊缝合术治疗东亚人鼻孔暴露的方法，并探讨其安全性和有效性。方法：选取2011年12月至2023年12月在我院就诊的鼻翼、脚、鼻孔外露上睑下垂患者。通过鼻内切口，切除鼻孔内侧多余的皮肤。用不可吸收缝线将鼻翼脚悬吊在梨状孔的骨膜上。统计分析手术前后鼻孔暴露面积和鼻翼脚抬高距离的变化。满意度采用四分式视觉模拟量表进行评估。结果：共纳入35例患者，平均随访时间15±6个月。术后鼻孔平均暴露面积较术前明显减少（9.14±1.93 mm²比20.97±2.64 mm²，P < 0.05）。鼻翼脚相对于鼻梁基部的平均高度术后有显著改善（+1.08±0.32 mm vs -1.82±0.32 mm, P < 0.05）。总体而言，91.4%（32/35）的患者对结果表示满意。结论：埋置引导下鼻翼足悬吊缝合联合鼻内皮切除是一种安全有效的矫正鼻孔外露的手术方法。
{"title":"Buried-guided suture suspension of the alar crus: A minimally invasive method to correct nostril exposure","authors":"Qiang Yue, Zilong Cao, Yunzhang Wang, Shu Rui, Jiayue Liu, Tiran Zhang, Liqiang Liu","doi":"10.1016/j.bjps.2024.11.056","DOIUrl":"10.1016/j.bjps.2024.11.056","url":null,"abstract":"<div><h3>Objectives</h3><div>To introduce a novel technique using the buried-guided suture method for suspending the alar crus to correct nostril exposure in East Asians and to investigate its safety and efficacy.</div></div><div><h3>Methods</h3><div>Patients with ptotic alar crus and nostril exposure at our clinic were enrolled between December 2011 and December 2023. Via an intranasal incision, the excess skin on the inner side of the nostrils was excised. The alar crus was suspended to the periosteum of the piriform aperture using non-absorbable sutures. Changes in the exposed area of the nostrils and distance of alar crus elevation were statistically analyzed before and after surgery. Satisfaction rate was assessed using a four-point visual analog scale.</div></div><div><h3>Results</h3><div>A total of 35 patients were included, with an average follow-up duration of 15 ± 6 months. Post-operatively, the mean exposed area of the nostrils was significantly reduced compared to the preoperative area (9.14 ± 1.93 mm² vs. 20.97 ± 2.64 mm², P < 0.05). The mean height of the alar crus relative to the base of the columella showed significant improvement post-operatively (+1.08 ± 0.32 mm vs. −1.82 ± 0.32 mm, P < 0.05). Overall, 91.4% (32/35) patients expressed satisfaction with the outcomes.</div></div><div><h3>Conclusions</h3><div>The buried-guided suture method for suspending the alar crus combined with excision of the inner nasal skin is a safe and effective surgical procedure for correcting nostril exposure.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 40-45"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2024.11.028
Alistair JM Reed , Ryckie G. Wade , Justin CR Wormald , Kathryn Dickson , Angelos Mantelakis , David Izadi , Dominic Furniss , On behalf of the PETAL collaborative
Background
Partial extensor tendon lacerations of the hand and forearm are common. There is a lack of evidence to guide their management and it is also unclear at what threshold surgeons would consider repair necessary. This study aimed to identify national surgical management of partial extensor tendon lacerations of the hand and forearm (zones 2–8) and assess surgeons’ willingness to randomise in a future trial.
Methods
A 34-item online survey was developed by the steering group and, via a trainee-led collaborative model, was disseminated to plastic and orthopaedic surgeons in the UK. Summary data were calculated for each survey item, and the variations between zones and specialties were explored using linear regression.
Results
142 complete responses were recorded (response rate 71%). On average, respondents said that 46% tendon division was the maximum they would manage in clinical practice without surgical repair. There was no significant difference in this percentage between zones or surgical specialties. Importantly, the majority (83%) of surgeons would be willing to randomise patients in a clinical trial to repair versus no-repair, within 29%−61% tendon division, demonstrating clinical equipoise.
Conclusions
There is significant variation in UK practice regarding the surgical management of partial extensor tendon lacerations of the hand and forearm and clinical equipoise exists regarding the decision to repair or not. A definitive randomised trial is warranted to identify the optimum management of this common injury.
{"title":"Management of partial extensor tendon lacerations of the hand and forearm: A national survey of practice in the United Kingdom","authors":"Alistair JM Reed , Ryckie G. Wade , Justin CR Wormald , Kathryn Dickson , Angelos Mantelakis , David Izadi , Dominic Furniss , On behalf of the PETAL collaborative","doi":"10.1016/j.bjps.2024.11.028","DOIUrl":"10.1016/j.bjps.2024.11.028","url":null,"abstract":"<div><h3>Background</h3><div>Partial extensor tendon lacerations of the hand and forearm are common. There is a lack of evidence to guide their management and it is also unclear at what threshold surgeons would consider repair necessary. This study aimed to identify national surgical management of partial extensor tendon lacerations of the hand and forearm (zones 2–8) and assess surgeons’ willingness to randomise in a future trial.</div></div><div><h3>Methods</h3><div>A 34-item online survey was developed by the steering group and, via a trainee-led collaborative model, was disseminated to plastic and orthopaedic surgeons in the UK. Summary data were calculated for each survey item, and the variations between zones and specialties were explored using linear regression.</div></div><div><h3>Results</h3><div>142 complete responses were recorded (response rate 71%). On average, respondents said that 46% tendon division was the maximum they would manage in clinical practice without surgical repair. There was no significant difference in this percentage between zones or surgical specialties. Importantly, the majority (83%) of surgeons would be willing to randomise patients in a clinical trial to repair versus no-repair, within 29%−61% tendon division, demonstrating clinical equipoise.</div></div><div><h3>Conclusions</h3><div>There is significant variation in UK practice regarding the surgical management of partial extensor tendon lacerations of the hand and forearm and clinical equipoise exists regarding the decision to repair or not. A definitive randomised trial is warranted to identify the optimum management of this common injury.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 46-52"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2024.12.002
Weiwei Li, Yongping Xue, Zhenyu Gong
{"title":"Nutritional support therapy is also an important part of rehabilitation after abdominoplasty surgeries","authors":"Weiwei Li, Yongping Xue, Zhenyu Gong","doi":"10.1016/j.bjps.2024.12.002","DOIUrl":"10.1016/j.bjps.2024.12.002","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 97-98"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2024.11.048
Yihua Li , Yiman Shen , Haopeng Wang , Zhongding Zhang , Baimiao Wang , Xiaomin Cai , Shiting Li
Background
This study aimed to investigate the risk factors affecting epineurectomy of the facial nerve trunk for facial synkinesis and use them to establish a prediction model to assess the recurrence of post-operative facial synkinesis.
Methods
A total of 68 patients with synkinesis after facial paralysis were enrolled in this study. They were randomized to the training and testing sets. All patients underwent standard surgical procedures and their clinical data were collected and analyzed. The condition of facial synkinesis was evaluated at 12 months after the operation. Univariable and multivariable logistic regression analysis was performed to identify independent risk factors and establish a model and related nomogram to predict the recurrence of post-operative facial synkinesis. Area under receiver operating characteristic curve (AUC) and calibration curves were employed to assess the predictive accuracy of the nomogram.
Results
Multivariate logistic regression analysis indicated that older age and higher preoperative score of synkinesis may be the potential factors for the recurrence of post-operative facial synkinesis at 12 months. The prediction model showed a good discrimination with mean AUC of 5-fold cross-validation of 0.781. The accuracy of the nomogram predicting the recurrence in the testing set reached 78.57%, respectively. Bias-corrected curve revealed a strong consistency between the actual observation and prediction.
Conclusion
The study illustrated that the proposed logistic regression model based on the age and preoperative score of synkinesis of 2 potential factors could be a promising tool to predict the recurrence of facial synkinesis after the surgery.
{"title":"Predicting the recurrence of facial synkinesis after epineurectomy of facial nerve trunk using logistic regression model","authors":"Yihua Li , Yiman Shen , Haopeng Wang , Zhongding Zhang , Baimiao Wang , Xiaomin Cai , Shiting Li","doi":"10.1016/j.bjps.2024.11.048","DOIUrl":"10.1016/j.bjps.2024.11.048","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the risk factors affecting epineurectomy of the facial nerve trunk for facial synkinesis and use them to establish a prediction model to assess the recurrence of post-operative facial synkinesis.</div></div><div><h3>Methods</h3><div>A total of 68 patients with synkinesis after facial paralysis were enrolled in this study. They were randomized to the training and testing sets. All patients underwent standard surgical procedures and their clinical data were collected and analyzed. The condition of facial synkinesis was evaluated at 12 months after the operation. Univariable and multivariable logistic regression analysis was performed to identify independent risk factors and establish a model and related nomogram to predict the recurrence of post-operative facial synkinesis. Area under receiver operating characteristic curve (AUC) and calibration curves were employed to assess the predictive accuracy of the nomogram.</div></div><div><h3>Results</h3><div>Multivariate logistic regression analysis indicated that older age and higher preoperative score of synkinesis may be the potential factors for the recurrence of post-operative facial synkinesis at 12 months. The prediction model showed a good discrimination with mean AUC of 5-fold cross-validation of 0.781. The accuracy of the nomogram predicting the recurrence in the testing set reached 78.57%, respectively. Bias-corrected curve revealed a strong consistency between the actual observation and prediction.</div></div><div><h3>Conclusion</h3><div>The study illustrated that the proposed logistic regression model based on the age and preoperative score of synkinesis of 2 potential factors could be a promising tool to predict the recurrence of facial synkinesis after the surgery.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 119-125"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2024.12.006
Fabio Ferrario, Nikolaos Gabriel, Paul Girard, Silvia Gandolfi, Yanis Berkane, Nicolas Bertheuil
{"title":"Medial thigh lift in the massive weight loss population: The Rennes University Center experience","authors":"Fabio Ferrario, Nikolaos Gabriel, Paul Girard, Silvia Gandolfi, Yanis Berkane, Nicolas Bertheuil","doi":"10.1016/j.bjps.2024.12.006","DOIUrl":"10.1016/j.bjps.2024.12.006","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 187-188"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2025.01.008
Georgios Karamitros, Athanasios Papas, Michael P. Grant, Gregory A. Lamaris
{"title":"Letter comments on: Prevalence of body dysmorphic disorder in plastic surgery: Addressing biases and improving screening approaches","authors":"Georgios Karamitros, Athanasios Papas, Michael P. Grant, Gregory A. Lamaris","doi":"10.1016/j.bjps.2025.01.008","DOIUrl":"10.1016/j.bjps.2025.01.008","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 190-191"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vascularized lymph node transfer (VLNT) is traditionally performed in patients with advanced-stage lymphedema. To enhance and promote the physiological effects of VLNT, lymphatic system transfer (LYST) was developed. In this technique, lymph nodes and a portion of their corresponding afferent lymphatic vessels are transferred to stimulate lymphangiogenesis. This study presented our experience, pearls, and pitfalls of using superficial circumflex iliac artery perforator LYST.
Methods
A retrospective review of patients treated with LYST for lymphedema treatment from July 2018 to March 2022 was included. Patient characteristics, perioperative data, and long-term outcomes were analyzed.
Results
Eight patients with unilateral lower-extremity lymphedema underwent LYST. The mean follow-up duration was 39.0 (24.0–60.0) months. The mean improvement in the excess volume percentage compared to the unaffected limb was 11.2% (100% improvement to 0% worsening) at the last follow-up, with statistical significance (p < 0.001). The incidence of cellulitis decreased with statistical significance (p = 0.025).
Conclusion
A long-term study on using LYST flaps in lymphedema treatment has not been previously performed. This study showed that the LYST procedure provides reliable and effective long-term outcomes in treating patients with advanced-stage lymphedema.
{"title":"The role of lymphatic system transfer (LYST) for treatment of lymphedema: A long-term outcome study of SCIP flap incorporating the lymph nodes and the afferent lymphatic vessels","authors":"Hidehiko Yoshimatsu , Min-Jeong Cho , Ryo Karakawa , Akira Okada , Akitatsu Hayashi , Yuma Fuse , Tomoyuki Yano","doi":"10.1016/j.bjps.2024.11.052","DOIUrl":"10.1016/j.bjps.2024.11.052","url":null,"abstract":"<div><h3>Background</h3><div>Vascularized lymph node transfer (VLNT) is traditionally performed in patients with advanced-stage lymphedema. To enhance and promote the physiological effects of VLNT, lymphatic system transfer (LYST) was developed. In this technique, lymph nodes and a portion of their corresponding afferent lymphatic vessels are transferred to stimulate lymphangiogenesis. This study presented our experience, pearls, and pitfalls of using superficial circumflex iliac artery perforator LYST.</div></div><div><h3>Methods</h3><div>A retrospective review of patients treated with LYST for lymphedema treatment from July 2018 to March 2022 was included. Patient characteristics, perioperative data, and long-term outcomes were analyzed.</div></div><div><h3>Results</h3><div>Eight patients with unilateral lower-extremity lymphedema underwent LYST. The mean follow-up duration was 39.0 (24.0–60.0) months. The mean improvement in the excess volume percentage compared to the unaffected limb was 11.2% (100% improvement to 0% worsening) at the last follow-up, with statistical significance (p < 0.001). The incidence of cellulitis decreased with statistical significance (p = 0.025).</div></div><div><h3>Conclusion</h3><div>A long-term study on using LYST flaps in lymphedema treatment has not been previously performed. This study showed that the LYST procedure provides reliable and effective long-term outcomes in treating patients with advanced-stage lymphedema.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 15-22"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2024.11.053
Sahar Vanessa Amiri , Cecilie Mullerup Laustsen-Kiel , Berit Carlsen , Elisabeth Taudorf , Jørgen Hesselfeldt , Gregor Borut Jemec , Jeanette Kaae
Experts have widely discussed rhinophyma treatment, proposing and testing various therapies over the years. The aim of this retrospective study was to compare the aesthetic outcomes of patients undergoing the cold blade technique at the Department of Plastic Surgery and ablative fractional carbon dioxide (CO2) laser treatment at the Department of Dermatology at Zealand University Hospital. We assessed rhinophyma severity using the RHISI scale with pre-and post-operative photographs evaluated by senior consultants from each department, who were blinded to the treatment method. Additionally, the patients completed a questionnaire to gauge their satisfaction and willingness to recommend the procedure. Cosmetic outcomes were deemed excellent or good (75% for surgery and 71% for CO2-laser) in both treatment methods. Only one patient answered with moderate satisfaction. Therefore, we recommend both methods as possible treatment options.
{"title":"Rhinophyma treatment: An observational study comparing the results of the cold blade technique and ablative fractional CO2-laser","authors":"Sahar Vanessa Amiri , Cecilie Mullerup Laustsen-Kiel , Berit Carlsen , Elisabeth Taudorf , Jørgen Hesselfeldt , Gregor Borut Jemec , Jeanette Kaae","doi":"10.1016/j.bjps.2024.11.053","DOIUrl":"10.1016/j.bjps.2024.11.053","url":null,"abstract":"<div><div>Experts have widely discussed rhinophyma treatment, proposing and testing various therapies over the years. The aim of this retrospective study was to compare the aesthetic outcomes of patients undergoing the cold blade technique at the Department of Plastic Surgery and ablative fractional carbon dioxide (CO<sub>2</sub>) laser treatment at the Department of Dermatology at Zealand University Hospital. We assessed rhinophyma severity using the RHISI scale with pre-and post-operative photographs evaluated by senior consultants from each department, who were blinded to the treatment method. Additionally, the patients completed a questionnaire to gauge their satisfaction and willingness to recommend the procedure. Cosmetic outcomes were deemed excellent or good (75% for surgery and 71% for CO<sub>2</sub>-laser) in both treatment methods. Only one patient answered with moderate satisfaction. Therefore, we recommend both methods as possible treatment options.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 90-96"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2024.11.042
Peter E. Shamamian , Derek Chen , Anya Wang , Subha Karim , Carol Wang , Keisha E. Montalmant , Alison Trebby , John Henry Pang , Bella Avanessian , Jess Ting , Elan Horesh
A necessary component of postoperative care in gender-affirming vaginoplasty is the dilation of the neovaginal canal. Difficulty with dilation can cause patient pain and distress, often decreasing compliance and leading to partial or complete closure of the neovaginal canal. This study sought to evaluate the sociodemographic, operative, and comorbid characteristics that contribute to patient difficulty with neovaginal dilation. A retrospective review of patients undergoing gender-affirming vaginoplasty between June 2019 and July 2023 was carried out. The primary outcome was consistent dilation difficulty reported during the follow-up clinic visits for any reason. Univariate and multivariate analyses were used to compare characteristics and outcomes of each group. Statistical significance was set at p < 0.05. In total, 614 patients were included in the study, 506 (82.5%) patients had no dilation difficulty and 108 (17.5%) had dilation difficulty. Medicare insurance status (p = 0.007), unemployment (p < 0.001), hyperlipidemia (p = 0.019), HIV (p < 0.001), psychiatric diagnosis besides gender dysphoria (p = 0.048), and primary peritoneal vaginoplasty (p = 0.019) were associated with postoperative dilation difficulty. Multiple logistic regression revealed higher odds of dilation difficulty in patients who are unemployed (OR 2.740, 95% CI 1.587–4.732, p < 0.001), have HIV (OR 2.588, 95% CI 1.290–5.190, p = 0.007), have a psychiatric diagnosis besides gender dysphoria (OR 1.606, 95% CI 1.001–2.577, p = 0.049), or received a primary peritoneal graft (OR 3.202, 95% CI 1.212–8.460, p = 0.019). The risk of postoperative dilation difficulty may be associated with multiple aspects of the care spectrum. Understanding these risks and continued encouragement of dilation is critical to optimizing patient outcomes and dilation success.
{"title":"Predictors of dilation difficulty in gender-affirming vaginoplasty","authors":"Peter E. Shamamian , Derek Chen , Anya Wang , Subha Karim , Carol Wang , Keisha E. Montalmant , Alison Trebby , John Henry Pang , Bella Avanessian , Jess Ting , Elan Horesh","doi":"10.1016/j.bjps.2024.11.042","DOIUrl":"10.1016/j.bjps.2024.11.042","url":null,"abstract":"<div><div>A necessary component of postoperative care in gender-affirming vaginoplasty is the dilation of the neovaginal canal. Difficulty with dilation can cause patient pain and distress, often decreasing compliance and leading to partial or complete closure of the neovaginal canal. This study sought to evaluate the sociodemographic, operative, and comorbid characteristics that contribute to patient difficulty with neovaginal dilation. A retrospective review of patients undergoing gender-affirming vaginoplasty between June 2019 and July 2023 was carried out. The primary outcome was consistent dilation difficulty reported during the follow-up clinic visits for any reason. Univariate and multivariate analyses were used to compare characteristics and outcomes of each group. Statistical significance was set at p<!--> <!--><<!--> <!-->0.05. In total, 614 patients were included in the study, 506 (82.5%) patients had no dilation difficulty and 108 (17.5%) had dilation difficulty. Medicare insurance status (p<!--> <!-->=<!--> <!-->0.007), unemployment (p<!--> <!--><<!--> <!-->0.001), hyperlipidemia (p<!--> <!-->=<!--> <!-->0.019), HIV (p<!--> <!--><<!--> <!-->0.001), psychiatric diagnosis besides gender dysphoria (p<!--> <!-->=<!--> <!-->0.048), and primary peritoneal vaginoplasty (p<!--> <!-->=<!--> <!-->0.019) were associated with postoperative dilation difficulty. Multiple logistic regression revealed higher odds of dilation difficulty in patients who are unemployed (OR 2.740, 95% CI 1.587–4.732, p<!--> <!--><<!--> <!-->0.001), have HIV (OR 2.588, 95% CI 1.290–5.190, p<!--> <!-->=<!--> <!-->0.007), have a psychiatric diagnosis besides gender dysphoria (OR 1.606, 95% CI 1.001–2.577, p<!--> <!-->=<!--> <!-->0.049), or received a primary peritoneal graft (OR 3.202, 95% CI 1.212–8.460, p<!--> <!-->=<!--> <!-->0.019). The risk of postoperative dilation difficulty may be associated with multiple aspects of the care spectrum. Understanding these risks and continued encouragement of dilation is critical to optimizing patient outcomes and dilation success.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 178-186"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.bjps.2023.11.055
Teniola Adeboye , Georgette Oni
Background
Despite the increase in the proportion of female plastic surgeons in the United Kingdom (UK), all-male panels continue to prevail. This article sought to establish whether the genders of speakers at conferences hosted by leading UK plastic surgery associations, the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), and the British Association of Aesthetic Plastic Surgeons (BAAPS), are representative of the consultant workforce.
Methods
Data on the gender distribution of plastic surgeons in the workforce over the last decade were obtained from NHS Digital Workforce Statistics. The demographics of invited speakers were sought from conference agendas for both BAPRAS (from 2012 to 2022) and BAAPS (from 2014 to 2021) posted on their association’s websites.
Results
The proportion of female consultants increased from 16% in 2012 to 22% in 2022. The average proportion of female speakers at BAPRAS conferences was 16% ± 9% SD that was similar to the proportion of female consultants in practice (p = 0.432). In contrast, the average proportion of female speakers at BAAPS conferences was lower than those in practice (7.88% ± 8.29% SD, p = 0.0032). At BAAPS, 43% of speakers were UK plastic surgeons.
Conclusions
Although the podium speakers at BAPRAS were reflective of the consultant population, BAAPS had little to no representation of UK based female plastic surgeons. Therefore, the conference organisers need to intentionally ensure that representation at podium is reflective of the workforce.
{"title":"Gender parity at the podium in UK plastic surgery conferences","authors":"Teniola Adeboye , Georgette Oni","doi":"10.1016/j.bjps.2023.11.055","DOIUrl":"10.1016/j.bjps.2023.11.055","url":null,"abstract":"<div><h3>Background</h3><div>Despite the increase in the proportion of female plastic surgeons in the United Kingdom (UK), all-male panels continue to prevail. This article sought to establish whether the genders of speakers at conferences hosted by leading UK plastic surgery associations, the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), and the British Association of Aesthetic Plastic Surgeons (BAAPS), are representative of the consultant workforce.</div></div><div><h3>Methods</h3><div>Data on the gender distribution of plastic surgeons in the workforce over the last decade were obtained from NHS Digital Workforce Statistics. The demographics of invited speakers were sought from conference agendas for both BAPRAS (from 2012 to 2022) and BAAPS (from 2014 to 2021) posted on their association’s websites.</div></div><div><h3>Results</h3><div>The proportion of female consultants increased from 16% in 2012 to 22% in 2022. The average proportion of female speakers at BAPRAS conferences was 16% ± 9% SD that was similar to the proportion of female consultants in practice (p = 0.432). In contrast, the average proportion of female speakers at BAAPS conferences was lower than those in practice (7.88% ± 8.29% SD, p = 0.0032). At BAAPS, 43% of speakers were UK plastic surgeons.</div></div><div><h3>Conclusions</h3><div>Although the podium speakers at BAPRAS were reflective of the consultant population, BAAPS had little to no representation of UK based female plastic surgeons. Therefore, the conference organisers need to intentionally ensure that representation at podium is reflective of the workforce.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"101 ","pages":"Pages 234-241"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139103374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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