BACKGROUND: Staged subpectoral expander-implant breast reconstruction is widely performed. Disruption of the pectoralis major origin and the frequent occurrence of animation deformity and functional discomfort associated with subpectoral reconstruction remain ongoing concerns. Prepectoral single-stage direct-to-implant reconstruction resolves many of these issues. In this study, the authors explored the rationale for prepectoral single-stage implant-based breast reconstruction with ...

BACKGROUND: The use of progressive tension sutures alone has been shown to be comparable to using abdominal drains in aesthetic abdominoplasty. This study reviews outcomes with the use of barbed progressive tension suture technique without drains in DIEP donor site closure compared to standard closure with drains.

METHODS: A two year retrospective review was conducted of DIEP flap reconstructions in the enhanced recovery program at Mayo Clinic, Rochester (USA). Donor site closure was ...

Body weight, body mass index (BMI), and percent excess weight loss are used to assess patient outcomes after bariatric surgery; however, they provide little insight into the true nature of the patient's weight loss. Body composition measurements monitor fat versus lean mass losses to permit interventions to reduce or avoid lean body mass loss after bariatric surgery. A retrospective review of patients who underwent bariatric surgery between 2002 and 2008 was performed. Patients ...

BackgroundFor treating the aging face, a facelift is the surgical standard. A variety of techniques have been described. The purpose of the current study is to evaluate the safety of the sub-SMAS facelift compared to the subcutaneous facelift with or without SMAS plication.MethodsA retrospective chart review was conducted on all patients who underwent facelift surgery between 2003 and 2011. Patients included in the study were seeking elective improvement of facial appearance. All charts ...

BACKGROUND: Keystone flaps have demonstrated growing clinical applications in reconstructive surgery in the past decade. This article highlights flap modifications and their versatility for clinical applications and management of complex defects.

METHODS: A retrospective chart review was conducted of consecutive patients undergoing keystone flap reconstruction at the authors' institution from January of 2012 to December of 2014. Patient demographics, indications, and operative and ...

BACKGROUND: Large cranial defects represent reconstructive challenges. Polyetheretherketone (PEEK) implants are preoperatively tailored to the exact size of the defect and exhibit an excellent combination of strength, durability, and environmental resistance. This study presents our experience with patient-specific PEEK implants with computer modeling.

METHODS: A retrospective chart review was conducted on all patients who underwent cranioplasty treated by a PEEK implant between 2007 and ...

BACKGROUND: Fast-track surgery has been described as a plan to facilitate early recovery. We present one surgeon's modifications to fast-track surgery for laparoscopic colectomy patients.

METHODS: We performed a retrospective review of 48 consecutive patients undergoing elective laparoscopic colectomy treated by a modified fast-track plan between 2004 and 2008. Elements included preoperative education, pre-anesthesia dexamethasone, immediate postoperative general diet, no urinary ...

BACKGROUND: This study aimed to delineate and compare the hot spots and three-dimensional vascular territories of dominant profunda artery perforators in the posterior thigh region, and modifications in flap design are discussed.

METHODS: Twenty-nine posterior thigh flaps were raised in fresh cadaveric specimens, and profunda artery perforators were documented. Dominant perforators were injected with iodinated contrast to assess perforasomes using computed tomographic angiography. ...

Extralobar sequestration, a discrete developmental mass of pulmonary parenchyma which is enclosed within a separate pleural envelope and has its own vascular supply, is recently diagnosed prenatally by ultrasonography. We report two male newborn babies, 10 days old, who prenatally underwent amnioperitoneal shunt, pleural drainage and laser ablation of the feeding artery. Both babies underwent thoracotomy on their 10th day of life, removal of the sequestration, ligation of the feeding ...

Autologous fat grafting is now considered the gold standard for buttock augmentation. Although a variety of techniques are currently being used by surgeons around the world, methods of fat grafting to the buttocks remain unsystematized, poorly understood, and controversial in terms of their safety and efficacy. Nonetheless, buttock augmentation by fat grafting has a satisfaction rate of 97.1%, and its mean complication rate has been estimated to be around 7 to 10%, with serious ...

OBJECTIVES: To avoid prosthesis-patient mismatch, posterior enlargement of the small aortic annulus using the Nicks-Nunez surgical approach was performed in fifteen patients and the immediate-intermediate results are reported retrospectively.

METHODS: During the period November 1995 to June 2005, 220 patients underwent aortic valve replacement (AVR) for primary aortic stenosis (AS). Fifteen patients (15/220 - 6%), all women, 40-76 years old (mean age 65.8 years) with AS, underwent AVR ...

Wise pattern skin reduction mastectomy with prepectoral placement of the device is a recent technique for reconstruction in patients with large and ptotic breasts. Expanders in the first stage, followed by implant exchange in the second stage are placed above the pectoralis major muscle, totally covered by acellular dermal matrix and an inferior dermal flap. This technique was performed on 6 breasts in 4 obese patients with macromastia and grade 2 and 3 ptosis. Two patients experienced ...

The role of fat grafting to the breasts has evolved in the recent past, gaining several new applications within both reconstructive and aesthetic surgery. Initially used for reconstructive purposes to fill lumpectomy defects or to correct residual contour deformities after breast reconstruction, it has since made its way into cosmetic breast surgery and has grown to encompass a wide variety of new indications. Fat grafting in aesthetic breast surgery may be performed as a form of primary ...

The upper third of the face, composed of the forehead and the brow, is a critical aesthetic subunit. Brow ptosis is a common presenting complaint for patients seeking elective improvement of their facial appearance. Browlift surgery has a long history of technique evolution, with various reported methods and refinements. Since the introduction of the endoscopic brow lifting in the 1990s, it has become widely accepted as an approach to forehead rejuvenation. Endoscopy provides minimal ...

The gluteal region is an important aesthetic symbol of the body and represents a major component of sexual attraction. Buttocks descent and atrophy are common presenting complaints for patients seeking elective improvement of their body. Gluteal surgery has a recent history of technique evolution, with various reported methods and refinements, including autologous tissue and alloplastic materials. It has been gaining popularity, and an exponential growth in buttocks procedures has been ...