Background: Online before-and-after photos commonly guide patient expectations in body contouring surgeries. However, recent artificial intelligence (AI) advancements allow for lifelike "photos" of hypothetical individuals, which patients can use in their decision-making. The accuracy of AI models, trained on divergent image sets, in showing realistic figures, cosmetic defects, and surgical outcomes is questionable.
View Article and Find Full Text PDFBackground: In the last decade, only 3 plastic surgery programs have faced nonvoluntary closure by the Accreditation Council of Graduate Medical Education. These closures all occurred unexpectedly in April 2021 and affected 23 trainees. Although the dust has largely settled from this event, the insights of the affected trainees remain uncharacterized.
View Article and Find Full Text PDF: The LGBTQ+ community faces discrimination within the workplace, with growing evidence emerging about the mistreatment of LGBTQ+ surgeon trainees. The purpose of this study was to better understand the experiences of LGBTQ+ surgeons in plastic and reconstructive surgery (PRS). A web-based survey was made available to all plastic surgeons who identified as LGBTQ+ across the US and Canada from October 2021 to November 2022.
View Article and Find Full Text PDFImportance: There is an urgent need for a validated gender-affirming care-specific patient-reported outcome measure (PROM).
Objective: To field test the GENDER-Q, a new PROM for gender-affirming care, in a large, international sample of transgender and gender diverse (TGD) adults and evaluate its psychometric properties.
Design, Setting, And Participants: This international cross-sectional study was conducted among TGD adults aged 18 years and older who were seeking or had received gender-affirming care within the past 5 years at 21 clinical sites across Canada, the United States, the Netherlands, and Spain; participants were also recruited through community groups (eg, crowdsourcing platform, social media).
Background: Plastic surgery training continues to evolve with integrated residents spending more time in plastic versus general surgery. Herein, we provide an updated description of interprogram differences in core general, core plastic, and plastic surgery-adjacent training curricula.
Methods: We obtained rotation schedules from US plastic surgery residency websites or program coordinators for AY2021-2022.
Burn-related chronic neuropathic pain can contribute to a decreased quality of life. When medical and pharmacologic therapies prove ineffective, patients should undergo evaluation for surgical intervention, consisting of a detailed physical examination and elective diagnostic nerve block, to identify an anatomic cause of pain. Based on symptoms and physical examination findings, particularly Tinel's sign, treatments can vary, including a trial of laser therapies, fat grafting, or nerve surgeries (nerve decompression, neuroma excision, targeted muscle reinnervation, regenerative peripheral nerve interfaces, and vascularized denervated muscle targets).
View Article and Find Full Text PDFBackground: Peripheral nerve decompression (PND) is generally safe, and newer techniques allow frail patients to undergo PND at less common sites. Current literature suggests patient frailty measures may more accurately predict postsurgical complications versus other proxies, but no current literature examines frailty in PND.
Methods: The authors reviewed data from the National Surgical Quality Improvement Program for patients who underwent PND outside the most common sites from 2013 to 2019.
Oral Maxillofac Surg Clin North Am
May 2024
For some patients, feminine facial features may cause significant gender dysphoria. Multiple nonsurgical and surgical techniques exist to masculinize facial features. Nonsurgical techniques include testosterone supplementation and dermal fillers.
View Article and Find Full Text PDFThe expansion of robotic surgery has led to developments in robotic-assisted breast reconstruction techniques. Specifically, robotic flap harvest is being evaluated to help maximize operative reliability and reduce donor site morbidity without compromising flap success. Many publications are feasibility studies or technical descriptions; few cohort analyses exist.
View Article and Find Full Text PDFThe past decade has demonstrated increased burn wound infections with atypical invasive fungal organisms. The range of previously regiospecific organisms has expanded, and plant pathogens are increasingly represented. Our institution sought to examine changes in severe fungal non-Candida infections in our patients, via retrospective review of patients admitted to our burn center from 2008 to 2021.
View Article and Find Full Text PDFBackground: Increased representation from both women and non-White ethnicities remains a topic of discussion in plastic surgery. Speakers at academic conferences are a form of visual representation of diversity within the field. This study determined the current demographic landscape of aesthetic plastic surgery and evaluated whether underrepresented populations receive equal opportunities to be invited speakers at The Aesthetic Society meetings.
View Article and Find Full Text PDFBackground: Although age, body mass index (BMI), and major comorbidities were historically used as predictors of surgical risk, recent literature supports patient frailty as a more accurate predictor. Database studies and chart reviews support the modified Charlson Comorbidity Index (mCCI) and the Modified Five-Item Frailty Index (mFI-5) as predictors of postsurgical complications in plastic surgery. The authors hypothesized that the mFI-5 and mCCI are more predictive of abdominoplasty complications than historic risk proxies.
View Article and Find Full Text PDFIntroduction: The current standard of practice in implant-based breast reconstruction is irrigation of the mastectomy pocket with antimicrobial solution before implant placement. Prior to being banned and formally recalled in January 2020, bacitracin was a very commonly utilized antibiotic. This study characterizes the effects of the national bacitracin ban on implant-based breast reconstruction infection rates by using a nationwide database to compare complication rates before and after bacitracin was banned.
View Article and Find Full Text PDFBackground: Heterotopic ossification (HO) is a rare but known complication of brain and nerve trauma, orthopedic trauma, and burns. Nerve compression due to HO is extremely rare; "bony cubital tunnel syndrome," or compression of the ulnar nerve at the elbow due to HO, is an unusual presentation that requires special considerations for treatment.
Case Presentation: We present a 50-year-old man who presented to our hospital after vehicular polytrauma with associated car fire and prolonged extrication.
Due to COVID-19, hospitals underwent drastic changes to operating room policy to mitigate the spread of the disease. Given these unprecedented measures, we aimed to look at the changes in operative volume and metrics of the burn surgery service at our institution. A retrospective review was conducted for operative cases and metrics for the months of March to May for 2019, 2020, and 2021, which correspond with pre-COVID, early COVID (period without elective cases), and late COVID (period with resumed elective cases).
View Article and Find Full Text PDFThe hypermetabolic state of patients with ≥20% total body surface area (TBSA) causes loss of muscle mass and compromised immune function with delayed wound healing. Weight loss is most severe in patients with ≥20% TBSA with initial weight gain due to fluid resuscitation. The American Burn Association (ABA) proposed quality measures for burn injury admissions, including weight loss from admission to discharge.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
June 2022
Background: Gender-affirmation surgery is a rapidly growing field in plastic surgery, urologic surgery, and gynecologic surgery. These procedures offer significant benefit to patients in reducing gender dysphoria and improving well-being. However, the details of gender-affirmation surgery are less well-known to other surgical subspecialties and other medical subspecialties.
View Article and Find Full Text PDFAnn Plast Surg
March 2021
Background: Bronchopleural fistula (BPF) is a dreaded complication of pulmonary resection. For high-risk patients, bronchial stump coverage with vascularized tissue has been recommended. The goal of this study was to report our experience with intrathoracic muscle transposition for bronchial stump coverage.
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