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Must-read articles chosen by the Southeastern Society of Plastic and Reconstructive Surgeons: October 2017

Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force
Mofid MM, Teitelbaum S, Suissa D, Ramirez-Montañana A, Astarita DC, Mendieta C, Singer R. Aesth Surg J., 37(7);796-806: July 2017

A sobering report of a survey of over 600 plastic surgeons worldwide, including almost 200,000 surgical cases of gluteal fat grafting. 32 fatalities and 103 non-fatal episodes of fat emboli are reported. Fat injections into the deep muscle and using cannulae smaller than 4 mm were correlated to fat emboli.


Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand: High-Surface-Area Textured Implants Are Associated with Increased Risk
Loch-Wilkinson A, Beath KJ, Knight RJW, Wessels WLF, Magnusson M, Papadopoulos T, Connell T, Lofts J, Locke M, Hopper I, Cooter R, Vickery K, Joshi PA, Prince HM, Deva AK. Plast Reconst Surg. 140(4):645-654, October 2017

A report of 55 cases of implant-associated ALCL in Australia and New Zealand over a 9 year period. Implant-specific risk was calculated revealing a correlation with higher-surface-area textured implants. Risk of developing breast implant-associated ALCL was found to be 14.11 times higher with Biocell textured implants and 10.84 higher with polyurethane (Silimed) textured implants compared with Siltex textured implants.


The “Sandwich Therapy”: A Microsurgical Integrated Approach for Presternal Keloid Treatment
Zeng, Ang MD; Song, Kexin MD; Zhang, Mingzi MD; Men, Quancang MD; Wang, Youbin MD; Zhu, Lin MD; Liu, Zhifei MD Ann Plast Surg. 79(3):280-285, September 2017.

A series of 12 patients with massive disfiguring sternal keloids were treated with preradiotherapy, resection and free fasciocutaneous flap, donor site radiotherapy, and final presternal radiotherapy. No recurrences were seen at 12 months follow up.



Past Journal Picks


Vertical Rectus Abdominis Myocutaneous Versus Alternative Flaps for Perineal Repair After Abdominoperineal Excision of the Rectum in the Era of Laparoscopic Surgery.
Johnstone MS.
Ann Plast Surg. 2017 Jul;79(1):101-106.


A meta-analysis was conducted of existing studies to compare complication rates of perineal reconstruction using VRAM, gracilis, or gluteal flaps. In the age of laparoscopic and robotic surgery, more reconstructive surgeons are looking to the gluteal or thigh regions for perineal reconstruction, but VRAM appears to be associated with the lowest complications.


DIEP flap for breast reconstruction: Is abdominal fat thickness associated with post-operative complications?
Modarressi A, Müller CT, Montet X, Rüegg EM, Pittet-Cuénod B.
J Plast Reconstr Aesthet Surg; S1748-6815(17)30174-2: May 2017


A single center retrospective study of 105 patients who underwent DIEP breast reconstruction shows no increased risk of flap related or donor site complications in patients with elevated BMI or greater abdominal wall thickness.


Refining the extended circumflex scapular flap for neck burn reconstruction: A 30-year experience.
Angrigiani C, Artero G, Sereday C, Khouri RK Jr, French ZP.
J Plast Reconstr Aesthet Surg. S1748-6815(17)30225-5, Jun e 2017


An update of a landmark 1994 paper, the patients report a 30-year, 150 patient experience using the extended circumflex scapular flap for microsurgical reconstruction of neck burn scars. Long term range of motion and patient satisfaction were excellent.

Oncoplastic Breast Reduction Technique and Outcomes: An Evolution over 20 Years
Losken, Albert M.D.; Hart, Alexandra M. M.D.; Broecker, Justine S. B.S.; Styblo, Toncred M. M.D.; Carlson, Grant W. M.D.
Plastic & Reconstructive Surgery; 139 (4):824e, April 2017


A single-center retrospective study of 353 patients demonstrates oncoplastic breast reduction to be an effective and oncologically sound treatment for breast cancer in the setting of macromastia, with higher rates of patient satisfaction than other techniques.


Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation: A Randomized Controlled Trial
Hidalgo, David A. M.D.; Weinstein, Andrew L. M.D., M.S.
Plastic & Reconstructive Surgery; 139(3):587, March 2017


In this study of 75 patients undergoing breast augmentation, a round implant was placed in one breast and a size-matched anatomic implant in the other. Photographs were taken, following which the anatomic implant was replaced with a round one. Photographs were shown to plastic surgeons and lay observers, and neither group showed a preference for the appearance of anatomic implants. Plastic surgeons were only able to correctly identify the implant shape in 26.5% of cases.


The Effect of Nasal Tip Rotation on Upper Lip Length
Kevin Perkins, BS Ajul Shah, MD Anup Patel, MD, MBA Derek Steinbacher, MD, DMD
Aesthetic Surgery Journal (2017) 37(5): 504, May 2017


Using 3D imaging, the authors quantify the impact of tip rotation on upper lip length and establish a predictable correlation between the two.

Treatment of Anterior Neck Aging without a Submental Approach: Lateral Skin-Platysma Displacement, a New and Proven Technique for Platysma Bands and Skin Laxity
Pelle-Ceravolo M, Angelini M, Silvi E.
Plastic and Reconstructive Surgery;139(2):10, February 2017


A single-surgeon study of 100 patients who underwent facial rejuvenation with a lateral access only for correction of anterior skin laxity and platysmal bands. Patient satisfaction rates and complication rates were improved compared to the “open-neck” technique. Convincing results are shown, even in difficult necks.


Cancer Risk after Fat Transfer: A Multicenter Case-Cohort Study
Myckatyn TM, Wagner IJ, Mehrara BJ, et al.
Plastic and Reconstructive Surgery;139(1):10, January 2017


A multicenter retrospective case-cohort study pooled data from 1,197 patients at four major cancer centers and showed that exposure to fat grafting was not predictive for cancer recurrence. This study offers the best evidence to date that fat grafting is safe in the setting of breast cancer treatment.


Is Routine Pathologic Evaluation of Sebaceous Cysts Necessary?: A 15-Year Retrospective Review of a Single Institution.
Gargya V, Lucas HD, Wendel Spiczka AJ, and Mahabir RC.
Annals of Plastic Surgery;78(2):e1, Feb 2017


A 15 year review of a single institution’s histologic database was conducted and identified 13,746 patients with a preoperative diagnosis of “cyst”. Of these, 48 were found to be malignancies, and in all cases the surgeon had a high suspicion for malignancy at operation. Authors conclude cysts should only be sent to pathology if clinical suspicion for malignancy exists.



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