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Top Journal Picks 2019
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Top Journal Picks 2019

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


 January 2019

Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients

Bennett, Katelyn G., M.D., M.S.; Kelley, Brian P., M.D.; Vick, Alexis D., B.S.; Lee, Jay S., M.D.; Gunaseelan, Vidhya, M.S., M.H.A.; Brummett, Chad M., M.D.; Waljee, Jennifer F., M.D., M.S.

Plastic and Reconstructive Surgery.  January 2019 - Volume 143 - Issue 1 - p 87–96

The authors surveyed the Clinformatics database and collected data on opioid use before and after body contouring procedure.  The study included data from over 11,000 unique patients, who had surgery over a 14 year period.  They found that, consistent with prior studies in other surgical groups, 6.1 percent of previously opioid-naive patients developed new persistent use of opioids.   The highest rates of opioid misuse were seen after thighplasty, and higher rates were observed in smokers and patients with preexisting mood or anxiety disorders.




Safe Gluteal Fat Graft Avoiding a Vascular or Nervous Injury: An Anatomical Study in Cadavers

Filiberto Alejandro Alvarez-Alvarez, MD  Hiram O González-Gutiérrez, MD César Felipe Ploneda-Valencia, MD

Aesthetic Surgery Journal, Volume 39, Issue 2, 17 January 2019, Pages 174–184

In the most comprehensive anatomic study to date on the subject, the authors injected synthetic graft material into 10 fresh cadavers under age 50.  They sought to determine which injection technique was the most effective in augmenting the subcutaneous plane while not resulting in the graft being in contact with the sciatic nerve or gluteal vessels.   Injection of the fat graft through the upper medial gluteal sulcus at 0° and 10° angles, and through the middle of the buttock at the level of posterior superior iliac crest at a −30° angle, reaches the surface needed for gluteal augmentation.  Injections through the middle lower gluteal sulcus had the highest complication rate.



Nasal Dorsal Augmentation with Freeze-Dried Allograft Bone:  A 10-Year Comprehensive Review

Clark, Richard P., M.D.; Pham, Phuong M., M.D.; Ciminello, Frank S., M.D.; Hagge, Rosalie J., M.D.; Drobny, Sarah, M.D.; Wong, Granger B., M.D., D.M.D.

Plastic and Reconstructive SurgeryJanuary 2019 - Volume 143 - Issue 1 - p 49e–61e

The authors present a series of patients who underwent dorsal nasal augmentation with freeze-dried allograft bone with 1-10 year follow up (mean 4.7 years).  Outcome measurements included  cephalometric radiography, cone beam volumetric computed tomography, and fluorine-18 sodium fluoride positron emission tomography.  The dorsal augmentation was assessed overall to be successful in 85 percent of 62 patients studied.



April 2019

Fenestration Improves Acellular Dermal Matrix Biointegration

Cottler, Patrick S.; Olenczak, J. Bryce; Ning, Bo; Seaman, Scott A.; Thuman, Jenna M.; Sun, Naidi; Piñeros-Fernandez, Angela; Hu, Song; DeGeorge, Brent R. Jr.; Campbell, Chris A.

Plastic and Reconstructive Surgery.  April 2019 - Volume 143 - Issue 4 - p 971-981

The authors report the results of an experimental study in a mouse model to study biointegration of acellular dermal matrix.  Mice were equipped with a skinfold window and serial photoacoustic microscopic imaging was used to provide a realtime assessment of the microvasculature.  Fibroblast migration, mean surface area vascular penetration, and mean oxygen saturation were all greater in fenestrated matrices than non-fenestrated, at two weeks and three weeks.  This study shows convincingly that fenestrations improve the revascularization and recellularization of acellular dermal matrices.






Experience With High-Volume Buttock Fat Transfer: A Report of 137 Cases

Pane, Thomas A.

Aesthetic Surgery Journal, Volume 39, Issue 5, May 2019, Pages 526-532

A single surgeon retrospective review of 137 patients who underwent high-volume buttock fat transfer, defined as 1000cc or more of fat per buttock.  Injections were all performed into the subcutaneous space, with care taken to reduce medial and intramuscular injection.  The patient reported satisfaction rate was 86% with the biggest dissatisfier being “wanted to be larger”.  There were no major complications and minor complications occurred in 10 patients, most of which related to the abdominal donor site.




False-Positive Rates for Nerve Conduction Studies and Ultrasound in Patients Without Clinical Signs and Symptoms of Carpal Tunnel Syndrome

John R. Fowler, Kevin Byrne, Tiffany Pan, Robert J. Goitz

 Journal of Hand Surgery, Volume 44, Issue 3, March 2019, Pages 181-185.

A prospective cohort study was performed on 40 patients who were referred for nerve conduction studies (NCS) for cubital tunnel syndrome or cervical radiculopathy, but who had no symptoms of carpal tunnel syndrome, with a CTS-6 score of 0.  NCS were positive for carpal tunnel in 43% of asymptomatic patients, and ultrasound was positive in 23% of asymptomatic patients.  Since studies with a low false-positive rate are generally preferred as confirmatory diagnostic tests, ultrasound may be a better confirmatory test for carpal tunnel syndrome than NCS.




July 2019

Microvascular Reconstruction of the Nose with the Radial Forearm Flap: A 17-Year Experience in 47 Patients

Salibian, Arthur H. M.D.; Menick, Frederick J. M.D.; Talley, John M.D.

Plastic and Reconstructive Surgery.  July 2019 - Volume 144 - Issue 1 - p 199-210

The authors present a series of 50 microvascular nasal reconstruction procedures performed on 47 patients.  They update prior work and provide a thorough review of how bony and cartilaginous framework restoration, microvascular lining flaps, forehead skin resurfacing, and sculpting procedures can work in concert to provide an optimal result in large nasal defects. 




Comparison of Costs and Outcomes for In-Office and Operating Room Excision of Nonmelanoma Skin Cancer

Ovadia, Steven A. MD; Spector, Seth A. MD, FACS; Thaller, Seth R. MD, DMD, FACS

Annals of Plastic Surgery: July 2019 - Volume 83 - Issue 1 - p 78–81

A retrospective review and cost analysis was performed on a series of 84 patients who underwent excision of non-melanoma skin cancer at the Miami VA Hospital.  Patients who underwent their procedure in the office treatment room setting had equivalent outcomes to those who underwent the procedure in the hospital OR setting, at less than one third the cost.



Female Sexual Function and Sexual Well-being Before and After Breast Reduction: A Pilot Cross-sectional Study and Review of Literature

Janik, Piotr E.; Charytonowicz, Daria; Miszczyk, Jakub

Annals of Plastic Surgery. 82(6):609-613, June 2019.

75 female patients were assessed with three different validated batteries both before and 12-36 months following reduction mammoplasty.  All three showed significant improvements following surgery.   This is the first evidence that breast reduction has a positive impact on female sexual well-being, as well as improving physical symptoms and self-image.



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