October 2021

Acellular Dermal Matrix–Associated Complications in Implant-Based Breast Reconstruction: A Multicenter, Prospective, Randomized Controlled Clinical Trial Comparing Two Human Tissues

Broyles, Justin M. M.D.; Liao, Eric C. M.D., Ph.D.; Kim, John M.D.; Heistein, Jonathan M.D.; Sisco, Mark M.D.; Karp, Nolan M.D.; Lau, Frank H. M.D.; Chun, Yoon S. M.D.

Plastic and Reconstructive Surgery: 148(3):493-500, September 2021.

The authors compared two acellular dermal matrices (AlloDerm RTU and Flex HD) in a head to head fashion in this prospective randomized trial.  The study group consisted of 130 women who underwent ADM-assisted implant reconstruction over a two year period.  80% of the patients underwent retropectoral placement of implants, 20% prepectoral.  There were 14 complications (infection or seroma) in the Alloderm group and 8 in the FlexHD group.  Obesity and pre-pectoral placement were found to be risk factors for complications, but there was no difference between the two types of ADM.

Link:https://journals.lww.com/plasreconsurg/Fulltext/2021/09000/Acellular_Dermal_Matrix_Associated_Complications.1.aspx

Comparing Outcomes of Wise-Pattern, Two-Stage Breast Reduction-Reconstruction with and without Acellular Dermal Matrix

Patel, Ashraf A. M.D.; Kayaleh, Hana B.S.; Sala, Luke A. B.S.; Peterson, Dylan J. B.A.; Upadhyaya, Prashant K. M.D.

Plastic and Reconstructive Surgery: September 2021 - Volume 148 - Issue 3 - p 511-521

The authors retrospectively reviewed the outcomes of 85 patients with macromastia and/or ptosis who underwent staged breast reconstruction with a Wise-pattern closure.  ADM was used in 68 of 164 breasts.  In the other 96 reconstructions, a deepithelialized inferior skin flap was used for expander coverage.  Both prepectoral and retropectoral reconstructions were included.  Minor infections were higher in the ADM group, but otherwise there were no differences seen in complication rates between the ADM group and the no-ADM group.  This reinforces the concepts that ADM is not always necessary to achieve optimal results in implant breast reconstruction, and the judicious application of autologous solutions can achieve the same goals as ADM at a reduced cost.

Link:https://journals.lww.com/plasreconsurg/Fulltext/2021/09000/Comparing_Outcomes_of_Wise_Pattern,_Two_Stage.4.aspx?WT.mc_id=HPxADx20100319xMP

Anterior Approach to the Neck: Long-Term Follow-Up

Andrew L Kochuba, MD,  Christopher C Surek, DO,  Carlos Ordenana, MD, James Vargo, MD,  Isis Scomacao, MD,  Eliana Duraes, MD, James E Zins, MD

Aesthetic Surgery Journal, Volume 41, Issue 8, August 2021, Pages 861–870

The authors review 27 patients with mild or moderate skin excess who underwent isolated submental cervioplasty without skin excision.  Photographs were examined by independent evaluators who graded the change in cervicomental angle based on the Knize scale and rated the reduction in apparent age using a validated scale. There was an average 3.6-year age reduction and 1.0-grade improvement in all patients.  The authors conclude the procedure is an option for patients who desire neck improvement but are unwilling to undergo a facelift.

Link:https://doi.org/10.1093/asj/sjaa099

July 2021

Turning Back the Clock: Artificial Intelligence Recognition of Age Reduction after Face-Lift Surgery Correlates with Patient Satisfaction

Zhang, Ben H. B.A.; Chen, Kevin M.D.; Lu, Stephen M. M.D., M.Div.; Nakfoor, Bruce; Cheng, Roger M.S.; Gibstein, Alexander B.A.; Tanna, Neil M.D.; Thorne, Charles H. M.D.; Bradley, James P. M.D.

Plastic and Reconstructive Surgery: 148(1):45-54, July 2021.

Neural network algorithms use artificial intelligence to analyze images and can be “taught” to recognize complex features.  They have been shown to accurately identify gender, age, and emotion in photographs of faces.  The authors applied four different neural network algorithms to the pre- and postoperative photos of 50 consecutive facelift patients.  The average age reduction measured by the neural networks was 4.3 years, and there was a positive correlation between neural network age reduction and patient satisfaction assessed by FACE-Q.  This objective measurement may be a game changer in the assessment of results following treatments for facial aging.

Link:https://journals.lww.com/plasreconsurg/Fulltext/2021/07000/Turning_Back_the_Clock__Artificial_Intelligence.8.aspx

Outcomes of Furlow Double-Opposing Z-Plasty Palatoplasty for the Treatment of Symptomatic Overt and Occult Submucous Cleft Palate: A Comparison Study

Brooker, Jack E. M.D.; Bykowski, Michael M.D.; Cray, James J. Ph.D.; Beiriger, Justin B.S.; Roy, Eva B.A.; Ford, Matthew D. M.S., C.C.C.-L.P.; Grunwaldt, Lorelei M.D.; Davit, Alexander M.D.; Goldstein, Jesse A. M.D.; Jabbour, Noel M.D.; Losee, Joseph E. M.D.

Plastic and Reconstructive Surgery: May 2021 - Volume 147 - Issue 5 - p 1141-1148

This is a thorough review of 351 patients who underwent Furlow Z-plasty for overt or occult submucous cleft palate by six surgeons at a major children’s hospital over a 14 year period.  There were no instances of palatal fistula, and the overall rate of referral for secondary speech surgery was 17%.  Greater impairment of speech preoperatively and presence of a known syndrome were predictive of need for secondary speech surgery.

Link:https://journals.lww.com/plasreconsurg/Fulltext/2021/05000/Outcomes_of_Furlow_Double_Opposing_Z_Plasty.20.aspx

The Prevalence of Self-Reported Health Complaints and Health-Related Quality of Life in Women With Breast Implants

Renée M L Miseré, MD,  Maartje J L Colaris, MD,   Jan W Cohen Tervaert, MD, PhD,  René R W J van der Hulst, MD, PhD

Aesthetic Surgery Journal, Volume 41, Issue 6, June 2021, Pages 661–668.

This questionnaire based study aimed to evaluate the prevalence of breast implant illness (BII) symptoms in women with and without breast implants, and to compare their health-related quality of life.  238 women completed the questionnaires comprising four groups: those with the diagnosis of BII, patients with silicone implants, patients with saline implants, and women without implants.  BII type symptoms were present in the majority of respondents.  Adjusted for age, smoking, and comorbidities, typical symptoms only occurred significantly more frequently in the first group.  The authors conclude that the adjusted prevalence of BII manifestations is not significantly higher in women with implants than in women without, and that previous reports on the prevalence of BII are subject to selection bias.

Link:https://academic.oup.com/asj/article/41/6/661/5872605

April 2021

Explantation in Tissue Expander and Direct-to-Implant Reconstruction with Acellular Dermal Matrix: How to Avoid Early Reconstructive Failures

Cohen, Leslie E. M.D.; Bogue, Jarrod T. M.D.; Jin, Julia B.A.; Disa, Joseph J. M.D.

Plastic and Reconstructive Surgery: April 2021 - Volume 147 - Issue 4 - p 579e-586e

A well written review of 137 patients who underwent implant based breast reconstruction using ADM at Memorial Hospital over a 4 year period.  The authors’ rate of explantation during this period was 3.4%.  The authors identify elevated BMI and history of XRT as risk factors for complications.  The authors provide useful treatment algorithms, stressing the importance of early excision of any mastectomy flap necrosis.

Link:https://journals.lww.com/plasreconsurg/Fulltext/2021/04000/Explantation_in_Tissue_Expander_and.3.aspx

Postoperative Abdominal Bulge and Hernia Rates in Patients Undergoing Abdominally Based Autologous Breast Reconstruction:  Systematic Review and Meta-Analysis

Espinosa-de-los-Monteros, Antonio; Frias-Frias, Roberto; Alvarez-Tostado-Rivera, Alejandro; Caralampio-Castro, Ali; Llanes, Sergio; Saldivar, Alberto

Annals of Plastic Surgery.86(4):476-484, April 2021.

In the most comprehensive review to date on the topic, the authors perform a rigorous meta-analysis of the existing high-quality studies on outcomes following abdominal flap-based breast reconstruction.  They conclude that for bilateral reconstruction, abdominal hernia/bulge rates are higher with traditional TRAMs and MS-2 free TRAMS without mesh than with DIEPs or MS-2 with mesh.  No statistical difference was seen between DIEPs and MS-2 free TRAM with mesh.

Link:https://journals.lww.com/annalsplasticsurgery/Fulltext/2021/04000/Postoperative_Abdominal_Bulge_and_Hernia_Rates_in.21.aspx

Identifying Regional Viscoelastic Properties of the Superficial Muscular Aponeurotic System

Robert Lukavsky, MD, Andrew Trussler, MD, Fritz E Barton, Jr, MD, FACS, Michael Lee, MD, FACS

Aesthetic Surgery Journal, Volume 41, Issue 3, March 2021, Pages 277–283.

In an anatomic study of 12 cadaveric hemifaces, the SMAS was divided into three zones: lateral, mid cheek, and medial.  The lateral SMAS was found to have greater bursting strength and lower creep.  The implications are that the greatest strength of fixation in a SMAS facelift is provided by laterally-placed tension, and that loss of predictability of fixation increases as SMAS tension is placed more medially in the cheek.

Link: https://academic.oup.com/asj/article/41/3/277/5848240

Top Journal Picks

Top Journal Picks 2020

Top Journal Picks 2019

Top Journal Picks 2018

Top Journal Picks 2017