Plastic and reconstructive surgery
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Injury to the facial nerve during a face lift is a relatively rare but serious complication. A large body of literature has been dedicated toward bettering the understanding of the anatomical course of the facial nerve and the relative danger zones. Most of these prior reports, however, have focused on identifying the location of facial nerve branches based on their trajectory mostly in two dimensions and rarely in three dimensions. ⋯ Although the precise location of facial nerve branches is variable, its relationship to soft-tissue planes is relatively constant. The focus of this report is to improve understanding of facial soft-tissue anatomy so that safe planes of dissection during surgical undermining may be identified for each branch of the facial nerve. Certain anatomical locations more prone to injury and high-risk patient parameters are further emphasized to help minimize the risk of facial nerve injury during rhytidectomy.
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With the increasing popularity and acceptance of nipple-sparing mastectomy with immediate reconstruction comes an associated higher complication rate of nipple and skin necrosis. Historically, management of this risk has been addressed by predictive technologies or staged surgery with placement of an initial tissue expander. ⋯ This report details a delay technique that allows safe preservation of the nipple-sparing mastectomy tissues, even in high-risk individuals, and facilitates straight-to-implant reconstruction without the need for tissue expansion. The aesthetic benefits, time savings, and acceptable complication profile in this series are presented.
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Plast. Reconstr. Surg. · Apr 2015
Randomized Controlled TrialOxygen reduces tourniquet-associated pain: a double-blind, randomized, controlled trial for application in hand surgery.
Why do limb tourniquets cause pain? If ischemia is the mechanism, can supplemental oxygen reduce pain? The Reducing Tourniquet Associated Pain study investigated whether this simple treatment could extend tourniquet tolerance time to facilitate hand surgery under local or regional anesthesia. ⋯ Oxygen is a readily available, low-risk, low-cost treatment that significantly reduced tourniquet-associated pain in this study and significantly increased the time taken to reach visual analogue scale score of 40 or more. The authors recommend oxygen to facilitate hand surgery under a tourniquet and when a regional block fails to control tourniquet pain.
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Plast. Reconstr. Surg. · Mar 2015
Review Meta AnalysisLooking at plastic surgery through Google Glass: part 1. Systematic review of Google Glass evidence and the first plastic surgical procedures.
Google Glass has the potential to become a ubiquitous and translational technological tool within clinical plastic surgery. Google Glass allows clinicians to remotely view patient notes, laboratory results, and imaging; training can be augmented via streamed expert master classes; and patient safety can be improved by remote advice from a senior colleague. This systematic review identified and appraised every Google Glass publication relevant to plastic surgery and describes the first plastic surgical procedures recorded using Google Glass. ⋯ Google Glass is an exciting translational technology with the potential to positively impact health care delivery, medical documentation, surgical training, and patient safety. Further high-quality scientific research is required to formally appraise Google Glass in the clinical setting.
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Plast. Reconstr. Surg. · Mar 2015
Multicenter StudyDefining the relationship between patient decisions to undergo breast reconstruction and contralateral prophylactic mastectomy.
Recent studies suggest that the decisions to undergo breast reconstruction and contralateral prophylactic mastectomy are closely related. In this article, the relationship between method of reconstruction and decision to undergo contralateral prophylactic mastectomy is described. Recent trends in contralateral use in the context of literature questioning its oncologic benefit are also evaluated. ⋯ Risk, II.