Plastic Surgery Commons^™

Response To The Letter To The Editor: Surgical Delay Of Thoracodorsal Artery Perforator Flaps For Bilateral Autologous Breast Reconstruction, Robert J. Allen, Mark A. Maier

School of Medicine Faculty Publications

No abstract provided.

Upper Helical Reconstruction During Aesthetic Facelift Procedure: A Case Report, Zachary N. Goldberg, David S. Goldberg

SKMC Student Presentations and Publications

We present a case of a two-stage reconstruction of a traumatic right upper helix deformity using a random pattern layover skin flap in conjunction with an aesthetic facelift procedure. This serves to encourage reconstructive surgeons to be mindful about seeking opportunities to address additional patient concerns when appropriate and safe.

Oncoplastic Nipple Sparing Mastectomy And Immediate Reconstruction In Non-Ideal Candidates, Aaron I. Dadzie, Paul Berry

Research Symposium

Background: Mastectomies have long been used as a surgical treatment for malignant and benign disorders of the breast, both as a therapy and prophylaxis in high-risk patients. A nipple-sparing mastectomy (NSM) allows for removal of most of the glandular and ductal tissues while preserving the surface architecture of the nipple-areola complex (NAC). In satisfactory surgical candidates, this procedure allows for superior aesthetic outcomes compared to other mastectomy techniques and minimizes the need for additional procedures to reconstruct the nipple. Here, we summarize the established treatment standards and suggest an expansion of the established surgical techniques and selection criteria of NSM …

Improvement Of Hair Transplantation In Postcicatracial Alopecia, Maurice Fekry, Ebrahim Awad

Journal of Medicine in Scientific Research

Background Because scarred tissue has less blood flow than normal tissue, fewer hair grafts are taken, and the patient may require many sessions to achieve the acquired density, resulting in a lengthy treatment duration of up to 5 years. The use of platelet-rich plasma (PRP) improves these findings. Patients and methods A prospective randomized-controlled study was conducted on 15 patients with cicatricial alopecia and candidates for follicular unit extraction hair transplantation, with ages between 25 and 60 years. Results Functional and esthetic outcomes were achieved by adding PRP regimen to follicular unit extraction hair transplantation for cases presented to us …

Women, Power, And Cancer: A Lancet Commission, Ophira Ginsburg, Verna Vanderpuye, Ann Marie Beddoe, Nirmala Bhoo-Pathy, Freddie Bray, Carlo Caduf, Narjust Florez, Ibtihal Fadhil, Nazik Hammad, Miriam Mutebi

General Surgery, East Africa

Women interact with cancer in complex ways, as healthy individuals participating in cancer prevention and screening activities, as individuals living with and beyond a cancer diagnosis, as caregivers for family members and friends, as patient advocates, as health workers and healthcare professionals, and as cancer researchers and policy makers. The topic of women and cancer spans broad terrain, beyond women’s cancers and the biomedical aspects of any type of cancer that women in all their diversities might experience. It is inclusive of the ways in which sex and gender influence exposures to cancer risk factors, interactions with the cancer health …

Autologous Fat Transfer For Gluteal Augmentation: A Meta-Analysis Study, Abd El Nasser Mohammed Khallaf, Al-Sayed Hussein El-Sharkawy, Mohammed Mohammed Ali Ahmed

Al-Azhar International Medical Journal

Background: In 1969, Bartels et al. presented the initial description of gluteal augmentation using a breast Cronin prosthesis to treat buttock asymmetry. In recent decades, gluteal fat grafting has seen one of the fastest-growing rates of any cosmetic surgery technique. Objectives: Analyze the published techniques of autologous fat transfer for Buttock augmentation (BBL), and compare different protocols to identify which technique is better in safety and effectiveness over the last 5 years, with demonstration of clinical cases. Subjects and methods: This research was carried out by the Plastic Surgery & Burn Unit of the Al-Azhar University School of Medicine. The …

Oropharyngeal Teratoma: Five-Month-Old Presenting With Failure To Thrive And Severe Obstructive Sleep Apnea., Anna Lawrence, Melissa Gener, Shao Jiang, Jill M. Arganbright

Manuscripts, Articles, Book Chapters and Other Papers

Oropharyngeal teratomas are an extremely rare congenital tumor. They are often diagnosed prenatally and can cause significant airway obstruction and feeding difficulties at birth. We present a five-month-old female that was diagnosed with a palatal teratoma that presented with failure to thrive, difficulty feeding, and eventually with severe obstructive sleep apnea. We present a five-month-old term, otherwise healthy female who became stridulous after an episode of the respiratory syncytial virus at one month old. At three months old, an otolaryngologist diagnosed mild laryngomalacia with no mass identified, and no surgical intervention was recommended. Due to continued poor weight gain, at …

Successful Latissimus Dorsi Free Flap Salvage Using Intraoperative Vasopressors: A Case Report, Aubree Ford, Hugo Palacios Vazquez, Sean Figy

Graduate Medical Education Research Journal

Arterial thrombosis is a rare, but dreadful complication in microvascular surgery. Here we report on a case of recurrent arterial thrombosis in a latissimus dorsi (LD) free flap used for scalp reconstruction in an 18-year-old woman who sustained a gunshot wound (GSW) to the head. In the immediate postoperative period, internal and external doppler signals to the flap were lost. Emergent surgical exploration revealed arterial thrombosis, which was emergently explored and successfully repaired. Doppler signals were again lost and the flap was emergently explored for a second time. Following revision of the arterial anastomosis, flap perfusion decreased and appeared to …

Red Breast Syndrome And Acellular Dermal Matrix, Allison Podsednik Gardner, Aidee Nunez, Mauricio De La Garza

School of Medicine Publications and Presentations

Increasingly popular for use in breast reconstruction, acellular dermal matrix (ADM) can provide support and protection to implants. However, use of ADM may be associated with infection and complications, including red breast syndrome (RBS). RBS is an inflammatory event that typically presents with cutaneous erythema over the domain where the ADM is surgically implanted. As ADM use increases, presumably, more cases of RBS will occur. Thus, techniques and tools to mitigate or manage RBS are needed to improve patient outcomes. Here, we describe a case where RBS was diagnosed and interestingly resolved after exchange for a different brand of dermal …

Acute Diplopia After Glabellar Hyaluronic Acid Filler Injection, Caroline W. Chung, Eric J. Shiuey, César A. Briceño, Vivian Lee

SKMC Student Presentations and Publications

Purpose: Blindness is a well-known complication of filler injection in the glabellar region. Acute diplopia from filler injection without vision loss is a rare complication that typically results in clinical ophthalmoplegia which can have permanent sequelae. Here, we describe a patient who presented with acute diplopia with grossly intact full extraocular motility after glabella hyaluronic acid filler injection that resolved after 1 month.

Observations: A previously healthy 43-year-old woman underwent her first hyaluronic acid injection in the glabella and developed immediate binocular double vision with severe pain and skin mottling above her right eyebrow and central forehead. Hyaluronidase injections, nitroglycerin …

The Spectrum Of Severity In 368 Patients With Metopic Craniosynostosis: An Update To The Craniorate™ Machine Learning Algorithm, Annie Glenney, Joseph Mocharnuk, Griffin Bins, Erin Anstadt, Lucas Dvoracek, Wenzheng Tao, Ross Whitaker, Lisa David, David Runyan, Jesse Goldstein

St. Chris Research Day

No abstract provided.

Pediatric Facial Fractures In Patients With Autism Spectrum Disorder, Annie Glenney, Zhazira Irgebay, Meeti Mehta, Joseph Mocharnuk, Janina Kueper, Lucas A. Dvoracek, Justin Schreiber, Joseph Losee, Jesse Goldstein

St. Chris Research Day

No abstract provided.

Risk Factors For Neonatal Brachial Plexus Injury: A Retrospective Review Of A Single-Institution’S Eleven-Year Experience, Annie Glenney, Meeti Mehta, Hilary Liu, Alexander Comerci, Yusuf Surucu, Tarek Arabi, Elizabeth Moroni, Alexander J. Davit Iii

St. Chris Research Day

No abstract provided.

Maximizing Patient Benefit In Interfacility Transfer For The Management Of Pediatric Hand Trauma, Annie Glenney, Zainab Balogun, Meeti Mehta, Shirley Liu, Vivian Wang, Lucille Cheng, Darya Fadavi, Alexander Davit Iii

St. Chris Research Day

No abstract provided.

Chronic Wound Management; Surgical Therapy And Complementary Nursing With Manuka Honey, Georgeta Paunică-Panea, Sergiu Teodorescu, Aurelia Preda, Laura Elena Gligor, Adrian Silaghi, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Objectives. This study aims to analyze the evolution of chronic wounds treated both surgically and by complementary nursing using Manuka honey. The parameters monitored were: presence/persistence of bacterial infection, the duration of healing, the recovery period and the patients' quality of life. Materials and Methods. The study group and the control group each consisted of 10 patients, aged between 50-60 years, with chronic wounds of various etiologies but without other significant systemic pathologies. Data collection was carried out through anamnesis, physical examination and analysis of medical documents. Results. In the study group, the depth of the wound was reduced rapidly …

Surgical Management Of Velopharyngeal Dysfunction: Major Techniques And Trends For The 21st Century, Dominic Alessio-Bilowus, Sadaf Hashemian, Kylie Nikolli, Ahmed Hashem Md

Medical Student Research Symposium

INTRODUCTION: Surgical management of velopharyngeal dysfunction (VPD) has become increasingly complex over recent decades with advances in diagnosis, evaluation and technique, and research focus in this area is expected to shift accordingly. This study aims to educate readers on updates in management of VPD and explore changes in surgical methods through the 21st century.

METHODS: A systematic review was conducted of all literature published on surgical treatment of VPD since the year 2000, following PRISMA reporting guidelines. Adult-acquired VPD, any non-surgical management, implants and prosthetic devices, animal or cadaver models, and case series involving less than 10 subjects were excluded. …

Effects Of Marijuana Use In Patients Undergoing Abdominal Free Flap Breast Reconstruction, Tala Al-Saghir, Kinan Sawar, Alexander Vraa, Dunya Atisha

Medical Student Research Symposium

PURPOSE: Marijuana use is associated with incidence of vascular inflammation and clotting, resulting in endothelial damage and arteritis. As marijuana use rises, few studies have evaluated its impact on surgical outcomes, wound healing, and vascular anastomoses in free flap breast reconstruction.

METHODS: A retrospective cohort study of patients undergoing abdominal free flap breast reconstruction between 2016 and 2022 at a large metropolitan healthcare system was performed. Patient demographics, comorbidities, procedural details, and complications were analyzed. Minor complications were defined as skin necrosis, any wound requiring management in the clinic, hematoma, seroma, or fat necrosis that did not require intervention. Major …

Radiated Immediate Prepectoral Direct To Implant Reconstruction: A Retrospective Cohort Study, Kinan Sawar, Tala Al-Saghir, Jamie Hall, Michael Diffley, Madeleine Gonte, Donna Tepper, Vigen Darian, Maristella Evangelista, Amy Tang, Dunya Atisha

Medical Student Research Symposium

Purpose: Increasing use of prepectoral plane in post mastectomy implant-based reconstruction has made immediate direct to implant (DTI) reconstruction more achievable. There has been increased incidence of post mastectomy radiation therapy (PMRT) making it important to understand the complication profile of immediate DTI reconstruction in patients who may require adjuvant radiation therapy.

Methods: A retrospective cohort study of consecutive patients undergoing prepectoral DTI reconstruction with and without PMRT was performed. Patient and treatment level factors, operative, and post-operative outcomes were extracted on both the patient and breast level for the prepectoral radiated and nonradiated patients. The presence of at least …

A Nationwide Analysis Of Gunshot Wounds Of The Head And Neck: Morbidity, Mortality, And Cost, John M. Menezes, Kavita Batra, Vladislav Pavlovich Zhitny

Plastic Surgery Faculty Publications

Background:

Gun violence in the United States rose continuously from 2010 to 2022, spiking during the pandemic, and peaking in 2021 at 48,830 deaths (14.8 per 100,000). Previous reports investigated health and financial burden associated with gunshot wounds (GSWs) during 2004 to 2013; however estimates related specifically to head and neck (H&N) injuries have been lacking. This population-based study aims to examine incidence, morbidity, mortality, and health resource utilization of H&N injuries utilizing the Nationwide Inpatient Sample database.

Methods:

A population-based study was undertaken using the National (Nationwide) Inpatient Sample (NIS) database (2015Q4–2017Q4). The International Classification of Diseases, Tenth Revision …

Review Of Orthoplastic Techniques For Lower Extremity Reconstruction: Part One, Benjamin Heddy, Brady Webb

Advances in Clinical Medical Research and Healthcare Delivery

Orthoplastic techniques are effective tools for limb salvage in the lower extremity. In order to apply proper techniques successfully, a surgeon must be aware of all the different types of flaps available. Proper pre-operative evaluation and patient selection are also important factors. The following review covers six papers that give surgeons a strong foundation in the anatomical basis and surgical technique of intrinsic muscle flaps and other fasciocutaneous or adipofascial flaps of the foot. These flaps, along with split thickness skin grafts, external fixation, and dermal regenerative templates, quickly close soft tissue deficits in the foot and ankle that often …

Evaluation Of Boomerang Pattern With J-Torsoplasty For Correction Of Gynecomastia After Massive Weight Loss, Ahmed Nabil Mohamed Emam, Abdel Moneam Hussien Hota, Ahmed Taha Sayed Hassan

Al-Azhar International Medical Journal

Background: Various degree of gynaecomastia with excessive ptosis, nipple malposition, overstretched skin, poorly defined infra-mammary fold, and prominent axillary and lat chest rolls, male chest deformity following significant weight loss is complicated and difficult to treat, so correction methods should allow for the technically correct removal of extra tissue without jeopardizing the blood and nerve supply to the nipple-areola complex. Aim of the work: To ascertain whether J torsoplasty with boomerang excision pattern correction of gynecomastia will result in well-hidden scars and adequate male chest contouring. Patients and methods: The study included 15 patients of bilateral gynecomastia with lateral chest …

Skin Graft For Treatment Of Crippled Hypospadias, Ahmed Salem, Khaled Abd Elhaleem Hefny, Mohammad El Sayed Daboos, Amr Mohamed Elsayed

Al-Azhar International Medical Journal

Background: Hypospadias is one of the most frequent birth defects, with an incidence of 1 in every 300 births. After several attempts at hypospadias surgery, the term "crippled hypospadias" has been used to describe patients with unresolved functional problems. Aim of the work: To evaluate the outcome of a two-stage skin graft for treatment of crippled hypospadias regarding graft uptake, penile reconstruction Patients and Method: This clinical study was done in Al-Azhar University Hospital on 15 cases presenting with crippled hypospadias from May 2021 to Oct 2022. After preoperative preparation, all patients were submitted for two-stage skin graft urethroplasty. Results: …

Evaluation Of Aesthetic And Oncological Outcomes Of Immediate Versus Delayed Reconstruction In Patients Of Breast Cancer: A Meta-Analysis, Abd-Elrahman Awadeen Abd-Elrahman, Ahmed Mohammed El Mahdy Salem, Hesham Mahmoud Ahmed Emam

Al-Azhar International Medical Journal

Background; with a lifetime probability of up to 10%, breast cancer is considered the utmost prevalent type of cancer among women. One of the key elements for an achieving successful reconstruction is the optimal timing. It is still debated to take a decision choosing between the immediate and the delayed reconstruction.

Aim and objectives: The goal of the present research was the evaluation of both the aesthetic and oncological results of reconstruction: the immediate vs. the delayed, in patients having breast cancer.

Methods: a search in literature was conducted in publications of PUBMED, SienceDirect, EMBASE, Google Scholar and the Cochran …

Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Case Report, Jennie Tan, Jamie Johnson-Eddy, Wesley Tang, Yanchun Li

Cooper Rowan Medical Journal

This report aims to review a case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) by comparing the patient's course with the current literature.

BIA-ALCL is a specific type of T-cell lymphoma that can develop after breast implantation, but has only recently been recognized within the last decade. Although overall rare, certain types of breast implants have increased association with developing subsequent lymphoma. This case occurred after mastectomy with breast reconstruction for unilateral invasive ductal carcinoma with a textured, saline Allergan breast implant. BIA-ALCL manifested and was symptomatic nine years after implantation.

Warren B. Davis And The Birth Of Plastic Surgery In Philadelphia: A Historical Vignette, Sarah F. Wagoner, Charles J. Yeo, Renee M. Tholey, James W. Fox, Steven E. Copit

Department of Surgery Faculty Papers

The field of plastic surgery, formally organized in 1931 with the founding of the American Society of Plastic and Reconstructive Surgery, was shaped in many ways by a small practice of Philadelphia physicians. At the center of the practice was Warren B. Davis, a Philadelphia otolaryngologist and plastics pioneer whose innovations in cleft palate surgery would lead to significant improvements in functional and cosmetic outcomes in his time. In addition to his own innovations, Davis was responsible for the training of John Reese, the inventor of the Reese dermatome that changed the face of burn medicine during World War II. …

Development Of An On-Call Assessment Tool For Competency-Based Surgical Training, Eric C. Mitchell

Electronic Thesis and Dissertation Repository

Introduction: A central tenet of competency-based medical education is formative assessment of trainees. There are no assessments examining resident competence on-call, despite this being a significant component of resident training and characterized by less supervision compared to daytime.

Methods: A national survey was conducted to evaluate the state of assessment in Canadian Plastic and Reconstructive Surgery programs. An on-call assessment tool was developed based on a consensus group and was piloted over six months. Validity of the tool was examined through qualitative and quantitative methods.

Results: There were 63 tools completed across ten residents and seven staff physicians. Tool reliability …

Severe Lower Extremity Trauma In Ontario: A Linked Population-Based Analysis, Stephanie M. Kim

Electronic Thesis and Dissertation Repository

Open tibia fractures (OTF) are a management challenge. Admission to a trauma center (TC) and a coordinated approach to bony fixation and soft-tissue reconstruction (STR) have been shown to improve outcomes. The objective of this study was to describe patients who had OTF in Ontario and analyze their outcomes. Linked population data pertaining to patients who had OTF between the years 2009-2020 were examined. Demographic information, admission location, and management course were collected. 4240 patients were found. The mean age was 47, and majority were males. Patients admitted to TC had greater proportion of having Injury Severity Score >15, and …

Innovative Therapeutic Approach To Chemical Burns Produced By Vesicants; An Experimental Study, Cristina Anca Secara, Otilia Liudmila Cinteza, Diana Popescu, Claudia Valentina Popa, Camelia Andreea Hirjeu, Oana Cristina Voinea, Luiza Georgia Serbanescu, Andreea Marilena Pauna, Mihail Tudosie

Journal of Mind and Medical Sciences

Vesicants are compounds that cause severe toxic effects on various tissues. Such chemical action causes tissue necrosis, with clinical expression of skin lesions with a burning character and characteristic blisters. Clinical toxic effects of cutaneous vesicles are correlated with the absorbed dose and exposure time. The goals of the study are to evaluate in vitro the skin toxicity produced by the vesicant chemical compound 2-chloroethyl-ethyl sulfide (CEES), to develop a complex antidote formula, and to optimize the therapeutic efficacy by inclusion in controlled release systems. The experimental protocol aims at the in vitro evaluation of the cytotoxicity of the vesicant …

Modern Therapeutic Options In Diabetic Foot Ulcer, Denisa Tanasescu, Andrei Moisin, Radu Fleaca, Carmen Popa, Ciprian Bacila, Cosmin Mohor, Claudia Diana Gherman, Bogdan Gaspar, Ciprian Tanasescu

Journal of Mind and Medical Sciences

Diabetic foot is a severe complication of diabetes that occurs as a result of poor glycemic control, being associated with significant morbidity and mortality. Mortality associated with this disease is estimated at 5% in the first 12 months, and about 42% in the next 5 years. On average, it affects about 15% of people with diabetes during their lifetime, including as possible manifestations neuropathy, peripheral vascular disease, and subsequent ulceration which, if treated incorrectly, can lead to amputation.

This paper presents a retrospective and descriptive study of patients diagnosed and treated for diabetic foot ulcers in the Proctoven Clinic. The …

Limb Amputations; Etiopathogenesis, Diagnosis And The Multidisciplinary Therapeutic Approach, Vlad Denis Constantin, Bogdan Socea, Bogdan Severus Gaspar, Dragos Epistatu, Ioana Paunica, Anca Silvia Dumitriu, Stana Paunica, Adrian Silaghi

Journal of Mind and Medical Sciences

Despite remarkable advances in medicine, limb amputations remain a therapeutic measure that saves the lives of many patients. Given the varied etiopathogenesis, such operations are performed both as an emergency and as an elective procedure. Such interventions address either only the distal segments of a limb, or even the entire limb, having a great psychological, functional and social impact on the patient. Due to these multiple implications, limb amputations must be performed by specialized teams, in order to achieve the best possible functional and aesthetic results to be compatible with the correction of the remaining deficit with a prosthesis. The …