bluuebunny/crossref_metadata_2025 huggingface dataset:
Cosmetic Surgery in a Different Voice: The Case of Madame Noël
Authors: Davis Kathy
Published: January 2017

Cosmetic surgery emerged at the end of the 19th century in the U.S. and Europe. Like most branches of surgery, it is a ‘masculine’ medical specialty, both numerically and in terms of professional ‘ethos’. Given the role cosmetic surgery – and, more generally, the feminine beauty system – play in the disciplining and inferiorization of women's bodies, a feminist cosmetic surgeon would seem to be a contradiction in terms. It is hard to imagine how cosmetic surgery might be practiced in a way which is not, by definition, disempowering or demeaning to women. In this paper, I explore the unlikely combination of feminist cosmetic surgeon, using one of the pioneers of cosmetic surgery, Dr. Suzanne Noël, as an example. She was the first and most famous woman to practice cosmetic surgery, working in France at the beginning of this century. She was also an active feminist. Based on an analysis of the handbook she wrote in 1926, La Chirurgie Esthétique, Son Rôle Social in which she describes her views about her profession, her techniques and procedures, and the results of her operations, I tackle the question of whether Noël's approach might be regarded as a ‘feminine’ or even feminist way of doing cosmetic surgery – in short, an instance of surgery in ‘a different voice’.

“The primary requisite for a good surgeon is to be a man – a man of courage.”

Edmund Andrews. (1861). The Surgeon. Chicago Medical Examiner

“Surgery involves bodies – those of surgeons as well as of patients … What does it mean when the body of the surgeon – the intrusive gazer, the violator, the recipient of sensory assaults – is that of a woman?”

Joan Cassell. (1998). The Surgeon in the Woman's Body
Venous Thromboembolism in Abdominoplasty Patients: A Study of Incidence and Prophylaxis Recommendations
Authors: Pancholi Samir , Cuzalina Angelo
Published: January 2017

Introduction:

Pulmonary embolism (PE) and deep vein thrombosis (DVT) comprise venous thromboembolism (VTE). VTE is the most common preventable cause of death in postsurgical hospitalized patients. The literature consistently defines prophylaxis as being integral to avoiding VTE. No study, however, specifically addresses this with abdominoplasty, a high-VTE-risk cosmetic procedure. This study aims to fill this void by providing specific data on VTE incidence and, through comprehensive literature review, providing specific abdominoplasty prophylaxis recommendations.

Methods:

A retrospective review of 267 patients undergoing abdominoplasty between January 2000 and June 2006 at a fully accredited outpatient surgical facility was performed to assess symptomatic VTE incidence. Analysis reviewed VTE risk factors and current prophylaxis practice. A review of current cosmetic, plastic, and general surgery prophylaxis measures in the literature was performed and correlated with the authors' practice to develop abdominoplasty-specific VTE prophylaxis recommendations.

Results:

Four of 267 abdominoplasty patients (1.5%) developed VTE (all DVT). None of the 97 patients undergoing abdominoplasty alone developed DVT. Four of 170 abdominoplasty patients undergoing additional cosmetic procedures developed DVTs (23%). Of these, 3 had liposuction and 1 had simultaneous breast augmentation/mastopexy. All patients underwent general anesthesia, received mechanical prophylaxis, and were encouraged to ambulate the morning after surgery.

Conclusions:

VTE is a real and preventable issue in patient safety. Cosmetic surgery patients frequently are treated with inconsistent and less aggressive VTE prophylaxis than similar noncosmetic surgery patients owing to scant relevant data and/or concerns of problematic bleeding. The authors present abdominoplasty-specific DVT and PE rates of 1.5% and 0%, respectively, when mechanical prophylaxis is used. Although the results mirror those in the literature, the demand for optimal VTE prevention led the authors to increase their current prophylaxis regimen to a higher standard. They soundly use and present a VTE prophylaxis protocol for abdominoplasty patients that includes mechanical as well as pharmacologic prophylaxis.
Effect of Bupivacaine (Marcaine) Injection into the Breast Pocket on Postoperative Pain in Patients Undergoing Augmentation Mammoplasty
Authors: Chao Ronald P. , Begalke Jason J. , Napolez Adolfo , Park Jung I.
Published: January 2017

Introduction:

Bupivacaine (Marcaine) is known to be an effective local anesthetic agent. The question arises as to whether there is a role for placing this anesthetic into the breast implant pocket in breast augmentation surgery to achieve a greater degree of postoperative pain relief. The purpose of this study was to test the effectiveness of locally administered intraoperative bupivacaine into the breast pocket during augmentation mammoplasty.

Materials and Methods:

The study group consisted of 62 consecutive female breast augmentation patients ranging in age from 17 to 58 years. The clinical trial took place between December 2003 and March 2005 and was conducted in a prospective, randomized, double-blinded fashion using patient opinion on a postoperative pain scale rated from 1–10. Bupivacaine (150 mg) was placed into the implant pocket of the random test side after implant insertion, while no anesthetic was placed for the control group. Data were collected at time points of 0, 1, 3, and 6 hours after surgery as well as 1 week following surgery. The 0-hour data point was collected as soon as the patient was alert at the end of the procedure. Data were analyzed using paired t tests with the Bonferroni correction applied.

Results:

Based on the 10-point pain scale, the only statistically relevant difference occurred at the 1-hour postoperative time point, at which the mean pain level for the bupivacaine injected side was 3.0, while the mean pain level for the noninjected side was 4.2 with a P value of .01. There were no dropouts in the study. No hematomas or complications requiring reoperation were noted.

Conclusion:

The use of locally injected bupivacaine into the breast pocket during breast augmentation may be beneficial in alleviating some of the postoperative pain associated with augmentation mammoplasty.
Safety of Tumescent Liposuction Compared with Liposuction in Systemic Sedation or General Anesthesia—A Review of the Literature
Authors: Boni Roland
Published: January 2017

Introduction:

Liposuction surgery is increasing in frequency and is currently the most commonly performed cosmetic procedure. In tumescent liposuction, the unwanted fat deposits are injected with tumescence fluid containing saline, epinephrine, and lidocaine, the latter used as the only source of pain control. Tumescent liposuction has to be clearly distinguished from liposuction, where tumescent solution is locally applied, but pain is controlled with systemic sedation (oral, intramuscular, or intravenous sedation, rarely spinal sedation), or general anesthesia.

Methods:

In this study, the different anesthesiologic techniques currently used for liposuction are compared with regard to safety. Reported fatalities attributed to liposuction were reviewed, and it was determined, whether tumescent liposuction was performed or whether liposuction was assisted with systemic sedation or general anesthesia.

Results:

To date, no fatalities have been reported in tumescent liposuction and only minor complications have been described. The safety of tumescent liposuction could be demonstrated in 396,457 reported cases (including own data) performed in either an office-based or a hospital setting. Fatalities (n = 110), however, have been reported when pain was controlled by systemic sedation or when general anesthesia was applied. A mortality rate of 2.6–19.1 per 100,000 cases was calculated.

Conclusion:

Based on these findings, it is concluded that tumescent liposuction is currently the safest anesthesiologic technique for liposuction surgery because it is impossible to perform liposuction beyond infiltrated areas and because only smaller volumes of fat can be removed. To ensure safety, lidocaine levels should not exceed limits (35–55 mg/kg body weight). Removal of larger fat volumes should be performed in more than one procedure. Intravenous sedation or general anesthesia should be more carefully considered for this cosmetic procedure.
Complications of Sculptra for Cosmetic Skin Contour Enhancements
Authors: Dreschnack Paul A. , Farber George A.
Published: January 2017

Background:

Five patients presented to the Kenner Dermatology Clinic with granuloma formation after cosmetic augmentation with poly-L-lactic acid (Sculptra). One patient had injections to the dorsum of the hands, and 4 patients had infraorbital skin augmentation. None were immunocompromised.

Methods:

Literature review and multiple case report.

Results:

Three patients required surgical excision. One responded to saline dilution therapy, and one is awaiting surgical removal.

Conclusion:

Although temporary fillers are more costly, permanent fillers can result in granuloma formation over time. If the granulomas do not respond to saline dilution or Kenalog treatment, surgical excision will become necessary.
Mammograms in Cosmetic Breast Surgery
Authors: Shiffman Melvin A.
Published: January 2017

Introduction:

The use of preoperative and postoperative mammograms in cosmetic surgery has never been standardized. This article discusses the medical benefits and legal issues of preoperative and postoperative mammograms in cosmetic breast surgery.

Method:

Review of the literature and a retrospective review of case.

Results:

The purpose of a preoperative mammogram is to detect any significant disorder of the breast(s) before cosmetic surgery so that the problem can be resolved before or during surgery. After cosmetic breast surgery, routine mammograms (6 to 12 months after surgery) help to formulate a baseline for the future detection of breast cancer. The changes that result from cosmetic breast surgeries, such as architectural scars, calcifications that form around an implant or around fat necrosis, and tissue thickenings make it more difficult to distinguish surgery artifacts from cancerous tumors.

Discussion:

It is the surgeon's choice whether to order a mammogram before cosmetic breast surgery on a patient under the age of 40. Patients under the age of 40 who refuse to have a requested preoperative mammogram may be safely operated upon, but the refusal should be noted in the medical record. This will help to protect the physician if there is future litigation. It is also the physician's choice whether to do cosmetic breast surgery on patients over the age of 40 who refuse a preoperative mammogram.

Conclusion:

Whether a mammogram is performed or not, the patient should be fully informed of the possible consequences of missing a significant abnormality early before surgery and that an implant or cosmetic surgery may reduce the chance of early detection of cancer.
Experience with Facelifting after Failed Barbed Sutures
Authors: Kumar Bobby A. , Hodgkinson Darryl J.
Published: January 2017

Barbed sutures inserted by closed technique offer temporary improvement to patients seeking facial rejuvenation. The supposed advantages of barbed sutures over open facelift and browlifting techniques include less morbidity, downtime, and financial strain, and the fact that patients are more accepting of a less than optimal result than with an open technique. Unlike other temporary procedures, such as those using Botox and hylauronic fillers, which disappear over time, permanent barbed sutures remain as a foreign body that must be negotiated when subsequent open techniques are performed. It is the authors' experience that many patients present for open facelift procedures because of dissatisfaction or complications following use of closed barbed sutures. When approaching an open facelift after closed barbed suture placement, surgeons should be cognizant of unique technical problems and challenges that might compromise the final facelift result; these must be overcome.
Three Important Considerations in Posttraumatic Rhinoplasty
Authors: Low Brian , Massoomi Nima , Fattahi Tirbod
Published: January 2017

Introduction:

Many factors must be considered when performing a posttraumatic rhinoplasty. Since nasal fractures are the most common fractures in the adult facial skeleton, many patients who suffer midface trauma also suffer from nasal deformity/deviation and nasal airflow impedance. There are three specific regions within the nose which may impede airflow: nasal septum, internal nasal valves, and inferior turbinates. Each component of functional and posttraumatic rhinoplasty has been studied independently. However, a review of posttraumatic rhinoplasty procedures in which multiple regions of the nasal anatomy were addressed, when indicated, has not been elucidated much in the literature.

Materials and Methods:

A retrospective review of the medical charts and operative reports of 42 consecutive patients who underwent a post-traumatic rhinoplasty from July 2002 to December 2006 by the same surgeon was undertaken to determine which specific regions of the nose required secondary repair. Postoperative results were then reviewed to determine objective complications and subjective complaints. The specific techniques employed in the each operative procedure were then analyzed and objective complications and subjective complaints were recorded.

Results:

The most common preoperative patient complaint included difficulty breathing and nasal complex deformity followed by difficulty breathing alone and isolated deviation/deformity. The most common preoperative objective findings included airflow obstruction and nasal deformity, followed by isolated airflow obstruction, and isolated deviation/deformity with no air flow disturbance. All patients underwent a secondary posttraumatic septorhinoplasty. Septoplasty was performed in 78.6% of the patients; spreader grafts were used in 74% of the patients, and inferior turbinate surgery was done in 62% of the patients. Postoperatively, subjective findings revealed no complaints in 38 patients (90.5%). Two patients had complaints of persistent nasal deformity and air flow obstruction; 1 patient had persistent nasal deformity, and another patient had persistent air flow obstruction. Objectively, 5 patients had persistent nasal deformity, 2 patients had persistent air flow obstruction, and two patients had persistent airflow obstruction and nasal deformity.

Conclusion:

When indicated, by appropriately addressing the key regions of the nasal complex, including the septum, internal nasal valves, and inferior turbinates, the majority of patients (90.5%) will have no subjective complaints of difficulty breathing or a nasal complex deformity.
The Effect of Mechanical Stress on Adipocyte Morphology and Metabolism
Authors: Campbell Graham LeM. , Laudenslager Nan , Newman Julius
Published: January 2017

This paper describes the effect of mechanical stress following lipo-suction surgery and passage of fat pads through needles on adipocyte morphology and metabolism. Biochemical assays for glucose oxidation, lipid synthesis, and insulin stimulation confirm the morphological evaluations, i.e., needles larger than 20 gauge have little, if any, effect. New strategies need to be developed for injection of adipocytes using needles smaller than 20 gauge. In addition, these assays may prove useful for clinicians to optimize fat pad preparation and the use of biological modifiers to enhance the successful outcome of autogenous lipografts.
Revision Rhinoplasty—Open Approach
Authors: Glasgold Alvin I.
Published: January 2017

Revision rhinoplasty has always been a great challenge. Often the difficulty is related to the inability to ascertain the cause of the problem. Sometimes correction is unreliable because of changes occurring during the healing process. Because of this, many qualified rhinoplastic surgeons shy away from revision surgery. In many cases an unsatisfactory result is left uncorrected, resulting in an unhappy patient.

The open approach to revision rhinoplasty has greatly enhanced the predictability of the results, particularly in tip revision. This occurs because the open technique exposes the cause of the problem directly and allows for a more accurate assessment of the means to be instituted in correcting the problem.
A Case for Traditional Surgical Treatment of Postrhinoplasty Arteriovenous Malformations
Authors: Gilmore Jim
Published: January 2017

Arteriovenous malformations or hemangiomas are rarely reported complications postrhinoplasty. While surgical lasers are gaining increasing use in the treatment of other etiologies of arteriovenous malformation, the potential for unacceptable cosmetic results justifies examination of other, more traditional techniques for repair of these difficult vascular problems. This case presentation details a successful surgical approach to treatment of the postrhinoplasty arteriovenous malformation and outlines the clinical judgments and findings used to rule out use of the laser as a primary surgical modality.
Unusual and Late Complication of Polyurethane-Coated Prosthesis—Intraprosthetic Hematoma
Authors: Jackson Robert F. , Jackson Robert F.
Published: January 2017

This case report deals with what we believe to be a previously unreported complication using the polyurethane-coated breast implants. Our patient presented with unilateral intraprosthetic breast prosthesis enlargement resulting in pain and excessive stretching of the skin. The focus of this study is to present the history, treatment, and possible explanations for the findings in this case.

Many have proposed the polyurethane-covered breast implants as the answer to the plaguing problems of contracture and firmness as well as recommending them for general use in augmentation mammoplasty. As use of the polyurethane-coated implants increases, there will no doubt be an increase in complications with these implants. In our experience of over 2 years with 60 patients, 120 implants total, with the Meme and Replicon implants, we have encountered only one major complication. Although nearly all of our patients have had satisfactory results, the one significant complication encountered was that of a unilateral, intraprosthetic enlargement 14 months postoperatively, resulting in intractable breast pain and excessive stretching of the skin. After failure at conservative therapy, surgery was required, and it was possible to examine the prosthesis and shed some light on the plausible causes of this phenomenon.
Suction-Assisted Lipectomy: A New Way to Prevent Postsurgical Skin Waves
Authors: Botti Giovanni
Published: January 2017

Although suction-assisted lipectomy (SAL) is becoming widely used, problems still arise from it. The occurrence of postsurgical skin waves clearly causes difficulties for surgeons. A surgical approach is presented that prevents these irregularities in the treated areas.

For the past 10 years, suction-assisted lipectomy (SAL) has proved to be one of the most effective techniques in solving the problem of localized adiposity.

SAL is a simple procedure which is becoming widespread throughout the world. It is also associated with other surgical operations such as face and neck lifts, abdominal lifts, thigh lifts, and breast reduction. This technique has become increasingly refined so that it produces very effective and exciting results. Nevertheless, an unsolved problem persists: the possibility of creating unattractive depressions or holes in the treated areas.

As is known, cosmetic surgical operations are performed not out of urgency or because of a need to treat a physical disease, but for aesthetic purposes. For this reason, any iatrogenic damage to the patient is of great concern, and doctors who perform such operations are oriented toward avoiding these complications.

The problem of skin waves which many physicians face today needs to be addressed. Although waves may appear after an operation and disappear quickly thereafter, in many cases a permanent mark in the skin occurs and is not easily remedied after the operation.
Benign Breast Calcifications
Authors: Johnson Gerald W.
Published: January 2017

Benign calcifications in the breast have been observed following breast biopsy, trauma, abscess, augmentation with prosthetic devices, reduction mammoplasty and mastopexy, and augmentation with autogenous fat grafts. These calcifications are generally thought to follow fat necrosis. However, fat necrosis in the breast is more likely to result in calcifications than similar necrosis elsewhere in the body. The author offers a theory that trauma, whether accidental or surgical, can cause not only fat necrosis, but also glandular damage or necrosis that releases an unknown mammary factor (tentatively called Factor MX) that promotes calcium concentration and reacts with the fatty acids to form calcifications.

The literature on breast calcifications following surgery is reviewed, and four case reports are presented. The author makes the point that the use of fat injection techniques for breast augmentation has not been proved to be any more likely to result in eventual breast calcifications than are numerous other surgical procedures. Therefore, criticism of this technique based on the potential for unnecessary biopsies at a later date is unwarranted.

Benign calcifications have been observed following breast biopsy, trauma, abscess, augmentation using prosthetic devices, reduction mammoplasty, mastopexy, and augmentation with autogenous fat graft. These calcifications are usually thought to follow fat necrosis. We present a summary of the literature and four case reports of benign breast calcifications, three involving patients who developed calcifications following augmentation with silicone prosthetic devices and the fourth, a patient who developed a calcification 4 years after an augmentation using autogenous fat.
History of Dermatologic Cosmetic Surgery
Authors: Hanke C. William , Coleman William P. , Francis Lisa A.
Published: January 2017

Dermatology has been one of the major disciplines that has contributed to the rapid advancement of cosmetic surgery. Various cosmetic procedures including chemical peel, dermabrasion, hair transplantation, laser surgery, soft-tissue augmentation, and liposuction have been refined or developed by dermatologists. This article describes the involvement by dermatologists in these cosmetic procedures.
Hair Transplantation by the Feathering Zone Technique: New Tools for the Nineties
Authors: Stough Dowling B.
Published: January 2017

In recent years, hair transplant surgeons have placed emphasis on refining the frontal hairline with minigrafts and micrografts in order to achieve a totally natural appearance. Minigrafts and micrografts can be used in areas other than the frontal hairline with excellent results. This article describes the newest techniques for harvesting and transplanting micrografts.
Electrocautery Smoke Elimination
Authors: Hirschfeld Jack J. , Niloff Paul H.
Published: January 2017

Smoke plumes resulting from electrocautery contain many potentially hazardous components. The composition of electrocautery smoke is reviewed. A simple and practical method for removal of these materials is described.
Fundamental Terms and Considerations in Rhinoplasty
Authors: Alexander Robert W. , Bailey Michael R.
Published: January 2017

This paper offers a review of important fundamental terms and considerations in rhinoplasty, with presentation of clear and concise terminology necessary to interpret and communicate with rhinoplastic surgeons and the literature. Afundamental discussion of patient selection considerations, surgical planes, incisions and approaches, and support structures is provided. A review of primary and secondary cartilagenous support mechanisms is followed by an overview of basic nasal tip support considerations. Emphasis on performing rhinoplasty in a logical, planned sequence of incisions and approaches that affords maximum intraoperative surgical flexibility for the cosmetic surgeon is given.
Silicone Gel Implants Associated with Autoimmune/Connective Tissue Disease
Authors: Shiffman Melvin A.
Published: January 2017

The association of silicone implants with autoimmune disease is comprehensively reviewed and four new cases presented. In some instances of reported cases there appears to be a cause-and-effect relationship between silicone gel implants and the onset of autoimmune diseases, although in most cases the disease appears to be more likely the expected occurrence rate in females of this age group. Basic criteria for establishing a possible causative relationship are presented.
Current Concepts in Alopecia Correction in the Black Patient
Authors: Randall John Karl , Schauder Craig S.
Published: January 2017

Current concepts of alopecia correction in black men and women address recent advances in alopecia correction surgery. Due to the plethora of new information presented in the past few years, there is a need for updated information in the surgical correction of alopecia in black patients. New harvesting techniques for hair transplantation are discussed, as well as new grafting procedures. A precis of current trends in scalp reductions, scalp extenders, and scalp lifting is also undertaken.
Complications of Augmentation Mentoplasty: A Review of 11,095 Cases
Authors: Scaccia Frank J. , Allphin Allan L. , Stepnick David W.
Published: January 2017

Augmentation mentoplasty is an increasingly common surgical procedure that reshapes the contour of the mental area. Presently, there is a paucity of information comparing the efficacy and potential complications of the various techniques and implant materials now utilized in correcting chin deficiencies. A survey was thus devised and sent to Fellows of the American Academy of Facial Plastic and Reconstructive Surgery. Ninety-two surgeons responded describing their results on 11,095 mentoplasty procedures. The overall complication rate was 7.6% with both intraoral and extraoral approaches having similar morbidity. Silicone prostheses had the lowest complication rate, while a higher incidence was associated with acrylic and Proplast® products. The ideal implant has yet to be found and the search should continue for more suitable materials.
Reduction Mammaplasty Using Nd:YAG Contact Tip Laser
Authors: Park Jung I.
Published: January 2017

Nd:YAG laser with contact tip provides unique advantages over a cold knife and electrocautery in a surgical dissection. The Nd:YAG laser places somewhere in the middle between the traditional electrocautery and the CO2 laser. The Nd:YAG laser has much less tissue damage compared to electrocautery. On the other hand, this laser has afar better ability to coagulate the blood vessels and the advantage of easy maneuverability as compared to the CO2 laser. The author presents his experiences in Nd:YAG laser contact tip for reduction mammaplasty. Seventeen reduction mammaplasties using Nd:YAG contact laser tip were presented. Several patients returned to work within a week after surgery. One patient was well enough to volunteer to go back to work on the fourth post-operative day. The Nd:YAG laser physics, equipment, applications, and surgical cases are discussed.
Expanded Bilateral Advancement Transposition (BAT) and Triple Advancement Transposition (TAT) Flaps for Treatment of Male Pattern Baldness
Authors: Anderson Richard D.
Published: January 2017

The purpose of this paper is to present and describe the Anderson Expanded Bilateral Advancement Transposition (BAT) Flap and Triple Advancement Transposition (TAT) Flap techniques for elimination of moderate and extensive degrees of male pattern baldness. The advantages, disadvantages, and results will also be presented.

At the present time, despite claims of success with various medical treatments, there is no nonsurgical method that will predictably reverse balding or stimulate the growth of new hair. The best results for the treatment of male pattern baldness and the popularity and predictability of hair replacement surgical techniques have advanced dramatically in recent years.

Scalp expansion definitely ranks as one of the most significant advances in surgical hair replacement in the last century. The goal of all our hair replacement surgery techniques is the most efficient and effective use of the remaining hair follicles to cover the bald or balding area. Expanded scalp flaps accomplish this goal in an effective and efficient manner.
Repair of Scalp Necroses Secondary to Scalp-Lifting Using Strip Donor Harvesting in Combination with a V-T Plasty
Authors: Brandy Dominic A.
Published: January 2017

Extensive scalp-lifting is a technique that involves undermining and advancement of the entire occipitoparietal scalp in an upward and inward direction. Because such a large area is undermined with this operation, scalp necrosis can occur at the nuchal ridge. Although the incidence of this complication has been virtually eliminated by using prior ligations of the occipital arteries through vertical incisions, the possibility still exists. This article, therefore, is written to briefly point out methods to significantly reduce the incidence and magnitude of the necroses and ways to repair this complication should it appear. A combination of a V-T plasty and cluster harvesting is used for amelioration of this problem should it occur and is hence demonstrated.
Relating Hair Growth Theory and Experimental Evidence to Practical Hair Transplantation
Authors: Limmer Bobby L. , Razmi Ronald , Davis Thomas , Stevens Charles
Published: January 2017

Hair transplantation methods as generally practiced utilize grafting of full follicles. Recent experimental evidence suggests that germinal cells responsible for follicular growth and differentiation may reside in specific localized areas within the follicle. This study was performed to relate experimental evidence to practical hair transplantation and to discuss results obtained from implantation of ½ follicular grafts. The study was done on four male patients with androgenetic alopecia who underwent transplantation with follicular half autografts. A total of 697 grafts of the upper ½ follicles and 694 grafts of lower ½ follicles were implanted. The results demonstrated that 50 hair shafts were produced from 697 upper ½ grafts, and 152 hair shafts from 694 lower ½ grafts. The conclusion is that the low percentage of terminal hair growth from ½ follicular grafts preclude this technique as an alternative method for cosmetic hair transplantation.
Augmentation Cheiloplasty: A Comparison of Different Techniques
Authors: Trimas Scott J. , Ellis David A.F.
Published: January 2017

The youthful and aesthetic lip is comprised of a full upper lip with a definite demarcation between the red “mucosa” and white “cutaneous” surfaces. The upper lip arches gracefully upward forming a Cupid's bow. The lower lip is comprised of a full red mucosa slightly larger than the upper lip. With aging, there is a progressive atrophy of the mucosa, subcutaneous tissue, and muscle, resulting in a thinner, less defined, upper and lower lip complex. Various surgical techniques have evolved to treat and augment the thin and inadequate lip. We performed a retrospective review of 44 patients over the last five years who underwent augmentation cheiloplasty for thin and deficient lips. We describe our results here and offer a comparison of the different methods available for lip augmentation (surgical lip advancement, collagen injection, and alloplastic material). Finally, we show the evolution in our treatment of the aged, thin, and deficient lip over the last five years.
Tubing Introducing Forceps—A New Instrument for Placement of Slit Micrografts and Minigrafts
Authors: Greco Joseph F.
Published: January 2017

This article introduces a new instrument and technique to facilitate slit mini- and micrograft placement, the tubing introducing forceps (TIF), and illustrates how the unique design of the TIF reduces follicular trauma when compared to traditional methods of direct placement with forceps (with or without dilators). Comparisons are made with TIF and traditional fine tissue forceps (with or without dilators). When compared with forceps-only placement of micrografts (with or without dilators) the TIF causes less trauma, eliminates the use of dilators, permits easy placement of micrografts, and decreases operating time. The TIF is a unique instrument that can decrease follicular trauma when compared to direct forceps placement of micrografts into slit incisions. It can be utilized as a planting forceps or a retractor for easy placement of micrografts.
Starch Granuloma following Liposuction—The Persisting Hazards
Authors: Baruchin Abraham M. , Ben-Dor David , Eventhal Dan
Published: January 2017

This report of a case illustrates the formation of starch granulomas following liposuction. The incidence of this complication is currently unknown and has not been adequately discussed in the medical literature.
Resorbable Screw Use for Endoscopic Browlift
Authors: Webber Caroline M. , Fidler John E. , Wilhelm Miles L.
Published: January 2017

Introduction:

Resorbable plates and screws have previously been used safely in patients for trauma and reconstruction. Screws made of the copolymer of poly-L-lactic acid (PLLA) and polyglycolic acid (PGA) have excellent strength and are completely resorbed. These characteristics make them ideal for endoscopic browlift patients.

Materials and Methods:

Endoscopic browlift incisions are made 1 or 2 cm behind the hairline and include a midline incision, paramedian incisions above the point of maximum desired lift, and curvilinear incisions in the temporal regions. The endoscope and dissectors are used through the incisions to complete the standard dissection. One resorbable screw is placed at the posterior portion of each paramedian incision. A suspension suture that has been passed through scalp tissue 1 or 2 cm anterior to the front of the incision is tied around the screw to obtain lift. Over a period of 1 year, 54 resorbable screws were placed in 27 patients using this technique; 22 of the patients were women and 5 were men.

Results:

Of these 27 patients, 10 have been followed up postoperatively for at least 1 year. There have been no complications reported to date: no infections, foreign body reactions, unsightly scars, hematomas, alopecia, or neurologic defects. All patients have been extremely satisfied with the results of this surgery.

Conclusions:

Preliminary results show that resorbable screws are safe for use during endoscopic browlift. Advantages over metal screw placement include longer retention of the scalp in its new lifted position, elimination of a second procedure to remove surgical hardware, and decreased incidence of depressed or hypertrophic scars. Placement method is technically easy for the surgeon to learn.
Fat Grafting: Techniques and Uses in Different Anatomic Areas
Authors: Hernández-Pérez Enríque , Lozano-Guarin Carlos
Published: January 2017

Introduction:

Fat grafting can be used to place fat in the face, hands, breasts, buttocks, calves, and genitals for cosmetic purposes. The procedure is also used to reconstruct some congenital abnormalities (such as hemifacial atrophy) or to correct selected traumatic facial defects; it may also be used in combination with other surgical procedures (facelifts) or as part of a facial rejuvenation program. We present a review of the steps for fat grafting performed at our center. We have experienced excellent cosmetic results using these techniques.

Method and Materials:

Of the 867 patients, 367 underwent facial fat transplant; 153 underwent bilateral augmentation mammaplasty by injection (BAMBI); 67 underwent fat injections to the buttock, calves, and other areas of the body; and 280 received fat grafts to the genitalia. Two hundred seventeen patients were men and 63 were women. The operations were performed as ambulatory procedures. Local anesthesia and intravenous (IV) sedation (midazolam plus fentanyl) were used. For all of our patients, we used a modification of the classic Klein formula. All of our patients were operated on under IV sedation.

Results:

Fat survival was approximately 70% at the end of 1 year. Of the 367 patients undergoing facial fat transplant, 65% were satisfied with the results, and 35% were not satisfied and required a touch-up procedure. Of the 153 undergoing BAMBI, 72% were satisfied with the results, and 28% were not satisfied and required touch-up procedures. Of the 67 patients undergoing fat transplant to the buttocks, calves, and other areas, 76% were satisfied, and 24% were not satisfied and required additional fat grafting. Of the 217 men undergoing genital fat transplant, 82% were satisfied with the results, and 18% were not satisfied. Of the 63 women undergoing genital fat transplant, 86% were satisfied with the results, and 14% were not satisfied. Absorption, infection, and embolism are the most common complications mentioned in the cases of fat injection. Out of 867 total fat transplant operations, absorption occurred after 1 procedure in an average of 30% of cases. In 5 cases, we saw some degree of infection, which was rapidly treated with antibiotics. We did not see any cases of fat embolism. We saw 2 cases of cysts in the dorsum of the hands and 2 in the breasts; these cysts were easily treated with triamcinolone injections.

Discussion:

When administered properly, autologous fat transplantation is an acceptable procedure resulting in highly satisfied patients. This satisfaction is mostly due to the fact that this process utilizes the patients' own tissue instead of a prosthetic or synthetic implant. Rejection or allergic reaction is not possible with autologous tissue.
Liposculpture of Legs Using a Tourniquet
Authors: Cherif-Zahar K.
Published: January 2017

Introduction:

This study describes the author's technique and discusses and the advantages and drawbacks of using a tourniquet to perform liposculpture on the legs.

Materials and Methods:

One hundred patients (1 man and 99 women) were followed for more than 4 years after receiving liposculpture of the calves and ankles. The patients ranged in age from 21 to 71 years (mean 44 years). Their motivation for treatment was to seek relief from painful excess fat. All of the patients had a preoperative Doppler study and a photographic sketch. Circumference measurements were taken every 5 cm from the malleolus before and after surgery. Operative tourniquet time and the volume of aspirated fat was recorded.

Results:

Most of the patients (96%) were satisfied with the results of the treatment at 6 months, and 95% reported an easy postoperative recovery. Some patients reported feeling that their legs were lighter (86%), and 6% of the patients experienced a reduction in shoe size. No phlebitis occurred. One patient had a tourniquet deflation during the procedure, which resulted immediately in a bloody aspirate, followed by marked edema, ecchymosis, and pain.

Conclusions:

Liposuction of the legs with a pneumatic tourniquet is an attractive technique for the surgeon because it allows the surgeon to go beyond the usual limits of liposuction of the legs in both extracted volume and treated surface. The absence of infiltration and blood in the fat reduces the distortion of the tissue, and the surgeon can more accurately view and sculpt the parts of the legs being treated. Liposculpture with a tourniquet allows the surgeon to obtain better cosmetic results with fewer postoperative problems.
Immunolocalization of PTCH Protein in Odontogenic Cysts and Tumors
Authors: Barreto D.C. , Bale A.E. , De Marco L. , Gomez R.S.
Published: January 2017

The human patched gene ( PTCH) functions in both embryologic development and tumor suppression. PTCH mutations have been found in odontogenic keratocysts. However, the expression and localization of the protein product of the gene have not been determined in odontogenic tumors and cysts. We investigated 68 odontogenic lesions by immunohistochemistry, and compared their PTCH expression with that in basal cell carcinomas. All odontogenic lesions, including two keratocysts with truncating mutations, were positive for PTCH. Different types of lesions had different amounts of staining. Lack of staining was noted in the majority of basal cell carcinomas. Taken together, these data suggest that odontogenic keratocysts arise with heterozygous mutations of the PTCH gene.
A DNA Vaccine Encoding a Cell-surface Protein Antigen of Streptococcus mutans Protects Gnotobiotic Rats from Caries
Authors: Fan M.W. , Bian Z. , Peng Z.X. , Zhong Y. , Chen Z. , Peng B. , Jia R.
Published: January 2017

A cell-surface protein antigen (PAc) of Streptococcus mutans is considered a virulence factor because it may mediate initial attachment of Streptococcus mutans to tooth surfaces. Thus, inhibiting PAc is predicted to provide protection against caries. To develop vaccines against dental caries, we constructed a DNA vaccine, pCIA-P, which encodes two high-conservative regions of PAc. Expression of the recombinant protein was obtained in eukaryotic cells in vitro and in vivo. In this report, we provide evidence that fewer caries lesions, and high levels of PAc-specific salivary IgA antibody and serum IgG antibody, were observed in gnotobiotic rats following targeted salivary gland (TSG) administration of pCIA-P. This study shows that the recombinant DNA vaccine pCIA-P could induce protective anti-caries immune responses and that TSG immunization is a promising strategy for the inhibition of dental caries.
Fabrication of Zn-Sr–doped laser-spinning glass nanofibers with antibacterial properties
Authors: Echezarreta-López María Magdalena , de Miguel Trinidad , Quintero Félix , Pou Juan , Landín Mariana
Published: January 2017

The morphology and dimensions of bioactive materials are essential attributes to promote tissue culture. Bioactive materials with nanofibrous structure have excellent potential to be used as bone-defect fillers, since they mimic the collagen in the extracellular matrix. On the other hand, bioactive glasses with applications in regenerative medicine may present antibacterial properties, which depend on glass composition, concentration and the microorganisms tested. Likewise, their morphology may influence their antibacterial activity too. In the present work, the laser-spinning technique was used to produce bioactive glass nanofibers of two different compositions: 45S5 Bioglass® and ICIE16M, bioactive glass doped with zinc and strontium. Their antibacterial activity against Staphylococcus aureus was tested by culturing them in dynamic conditions. Bacterial growth index profiles during the first days of experiment can be explained by the variations in the pH values of the media. The bactericidal effect of the doped nanofibers at longer times is justified by the release of zinc and strontium ions. Cytotoxicity was analyzed by means of cell viability tests performed with BALB/3T3 cell line.
Access to Justice for Immigrants Who are Victimized: The Perspectives of Police and Prosecutors
Authors: Davis Robert C. , Erez Edna , Avitabile Nancy
Published: January 2017

The increased diversity of the U.S. population poses special challenges to the criminal justice system. High levels of immigration to the United States within the past decade require that law enforcement and court organizations understand the concerns of crime victims who are recent immigrants, and facilitate meaningful access to the justice system. Employing survey methodology, this research describes the barriers that immigrants encounter in accessing justice, as they emerged from the responses of police chiefs and prosecutors in the 50 largest cities of the United States. Criminal justice officials believe that failure to report crimes and to cooperate in their prosecution is a significant problem, especially for domestic violence offenses. The results suggest that many metropolitan areas have made some efforts to promote participation of immigrant victims in the criminal justice system. But far more needs to be done to ensure access to justice for this growing segment of society.
Current Practices in the Use of Televised Child Testimony: Questions of Constitutionality and Personal Biases
Authors: Hamill Sharon Boland , Graham Ernest S. , Thomason Emmett , Huerta-Choy Renee
Published: January 2017

This study surveyed prosecuting attorneys' offices to determine the current practices involving the use of televised testimony of child witnesses. Members (or designates) of the National District Attorneys Association (n = 768) completed questionnaires that assessed whether they had ever used televised child testimony and whether its use had led to an appeal. Respondents who had never used televised testimony were asked to indicate the reason(s) why they had chosen not to use it. Results suggested that televised testimony is not a common practice among respondents in that only 17.1% of the sample used it. If a respondent did use it, it was unlikely to lead to an appeal (only 22.9% of the time). Respondents who had never used this type of testimony reported that a variety of legal and practical restrictions, as well as their own personal beliefs, prevented them from doing so. Results are discussed in terms of the controversy regarding the use of televised testimony.
X-Rated X-Ray Invades Privacy Rights
Authors: Murphy Michael C. , Wilds Michael R.
Published: January 2017

X-rated X-ray machines utilizing backscatter technology are strip-searching unsuspecting travelers as they pass through our nation's border and airport checkpoints. These machines not only check for explosives, drugs, or other contraband, but also are capable of counting hairs on a man's chest or measuring the depth of a woman's navel. At the same time the machines are checking for contraband, they can produce an X-rated image comparable in quality to those found in Playboy magazine. This article focuses on the efficacy of the device, the need to protect society, and individual privacy rights in light of the boundaries provided by Fourth Amendment search and seizure laws. Supporting arguments advanced for use of backscatter technology include (a) the enhanced security to society, (b) reduced invasiveness of the search, and (c) the reduction in health risks associated with the use of the devices. Opposing arguments focus upon the slippery slope and unacceptable degree of intrusion upon the privacy rights of the individual. The article concludes by framing the legal arguments within an analysis of the opportunity costs associated with implementation of the X-rated X-ray devices.
The MSA and the McCain Tobacco Bill: Smoke without a Fire?
Authors: McSkimming Michael J. , Smith Nora A.
Published: January 2017

This article critically examines the mandates of the McCain Tobacco Bill and the Master Settlement Agreement toward addressing the youth smoking crisis in the United States. An overview of teenage smoking trends is presented, followed by the legislative history of the McCain Tobacco Bill and the Master Settlement Agreement. Reactions to this legislation are discussed, as well as predicted consequences. A review of the literature on youth smoking prevention, rooted in risk taking and social control theory, is presented. Empirical and theoretical support is provided for suggesting alternative solutions. The need for a comprehensive, coordinated approach involving law enforcement, the media, the family, and the educational system is described.