bluuebunny/crossref_metadata_2025_split huggingface dataset:
Marcaine: A Dependable Local Anesthetic for Breast Augmentation
Authors: Dampier Loucinda R. , Smith Lane F. 
Published: January 2017

Background: Many investigators have evaluated the utility of local anesthetic use before, during, and after augmentation mammoplasty. Routes used include subcutaneous injections, intercostal nerve blocks, pump infusions, drain infusions, and “splashing” into the submuscular pocket. Although many of these techniques yield statistically significant results, they can add time to the operation and can cause additional complications. In particular, local anesthetic pump infusions add significant cost and require a foreign body to be in contact with the skin in a pocket with a sterile implant. We sought to find an affordable solution that would decrease postoperative recovery time, reduce narcotic requirements, and decrease pain in the early postoperative period without adding significant cost or risk to the procedure. Objective: To determine whether Marcaine placement into the breast pocket during breast augmentation actually improves patient pain in the early postoperative period, and to determine whether this therapy has any detrimental effects. Methods: This double-blind, randomized study was undertaken to compare the effects of placing 10 mL 0.25% Marcaine with epinephrine into 1 or both breast pockets of each patient undergoing bilateral breast augmentation. We sought to evaluate whether this therapy improved postoperative pain and to assess the safety of using Marcaine for this purpose. Results: A total of 26 patients voluntarily enrolled in and completed our study. Of these, 25 received Marcaine in 1 or both breast pockets. In all, 24 patients reported less pain on the Marcaine-infused side, and 1 believed that her pain was equal in the 2 breasts. Among 4 patients who received Marcaine in both pockets, no narcotics were required in the recovery suite. No negative reactions to Marcaine were reported in any patient, nor were any infections or hematomas noted. Conclusions: Placing 10 mL of 0.25% Marcaine with epinephrine into each breast pocket during breast augmentation is a safe and effective form of early postoperative analgesia.
Body Dysmorphic Disorder
Authors: Shiffman Melvin A. 
Published: January 2017

Introduction: Body dysmorphia disorder (BDD) is defined as a preoccupation with an imagined or a very slight defect in physical appearance that causes significant distress to the individual. Patients with body dysmorphia may approach cosmetic surgeons or dermatologists seeking surgery or medical treatments, and this places the doctor at risk of having a patient who is continually dissatisfied with whatever is done. Symptoms: With BDD there is preoccupation with the supposed appearance problem. The patient takes actions to “hide” the defect or avoid certain situations because they feel ugly and do not want to be seen by others. Many patients with BDD also suffer from depression and from obsessive compulsive disorders, such as eating disorders, anxiety disorders, trichotillomania (hair pulling), and abuse of drugs or alcohol. There is a high rate of suicidal ideation. Discussion: Serotonin-reuptake inhibitors (SRIs) are a group of medications that appear to be useful and effective in patients with BDD. Cognitive behavioral therapy appears to be an effective treatment for BDD. The behavioral component consists of exposure and response prevention, where the patient exposes his or her defect in situations that they would usually avoid and response prevention involves helping the patient stop the compulsive behavior related to the defect. Conclusion: Treatment for patients with BDD is medication, usually SRIs, or psychiatric care with cognitive behavioral therapy. Surgeons need to identify patients with BDD before surgery, tell them that surgery is not the treatment for their problem, and refer them to a psychiatrist for treatment.
Low-Level Laser Therapy Effectiveness for Reducing Pain after Breast Augmentation
Authors: Jackson Robert F. , Roche Gregory , Mangione Todd 
Published: January 2017

Introduction: The purpose of this Institutional Review Board (IRB)-approved, placebo-controlled, randomized, double-blinded parallel-grouped, multicenter trial was to determine the effectiveness of low-level laser therapy (LLLT) in decreasing patients' postoperative pain 24 hours post breast augmentation surgery. Materials and Methods: The Erchonia EML, 630–640 nm, (Erchonia Medicial, Inc., McKinney, Texas) with 2 7-mw laser-emitting diodes was used within 10 minutes of the start of the procedure over each breast for 4 minutes at a distance of 6 inches. This was repeated within 10 minutes of completion of the procedure with the same methodology. One hundred and four (104) patients participated in the study, 50 test subjects and 54 controls. Primary investigator and patient were blinded with respect to treatment group. Results: The success criteria for this study using the standardized Visual Analogue Scale (VAS) was a self-reported degree-of-pain rating of less than 30 at 24 hours after the implant procedure. At this time the patient had not taken pain medication for 4 hours. Overall study success criteria were defined as at least 30% difference between treatment groups with respect to proportion of successes. At the 24-hour time interval 37 (74%) of the test subjects and 20 (37%) of the control subjects met the success criteria, a difference of 37% (p<.0002). The amount of pain medication used over the first 7 days post operatively was measured as a covariant. The test subjects used less medication 848 versus 932 total doses (p<.01). Conclusion: Low-level laser therapy is effective at significantly decreasing postoperative pain and the amount of pain medication needed after breast augmentation at 1 day and 1 week respectfully. All other covariants studied including, implant type, implant size, incision size, implant location, test site location, amount of swelling measurements, hydration level, and adverse events were found to be neglible.
Ideal Breast LiftSM Augmentation Mastopexy for Moderately to Severely Ptotic Breasts: Previsualizing Breast Shape and Symmetry with an Innovative and Versatile Stapling Technique
Authors: Eisenberg Ted S. 
Published: January 2017

Introduction: Augmentation mastopexy is one of the more challenging surgeries. This article presents a new technique in which tailor tacking with skin staples provides maximum tightening of the redundant breast tissue and allows me to previsualize breast shape and symmetry—before the scalpel is raised for a 1-stage skin resection. I believe this is a more precise approach than the standard technique of drawing a pattern, resecting skin, and then tailor tacking the tissues together. Materials and Methods: A total of 41 patients with moderate to severe ptosis and hypotrophy were reviewed for this article. They all had bilateral submuscular saline breast augmentation with bilateral mastopexy with this stapling technique. Surgeries were performed over a 5-year period. The technique is described in detail. Preoperative and postoperative photographs are provided. Results: Patients reported great satisfaction with their results. Only 6 had small areas that healed by secondary intention, and only 1 patient had a mildly hypertrophic scar. Subjectively, this technique allowed me to achieve consistent, reproducible symmetry with single en bloc tissue resection and with less anxiety and guesswork. Conclusions: This augmentation/mastopexy technique produces predictable and reproducible results regardless of the implant size or the amount of skin that needs to be resected. With the adage of measure twice, cut once, it is very comforting to be able to preview the surgery results before having to cut skin.
Evaluation of a Web-based Patient Education Tool for Breast Augmentation
Authors: DeLuca-Pytell Danielle , Spanknebel Kathryn , Rosenberg Michael , Petro Jane , Bonanno Philip 
Published: January 2017

Introduction: To evaluate the utility of a Web-based educational tool for women who have had or who are considering breast augmentation. Materials and Methods: A definitive Web-based resource, http://www.breastimplantcare.com , was developed for use by patients and physicians, which summarizes, in lay terminology, contemporary, evidence-based information for decision-making and long-term follow-up regarding breast augmentation. Urchin Web analytics v.5.7.03 data and Google Analytics for Web site traffic reporting were analyzed. Results: Over a 1-year period, the Web site received over 12 800 hits. Within 6 months, there were 2548 unique visitors. The number of daily visitors has ranged from 12 to 71. The average visitor looks at 5 to 6 pages of the site. Monitoring Your Implants is the most popular page viewed. Patients have contacted this site from a wide geographic area looking for immediate postoperative advice and for help with long-term problems. Those with immediate postoperative questions are referred back to their treating physician. Though over 70 visitors have visited the pages with downloadable forms to be a part of a prospective study funded by the Cosmetic Surgery Foundation (CSF), only 5 new patients have joined the study. Discussion: This Web-based educational tool for women who have had or are considering breast augmentation has demonstrated utility in providing information and helping educate women who are considering or who have had breast augmentation. The site is less effective as a recruiting tool for the grant study, but from a Web marketing standpoint, it is a good return on investment.
Do You Know Your Fat? A Review of Adipose Tissue and its Implications in Cosmetic Surgery
Authors: Mallalieu Jared , O'Connell Adrienne , Forouzanpour Fardad 
Published: January 2017

Introduction: New procedures and technologies abound in cosmetic surgery as in other areas of medicine. It is critical that physicians performing cosmetic procedures involving adipose tissue have knowledge about the embryology, anatomy, and physiology of adipose tissue. This knowledge will allow informed decision making with regard to patient selection, procedure implementation, and postoperative expectations. Method: A review of the literature. Results: Anatomically, adipose tissue is an intricate structure consisting of a variety of cell types working together. It functions in thermoregulation of the body and provides protection for internal organs. Physiologically, it is an endocrine organ whose adipokines impact the entire body, including determining feelings of satiety and ultimately, body composition. Adipose metabolism is itself regulated by a host of hormones. Obese patients will likely experience complications, including those resulting from insulin resistance, diabetes, hypertension, hyperlipidemia, and hyperandrogenism in women. These complicating conditions are more strongly associated with intra-abdominal and upper body fat, than to overall adiposity. Discussion: The estimated prevalence of overweight individuals, when defined by body mass index (BMI) > 25, continues to rise. Currently, more than 60% of men and more than 55% of women fall into this category. The cosmetic surgeon must be aware that a patient with excess fat will be at an increased risk for intraoperative and postoperative complications associated with higher rates of diabetes, hypertension, and atherosclerosis. Surgeon and patient must consider the ramifications of fat volume removal, and the implications it has on the patient's metabolism and adipokine levels. Since the data about the ramification of manipulating of adipose tissue are conflicting, disrupting adipose tissue may have unforeseen consequences for the patient.
Auricular Sandwich Graft for Caudal Septal Augmentation
Authors: Newman Julius , Nguyen Abram , Anderson Roger 
Published: January 2017

Retraction of columella and collapse of nasal tip may be a primary phenomenon or secondary to poor results of rhinoplasty. This may be due to excessive resection of dorsocaudal septum or inappropriate removal of the nasal spine. Reconstruction of the columella is a difficult surgical procedure and many techniques have been described. This report describes a technique of interposition of a composite skin-conchal cartilage graft between the caudal septum and columella. The graft will restore the projection of the nasal tip and correct a retracted columella by increasing its base. The newly positioned columella forms an aesthetically acceptable obtuse angle with the lip and is 2–3 mm lower than the alar rims. The cartilage from the concha of the ear is an excellent grafting material for nasal reconstruction. It has been used for augmentation of the nasal dorsum, tip grafting, and correction of vestibular atresia. The graft is harvested utilizing a technique that allows for minimal postoperative auricular deformity at the donor site. Aesthetic results have been satisfactory, with very low morbidity following this method.
Silicone Breast Implants and Cancer
Authors: Shiffman Melvin A. 
Published: January 2017

Cancer is a result of genetic changes precipitated by heredity, viruses, industrial agents, drugs, radiation, diet, and many other unknown agencies. At least 2 and perhaps as many as 10 or more chromosomal abnormalities are necessary. Certain genetic aberrations cause the malignancy to become more aggressive and metastasize. At this time, there is little evidence that silicone can cause cancer in the human except, perhaps, under the theory of solid-state carcinogenesis. Information on all types of cancers in patients with silicone breast implants has to be gathered. Prospective studies must be started and retrospective analyses and clinical cases should be reported. This article adds six new cases to the record and offers a review of the literature.
Use of Auricular Cartilage for Reconstruction of Cartilaginous Defects of the Nose: Emphasis on Reconstruction of the Lower Lateral Cartilage Complex
Authors: Bartlett John Andrew , Hilger Peter A. 
Published: January 2017

During a year of fellowship with Dr. R. C. Webster, a preceptor with the American Academy of Facial Plastic and Reconstructive Surgery Fellowship Program, the senior author was introduced to innovative techniques utilizing conchal cartilage to repair various defects of the nasal tip. In the past 15 years of practice, we have modified his technique slightly but many of his basic concepts and principles remain. We have replaced the entire lower lateral cartilage complex as well as segmental defects of the nose. The presentation will review techniques for reconstruction of the entire lower lateral cartilage complex, as well as segmental defects due to trauma, previous surgery, congenital defects and defects secondary to oncologic resection. Preoperative and postoperative case presentations will highlight salient surgical principles.
Herpes Simplex Flare-Ups following CO2 Laser Resurfacing
Authors: Fulton James E. 
Published: January 2017

Background: Outbreaks of herpes simplex have plagued the patient and the physician since skin resurfacing began. The outbreaks are becoming more frequent and more difficult to treat. Objective: To present several case histories demonstrating unusual cases and therapeutic difficulties of skin resurfacing in patients with herpes simplex. Methods: Patients were usually placed on antivirals at the time of skin resurfacing. This therapeutic plan was not always successful. Results: Several patients had herpes simplex flare-ups after skin resurfacing. They were not easily controlled with acyclovir. Conclusions: A high index of suspension is needed to diagnose herpes simplex flare-ups after skin resurfacing. The new antivirals, famciclovir and valacyclovir, may have a better therapeutic index for success in the future.
A New Camera for Cosmetic Surgery
Authors: Shiffman Melvin A. 
Published: January 2017

Introduction: The use of a camera is essential in cosmetic surgery to record results using preoperative and postoperative photographs. The Polaroid Macro 5 SLR is a new camera for close-up photographs. The camera was examined to evaluate the ease of its use and the quality of the close-up photos. Materials and Methods: Photographs were reproduced at the settings available; these settings are: 0.2× (20%), 0.4× (40%), 1× (100%), 2× (200%), and 3× (300%). Multiple exposures were utilized in six patients to show a variety of problems such as skin lesions, facial abnormalities, and ryhtids. Results: The instant photos were of high quality with accurate reproduction of the abnormalities. The camera was easy to load, focus, and use. Discussion: The Polaroid camera takes exposures with almost instant reproduction of the abnormality. There is no need to wait for the results or to send the film out for processing. Since the Macro 5 SLR is only for close-up photographs, the camera is limited to subjects only as large as the head. Another camera is necessary for exposures requiring larger portions of the body. The close-up photography does not require lens changes but has a convenient rotating magnification selector knob. This easy-to-use camera is an excellent addition to the needs of the cosmetic surgeon who requires photos of small areas.
The Mushroom Technique for Penile Enhancement
Authors: Sito Giuseppe , Sorrentino Laura 
Published: January 2017

Introduction: Penile enhancement is used to increase patient appearance, confidence, and sexual satisfaction. This study was undertaken to evaluate the effect of a mushroom technique in terms of its simplicity, its effectiveness, and in terms of the prolonged enhancement it provides. Materials and Methods: Seventy-five male patients were subjected to the mushroom procedure and then followed for 6 months. The technique involved injection of bovine purified collagen conjugated with glutaraldehyde circumferentially into the prepuce area of the penis. This increased the diameter of the penile prepuce. Results: No patient reported pain or discomfort following the procedure and there were no infections. Seventy-two patients (96%) had moderate ecchymoses. All patients had early increased sensation during intercourse. Volume was maintained for 3 months, but from 4 to 6 months there was progressive reduction in the volumetric cosmetic appearance. After 6 months, 42 patients (60%) had had a second infiltration. Discussion: Total penile enhancement has prompted reports of problems with infection and penile distortion. The procedure can be painful, especially with ligament release. The mushroom enhancement is well tolerated, simple to perform, and has excellent early results. Secondary procedures are usually necessary.
A New Autologous Collagen Technique
Authors: Alkek David S. 
Published: January 2017

Introduction: Autologous tissue culture fibroblasts and collagen (Isolagen) have been evaluated in rhytids, scars, and defects to determine indications and effects of filling. Materials and Methods: Forty-nine patients since January 1997 have been injected with Isolagen for depressed scars, rhytids, and lip augmentation. Results: Fine lines, such as periorbital and perioral lines, respond better than deeper furrows. Saucer-shaped scars and depressions with soft, distensible shoulders improve with an average of three injections. Lips can be augmented quite well. There were essentially no side effects. Discussion: Isolagen is expensive and requires precise patient scheduling since the material degenerates quickly. Patients are impressed by the fact that we are using their own collagen and because it provides a more permanent result than bovine collagen.
Aesthetic Changes in Lip Profile following Advancement Genioplasty
Authors: Lupori John P. , Schmitz John P. , Jeter Thomas 
Published: January 2017

This study examined the aesthetic changes in the labiomental fold profile after advancement genioplasty. We presented a Cartesian system, based on symphyseal landmarks, to compare both hard and soft tissue changes occurring after advancement genioplasty. This technique was then utilized to compare quantitatively the soft tissue changes in patients who have had advancement genioplasty with or without bone grafts in the anterior osteotomy site. Thirty-one consecutive patients who had undergone advancement horizontal mandibular osteotomies (HMOs) for the correction of a deficient chin in the period 1989 through 1994 were included in this study. All patients underwent HMO either with or without the insertion of a freeze-dried rib to contour the osteotomy step defect. The majority of patients underwent additional procedures, including Le Fort I osteotomy (LFI) and bilateral sagittal split osteotomy (BSSO), alone or in combination. In the grafted group, after the segment was fixed, a split-thickness freeze-dried rib graft was contoured and secured in the anterior osteotomy site with 2-mm position screws. Cephalograms were taken at two time periods: preoperatively and 1 year postoperatively. The cephalograms were traced, and bony landmarks in the mandibular symphysis were identified: genion, infradentale, and B point. These points were chosen because they were not affected by any surgical procedure. A Cartesian coordinate system was then derived from the preoperative tracings and superimposed on the 1-year postoperative tracings. The depth of the labiomental fold was measured from the soft tissue chin profile. The data were analyzed with a Student's t-test to test the hypothesis that horizontal advancement of the mandibular symphysis produced unfavorable aesthetic changes in the labiomental sulcus in patients with no graft in the anterior osteotomy site. The significance level to reject the null hypothesis was set at P < 0.05. The mean change in the sulcus depth for nongrafted HMOs was 2.22 mm, while the mean change in sulcus depth for grafted HMOs was −2.79 mm. A positive change represented a deepening of the labiomental fold. The mean difference between the two groups was 5.00 mm (P < 0.0001). The amount of advancement did not correlate with sulcus depth changes in either group (no graft, r2 = 0.012, P = 0.72; with graft, r2 = 0.03, P = 0.15). Significant change occurred at the deepest point of the labiomental fold. The mean change there in patients with no graft was 0.59 mm (P = 0.4); for grafted patients it was 3.42 mm (P < 0.0001). The mean difference between the two groups was 2.83 mm (P = 0.0017). Changes at lower incisor, lower lip, and soft tissue pogonion were not significantly different between the two groups. We found that the sulcus depth deepens significantly after advancement genioplasty when no graft is placed in the anterior osteotomy site. The significant change occurs at the depth of the sulcus, the site of the anterior step, and does not correlate with the amount of advancement.