bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Impact of the COVID-19 Pandemic on Manuscript Submission by Women to Plastic and Reconstructive Surgery”
Authors: Blum Jessica D , Rohrich Rod J. , Taylor Jesse A 
Published: February 2023

Introduction:
The COVID-19 pandemic has had far-reaching consequences, occasionally amplifying pre-existing disparities. This study examines the impact of COVID-19 on Plastic and Reconstructive Surgery (PRS) manuscript submissions by female authors.

Methods:
All manuscripts submitted to PRS during the months of March and April 2018 through 2021 were examined. Gender of the first, corresponding, and senior authors was confirmed using https://gender-api.com/, the country of the author was abstracted, and appropriate statistical comparisons were made.

Results:
There were 2,512 submissions to PRS during the study periods, with a statistically significant increase observed between 2019 and 2020 (Figure 2, p = 0.008). Despite this significant increase, the proportion of publications by female corresponding and senior authors decreased significantly with the onset of the pandemic (p < 0.001 for both). This decrease was mirrored by a significant increase in the proportion of male senior and corresponding author publications (p < 0.001 for both) and female first author publications (p = 0.002).

Conclusions:
Despite a significant increase in overall submissions to PRS during the COVID-19 pandemic, the proportion submitted by senior and corresponding female authors declined. While causality cannot be determined by our methodology, our findings suggest a disproportionate burden on senior female authors during the pandemic with unclear academic repercussions.
Seeing Cleft Lip from a New Angle: Crowdsourcing to Determine Whether Scar Severity or Lip Angle Matters More to the General Public
Authors: Sescleifer Anne M. , Francoisse Caitlin A. , Osborn Tamara A. , Rector Jeffrey D. , Lin Alexander Y. 
Published: February 2023

Purpose:
Modern cleft lip surgery aims to restore symmetry and create a level, normal-appearing Cupid bow. However, families’ concerns often center on the degree of scarring. We hypothesized that the lip angle would be less influential than scar severity in layperson ratings.

Methods:
We received IRB approval for modifying patients' postoperative photos to create systematic variations displaying different levels of scarring and lip angle. Each child’s resulting composite images were presented in pairs to internet raters using Amazon Mechanical Turk. Users selected the simulated postoperative result they felt most normal. The Bradley-Terry (BT) model was used to determine raters’ preferences between different levels of scarring and lip angle.

Results:
Four children with primary unilateral cleft lip repair had their postoperative photos modified, mean age 1.4 years (mean followup 1.0 years). Twelve-hundred crowdsourced pairwise ratings were collected for each patient (4,800 combined ratings). For all 4 children, raters preferred images with more severe scarring than those with a greater lip angle, suggesting uneven lip angle has a more negative effect on perceived appearance.

Conclusion:
Online crowdsourcing postoperative lip angle had a significantly greater influence on ratings of normal appearance than does the severity of scarring. Although patients may ask about scars more often, clinically, this study suggests perceptions of a cleft lip repair result may be more likely influenced by the angle of the cleft lip repair.
“Intramuscular gluteoplasty: a comparative study between different incisional access.”
Authors: Ramos da Silva Cláudio G. , Guimarães Fernando S. , Aboudib José H. , Morales Pedro J. 
Published: February 2023

Background:
Silicone implants have been used to improve volume and body contour in buttocks for almost 45 years. Although the intramuscular plane continues to be the gold standard, surgeons still diverge on the best incision technique: using a vertical incision, and thus without the preservation of the intergluteal groove, or preserving this area through a triangular dissection. The goal of this research study is to evaluate and compare these techniques of intramuscular augmentation gluteoplasty.

Methods:
Two randomized groups were formed with fifty-three patients in each group. One of the groups underwent intramuscular gluteoplasty with a vertical incision in the intergluteal groove, and therefore without the preservation of said intergluteal groove (group A). The other group performed intramuscular gluteoplasty using a triangular dissection, thus preserving the intergluteal groove (group B). The groups were compared in relation to the incidence of complications (dehiscence, hematoma, seroma and infection).

Results:
7.5% of patients in group A presented dehiscence and 1.9% seroma. In group B however, 28.3% of patients presented dehiscence and 7.5% seroma and dehiscence during the first 21 days after surgery. No patient had hematoma or infection in either group.

Conclusions:
In the comparison between the groups of patients, the technique with a vertical incision in the intergluteal groove showed a lower number of surgical wounds, dehiscences and seromas when compared to the technique that preserves the intergluteal groove.
Hybrid Augmentation Mastopexy with Composite Reverse Inferior Muscular Sling: Combining the Benefits of Fat Grafting, Inferior Muscle Support, and an L-Shaped Scar in a Single-Stage Procedure
Authors: Munhoz Alexandre Mendonça , Marques Neto Ary de Azevedo , Maximiliano João 
Published: February 2023

Augmentation mastopexy (AM) is a challenging procedure, and complications include implant displacement and visibility. These deformities can be addressed, but the stability of the smooth implant surface and patients with poor soft-tissue coverage may present limitations. This article describes a surgical technique for AM using a composite reverse inferior muscle sling associated with autogenous fat grafting.

Objectives:
To assess outcomes from primary AM procedures using the present technique in a cohort of patients operated on by a single surgeon.

Methods:
Forty-five patients (90 breasts) with a mean age of 37.7±7.2 years underwent hybrid composite reverse inferior muscular sling AM to treat ptosis (grade II–III). An upper/medial pole area between the implant and the clavicle region and parasternal area was marked to receive subsequent fat grafting and divided into three zones. Three-dimensional imaging from the Divina scanner system was used to evaluate lower pole (LP) stretch and intermammary distance (IMD).

Results:
The average implant volume was 265 cc (range: 175–335 cc). Patients received an average volume of 115.34cc of AFG / breast (86.2–145.2 cc); the average fat volumes in zones I-II and III were 80.1 (61.6–95.2 cc) and 39.3 (25.2–47.3 cc), respectively. Five cases of complications were observed in 3 patients (6.6%): minor dehiscence in 2 (4.4%) and nipple-areola asymmetry in 1 (2.2%) over a mean follow-up period of 38 (6–49) months. At 12 months, the average values for nipple-inframammary fold were 85.8 mm and 86.4 mm for right and left sides, respectively. The LP stretched 11.51% (9.9 mm) and 9.8% (8.5 mm) on the right and left sides, respectively (p <0.0001), between 10 days and 1 year postoperative. IMD was reduced by an average of 49.9% (25.1 mm) (p <0.001) between the preoperative value and 1 year after surgery.

Conclusions:
Advances in AM and hybrid composite reverse inferior muscular sling have led to improved aesthetic results for patients with breast ptosis and poor tissue coverage. Fat grafting and recognizing cleavage zones are still important to obtain satisfactory results. Our data show this procedure offers a good alternative for AM candidates, providing an adequate smooth surface for implant stabilization.
Pregnancy Associated Breast Changes after Nipple Sparing Mastectomy”
Authors: Aschen Seth Z. , Paik Kristine C. , Swistel Alexander S. , Talmor Mia 
Published: February 2023

Background:
Women of reproductive age are chronically underrepresented in breast cancer studies. Recent studies suggest that almost 40% of patients diagnosed with breast cancer, who are of reproductive age, want to have children after completing treatment. In this study, we evaluate patients of reproductive age who have undergone nipple sparing mastectomy (NSM) and implant-based reconstruction. We compare those who have become pregnant and those who have not, with respect to clinical and radiologic changes that are reported on follow-up.

Methods:
Any patient 45 years of age or younger at the time of NSM was defined to be of reproductive age and selected for evaluation and followed prospectively. The presence or absence of breast exam changes in the setting of pregnancy after NSM were recorded.

Results:
35 patients became pregnant after NSM and 159 patients did not become pregnant after NSM. Of those who became pregnant, nearly half reported some clinical change just prior to, or immediately after delivery. These included color change and discharge at the residual nipple areolar complex, and palpable nodularity elsewhere. For those with palpable changes, an ultrasound was performed and hypoechoic lesions with variable vascularity were identified. For those who went on to excision, lactational hyperplasia was the most common diagnosis.

Conclusions:
Ultrasound is an appropriate first line investigation of changes which can include hyperplasia of remaining ductal and glandular tissue. Patients who became pregnant after NSM commonly had clinical breast exam changes, however the majority of these changes are found to be benign on further evaluation.
A Systematic Review of Efficacy and Complications of High Definition Liposuction
Authors: Willet Jake W. , Alvaro Anton I. , Ibrahim Abdullah K. , Javed Muhammad U. 
Published: February 2023

Background:
Traditionally liposuction is performed on the deeper layer of fat. However, in 1983 Illouz described a liposuction technique targeting the superficial layer of fat. High definition liposuction (HDL) is an advanced technique of liposuction that generates a desirable profile of anatomical area whilst promoting skin retraction. Although the safety profile of basic or traditional liposuction has been extensively studied, data relevant to HDL is limited. A systematic review to determine the effectiveness and complications was conducted.

Method:
Across the 21 articles included in the synthesis, a total of 6964 patients underwent HDL procedures. Of the cases where gender was reported, 44% were females (n=1241) and 56% males (n=1556). The average age of patients was 38 years (range 15 -76) and BMI was 25kg/m2 (range 18-38).

Results:
An overall complication rate of 14.4% (n=994) was calculated, with only 0.2% (n=13) of complications classified as major. Transient Hyperpigmentation was the most frequently reported complication affecting 3.8% (n=260) patients, followed by seroma 3.3% (n=231) and transient soft tissue fibrosis 2.7% (n=185). Despite an absence of uniform reporting, satisfaction rates of 92.6% (n= 1497) were reported.

Conclusion:
There is a high demand for HDL surgery globally and this systematic review illustrates the safety and efficacy of HDL. Major complication rates across the entirety of the literature reviewed were 0.2%, with minor complications seen in 14.2% across the 6964 cases reported. High patient satisfaction of 92.6% from HDL procedures was achieved, indicating efficacy of this procedure.
How the Lifting Amount in an Endoscopic Brow Lift is Influenced by Supraorbital Nerve Tension and Gliding-Layer Mobility of the Brow: A Cadaveric Study
Authors: Kim Sang-Hyun , Kim In-Beom , Choi Yeop 
Published: February 2023

Background:
Sensory nerve tension and gliding-layer mobility in the brow may be significant factors affecting postoperative brow level in an endoscopic brow lift, yet have rarely been studied.

Methods:
To investigate the effects of sensory nerve tension and gliding-layer mobility, the following measurements were performed alongside the endoscopic brow lift in 50 fresh cadaveric hemifaces: amount of brow elevation, critical lifting amount (as sensory nerves became tense), laxity of sensory nerve courses, and mobility of brow-gliding layers. The sensory nerve situations in the subperiosteal and subgaleal dissections were also observed.

Results:
Supraorbital nerve tension limited the cephalic advancement of the forehead flap. The mean elevation of the brow was 5.8±1 mm (range, 3.5–8.6 mm). The mean critical lifting amount was 5.3±1.1 mm (range, 4.0–7.3 mm). The mean amount of laxity in the supraorbital nerve (the permissible amount of lift) was 4.1±0.9 mm (range, 2.5–5.5 mm). The galeal fat pad was responsible for 60% of brow mobility. The sensory nerve was more protected in a subgaleal dissection in the brow and inferior forehead, and in a subperiosteal dissection in the middle and upper forehead.

Conclusion
Cephalic movement of the forehead flap is limited by supraorbital nerve tension. The permitted lifting amount varies from 2.5–5.5 mm.
2. Gliding-layer mobility in the brow offsets the postoperative amount of cephalic advancement of the forehead flap.
3. Consideration of supraorbital nerve tension and gliding-layer mobility is recommended to obtain an optimal brow level in endoscopic brow lifts.
Co-administration of autologous concentrated growth factor (CGF) increases skin thickness and area during tissue expansion: a randomized clinical trial
Authors: Tan Poh-Ching , Zhang Pei-Qi , Zhou Shuang-Bai , He Ji-Zhou , Qian Jia , Huang Ru-Lin , Zhang Zhi-Yue , Cheng Chen , Li Qing-Feng , Xie Yun 
Published: February 2023

Background:
Mechanical stretching of the skin, in terms of tissue expansion, could generate additional skin, but it is limited by the intrinsic growth capacity. Here, we conducted on autologous concentrated growth factor (CGF) to promote skin regeneration by increasing skin thickness and area during tissue expansion.

Methods:
A single-center, randomized controlled trial (registered with ClinicalTrials.gov [NCT03406143]) was conducted from 2016 to 2019. Participants undergoing skin expansion received either CGF or saline via intradermal injection on the expanded skin (0.02 ml/cm 2), for a total of three treatments at 4-week intervals. The primary endpoint was the expanded skin thickness at 12 weeks, which was measured by ultrasound. The secondary endpoints included the skin thickness at 4 and 8 weeks and the surface area, expansion index (EI), and skin texture score of the expanded skin at 12 weeks. Safety assessments, such as infection symptoms and nodule formation, were assessed at 24 weeks.

Results:
In total, 26 patients were enrolled and assigned to the CGF group or the control group. Compared with the control group, the CGF group had significantly increased skin thickness at 8 (control: 1.1 ± 0.1 mm, CGF: 1.4 ± 0.1 mm; -0.6 mm to 0.0 mm, p = 0.047) and 12 weeks (control: 1.0 ± 0.1 mm, CGF: 1.3 ± 0.1 mm; -0.6 mm to 0.0 mm, p = 0.047). Compared with the baseline thickness (control: 1.6 ± 0.1 mm, CGF: 1.5 ± 0.1 mm; -0.3 mm to 0.5 mm, p=0.987), skin thickness was sustained in the CGF group at 8 weeks posttreatment (-0.1 mm to 0.3 mm, p = 0.711) but decreased in the control group (0.3 mm to 0.7 mm, p＜0.001). At 12 weeks, the CGF group showed greater increases in surface area (control: 77.7 ± 18.5 cm 2, CGF: 135.0 ± 15.7 cm 2; 7.2 cm 2 to 107.4 cm 2, p = 0.027) and EI (control: 0.9 ± 0.1, CGF: 1.4 ± 0.2; 0.0 to 0.8, p=0.030) than the control group. Additionally, CGF-treated skin showed an improvement in texture (CGF: grade 3: 2 [15.8%], grade 2: 4 [30.7%]; control: grade 3: 0 [0.0%], grade 2: 3 [23.0%]). No severe adverse events occurred.

Conclusion:
CGF treatment increases skin thickness and area during tissue expansion, as represents a safe and effective strategy for managing skin expansion.

Evidence Rating:
Therapeutic Studies, Level II
Cupid’s Bow Leveling and Preservation of Lip Height and Width: A Modified rotation-advancement Technique
Authors: Alkebsi Khaled , Li Chenghao , Aonan Xie , Zeyu Huang , Shi Bing , Li Yang , Sakran Karim A. , Al-Watary Mohammed Q. , Abotaleb Bassam M. , Almoraissi Essam 
Published: February 2023

Background:
Several methods for cleft lip repair have been developed over time, indicating no single best one. In our department, the use of a modified rotation advancement technique rather than the rotation-advancement technique in unilateral complete cleft lip repair has increased over the last decade. This study aims to determine which technique gives better outcomes accordingly.

Material and method:
This retrospective study was conducted by analyzing the preoperative and postoperative aesthetic nasal and labial anthropometric measurements of the front and basal views of 213 consecutive patient’s photographs treated between October 2013- June 2019. 141 participants were treated by using the rotation-advancement technique, and 72 patients by the modified rotation-advancement technique. The inclusion criteria included; non-syndromic unilateral complete cleft lip patients with high-resolution quality photographs, no pre-surgical nasoalveolar molding, no revision in the lip and nose areas, and at least one year of follow-up.

Result:
Patients who received the modified rotation-advancement technique had significantly improved Cupid's bow position and orientation (P<0.02, P<0.01 respectively) and enhanced vertical lip height symmetry (P<0.01) while preserving the lip width. The columellar length (P<0.03) and angulation (P<0.045) were also significantly improved, with enhanced nostril inclination in this group (P<0.06).

Conclusion:
According to the findings of the current study, modified rotation-advancement technique assisted surgeons in improving the symmetrical leveling of the Cupid's bow and significantly aided in correcting lip height without compromising lip width. Moreover, the modified rotation-advancement technique resulted in better aesthetic nasal outcomes.
Crowdsourcing in Plastic & Reconstructive Surgery: A Systematic Review with Reporting Recommendations
Authors: Villavisanis Dillan F , Blum Jessica D , Cheung Liana , Cho Daniel Y , Bartlett Scott P , Swanson Jordan W , Taylor Jesse A 
Published: February 2023

Background:
Crowdsourcing uses online platforms to collect large data from laypersons and has been increasingly utilized over the past five years to answer questions about aesthetic and functional outcomes following plastic and reconstructive surgery. This systematic review evaluates crowdsourcing manuscripts in plastic and reconstructive surgery based on study topic, participants, and effect size in the hopes of describing best-practices.

Methods:
A systematic search strategy was developed with a licensed librarian and attending plastic surgeon to query all manuscripts using crowdsourcing in plastic and reconstructive surgery. Covidence systematic review manager was used by two independent reviewers to import articles, screen abstracts, evaluate full texts, and extract data.

Results:
A search run on October 8, 2021 yielded 168 studies, of which 45 were ultimately included. Craniofacial surgery and aesthetic surgery collectively comprised over one half of studies. Participants in plastic surgery crowdsourcing studies are more commonly from the US, female, straight, 25 to 35 years old, have completed college, and earn 20,000 – 50,000 USD per year. Studies typically assessed aesthetic perceptions, cost about $350, run a median of nine days, include about 60 unique survey items, and include about 40 unique human images.

Conclusions:
Crowdsourcing is a relatively new, low-cost method of garnering high-volume data from laypersons that may further our understanding of public perception in plastic and reconstructive surgery. As with other nascent fields, there is significant variability in number of subjects utilized, subject compensation, and methodology, indicating an opportunity for quality improvement.
Microsurgical Peritoneovenous Bypass for the Treatment of Recalcitrant Chylous Ascites
Authors: Klifto Kevin M. , Card Elizabeth B. , Itkin Maxim , Kovach Stephen J. 
Published: February 2023

Background:
New treatments for recalcitrant chylous ascites are needed to avoid sequelae associated with increased intra-abdominal pressures, chyle loss, and diminished quality of life. An autologous microsurgical technique was developed to treat recalcitrant chylous ascites and restore normal physiology.

Methods:
A retrospective case-series was performed for patients with recalcitrant chylous ascites surgically treated from 2018 to 2020. We included all patients with recalcitrant chylous ascites refractory to current standard of care interventions such as diet modifications, pharmacologic therapies, and peritoneovenous mechanical shunts. All were treated with microsurgical peritoneovenous bypass with a minimum follow-up of 12 months.

Results:
Six patients were included over a 2-year period. Surgery was aborted for two patients (33%) with intra-operative venous reflux of the deep inferior epigastric vein (DIEV), negative on pre-operative ultrasound. One patient had a successful reoperation using the contralateral greater saphenous vein (GSV), while the other elected for a chronic indwelling drain for chyle drainage. Among the five successful surgeries (83%), ascites drainage decreased from a median pre-operative volume of 1 L/day to post-operative volume of 0.06 L/day. Median hospital length-of-stay (LOS) was 7 days (range: 2-194). Three patients each had one complication, including vancomycin resistant enterococcus (VRE), spontaneous bacterial peritonitis (SBP), and pulmonary embolism (PE). All complications resolved with additional interventions. Median follow-up was 13.5 months (range: 12-27).

Conclusions:
Microsurgical peritoneovenous bypass was a reliable and reproducible autologous surgery for the treatment of recalcitrant chylous ascites at a minimum follow-up of 12 months.
A 20-Year Analysis of Medicare Reimbursement for Abdominal Wall Reconstruction (2000-2020)
Authors: Harrington Maya T. , Hammond Jacob B. , Janbieh Javier , Haglin Jack M. , Thornburg Danielle A. , Pearson David , Harold Kristi , Rebecca Alanna M. , Howard Michael A. , Teven Chad M. 
Published: February 2023

Purpose:
The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for 30 abdominal wall reconstruction surgical procedures over a 20-year period (2000-2020).

Methods:
The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services was utilized for each of the 30 included current Procedural Terminology (CPT) codes, and reimbursement data was extracted. Monetary data was adjusted for inflation to 2020 US dollars (USD) utilizing changes to the United States consumer price index (CPI). The R-squared, average annual percent change and average total percentage change in reimbursement were calculated based on these adjusted trends for all included procedures.

Results:
After adjusting for inflation, the average reimbursement for all procedures decreased by 17.1% from 2000 to 2020. The greatest mean decrease was observed for CPT code 49568 (the implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection, -34.4%). The only procedure with an increased adjusted reimbursement rate throughout the study period was CPT code 20680 (+3.9%). From 2000 to 2020, the adjusted reimbursement rate for all included procedures decreased by an average of 0.85% each year, with an average R-squared value of 0.78, indicating a stable decline throughout the study period.

Conclusions:
Reimbursement rates are declining when adjusted for inflation. Increased awareness of these trends is helpful to maintain access to optimal abdominal reconstruction care in the US.