Background: The authors introduce the technique of reverse lymphatic mapping for vascularized lymph node transfer. This physiologic allows one to identify which nodes drain trunk as opposed extremity, minimize risk iatrogenic lymphedema. Methods: A prospective study patients undergoing transfer using was conducted. Patients received technetium injections in first and second webspaces foot intradermal indocyanine green lower abdomen. Lymphatic vessels were traced draining abdomen that...

Soft-tissue filler use has grown considerably related to the increasing popularity of minimally invasive cosmetic procedures. Hyaluronic acid products are currently most utilized soft-tissue fillers. Proper working knowledge individual products, limitations use, and anatomic principles can improve outcomes. Prevention is key minimize complications; however, when present, complications must be managed methodically. Complications categorized based on timing presentation include early, late,...

Increasingly, patients are seeking minimally invasive methods to tighten skin and remodel adipose tissue. A large treatment gap exists among 3 types of patients: (1) the younger demographic, who increasingly desire soft tissue tightening without traditional operations, scars, downtime; (2) with laxity not "severe enough" justify an excisional procedure, but "mild rely on liposuction contraction alone; (3) those recurrent already underwent procedures. In these populations, plastic surgeons...

Vascularized groin lymph node transfer (VGLNT) has been successfully used to treat lymphedema. However, lack of familiarity with the inguinal anatomy and concerns regarding donor site morbidity have limited its widespread use. The purpose this study was use magnetic resonance angiography (MRA) clarify provide a reliable method for identifying location superficial transverse nodes. In MRA evaluate nodes in 117 patients. Coordinates were plotted relative an axis from anterior superior iliac...

Summary: Effective control of nasal tip projection and rotation is a key component in modern rhinoplasty. Tip product several anatomical factors: length strength lower lateral cartilages, the suspensory ligament, fibrous connections to upper anterior septal angle. Several cartilage grafts have been described for effectively altering rotation. Columellar struts extension are both commonly used rhinoplasty affect tip. Although columellar strut shown moderate efficacy maintaining unifying...

Background: Recent anatomical studies have demonstrated that fat placed subjacent to the fascia of gluteus maximus muscle can migrate deep through into submuscular space, possibly causing tears in gluteal veins, leading embolisms. The purpose this study was define and subcutaneous migration determine whether space under a variety pressures fascial integrity scenarios indeed space. Methods: Four hemibuttocks from two cadavers were used. Proxy inserted using syringes with various (1: intact;...

Summary: The use of radiofrequency for soft tissue tightening has increased over the past 10 years. Both minimally invasive and noninvasive devices are frequently in use. This article describes different types technology current evidence behind their safety efficacy.

Abstract Background For many years, liposuction remains one of the most-performed cosmetic procedures by plastic surgeons around world. However, determining degree residual skin laxity after evacuation fat a challenge. Renuvion® (J-Plasma) is radio-frequency device propelled helium plasma that generates rapid heating at subcutaneous layer leading to controlled retraction. Objectives We present clinical results our experience with J-plasma in combination High Definition Liposculpture (HDL),...

Fat accumulation is frequently observed in patients with lymphedema but not accounted for existing staging systems. In addition, the specific regional patterns of fat and fluid remain unknown might affect outcomes following medical or surgical intervention. The purpose this study was to evaluate distribution lower extremity using magnetic resonance angiography.

An increasing number of aesthetic surgery procedures are being performed in an ambulatory fashion office-based settings. Postoperative monitoring these patients has historically required paid private-duty nurses measuring vital signs, encouraging ambulation, and overall comfort level. Recently, advancements nanotechnology have permitted high-acuity data acquisition multiple clinical parameters that can be transmitted to the surgeon's mobile device a continuous fashion.The aim this study was...

Patients with node positive or locally advanced breast cancer desiring deep inferior epigastric perforator (DIEP) flap reconstruction frequently require postmastectomy radiation therapy (PMRT). To avoid the deleterious effects of PMRT, surgeons will often delay until after PMRT is complete. Drawbacks to this approach include additional surgery, recuperation, cost, and an extended reconstructive process. Even if a tissue expander used preserve skin envelope during irradiation, post-PMRT...

Background: Nonexcisional facial skin tightening has long been an elusive goal in aesthetic surgery. The “treatment gap” includes cases who are not “severe” enough for excisions surgery but “mild” most traditional noninvasive modalities. In this retrospective review, we present the largest evaluation to date of radiofrequency (RF) technology combination including bipolar RF (FaceTite; InMode) and fractional (Fractora modified Morpheus8; InMode). Methods: A multicenter study was conducted...

Background: On January 1, 2011, New York State amended the Public Health Law to ensure that patients receive "information and access breast reconstruction surgery." The purposes of this study were investigate early impact legislation on rates evaluate influence patient variables versus physician incidence type performed. Methods: A retrospective was conducted all who underwent mastectomy between 2010, December 31, 2011. Reconstruction analyzed in relation timing legislation, surgeon...

INTRODUCTION: The transverse upper gracilis (TUG) has been successfully used for autologous breast reconstruction. However, concerns regarding wound healing, lymphedema, and cosmesis at the donor site have limited its widespread use. Profunda Artery Perforator (PAP) flap is a useful alternative that addressed some of morbidity associated with TUG. PAP may result in distortion gluteal crease lead to sensory changes this region. In study we describe new design: DUG (Diagonal Upper Gracilis)...

Background The use of heterotopic vascularized lymph node transfer (HVLNT) for the treatment lower extremity lymphedema is still evolving. Current techniques, either place nodes in thigh without a skin paddle or at ankle requiring an unsightly and often bulky closure. We explored feasibility doing below‐knee using medial sural vessels as recipient report our experience 21 patients. Methods A retrospective review all patients who underwent HVLNT to calf was performed. Postoperative magnetic...

Reconstruction of bony craniofacial defects requires precise understanding the anatomic relationships. The ideal reconstructive technique should be fast as well economical, with minimal donor-site morbidity, and provide a lasting aesthetically pleasing result. There are some circumstances in which patient's own tissue is not sufficient to reconstruct defects. development sophisticated software has facilitated manufacturing patient-specific implants (PSIs). aim this study was analyze utility...

Learning Objectives: After studying this article, the participant should be able to: 1. Classify commonly performed types of face-lift procedures based on extent skin incision and face neck dissection, superficial musculoaponeurotic system treatment perform appropriate amount undermining in variations techniques. 2. Select optimal placement incisions list danger zones encountered dissection their relationship to fat compartments retaining ligaments. 3. Use grafting as an adjunctive procedure...

After studying this article, the participant should be able to: 1. Identify patients who are candidates for headache surgery. 2. Counsel patient preoperatively with regard to success rates, recovery, and complications. 3. Develop a surgical plan primary secondary nerve decompression. 4. Understand anatomy at all trigger sites. 5. Select appropriate International Classification of Diseases, Tenth Revision, CPT codes.Headache surgery encompasses release extracranial peripheral sensory nerves...

Background: The gluteal lift (“Brazilian butt lift”) has improved significantly in technique and outcomes. Some postulate that fat embolism occurs because of damage to veins superficial the gluteus muscles must be injected intramuscularly achieve satisfactory aesthetic results. purpose this article is present data where performed under local anesthesia, address safety concerns, clarify these speculations. Methods: All patients underwent anesthesia using oral medications tumescent...

We don't have a choice on whether we do social media; the question is how well it. —Erik Qualman1 Of all medical specialties, plastic surgery one most present media. This synergy natural and no surprise to most. Nearly every operation perform from head toe has an aesthetic visual component. More than ever, public wants access operating room. They want see what it—preferably in real time. Before-and-after photographs our websites are longer sufficient convey quality of work. Patients learning...

Summary: When septal cartilage is lacking, commercially available costal allograft can be used. Such allografts have “off-the-shelf” accessibility, are in multiple sizes, aseptically processed to meet sterility, and screened minimize infectious risks. The purpose of this study was evaluate the effect donor age, storage temperature, orientation a bilayered construct on degree warping commercialized fresh frozen vitro over time. A total 140 cadaveric specimens were separated into three age...