Background: Despite the medical necessity, legislative mandates, and economic benefits of gender-affirming surgery, access to treatment remains limited. The World Professional Association for Transgender Health (WPATH) has proposed guidelines transition-related surgery in conjunction with criteria delineate necessity. authors assessed insurance coverage “top” evaluated differences between policy WPATH recommendations. Methods: conducted a cross-sectional analysis policies top surgery....

Anatomical studies show that facial fat is partitioned into distinct compartments, with the nasolabial pad in a superficial compartment and deep medial cheek compartment. Gross morphologic differences may exist between these depots, but this has never been established at cellular level.Adipose tissue specimens from pads were obtained 63 cadaveric (38 female 25 male cadavers) aged 47 to 101 years (mean, 71 years). Thirty-seven cadavers had normal body mass index (≤25 kg/m) 26 high (>25 kg/m)....

Background: Augmentation mastopexy remains a procedure wrought with high rates of complications and revisions given the diametrically opposing forces in this combined procedure. Thus, many surgeons remain cautious err on staged This article provides dependable, predictable, straightforward approach to challenging operation. The technique centers five key points, including precise preoperative markings, 8-cm vertical limbs broad pedicle base, limited undermining thick skin flaps, small...

Background: Plastic surgery continues to be one of the most competitive specialties in residency match. Research productivity is a key component selection process. Nevertheless, potential applicants have poor understanding strength their research credentials comparison other applicants. Methods: The authors identified successful from 2012 2017 integrated plastic application cycles. performed bibliometric analysis these residents using Scopus, PubMed, and Google Scholar identify published...

Background: The internal mammary artery perforator flap has been used in head and neck reconstruction. Although anatomical perfusion studies with ink have performed previously, the authors now use three- four-dimensional computed tomographic angiography to precisely visualize vascular anatomy of individual perforators (perforasomes) axiality perfusion. Methods: Eleven hemichest adipocutaneous flaps were dissected from cadavers. Measurements recorded, such as distance each sternal edge,...

Implant-based breast reconstruction is commonly performed by plastic surgeons worldwide. Bacterial contamination of paramount concern because its role in biofilm formation and capsular contracture. Plastic have adopted a variety perioperative interventions efforts to reduce implant contamination; however, definitive evidence supporting these practices lacking.The goal this study was assess current practice patterns aimed at reducing implant-related infections.A 20-question survey assessing...

Contemporary description of facial fracture patterns and factors associated with early operative intervention at trauma centers is lacking. The purpose this study was to characterize injuries initial treatment patients suffering from fractures.Using the National Trauma Databank 2007 2015, fractures were included. Demographics, injury characteristics, outcomes including interventions assessed.Over 9 years, 626,270 included: 74.5% male, 39.0% suffered traumatic brain (TBI), 23.3% severe...

To assess the characteristics of cooking-related burn injuries in children reported to World Health Organization Global Burn Registry.On 1 February 2021, we downloaded data from Registry on demographic and clinical patients younger than 19 years. We performed multivariate regressions identify risk factors predictive mortality total body surface area affected by burns.Of 2957 paediatric with injuries, 974 involved cooking (32.9%). More burns occurred boys (532 patients; 54.6%) girls, 2 years...

Background: Over the past decade, plastic surgery programs have continued to evolve with addition of 1 year training, increase in minimum number required aesthetic cases, and gradual replacement independent positions integrated ones. To evaluate impact these changes on a survey was sent residents program directors. Methods: A 37 question at all Accreditation Council for Graduate Medical Education–approved training United States. 13 directors same institutions. Both surveys were analyzed...

Background Breast augmentation is one of the most commonly performed aesthetic surgery procedures worldwide. Bacterial contamination paramount concern due to its role in biofilm formation and capsular contracture. Plastic surgeons have adopted a variety perioperative interventions efforts reduce implant contamination, however definitive evidence supporting these practices lacking. Objective The goal this study was assess current practice patterns aimed at reducing implant-related infections...

Background: Infections are challenging complications of implant-based breast reconstruction and augmentation. They pose a clinical challenge, with significant economic implications. One proposed solution is implant irrigation at the time placement. There no consensus on optimal irrigant solution. Methods: The authors tested relative efficacy 10% povidone-iodine, Clorpactin, Prontosan, triple-antibiotic solution, or normal saline (negative control) against two strains each...

Background: Gender parity remains elusive in academic plastic surgery. It is unknown whether this disparity attributable to differences qualifications or the glass ceiling of gender bias. To parse this, authors compared titles and departmental leadership female surgeons a matched group their male counterparts. Methods: The conducted cross-sectional analysis surgeons. identified faculty, sex, rank, positions from surgery residency program websites. then collected details on training...

Plastic surgery residency comprises a significant portion of early adulthood. The difficulties are well documented, particularly with the impact on wellness and risk burnout. Structured programs, mentorship, social support, autonomy can decrease This study looked at how plastic program websites GME represent support programs between both integrated independent residencies. A cross-sectional analysis US was performed during month April 2024. authors conducted systematic content available...

Background: The increasingly more common secondary rhytidectomy patient presents with recurrent soft-tissue descent and stigmata of primary face lift, which can require techniques unique to rhytidectomy. senior author's (R.J.R.) experience is reviewed, focusing on surgical technique, longevity, outcomes. Methods: Data collected after chart review a 20-year study period included face-lift technique; duration between primary, secondary, tertiary lifts; concurrent procedures; complications...

Three-dimensional printing of patient-specific models is being used in various aspects craniomaxillofacial reconstruction. Printing typically outsourced to off-site vendors, with the main disadvantages increased costs and time for production. Office-based 3-dimensional has been proposed as a means reduce delays, but remains largely underused because perception among surgeons that it futuristic, highly technical, prohibitively expensive. The goal this report demonstrate feasibility ease...

Presentation of pediatric facial fractures varies widely and many injuries are encountered infrequently by most practitioners. This study summarizes injury patterns in a large cohort their subsequent surgical management.Demographic clinical characteristics patients 18 years age or younger admitted between 2009 2015 to trauma centers participating the National Trauma Data Bank were examined. Craniofacial reconstructive procedures performed at index admission selected based on ICD-9 AIS codes....

Plastic surgery plays an essential role in the treatment of gender dysphoria. International standards care currently consider genital and chest surgeries to be medically necessary. Ancillary procedures such as facial surgery, chondrolaryngoplasty, hair restoration/removal, body contouring are considered cosmetic except individual circumstances. The authors sought assess frequency coverage provision for ancillary transition-related through a cross-sectional analysis US insurance policies....

Background: Reduction mammaplasty provides symptomatic relief to patients with macromastia. Insurance companies act as gatekeepers of health care by determining the medical necessity surgical procedures, including reduction mammaplasty. The authors sought evaluate insurance coverage and policy criteria for Methods: conducted a cross-sectional analysis U.S. policies on providers were selected based their enrolment data market share. telephone interviews Web-based searches identify policies....

In Brief Numerous studies have shown that the final stage in breast reconstruction, creation of nipple-areolar complex, correlates highly with patient satisfaction and acceptance body image. There are many different techniques, including nipple sharing, free-composite grafts, local “pull-out” flaps, all which vulnerable to an unpredictable degree loss projection possible need for reoperation. This leads problems symmetry overbuilding initial reconstruction wider-based, larger may cause...

Background: Injectable forms of anesthesia for nonsurgical facial rejuvenation, although efficacious, are uncomfortable the patient. Preclinical studies have demonstrated that laser pretreatment at low energies enhances absorption topical lidocaine. Objectives: The authors assess safety and efficacy laser-assisted transdermal delivery anesthetic. Method: Ten patients were split into 2 groups (A B). All received 15 g BLT (20% benzocaine, 6% lidocaine, 4% tetracaine triple anesthetic cream) 20...