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Larry Weinstein, MD, F.A.C.S.
Weinstein Plastic Surgery
Listed in Top Doctors in New York Metro Area

Articles Spring 2009

Original Articles Spring 2009, Volume 17 Issue 1: 17-21

Decreasing expander breast infection: A new drain care protocol
JD Murray, ET Elwood, GE Jones, R Barrick, J Feng

BACKGROUND: Risk factors for expander reconstruction infection are well known. However, drain use as a risk factor for the development of infection is unclear.

OBJECTIVE: To review a simple method for drain use to help reduce rates of infection in expander breast reconstruction.

METHODS: Two hundred consecutive single-surgeon (JDM) immediate first-stage expander breast reconstructions were retrospectively reviewed. The records were reviewed for history and physical examination, intraoperative technique, perioperative management, adjuvant therapy, and outcome with respect to expander infection necessitating premature explantation within the first eight weeks. Infection was defined on clinical basis, with or without culture positivity. All expanders (Mentor, USA) were the same model (textured, port-integrated and biodimensional). Two consecutive series of reconstructions were then created. The first series included 177 reconstructions while the second series included 23 reconstructions. Unlike the first series, the second series introduced a protocol in which all reconstructions received mupirocin 2% cream to the drain sites and all drains were removed at the end of the first week. Additionally, in the second series, all expanders were secluded from direct in vivo contact with the closed suction drain either by the use of an intervening Alloderm sling (LifeCell Corporation, USA, 15 of 23 breasts) or by subdermally tunnelling the drain superficial to an adequate fatty subcutaneous layer (eight of 23 breasts).

RESULTS: Patients who developed infection in the first series and all patients in the second series shared statistically the same level of aggregate risk factors (P=0.531). The infection rate (5.65%, 10 infections in 177 breasts) in the first series was statistically greater than in the second series (0%, 0 in 23 breasts, P=0.001).

CONCLUSIONS: The present study found that percutaneous closed suction drains do serve as an increased risk for expander infection. However, early results indicate that in vivo protection of the expander with Alloderm or subdermal tunnelling, topical antibiotic ointment use and early drain removal may significantly reduce expander infection. Note: Any drain requires care. It is a potential source of bacterial contamination. Cleansing with Betadine and applying Bacitracin oitment has been successful in my practice in avoiding drain site infections.

Larry Weinstein, MD FACS www.drlarryweinstein.com www.docweinstein.com


Incidence of Alarplasty in Primary and Revision Rhinoplasty in a Private Practice Setting
Benjamin E. Saltman, MD; Steven J. Pearlman, MD
Arch Facial Plast Surg. 2009;11(2):114-118.

Objective: To evaluate the incidence of alarplasty in primary and revision rhinoplasty during a 3-year period.

Methods: We conducted a retrospective medical record review of patients undergoing primary and revision rhinoplasty between January 1, 2004, and December 31, 2006. Patients were divided into the following categories: primary or revision rhinoplasty, alarplasty, and ethnicity. The incidence of alarplasty was calculated and compared for primary vs revision rhinoplasty and for ethnicity. Statistically significant differences were confirmed using the 2 test.

Results: A total of 168 patients underwent rhinoplasty with minimum follow-up of 6 months; 116 patients had primary rhinoplasty and 52 revision rhinoplasty. All alarplasties were bilateral. Of 50 alarplasties performed, 35 were in the primary group and 15 in the revision group. The incidence of alarplasty was 30.2% in the primary group and 28.8% in the revision group. Nonwhite patients had a higher overall incidence of alarplasty (63.0%) than did white patients (25.4%). Each ethnic category identified had a higher incidence of alarplasty than the white group.

Conclusions: Alarplasty is an important technique in rhinoplasty. The high incidence of alarplasty in revision rhinoplasty procedures suggests that alarplasty is underused by many surgeons currently performing rhinoplasty. One should consider alarplasty for all patients' noses, not just those of nonwhite ethnic rhinoplasty patients. Note:Most patients I have seen over twenty years have required some reduction of the alars to achieve a best outcome.

Larry Weinstein, MD FACS www.drlarryweinstein.com  www.docweinstein.com


Correction of the High Female Hairline
Alexander L. Ramirez, MD; Kevin H. Ende, MD; Sheldon S. Kabaker, MD
Arch Facial Plast Surg. 2009;11(2):84-90.

Objectives: To review a technique and to make quantitative analyses of the senior author's 20-year experience with his preferred technique to correct the high female hairline.
Methods A retrospective review of 29 female patients who underwent the hairline-lowering procedure performed by the same surgeon (S.S.K.). We analyzed preoperative and postoperative standardized photographs by taking measurements from the medial and lateral canthi to the anterior hairline. Facial height, from the menton to the hairline, was also measured. We calculated mean values and then used a 2-tailed, paired t test to evaluate for statistical significance. Patients also underwent evaluation for satisfaction, complications, and aesthetic result. We reevaluated the measurements from the profile view and compared them with the original data.

Results: The photographed midfrontal hairline position was vertically lowered on average 1.3 cm in patients who underwent a single-stage procedure (P < .001). In retrospect, the analysis was flawed compared with clinical experience. Therefore, the profile views were evaluated, and the correlating true curvilinear advancement was an average of 2.1 cm. Three complications occurred, including 1 major effluvium, 1 minor effluvium, and 1 scar that required revision. Patient satisfaction was extremely high.

Conclusions: Advancement of the female hairline by incorporating an irregular trichophytic incision and a posterior scalp advancement flap is an effective and safe technique that has been used by the senior author for more than 2 decades. The average advancement was 2.1 cm in this study. The technique is immediately effective, well tolerated by patients, and associated with minimal complications. Although it is associated with a potentially visible incision, this technique can be used to make the scar virtually invisible.Note: This is one of the alternatives I use for brow lifting, hooded eyelids or high hairline corrections. In the past 20 years with very natural results.

Larry Weinstein, MD FACS www.drlarryweinstein.com  www.docweinstein.com


The Lateral Tarsal Strip Mini-Tarsorrhaphy Procedure

M. Reza Vagefi, MD; Richard L. Anderson, MD

Arch Facial Plast Surg. 2009;11(2):136-139.

The lateral canthus normally sits 1 to 2 mm higher than the medial canthus. With time, aging and gravity produce inferior displacement of the canthus. Numerous eyelid disorders can also result in lower eyelid or lateral canthal tendon laxity or malposition, requiring horizontal eyelid tightening or canthal repositioning. The lateral tarsal strip procedure has proven to be a useful technique in addressing these problems. Care must be taken when suspending the tarsal strip to the lateral orbital rim to preserve the almond shape of the lateral canthal angle. If mild to moderate upper eyelid laxity is present, suspension of the strip can result in upper eyelid overhang with lower eyelid and eyelash imbrication. We describe the lateral tarsal strip mini-tarsorrhaphy procedure that overcomes this problem. The technique provides excellent functional and aesthetic results and adds to the versatility of a time-tested procedure. Note: This is one method of alleviating ectropion.

Larry Weinstein, MD FACS www.drlarryweinstein.com  www.docweinstein.com


Patients Who Gave Up Smoking Before Surgery Had Half As Many Complications Afterwards
ScienceDaily
(Mar. 17, 2009) — More than a third of patients who took part in an eight-week smoking cessation programme before and after planned surgery were able to give up and most of them were still smoke free after a year, according to new research.They also experienced half as many complications after surgery as the patients who did not receive help to give up smoking, with 21 per cent experiencing problems as opposed to 41 per cent. Researchers randomly assigned 117 patients who were due to undergo general or orthopaedic surgery to an intervention and control group.

“The intervention group attended weekly meetings or received telephone support and were provided with free nicotine replacement therapy, while the control group just received standard pre-operative care” says lead author Dr Omid Sadr Azodi from the Karolinska Institute in Stockholm, Sweden.

“Patients were then assessed at regular intervals before and after surgery and after 12 months.

“One interesting thing to emerge from the study was the high refusal rate. A further 76 patients declined to take part in our research because they were unwilling to give up smoking or were stressed by their forthcoming surgery.”

Key findings from the study included: 

  •  Twenty of the patients in the intervention group (36 per cent) abstained from smoking for the minimum period of three weeks before their operation and four weeks after surgery, compared with one patient in the control group (two per cent). The figures peaked at 58 per cent one week before surgery.
  • People in the intervention group were more than twice as likely to be smoke free at 12 months than those in the control group. Eighteen of the intervention group (33 per cent) were still smoke free and nine members of the control group had given up (15 per cent).
  • Patients with a lower level of nicotine dependence – who scored less than four on the zero to ten Fagerstrom scale – were 3.4 times more likely to be smoke free at 12 months.
  • Those with a high body mass index - of more than 30 - were 3.3 times more likely to be smoke free after 12 months.
  • Being employed increased the long-term success rate to 2.3, but marital status, education and living with a smoker had no significant bearing on abstinence rates at 12 months.
  • The majority of the patients who took part completed the study - 87 per cent of the intervention group and 84 per cent of the control group.
  • Just over half of the 117 patients (53 per cent) were male and the average age was 56. Their average body mass index was just over 25. Median smoking levels were ten to 20 cigarettes a day and the median time since patients started smoking was just over 35 years. Just over a third (36 per cent) had a nicotine dependency score of less than four.

As well as the medical condition they were receiving surgery for, 15 per cent suffered from depression, 12 per cent from chronic obstructive pulmonary disease, nine per cent from chronic heart disease and two per cent from diabetes.

“Smokers are prone to developing a number of complications after surgery, ranging from impaired wound and bone healing to life-threatening pulmonary and cardiovascular problems” says Dr Sadr Azodi. “This is why it is so important to find feasible, financially attractive and effective ways to help patients stop smoking before surgery.

“Our study shows that providing support in the run up to surgery enabled a third of the patients who took part in the study to remain smoke free after a year.

“Lower nicotine dependence levels were significantly associated with long-term abstinence and we believe that high levels should be classed as a chronic disorder. Our intervention was for a fairly intense eight-week period, but we recognise that people with higher levels of dependency may need longer to help them stop smoking before surgery.”
________________________________________
Journal reference:
1. Sadr Azodi et al. The efficacy of a smoking cessation programme in patients undergoing elective surgery - a randomised clinical trial. Anaesthesia, 2009; 64 (3): 259 DOI: 10.1111/j.1365-2044.2008.05758.x

Note: Nicotine alone has little or no effect on surgery. The smoke from smoking has very negative effects on flap survival. Tummy tucks and facelifts can be disasterous in smokers with loss of skin flaps. The impaired oxygen delivery from competitive binding of the CO to the red blood cell hemoglobins which are needed for gaseous exchange is improved with a minumum of two weeks of no smoking prior to surgery.

Larry Weinstein, MD FACS www.drlarryweinstein.com  www.docweinstein.com


Original Articles Winter 2008, Volume 16 Issue 4: 211-215

Incidence of capsular contracture in silicone versus saline cosmetic augmentation mammoplasty: A meta-analysis
Y El-Sheikh, R Tutino, C Knight, F Farrokhyar, N Hynes

INTRODUCTION: Capsular contracture after augmentation mammoplasty occurs at a rate of 15% to 45%. The purpose of the present study was to determine the effect of implant core type (silicone versus saline) on the rate of capsular contracture in augmentation mammoplasty.

METHODS: A systematic review was conducted through a search of three electronic databases. Two reviewers independently scanned titles yielded by the search and identified potentially relevant papers. Interreviewer variability and the scientific quality of the articles were assessed. Meta-analysis was performed.

RESULTS: Eighty-eight titles of potential relevance were selected from the 393 articles yielded by the search. Inter-rater agreement for selection of potentially relevant articles was 84% (k=0.54). Four comparative studies were included in the analysis. Scientific quality scores of the included studies ranged from 5 of 14 to 9 of 14. Three of the four studies reported a higher rate of capsular contracture in patients with silicone implants. A combined odds ratio calculated on two of the studies found a 2.25-fold increased risk of capsular contracture in patients who received silicone implants. Eight series of patients who received cohesive gel silicone implants reported rates of capsular contracture from 0% to 13.6%.

CONCLUSIONS: Higher rates of capsular contracture were found in patients who received silicone implants when compared with those who received saline implants. However, the scientific quality of the comparative studies to date on this subject is poor. Recent series evaluating cohesive gel implants report relatively low rates of capsular contracture. A randomized controlled trial comparing rates of capsular contracture in cohesive gel and saline implants is recommended.
Note: of over 500 patients in my practice with saline and silicone implants who have been instructed in massage techniques of the implant and have submuscular implants with smooth walls we have less than 10 % recorded capsular contracture.

Larry Weinstein, MD FACS www.doccweinstein.com  www.drlarryweinstein.com


Woman boxer becomes first to be banned from the ring for having breast implants
By Daily Mail Reporter
Last updated at 11:01 AM on 16th February 2009
• Comments (48)
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A model-turned-boxer has been banned from fighting - because of her breast implants.
Sarah Blewden, 25, has been told that repeated blows to her false breasts could knock them out of shape and damage her breast tissue.
Now boxing chiefs won't allow her to compete - dealing a knock-out blow for her hopes of competing in the Olympics in the future.
The pretty pugilist had breast enlargement surgery in 2003 to take her chest size up to a 32C from a 32B and to boost her modeling career.

Banned: Former model Sarah Blewden's fledgling boxing career has been hit by a ban in case she damages her 32C breast implants

Talking about the ban Miss Blewden said: 'I think it is just ridiculous. My surgeon said they make me no more vulnerable than any other woman. They are not enormous ones - they are in proportion.'
She turned to boxing two years ago as a way of keeping fit but realised she had a natural talent for it.

Sarah, who runs a successful hair salon, applied to the Amateur Boxing Association (ABA) so she could compete in the ring.
She was stunned when she was told she wasn't allowed to fight under Queensbury rules due to her implants.

A medical expert from the association said Sarah's chest was at risk of 'capsular contracture' or distortion if they were repeatedly hit. Blood cells in the breast tissue pushed forward by the implants could also be harmed, it was ruled. Sarah, from Poole, Dorset, said: 'I think it is just ridiculous. My surgeon said they make me no more vulnerable than any other woman. They are not enormous ones - they are in proportion.
'They are gel implants and not liquid so they won't burst. And if I suffer capsular contracture and need to pay for corrective surgery then that is my decision.'
Sarah also asked the ABA if she could wear a breast protector in the ring but was told that might not prevent her breasts from damage.
She said: 'They told me they have not got an approved breast protector but it just seems they haven't done the research and aren't willing to do it. I think I am the first woman to approach the ABA with this problem.
'Women haven't been allowed to box for that long and this is an obstacle I want to get over so other women like me won't have the same problem.'



Long-term fate of transplanted autologous fat in the face
Published online: 13 March 2009
Luiz Haroldo Pereira, Aris Sterodimas
DOI: 10.1016/j.bjps.2009.01.040
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900097-7/abstract


Free tissue transfers in the first 2 years of life – A successful cost
effective and humane option
Published online: 12 March 2009
R.M. Pinder, A. Hart, R.I.S. Winterton, A. Yates, S.P.J. Kay
DOI: 10.1016/j.bjps.2009.01.051
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900148-X/abstract


Collodion baby associated with congenital auricular anomalies:
Postpartum splinting of a rare congenital auricular deformity
Published online: 12 March 2009
Fabrizio Schonauer, Alda Scarcella, Ilaria Mataro, Angela Umbaldo,
Guido Molea
DOI: 10.1016/j.bjps.2009.01.054
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900151-X/abstract


Reconstruction of hand and forearm after sarcoma resection using
anterolateral thigh free flap
Published online: 09 March 2009
Naeho Lee, Sigyun Roh, Kyungmoo Yang, Jungryul Kim
DOI: 10.1016/j.bjps.2008.11.118
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2808%2901230-8/abstract


Congenital duplication of lower extremity – A case report and review of
the literature
Published online: 09 March 2009
Y. Osaki, S. Nishimoto, T.
Oyama, Y. Yoshimura
DOI: 10.1016/j.bjps.2009.01.030
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900085-0/abstract  


Hair control: a quick and simple method – Reply to ‘A draping technique
for scalp operations’ and ‘Secure sterile head drape for head and neck
surgery’
Published online: 09 March 2009
W.Y. Chan, J.K.G. Laitung
DOI: 10.1016/j.bjps.2009.01.032
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900087-4/abstract  


Modified thin abdominal wall flap (glove flap) for the treatment of
acute burns
to the hands and fingers
Published online: 09 March 2009
S. Urushidate, T. Yotsuyanagi, M. Yamauchi, M. Mikami, K. Ezoe, T.
Saito, K..
Yokoi, K. Ikeda, Y. Higuma, M. Shimoyama
DOI: 10.1016/j.bjps.2009.01.041
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900096-5/abstract  


Self injection of lipase – an extreme case for regulation in
non-surgical
cosmetic procedures
Published online: 09 March 2009
A.A.K-A. Khoo, O.A. Branford, M. Javaid
DOI: 10.1016/j.bjps.2008.11.122
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900138-7/abstract  


Knowledge and perceptions of facial plastic surgery among a selected
group of
professionals in Lagos, Nigeria
Published online: 09 March 2009
W.L. Adeyemo, B.O. Mofikoya, B.O. Bamgbose
DOI:=2
010.1016/j.bjps.2009.01.046
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900147-8/abstract  


A simple method for fishing out the umbilicus in abdominoplasty surgery
Published online: 09 March 2009
M. Taifour Suliman
DOI: 10.1016/j.bjps.2009.01.053
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900150-8/abstract  


Venous thromboembolism in plastic surgery: incidence, current practice
and
recommendations
Published online: 06 March 2009
Krystyna Miszkiewicz, Isabelle Perreault, Genevieve Landes, Patrick G.
Harris,
John S. Sampalis, Alexandre Dionyssopoulos, Andreas Nikolis
DOI: 10.1016/j.bjps.2008.11.109
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2808%2901223-0/abstract  


Motivational factors and psychological processes in cosmetic breast
augmentation
surgery
Published online: 06 March 2009
Anette S. Solvi, Kaja Foss, Tilmann von Soest, Helge E. Roald, Knut C.
Skolleborg, Arne Holte
DOI: 10.1016/j.bjps.2009.01.024
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900079-5/abstract  

Reverse facial artery flap from the submental region
Published online: 04 March 2009
Makoto Yamauchi, Takatoshi Yotsuyanagi, Kyori Ezoe, Tamotsu Saito,
Kanae Ikeda,
Koshiro Arai
DOI: 10.1016/j.bjps.2009.01.035
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900092-8/abstract  


Resurfacing of colour-mismatched free flaps on the face with
split-thickness
skin grafts from the scalp
Published online: 02 March 2009
D.A. Lannon, C.B. Novak, P.C. Neligan
DOI: 10.1016/j.bjps.2008.06.044
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2808%2900784-5/abstract  


One-Stage Integra reconstruction in head and neck defects
Published online: 02 March 2009
Andrew Burd, Pauline S.Y. Wong
DOI: 10.1016/j.bjps.2008.11.105
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2808%2901218-7/abstract  


Improvement of the maxillary bone growth suppression in the cleft
palate operation with cultured dermal substitute: animal experiment and
patient reports
in preliminary clinical application
Published online: 02 March 2009
N. Kurokawa, K. Ueda, Y. Kuroyanagi
DOI: 10.1016/j.bjps.2008.11.108
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2808%2901222-9/abstract  


A case of insulin lipohypertrophy in a young diabetic female
successfully
treated by vibroliposuction
Published online: 02 March 2009
Eugenio Gandolfi, Thione Alessandro


DOI: 10.1016/j.bjps.2008.11.114
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2808%2901225-4/abstract  


Extending the reverse posterior interosseous artery flap using a
de-epithelised
bridge segment
Published online: 02 March 2009
Yi-Jia Lim, Sandeep Jacob Sebastin, Poh Ling Fong, Winston Yoon Chong
Chew
DOI: 10.1016/j.bjps.2008.12.012
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900007-2/abstract  


Palmar Crease-plasty
Published online: 02 March 2009
Tai Suk Roh, Dong Won Lee, Hyun Joon Hong, Won Min Yoo
DOI: 10.1016/j.bjps.2009.01.008
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900060-6/abstract  


Onychomatricoma: an unusual case of ungual pathology. Case report and
review of the literature.
Published online: 02 March 2009
Ioannis Goutos, Dominic Furniss, Gillian D. Smith
DOI: 10.1016/j.bjps.2009.01.009
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900062-X/abstract  


Nasal specimen orientation: a useful technique to aid histological
interpretation of resection margins
Published online: 02 March 2009
A.J. Young, R. Hettige, N. Ibery
DOI: 10.1016/j.bjps.2009.01.017
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900071-0/abstract  


22q11 chromosome abnormalities and the cleft service
Published online: 02 March 2009
N. Nugent,=2
0A. McGillivary, M.J. Earley
DOI: 10.1016/j.bjps.2009.01.021
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900073-4/abstract  


Management of complex melanomas of head and neck region
Published online: 02 March 2009
Rajive Mathew Jose, William Kisku, Anup Pradhan, Dan Prinsloo
DOI: 10.1016/j.bjps.2009.01.026
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900075-8/abstract  


Novel method of applying Matriderm and SSG as a composite unit,
improving
accuracy, speed and adherence to the recipient site
Published online: 02 March 2009
S. Saour, J. Atkins, C.M.J. Healy
DOI: 10.1016/j.bjps.2009.01.023
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900076-X/abstract  


Combined use of power-assisted liposuction and trans-areolar incision
for
gynaecomastia treatment
Published online: 02 March 2009
N. Scuderi, L.A. Dessy, M. Tempesta, G. Bistoni, M. Mazzocchi
DOI: 10.1016/j.bjps.2009.01.025
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900081-3/abstract  


Concerns relating to the conduct and statistical analysis of the
Multicenter
Selective Lymphadenectomy Trial (MSLT-1) in patients with melanoma
Published online: 02 March 2009
Joseph Meirion Thomas
DOI: 10.1016/j.bjps.2009.01.027
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900083-7/abstract  


0AFine-Lubinsky syndrome: Managing the rare syndromic synostosis
Published online: 02 March 2009
Patrick Cole, Daniel A. Hatef, Yoav Kaufman, Larry H. Hollier
DOI: 10.1016/j.bjps.2009.01.031
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900086-2/abstract  


Ear avulsion
Published online: 02 March 2009
Greg O'Toole, Walid Sabbagh
DOI: 10.1016/j.bjps.2009.01.028
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900089-8/abstract


Did Nicolò Manuzzi (1639–1717) carry out reconstructive nose surgery
himself?
Published online: 02 March 2009
Robert C. van de Graaf
DOI: 10.1016/j.bjps.2009.01.029
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900090-4/abstract  


Autologous fat transfer: Controversies and current indications for
breast surgery
Published online: 02 March 2009
Ali Mojallal, Michel Saint-Cyr, Ignacio Garrido
DOI: 10.1016/j.bjps.2009.01.037
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900095-3/abstract  


Block and tackle tension sutures in keystone island flaps
Published online: 02 March 2009
Felix C. Behan, Cheng Hean Lo, Pauline Wong, David Sau Yan Wong
DOI: 10.1016/j.bjps.2009.01.047
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900139-9/abstract  


The keystone technique for resolution of chronic lower limb wound with


lymphoedema
Published online: 02 March 2009
Felix C. Behan, Cheng Hean Lo, Ramin Shayan, Michael Findlay
DOI: 10.1016/j.bjps.2009.01.048
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900140-5/abstract  


Skin necrosis after self-administered intramuscular diclofenac
Published online: 02 March 2009
Ofir Uri, Ehud Arad
DOI: 10.1016/j.bjps.2009.01.049
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900142-9/abstract


Gastric acid burns from binge drinking
Published online: 02 March 2009
Susan Wood, Duncan Donald Atherton, Roger Stevens, Greg Williams
DOI: 10.1016/j.bjps.2009.01.043
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900144-2/abstract  


The disaster of DIY breast augmentation
Published online: 02 March 2009
R.Y. Kannan, T.K. Sankar, D.J. Ward
DOI: 10.1016/j.bjps.2009.01.052
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900149-1/abstract  


The role of surgery in the management of congenital melanocytic naevi
in
children: a perspective from Great Ormond Street Hospital
Published online: 26 February 2009
Veronica Kinsler, Neil Bulstrode
DOI: 10.1016/j.bjps.2008.12.016
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900018-7/abstract


Preserving the neurovascular supply in the Hall-Findlay superomedial
pedicle
breast reduction: an an
atomical study
Published online: 26 February 2009
Cara Michelle le Roux, Birgitte J. Kiil, Wei-Ren Pan, Warren M. Rozen,
Mark W.
Ashton
DOI: 10.1016/j.bjps.2009.01.014
Journal of Plastic, Reconstructive & Aesthetic Surgery,
http://www.jprasurg..com/article/S1748-6815%2809%2900068-0/abstract  

1. A new validated otoplasty dressing technique
European Journal of Plastic Surgery, 01/29/09

2. Long–Term Outcomes of Free Muscle Transfer for Smile Restoration in Children
Plastic and Reconstructive Surgery, 02/04/09

3. Anatomical Repair of Zone 1 Flexor Tendon Injuries
Plastic and Reconstructive Surgery, 02/04/09

4. Selective Breast Reduction: A Personal Approach with a Central–Superior Pedicle
Plastic and Reconstructive Surgery, 02/02/09

5. Surgical correction of congenital constriction band syndrome in children: Replacing Z–plasty with direct closure
Canadian Journal of Plastic Surgery, 02/06/09

6. Transfixion incision as an initial technique in nasal tip deprojection
Canadian Journal of Plastic Surgery, 02/06/09

7. Incidence of capsular contracture in silicone versus saline cosmetic augmentation mammoplasty: A meta–analysis
Canadian Journal of Plastic Surgery, 02/06/09

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