Ultrasound to Improve the Safety and Efficacy of Lipofilling of the Temples

2020 ◽  
Author(s):  
Jonathan Kadouch ◽  
Leonie W Schelke ◽  
Arthur Swift
Keyword(s):  
Adverse Events ◽  
Temporal Artery ◽  
Level Of Evidence ◽  
Temporal Fossa ◽  
Autologous Fat ◽  
The Past ◽  
The Face ◽  
Vascular Mapping ◽  
Permanent Fillers ◽  
Vascular Adverse Events

Abstract Background Autologous fat is known for a reliable and natural safety profile, but complications do occur—even serious vascular adverse events. Objectives The authors sought to examine doppler-ultrasound (DUS) imaging for the harvesting and subsequent facial implantation of autologous fat tissue. Methods All patients underwent lipofilling treatment of the temporal fosse of the face. DUS examination was performed for preprocedural vascular mapping and imaging of previously injected (permanent) fillers. In addition, the injection of autologous fat was performed DUS-guided. Results Twenty patients (all female; mean age, 57.9 years; range, 35-64 years). DUS examination showed that 16 of the 20 patients (80%) had been injected with resorbable or nonresorbable fillers elsewhere in the past. The temporal artery could be visualized and avoided in all cases. An average of 1.1 cc of autologous fat was injected in the temporal fossa per side. One case of edema and nodules was described, but no other adverse events were reported. Conclusions The utilization of DUS can add valuable information to a lipofilling procedure and should be considered an integral part of a safe lipofilling treatment. Level of Evidence: 4

scholarly journals Assessing Clinical Outcomes in Autologous Fat Grafting: A Current Literature Review

2021 ◽  
Vol 41 (Supplement_1) ◽  
pp. S50-S60
Author(s):  
Teri N Moak ◽  
Trina G Ebersole ◽  
Damini Tandon ◽  
Marissa Tenenbaum
Keyword(s):  
Standard Of Care ◽  
Fat Grafting ◽  
The Body ◽  
Autologous Fat Grafting ◽  
Level Of Evidence ◽  
Autologous Fat ◽  
Aesthetic Appearance ◽  
Radiologic Imaging ◽  
The Face ◽  
Surgeon Satisfaction

Abstract Autologous fat grafting, first described in the 1890s, has since undergone many modifications to optimize safety and efficacy. These changes have resulted in the technique that we now consider standard of care, one that is applied to reconstruction and cosmetic enhancement of the breast and the face both independently and in conjunction with surgical treatment. There is a growing body of evidence that this application has positive outcomes for patient satisfaction, surgeon satisfaction, and overall aesthetic appearance. This article summarizes the body of literature regarding these outcomes, reviews complications of fat grafting in the face and breast, and discusses controversies including radiologic imaging changes and longevity of grafting. Level of Evidence: 4

Safety Considerations of Fat Grafting in Buttock Augmentation

2021 ◽  
Vol 41 (Supplement_1) ◽  
pp. S25-S30
Author(s):  
Rebecca C O’Neill ◽  
Summer E Hanson ◽  
Edward Reece ◽  
Sebastian Winocour
Keyword(s):  
Mortality Rate ◽  
Plastic Surgery ◽  
Fat Embolism ◽  
Fat Grafting ◽  
Autologous Fat Grafting ◽  
Level Of Evidence ◽  
Autologous Fat ◽  
The Past ◽  
Safety Considerations ◽  
A Current

Abstract Autologous fat grafting for buttock augmentation is one of the fastest growing plastic surgery procedures, but has also received significant publicity for the relatively high mortality rate secondary to fat emboli. The literature has grown exponentially in the past 5 years on this subject, helping to clarify our knowledge and providing recommendations to minimize risks, including avoiding intramuscular injections, placing the patient in the jackknife position, and utilizing larger-bore cannulas. Since the application of these recommendations, the rate of pulmonary fat embolism has decreased from 0.097% to 0.04%, with a current mortality of 1 in 14,921, making it statistically safer than abdominoplasty. Despite the evolution in our knowledge, techniques, and outcomes, it remains of utmost importance to properly select and educate patients about the safety of fat grafting for buttock augmentation. Level of Evidence: 4

Epilogue: On the Current and Future State of Historical Writing

2018 ◽  
Author(s):  
Allan Megill
Keyword(s):  
Historical Writing ◽  
Conceptual Difficulty ◽  
Universal History ◽  
The Past ◽  
Initial Decision ◽  
Future State ◽  
The Face ◽  
History Of

This epilogue argues that historians ought to be able to produce a universal history, one that would ‘cover’ the past of humankind ‘as a whole’. However, aside from the always increasing difficulty of mastering the factual material that such an undertaking requires, there exists another difficulty: the coherence of universal history always presupposes an initial decision not to write about the human past in all its multiplicity, but to focus on one aspect of that past. Nevertheless, the lure of universal history will persist, even in the face of its practical and conceptual difficulty. Certainly, it is possible to imagine a future ideological convergence among humans that would enable them to accept, as authoritative, one history of humankind.

Maxillofacial Bony Considerations in Facial Transplantation

2021 ◽  
Author(s):  
Aurora G. Vincent ◽  
Anne E. Gunter ◽  
Yadranko Ducic ◽  
Likith Reddy
Keyword(s):  
Soft Tissue ◽  
Current Literature ◽  
Preoperative Planning ◽  
Surgical Anatomy ◽  
The Past ◽  
Facial Transplantation ◽  
Tissue Transfer ◽  
Reconstructive Ladder ◽  
The Face ◽  
Facial Wounds

AbstractAlloplastic facial transplantation has become a new rung on the proverbial reconstructive ladder for severe facial wounds in the past couple of decades. Since the first transfer including bony components in 2006, numerous facial allotransplantations across many countries have been successfully performed, many incorporating multiple bony elements of the face. There are many unique considerations to facial transplantation of bone, however, beyond the considerations of simple soft tissue transfer. Herein, we review the current literature and considerations specific to bony facial transplantation focusing on the pertinent surgical anatomy, preoperative planning needs, intraoperative harvest and inset considerations, and postoperative protocols.

scholarly journals Deep-Emotion: Facial Expression Recognition Using Attentional Convolutional Network

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3046
Author(s):  
Shervin Minaee ◽  
Mehdi Minaei ◽  
Amirali Abdolrashidi
Keyword(s):  
Deep Learning ◽  
Facial Expression ◽  
Facial Expression Recognition ◽  
Expression Recognition ◽  
Visualization Technique ◽  
Convolutional Network ◽  
The Past ◽  
Multiple Datasets ◽  
The Face ◽  
Traditional Approaches

Facial expression recognition has been an active area of research over the past few decades, and it is still challenging due to the high intra-class variation. Traditional approaches for this problem rely on hand-crafted features such as SIFT, HOG, and LBP, followed by a classifier trained on a database of images or videos. Most of these works perform reasonably well on datasets of images captured in a controlled condition but fail to perform as well on more challenging datasets with more image variation and partial faces. In recent years, several works proposed an end-to-end framework for facial expression recognition using deep learning models. Despite the better performance of these works, there are still much room for improvement. In this work, we propose a deep learning approach based on attentional convolutional network that is able to focus on important parts of the face and achieves significant improvement over previous models on multiple datasets, including FER-2013, CK+, FERG, and JAFFE. We also use a visualization technique that is able to find important facial regions to detect different emotions based on the classifier’s output. Through experimental results, we show that different emotions are sensitive to different parts of the face.

scholarly journals Are the First and Second Hip in Staged Bilateral Total Hip Arthroplasty Equal? A Hospital Adverse Event and Perioperative Risk Comparison

2021 ◽  
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Carlos A. Higuera ◽  
Juan C. Suarez ◽  
Preetesh D. Patel ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Adverse Events ◽  
Hip Arthroplasty ◽  
Retrospective Chart Review ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Exact Test ◽  
Total Hip ◽  
Discharge Disposition ◽  
The Mean

AbstractHospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second. Level of Evidence Level III.

scholarly journals Levels of Evidence in Rhinology and Skull Base Surgery Research

2021 ◽  
pp. 019459982098713
Author(s):  
Jennifer A. Silver ◽  
Marco Mascarella ◽  
George Tali ◽  
Rickul Varshney ◽  
Marc A. Tewfik ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Absolute Number ◽  
High Quality ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
The Past ◽  
Significant Difference ◽  
Surgery Research ◽  
Based Medicine

Objective The purpose of this study was to evaluate the quality of evidence of rhinology and rhinologic skull base surgery (RSBS) research and its evolution over the past decade. Study Design Review article. Setting We reviewed articles from 2007 to 2019 in 4 leading peer-reviewed otolaryngology journals and 3 rhinology-specific journals. Methods The articles were reviewed and levels of evidence were assigned using the Oxford Centre for Evidence-Based Medicine 2011 guidelines. High quality was defined as level of evidence 1 or 2. Results In total, 1835 articles were reviewed in this study spanning a 13-year period. Overall, the absolute number of RSBS publications increased significantly 22.6% per year, from 108 articles in 2007 to 481 in 2019 ( P < .001; 95% CI, 7.9-37.2). In 2007, only 13 articles, or 15%, were high quality, and this grew to 146 articles, or 39%, in 2019. A 14.0% per year exponential increase in the number of high-quality publications was found to be statistically significant ( P < .001; 95% CI, 7.2, 20.7). Overall, high-quality publications represented just 25.8% of RSBS articles overall. There was no significant difference in quality between rhinology-specific journals and general otolaryngology journals (χ2 = 3.1, P = .077). Conclusion The number of overall publications and of high-quality RSBS publications has significantly increased over the past decade. However, the proportion of high-quality studies continues to represent a minority of total RSBS research.

scholarly journals Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15 years

2021 ◽  
Author(s):  
Stephanie Kirschbaum ◽  
Thilo Kakzhad ◽  
Fabian Granrath ◽  
Andrzej Jasina ◽  
Jakub Oronowicz ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Special Topic ◽  
Computer Assisted ◽  
Time Interval ◽  
Search Term ◽  
Level Of Evidence ◽  
The Past ◽  
Patient Reported ◽  
Over Time ◽  
Number Of Authors

Abstract Purpose This study aimed to evaluate both publication and authorship characteristics in Knee Surgery, Sports Traumatology, Arthroscopy journal (KSSTA) regarding knee arthroplasty over the past 15 years. Methods PubMed was searched for articles published in KSSTA between January 1, 2006, and December 31st, 2020, utilising the search term ‘knee arthroplasty’. 1288 articles met the inclusion criteria. The articles were evaluated using the following criteria: type of article, type of study, main topic and special topic, use of patient-reported outcome scores, number of references and citations, level of evidence (LOE), number of authors, gender of the first author and continent of origin. Three time intervals were compared: 2006–2010, 2011–2015 and 2016–2020. Results Between 2016 and 2020, publications peaked at 670 articles (52%) compared with 465 (36%) published between 2011 and 2016 and 153 articles (12%) between 2006 and 2010. While percentage of reviews (2006–2010: 0% vs. 2011–2015: 5% vs. 2016–2020: 5%) and meta-analyses (1% vs. 6% vs. 5%) increased, fewer case reports were published (13% vs. 3% vs. 1%) (p < 0.001). Interest in navigation and computer-assisted surgery decreased, whereas interest in perioperative management, robotic and individualized surgery increased over time (p < 0.001). There was an increasing number of references [26 (2–73) vs. 30 (2–158) vs. 31 (1–143), p < 0.001] while number of citations decreased [30 (0–188) vs. 22 (0–264) vs. 6 (0–106), p < 0.001]. LOE showed no significant changes (p = 0.439). The number of authors increased between each time interval (p < 0.001), while the percentage of female authors was comparable between first and last interval (p = 0.252). Europe published significantly fewer articles over time (56% vs. 47% vs. 52%), whereas the number of articles from Asia increased (35% vs. 45% vs. 37%, p = 0.005). Conclusion Increasing interest in the field of knee arthroplasty-related surgery arose within the last 15 years in KSSTA. The investigated topics showed a significant trend towards the latest techniques at each time interval. With rising number of authors, the part of female first authors also increased—but not significantly. Furthermore, publishing characteristics showed an increasing number of publications from Asia and a slightly decreasing number in Europe. Level of evidence IV.

scholarly journals Chronic (Rasmussen’s) Encephalitis in an Adult

2003 ◽  
Vol 30 (3) ◽  
pp. 263-265 ◽  
Author(s):  
Richard Wennberg ◽  
Sukriti Nag ◽  
Mary-Pat McAndrews ◽  
Andres M. Lozano ◽  
Richard Farb ◽  
...  
Keyword(s):  
Visual Field ◽  
Right Visual Field ◽  
Loss Of Consciousness ◽  
Mild Head Injury ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
The Past ◽  
Rasmussen’S Encephalitis ◽  
The Face ◽  
The Right

A 24-year-old woman was referred because of incompletely-controlled complex partial seizures. Her seizures had started at age 21, after a mild head injury with brief loss of consciousness incurred in a biking accident, and were characterized by a sensation of bright flashing lights in the right visual field, followed by numbness and tingling in the right foot, spreading up the leg and to the arm, ultimately involving the entire right side, including the face. Occasionally they spread further to involve right facial twitching with jerking of the right arm and leg, loss of awareness and, at the onset of her epilepsy, rare secondarily generalized convulsions. Seizure frequency averaged three to four per month. She was initially treated with phenytoin and clobazam and subsequently changed to carbamazepine 800 milligrams per day. She also complained that her right side was no longer as strong as her left and that it was also numb, especially the leg, but felt that this weakness had stabilized or improved slightly over the past two years.

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