Liposuction as the Primary Procedure for Treating Ptotic Abdominal Wall

In 1982 Illouz introduced liposuction to North America. Now, it is the most common aesthetic plastic surgery for females. Indications for the procedure have increased. During a 10-year period we performed liposuction on 1000 patients who were under local anesthesia. On 446 patients the treated area was the abdomen, alone or in combination with other areas. Of the patients who underwent abdominal liposuction, 92 had ptotic abdominal wall. Five of those patients had planned two-stage procedures or touch-ups of the abdomen. We followed 45 of the 92 patients. None have had abdominoplasty by us or other surgeons. The longest follow-up for a patient was 10 years and the shortest follow-up was 1 year.

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IS THE COMBINATION OF LOCAL ANESTHESIA AND CONSCIOUS SEDATION TECHNIQUE SAFE IN AESTHETIC PLASTIC SURGERY?

Southern Medical Journal ◽

10.1097/00007611-199009001-00266 ◽

1990 ◽

Vol 83 (Supplement) ◽

pp. 2S-67

Author(s):

Radoslav M. Kosanin ◽

Verne C. Lanier

Keyword(s):

Plastic Surgery ◽

Local Anesthesia ◽

Conscious Sedation ◽

Aesthetic Plastic Surgery

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Post‐operative follow‐up of 150 patients with sentinel lymph node biopsy under tumescence local anesthesia

JDDG Journal der Deutschen Dermatologischen Gesellschaft ◽

10.1111/ddg.14351 ◽

2021 ◽

Author(s):

Julia Eckardt ◽

Hans‐Martin Häfner ◽

Katrin Kofler ◽

Gabi Mroz ◽

Alexander Scheu ◽

...

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Local Anesthesia ◽

Lymph Node Biopsy ◽

Node Biopsy ◽

Tumescence Local Anesthesia

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LVIS-within-enterprise double-stent procedure without coiling beneficial as treatment of unruptured vertebral artery dissecting aneurysms

Interventional Neuroradiology ◽

10.1177/15910199211025109 ◽

2021 ◽

pp. 159101992110251

Author(s):

Hyun Ho Choi ◽

Young Dae Cho ◽

Dong Hyun Yoo ◽

Hyun-Seung Kang ◽

Moon Hee Han

Keyword(s):

Vertebral Artery ◽

Clinical Outcomes ◽

Local Anesthesia ◽

Thrombus Formation ◽

Flow Diversion ◽

Fusiform Aneurysm ◽

Stent Deployment ◽

Double Stent ◽

Dissecting Aneurysms

Stenting of vertebral artery dissecting aneurysms (VADAs) may promote mural apposition of intimal flaps, preserving the patency of injured vessels. Moreover, stent deployment may serve to alter intra-aneurysm flow, inducing saccular thrombus formation, neointimal development, and remodeling of injured vessels. Although an overlapping multistent strategy with coiling has proven successful in this setting, yielding good anatomic and clinical outcomes, coiling may be technically infeasible in some VADAs with unfavorably configured circumferential elevations. Herein, we describe three patients with VADAs for whom coiling was deemed technically problematic. Each underwent double stenting (LVIS within Enterprise), without coil insertion, using local anesthesia. Conventional angiographic follow-up regularly disclosed excellent saccular occlusion and subsequent remodeling of stented arteries. LVIS-within-Enterprise double stenting may be of particular benefit in patients with VADAs, the Enterprise providing outer support to minimize stent bulging (as a fusiform aneurysm) as the inner LVIS reinforces flow diversion.

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An empirical example of analysis using a two-stage modeling approach: within-subject association of outdoor context and physical activity predicts future daily physical activity levels

Translational Behavioral Medicine ◽

10.1093/tbm/ibaa107 ◽

2020 ◽

Author(s):

Chih-Hsiang Yang ◽

Jaclyn P Maher ◽

Aditya Ponnada ◽

Eldin Dzubur ◽

Rachel Nordgren ◽

...

Keyword(s):

Physical Activity ◽

Vigorous Physical Activity ◽

Wearable Sensors ◽

Activity Levels ◽

Two Stage ◽

Modeling Approach ◽

Source Program ◽

Modeling Strategy ◽

Stage Modeling

Abstract People differ from each other to the extent to which momentary factors, such as context, mood, and cognitions, influence momentary health behaviors. However, statistical models to date are limited in their ability to test whether the association between two momentary variables (i.e., subject-level slopes) predicts a subject-level outcome. This study demonstrates a novel two-stage statistical modeling strategy that is capable of testing whether subject-level slopes between two momentary variables predict subject-level outcomes. An empirical case study application is presented to examine whether there are differences in momentary moderate-to-vigorous physical activity (MVPA) levels between the outdoor and indoor context in adults and whether these momentary differences predict mean daily MVPA levels 6 months later. One hundred and eight adults from a multiwave longitudinal study provided 4 days of ecological momentary assessment (during baseline) and accelerometry data (both at baseline and 6 month follow-up). Multilevel data were analyzed using an open-source program (MixWILD) to test whether momentary strength between outdoor context and MVPA during baseline was associated with average daily MVPA levels measured 6 months later. During baseline, momentary MVPA levels were higher in outdoor contexts as compared to indoor contexts (b = 0.07, p < .001). Participants who had more momentary MVPA when outdoors (vs. indoors) during baseline (i.e., a greater subject-level slope) had higher daily MVPA at the 6 month follow-up (b = 0.09, p < .05). This empirical example shows that the subject-level momentary association between specific context (i.e., outdoors) and health behavior (i.e., physical activity) may contribute to overall engagement in that behavior in the future. The demonstrated two-stage modeling approach has extensive applications in behavioral medicine to analyze intensive longitudinal data collected from wearable sensors and mobile devices.

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Subthreshold laser treatment for reticular pseudodrusen secondary to age-related macular degeneration

Scientific Reports ◽

10.1038/s41598-021-81810-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Giuseppe Querques ◽

Riccardo Sacconi ◽

Francesco Gelormini ◽

Enrico Borrelli ◽

Francesco Prascina ◽

...

Keyword(s):

Macular Degeneration ◽

Laser Treatment ◽

Age Related Macular Degeneration ◽

Short Term ◽

Treated Area ◽

Reticular Pseudodrusen ◽

End Point ◽

Age Related ◽

Subthreshold Laser

AbstractThere is a lack of treatment aimed at the regression of reticular pseudodrusen (RPD) secondary to age-related macular degeneration (AMD). The aim of this prospective, pilot study is to evaluate the safety and short-term efficacy of subthreshold laser treatment (SLT) in patients affected by RPD secondary to dry AMD (dAMD). Twenty eyes of 20 patients (mean age 78.4 ± 6.8 years) with RPD secondary to dAMD were prospectively enrolled. All patients were treated in an extrafoveal area of 1.27 mm2 using end-point management yellow subthreshold laser and followed for 3 months. Best-corrected visual acuity was 0.140 ± 0.09 LogMAR at the baseline and no changes were observed during the follow-up (p = 0.232). No significant worsening was disclosed before and after the treatment analyzing the macular sensitivity of the treated area (p = 0.152). No topical and/or systemic side effects were disclosed during the 3-month follow-up. The distribution among the RPD stages changed after the treatment (p < 0.001). In detail, in the treated area, we observed a significant increase in the number of Stage 1 RPD during the follow-up (p = 0.002), associated with a significant decrease of Stage 3 RPD (p = 0.020). Outer nuclear layer (ONL) thickness analysis showed a significant increase after the treatment associated with RPD regression (p = 0.001). End-point management SLT appears a safe treatment for RPD secondary to dAMD, showing short-term safety outcomes. Our results suggest that SLT could be effective in inducing a RPD regression in terms of RPD stage and ONL thickening.

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Long-term outcomes of two-stage, immediate and delayed breast reconstruction with polyurethane-covered versus textured implants: protocol of a prospective, multicentre randomised controlled trial (TIPI trial)

BMJ Open ◽

10.1136/bmjopen-2020-044219 ◽

2021 ◽

Vol 11 (5) ◽

pp. e044219

Author(s):

J X Harmeling ◽

Kevin Peter Cinca ◽

Eleni-Rosalina Andrinopoulou ◽

Eveline M L Corten ◽

M A Mureau

Keyword(s):

Randomised Controlled Trial ◽

Breast Reconstruction ◽

Controlled Trial ◽

Capsular Contracture ◽

Tissue Expander ◽

Complication Rates ◽

Two Stage ◽

Randomised Controlled

IntroductionTwo-stage implant-based breast reconstruction is the most commonly performed postmastectomy reconstructive technique. During the first stage, a tissue expander creates a sufficiently large pocket for the definite breast implant placed in the second stage. Capsular contracture is a common long-term complication associated with implant-based breast reconstruction, causing functional complaints and often requiring reoperation. The exact aetiology is still unknown, but a relationship between the outer surface of the implant and the probability of developing capsular contracture has been suggested. The purpose of this study is to determine whether polyurethane-covered implants result in a different capsular contracture rate than textured implants.Methods and analysisThe Textured Implants versus Polyurethane-covered Implants (TIPI) trial is a multicentre randomised controlled trial with a 1:1 allocation rate and a follow-up of 10 years. A total of 321 breasts of female adults undergoing a two-stage breast reconstruction will be enrolled. The primary outcome is capsular contracture at 10-year follow-up which is graded with the modified Baker classification. It is analysed with survival analysis using a frailty model for clustered interval-censored data, with both an intention-to-treat and per-protocol approach. Secondary outcomes are other complication rates, surgical revision rate, patient satisfaction and quality of life and user-friendliness. Outcomes are measured 2 weeks, 6 months, 1, 2, 3, 5 and 10 years postoperatively. Interim analysis is performed when 1-year, 3-year and 5-year follow-up is completed.Ethics and disseminationThe trial has been reviewed and approved by the Medical Research Ethics Committee of the Erasmus MC, University Medical Centre Rotterdam (MEC-2018-126) and locally by each participating centre. Written informed consent will be obtained from each study participant. The results will be disseminated by publication in peer-reviewed journals.Trial registrationNTR7265.

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ASJ Welcomes New International Affiliate—The Spanish Association of Aesthetic Plastic Surgery

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa241 ◽

2020 ◽

Vol 41 (1) ◽

pp. 140-140

Author(s):

Foad Nahai

Keyword(s):

Plastic Surgery ◽

Aesthetic Plastic Surgery ◽

International Affiliate

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Long-Term Clinical Outcomes of an Antibiotic-Coated Non–Cross-linked Porcine Acellular Dermal Graft for Abdominal Wall Reconstruction for High-Risk and Contaminated Wounds

The American Surgeon ◽

10.1177/00031348211023392 ◽

2021 ◽

pp. 000313482110233

Author(s):

Jordan Robinson ◽

Jesse K. Sulzer ◽

Benjamin Motz ◽

Erin H. Baker ◽

John B. Martinie ◽

...

Keyword(s):

High Risk ◽

Abdominal Wall ◽

Clinical Outcomes ◽

Open Abdomen ◽

Abdominal Wall Reconstruction ◽

Dermal Graft ◽

Elective Repair ◽

Acellular Dermal

Background Abdominal wall reconstruction in high-risk and contaminated cases remains a challenging surgical dilemma. We report long-term clinical outcomes for a rifampin-/minocycline-coated acellular dermal graft (XenMatrix™ AB) in complex abdominal wall reconstruction for patients with a prior open abdomen or contaminated wounds. Methods Patients undergoing abdominal wall reconstruction at our institution at high risk for surgical site occurrence and reconstructed with XenMatrix™ AB with intent-to-treat between 2014 and 2017 were included. Demographics, operative characteristics, and outcomes were collected. The primary outcome was hernia recurrence. The secondary outcomes included length of stay, surgical site occurrence, readmission, morbidity, and mortality. Results Twenty-two patients underwent abdominal wall reconstruction using XenMatrix™ AB during the study period. Two patients died while inpatient from progression of their comorbid diseases and were excluded. Sixty percent of patients had an open abdomen at the time of repair. All patients were from modified Ventral Hernia Working Group class 2 or 3. There were a total of four 30-day infectious complications including superficial cellulitis/fat necrosis (15%) and one intraperitoneal abscess (5%). No patients required reoperation or graft excision. Median clinical follow-up was 38.2 months with a mean of 35.2 +/− 18.5 months. Two asymptomatic recurrences and one symptomatic recurrence were noted during this period with one planning for elective repair of an eventration. Follow-up was extended by phone interview which identified no additional recurrences at a median of 45.5 and mean of 50.5 +/−12.7 months. Conclusion We present long-term outcomes for patients with high-risk and contaminated wounds who underwent abdominal wall reconstruction reinforced with XenMatrix™ AB to achieve early, permanent abdominal closure. Acceptable outcomes were noted.

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Surgery of tympanosclerosis

The Journal of Laryngology & Otology ◽

10.1017/s0022215100138976 ◽

1997 ◽

Vol 111 (10) ◽

pp. 917-923 ◽

Cited By ~ 15

Author(s):

Syed Akhtar Kamal

Keyword(s):

Middle Ear ◽

Radical Surgery ◽

Stapes Surgery ◽

Hearing Improvement ◽

Short Term ◽

Two Stage ◽

Chi Square ◽

Physiological Basis

AbstractEighty-five cases with tympanosclerosis of the middle ear were treated surgically in this series from 1984 to 1995. Twelve of them were associated with cholesteatoma and had radical surgery performed. An attempt is made here to classify the tympanosclerosis on a patho-physiological basis. A planned two-stage procedure was performed in 36 cases after an interval of 18 months. The majority of patients had stapes surgery carried out by a two-stage procedure. One of the patients who did not have stapes surgery developed anacusis after 18 months post-operatively and in another patient recurrence was observed. Post-operative hearing improvement was found to be satisfactory in the short-term follow-up period of two to five years. The hearing improvement was analysed by using Chi-square value (x2) and also plotted in the Glasgow Benefit Plot.

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