Aesthetic Goldilocks mastectomy and breast reconstruction: promoting its use in the ideal candidate

Breast reconstruction after mastectomy is commonly performed using transverse rectus abdominis myocutaneous (TRAM) flap. Previous studies have demonstrated that botulinum neurotoxin injections in TRAM flap surgeries lower the risk of necrosis and allow further expansion of arterial cross-sectional diameters. The study was designed to determine the ideal injection points for botulinum neurotoxin injection by exploring the arborization patterns of the intramuscular nerves of the rectus abdominis muscle. A modified Sihler’s method was performed on 16 rectus abdominis muscle specimens. Arborization of the intramuscular nerves was determined based on the most prominent point of the xyphoid process to the pubic crest. All 16 rectus abdominis muscle specimens were divided into four muscle bellies by the tendinous portion. The arborized portions of the muscles were located on the 5–15%, 25–35%, 45–55%, and 70–80% sections of the 1st, 2nd, 3rd, and 4th muscle bellies, respectively. The tendinous portion was located at the 15–20%, 35–40%, 55–60%, and 90–100% sections. These results suggest that botulinum neurotoxin injections into the rectus abdominis muscles should be performed in specific sections.

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Indications for Preservation Rhinoplasty: Avoiding Complications

Facial Plastic Surgery ◽

10.1055/s-0041-1725154 ◽

2021 ◽

Vol 37 (01) ◽

pp. 045-052

Author(s):

Mario Bazanelli Junqueira Ferraz ◽

Guilherme Constante Preis Sella

Keyword(s):

Nasal Bone ◽

Nasal Dorsum ◽

Ideal Candidate ◽

Deviated Nose ◽

Lateral Osteotomy ◽

Upper Lateral Cartilage ◽

High Radix ◽

The One ◽

Different Levels ◽

The Ideal

AbstractNasal dorsal preservation surgery was described more than 100 years ago, but recently has gained prominence. Our objective is to show the surgical technique, the main indications and counterindications, and the complications. It is a technique that does not cause the detachment of the upper lateral cartilage (ULC) from the nasal septum, and has the main following sequence: preparation of the septum and its resection can be at different levels (high or low, i.e., SPAR [septum pyramidal adjustment and repositioning] A or B); preparation of the pyramid; transversal osteotomy; lateral osteotomy(s); and septopyramidal adjustment. The result is a nose with a lower radix than the original, a deprojection of the nasal dorsum tending to maintain its original shape; an increase in the interalar distance (IAD) and enlargement of the nasal middle ⅓; and loss of projection of the nasal tip and roundness of the nostrils. Thus, the ideal candidate is the one who benefits from such side effects, that is: tension nose, that is, high radix with projected dorsum, projected anterior nasal septal angle (ANSA), narrow middle ⅓, narrow IAD, thin nostrils and straight perpendicular plate of the ethmoid (PPE), and, depending on the characteristics, the deviated nose. The counterindications are low radix, irregularities in the nasal dorsum, ANSA lower than rhinion, and a wide middle ⅓. And the main stigmas are: a nose with a very low radix, middle ⅓ enlarged, residual hump, and saddling of the supratip area. Other issues of this technique are: the shape of the radix; the need or not to remove PPE; wide dorsum; irregular dorsum; ANSA lower than rhinion; weak cartilages; long nasal bone; deviated PPE; and obsessive patient. We conclude that this is a great technique for noses with characteristics suitable to it; care must be taken with the stigmas it can cause.

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Toward a Better Understanding of Metal Nanoparticles, a Novel Strategy from Eucalyptus Plants

Plants ◽

10.3390/plants10050929 ◽

2021 ◽

Vol 10 (5) ◽

pp. 929

Author(s):

Hanadi Sawalha ◽

Rambod Abiri ◽

Ruzana Sanusi ◽

Noor Azmi Shaharuddin ◽

Aida Atiqah Mohd Noor ◽

...

Keyword(s):

Metal Nanoparticles ◽

Woody Plants ◽

Woody Species ◽

Forest Products ◽

Ideal Candidate ◽

Promising Tool ◽

Novel Strategy ◽

The Ideal

Nanotechnology is a promising tool that has opened the doors of improvement to the quality of human’s lives through its potential in numerous technological aspects. Green chemistry of nanoscale materials (1–100 nm) is as an effective and sustainable strategy to manufacture homogeneous nanoparticles (NPs) with unique properties, thus making the synthesis of green NPs, especially metal nanoparticles (MNPs), the scientist’s core theme. Researchers have tested different organisms to manufacture MNPs and the results of experiments confirmed that plants tend to be the ideal candidate amongst all entities and are suitable to synthesize a wide variety of MNPs. Natural and cultivated Eucalyptus forests are among woody plants used for landscape beautification and as forest products. The present review has been written to reflect the efficacious role of Eucalyptus in the synthesis of MNPs. To better understand this, the route of extracting MNPs from plants, in general, and Eucalyptus, in particular, are discussed. Furthermore, the crucial factors influencing the process of MNP synthesis from Eucalyptus as well as their characterization and recent applications are highlighted. Information gathered in this review is useful to build a basis for new prospective research ideas on how to exploit this woody species in the production of MNPs. Nevertheless, there is a necessity to feed the scientific field with further investigations on wider applications of Eucalyptus-derived MNPs.

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Meet the (Ideal) Candidate: How Viewers Interpret Political Advertising During the “Invisible Primary”

Communication Studies ◽

10.1080/10510970701849404 ◽

2008 ◽

Vol 59 (1) ◽

pp. 68-83 ◽

Cited By ~ 1

Author(s):

John H. Parmelee

Keyword(s):

Political Advertising ◽

Ideal Candidate ◽

The Ideal ◽

The Invisible

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The Ideal Candidate

Aesthetic Surgery of the Facial Mosaic ◽

10.1007/978-3-540-33162-9_14 ◽

2007 ◽

pp. 68-69

Keyword(s):

Ideal Candidate ◽

The Ideal

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Study of the Structural and Robustness Characteristics of Madrid Metro Network

Sustainability ◽

10.3390/su11123486 ◽

2019 ◽

Vol 11 (12) ◽

pp. 3486 ◽

Cited By ~ 2

Author(s):

Elisa Frutos Bernal ◽

Angel Martín del Rey

Keyword(s):

Network Analysis ◽

Qualitative Analysis ◽

Smart Cities ◽

Transport Networks ◽

Ideal Candidate ◽

Transportation Service ◽

Topological Characteristics ◽

Metro Networks ◽

The Ideal ◽

Metro Network

A transportation service must be sustainable, respectful of the environment, and socially and economically responsible. These requirements make metro networks the ideal candidate as the most efficient mean of transport in our society. Now, a correct management of this type of infrastructures entails the analysis of the structure and robustness of these networks. This allows us to detect malfunctions and, above all, to design in the most appropriate way the expansion of subway networks. This is one of the major challenges facing the study of transport networks in sustainable smart cities. In this sense, the complex network analysis provides us with the necessary scientific tools to perform both quantitative and qualitative analysis of metro networks. This work deals with Madrid metro network, which is the largest in Spain. The main structural and topological characteristics, and robustness features of Madrid metro network were studied. The results obtained were analyzed and some conclusions were derived.

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The Ideal Microsurgery Fellowship: A Survey of Fellows and Fellowship Directors

Journal of Reconstructive Microsurgery ◽

10.1055/s-0040-1715879 ◽

2020 ◽

Author(s):

Meera Reghunathan ◽

Michelle Zaldana-Flynn ◽

John Rose ◽

Christopher A. Crisera ◽

Chris M. Reid

Keyword(s):

Breast Reconstruction ◽

Time Allocation ◽

Clinical Decision Making ◽

Revisional Surgery ◽

Clinical Decision ◽

Head And Neck Reconstruction ◽

Free Fibula Flap ◽

Lower Extremity Reconstruction ◽

Free Fibula ◽

The Ideal

Abstract Background Although microsurgery fellowships have existed since the 1980s, there is no established curriculum. Microsurgery fellowships vary greatly in clinical caseload, case diversity, and training resources, and there is no consensus on the appropriate composition of a microsurgery fellowship. This study surveys fellowship directors (FD) and recent microsurgery fellows (MFs), graduates, to describe the ideal microsurgery fellowship program. Methods A 15-item questionnaire was sent to 38 FDs and 90 recent microsurgery fellowship graduates. This questionnaire addressed program attributes, case volumes and compositions, ideal experiences, and time allocation to different fellowship experiences. Data were analyzed using descriptive statistics, t-tests, and Chi-squared tests. Results The FD and MF surveys had a response rate of 47 and 49%, respectively. Both MF and FD agreed that exposure to microsurgical breast reconstruction is the most important characteristic of a microsurgery fellowship (p = 0.94). MF ranked replantation and supermicro/lymphatic surgery as the next most important microsurgical cases, while FD ranked the anterolateral thigh (ALT) flap and free fibula flap (p < 0.001). Both agreed that revisional surgery after microsurgical reconstruction is a very valuable fellowship experience (p = 0.679). Both agreed that 1 day of clinic a week is sufficient. Conclusion Microsurgical training programs vary in quality and resources. The ideal microsurgery fellowship prioritized breast reconstruction, head and neck reconstruction, and lower extremity reconstruction. Although microsurgical technical expertise is important, a fellowship should also train in revisional surgeries and clinical decision making.

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