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Stein MJ, Smith D, Chia C, Matarasso A. Paradoxical Adipose Hyperplasia Following Cryolipolysis. Aesthet Surg J 2024:sjae077. [PMID: 38573568 DOI: 10.1093/asj/sjae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/05/2024] Open
Abstract
Cryolipolysis (CL) is a noninvasive technique that uses applicators to cool tissue to temperatures that selectively destroy adipocytes. Since its introduction to the market, it has rapidly become one of the leading non-surgical modalities to reduce fat in the aesthetic industry. Paradoxical Adipose Hyperplasia (PAH) is an adverse reaction to CL, whereby there is initial reduction in fat volume, followed by abnormal fat growth exceeding the original volume in the treated area. The incidence of PAH is thought to be underreported, and its pathophysiology and management remains unclear. The objective of this study was to present a series of PAH cases and review efficacy of management modalities.
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Affiliation(s)
- Michael J Stein
- From Manhattan Eye Ear and Throat Hospital, New York, NY, USA
| | - Darren Smith
- From Manhattan Eye Ear and Throat Hospital, New York, NY, USA
| | | | - Alan Matarasso
- From Manhattan Eye Ear and Throat Hospital, New York, NY, USA
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Stein MJ, Yuksel SS, Harrast J, Taub PJ, Matarasso A, Gosain AK. Clinical Practice Patterns and Evidence-Based Medicine in Rhinoplasty: A 10-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery. Aesthetic Plast Surg 2024; 48:1312-1320. [PMID: 37605029 DOI: 10.1007/s00266-023-03599-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND The American Board of Plastic Surgery (ABPS) has collected data on cosmetic surgery from member surgeons since 2003. These data offer valuable information on national trends in clinical practice. OBJECTIVES The present study was performed to analyze trends in rhinoplasty over the last decade. METHODS Tracer data were compared between two cohorts 2012-2016 (early cohort "EC") and 2017-2021 (recent cohort "RC"). Data included patient demographics and surgical techniques. Results were considered in the context of current EBM-based guidance in the plastic surgery literature. RESULTS Data from 730 rhinoplasties (270 EC and 460 RC) were analyzed. The median age was 30 years, and the most common patient concern was the nasal dorsum (79%). In the RC group, fewer patients voiced concerns about tip projection (58% vs 43%, p = 0.0002) and more complained of functional airway problems (38% vs 49%, p = 0.004). An open approach was most common (83%). Septoplasty (47% vs 52%, p = 0.005), caudal septum repositioning (14% vs 23%, p = 0.002), and tip rotation maneuvers (32% vs 49%, p < 0.0001) became more popular. There was also an increase in the use of spreader grafts (35% vs 45%, p = 0.01) and columellar strut grafts (42% vs 50%, p = 0.04), while there has been a decrease in alar base resection (17% vs 10%, p = 0.007) and non-cartilaginous dorsum/radix augmentation (9% vs 4%, p = 0.02). CONCLUSIONS ABPS tracer data provide an excellent resource for the objective assessment of procedures in plastic surgery. The present study is the first to highlight evolving trends in rhinoplasty over the last 10 years. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Michael J Stein
- Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital, New York, NY, USA
| | - Selcen S Yuksel
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 93, Chicago, IL, 60611, USA
| | - John Harrast
- Data Harbor Solutions, American Board of Plastic Surgery, Philadelphia, PA, USA
| | - Peter J Taub
- American Board of Plastic Surgery and Division of Plastic and Reconstructive Surgery, Mount Sinai Medical Center, New York, NY, USA
| | - Alan Matarasso
- Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital, New York, NY, USA
| | - Arun K Gosain
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 93, Chicago, IL, 60611, USA.
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Stein MJ, Shah N, Harrast J, Zins JE, Matarasso A, Gosain AK. Clinical Practice Patterns in Facelift Surgery: A 15-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery. Aesthetic Plast Surg 2024; 48:793-802. [PMID: 38302713 DOI: 10.1007/s00266-023-03841-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND This study evaluates change in practice patterns in facelift surgery based on a 15-year review of tracer data collected by the American Board of Plastic Surgery as part of the Continuous Certification process. METHODS Tracer data for facelift was reviewed from 2006 to 2021. The 15-year collection period was divided into an "early cohort (EC)" from 2006 to 2014 and a "recent cohort (RC)" from 2015 to 2021. RESULTS Of 3400 facelifts (1710 EC/1690 RC) performed, 18% were done in hospital and 76% were done in an accredited office facility. Ninety one percent of patients were female with an average age of 61 years. There was an increase in the number of secondary facelifts (4% EC vs 18% RC; p < 0.001) and an increased number of patients concerned about volume loss/deflation (25% EC vs 37% RC; p < 0.001). The surgical approach to the SMAS involved plication (40%), flaps (35%), SMASectomy (22%) and MACS lift (6%). One percent of facelifts were subperiosteal and 8% skin-only. Significantly more surgeons used the lateral SMAS flap (14% EC vs 18% RC, p < 0.005), while less used an extended SMAS flap (21% vs 18%; p = 0.001) and MACS lift (10% EC vs 6% RC; p = 0.021) techniques. The concomitant use of facial fat grafting is becoming more common (15% EC vs 24% RC, p = 0.0001). CONCLUSIONS A 15-year review of ABPS tracer data provides an excellent venue for the objective assessment of the current status of facelift surgery, and key changes in practice patterns during that time. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Michael J Stein
- Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital, New York, NY, USA
| | - Nikhil Shah
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital of Northwestern Feinberg School of Medicine, 225 E. Chicago Ave., Box 93, Chicago, IL, 60611, USA
| | | | - James E Zins
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Alan Matarasso
- Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital, New York, NY, USA
| | - Arun K Gosain
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital of Northwestern Feinberg School of Medicine, 225 E. Chicago Ave., Box 93, Chicago, IL, 60611, USA.
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Stein MJ, Weissman JP, Harrast J, Rubin JP, Gosain AK, Matarasso A. Clinical Practice Patterns in Abdominoplasty: 16-Year Analysis of Continuous Certification Data from the American Board of Plastic Surgery. Plast Reconstr Surg 2024; 153:66-74. [PMID: 37010463 DOI: 10.1097/prs.0000000000010500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
BACKGROUND The authors evaluated trends in practice patterns for abdominoplasty based on a 16-year review of tracer data collected by the American Board of Plastic Surgery as part of the continuous certification process. METHODS To facilitate comparison of an equal number of patients over time, tracer data from 2005 to 2021 were split into an early cohort (EC) (from 2005 to 2014) and a recent cohort (RC) (from 2015 to 2021). Fisher exact tests and two-sample t tests were used to compare patient demographics, surgical techniques, and complication rates. RESULTS Data from 8990 abdominoplasties (EC, n = 4740; RC, n = 4250) were analyzed. RC abdominoplasties report a lower rate of complications (RC, 19%; EC, 22%; P < 0.001) and a lower rate of revision surgery (RC 8%; EC, 10%; P < 0.001). This has occurred despite the increased use of abdominal flap liposuction (RC, 25%; EC, 18%; P < 0.001). There has been a decline in the use of wide undermining (81% versus 75%; P < 0.001), vertical plication of the abdomen (89% versus 86%; P < 0.001), and surgical drains (93% versus 89%; P < 0.001). Abdominoplasty surgery is increasingly performed in an outpatient setting, with increased use of chemoprophylaxis for thrombosis prevention. CONCLUSIONS Analysis of these American Board of Plastic Surgery tracer data highlights important trends in clinical practice over the past 16 years. Abdominoplasty continues to be a safe and effective procedure with similar complication and revision rates over the 16-year period.
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Affiliation(s)
- Michael J Stein
- From the Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital
| | - Joshua P Weissman
- Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg, School of Medicine
| | | | - J Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh
| | - Arun K Gosain
- Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg, School of Medicine
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital
| | - Alan Matarasso
- From the Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital
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Coombs DM, Sinclair NR, Kochuba A, Grow J, Couto RA, Matarasso A, Zins JE. Practice Patterns: An American Society of Plastic Surgeons (ASPS) Member Survey, 2000 and 2020-How Much Has Brow Lifting Changed? Aesthet Surg J 2023; 44:1-8. [PMID: 37409963 DOI: 10.1093/asj/sjad207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/11/2023] [Accepted: 07/05/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND In 2001, Elkwood and Matarasso published an American Society of Plastic Surgeons (ASPS) member survey detailing brow lift practice patterns. Interval changes in practice patterns have not been studied. OBJECTIVES The previous survey was revised to elucidate current trends in brow lift surgery. METHODS A 34-question descriptive survey was distributed to a random group of 2360 ASPS members. Results were compared to the 2001 survey. RESULTS A total of 257 responses were collected (11% response rate; ± 6% margin of error at 95% CI). The most frequent technique for the correction of brow ptosis in both surveys was the endoscopic approach. The use of hardware fixation has increased in endoscopic brow lifting, whereas the use of cortical tunnels has decreased. Although coronal brow lifting has decreased in frequency, hairline and isolated temporal lift have increased. Neuromodulators have replaced resurfacing techniques as the most common nonsurgical adjunct. Frequent use of neuromodulators has risen from 11.2% to 88.5%. Nearly 30% of current surgeons feel that neuromodulators have replaced formal brow lifting procedures to a significant degree. CONCLUSIONS In comparing the 2001 and current ASPS member survey there has been a clear transition to less invasive procedures over time. Although the endoscopic approach was the most popular means of forehead correction in both surveys, coronal brow lifting has decreased in frequency and the hairline and temporal approaches have increased. Neurotoxins have replaced laser resurfacing and chemical peeling methods as an adjunct, and in some cases replaced the invasive procedure entirely. Possible explanations for these findings will be discussed. LEVEL OF EVIDENCE: 4
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Stein MJ, Applebaum SA, Harrast JJ, Lipa JE, Matarasso A, Gosain AK. Practice Patterns in Primary Breast Augmentation: A 16-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery. Plast Reconstr Surg 2023; 152:1011e-1021e. [PMID: 37014959 DOI: 10.1097/prs.0000000000010497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
BACKGROUND As part of the continuous certification process, the American Board of Plastic Surgery collects case data for specific tracer procedures in aesthetic surgery to assess practice improvement by the diplomates. These case-based data provide valuable information on national trends in clinical practice. The current study was performed to analyze practice patterns in aesthetic primary breast augmentation. METHODS Breast augmentation tracer data were reviewed from 2005 to 2021 and grouped into an early cohort (EC), from 2005 through 2014, and a recent cohort (RC), from 2015 through 2021. Fisher exact tests and two-sample t tests compared demographic characteristics of the patients, surgical techniques, and complication rates. RESULTS Patients in the RC were slightly older (34 versus 35 years; P < 0.001), more likely to have ptosis greater than 22 cm (20% versus 23%; P < 0.0001), less likely to smoke (12% versus 8%; P < 0.0001), and less likely to undergo a preoperative mammogram (29% versus 24%; P < 0.0001). From a technical standpoint, inframammary incisions have become more common (68% versus 80%; P < 0.0001), whereas periareolar incision use has decreased (24% versus 14%; P < 0.0001). Submuscular plane placement has increased (22% versus 56%; P < 0.0001), while subglandular placement has decreased (19% versus 7%; P < 0.0001). Silicone implants are most popular (58% versus 82%; P < 0.0001). Textured implant use increased from 2011 (2%) to 2016 (16%), followed by a sharp decline to 0% by 2021. Trends follow U.S. Food and Drug Administration approvals and warnings. CONCLUSIONS This study highlights evolving trends in aesthetic breast augmentation over the past 16 years. The most common technique remains a smooth silicone prosthesis placed in the subpectoral plane through an inframammary incision.
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Affiliation(s)
- Michael J Stein
- From the Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital
| | - Sarah A Applebaum
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital
| | | | - Joan E Lipa
- American Board of Plastic Surgery, Inc
- Division of Plastic, Reconstructive, and Aesthetic Surgery, University of Toronto
| | - Alan Matarasso
- From the Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital
| | - Arun K Gosain
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital
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Stein MJ, Sasson DC, Harrast J, Alderman A, Matarasso A, Gosain AK. A 16-Year Review of Clinical Practice Patterns in Liposuction Based on Continuous Certification by the American Board of Plastic Surgery. Plast Reconstr Surg 2023; 152:523-531. [PMID: 36735816 DOI: 10.1097/prs.0000000000010254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The American Board of Plastic Surgery has collected data on cosmetic surgery tracers as part of the Continuous Certification process since 2005. The current study was performed to analyze evolving trends in liposuction from the American Board of Plastic Surgery database. METHODS Tracer data from 2005 through 2021 were reviewed and grouped into an early cohort (EC) (2005-2014) and a recent cohort (RC) (2015-2021). Fisher exact tests and two-sample t tests were used to compare patient demographics, techniques, and complications. RESULTS A total of 2810 suction-assisted liposuction cases were included (1150 EC, 1660 RC). In-office procedures increased (36% EC versus 41% RC). The use of general anesthesia remained the same (63% EC versus 62% RC). The use of power-assisted liposuction increased (24% EC versus 40% RC) and use of ultrasound-assisted liposuction decreased (5% versus 2%). With respect to body areas treated, liposuction of the abdomen (64% EC versus 69% RC), flanks (60% EC versus 64% RC), and back (22% EC versus 34% RC) increased; treatments of thighs (36% EC versus 23% RC), and knees (8% EC versus 5% RC) decreased. Intraoperative position changes are more common (30% EC versus 37% RC), as is liposuction of multiple areas in one case (28% EC versus 36% RC). The volume of lipoaspirate also increased (1150 cc EC versus 1660 cc RC). CONCLUSIONS This study highlights evolving trends in liposuction over 16 years. Liposuction is becoming more common as an outpatient procedure performed concomitantly with other procedures. Despite multiple emerging technologies, the popularity of power-assisted liposuction is increasing. Although adverse events have not significantly increased with these changes, the authors stress careful preoperative evaluation of patients to identify factors that increase the risk of complications.
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Affiliation(s)
- Michael J Stein
- From the Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital
| | - Daniel C Sasson
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital
| | | | | | - Alan Matarasso
- From the Department of Plastic and Reconstructive Surgery, Lenox Hill Hospital
| | - Arun K Gosain
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital
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Savetsky IL, Cohen JM, Matarasso A. Subcutaneous Lateral Temporal Lift. Clin Plast Surg 2022; 49:365-375. [DOI: 10.1016/j.cps.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sultan DL, Clappier M, Perrotti J, Siddiqui S, Bradley JP, Levine SM, Matarasso A, Reece EM, Kasabian AK, Tanna N. “Plastic Surgery Trainees Practicing in Your Backyard? An Analysis of Career Patterns for Fellowship and Residency Graduates”. Surgery in Practice and Science 2022. [DOI: 10.1016/j.sipas.2022.100082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Stein MJ, Matarasso A. The Male Abdominoplasty. Clin Plast Surg 2022; 49:285-291. [DOI: 10.1016/j.cps.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Stein MJ, Matarasso A. High-Definition Liposuction in Men. Clin Plast Surg 2022; 49:307-312. [DOI: 10.1016/j.cps.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Steinbrech DS, Matarasso A. Plastic Surgery for Men. Clin Plast Surg 2022. [DOI: 10.1016/s0094-1298(22)00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Weissman JP, Stein MJ, Harrast J, Rubin JP, Matarasso A, Gosain AK. 61. EVOLVING CLINICAL PRACTICE PATTERNS IN ABDOMINOPLASTY: A 16-YEAR ANALYSIS OF CONTINUOUS CERTIFICATION TRACER DATA FROM THE AMERICAN BOARD OF PLASTIC SURGERY. Plast Reconstr Surg Glob Open 2022. [PMCID: PMC8984454 DOI: 10.1097/01.gox.0000828232.96327.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Matarasso A. Plastic Surgery in Men. Clin Plast Surg 2022; 49:xi. [DOI: 10.1016/j.cps.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Most SP, Matarasso A. Rhinoplasty: A Complex, Four-Dimensional Procedure. Clin Plast Surg 2021; 49:xiii-xiv. [PMID: 34782144 DOI: 10.1016/j.cps.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94304, USA.
| | - Alan Matarasso
- Hofstra-Northwell Health System, New York, NY 10028, USA.
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Ghersi M, Matarasso A, Sakharpe AK. Mastery of Basic Rhinology: An Important Tool for the Modern Rhinoplasty Specialist. Aesthet Surg J 2021; 41:NP1141-NP1151. [PMID: 33367489 DOI: 10.1093/asj/sjaa384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Rhinology is the branch of medicine that deals with nasal function as part of the respiratory apparatus. It is a fundamental component of otolaryngology curricula and thus generously found in that specialty's literature. Ear, nose, and throat specialists who have made aesthetic rhinoplasty a cornerstone of their practice have understood the importance of rhinology for years. We propose that deeper knowledge and understanding of rhinology would be incredibly useful for the cosmetic rhinoplasty surgeon, especially the one who has no formal training in otolaryngology. This is of critical importance because sometimes, cosmetic rhinoplasties may have negative repercussions on nasal function, a problem that must be dealt with either preemptively at the time of surgery or at a revision procedure. Moreover, many of today's rhinoplasty patients are seeking comprehensive surgical care by a specialist who can manage both aesthetic and functional concerns in a single operation.
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Affiliation(s)
| | - Alan Matarasso
- Northwell Health System/Hofstra University, Zucker School of Medicine, New York, NY, USA
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Matarasso A. Invited Discussion on: Medical Tourism in Aesthetic Breast Surgery-A Systematic Review. Aesthetic Plast Surg 2021; 45:1910-1911. [PMID: 34046734 DOI: 10.1007/s00266-021-02346-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
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O’Kelly N, Nguyen K, Gibstein A, Bradley JP, Tanna N, Matarasso A. Standards and Trends in Lipoabdominoplasty. Plast Reconstr Surg Glob Open 2020; 8:e3144. [PMID: 33173672 PMCID: PMC7647643 DOI: 10.1097/gox.0000000000003144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 08/03/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Lipoabdominoplasty has evolved over the last 6 decades through contributions from numerous luminaries in plastic and reconstructive surgery. METHODS The authors review historical perspective and provide a contemporary examination of trends in lipoabdominoplasty. RESULTS In 1967, Pitanguy popularized abdominoplasty (without liposuction) as a technique for augmenting ventral hernias repairs and subsequently for aesthetic improvement of the abdomen. After the introduction of suction assisted lipectomy by Illouz in 1983, abdominoplasty became a central tool in a diverse armamentarium of anterior and lateral abdominal wall contouring procedures. Liposuction was initially utilized with mini-abdominoplasty in order to improve contour. Subsequently, Matarasso advanced the safe combination of liposuction with full abdominoplasty. Additionally, he systematized the variety of cutaneous undermining, excision, and liposuction procedures utilized in abdominal contouring as indicated by the degree of skin laxity and musculofascial diastasis. Lockwood advocated high lateral tension closure of the superficial fascial system of the abdomen to improve the contour of the hips and flanks. Saldanha advanced selective undermining and anterior abdominal wall perforator preservation to minimize wound healing and seroma complications associated with lipoabdominoplasty procedures. CONCLUSION In abdominal contour surgery, surgeons can rely on classic techniques and algorithms that have withstood the test of time while modifying their approaches with advances backed by compelling and rigorously obtained evidence.
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Affiliation(s)
- Neil O’Kelly
- From the Division of Plastic and Reconstructive Surgery, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Great Neck, N.Y
| | - Khang Nguyen
- From the Division of Plastic and Reconstructive Surgery, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Great Neck, N.Y
| | - Alexander Gibstein
- From the Division of Plastic and Reconstructive Surgery, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Great Neck, N.Y
| | - James P. Bradley
- From the Division of Plastic and Reconstructive Surgery, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Great Neck, N.Y
| | - Neil Tanna
- From the Division of Plastic and Reconstructive Surgery, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Great Neck, N.Y
| | - Alan Matarasso
- From the Division of Plastic and Reconstructive Surgery, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Great Neck, N.Y
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Matarasso A, Zins JE. Abdominoplasty. Clin Plast Surg 2020. [DOI: 10.1016/s0094-1298(20)30033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Matarasso A, Zins JE. Abdominoplasty: State-of-the-Art. Clin Plast Surg 2020; 47:ix-x. [PMID: 32448480 DOI: 10.1016/j.cps.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Alan Matarasso
- Hofstra University/Northwell School of Medicine, 1009 Park Avenue, New York, NY 10028, USA.
| | - James E Zins
- Department of Plastic Surgery, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, A60, Cleveland, OH 44195, USA.
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Matarasso A. Commentary on: Buccal Fat Pad Excision: Hydrodissection Technique. Aesthet Surg J 2019; 39:1046-1047. [PMID: 31073600 DOI: 10.1093/asj/sjz086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alan Matarasso
- Northwell Health System/Hofstra University, Zuckerman School of Medicine, New York, NY
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Affiliation(s)
- Alan Matarasso
- Northwell Health System/Hofstra University, Zuckerman School of Medicine, New York, NY
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Matarasso SL, Matarasso A. Commentary on: Botulinum Toxin Treatment for Mild to Moderate Platysma Bands: A Systematic Review of Efficacy, Safety, and Injection Technique. Aesthet Surg J 2019; 39:207-208. [PMID: 30285086 DOI: 10.1093/asj/sjy232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Alan Matarasso
- Hofstra University/Northwell School of Medicine, Hempstead, NY
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Abstract
Traditionally, surgeons have avoided performing an aesthetic rhinoplasty in the presence of acute or chronic sinus disease. In most instances, the acute or chronic infection is first rectified through either medical or surgical treatment, after which the rhinoplasty is performed as a staged procedure. However, with the advent of endoscopic sinonasal surgery, this adage need not necessarily apply; the sinuses may be treated at the same time as the rhinoplasty without undue risk. Two patients requesting rhinoplasty presented with chronic sinusitis. Their clinical features, surgical treatment, and results are reviewed. Six additional patients with sinusitis undergoing endoscopic sinus surgery have had cosmetic procedures simultaneously performed with similar results. The benefits of the combined procedure are discussed.
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Affiliation(s)
- Larry J. Shemen
- Attending Surgeon, Department of Otolaryngology–Head and Neck Surgery, Manhattan Eye, Ear and Throat Hospital
| | - Alan Matarasso
- Attending Surgeon, Department of Plastic Surgery, Manhattan Eye, Ear and Throat Hospital; Instructor, Department of Plastic Surgery, The Albert Einstein College of Medicine
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Abstract
Minimally invasive procedures in an aesthetic practice have grown over the past decade. Plastic surgery practices are embracing the incorporation of injectables and lasers as adjuncts to their surgical procedures. The use of botulinum toxin, hyaluronic acid fillers, and lasers has made a significant impact on the authors' practice. The authors describe the important considerations, consultation goals, and procedural steps with injectables and fillers. The novel use of deoxycholic acid injections is also described. The authors strongly think that as options continue to expand, plastic surgeons will benefit from taking an active role in adopting these new innovations.
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Affiliation(s)
- Alan Matarasso
- Department of Plastic Surgery, Manhattan Eye, Ear, and Throat Hospital, Lennox Hill Hospital, Northwell Healthcare Systems, 1009 Park Avenue, New York, NY 10028, USA
| | - Jeremy Nikfarjam
- Division of Plastic Surgery, Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, 182 East 210 Street, Bronx, NY 10467, USA.
| | - Lauren Abramowitz
- Park Avenue Skin Solutions, 1009 Park Avenue, New York, NY 10028, USA
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Paresi RJ, Myers RS, Matarasso A. Contraceptive Vaginal Rings: Do They Pose an Increased Risk of Venous Thromboembolism in Aesthetic Surgery? Aesthet Surg J 2015; 35:721-7. [PMID: 26048332 DOI: 10.1093/asj/sju166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Nuvaring (Organon, Kenilworth, NJ) is a vaginal contraception ring inserted by the patient. It was approved by the Food and Drug Administration in 2001 for the prevention of pregnancy. The intent of this paper is to increase the awareness of Nuvaring among plastic surgeons, and to explore the risks associated with its use. We report the cases of two cosmetic surgery patients. These patients developed deep venous thrombosis and pulmonary emboli in the postoperative period while using Nuvaring. The very advantages of the Nuvaring-the ease of use, the avoidance of daily administration, and the insertion and removal of the device by the patient-may lead to the failure of patients to recollect being on a vaginal ring for contraception. LEVEL OF EVIDENCE 4 Risk.
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Affiliation(s)
- Robert J Paresi
- Dr Paresi is in private practice in Chicago, IL, and is an Attending Plastic Surgeon with Mercy Health System in Lake Geneva, WI, and Woodstock, IL. Dr Myers is an Assistant Professor in the Division of Plastic Surgery at the University of Toledo Medical Center in Toledo, OH. Dr Alan Matarasso is an Attending Surgeon at Manhattan Eye Ear and Throat Hospital (MEETH) and Lenox Hill Hospital, both part of the North Shore Long Island Jewish Health System
| | - Robert S Myers
- Dr Paresi is in private practice in Chicago, IL, and is an Attending Plastic Surgeon with Mercy Health System in Lake Geneva, WI, and Woodstock, IL. Dr Myers is an Assistant Professor in the Division of Plastic Surgery at the University of Toledo Medical Center in Toledo, OH. Dr Alan Matarasso is an Attending Surgeon at Manhattan Eye Ear and Throat Hospital (MEETH) and Lenox Hill Hospital, both part of the North Shore Long Island Jewish Health System
| | - Alan Matarasso
- Dr Paresi is in private practice in Chicago, IL, and is an Attending Plastic Surgeon with Mercy Health System in Lake Geneva, WI, and Woodstock, IL. Dr Myers is an Assistant Professor in the Division of Plastic Surgery at the University of Toledo Medical Center in Toledo, OH. Dr Alan Matarasso is an Attending Surgeon at Manhattan Eye Ear and Throat Hospital (MEETH) and Lenox Hill Hospital, both part of the North Shore Long Island Jewish Health System
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Abstract
Since its introduction by Illouz and others over 30 years ago, suction-assisted lipectomy/liposuction/lipoplasty has evolved tremendously and has developed into one of the most popular procedures in aesthetic plastic surgery. Liposuction is an effective procedure employed to treat localized adipose deposits in patients not suffering from generalized obesity. These accumulations of subcutaneous fat often occur in predictable distributions in both men and women. A cannula connected to a suction-generating source allows for small incisions to be strategically placed and large volumes of fat to be removed. This fat removal leads to improved harmonious balance of a patient's physique and improved body contour. Various surgical techniques are available and have evolved as technology has improved. Current technology for liposuction includes suction-assisted lipectomy, ultrasound-assisted, power-assisted, laser-assisted, and radiofrequency-assisted. The choice of technology and technique often depends on patient characteristics and surgeon preference. The objective of this review is to provide a thorough assessment of current technologies available to plastic surgeons performing liposuction.
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Affiliation(s)
- Sachin M Shridharani
- The Department of Plastic Surgery, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
| | - Justin M Broyles
- The Department of Plastic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alan Matarasso
- The Department of Plastic Surgery, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
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Matarasso A, Tepper OM, Wulkan M. Response to "ninfoplasty: a new approach?". Aesthet Surg J 2014; 34:333. [PMID: 24497622 DOI: 10.1177/1090820x13519104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Alan Matarasso
- Dr Matarasso is from the Department of Plastic Surgery, Manhattan Eye, Ear & Throat Hospital, Lenox Hill Hospital, New York City, New York; North Shore University Hospital, Manhasset, New York; and Long Island Jewish Medical Center, New Hyde Park, New York
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Affiliation(s)
- Alan Matarasso
- Dr Matarasso is a Clinical Professor in the Department of Plastic and Reconstructive Surgery, Albert Einstein College of Medicine, Bronx, New York, New York
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Abstract
Barbed sutures first received US Food and Drug Administration approval for soft tissue approximation in 2005 and early adopters readily embraced this device to develop new techniques. It has become apparent that the advantages are more than just "skin deep." Superficial and deep fascia, cartilage, tendon, joint capsule, and fibrous periprosthetic capsules can also be manipulated. Barbed sutures have revolutionized our approach to facial rejuvenation and body contouring by enhancing our ability to quilt and powerfully lift tissue. The elimination of surgical drains and shorter surgical times has made this a true boon for plastic surgeons as well as many other surgical specialists. This article summarizes some of the current and evolving applications of this exciting new tool.
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Affiliation(s)
| | - Allen D. Rosen
- Dr Rosen is an Assistant Clinical Professor in the Department of Plastic Surgery, University of Medicine and Dentistry of New Jersey, Montclair
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Tepper OM, Matarasso A. Authors' Response. Aesthet Surg J 2011. [DOI: 10.1177/1090820x11422229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
Increasing numbers of women are seeking correction of labial hypertrophy for aesthetic and/or functional reasons. It is therefore important for plastic surgeons to become familiar with labioplasty surgical techniques. The authors review the history and current status of labioplasty surgery for practicing plastic surgeons, with particular emphasis on anatomy, diagnosis, indications, and various techniques.
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Affiliation(s)
- Oren M Tepper
- Albert Einstein College of Medicine, Bronx, New York, USA
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Abstract
The introduction of liposuction in the 1980s permanently altered the landscape of body contour surgery. The abdomen became a ''group'' of contour procedures that were referred to as the abdominolipoplasty system of classification and treatment (Types I-IV). This article describes a full (Type IV) abdominoplasty with or without liposuction is performed. When extensive abdominal liposuction is performed in conjunction with a full abdominoplasty, it is also known as lipoabdominoplasty. The article also describes 10 "special situations" in the abdominoplasty population.
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Affiliation(s)
- Alan Matarasso
- Department of Surgery (Plastic Surgery), Albert Einstein College of Medicine, 1009 Park Avenue, New York, NY 10028, USA.
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Matarasso A, Shafer D. Botulinum neurotoxin type A-ABO (Dysport): clinical indications and practice guide. Aesthet Surg J 2009; 29:S72-9. [PMID: 19945008 DOI: 10.1016/j.asj.2009.09.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Accepted: 09/17/2009] [Indexed: 11/28/2022] Open
Abstract
The key points to remember about abobotulinumtoxinA are as follows: BoNTA-ABO (abobotulinumtoxinA [Dysport]; Medicis Aesthetics, Scottsdale, AZ) and BoNTA-ONA (onabotulinumtoxin A [Botox Cosmetic]; Allergan, Irvine, CA) are both derivatives of botulinum toxin A produced from different strains of the bacterium Clostridium botulinum through proprietary manufacturing processes, and both are approved by the US Food and Drug Administration (FDA). BoNTA-ABO and BoNTA-ONA, which are both type A botulinum toxins, should be further differentiated from Myobloc (Solstice Neurosciences, San Francisco, CA), which is the only FDA-approved type B botulinum toxin. BoNTA-ABO, as with other derivatives of botulinum toxin, produces a chemodenervation of the muscle by preventing the release and binding of acetylcholine at the neuromuscular endplate. The paralytic effect of BoNTA-ABO, as with other derivatives of botulinum toxin, produces a relaxation of the underlying muscle with the associated benefit of reducing dynamic rhytids of the overlying skin. BoNTA-ABO units are not interchangeable with BoNTA-ONA units. An understanding of the proper dosing and familiarity with the use of either botulinum toxin in aesthetic applications is required to produce results that are both safe and consistent. Spread of the toxin is dependent on solution volume and injection technique (physically pushing the toxin from the area of injection). Diffusion of the toxin is largely dependent on toxin dose and receptor concentration; unbound toxin moves down a concentration gradient. Beyond the treatment of glabellar rhytids, there are few, if any, randomized, double blind, placebo-controlled studies on the aesthetic uses of BoNTA-ABO. This guide summarizes what is known and serves as a basis for clinical use and continued understanding.
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Matarasso A. The continuing evolution of neurotoxins for nonsurgical facial rejuvenation: an introduction. Aesthet Surg J 2009; 29:S29-30. [PMID: 19945001 DOI: 10.1016/j.asj.2009.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gerstner G, Matarasso A. Surgical versus nonsurgical cosmetic procedures. Cutis 2008; 82:285-290. [PMID: 19055173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
There has been an increase in nonsurgical interventions for facial rejuvenation since 2001, which can be attributed to an increase in the use of injectable fillers, volumizers, and biostimulators for soft tissue augmentation. The efficacy and duration of these products depend on their mode of operation, site of injection, and composition. Semipermanent devices offer a compromise between short-term and long-term results.
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Affiliation(s)
- Gervaise Gerstner
- Department of Plastic Surgery, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA
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Liapakis I, Anagnostoulis S, Karayiannakis A, Korkolis D, Lambropoulou M, Matarasso A, Simopoulos C. Burn wound angiogenesis is increased by exogenously administered recombinant leptin in rats. Acta Cir Bras 2008; 23:118-24. [DOI: 10.1590/s0102-86502008000200002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Accepted: 12/18/2007] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: Leptin is a potent direct angiogenic factor that stimulates endothelial cell migration and activation in vitro and angiogenesis in vivo. In addition, leptin has been discussed to play an important role in angiogenesis, as it promotes the formation of new blood vessels. PURPOSE: The effect of exogenously administered leptin on the healing process of a full tissue burn wound model. METHODS: Sixty-three Sprague-Dawley male rats were used. Full tissue burn wound was created by electrocautery. The width of the pin was 0.3 cm; its length was 2 cm and was used at the "cut" modulation. Rats were divided into seven groups of nine animals each. Burn wounds were injected with murine recombinant leptin and the rats were sacrificed 3, 7 and 9 days after surgery. Every group had obtained three animals for the three different days of sacrifice. Three different leptin doses of 250 pg/ml, 500 pg/ml and 1000 pg/ml were used in different animal groups (A, B and C). For every one of the three leptin doses used, another animal group was evaluated by using the combined injection of leptin and antileptin (A1, B1, and C1), in order to study the inhibitory effect to the leptin factor. Nine rats were served as controls. These were injected with 0.3 ml water for injection solution and sacrificed at the same time intervals. After sacrifice of the animals, the skin was grossly determined by its appearance, colour and texture. Full thickness burn wounds were dissected for histological examination. A qualitative analysis of angiogenesis in the burn wound was conducted following a standard hematoxylin and eosin stain. The wound tissue samples from each experimental group underwent immunohistochemical evaluation of microvessel density by endothelial cell staining with mouse anti-rat CD 34 monoclonal antibody. RESULTS: The most impressive growth of new blood vessels appeared seven and nine days after treatment with the highest leptin doses. There were no significant differences in microvessel density between the seventh and the ninth postoperative day among different groups treated with leptin. All wounds from the control group, as well as those from animal groups treated with the combined injection of leptin and antileptin did not develop any new vessels. CONCLUSION: Exogenous administration of recombinant leptin increases early tissue angiogenesis in the burn wound level of an experimental animal model.
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Affiliation(s)
| | | | | | | | | | - Alan Matarasso
- Albert Einstein College of Medicine/Montefiore Medical Center
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Affiliation(s)
- Alan Matarasso
- New York, N.Y. From the Department of Plastic Surgery, Albert Einstein College of Medicine, and the Department of Surgery, Lenox Hill Hospital
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Jejurikar SS, Orseck MJ, Matarasso A. Reevaluating resumption of oral intake after abdominoplasty. Aesthet Surg J 2007; 27:233-8. [PMID: 19341649 DOI: 10.1016/j.asj.2007.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2006] [Accepted: 02/22/2007] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Traditional postoperative management of patients undergoing abdominoplasty has involved withholding food until patients demonstrate evidence of bowel activity. No literature exists to support this practice, however, and with the expanding trend toward ambulatory abdominoplasty, early feeding may obviate, at least partially, the need for postoperative hospital admission for intravenous hydration, thereby allowing for faster discharge. OBJECTIVE We sought to investigate whether early feeding of patients contributed to an increased incidence of postoperative nausea and vomiting (PONV), as well as impacted the return of bowel sounds or the usage of antiemetic medications. METHODS Hospital records of the authors' patients who underwent full abdominoplasty with adjunctive suction-assisted lipoplasty were examined. The senior author (A.M.) held patients nil per os (NPO) until bowel sounds were auscultated (group I), whereas the other authors (S.S.J., M.J.O.) began a regimen of feeding immediately after surgery (group II). RESULTS No significant differences in age, gender, or body mass index were present. Operative time was significantly shorter in group I. The incidence of PONV, use of antiemetic medications, and presence of audible bowel sounds on postoperative day 1 did not vary significantly between groups. None of the patients with inaudible bowel sounds in either group experienced PONV. CONCLUSIONS Early feeding after abdominoplasty did not lead to an increased incidence of PONV, increased use of antiemetic medications, or delayed return of bowel sounds. In routine abdominoplasties, early feeding may permit patients to sustain adequate hydration and possibly allow for earlier discharge.
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Affiliation(s)
- Sameer S Jejurikar
- Scott and White Clinic, The Cosmetic Surgery Center, 1600 University Drive East, College Station, TX 77840, USA
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Matarasso A. A "brave new world" for bariatric surgery? Aesthet Surg J 2006; 26:697-8. [PMID: 19338961 DOI: 10.1016/j.asj.2006.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Matarasso A, Klatsky SA, Nahai F, Maxwell GP. Secondary breast reduction. Aesthet Surg J 2006; 26:447-55. [PMID: 19338930 DOI: 10.1016/j.asj.2006.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abstract
BACKGROUND According to the American Society for Aesthetic Plastic Surgery's 2004 Cosmetic Surgery National Data Bank, during the last 7 years, the number of abdominoplasty procedures performed has increased 344 percent. A national report on abdominoplasty has not been since 1977. Grazer and Goldwyn's study reflects the preliposuction era of abdominal contouring surgery. The purpose of this study was to assess current trends in abdominal contouring techniques and associated procedures and the incidence of their complications. METHODS The study was designed as a descriptive correlation survey evaluating the frequency of various abdominal contour techniques and complications among 3300 randomly chosen members of the American Society of Plastic Surgeons. There were 497 respondents, for a response rate of 15 percent. RESULTS A total of 20,029 procedures were reported in the survey; 35 percent (n = 7010) were liposuction of the abdomen, 10 percent (n = 2003) were limited abdominoplasties, and 55 percent (n = 11,016) were full abdominoplasties. Survey data covered the plastic surgeon's demographics, techniques, and incidence of complications during a 12-month period. CONCLUSIONS The authors report the largest series of local and systemic complication rates and compare them with those of previously published abdominoplasty surveys. With respect to full abdominoplasty, lower complication rates for deep vein thrombosis (0.04 percent) and pulmonary embolus (0.02 percent) were seen. No deaths were reported. There was no correlation between a surgeon's years in practice and complication rates, in concordance with the earlier study by Grazer and Goldwyn. Despite more extensive abdominal contouring techniques and the addition of liposuction to abdominal contouring, the local and systemic complication rates coincided with previous complication rates, as outlined in other studies.
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Abstract
The author performs buccal fat pad excision to improve facial contour in some patients with buccal lipodystrophy and to treat buccal fat pad pseudoherniation. He recommends an intraoral approach, taking care not to pull on the fat pad and resecting only that which protrudes easily with gentle pressure.
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Abstract
Fibrin sealants have been used in surgical procedures for decades. This article focuses on the short scar face-lift and the applicability of Tisseel fibrin sealant, or "tissue glue," in expediting the healing process in a series of consecutive patients undergoing face-lift surgery. The evolution of the face-lift incision into the short scar and the adjunctive use of the Tisseel fibrin sealant have both resulted in faster recovery.
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Affiliation(s)
- Alan Matarasso
- Associate Clinical Professor, Department of Plastic Surgery, Albert Einstein College of Medicine, New York, NY, USA
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49
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Abstract
Surgical science continues to increase the options available to an individual seeking an improved abdominal contour. Appropriately applied, abdominal-contouring procedures offer significant aesthetic improvements and result in a high level of patient satisfaction. Liposuction is one procedure in a continuum of techniques available for addressing abdominal contour, and it is the one with which patients are most familiar and most likely to request. Advising patients of the many available methods involves an understanding of the scope of each technique and an accurate assessment of individuals' anatomy and their expectations and perceptions of what a successful result represents. This article outlines the various surgical methods of abdominal contouring and fosters an understanding of how to select the appropriate procedure.
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Affiliation(s)
- Alan Matarasso
- Department of Plastic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.
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50
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Affiliation(s)
- Alan Matarasso
- Department of Plastic Surgery, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA.
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