Surgical Aesthetics

JAN-FEB 2014

For plastic surgery and cosmetic surgery trends, techniques and equipment, plastic and cosmetic surgeons turn to Surgical Aesthetics for the latest on breast augmentation, liposuction, rhinoplasty and more.

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Cutting Edge Dermal Autografts a Viable Alternative to ADM In Breast Reconstruction Plastic Surgeon Launches Consultation App In an effort to help plastic surgeons enhance the consultation process for their patients and boost the bottom line for their practices, Jon E. Mendelsohn, MD, medical director of the Advanced Cosmetic Surgery & Laser Center in Cincinnati, has developed a new, user-friendly iPad application called Data Direct. Patients are given an iPad when they enter the surgeon's office and asked to complete a two-minute cosmetic interest questionnaire, which can be custom designed by the practice. The questionnaire includes a self-assessment of symptoms and concerns, and asks patients to identify the procedures they are interested in learning more about. The data is delivered to key team members via email and text message. Following the patient's visit, the information can be used to deliver targeted, educational marketing materials to the patient in the desired categories. Practices pay a monthly fee to offer the app, which includes set up, support and data collection. "By analyzing the patient's concerns, symptoms, complaints and desired procedures, we obtain valuable information that we don't often get by simply inquiring about the procedures alone," says Dr. Mendelsohn. 4 Surgical Aesthetics ❘ January/February 2014 Brow Modification Improves Rhinoplasty Outcomes Rhinoplasty patients may achieve a better aesthetic outcome if the procedure is combined with brow lifting. For "Rhinoplasty and Brow Modification: A Powerful Combination" (Aesthetic Surgery Journal, September 2013), Rollin K. Daniel, MD, et al, of The Aesthetic & Plastic Surgery Institute, University of California–Irvine, based their findings on cadaver dissections and a retrospective chart review of patients. The authors dissected the nose and central forehead area of seven cadavers at the time of autopsy to identify the anatomical relationship between the muscles in the radix/glabellar region, and to assess the muscle resection occurring in the clinical procedures. They then reviewed the charts of 24 of Dr. Daniel's patients who underwent combined rhinoplasty and brow modification. They conclude, "Modification of the central brow can dramatically change the aesthetic polygons of the nose/ glabellar region. A CBL with radix/glabellar muscle excision is important in younger patients who need a well-defined nasion, and older secondary patients who feel that the upper third of their nose is still heavy. A full EBL can enhance the facial appearance of older patients, in whom a rhinoplasty alone would have a modest impact." © ISTOCKPHOTO.COM Dermal autografts may offer "a safer, more cost effective alternative" to acellular dermal matrix (ADM) in tissue expander breast reconstruction, according to a new study in the November 2013 issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery. Researchers Michael P. Lynch, MD, et al, of the University of Kentucky, Department of Surgery, Division of Plastic and Reconstructive Surgery in Lexington, Kentucky, compared the outcomes of 48 patients (27 patients received ADM and 21 patients received dermal autografts harvested from the lower abdomen). The researchers compared expansion parameters, complications, procedural costs and operative times. In addition, they evaluated biopsies taken at the time of device exchange histologically with CD34 staining to assess tissue integration and vessel ingrowth. They found that wound healing complications "were significantly higher in the ADM group (14.8% versus 4.8%, p-value = 0.03), as were major complications (18.5% versus 0%, p-value < 0.01). Histologic vessel counts in the autograft group averaged 21 vessels/mm², compared to 7 vessels/mm² in the ADM group (p-value < 0.01)." There was no significant difference in patient satisfaction between the two groups.

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