No abstract

With their unique mechanism of action, bipolar and multipolar RF devices remain versatile treatment options associated with minimal downtime and pain compared with monopolar RF and other nonablative modalities. Proper patient selection and education along with an experienced treating physician is crucial in achieving patient satisfaction and results. It is important that larger studies are conducted to provide data on upcoming devices. Review of the literature provides a starting point for physicians seeking to treat patients safely and effectively with newer devices.

This study demonstrates that AWT is safe and efficacious for the treatment of localized adiposities in the saddlebag area. However, the results obtained were not statistically significant. Larger studies will be needed to further access the effects of AWT on thigh circumference reduction. Furthermore, the authors also found an improvement in the appearance of both cellulite and skin firmness after the treatments.

Background: Interviews for the integrated plastic surgery residency match took place in a virtual format for the 2020–2021 application cycle. Current literature lacks the perspectives of program directors (PDs) on virtual interviews compared with traditional in-person interviews. Methods: Following institutional review board approval, an anonymous 17-question survey was distributed by email to 82 program directors of integrated plastic surgery residency programs in the United States. Participants were asked baseline program information, the number of positions and interview invites offered, and their perspectives on various aspects of the virtual interview process. Results: Sixty-two (75.6%) PDs completed the survey. Thirty-seven percent reported increasing the number of interview offers per available residency spot. On a five-point Likert scale (1, not well at all; 5, extremely well), PDs showed no significant differences in their ability judge an applicant’s professionalism (3.1 ± 1.1), interpersonal and communication skills (3.2 ± 1.1), and “fit” with their program (2.9 ± 0.9) during virtual interviews (P = 0.360). Sixty-eight percent reported being satisfied (15.3% extremely satisfied, 52.5% somewhat satisfied) with the virtual interview process, though 76.3% preferred in-person interviews. Conclusions: This study is the first to provide insight into PDs’ impressions of virtual residency interviews. Although most reported being satisfied with the virtual interview process, the majority still preferred in-person interviews. Further long-term studies evaluating the pros and cons of each interview modality may provide more information on whether virtual interviews could become a sustainable alternative to the traditional in-person residency interview.

Background: While there has been ample interest and literature published regarding craniosynostosis surgical technique, there are few reports on adverse hospital and health system outcomes. The purpose of this study was to describe rate of and risk factors for complications, and adverse outcomes following craniosynostosis reconstruction. Methods: This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Pediatric database and identified all patients undergoing craniosynostosis repair from 2012 to 2016. Univariate logistic regression analysis was used to identify significant associations between preoperative risk factors and adverse outcomes. Multivariate logistic regression analysis was then used to identify independent risk factors and causes of prolonged operative times, transfusions, reoperation, prolonged length of hospital stays, and readmission. Results: There were 3924 patients included who underwent craniosynostosis repair, of whom 1732 underwent frontoorbital advancement and 2192 underwent cranial vault remodeling. Transfusion was the most common NSQIP reportable outcome, occurring for 66.5% of all patients. The incidence of reoperation was 2.4% and readmission was 3.0%. Conclusion: This study provides a large descriptive analysis of craniosynostosis repair throughout the United States. Largely nonmodifiable patient risk factors lead to worse health system metrics, with young age, gastrointestinal comorbidities, American Society of Anesthesiologist scores of 3 and greater, reoperation, and a prolonged length of stay as independent risk factors for readmission. This analysis can be used to identify the standard of practice in synostosis care and enhance the implementation of ancillary care services to provide safe and cost-effective care for patients undergoing craniosynostosis repair.

Background The benefits of preoperative perforator imaging for microsurgical reconstruction have been well established in the literature. Methods An extensive literature review was performed to determine the most commonly used modalities, and their applicability, advantages and disadvantages. Results The review demonstrated varioius findings including decreases in operative time and cost with the use of CT angiography to identification of perforators for inclusion in flap design with hand-held Doppler ultrasound. Modalities like MR angiography offer alternatives for patients with contrast allergies or renal dysfunction while maintaining a high level of clarity and fidelity. Although the use of conventional angiography has decreased due to the availability of less invasive alternatives, it continues to serve a role in the preoperative evaluation of patients for lower extremity reconstruction. Duplex ultrasonography has been of great interest recently as an inexpensive, risk free, and extraordinarily accurate diagnostic tool. Emerging technologies such as indocyanine green fluorescence angiography and dynamic infrared thermography provide real-time information about tissue vascularity and perfusion without requiring radiation exposure. Conclusion This article presents an in-depth review of the various imaging modalities available to reconstructive surgeons and includes hand held Doppler ultrasound, CT angiography, MR angiography, conventional angiography, duplex ultrasonography, Indocyanine Green Fluorescence Angiography and Dynamic Infrared Thermography.

Background: The 2020 to 2021 residency application cycle marked the first year of fully virtual integrated plastic surgery interviews. The virtual format was a double-edged sword for applicants with several advantages, such as reduced costs and time lost from travel, and disadvantages as the novel format introduced new stressors on top of an already demanding process. Concerns included unfair interview invitation distribution, interview “hoarding,” and assessing “fit” virtually. In this study, the authors aimed to understand applicants’ experiences of the 2020 to 2021 virtual plastic surgery interview cycle. Methods: A survey was sent to 330 applicants in the 2020 to 2021 integrated plastic surgery application cycle. The survey included questions about participant demographics, preinterview preparation, virtual interview experiences, and postinterview process. Statistical comparisons were performed on responses using IBM SPSS Statistics version 25.0 (IBM, Armonk, N.Y.). Results: Eighty-nine participants responded to the survey, representing a 27 percent response rate. Applicants received an average of 13.3 interview invitations (range, 0 to 45) and attended an average of 11.4 interviews (range, 0 to 30). Almost half (48.2 percent) did not feel interview invitations were distributed equitably, and more than half (68.2 percent) reported that there should be a limit on the number of interview invitations an applicant can accept. The majority of respondents (88.1 percent) reported spending $500 or less on virtual interviews. Half (50.6 percent) participated in virtual subinternships, of which 30.4 percent became significantly less interested in a program afterward. Conclusions: The inaugural virtual interview cycle had several advantages and disadvantages. Lessons learned from this year could be utilized toward building a more equitable, fair, and effective potential virtual cycle in years to come.

agittal synostosis presenting with scaphocephaly is the most common form of craniosynostosis. 1 Various phenotypes have been described, including frontal bossing, occipital protuberance, bitemporal protrusion, and coronal constriction, 2 in addition to variations in treatment with regard to timing 3,4 and technique. 5-8 However, a commonality is to achieve an increase in parietal width and a decrease the cephalic index, as a measure of cranial length to width. 9 There are several considerations that go into the timing of surgical treatment of sagittal synostosis, including the technique used, 5-7 implications on neurocognitive function, 4,10 and the potential to prevent a progressive deformity. 11,12 It is important for us to understand which morphometrics are consistent or worsen with time before surgery, and which have the potential to improve. In this way, we can tailor our surgical interventions to the areas at highest risk of progressive deformity.