Background The purpose of this study is to evaluate if and what social media use influences our patients’ decisions to undergo breast augmentation. Objectives A single-institution study was designed to evaluate women who underwent elective breast augmentation from 2017 to 2018. Methods Patients were contacted via validated, prompted telephone survey. Data regarding their demographic information and social media utilization pertaining to breast augmentation were collected after obtaining verbal consent. Results Inclusion criteria were met by 180 patients, of which 69% participated in the survey. Ninety-seven percent of the participants reported utilizing social media in general; the most common platforms were Facebook, Instagram, and the physician’s website. Millennials (97%) and Generation X (92%) utilized social media the most and none of the baby boomers. Sixty-four percent of participants reported utilizing some form of social media to research breast augmentation, with the most common resource being Instagram. When analyzing the impact of the social media resources utilized by the participants, Instagram was reported as the most impactful at 54%. Only 18% of participants were utilizing a physician’s social media account to research breast augmentation. Among the 50% of patients who utilized social media to compare their surgeon’s work with another physician’s, the majority (83%) were utilizing the physician’s website. Conclusions Social media influences patients’ education and decisions to undergo breast augmentation, with Instagram being the most impactful. This study evaluated the patient population to stay up to date on their social media utilization and resources of education prior to breast augmentation.

Background: Orbital fractures are common in maxillofacial trauma and have varying anatomical deficits depending on the mechanism of injury. Orbital floor fractures are most common, but many patients suffer from two wall-floor and medial wall defects. Precise reconstruction and positioning of the orbital implant post traumatic injury can be technically challenging, especially in two wall fractures. We present our experience using the 3D Titan implant on a series of 7 patients with combined medial wall and orbital floor fractures. Methods: A retrospective chart review was performed of patients with combined medial wall and orbital floor fractures treated with 3D Titan between February 2016 and June 2020. The inclusion criteria were unilateral combined medial and orbital floor fractures due to traumatic etiologies, no previous history of orbital trauma, age older than 18 years, a contralateral healthy orbit, and a clinical follow-up of at least 1 month. Variables and outcomes included patient age, gender, mechanism of injury, visual defects, post-op infections, enophthalmos, proptosis, and diplopia. An O-arm intraoperative CT scanner was used to verify the implant position. Results: Ten patients presented with combined medial wall and orbital floor fractures, 3 were lost to follow-up. There were 6 men and 1 woman, and their ages ranged from 24 to 57 (mean age 38). Follow-up time ranged from 4 to 52 weeks, and a mean of 20 weeks. None of the patients experienced intraoperative complications such as hemorrhage, soft tissue incarceration, or acute optic neuropathy. No patients had postoperative infection or any change in visual acuity. All patients had satisfactory implant positioning as verified by intraoperative CT. Conclusions: The prefabricated design of the 3D Titan along with use of intraoperative CT guidance allows for efficient and precise reconstruction of combined medial wall and orbital floor fractures.

Introduction: Plastic surgeons frequently take facial trauma calls, and their responsibilities may include infection care. The head and neck is a site of presentation for necrotizing fasciitis which requires a high level of suspicion and prompt acti2on for diagnosis and treatment. We performed a meta-analysis of the literature on necrotizing fasciitis of the head and neck (HNnf) to summarize clinical factors, causative organisms, and treatment, and included 2 cases presenting to our institution. Methods: A meta-analysis of the literature from 1990 to 2021 was completed on HNnf. After institutional review board approval, medical records of 2 patients presenting with a diagnosis of HNnf to an academic plastic surgery center between July and September 2021 were retrospectively reviewed. Systematic reviews and articles without comprehensive individualized patient data were excluded. Results: A systematic review was performed including 2 cases presenting to our institution. A total of 149 individual cases of HNnf spanning a 30-year period were included. The most common associated comorbidity was diabetes mellitus. The most frequent source of infection was odontogenic. Most patients required serial debridements in addition to IV antibiotics. Streptococcus pyogenes was the most frequent pathogen; however, most infections were polymicrobial. Infections in the periorbital region were significantly monomicrobial ( P = .011). Acute reconstructive surgery requirements: 27 patients had skin grafting, 9 had flap reconstruction. Mortality rate was 12.3%. Increasing age was a significant predictor of mortality ( P = .01). Patients with diabetes were significantly more likely to die from HNnf (52.6%, P = .039) and require multiple debridements ( P = .001) for HNnf as compared to patients without diabetes. Infections initially arising from the submandibular region were found to be an independent negative predictor of mortality ( P = .029). Conclusion: Our experience with HNnf along with meta-analysis of the literature revealed trends in demographics, presentation, organisms, and outcomes, increasing the collective knowledge of this rare entity.

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