Although instruments are available for measuring outcomes with respect to facial function, there are few instruments developed to specifically evaluate the impact of facial paralysis on quality of life. To quantify treatment outcomes of facial paralysis patients, future research to develop and validate a new patient-reported outcome instrument is needed.

Therapeutic, III.

Granulomatous mastitis is an inflammatory breast condition of unknown etiology. Management remains controversial and treatment algorithms are lacking from the literature. Few resources exist that discuss breast reconstruction following extirpation. This descriptive case series reviews the clinicopathologic features of granulomatous mastitis.We describe the surgical management undertaken at our institution including General and Plastic Surgery procedures. Eleven clinical charts and histologic slides of biopsy specimens were reviewed in our health region between 1992 and 2007. Demographic data, clinical presentation, and radiologic findings were tabulated. Treatment consisted of empirical antibiotics and surgical excision. Procedures performed included incision and drainage (n = 8), excisional biopsy (n = 15), partial mastectomy (n = 5), partial mastectomy with reduction mammaplasty (n = 2), and mastectomy with TRAM flap reconstruction (n = 1).Treatment was successful in all but one case. Multiple surgeries for recurrent lesions were often required to achieve final remission. Following extirpation, we recommend delayed breast reconstruction to monitor for recurrence.

Background:Body contouring performed for cosmetic purposes, or after weight loss, has the potential to improve body image and health-related quality of life (HRQL). The BODY-Q is a new patient-reported outcome (PRO) instrument designed to measure patient perceptions of weight loss and/or body contouring. In this article, we describe the psychometric properties of the BODY-Q scales after an international field-test.Methods:Weight loss and body contouring patients from Canada, United States, and United Kingdom were recruited between November 2013 and February 2015. Data were collected using an iPad directly into a web-based application or a questionnaire booklet. Rasch measurement theory analysis was used for item reduction and to examine reliability, validity, and ability to detect change.Results:The sample included 403 weight loss and 331 body contouring patients. Most BODY-Q items had ordered thresholds (134/138) and good item fit. Scale reliability was acceptable, ie, Person separation index >0.70 for 16 scales, Cronbach α ≥0.90 for 18 of 18 scales, and Test–retest ≥0.87 for 17 of 18 scales. Appearance and HRQL scores were lower in participants with more obesity-related symptoms, higher body mass index, and more excess skin and in those pre- versus postoperative body contouring. The 134 weight loss patients who completed the BODY-Q twice, either 6 weeks (weight loss/nonsurgical body contouring program) or 6 months (bariatric program) later, improved significantly on 7 appearance and 4 HRQL scales.Conclusion:The BODY-Q is a clinically meaningful and scientifically sound patient-reported outcome instrument that can be used to measure outcomes in patients who undergo weight loss and/or body contouring.

Therapeutic, IV.

We found no difference in the rate of MFN when comparing immediate alloplastic and autologous reconstruction methods. A number of patient and surgical factors were found to be predictors of MFN. The results of this large, retrospective study will help surgeons to tailor their reconstruction based on a patient's risk factors to minimize the incidence of MFN.

Therapeutic, I.

This is the largest study to compare patients undergoing autologous breast reconstruction older than and younger than 65 years within the same cohort. Women older than 65 years represent a minority and constituted only 3% of patients in this multicenter 10-year review. We have shown that with careful patient selection, abdominally based autologous reconstruction should be considered in the elderly patient population because it is well tolerated and achieves high patient satisfaction.