The open TAP block provided more effective analgesia than a standard nerve block in the observation period after abdominoplasty with or without flank liposuction. Larger studies are needed to confirm the results.

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The malar fat pad suspension technique is a safe and effective method for rejuvenation of the aging midface. When combined with the SMAS-platysma rotation flap face-lift as a multi-vector technique, most of the changes that occur with aging are addressed and corrected in an anatomic fashion, resulting in an aesthetically pleasing result. Careful attention to the tension and position of the suspension suture enhances the improvement of the infraorbital flattening as well as correcting the excessive prominence of the nasolabial fold.

While most surgeons are well aware of outcomes studies and quality assessment based on technical quality (TQ) measurements, there has been little attention given in the plastic surgery literature to the discussion of functional quality (FQ)-the process by which a health care service is delivered, as opposed to the actual procedure itself. Most patients judge the quality of their hospital experience based on FQ issues. They use their assessment of FQ to secondarily infer a judgment of the TQ level of a surgeon or facility. Surgeons, conversely, typically rate their own success with purely technical quality measures, paying little attention to FQ. This article reviews the relevant service-quality medical literature and introduces plastic surgeons to the importance of differentiating between TQ and FQ. Important FQ assessment techniques are reviewed. Implications for the plastic surgeon are discussed.

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Background A novel FDA-cleared device uses a 1064-nm laser to noninvasively induce apoptosis for lipolysis of subcutaneous abdominal fat while maintaining comfortable skin temperatures with a proprietary jet cooling system (eon; Dominion Aesthetic Technologies, Inc., San Antonio, TX). A programmable articulated robotic arm moves the treatment head without any subject contact, maintaining an appropriate 3-dimensional treatment path, compensating for patient movement. Objectives The goal of this prospective, single center, open-label study was to demonstrate the safety and effectiveness of this device for reducing subcutaneous abdominal fat when operated with an updated power delivery curve. Methods Male and female subjects with Fitzpatrick skin types I to VI (N = 26) were treated. Four abdominal zones up to 150 cm2 each, customized in size and location for body habitus, were treated. Each zone underwent a single 20-minute treatment session. Follow-up visits occurred after 6 and 12 weeks. A standardized protocol was used to obtain ultrasound measurement of subcutaneous abdominal fat thickness, abdominal circumference, reported patient satisfaction and digital images. Results The mean treatment area was 378.5 cm2. At Week 12, there was a 21.6% or 6.3 mm mean reduction in abdominal subcutaneous fat thickness and a 4.1-cm (1.6-inch) mean reduction in abdominal circumference. Most subjects (84.6%) were satisfied or very satisfied with their results. The mean pain score was 2.5 on an 11-point ordinal scale. There were no nonresponders. Only 2 adverse events were noted: mild transient erythema (n = 1, 3.8%) and localized subcutaneous firmness (n = 1, 3.8%) which resolved without intervention within 12 weeks. Conclusions This contact-free device is safe and effective for reducing subcutaneous abdominal fat and represents an improvement on the prior treatment protocol. Level of Evidence: 4

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This pilot study demonstrates the safety and efficacy of liposomal bupivacaine TAP blocks under direct vision. Favorable pain control was demonstrated. This represents an exciting opportunity to decrease postoperative pain in the early and intermediate recovery period after abdominoplasty.