Day 1 :
Keynote Forum
Joseph W. Rucker
MD FACS, American Society of Plastic Surgery
Keynote: Long Term Outcomes After Breast Reconstruction Utilizing A Template Designed Technique for Inframammary Fold Placement and Breast Mound Positioning
Biography:
Dr. Rucker has been in solo practice for 27 years. He has focused a significant portion of his surgical practice on refining and producing an improved aesthetic result in all fields of Breast Surgery. His specific areas of focus have been in Breast Reduction, Breast Lift, the treatment of Gynecomastia and Post-Mastectomy Breast Reconstruction. Dr. Rucker has used his experience in Breast surgery to develop a technique that hopefully produces a reproducible and more aesthetically pleasing outcome in his Post-Mastectomy Reconstructive patients
Abstract:
BACKGROUND/OBJECTIVE: A new method offered for a less technically demanding, and more predictable technique for post-mastectomy inframammary fold reconstruction utilizing a lower thoracic advancement flap, the placement of a suture sling template acting as a guide for IMF placement and internal IMF fixation. It has been the authors experience that, a smooth well defined and properly placed inframammary fold (IMF) is the most important factor in producing a natural appearing breast mound and secondarily a more symmetrical reconstructive result. Because of the authors inability to consistently reconstruct this important structure this method was developed.
METHODS: 118 patients over a 27-year history, selected for IMF reconstruction from 2 main categories. Group 1 consisted of 92 patients that underwent IMF reconstruction with a permanent suspension suture technique which was connected to the sternum medially and to the fourth rib laterally. These patients had undergone a delayed prosthetic reconstruction after a tissue expansion phase. Group 2 consisted of the remaining 26 patients that underwent a temporary placement of a suspension suture to act only as a guide for IMF placement which was subsequently removed after fixation of the IMF to the chest wall. The patients in Group 2 fell into the category of either a revision of a post mastectomy reconstruction with displacement of IMF position or the loss of IMF definition immediately following a skin sparring mastectomy.
- Reconstructive Surgery
Session Introduction
WooKoung Lee
MD, Root Hair Transplantation Center
Title: The visualization of hair follicles by means of Ultrasound scanner to reduce damage for hair follicles during FUE(follicular unit extraction).
Biography:
Doctor WooKoung Lee has been since 2010 as a dermatologic surgeon. He has been a active lecturer or participant at a lot of international conferences. He has performed hair transplantation by means of FUE or FUT for about 1,500patients during last 8years and most of them were satisfied with the their results.
Abstract:
FUE has many advantages but definitely have disadvantages as well. One of them include potential for high follicle transection rate. There is a difference in angle between hair and follicle. We want to use ultrasound as a way to overcome the difference. In addition, we will present a method to make the FUE more easily using our sensor.
Keywords : angle, follicle, hair, ultrasound-guided FUE, sensor
- Facial Surgery
Session Introduction
Shahab Shahid
Junior Doctor, Barts Health NHS Trust. London, UK
Title: First Webspace Trauma- Development of a Prognostic Score
Biography:
Shahab Shahid is a junior doctor in London, UK. As well as being a published author, educator and illustrator, Shahab is pursuing a career in Orthopaedic Surgery
Abstract:
Statement of the Problem:
The first web space and thumb is an essential area for hand function and contains a number of vital neurovascular and muscular structures. Injury has the potential to cause significant impairment of hand function.
Methodology & Theoretical Orientation:
We retrospectively collected the data of 102 patients who suffered first webspace trauma. Data from hand therapy appointments for this cohort has enabled us to analyze the importance of each of the components of the first web-space for overall hand function. We liaised with the hand therapy team at the Royal London Hospital and devised a prognostic score, based on the extent of recovery of hand function.
Findings:
68% of cases were male with an average age of 29. Injuries to the volar aspect were more common (58%) than the dorsal aspect (27%). 70% of injuries were lacerations and 8% were abscesses. Thumb injuries were a major component, with flexor thumb injuries in zone 2 (42%) and zone 3 (42%).
Conclusion & Significance:
Factors linked to poor function include nerve involvement, infection, multiple injuries, skin loss, compound fracture and amputation. Factors linked to better function included clean-cut injuries, short time between injury and therapy, no tendon/bone/nerve involvement, and good quality digital nerve repair.
- Breast Surgery
Session Introduction
Shirin Ghatrehsamani
Doctoral candidate, University of Florida, USA
Title: Application of computational fluid dynamic to optimize thermotherapy system for treating citrus greening
Biography:
Shirin Ghatrehsamani is currently a doctoral candidate at the University of Florida, her doctoral dissertation is focused on the needs of Florida’s citrus industry due to the spread of the citrus greening disease (HLB) that has sparked concern for the continuity of the citrus industry in Florida.
She has developed an integrated model to simulate and analyze heat distribution throughout the tree canopy and improve a supplementary heat thermotherapy system to generate a uniform temperature and treat HLB-infected trees. She has helped to develop a smart automated smart thermotherapy system for this purpose.
Abstract:
The citrus industry in Florida and several other citrus producing areas in Brazil and China is suffering from the citrus greening disease (known as HLB) and there is no known cure. HLB-infected trees have low production, low fruit quality and could die within about three to four years. This disease has been a fatal disease for the citrus industry in Florida since 2005. Heat treatment (Thermotherapy) is one of the non-chemical methods and it is based on the idea that heating a plant at a specific temperature and for a pre-determined time can kill pathogen microorganisms, while minimizing host devastation.
In this study, heat treatment system has been developed for sustaining productivity of HLB-infected trees. Using steam to treat HLB-infected citrus trees under field conditions requires an enclosure to cover the tree canopy and hold the steam for a certain amount of time. We evaluate a mobile heat thermotherapy system for the appropriate temperature and time combination. The heat distribution inside the canopy cover was monitored and simulated by mathematical model and computational fluid dynamic (CFD) method to develop and improve the supplementary heat thermotherapy system to generate a uniform temperature. The theoretical predictions are in good agreement with the experimental measurements, which can possibly be described/predicted satisfactorily by the model developed in the present study.
- Body Lift
Session Introduction
Hope Xu
Student, Icahn School of Medicine, at the Mount Sinai Hospital in New York City
Title: Complications Profile of Primary Breast Augmentation in Transgender Patients
Biography:
Hope Xu is a rising fourth year medical student at the Icahn School of Medicine, at the Mount Sinai Hospital in New York City. After completing her undergraduate education at Princeton University in 2015, Hope matriculated into the Icahn School of Medicine where she has become a leader in community outreach, including being the Clinical Manager of the East Harlem Health Outreach Partnership, a free clinic run by Mount Sinai medical students servicing the uninsured patients of East Harlem. She has been working with the gender reassignment surgeons for most of her medical school career, including spearheading multiple research projects based around improving surgical outcomes and treatment guidelines for the transgender population. As such she plans to continue to improve the surgical outcomes for a population who is much in need
Abstract:
Background & Purpose: Primary breast augmentation is an extremely common procedure, with reported complications rates between 1.4% and 14.5% in cisgender patients1,2. Unfortunately, such data for transgender patients is limited3-6. This study seeks to address this paucity of data by examining the complication profile of primary breast augmentation in male-to-female transgender patients.
Methodology: A retrospective chart review was performed of all male-to-female transgender patients who underwent breast augmentation at a single institution from 2017-2019. Preoperative clinical parameters and postoperative surgical outcomes were compared.
Results: A total of 96 patients were identified. Mean age was 37.9 years (range, 21 to 60 years). Primary augmentation was performed in 81% of patients, and 19% presented for secondary/revision augmentation. Ninety-two patients returned for follow-up, with a mean follow-up time of 5.5 months (range: 4 days to 27.4 months). The overall complication rate was 20.5% in primary augmentation patients and 44.4% in secondary augmentation. Of the 24 patients who developed complications, 19 required revision. Complications included 17 cases of capsular contracture, 4 wound dehiscence, 2 seromas, 2 synmastias, 2 implant migrations, 1 hematoma, 1 SSI, 1 implant infection, and 1 implant extrusion. Baker grade III/IV capsular contracture was noted in 7.7% of primary augmentation patients and 33% of secondary augmentation patients.
Conclusion & Significance: In this first study of its kind, complication rates after primary breast augmentation in transgender patients may occur at a higher frequency than those seen in cisgender patients. This study is the first to examine in-depth the complication profile of primary breast augmentation in male-to-female transgender patients. As gender affirming surgery increases in frequency, an understanding of the complication profile is crucial for optimal management of this unique patient populations.