Recent developments in three-dimensional (3D) imaging technology offer a more comprehensive means of assessing facial features. 3D printing allows for the transition of planning from simply a preoperative tool to an intraoperative device with the use of tools such as 3D-printed cutting guides, marking guides, or positioning guides. With the advent of 3D printing technology, 3D surface images can now be used to generate new medical models, devices, or tools to assist with rhinoplasty during preoperative, intraoperative, and postoperative phases. In the field of rhinoplasty, 3D printing can be applied in three main areas: (1) reference models, (2) surgical guides, and (3) nasal splints. The value of 3D imaging extends far beyond the benefits of “conversion” during a preoperative consultation and has the potential to greatly enhance the overall treatment of rhinoplasty patients with enhanced communication and personalized devices that can be used during surgery and in the postoperative phase.

Background Implant-based breast augmentation is one of the most popular plastic surgery procedures performed worldwide. As the number of patients who have breast implants continues to rise, so does the number of those who request breast implant removal without replacement. There is little in the current scientific literature describing total intact capsulectomy and simultaneous mastopexy procedures. Objectives Here, the authors present their current method using the mammary imbrication lift and fixation technique after explant and total capsulectomy. Methods Between 2016 and 2021, a total of 64 patients (mean age: 42.95 years; range: 27-78 years) underwent the described mammary imbrication lift and fixation technique with bilateral breast implant removal and total capsulectomy. Results Mean follow up was 6.5 months (range: 1-36 months). Postoperative complications included minor cellulitis in 1 patient (1.6 %), late onset hematoma with infection in 1 patient (1.6 %), fat necrosis and pulmonary embolism in 1 patient with prior history of thromboembolic events (1.6%), and breast scar irregularity in 4 patients (6.2%) who required subsequent minor scar revision or steroid injections. Two patients (1.6 %) underwent revision surgery with bilateral breast fat grafting to improve shape and add volume. Conclusions The mammary imbrication lift and fixation technique described here can safely and simultaneously be performed with a total intact capsulectomy and explant procedure. This technique avoids wide undermining, intentionally opening the capsule, performing subtotal capsulectomy, and preserves blood supply to the breast tissue and nipple with low complication rates.

BackgroundEsophagectomy is the surgical excision of part or all of the esophagus and is associated with both common and serious complications. Various comorbidities, such as diabetes mellitus, smoking, and congestive heart failure (CHF), have been detected in individuals who have undergone esophagectomy. This study investigates the association of baseline characteristics and comorbidities with postoperative complications. MethodsA retrospective cohort study based on data from the National Surgical Quality Improvement Program database was conducted, evaluating 2,544 patients who underwent esophagectomy between January 2016 and December 2018. Data included baseline characteristics, established comorbidities, and postoperative complications within 30 days of the procedure. Risk-adjusted and unadjusted logistic regressions were used to assess the odds of postoperative complications against baseline characteristics. ResultsThe majority of our population were white males (80.8% male; 78.2% white), with a mean age of 63.5 years. More than half of the patients were overweight or obese. A minority of our patients had a smoking history, weight loss, diabetes mellitus, chronic obstructive pulmonary disease (COPD), or CHF. The most frequent postoperative complications were as follows: return to the operating room (15.7%), anastomotic leak (12.9%), pneumonia (12.7%), bleeding/transfusions (11.8%), readmissions (11.4%), and unplanned intubation (10.5%). Adjusted associations for odds of experiencing a postoperative complication were found to be statistically significant for age (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01-1.03, and P < 0.001), operation time (OR 1.002, 95% CI 1.001-1.003, and P < 0.001), race (not white) (OR 1.76, 95% CI 1.26-2.47, and P = 0.001), BMI (underweight) (OR 2.18, 95% CI 1.36-3.50, and P = 0.001), smoking (OR 1.42, 95% CI 1.14-1.76, and P = 0.001), and chemotherapy and/or radiation (OR 0.82, 95% CI 0.68-0.99, P = 0.038). ConclusionsOur study found that age, operation time, nonwhite race, underweight BMI, and smoking were independently associated with an increased risk of developing a postoperative complication following esophagectomy. Additionally, neoadjuvant chemotherapy and/or radiation are associated with a decreased risk. Understanding how baseline characteristics and comorbidities can affect rates of postoperative complications may help to adjust care for patients in both pre-and postoperative settings.

Background Aesthetic norms fluctuate over time and often result in generational differences in preferred ideal nasal aesthetics. While some traditional concepts in ideal nasal aesthetic have been suggested in our literature, there is no study to date which has identified contemporary preference across different age groups. Objectives To understand the general population’s current perception of ideal nasal profiles. Methods Two dimensional (2D) images of female noses (n=10) of varying ethnicities were simulated to alter either the radix height or nasolabial angle (NLA) independently. Radix height was manipulated by increasing or decreasing the height by 5 mm relative to baseline. For NLA, 3 images were created with the following measurements: (1) 90, (2) 100, and (3) 110 degrees. Groups were categorized by generation and age at the time of completing the study: Generation Z (age 18-23), Millennial 20s (age 24-30), Millennial 30s (age 31-39), and Generation X (age 40-55). Each figure consisted of either 3 variations in radix height (n=10) or 3 variations in NLA (n=10). Within each figure, volunteers were asked to choose their preferred nose. Results The younger generations, Generation Z (Gen Z) and Millennial 20s and 30s, preferred a more augmented radix compared to Generation X (Gen X) which preferred baseline radix height. Gen Z, Millennial 20s, and Gen X preferred a 90-degree NLA while Millennial 30s preferred a NLA of 100-degrees. Conclusions The authors found that younger populations (Gen Z, Millennial 20s, and Millennial 30s) preferred a more augmented appearance to the nasal radix and, on average, a more acute NLA than published data suggests.