Background:Non–melanoma skin cancer (NMSC) is the most common malignancy in the United States. Recommended treatment for NMSC remains surgical excision following a positive biopsy. Evidence of complete spontaneous regression of residual NMSC exists in the case of small lesions macroscopically removed by shave biopsy, but with a positive microscopic margin. The present study investigates the rate at which residual tumor is present at subsequent excisional biopsy, with the aim to assess if recommendation to forgo surgical excision can be made.Methods:A total of 233 shave biopsies of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) were performed during a 5-year period. All specimens included in the study were less than 2 cm in diameter, were macroscopically removed by shave biopsy, and had a positive initial microscopic margin.Results:On subsequent surgical excisional biopsy, 42% of BCC specimens were negative for residual tumor, 38% had residual tumor, but the tumor was completely contained in the excised specimen, and 20% of the specimens had positive margin residual tumor. For SCC specimens, 73% were negative for residual tumor, 21% had residual tumor, but the tumor was completely contained in the excised specimen, and 6% of the specimens had positive margin residual tumor.Conclusions:Although reduction of residual tumor at reexcision is noted with both BCC and even more so with SCC, the rate at which this occurs is not sufficient that a general recommendation to forgo surgical excision can be made.

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Background Males represent a significant portion of patients undergoing abdominal contouring. Despite this, there are few studies examining the implication of gender on complications. Objective The aim of this study was to examine the association between gender and early postoperative outcomes in patients undergoing abdominal contouring procedures. Methods The American College of Surgeons National Surgical Quality Improvement Program database (2006–2016) was queried to identify subjects undergoing panniculectomy or abdominoplasty. Minor and major complications were identified. Operative time and length of hospital stay were evaluated. A logistic regression model was used to examine associations between patient gender and adverse outcomes. Results Ten thousand four hundred seventy-three patients were identified. Of these, 4369 underwent abdominoplasties, and 6104 underwent panniculectomies. Males represented a higher percentage of the panniculectomy cohort (15.3% vs 9.2%). Males were older and generally had more comorbidities including diabetes, hypertension, chronic obstructive pulmonary disease, and elevated body mass index. Males also had a higher American Society of Anesthesiologists classification (P < 0.001). In the abdominoplasty cohort, male gender is an independent risk factor for any complication (odds ratio [OR], 1.3; confidence interval [CI], 1.16–1.45; P < 0.001) and major complications (OR, 1.52; CI, 1.01–2.29; P = 0.043). In the panniculectomy cohort, male gender is also an independent risk factor for any complication (OR, 1.47; CI, 1.24–1.75; P < 0.001) and major complications (OR, 1.43; CI, 1.12–1.83; P < 0.001). Males also had a significantly longer operative times in this cohort (171.3 vs 157.5 minutes; P < 0.001). Conclusions Male gender is independently associated with minor and major complications in these patient populations. With this knowledge, plastic surgeons may be better able to identify higher-risk individuals and educate patients on their risk profile.

Medical photography has become essential to patient care, trainee education, and research in highly visual specialties such as plastic surgery. As smartphone technology advances, plastic surgeons and trainees are using their personal smartphones to take medical photographs prompting ethical and legal concerns about patient consent and privacy. This study aims to determine the prevalence of personal smartphone use for patient photography among plastic surgery trainees, evaluate encryption practices, and establish understanding of current guidelines. Through a survey of 71 plastic surgery trainees throughout the United States, we show that 99% use their personal cell phone to take medical photographs while only 65% use HIPAA-compliant photo storage applications, and only 49% are aware of standard guidelines. This highlights that personal smartphone use among plastic surgery trainees is ubiquitous and there is a need for additional education and access to HIPAA-compliant photo storage applications.

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