For patients with unresectable ICC treated with HAT, HAI offered the best outcomes in terms of tumor response and survival but may be limited by toxicity.

Background: Recent advances in mastectomy and reconstruction have allowed for an evolution in implant-based breast reconstruction to a muscle-sparing, prepectoral approach. Advantages of this technique may include reductions in postoperative pain, shorter hospitalization, less narcotic usage, and improved aesthetic outcomes. Postoperative complication rates are described as comparable to subpectoral techniques; however, little comparative data exist to adequately assess prepectoral versus subpectoral implant placement. Methods: To address this knowledge gap, we performed a single institution retrospective review of 186 (83 prepectoral, 103 subpectoral) consecutive immediate breast reconstructions. All cases were tracked for a minimum of 2 years between 2016 and 2021. Results: Prepectoral patients demonstrated an overall higher seroma rate (P = 0.001), with all other postoperative complications being comparable. Prepectoral patients tolerated higher intraoperative tissue expander fill volumes (P < 0.001), shorter hospital stays (P = 0.007), fewer clinic visits for tissue expansion (P < 0.001), and experienced less animation deformity (P = 0.005). Both groups demonstrated similar pain scores (P = 0.65) and needs for narcotics (P = 0.8) as well as comparable scores of capsular contracture (P = 0.791). Conclusions: Our comparative analysis of consecutive immediate implant-based breast reconstructions finds prepectoral reconstruction to be safe and effective. Compared with subpectoral reconstruction, the prepectoral approach may offer quicker tissue expansion, less postoperative office visits, less need for muscle relaxants, and a shorter hospital stay with a comparable complication profile.

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Background: Anatomical studies have identified separate superficial and deep facial fat compartments, leading some to theorize that volume loss from the deep midface causes overlying superficial fat pseudoptosis. Unfortunately, a paucity of evidence exists regarding whether facial fat volume is truly lost with age and, if so, whether it is lost equally or differentially from the superficial and deep compartments. The aim of this study was to quantify volume changes occurring with age within the superficial, deep, and buccal fat compartments of the midface. Methods: A retrospective longitudinal study was performed evaluating individuals aged 30 to 65 years who underwent facial computed tomography followed by facial computed tomography greater than or equal to 10 years later. Superficial midface, deep midface, and buccal fat volumes were quantified using Horos radiology software. Results: Nineteen subjects met inclusion criteria. Mean total fat volume decreased significantly from 46.47 cc to 40.81 cc (p < 0.01). The mean superficial and deep fat volumes both decreased significantly from 26.10 cc to 23.15 cc (p < 0.01) and from 11.01 cc to 8.98 cc (p < 0.01), respectively. No significant difference was observed in buccal fat volume over time (9.36 cc to 8.68 cc; p = 0.04). Patients lost an average of 11.3 percent of their initial superficial fat volume and 18.4 percent of their initial deep fat volume. Conclusions: Significant volume loss was observed from both superficial and deep facial fat compartments over a mean 11.3 years. Patients lost a greater percentage of deep facial fat volume, providing support for the theory of pseudoptosis caused by deep midface fat loss.