Summary: Asian rhinoplasty generally requires augmentation procedures rather than reduction. Alloplastic grafts are fraught with higher complication rates. Autologous cartilage grafts are safer. However, Asian patients typically do not have adequate septal cartilages, and other autologous cartilage grafts may cause surgical site morbidities, prolonged surgical time, and complications, including warping and infection. Asian rhinoplasties were performed using fresh frozen cartilage by the senior author. Patients’ demographics and medical histories were recorded. Anthropometric measurements (nasofrontal angle, nasofacial angle, nasolabial angle, and Goode ratio) were taken on two-dimensional photographs. FACE-Q scales were used to assess patient-reported outcomes. Five Asian patients underwent rhinoplasty using the fresh frozen cartilage and were followed up for an average period of 14.2 ± 3.35 months. There was no resorption, warping, or infection. Anthropometric measurements showed no significant changes 2–4 months or 8–20 months after surgery. At the time of the 1-year follow-up, mean FACE-Q Satisfaction with Nose, and Satisfaction with Nostrils scores improved from 35.2 ± 10.06 to 60 ± 15.48 ( P = 0.0002), and 42.6 ± 20.31 to 59.8 ± 38.21 ( P = 0.12), respectively. Fresh frozen cadaveric cartilage is a novel option for Asian rhinoplasty. Our study demonstrated its safety and satisfying surgical outcomes.

Background Aggregated data shows that Black patients receive disproportionately lower rates of cosmetic surgery than their Caucasian counterparts. Similarly, our lab has shown that social media representation is lower among Black patients for breast reconstruction surgery, and we expect that this could be the case in cosmetic surgery as well. Objectives In this study, we explore the social media representation of Black patients and physicians in the five most common cosmetic surgery procedures: rhinoplasty, blepharoplasty, abdominoplasty, breast augmentation, and liposuction. Methods We collected data from RealSelf (Seattle, WA), the most popular social media site for sharing cosmetic surgery outcomes. Our lab assessed the skin tone of 1000 pictures of patients in each of the top five cosmetic surgeries according to the Fitzpatrick scale, a commonly utilized skin tone range. Additionally, we gathered Fitzpatrick scores of 72 providers who posted the photos within each surgical category. Results We found that Black patients and providers are underrepresented in rhinoplasty, blepharoplasty, breast augmentation, and liposuction compared to the general population (defined by the US Census Bureau) while being proportionately represented in abdominoplasty. Additionally, we found that patients most often matched Fitzpatrick scores when both had scores of two, while patients with a score of five and six rarely matched their provider’s score. Conclusions We suspect that the underrepresentation of Black patients and providers in social media for cosmetic surgery discourages patients from pursuing cosmetic surgeries. Therefore, it is essential to properly represent patients to encourage patients interested in considering cosmetic surgery.

Objective: Pressure ulcers (PUs) are hard-to-heal, open wounds that affect millions of adults worldwide. Patients experience physical, mental, social and financial impairment. On average, <50% of stage 3 and 4 PUs heal by the sixth month. Treatment of PUs is highly variable due to a patient's comorbidities, demographics and wound characteristics. Because of this, there exists no standard dressing for PUs. Altrazeal transforming powder dressing (TPD, Uluru Inc., US) offers a promising new form of wound treatment; however, little evidence exists for TPD in the treatment of hard-to-heal PUs. This case series sought to examine the effect of TPD in hard-to-heal PUs that have previously undergone unsuccessful standard of care (SoC) wound therapy. Methods: This case series used retrospective data from patients with stage 2–4 PUs that failed to heal after SoC therapies. Factors examined were: number of dressing changes; time between dressing changes; time to wound closure; and pain level. While data were assessed for all patients, we focused on the six particular cases that most clearly illustrated the effect of TPD on wound healing. Results: Each of the 21 patients treated with TPD experienced successful and expedited wound closure. Stage 4 PUs took an average of 87 days with approximately six dressing changes to closure. Stage 3 PUs took an average of 41 days with approximately four dressing changes, and stage 2 PUs an average of 13 days to closure with approximately one dressing change. In the cases presented herein for which pain scores were reported, each showed a reduction in pain from an 8 or 9/10 to a 1 or 2/10 with the first dressing change. Conclusion: In this case series, TPD effectively reduced pain and healed PUs that had previously failed SoC interventions. We suggest future prospective studies in order to more effectively measure the wound healing capability and healthcare utilisation of TPD for treatment of PUs.

Lack of surgical access severely harms countless populations in many low- and middle-income countries (LMICs). Many types of surgery could be fulfilled by the plastic surgeon, as populations in these areas often experience trauma, burns, cleft lip and palate, and other relevant medical issues. Plastic surgeons continue to contribute significant time and energy to global health, primarily by participating in short mission trips intended to provide many surgeries in a short time frame. These trips, while cost-effective for lack of long-term commitments, are not sustainable as they require high initial costs, often neglect to educate local physicians, and can interfere with regional systems. Education of local plastic surgeons is a key step toward creating sustainable plastic surgery interventions worldwide. Virtual platforms have grown popular and effective—particularly due to the coronavirus disease 2019 pandemic—and have shown to be beneficial in the field of plastic surgery for both diagnosis and teaching. However, there remains a large potential to create more extensive and effective virtual platforms in high-income nations geared to educate plastic surgeons in LMICs to lower costs and more sustainably provide capacity to physicians in low access areas of the world.

Introduction. Clinical options are lacking for the management of chronic wounds or ulcers following failed debridement, skin grafting, or negative pressure wound therapy dressings. Objective. This retrospective case series evaluated the efficacy of injectable AAM in the management and closure of chronic wounds. Materials and Methods. Patients with nonhealing wounds of any etiology, anatomic location, and length of chronicity were included; those with multiple chronic wounds or prior skin grafting for wound repair were excluded. Data on location, etiology, chronicity, and number of AAM applications were collected for each wound. Patients were evaluated for possible complications related to wound healing and infection. Eleven patients (7 males, 4 females), each with 1 chronic wound, were recruited (average age, 65 years). Wound etiologies were postoperative (n = 7), traumatic (n = 2), and foot ulcer (n = 2). Average wound dimensions were 8.45 mm × 7.36 mm, and the average chronicity was 3.77 months. Ten patients received only 1 application of AAM, and 1 patient received 2 treatments 5 days apart. Average follow-up time was 6.6 weeks. Results. Seven patients (63%) achieved wound closure, 4 of which (57%) healed within 1 week of application. Conclusion. Most patients with chronic wounds treated with AAM experienced complete wound closure. AAM shows promising results for enhancing wound healing by providing scaffolding for cell growth.