Background: Breast augmentation is one of the most common aesthetic surgical procedures. Tissue expansion followed by permanent implants is the most frequent postmastectomy breast reconstruction method. Implant contamination remains a critical problem with these procedures‚ resulting in acute infection as well as capsular contracture. To reduce the risk of implant contamination, the “no-touch technique” utilizing the Keller funnel has been adopted by many surgeons. This systematic review aims to investigate the advantages of the Keller funnel method for breast augmentation–reconstruction. Methods: A systematic review of PubMed, Embase, the Cochrane database, and Google Scholar was performed between 2005 and 2021. All clinical-based, retrospective and prospective studies utilizing the Keller funnel method for breast implant insertion were selected. Results: Six studies were identified for evaluation: five were retrospective cohorts and one was a prospective trial. No randomized controlled trials were found. Outcomes reported included lower rates of capsular contracture (RR, 0.42; P = 0.0006; 95% CI, 0.25–0.69), shorter incision lengths (35.5 ± 2.1 mm), less insertion time (mean = 6 seconds), and decreased complications, and one paper reported ultimately greater patient satisfaction with outcomes (BREAST-Q Score: 92%). Conclusions: This review suggests that the Keller funnel is a useful method for no-touch breast augmentation and reconstruction surgery. The Keller funnel reduces subsequent capsular contracture rate, surgical time, and incision length and allows for easier insertion. However, our findings support recommendation of a prospective randomized controlled clinical trial with larger population size and follow-up intervals.

Background Alopecia reduces perceptions of age, beauty, success, and adaptability. Hair loss can be caused by genetic, physiological, environmental, and immunologic factors. The current treatment for alopecia is varied. This systematic review and meta-analysis evaluates activated platelet rich plasma (A-PRP) for alopecia treatment. Objectives The objective of this review was to assess the clinical efficacy and safety of autologous activated PRP (A-PRP) injections in alopecia patients. We compare the safety, limitations, and outcomes of A-PRP use with those of prior research on alopecia. Methods We searched PubMed, EMBASE, the Cochrane Database, and Google Scholar for relevant articles. We included all primary clinical studies involving patients that evaluated A-PRP. Results Twenty-nine articles met the eligibility criteria, which included 864 patients, and were analyzed for qualitative review. Our review found that 27 studies indicated that A-PRP is significantly effective in treating alopecia, especially for improving hair density before and after therapy (n = 184, MD = 46.5, I2 = 88%, 95% CL 29.63–63.37, P 0.00001) as well as when comparison is made between treatment and control group (n = 88, MD = 31.61, I2 = 80%, 95% CI: 6.99-56.22, P = 0.01); terminal hair density between treatment and control group (n = 55, MD = 26.03, I2 = 25%, 95% CI 8.08-43.98, P = 0.004); hair counts after therapy (n = 85, MD = 12.79, I2 = 83%, 95% CI -5.53, 31.12, P = 0.0006); promoting hair regrowth; folliculogenesis; reducing hair loss; combining with FUs surgery; and initiating the hair cycle. Two studies did not report significant results. Conclusions This is the first systematic review and meta-analysis of A-PRP as a treatment option for alopecia. A-PRP appears to be a promising and safe method for treating alopecia.

Conclusion:Operative time (per hour) independently predicts morbidity, UR and LOS in DIEP flaps. Furthermore, 5 hours and 9 hours are critical cutoffs for eLOS. These findings emphasize the benefits of decreasing OT through efficiency models, such as process analysis, team-based intraoperative protocols, and co-surgery model.

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