Background: Implant-based breast reconstruction can be accomplished in a variety of ways and can result in vastly different postoperative experiences for patients. The COVID-19 pandemic and recent trends have resulted in a shift toward outpatient management of these patients. Methods: A systematic review of PubMed and Embase databases was conducted. A total of 1328 articles were identified on initial search, and after several rounds of review, a total of four met inclusion and exclusion criteria. Manuscripts were included if postmastectomy alloplastic breast reconstruction was performed, and there was documentation of same-day discharge. This cohort of patients was compared with traditional, planned overnight admission cohorts found in the literature. Objective data compared between groups included preoperative patient factors and postoperative complication rates. Results: Four studies representing data on a total of 574 patients were included: 289 were same-day discharge and 285 were overnight admission. Patient characteristics of body mass index, radiation, smoking, and bilateral procedures were comparable. Tissue expanders were used more frequently than implants in both cohorts. The rate of overall complications was 33% for same-day discharge and 34% for overnight admission. Rates of major and minor complications, including infection, seroma, and hematoma, were similar. There was no increase in reoperations or readmissions reported in any of the studies. Conclusions: Same-day discharge after mastectomy with immediate alloplastic reconstruction is a safe approach to treatment in both the ambulatory and hospital setting. There are comparable rates of common complications such as infection, seroma, and hematoma, with no increase in readmission or reoperation.

Social media has been demonstrated to serve as a critical tool for plastic surgeons, facilitating patient engagement, peer-to-peer education and learning, and outreach to the broader public community. This study aims to perform a meta-analysis of data to determine the most valuable and useful social media platforms for practicing plastic surgeons developing their practice by assessing the perceived value to the practice and quantifying return on investment. A systematic review was performed using PubMed (National Institutes of Health, Bethesda, MD). The initial search yielded 3592 articles. Sixteen articles met inclusion and exclusion criteria. It was found that patients are more likely to engage with aesthetic content rather than scientific content. Younger generations are more likely to utilize Instagram (Meta, Menlo Park, CA), Snapchat (Santa Monica, CA), and TikTok (Culver City, CA), while older generations may be more likely to utilize Facebook (Meta, Menlo Park, CA) and YouTube (San Bruno, CA). Age specific recommendations include utilizing Instagram, Snapchat, and TikTok with emphasis on breast augmentation for patients aged 17 and 35 given this is the most common procedure performed for this age group. Patients between the ages of 36 and 70 are most likely to be engaged on Facebook, Instagram, and Facebook with liposuction being the most common procedure in this age group. For ages 70+, patients are most likely to utilize Facebook with the most common procedure performed as blepharoplasty. Effective social media marketing for the plastic surgeon considers delivering the right content and choosing the right platform. The right content and platform are critically dependent on the specific age of the audience.

Background: COVID-19 significantly impacted the residency match process. Away rotations and in-person interviews were canceled in 2021, resulting in a geographic shift in integrated plastic surgery match results. Although several of these limitations were lifted during the 2022 cycle, the resulting geographic outcomes have yet to be described. This study aims to determine whether the changes seen during the previous cycle persisted despite loosened restrictions. Methods: Integrated plastic surgery match results and applicants' home institutions from the 2022 match cycle were determined using publicly available data. Geographic data from this cycle were then compared with pre-COVID-19 match cycles (2016-2020) and the COVID-19-affected 2021 match cycle. Results: Eighty percent (n = 68) of US integrated plastic surgery programs were included in this study. In 2022, 18.42% of applicants matched at their home institution compared with 25.12% in 2021. There was no significant difference in home, state, or regional match rates between 2022 and the five cycles preceding the pandemic (2016)(2017)(2018)(2019)(2020). Combining these data to reflect the non-COVID-19-affected cycles (2016-2020 and 2022) and comparing to the COVID-19-affected cycle (2021), a significant difference in rates of home matches (P = 0.0395) was identified. Conclusions: A significant increase in home institution match rates was not noted during the 2022 cycle. This return to pre-COVID-19 rates is likely attributed to the loosening of restrictions and more opportunities for interaction between applicants and programs outside of their home institution.

Background: Bleeding complications are not uncommon after breast reduction surgery, and recently, tranexamic acid (TXA) as an antifibrinolytic agent has been used in various surgical specialties as a way to minimizes such adverse outcomes. We elected to evaluate the effectiveness of intravenous (IV) intraoperative TXA in reduction mammoplasty patients. Methods: This is a retrospective chart review of clinical charts of all patients who received reduction mammoplasty by a single surgeon at Emory University Hospital or its affiliated Aesthetic Center from January 1, 2020, to March 1, 2022. Seventy-four consecutive breast reduction patients received 1-g IV TXA intraoperatively compared with 117 consecutive controls. The outcome of interest included 30-day postoperative bleeding complications. Results: There was no significant difference in age (P = 0.92), body mass index (P = 0.98), percentage of smokers (P = 0.56), operating time (P = 0.87), estimated blood loss (P = 0.90), or weight removed (P = 0.98) between patients in each arm. There were 19 bleeding events (16.2%) in the non-TXA arm compared with 1 bleeding event (1.4%) in the TXA arm (P = 0.0143). Of the 19, 6 (5.1%) were major events, and 13 were minor events (11.1%); the only bleeding event in the TXA arm was minor. Number needed to treat all bleeding events with use of TXA was 7, and the number needed to treat minor hematomas was 11. There was no significant difference in the rate of seroma, wound healing complications, infection, or nipple necrosis between the 2 arms (P > 0.05). Conclusions: The use of IV TXA is a safe and effective way to reduce hematoma rates in patients receiving reduction mammoplasty.