The transversus abdominis plane (TAP) block provides analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall. These same muscles and skin are operated on during an abdominoplasty. The purpose of this study was to determine whether the use of the TAP block will lead to reduced use of narcotics during the acute postoperative (PO) period (PO day 1 and PO 1 week). The study used a prospective, comparative design. Twenty women between 25 and 65 years of age who underwent abdominoplasty with core liposuction were recruited to participate in this study. All women were given the same PO pain medication Percocet 7.5/325 mg (1-2 tabs by mouth Q4-6 hours PRN pain #20) and Valium 2 mg (1-3 tabs by mouth Q4-6 hours PRN pain #40) at the time of surgery. The women were randomly divided into 2 groups: 10 women received local anesthetic infiltrated along the rectus plication and along the edges of the incision and 10 women received a TAP block (15 cc of 0.25% Bupivacaine with 8 mg of Decadron per side) placed under ultrasound guidance prior to the start of the procedure in conjunction with the local anesthetic along the rectus plication. Each woman was asked to record the number of narcotic pills consumed during the first 24 hours and during the first week. Data from the 2 groups were compared to determine the number of narcotics consumed during the acute PO period. The mean age of participants was 43.8 years (range: 31-63 years) in the treatment group and 38.8 years (range: 26-56 years) in the control group. The mean number of narcotics used during the first 24 hours in the treatment group was 1.95 (1.5) pills, with several women requiring no narcotics within the first 24 hours. The mean number of narcotics used during the first 24 hours in the control group was 4.6 (2.3) pills. The mean number of narcotics used during the first PO week in the treatment group was 7.15 (7.26) pills, with several women requiring no narcotics during the first PO week. The mean number of narcotics used during the first PO week in the control group was 18.7 (7.7), with 1 woman requiring 38 narcotic pills during that first PO week. Statistically significant differences were found between groups ( P = .006) at 24 hours PO and ( P = .01) at 1 week. Our results suggested that receiving a TAP block prior to the start of the procedure significantly reduced the number of narcotics used during the acute PO period.

Introduction: Patients seeking facial rejuvenation are looking for improved results with little downtime. The authors present results from a series of 16 patients treated with fractional carbon dioxide (CO2) laser resurfacing and laser lipolysis in the subdermal plane, as a laser face-lift. Materials and Methods: A 1064/1320 nm blend laser device was used for laser lipolysis of the lower face and neck. Full-face laser skin resurfacing using a fractionated CO2 laser was then completed. Six-month results were analyzed using before and after photosets and a questionnaire. Both the patients and 2 independent cosmetic surgeons rated the photosets for improvements. Results: Based on questionnaire results, 63% of participants would recommend the laser face-lift procedure to a family member or friend. Approximately 73% thought the procedure made them look younger. Sixty-nine percent thought the experience was positive, 19% had no strong feelings either way, and 13% reported a negative experience. Eighty-seven percent reported downtime of 6 days or less, with 56% noting less than 4 days of downtime. Sixty-two percent of the patients said the procedure met their expectations. There were no significant complications. Conclusions: Combining laser lipolysis and fractionated CO2 laser resurfacing into a single procedure for facial rejuvenation can provide noticeable improvements in neck and jawline contour, dyschromias, skin tightness, and overall skin tone and texture. The procedure is safe when performed by a trained surgeon using a standardized approach. Overall, patient satisfaction was high and downtime was minimal.

This article describes the mastopexy technique as used by multiple physicians at Southern Surgical Arts. The procedure is based off the tailor-tacking technique that has been modified to improve efficiency and consistency in obtaining cosmetically pleasing results. The procedure has proven to be safe when performing in combination with augmentation and other cosmetic procedure.