Infection after augmentation gluteoplasty in a pregnant patient.

The authors present a case of late postoperative infection after augmentation gluteoplasty in a 32-year-old pregnant woman. The case is unique in that it is the first documented example of a gluteal implant infection in a pregnant woman and because the infection was not preceded by trauma to the anatomic region.

The effect of liposuction and diet on ghrelin, adiponectin, and leptin levels in obese Zucker rats.

BACKGROUND: The fat-regulating hormones, adiponectin, ghrelin, and leptin, have been studied extensively with the hope that some therapeutic modality might be gleaned from their augmentation or blockade. The authors studied levels of ghrelin, adiponectin, and leptin after liposuction in obese male Zucker rats. In addition, they altered the fat and carbohydrate content of the rats' postoperative diets to determine whether diet affects hormonal levels and/or liposuction outcome. METHODS: Thirty-five male, obese Zucker rats were divided into four experimental groups. Group I (n = 10) was fed a low-fat/low-carbohydrate diet; group II (n = 10) was fed a regular chow diet; and group III (n = 10) was fed a high-fat/high-carbohydrate diet. Five additional rats served as the baseline, unoperated group. The experimental rats underwent subcutaneous liposuction, and for 6 weeks they were then fed their experimental diets starting on day 0. Experimental rats were euthanized on day 42 and blood was sampled for hormonal, triglyceride, and cholesterol levels. RESULTS: Triglyceride levels were significantly higher in the high-fat/high-carbohydrate group compared with the regular chow and low-fat/low-carbohydrate groups, indicating an effect of diet on systemic circulation after liposuction. Ghrelin levels decreased significantly and leptin levels demonstrated an increasing trend after liposuction. Adiponectin levels did not demonstrate any change with alteration in diet or liposuction. CONCLUSIONS: Liposuction may prove to offer patients medically therapeutic benefits through hormonal alterations. After liposuction, diet plays an important role in weight gain.

Beauty lies in the "eyebrow" of the beholder: a public survey of eyebrow aesthetics.

BACKGROUND: Several studies have attempted to define the dimensions of an aesthetically pleasing eyebrow. However, these dimensions represent the views of plastic surgeons and cosmetologists, not necessarily the general public. We hypothesized that many patients who present to their plastic surgeon for periorbital rejuvenation actually want their eyebrows to be in a more natural position than was represented in the studies we surveyed. OBJECTIVE: A study was designed to define the dimensions of an aesthetically pleasing eyebrow from the perspective of the general public. This was achieved by surveying individuals in our local community. METHODS: One hundred individuals were surveyed and asked to rank 27 photographs (including photographs of pre- and postoperative patients and of models) on a scale of 1 to 10 and grade each photograph as either "attractive" or "unattractive". Each survey taker provided extensive background information. The photographs receiving the highest number of points and "attractive" grades were then analyzed for eyebrow dimensions. The following distances were measured: medial canthus (MC) to medial eyebrow (ME), lateral limbus (LL) to lateral eyebrow (LE), and eyebrow arch position (EAP) to eye width (EW). Ratios were determined using the EW for comparison. We also evaluated the EAP in relation to the LL. RESULTS: The eyebrow dimensions (mean +/- SD) of the most highly ranked female photographs were as follows: MC-ME:EW ratio 0.573 +/- 0.126, LL-LE:EW ratio 0.668 +/- 0.083, and EAP:EW 0.703 +/- 0.1. The eyebrow dimensions (mean +/- SD) of the most highly ranked male photographs were as follows: MC-ME:EW ratio 0.547 +/- 0.177, LL-LE:EW ratio 0.58 +/- 0.171, and EAP:EW 0.63 +/- 0.175. The EAP in relation to the LL was found to be 0.925 +/- 0.884 cm lateral to the LL in women, and 1.05 +/- 1.04 cm lateral to the LL in men. CONCLUSIONS: Previously published dimensions of an aesthetically pleasing eyebrow, as defined by plastic surgeons and cosmetologists, differ from dimensions currently defined as attractive by the general public in our study.

Comparison study of nipple-areolar sensation after reduction mammaplasty.

BACKGROUND: Although many techniques of reduction mammaplasty are currently in use, a prospective study quantitating the sensation of the nipple-areolar complex (NAC) after the performance of specific techniques has not been performed. OBJECTIVE: The purpose of this study was to quantitate the postoperative sensation of the NAC after reduction mammaplasty and to compare the results on the basis of the orientation of the vascularized pedicle. METHODS: We tested 42 patients divided into 4 groups: medial pedicle (9 patients), inferior pedicle (8 patients), free nipple transfer (8 patients), and a control group (17 patients). The specific mammaplasty technique chosen was based on the preoperative assessment and the estimated volume of resection. A Wise pattern approach was used in all cases. NAC sensation was quantified with the use of the Pressure Specified Sensory Device (Sensory Management Services LLC, Baltimore, MD). RESULTS: We detected no significant difference in the volume of reduction between the free nipple group and the medial pedicle group (P =.14). NAC sensation in the free nipple transfer group was significantly lower than either of the pedicle techniques and control group in all areas of testing (P < 0.001), whereas the medial and inferior pedicle groups had no significant sensory differences in NAC sensation (P < 0.001). CONCLUSIONS: The medial pedicle technique is safe and reliable and can be used for large-volume reduction mammaplasty to optimize sensation of the NAC.