Combination of Melolabial Interpolation Flap and Nasal Sidewall and Cheek Advancement Flaps Allows for Repair of Complex Compound Defects.

BACKGROUND: The paramedian forehead flap (PMFF) is the repair of choice for large nasal defects involving multiple cosmetic subunits. However, the PMFF may not be optimal for all patients. The combination of a melolabial interpolation flap (MLIF) and a nasal sidewall flap may serve as an alternative. OBJECTIVE: To present the surgical technique and aesthetic outcomes of the alternative reconstruction for surgical defects of the lower nose. MATERIALS AND METHODS: Fourteen patients with multisubunit nasal Mohs defects reconstructed alternatively were identified from 2 academic centers in this retrospective case series. Illustrations and photographs were used to demonstrate surgical technique and outcomes. Final aesthetic results were analyzed using the Patient and Observer Scar Assessment Scale. RESULTS: The physician observer rated the scar outcome a mean score of 10.9 ± 3.3. Patients rated their results as a mean of 9.1 ± 4.7. The mean "Patient" Overall Opinion score was 2.3 ± 2.6 and the mean "Observer" Overall Opinion score was 1.9 ± 0.9. No patients reported problems with nasal airflow or obstruction, and cosmetic complications such as pincushioning or alar buckling were not observed. CONCLUSION: The combined MLIF and nasal sidewall flap is an alternative repair for complex distal nasal defects.

Noninvasive approach to treatment of submental fullness.

A recent survey done by the American Society for Dermatologic Surgery indicated that 67% of respondents were bothered by "excess fat under the chin/neck." Accumulation of fat in the preplatysmal compartment of the neck is a common cause for fullness in the submental area. In the past, surgical liposuction was the only option to remove fat in the submental area. Although effective, liposuction does have risks and downtime. Recently, noninvasive options for treatment of submental fat have been introduced. These include treatment with deoxycholic acid, known as Kybella®, and cryolipolysis using the CoolMini™ handpiece. Both of these treatments offer less downtime fewer potential risks than the surgical counterpart. This article summarizes these two procedures and describes noninvasive approaches to treatment of submental fat.

A 30-Minute, Monthly, Live, Webinar-Based Journal Club Activity Alters the Self-Reported Behaviors of Dermatologic Surgeons.

BACKGROUND: Journal clubs provide a way to communicate advances in recent literature. In outpatient surgical subspecialties, such as dermatologic surgery, physicians may face challenges in finding or attending meetings pertinent to their practice. OBJECTIVE: To assess the utility of a live web-based journal club in dermatologic surgery. MATERIALS AND METHODS: Monthly 30-minute journal club sessions covering 5 to 6 scholarly articles. Anonymous surveys were used to evaluate the utility and self-reported learning associated with each meeting. RESULTS: From December 2012 to February 2015, 117 articles were reviewed. Survey data were acquired monthly, apart from 5 months of missing data. On average, the survey response rate was 37% (range: 7%-82%), with an average of 17 participants per monthly session (range: 9-25). The mean monthly usefulness score was 83.7 (101-point scale), with participants scoring their likelihood of returning in the future as 96.2 (0 = not likely, 100 = extremely likely). At each session, a mean of 68% of participants felt that at least one article would change their practice of medicine. CONCLUSION: A monthly online and telephonic journal club may be a practical and effective way to inform dermatologic surgeons of new developments in high impact literature and may influence improvements in individual practice.

Management of Skin Cancer in Solid-organ Transplant Recipients: A Multidisciplinary Approach.

Solid-organ transplant recipients are at increased risk for the development of skin cancers. A promising strategy for managing these complex patients involves a multidisciplinary approach that incorporates clinicians from various specialties, which provides the optimal milieu for patient education, treatment, and follow-up. The multidisciplinary clinic also facilitates communication between dermatologists and transplant physicians regarding such crucial concerns as revision of immunosuppression. This article reviews the problem of skin cancer in solid-organ transplant recipients, outlines preventive measures, discusses therapeutic modalities, and reinforces the advantage of a multidisciplinary approach in the management of this population.