Assessing Clinical Outcomes in Autologous Fat Grafting: A Current Literature Review.

Autologous fat grafting, first described in the 1890s, has since undergone many modifications to optimize safety and efficacy. These changes have resulted in the technique that we now consider standard of care, one that is applied to reconstruction and cosmetic enhancement of the breast and the face both independently and in conjunction with surgical treatment. There is a growing body of evidence that this application has positive outcomes for patient satisfaction, surgeon satisfaction, and overall aesthetic appearance. This article summarizes the body of literature regarding these outcomes, reviews complications of fat grafting in the face and breast, and discusses controversies including radiologic imaging changes and longevity of grafting. Level of Evidence: 4.

Clinical experience of poly-L-lactic acid injections for body contouring treatment.

INTRODUCTION: Clinical data on body contouring with injectable poly-L-lactic acid are sparsely reported in published literature. This study describes the lead author's clinical experience using injectable poly-L-lactic acid for body contouring in various anatomic locations. METHODS: Twenty consecutive patients undergoing body contouring treatments with poly-L-lactic acid were prospectively followed. All treatments were performed at a single clinic between February 2017 and February 2019. Treatment details such as reconstitution, injection volume and dosage were documented. Treatment response was assessed independently by patients and the treating physician. Adverse events were recorded. RESULTS: Twenty patients (85% women) received injectable poly-L-lactic acid for body contouring treatments such as buttocks volumization, cellulite and skin quality treatment. In most patients (65%), poly-L-lactic acid was administered to correct postsurgical soft tissue deformities. Overall, patients had a mean of 5.1 treatment sessions in a mean of 1.4 anatomic locations. The most commonly treated anatomic locations were buttocks (58% of treatment sessions), thighs (20%) and abdomen (9%). Dosage and injection volume varied between patients depending on anatomic location and desired outcome. Most treatment sessions (86%) resulted in improvement of the treated area. Adverse events included bruising, oedema, numbness and tenderness. Nodule formation was recorded for one patient (5%). CONCLUSION: According to the lead author's clinical experience, poly-L-lactic acid injection is well tolerated and can achieve good aesthetic outcomes when used for body contouring in appropriate patients. Preliminary data suggest that poly-L-lactic acid injection may be a viable nonsurgical technique for correcting postsurgical soft tissue deformities.

The Leaky Pipeline of Women in Plastic Surgery: Embracing Diversity to Close the Gender Disparity Gap.

The Balance for Better campaign theme of the 2019 International Women's Day prompted a closer look at diversity within the plastic surgery specialty. Gender balance in the United States has improved through many organizational efforts and enactment of laws. Unfortunately, despite these endeavors, statistics show that men still enjoy greater financial and career success. Within the field of medicine, a similar trend has been observed. Although women constitute 50% of medical school graduates, the majority still enter fields outside of surgical subspecialties. In comparison to other surgical subspecialties, women are most represented in plastic surgery. Unfortunately, significant gender discrepancies remain in postgraduate practice including academic practice rank, societal board membership, invited speaker opportunities, and compensation, to name a few. The "leaky pipeline" of women describes the precipitous decline in the numbers of women at each step up the professional ladder. We explore the multifaceted nature of this phenomenon and highlight factors that contribute to limiting female growth within the plastic surgery profession. We also emphasize the continued growth of female plastic surgeon presence in all sectors despite these existing obstacles. We submit that continued leadership, mentorship, and sponsorship provided by both male and female physicians in the field will facilitate future leadership, advance gender parity, and cultivate a sense of belonging within the plastic surgery community, allowing brilliant minds to flourish and the profession to thrive.