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Abraham MT, Klimczak JA, Abraham-Aggarwal M. Comparing Lateral Rhytidectomy With and Without Neck Suture Suspension. Plast Surg (Oakv) 2023; 31:275-286. [PMID: 37654534 PMCID: PMC10467435 DOI: 10.1177/22925503211042868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/14/2021] [Accepted: 07/21/2021] [Indexed: 09/02/2023] Open
Abstract
Background: Characteristic aesthetic changes of the aging neck include skin laxity and rhytid formation, submental fat deposition, plastysmal banding, and ptosis of underlying structures that lead to the development of an obtuse cervicomental angle (CMA). Cervical rejuvenation techniques that aim to restore the CMA are widely discussed in the literature, and share variable outcomes. The aim of this study is to compare the restoration of the CMA in patients undergoing the addition of midline platysmal plication using a modified Giampapa stitch with absorbable PDS suture, to those patients undergoing standard deep plane lateral rhytidectomy alone. Methods: A retrospective cohort study was performed by a single surgeon in a private facial plastics practice. 264 patients undergoing rhytidectomy were included in the study. Pre and postoperative measurement differences in CMA degree and depth were compared in patients undergoing only traditional deep plane lateral rhytidectomy (TDPLR) in isolation, with those who also had modified suture suspension and platysma plication (MSSPP). The primary outcome in the study was the change in the degree of the CMA taken from standardized preoperative and postoperative surgical photos in the Frankfort profile view. Secondary outcomes include the change in the depth of the CMA as determined by the hyomental distance between study and control groups. Results: A total of 264 patients were identified who met the study criteria. A total of 134 (123 female; 11 male; average age, 62.66 ± 8.19) underwent TDPLR with MSSPP, and 130 (127 female; 3 male; average age, 63.09 ± 7.75) underwent TDPLR alone. All patients in the study underwent preoperative photographic evaluation in Frankfurt profile view and the same postoperative photographic evaluation at an average of 436.56 days (14.4 months) after surgery. Patients in the cohort study group were found to have a statistically significant increase in the depth of the CMA by an average of 13.9 degrees ± 6.26 and increase in the hyomental distance of 1.38 cm ± 0.87, compared to the control group who underwent traditional lateral rhytidectomy with an average CMA change of 6.87 degrees ± 6.7 (P = .00146) and hyomental distance increase of 0.75 ± 0.68 (P = .00031), respectively. Statistical significance was taken at P < .05. Conclusions: The results from this study indicate that the addition of a relatively minimally invasive approach to neck rejuvenation using a modified Giampapa stitch with absorbable PDS suture is helpful in restoring the CMA in an aging neck.
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Özcan Y, Gamsizkan M. Dermatoscopic and Dermatopathologic Features of a 3-Year-Old Buried Polypropylene Suture. Adv Skin Wound Care 2023; 36:1-4. [PMID: 37079795 DOI: 10.1097/01.asw.0000923092.57459.7a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
ABSTRACT Cutaneous foreign bodies are a well-known cause of delayed wound healing and complications such as abscesses, fistula formation, and secondary infections. Polypropylene sutures are widely utilized in cutaneous surgery because they easily travel through tissues while eliciting minimal tissue reactions. Despite these advantages, retained polypropylene sutures can cause complications. The authors report a case of a retained polypropylene suture that remained buried after a total excision 3 years prior. It started to cause cutaneous symptoms when the patient began exercising 1 week prior to presentation. The authors also examine the dermatoscopic and dermatopathologic features and other complications related to retained polypropylene sutures that have been reported in the literature.
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Affiliation(s)
- Yunus Özcan
- Yunus Özcan, MD, is Dermatologist, Department of Dermatology, Duzce Ataturk State Hospital, Turkey. Mehmet Gamsizkan, MD, is Professor, Department of Pathology, School of Medicine, Duzce University
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Study on Size Estimation of Prosthesis in Rhinoplasty Based on Mechanical Test and Analysis. J Craniofac Surg 2022; 33:2433-2442. [PMID: 35921082 DOI: 10.1097/scs.0000000000008822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/09/2022] [Indexed: 11/26/2022] Open
Abstract
Rhinoplasty is a common plastic surgery. The determination of prosthesis size for rhinoplasty has long been dependent on the surgeon's experience. Some of the patients suffered from complications after the surgery. In this paper, we present a method for estimating the size of prosthesis in rhinoplasty. A nasal tension tester is designed and implemented. On the basis of the mechanical theory of Hyperelastic Materials, an algorithm for inverse calculation of material parameters is proposed; On the basis of the material parameters, an algorithm for estimating the safety range of nasal stretch is established. The nasal tension tester can obtain the nasal tension data without harming the subject. Our results show that different subjects generally have different nasal skin elasticity and tolerance to skin stretch. Therefore, the selection of prosthesis size for rhinoplasty should not be generalized, but should be tested and calculated separately for each subject. The results of this study are helpful for doctors to quantitatively understand the skin condition of the subject 's nose and the safe range of nasal stretch, based on which the determination of prosthesis size can be made for rhinoplasty.
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Contact Dermatitis in the Surgical Patient: A Focus on Wound Closure Materials. Dermatitis 2022; 34:191-200. [PMID: 35481860 DOI: 10.1097/der.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Irritant and allergic contact dermatitis from wound closure materials can occur in patients after surgical procedures. The resulting inflammation from contact dermatitis can compromise wound healing, mimic surgical site infections, and result in wound dehiscence. Components of wound closure material, such as antibiotic coatings, dyes, sterilizing compounds, or the material itself, have been implicated as contact allergens. This article provides the latest overview of the components of 3 major forms of wound closure materials-sutures, staples, and tissue adhesives-associated with contact dermatitis, discusses their cross-reactivity, and provides diagnostic and treatment guidelines.
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Othman D, Gorman M, Abbas Khan MA, Ma Y, Bhatti DS, Rafiq S, Shami HB, Lye G, McBride M, Riaz M. A Single Stage Composite Cleft Septorhinoplasty for Correction of the Mature Unilateral Cleft Nose Deformity - The Gujrat Technique. Cleft Palate Craniofac J 2022:10556656221082765. [PMID: 35234518 DOI: 10.1177/10556656221082765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate the results of a single stage composite cleft septorhinoplasty procedure ("The Gujrat Technique") to correct the exaggerated cleft nose deformity after completion of nasal growth in an adult patient cohort. METHODS Adult patients with a residual unilateral cleft nasal deformity were deemed eligible for the proposed "Gujrat Technique". Over a 10-year period (2007-2017), 96 adult patients underwent this composite cleft septorhinoplasty as a single stage operation. Post-operative nasal symmetry evaluation was undertaken using the validated computer program 'SymNose'. Functional outcome and patient satisfaction were assessed using Nasal Obstruction Symptom Evaluation scale and Rhinoplasty Outcome Evaluation (ROE) questionnaires respectively. Various statistical analysis methods were used to validate the obtained results. RESULTS Due to poor compliance with follow-up, post-operative assessments were undertaken in only 32 patients. The single group study design using the non-parametric matching pairs Wilcoxon Sign test (p < 0.001) showed overall good to excellent functional and aesthetic outcomes and higher scores of the digital SymNose grading system. There was a significant improvement in ROE scores (from 26.4 ± 2.9 to 85.9 ± 4.7, p < 0.001). There were no major complications or revisions needed in our series. CONCLUSION The individual components of "The Gujrat Technique" are not novel but their combination in this adult unilateral cleft rhinoplasty cohort has demonstrated a high patient satisfaction with its aesthetic appeal and functional versatility. In the background of limited resources and unpredictable patient follow up, the simplicity, reproducibility and cost effectiveness of this technique make it a practical reconstructive option.
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Affiliation(s)
- Diaa Othman
- Dr Sulaiman Al Habib Medical Group, Riyadh, KSA
| | | | | | - Yangmyung Ma
- 105646Royal Stoke University Hospital, Stoke-on-Trent, UK
| | | | | | | | - George Lye
- 7318Sheffield Teaching Hospitals, Sheffield, UK
| | | | - Muhammad Riaz
- 4020Hull and East Yorkshire Hospitals NHS Trust, Hull, UK (Senior Author)
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BAĞIR M, MİRİOĞLU A, KUNDAKÇI B, BİÇER Ö, ÖZKAN C. Elin ekstensör tendon onarımlarında kullanılan sütür materyallerinin reoperasyonlar ile ilişkisi. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.986874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dermatologic Complications Following Cosmetic and Reconstructive Plastic Surgery: A Systematic Review of the Literature. Aesthetic Plast Surg 2021; 45:3005-3018. [PMID: 34231016 DOI: 10.1007/s00266-021-02362-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Plastic surgery procedures, including minimally invasive cosmetic procedures, continue to grow in popularity. Although dermatologic complications following plastic surgery procedures are rare, the authors have encountered several of these complications in their practice, including herpes simplex virus (HSV-1) and varicella zoster virus (VZV) infections, pyoderma gangrenosum (PG), contact dermatitis, and suture hypersensitivity. These cases prompted a systematic literature review of dermatologic complications following plastic surgery procedures. METHODS The authors conducted a systematic review of PubMed, MEDLINE, EMBASE, Scopus, Web of Science, and the Cochrane Library to identify relevant articles published from 1975 to 2021. Articles were independently reviewed by the authors to determine whether studies met inclusion criteria. RESULTS The majority of articles that met inclusion criteria represented level V evidence. The most robust evidence in the literature was for PG, for which there were 63 total studies. Pyoderma gangrenosum was most frequently reported following breast surgery (85.1%), while HSV-1 infections were frequently seen following minimally invasive procedures (84.6%). VZV reactivation was reported after a range of interventions, including pedicled flap surgeries and laser treatments. Other complications, such as suture hypersensitivity, were less frequently reported in the literature, usually as isolated case reports. CONCLUSIONS Dermatologic complications represent a rare but serious concern following plastic surgery procedures. While most dermatologic complications resolve with appropriate treatment, sequelae of these conditions can be devastating to the patient's overall outcome. Plastic surgeons performing procedures at a high risk of these complications should recognize the diagnostic criteria to facilitate appropriate treatment. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Lee DW, Ryu H, Jang SH, Kim JH. Clinical features and literature review related to the material differences in thread rhinoplasty: Two case reports. World J Clin Cases 2021; 9:9635-9644. [PMID: 34877301 PMCID: PMC8610882 DOI: 10.12998/wjcc.v9.i31.9635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/24/2021] [Accepted: 09/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Thread rhinoplasty can trigger a reaction to thread material, which is a foreign body. We compared clinical features induced by absorbable and non-absorbable threads following thread rhinoplasty.
CASE SUMMARY Two patients who underwent different thread materials showed different clinical courses and different Hounsfield unit (HU) values in computed tomography. Patients with absorbable thread showed high HU values similar to a metallic material, and the HU value of inflammation was similar to vascular tissues with a lot of water (250). In the intraoperative field, absorbable thread materials and micro-abscesses were observed. In contrast, in the case of a non-absorbable thread, an object presumed to be thread was seen on the computed tomography (CT), and the HU value of inflammatory tissues was less than 100. In both patients, post-operative HU decreased to less than 100 and the clinical course improved. In both cases, histopathologic findings revealed foreign body granuloma associated with inflammation.
CONCLUSION Absorbable threads were more aggressive and are more easily detected on CT.
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Affiliation(s)
- Da Woon Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan 31151, Chungcheongnam-do, South Korea
| | - Heongrae Ryu
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan 31151, Chungcheongnam-do, South Korea
| | - Si-Hyong Jang
- Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan 31151, Chungcheongnam-do, South Korea
| | - Jun Hyuk Kim
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan 31151, Chungcheongnam-do, South Korea
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The role of internal sutures in stabilization of nasal dorsum in primary rhinoplasty. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-021-01793-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Al-Qattan MM, Al-Zahrani K, Kfoury H, Al-Qattan NM, Al-Thunayan TA. A delayed foreign body granuloma associated with polypropylene sutures used in tendon transfer. A case report. Int J Surg Case Rep 2016; 26:118-20. [PMID: 27490676 PMCID: PMC4972926 DOI: 10.1016/j.ijscr.2016.07.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 07/25/2016] [Indexed: 12/04/2022] Open
Abstract
Delayed suture reactions are rare. We present an unusual case of foreign body granuloma to polypropylene. Differential diagnosis and management are discussed.
Introduction A delayed foreign body reaction to polypropylene sutures has not been previously reported following tendon repair. Presentation of case A 12-year old boy underwent tendon transfer. Tendon repair was done using polypropylene sutures. Five months later, a slowly growing granuloma was seen at the tendon repair site. Skin testing did not show an allergic reaction to the suture. Excision of the granuloma and removal of sutures were curative. Histology confirmed a foreign body granuloma. Discussion A mass developing several months at the site of tendon repair indicates either an allergic or foreign body reaction to the suture. Skin testing (for allergy) and histological examination of the mass differentiate allergic from foreign body reactions. Conclusion We report on a rare case of a giant granuloma caused by a delayed foreign body reaction to polypropylene sutures used in tendon repair.
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Affiliation(s)
- Mohammad M Al-Qattan
- The Department of Surgery, King Saud University, Riyadh, Saudi Arabia; National Hospital (Care), Riyadh, Saudi Arabia.
| | - Khalid Al-Zahrani
- The Department of Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Hala Kfoury
- Department of Pathology, King Saud University, Riyadh, Saudi Arabia
| | - Noha M Al-Qattan
- The Department of Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Turki A Al-Thunayan
- Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Keleş MK, Aksakal İA, Park TH, Yağmur Ç, Küçüker İ. Unintentional Complications After Uneventful Rhinoplasty Operations: Case Reports and a Review of the Literature. Aesthetic Plast Surg 2016; 40:54-61. [PMID: 26684836 DOI: 10.1007/s00266-015-0594-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 11/13/2015] [Indexed: 12/13/2022]
Abstract
INTRODUCTION No surgical procedure is free of complications; however, some of these complications are unintentional. Plastic surgeons may be unfamiliar with certain complications after rhinoplasty operations. In this study, we aimed to present four unintentional complications that have occurred in our patients and review the literature related to these complications. MATERIALS AND METHODS In this study, we conducted a review of 1400 patients who were operated on from 2007 to 2015. The medical recordings of all patients were investigated. Four patients with unintentional complications after rhinoplasty operations are presented and the related literature was reviewed. CASES Cases 1 and 2: These patients included a 26-year-old woman and a 30-year-old man who developed herpes simplex virus (HSV) infections after a primary septorhinoplasty. Case 3: This was a 25-year-old woman who developed periorbital emphysema after a primary rhinoplasty operation. Case 4: This was a 22-year-old woman who developed a second-degree burn on the nasal dorsum. All patients healed without sequel or scars. DISCUSSION Many unexpected complications have been reported in the literature. Some of these complications include bleeding disorders, allergic reactions, dermatitis, visual loss, gastric bleeding, benign paroxysmal positional vertigo, false aneurysm after rhinoplasty, pneumocephalus, Tapia's syndrome, cavernous sinus syndrome, and skin reactions to prolene. CONCLUSION Meticulous patient histories, consistent surgical routines, careful radiologic examinations, and frequent patient visits can help surgeons control these types of complications. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Musa Kemal Keleş
- Deartment of Plastic, Reconstructive and Aesthetic Surgery, Diskapi Yildirim Beyazit Education and Research Hospital, 06110, Ankara, Turkey.
| | | | - Tae Hwan Park
- Buleun Health Care Center Plastik Cerrahi Bölümü, Incheon, Republic of Korea
| | - Çağlayan Yağmur
- Department of Plastic Surgery, Ondokuz Mayıs University Hospital, Samsun, Turkey
| | - İsmail Küçüker
- Department of Plastic Surgery, Ondokuz Mayıs University Hospital, Samsun, Turkey
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Allergy to Prolene Sutures in a Dural Graft for Chiari Decompression. Case Rep Med 2015; 2015:583570. [PMID: 26798347 PMCID: PMC4699009 DOI: 10.1155/2015/583570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/08/2015] [Indexed: 12/02/2022] Open
Abstract
Allergy to Prolene suture is exceedingly rare with only 5 cases reported in the literature. There have been no such cases associated with neurosurgical procedures. Diagnosis is nearly always delayed in spite of persistent symptomatology. A 27-year-old girl with suspected Ehlers-Danlos, connective tissue disorder, underwent posterior fossa decompression for Chiari Type 1 malformation. One year later, the patient presented with urticarial rash from the neck to chest. Cerebrospinal fluid and blood testing, magnetic resonance imaging, and intraoperative exploration did not suggest allergic reaction. Eventually skin testing proved specific Prolene allergy. After suture material was removed, the patient no longer complained of pruritus or rash. This single case highlights the important entity of allergic reaction to suture material, namely, Prolene, which can present in a delayed basis. Symptomatology can be vague but has typical allergic characteristics. Multidisciplinary approach is helpful with confirmatory skin testing as a vital part of the workup.
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Al-Qattan MM, Kfoury H. A Delayed Allergic Reaction to Polypropylene Suture Used in Flexor Tendon Repair: Case Report. J Hand Surg Am 2015; 40:1377-81. [PMID: 25899181 DOI: 10.1016/j.jhsa.2015.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 03/03/2015] [Accepted: 03/03/2015] [Indexed: 02/02/2023]
Abstract
We report a patient who developed a delayed hypersensitivity reaction to a polypropylene suture used in flexor pollicis longus repair. We also review the literature and aim to increase the awareness of hand surgeons to the presentation, diagnosis, and management of these rare cases.
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Affiliation(s)
- Mohammad M Al-Qattan
- Departments of Surgery and Pathology, King Saud University, Riyadh, Saudi Arabia.
| | - Hala Kfoury
- Departments of Surgery and Pathology, King Saud University, Riyadh, Saudi Arabia
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Affiliation(s)
- Mark B Constantian
- Dr Constantian is Attending Staff, Department of Surgery (Plastic Surgery), St. Joseph Hospital, Nashua, New Hampshire; Adjunct Professor of Surgery, Department of Surgery, Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; and Visiting Professor of Plastic Surgery, University of Virginia Health System, Charlottesville, Virginia. Dr Martin is Chief Resident, Department of Plastic Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Justin P Martin
- Dr Constantian is Attending Staff, Department of Surgery (Plastic Surgery), St. Joseph Hospital, Nashua, New Hampshire; Adjunct Professor of Surgery, Department of Surgery, Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; and Visiting Professor of Plastic Surgery, University of Virginia Health System, Charlottesville, Virginia. Dr Martin is Chief Resident, Department of Plastic Surgery, University of Virginia Health System, Charlottesville, Virginia
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