Alan Matarasso - Academia.edu (original) (raw)
Papers by Alan Matarasso
Plastic and reconstructive surgery, Sep 1, 2017
www.PRSJournal.com 488 B and colleagues have demonstrated the safety and efficacy of inserting br... more www.PRSJournal.com 488 B and colleagues have demonstrated the safety and efficacy of inserting breast implants through a traditional abdominoplasty incision with the aid of a balloon dissector.1 The authors begin by acknowledging that a common concern and therefore frequent accompanying procedure in abdominoplasty patients is the appearance and enhancement of their breasts.2 They verify the complication rate from transabdominal breast augmentation is essentially the same as would be expected from either operation alone. So why then has this technique not gained more widespread use? When I reported my experience with Planas’ concept of inserting implants through an abdominoplasty incision,3 I had a similarly favorable experience as the authors. Interestingly, although I adopted Planas’ concept of preexcising the undermined abdominal pannus (which also makes implant insertion easier, and I always remove the old umbilical site), I no longer routinely insert implants through the abdominoplasty incision. Despite my initial enthusiasm, I suspect my reluctance stems from the transition in surgical thinking that occurred around that time from wide abdominal flap undermining in an abdominoplasty to a more inverted-V flap type undermining. This method of dissection preserves the Huger zone III blood supply and now has been demonstrated by Smith4 and Roostaeian et al.5 to possibly also preserve the Huger zone I blood supply. The change in the pattern of undermining was deemed necessary because surgeons were becoming interested in liposuction of the undermined abdominal flap6,7 and altering dissection techniques were felt to minimize the potential for flap ischemia. Consequently, I began to insert implants less frequently through the open wound, which theoretically requires wider undermining (although I did not use the balloon dissector) and potentially increases the risk of flap ischemia. In this article and in the examples shown, patients appear not to require liposuction, and no mention is made of flap liposuction. So, presumably they could safely undergo wider flap undermining to insert the implants, with less concern about preserving additional blood supply. With regard to who can safely undergo wide abdominoplasty flap undermining, I believe massive weight loss patients can tolerate it in addition to patients who have had prior liposuction followed by an abdominoplasty,8,9 because these are essentially delayed flaps. Thus, the question becomes, excluding these two groups of patients who can safely undergo wide flap undermining, is the wider undermining required for a transabdominal breast augmentation procedure safe (without liposuction, the authors have demonstrated that it is equal to either procedure independently) if the undermined flap is also contoured with liposuction? If it is, then conceptually the idea of inverted-V flap undermining that we perform with concurrent flap liposuction would have to be revisited. The authors have again rekindled our interest in an uncommonly used and previously described technique10 and supported it with excellent results and a safety profile comparable to that of either procedure alone. Despite the fact that over 40 percent of breast augmentation patients in the lifetime arc of their augmentation will require another operation, or may require a breast procedure soon after surgery (e.g., for hematoma, malposition, size adjustment), thus necessitating a breast incision, the majority will not. Therefore, eliminating the small and albeit well-tolerated separate augmentation incision in patients who are also undergoing an abdominoplasty can be desirable, particularly if it is safe and comes without additional risks and ostensibly has few disadvantages.
Plastic and Aesthetic Research
Plastic & Reconstructive Surgery, 1997
Despite the existence of basic clinical standards in plastic surgery, specific guidelines for bod... more Despite the existence of basic clinical standards in plastic surgery, specific guidelines for body contour photography have not been detailed previously. In this report we propose standard and supplemental views for positioning of the subject for suction-assisted lipectomy and body contour surgery. Also demonstrated are specialty views for the face, where liposuction has become an integral component of the procedures. Finally, recommendations for photographic documentation of skin "textural" changes and "cellulite" improvement with liposuction, as well as regions requiring lipectomy, are discussed. A professional photographic studio and a model were utilized. Proper lighting, equipment, and backgrounds are described to achieve such standards. General principles for clinical photography are reviewed. We present standard and supplemental views for suction-assisted lipectomy and body contour surgery, with an emphasis on methods to address advanced liposuction techniques (i.e., superficial suction lipectomy) that may affect texture and contour of the skin. These techniques provide consistency for all practitioners, allowing comparison of results and techniques.
Level of Evidence V This journal requires that authors assign a level of evidence to each submiss... more Level of Evidence V 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
Plastic and Reconstructive Surgery, 2016
The use of tobacco-based products, most notably cigarettes, is related directly to wound healing ... more The use of tobacco-based products, most notably cigarettes, is related directly to wound healing problems and poorer outcomes in plastic surgery. Current abstracts have highlighted the potential complications from nicotine, specifically following plastic surgery in patients who choose to smoke. Recently, products that use electricity to vaporize liquid nitrogen have been gaining popularity. New rules were recently proposed that would give the federal government authority over electronic cigarettes. However, the health-related issues surrounding e-cigarettes are still largely unknown or misunderstood. These issues also extend to their impact on surgical procedures, notably their effect on plastic surgical procedures that rely heavily on the vascularity of either the host wound bed or the replacement tissue.
Techniques in Aesthetic Plastic Surgery Series: Minimally-Invasive Facial Rejuvenation, 2009
Clinics in Plastic Surgery
Plastic and Reconstructive Surgery
Aesthetic Surgery Journal
Aesthetic Surgery Journal
Plastic and Reconstructive Surgery
Plastic and Reconstructive Surgery
Plastic and reconstructive surgery, Jul 1, 2017
Operative Techniques in Plastic and Reconstructive Surgery
Plastic and reconstructive surgery, Mar 28, 2017
Plastic and reconstructive surgery, Feb 6, 2016
Plastic and Reconstructive Surgery, 2001
The purpose of this survey was to assess trends in brow lifting philosophy, techniques, and compl... more The purpose of this survey was to assess trends in brow lifting philosophy, techniques, and complications. This is the second of a three-part survey; the first part reported on complications with face lift techniques, and the final report will address practice management issues, including facility and ancillary procedures. Surveys were sent to 3800 members of the American Society of Plastic Surgeons; the response rate was 15 percent. This survey represents data on 6951 brow lifts, of which approximately 50 percent were performed endoscopically and 50 percent with a coronal incision. Several conclusions about the practice of the respondents were reached: (1) Both brow lift techniques were considered to be effective. (2) Surgeons considered coronal brow lifting to be more effective for the three basic goals of brow lifting: brow elevation, reduction of transverse lines, and reduction of glabellar lines. (3) Reported complication rates for both techniques were low, and the most frequent complication was alopecia (varying from 2.9 percent to 4 percent). (4) Patient satisfaction varied from 98.2 percent to 99.2 percent. (5) Major complications were rarely reported.
Plast Reconstr Surg, 1996
Plastic Amp Reconstructive Surgery, May 1, 1993
A graphic and written anatomic data sheet (ADS) for facial aesthetic surgery and body contour sur... more A graphic and written anatomic data sheet (ADS) for facial aesthetic surgery and body contour surgery is presented as a tool for: (1) analyzing surgical maneuvers and their effect on final outcome; (2) recording individual anatomic variations; (3) communicating data between office personnel and colleagues; (4) aiding in the treatment of the postsurgical patient; (5) use as a worksheet for the surgeon; and (6) standardizing, evaluating, and comparing surgical techniques. The ADS takes account of the common aesthetic facial and body contour procedures performed in plastic surgery. A supplemental rubber stamp for use on the office chart, with graphics identical to those of the ADS, identifies areas of treatment concern before and after surgery.
Plastic and Reconstructive Surgery, 2016
Thigh contour deformities-in particular, those of the medial thighs-are a common concern for many... more Thigh contour deformities-in particular, those of the medial thighs-are a common concern for many individuals seeking body contouring. Despite the frequency of this concern, some plastic surgeons have often been reluctant to embrace the medial thigh-lift procedure because of the risk for significant complications and relatively poor results. The authors' approach to medial thigh contouring is to address the variables outside of the medial thighs affecting the medial thighs before considering a medial thigh-lift procedure with a vertical component. In this article, the authors review the senior author's (J.F.C.) experience of 350 vertical medial thigh lifts in the weight-loss patient. The charts of 350 consecutive individuals who had undergone vertical medial thigh lifts were reviewed for complications and other variables. The procedures were all performed by the senior author between February of 2000 and February of 2014. The preoperative markings, current surgical technique, and postoperative care are described. There were 326 women and 24 men in the study, with an average age of 43 years. The overall complication rate was 45.14 percent. Skin dehiscence and seroma formation were the most frequent complications, at 31.14 percent and 18.18 percent, respectively. The vast majority of patients were pleased with the aesthetic and functional results of their surgery. The medial thigh deformities of the weight-loss patient are effectively addressed by a vertical medial thigh lift when the variables adjacent to the medial thighs are first treated by a body lift. Therapeutic, IV.
Plastic and reconstructive surgery, Sep 1, 2017
www.PRSJournal.com 488 B and colleagues have demonstrated the safety and efficacy of inserting br... more www.PRSJournal.com 488 B and colleagues have demonstrated the safety and efficacy of inserting breast implants through a traditional abdominoplasty incision with the aid of a balloon dissector.1 The authors begin by acknowledging that a common concern and therefore frequent accompanying procedure in abdominoplasty patients is the appearance and enhancement of their breasts.2 They verify the complication rate from transabdominal breast augmentation is essentially the same as would be expected from either operation alone. So why then has this technique not gained more widespread use? When I reported my experience with Planas’ concept of inserting implants through an abdominoplasty incision,3 I had a similarly favorable experience as the authors. Interestingly, although I adopted Planas’ concept of preexcising the undermined abdominal pannus (which also makes implant insertion easier, and I always remove the old umbilical site), I no longer routinely insert implants through the abdominoplasty incision. Despite my initial enthusiasm, I suspect my reluctance stems from the transition in surgical thinking that occurred around that time from wide abdominal flap undermining in an abdominoplasty to a more inverted-V flap type undermining. This method of dissection preserves the Huger zone III blood supply and now has been demonstrated by Smith4 and Roostaeian et al.5 to possibly also preserve the Huger zone I blood supply. The change in the pattern of undermining was deemed necessary because surgeons were becoming interested in liposuction of the undermined abdominal flap6,7 and altering dissection techniques were felt to minimize the potential for flap ischemia. Consequently, I began to insert implants less frequently through the open wound, which theoretically requires wider undermining (although I did not use the balloon dissector) and potentially increases the risk of flap ischemia. In this article and in the examples shown, patients appear not to require liposuction, and no mention is made of flap liposuction. So, presumably they could safely undergo wider flap undermining to insert the implants, with less concern about preserving additional blood supply. With regard to who can safely undergo wide abdominoplasty flap undermining, I believe massive weight loss patients can tolerate it in addition to patients who have had prior liposuction followed by an abdominoplasty,8,9 because these are essentially delayed flaps. Thus, the question becomes, excluding these two groups of patients who can safely undergo wide flap undermining, is the wider undermining required for a transabdominal breast augmentation procedure safe (without liposuction, the authors have demonstrated that it is equal to either procedure independently) if the undermined flap is also contoured with liposuction? If it is, then conceptually the idea of inverted-V flap undermining that we perform with concurrent flap liposuction would have to be revisited. The authors have again rekindled our interest in an uncommonly used and previously described technique10 and supported it with excellent results and a safety profile comparable to that of either procedure alone. Despite the fact that over 40 percent of breast augmentation patients in the lifetime arc of their augmentation will require another operation, or may require a breast procedure soon after surgery (e.g., for hematoma, malposition, size adjustment), thus necessitating a breast incision, the majority will not. Therefore, eliminating the small and albeit well-tolerated separate augmentation incision in patients who are also undergoing an abdominoplasty can be desirable, particularly if it is safe and comes without additional risks and ostensibly has few disadvantages.
Plastic and Aesthetic Research
Plastic & Reconstructive Surgery, 1997
Despite the existence of basic clinical standards in plastic surgery, specific guidelines for bod... more Despite the existence of basic clinical standards in plastic surgery, specific guidelines for body contour photography have not been detailed previously. In this report we propose standard and supplemental views for positioning of the subject for suction-assisted lipectomy and body contour surgery. Also demonstrated are specialty views for the face, where liposuction has become an integral component of the procedures. Finally, recommendations for photographic documentation of skin "textural" changes and "cellulite" improvement with liposuction, as well as regions requiring lipectomy, are discussed. A professional photographic studio and a model were utilized. Proper lighting, equipment, and backgrounds are described to achieve such standards. General principles for clinical photography are reviewed. We present standard and supplemental views for suction-assisted lipectomy and body contour surgery, with an emphasis on methods to address advanced liposuction techniques (i.e., superficial suction lipectomy) that may affect texture and contour of the skin. These techniques provide consistency for all practitioners, allowing comparison of results and techniques.
Level of Evidence V This journal requires that authors assign a level of evidence to each submiss... more Level of Evidence V 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
Plastic and Reconstructive Surgery, 2016
The use of tobacco-based products, most notably cigarettes, is related directly to wound healing ... more The use of tobacco-based products, most notably cigarettes, is related directly to wound healing problems and poorer outcomes in plastic surgery. Current abstracts have highlighted the potential complications from nicotine, specifically following plastic surgery in patients who choose to smoke. Recently, products that use electricity to vaporize liquid nitrogen have been gaining popularity. New rules were recently proposed that would give the federal government authority over electronic cigarettes. However, the health-related issues surrounding e-cigarettes are still largely unknown or misunderstood. These issues also extend to their impact on surgical procedures, notably their effect on plastic surgical procedures that rely heavily on the vascularity of either the host wound bed or the replacement tissue.
Techniques in Aesthetic Plastic Surgery Series: Minimally-Invasive Facial Rejuvenation, 2009
Clinics in Plastic Surgery
Plastic and Reconstructive Surgery
Aesthetic Surgery Journal
Aesthetic Surgery Journal
Plastic and Reconstructive Surgery
Plastic and Reconstructive Surgery
Plastic and reconstructive surgery, Jul 1, 2017
Operative Techniques in Plastic and Reconstructive Surgery
Plastic and reconstructive surgery, Mar 28, 2017
Plastic and reconstructive surgery, Feb 6, 2016
Plastic and Reconstructive Surgery, 2001
The purpose of this survey was to assess trends in brow lifting philosophy, techniques, and compl... more The purpose of this survey was to assess trends in brow lifting philosophy, techniques, and complications. This is the second of a three-part survey; the first part reported on complications with face lift techniques, and the final report will address practice management issues, including facility and ancillary procedures. Surveys were sent to 3800 members of the American Society of Plastic Surgeons; the response rate was 15 percent. This survey represents data on 6951 brow lifts, of which approximately 50 percent were performed endoscopically and 50 percent with a coronal incision. Several conclusions about the practice of the respondents were reached: (1) Both brow lift techniques were considered to be effective. (2) Surgeons considered coronal brow lifting to be more effective for the three basic goals of brow lifting: brow elevation, reduction of transverse lines, and reduction of glabellar lines. (3) Reported complication rates for both techniques were low, and the most frequent complication was alopecia (varying from 2.9 percent to 4 percent). (4) Patient satisfaction varied from 98.2 percent to 99.2 percent. (5) Major complications were rarely reported.
Plast Reconstr Surg, 1996
Plastic Amp Reconstructive Surgery, May 1, 1993
A graphic and written anatomic data sheet (ADS) for facial aesthetic surgery and body contour sur... more A graphic and written anatomic data sheet (ADS) for facial aesthetic surgery and body contour surgery is presented as a tool for: (1) analyzing surgical maneuvers and their effect on final outcome; (2) recording individual anatomic variations; (3) communicating data between office personnel and colleagues; (4) aiding in the treatment of the postsurgical patient; (5) use as a worksheet for the surgeon; and (6) standardizing, evaluating, and comparing surgical techniques. The ADS takes account of the common aesthetic facial and body contour procedures performed in plastic surgery. A supplemental rubber stamp for use on the office chart, with graphics identical to those of the ADS, identifies areas of treatment concern before and after surgery.
Plastic and Reconstructive Surgery, 2016
Thigh contour deformities-in particular, those of the medial thighs-are a common concern for many... more Thigh contour deformities-in particular, those of the medial thighs-are a common concern for many individuals seeking body contouring. Despite the frequency of this concern, some plastic surgeons have often been reluctant to embrace the medial thigh-lift procedure because of the risk for significant complications and relatively poor results. The authors' approach to medial thigh contouring is to address the variables outside of the medial thighs affecting the medial thighs before considering a medial thigh-lift procedure with a vertical component. In this article, the authors review the senior author's (J.F.C.) experience of 350 vertical medial thigh lifts in the weight-loss patient. The charts of 350 consecutive individuals who had undergone vertical medial thigh lifts were reviewed for complications and other variables. The procedures were all performed by the senior author between February of 2000 and February of 2014. The preoperative markings, current surgical technique, and postoperative care are described. There were 326 women and 24 men in the study, with an average age of 43 years. The overall complication rate was 45.14 percent. Skin dehiscence and seroma formation were the most frequent complications, at 31.14 percent and 18.18 percent, respectively. The vast majority of patients were pleased with the aesthetic and functional results of their surgery. The medial thigh deformities of the weight-loss patient are effectively addressed by a vertical medial thigh lift when the variables adjacent to the medial thighs are first treated by a body lift. Therapeutic, IV.