Erez Dayan

• M.D.
• Harvard Medical School

Background An increasing number of aesthetic surgery procedures are being performed in the office-based setting in an ambulatory fashion. Postoperative monitoring for these patients has historically been comprised of paid private-duty nurses measuring vital signs, encouraging ambulation, and monitoring overall comfort level. Recently, advancements...

Radiofrequency is an effective and safe method for both pelvic floor restoration and nonsurgical labiaplasty. Bipolar radiofrequency with temperature control is more effective than monopolar radiofrequency for volumetric heating of vulvovaginal tissue. Combination of electrical muscle stimulation and radiofrequency can provide combined nonsurgical...

Introduction: Patients desiring noninvasive body contouring increasing require a more comprehensive approach to soft tissue laxity, muscle, and adipose hypertrophy. Previous devices have typically focused on only adipose reduction, without impact on muscle or skin laxity. This study descripes the first use of noninvasive bipolar radiofrequency in...

Background:. The use of radiofrequency in aesthetic surgery has evolved significantly since it was first introduced in the early 2000s. Nonexcisional correction of the lower one-third of the face and neck has long been a challenging problem. The purpose of this prospective study was to assess the safety and efficacy of the first handsfree thermoreg...

Background: The use of radiofrequency in aesthetics has increased in popularity since the early 2000s. To date, there have been limited studies investigating the effect of thermal energy secondary to radiofrequency treatment. The purpose of this study was to evaluate perfusion and lymphatic assessment tools pre and post bipolar and fractional radi...

Introduction The COVID‐19 pandemic requires us all to re‐evaluate aesthetic practices to ensure optimal patient safety during elective procedures. Specifically, energy‐based devices and lasers require special consideration, as they may emit plume which has been shown to contain tissue debris and aerosolized biological materials. Prior studies have...

Volume restoration with autologous fat augmentation has become a key technique in facial rejuvenation. It is highly versatile and useful as an independent operation or as an adjunct to rhytidectomy and blepharoplasty. The goal of this article and the accompanying videos is to provide a detailed step-by-step guide to achieving predictable and optimi...

Background: One-stage augmentation mastopexy is a challenging procedure, with the highest cited revision rates in plastic surgery. This is because when mastopexy and augmentation are performed together, they lead to opposing forces, which must be balanced carefully to avoid complications. The goal of this study was to revisit a previously describe...

Nonexcisional facial skin tightening has long been an elusive goal in aesthetic surgery. The "treatment gap" includes cases who are not "severe" enough for excisions surgery but not "mild" enough for most traditional noninvasive aesthetic modalities. In this retrospective review, we present the largest evaluation to date of radiofrequency (RF) skin...

The use of radiofrequency for soft tissue tightening has increased over the past 10 years. Both minimally invasive and noninvasive devices are frequently in use. This article describes the different types of radiofrequency technology and the current evidence behind their safety and efficacy.

When septal cartilage is lacking, commercially available costal cartilage allograft can be used. Such allografts have "off-the-shelf" accessibility, are available in multiple sizes, are aseptically processed to meet sterility, and are screened to minimize infectious risks. The purpose of this study was to evaluate the effect of donor age, storage t...

Effective control of nasal tip projection and rotation is a key component in modern rhinoplasty. Tip projection is a product of several anatomical factors: length and strength of lower lateral cartilages, the suspensory ligament, fibrous connections to the upper lateral cartilages, and the anterior septal angle. Several cartilage grafts have been d...

This invited Special Topic article outlines the authors' evolution and technique to optimize consistent results in rhinoplasty.

Labiaplasty has rapidly increased in popularity over the past 5 years.Traditional labiaplasty is associated with potential complications, such as dehiscence, hematoma, flap necrosis, narrowed introitus, pain, and asymmetry. Minimally invasive techniques such as radiofrequency (RF) have emerged as viable alternatives to traditional labiaplasty throu...

Dietary supplements are frequently used in surgical patients. Surgeons should be uptodate with regards to the efficacies and potential complications related to these supplements. This manuscript provides the most updated practices and evidence of commonly used supplements.

Background: Fat accumulation is frequently observed in patients with lymphedema but is not accounted for in existing staging systems. In addition, the specific regional patterns of fat and fluid accumulation remain unknown and might affect outcomes following medical or surgical intervention. The purpose of this study was to evaluate fluid and fat...

The facial fat compartments were described over a decade ago, but their clinical relevance to both deflation and techniques in facial rejuvenation is underappreciated. Although much of the literature following their description has focused on further anatomical elucidation of compartment anatomy, clinical relevance has focused on volumetric compart...

Learning objectives: After studying this article, the participant should be able to: 1. Classify the commonly performed types of face-lift procedures based on the extent of skin incision and face and neck dissection, and superficial musculoaponeurotic system treatment and perform the appropriate amount of skin undermining in variations of superfic...

Soft-tissue filler use has grown considerably related to the increasing popularity of minimally invasive cosmetic procedures. Hyaluronic acid products are currently the most utilized soft-tissue fillers. Proper working knowledge of individual products, limitations to use, and anatomic principles can improve outcomes. Prevention is key to minimize c...

Background: Recent anatomical studies have demonstrated that fat placed subjacent to the fascia of the gluteus maximus muscle can migrate deep through the muscle into the submuscular space, possibly causing tears in the gluteal veins, leading to fat embolisms. The purpose of this study was to define and to study subcutaneous migration and to deter...

Trichloroacetic acid (TCA) is a versatile agent, efficacious in treating a spectrum of facial rhytids and dyschrommias at varying concentrations. TCA is commonly used in a 30%–35% concentration to achieve a medium-depth peel into the upper reticular dermis. The addition of Jessner’s solution before the TCA peel application leads to partial removal...

Increasingly, patients are seeking minimally invasive methods to tighten skin and remodel adipose tissue. A large treatment gap exists among 3 types of patients: (1) the younger demographic, who increasingly desire soft tissue tightening without traditional operations, scars, and downtime; (2) patients with soft tissue laxity who are not “severe en...

Background:. Postpartum pelvic floor disorders are estimated to impact 24% of women in the United States. This study describes the use of a radiofrequency device (Votiva, InMode) for postpartum pelvic floor restoration using an electrostimulator to objectively measure treatment effect. Methods:. A retrospective evaluation was conducted between Apri...

The purpose of this Special Topic article is to present the current state of scientific evidence related to the safety of silicone breast implants. There is presently overwhelming evidence to support the safety of silicone breast implants. Ultimately, the decision to obtain, keep, or remove breast implants is the choice of the patient. If a patient...

Background: The gluteal lift ("Brazilian butt lift") has improved significantly in technique and in outcomes. Some postulate that fat embolism occurs because of damage to veins superficial to the gluteus muscles and that fat must be injected intramuscularly to achieve satisfactory aesthetic results. The purpose of this article is to present data w...

Hallmark deformities of systemic scleroderma are early onset and progressively disabling flexion contractures of the proximal interphalangeal (PIP) joints often in conjunction with extension or, less frequently, flexion contractures of the metacarpophalangeal (MCP) joints. Although surgical correction is generally recommended, a prevailing reluctan...

Background Free flaps have a well-established role in breast reconstruction after mastectomy; however, their role in partial breast reconstruction remains poorly defined. We reviewed our experience with partial breast reconstruction to better understand indications for free tissue transfer. Methods A retrospective review was performed of all patien...

Lipedema

Background: The use of heterotopic vascularized lymph node transfer (HVLNT) for the treatment of lower extremity lymphedema is still evolving. Current techniques, either place the lymph nodes in the thigh without a skin paddle or at the ankle requiring an unsightly and often bulky skin paddle for closure. We explored the feasibility of doing a bel...

Background The medial sural vessels have been used extensively as donor vessels in free tissue transfer; however, there is sparse literature detailing their use as recipient vessels. The few existing reports involve small numbers of patients and describe operative approaches that are unnecessarily cumbersome. We explored our experience in free tiss...

Reconstruction of bony craniofacial defects requires precise understanding of the anatomic relationships. The ideal reconstructive technique should be fast as well as economical, with minimal donor-site morbidity, and provide a lasting and aesthetically pleasing result. There are some circumstances in which a patient's own tissue is not sufficient...

Advances in microsurgical techniques have improved autologous reconstructions by providing new donor site options while decreasing donor site morbidity. Various preoperative imaging modalities have been studied to assess the relevant vascular anatomic structures, with magnetic resonance (MR) angiography traditionally lagging behind computed tomogra...

On January 1, 2011, New York State amended the Public Health Law to ensure that patients receive "information and access to breast reconstruction surgery." The purposes of this study were to investigate the early impact of this legislation on reconstruction rates and to evaluate the influence of patient variables versus physician variables on the i...

Background: The authors introduce the technique of reverse lymphatic mapping for vascularized lymph node transfer. This physiologic technique allows one to identify which lymph nodes drain the trunk as opposed to the extremity, to minimize the risk of iatrogenic lymphedema. Methods: A prospective study of patients undergoing vascularized lymph n...

Achieving an aesthetic appearance of the scrotum after extensive Fournier's gangrene is a reconstructive challenge. Testicular coverage is often prioritized over scrotal cosmesis due to the comorbidities typically seen in this patient population. We describe our treatment of a young, healthy male with extensive Fournier's gangrene, with loss of the...

Journal: Revista Colombiana de Cirugia Plastica y Reconstructiva

Background: Proximal facial nerve sacrifice during tumor extirpation results in complete ipsilateral facial paralysis. Primary nerve grafting requires a long time to reinnervation with variable outcomes and may not be an option if a proximal facial nerve stump is absent. In these cases, patients are often limited to a static sling following complet...

Background: Vascularized groin lymph node transfer has been described as a successful treatment for lymphedema.1,2 However, patients with bilateral lower extremity lymphedema may not be candidates, and the short pedicle may not be ideal if the recipient site requires greater pedicle length. Transfer of axillary lymph nodes draining the chest wall h...

Introduction: While vascularized groin lymph node transfer has been successfully used to treat lymphedema,1,2 lack of familiarity with the anatomy and concern regarding donor site lymphedema have limited its widespread use. The purpose of this study was to integrate the use of four separate modalities to localize the lymph nodes draining the abdome...

Introduction: The transverse upper gracilis (TUG ) flap has been successfully used in breast reconstruction.1 However concerns regarding wound healing, potential for lymphedema, and cosmesis at the donor site have limited its widespread use.2 We describe a new oblique skin paddle design along Langer's lines that allows for abundant soft tissue harv...

Vascularized groin lymph node transfer (VGLNT) has been successfully used to treat lymphedema. However, lack of familiarity with the inguinal node anatomy and concerns regarding donor site morbidity have limited its widespread use. The purpose of this study was to use magnetic resonance angiography (MRA) to clarify the inguinal anatomy and provide...

Patients with node positive or locally advanced breast cancer desiring deep inferior epigastric perforator (DIEP) flap reconstruction frequently require postmastectomy radiation therapy (PMRT). To avoid the deleterious effects of PMRT, surgeons will often delay reconstruction until after PMRT is complete. Drawbacks to this approach include addition...

Performing bilateral autologous breast reconstruction using the abdominal donor site usually entails harvesting one flap from each hemiabdomen. However, the overlapping vascular territories of the superior epigastric, deep inferior epigastric, superficial inferior epigastric, and superficial circumflex iliac vessels make it theoretically possible t...

Background: Historically, the incidence of C. difficile-associated colitis has increased significantly over the last decade. Of these patients, approximately 10% -20% will ultimately require colectomy due to fulmi-nant disease and progression to toxic colitis. Despite operative intervention, the mortality for this popula-tion remains high (35% -80%...

PURPOSE/AIM Educate the reader regarding various autologous-based tissue flap reconstructions, an increasingly common surgical technique, particularly in head & neck and breast surgeries. Discuss the general MRI protocol for imaging donor flaps and to highlight the differences related to each specific flap. Review the associated imaging findings, r...