Vahe Fahradyan

Contrast-enhanced ultrasound (CEUS) offers vascular-based real-time visualization of anatomy and pathology while maintaining the advantages of ultrasound: no radiation exposure and cost-effectiveness. This review provides an overview of the past, the current technology, and the future prospects of using CEUS to evaluate the lymphatic system. It has...

Background Penile inversion vaginoplasty (PIV) entails considerable soft-tissue dissection to the perineal region and involves complex tissue rearrangement. This study examines the role of an enhanced recovery after surgery (ERAS) pathway after PIV in reducing opioid use and controlling postoperative pain. Methods A retrospective study of 50 trans...

Penile inversion vaginoplasty (PIV) is the most common surgical technique used in “gender-affirming bottom surgery.” During this process, penile tissue is used to create a functional neo-vagina, allowing the individual to experience a more aligned physical manifestation of their “gender” identity. In this technical note, we describe the steps and n...

Summary: Prior studies on contrast-enhanced ultrasound (CEUS) lymphography for preoperative mapping before lymphaticovenous anastomosis surgery in patients with extremity lymphedema have been limited to using only Lumason and Sonazoid as microbubble contrast agents. The purpose of this study was to determine the feasibility of using two other Food...

Lymphedema following oncologic intervention can cause significant lifelong morbidity for patients in whom conservative management fails. The associated swelling, discomfort, pain, and recurrent cellulitis greatly diminish quality of life. Surgical procedures, including suction-assisted lipectomy, lymphovenous anastomosis (LVA), and vascularized lym...

Background Implant-based breast augmentation is a gold standard procedure for transfeminine patients to create a more feminine-appearing chest. In many cases, ancillary procedures are performed simultaneously to achieve an optimal aesthetic result. Objectives To determine the clinical outcomes of patients undergoing feminizing gender-affirming bre...

Context Transgender and gender diverse (TGD) individuals have greater access to genital surgery (GS) with improved insurance coverage and access to trained surgeons and interdisciplinary gender-affirming providers. Objective To determine perioperative medical and behavioral health outcomes in transfeminine (TF) individuals undergoing GS, with use...

Lymphaticovenous anastomosis (LVA) surgery is an effective surgery for the treatment of lymphedema in the extremities. Indocyanine green lymphography is the reference standard for visualizing lymphatics for LVA surgery, but it has several limitations; most notably, superficial dermal congestion can mask deeper lymphatic vessels. To overcome the lim...

Masculinizing chest wall gender-affirming surgery is an important element in the treatment of gender dysphoria. In this study, we report an institutional series of subcutaneous mastectomies and aim to identify the risk factors for major complications and revision surgery. A retrospective review of consecutive patients who underwent primary masculin...

Purpose The use of acellular dermal matrix changed the breast reconstruction algorithm facilitating implant coverage and direct to implant technique. This study aims to evaluate the effect of the ADM surgical complications, breast aesthetics, and patient satisfaction. Methods In a tertiary hospital, patients that underwent implant-based breast rec...

Background: Ischemia-reperfusion injury remains a primary concern in upper extremity transplantation. Ex vivo normothermic perfusion (EVNP) enables near-physiological organ preservation, avoiding the deleterious effects of hypoxia and cooling. We investigated the effectiveness of human limb EVNP compared with static cold storage (SCS). Methods:...

Background Histomorphometry quantitatively evaluates nerve regeneration. Total myelinated fiber count (TMFC) is most accurately obtained manually across full nerve cross-sections, but most researchers opt for automated, sampled analysis. Few of the numerous techniques available have been validated. The goal of this study was to compare common histo...

The branches of the axillary artery offer a great resource for use as recipient in microsurgical flap reconstruction. The current chapter describes the applied anatomy of the subscapular, circumflex scapular, thoracodorsal, and lateral thoracic vessels as well as surgical technique for their exposure.

Early surgical intervention for lymphedema can delay, prevent, and even reverse lymphatic degeneration. Vascularized lymph vessel transplant (VLVT) has emerged as an alternative to vascularized lymph node transplant (VLNT) for the treatment of advanced, fluid-predominant lymphedema, providing highly favorable outcomes with reduced donor-site compli...

Introduction Rat sciatic nerve injury (PNR) is the most utilized model in studies on peripheral nerve regeneration. However, large animal models are increasingly favored based on the assumption that nerve regeneration in rodents achieves more favorable outcomes than in humans. The purpose of this meta‐analysis was to investigate which rat PNR model...

Introduction Ex vivo normothermic limb perfusion (EVNLP) provides several advantages for the preservation of limbs following amputation: the ability to maintain oxygenation and temperature of the limb close to physiological values, a perfusion solution providing all necessary nutrients at optimal concentrations, and the ability to maintain physiolo...

Background Leukodepletion of whole blood-based perfusates remains a challenge in experimental models of ex vivo perfusion. This study investigated the leukoreduction efficacy of the commonly used LeukoGuard LG Arterial and BC2 Cardioplegia filters. Methods Eleven liters of washed porcine blood was used to evaluate the filtration efficiency of LG (...

Background: Dynamic and functional abdominal wall reconstruction (FAWR) remains a complex challenge. The ideal flap should have a minimal donor-site morbidity and cover a large surface area with motor and sensory capabilities. The goal was to investigate the feasibility of using a free chimeric flap with anterolateral thigh (ALT) and rectus femori...

Background: Facial allotransplantation including the temporo-mandibular joints (TMJ) may improve the functional outcomes in face transplant candidates who have lost or damaged this joint. Methods: Linear and angular measurements were taken in hundred dry skulls and mandibles, and in hundred 3D-reconstructed facial CT-scans, to determine the vari...

Pedicled and free flaps have become major instruments in the reconstruction of complex body defects. Traditionally used clinical signs such as flap color, capillary refill time, temperature, and Doppler ultrasound assessment of the vascular pedicle remain the gold standard for flap evaluation. Indocyanine green angiography is a safe, quick, and rep...

Ischemia and reperfusion injury remains a significant limiting factor for the successful revascularization of amputated extremities. Ex vivo normothermic perfusion is a novel approach to prolong the viability of the amputated limbs by maintaining physiologic cellular metabolism. This study aimed to evaluate the outcomes of extended ex vivo normothe...

Background: Concerns of nonlasting results and potential nasal growth damage precluded cleft nasal correction at the time of initial cleft lip repair. Our goal was to evaluate the outcome of primary cleft nasal correction in our patients with unilateral cleft lip. Methods: A retrospective review of patients with complete and incomplete unilatera...

Change in mitochondrial ultrastructure in response to normothermic ex-vivo perfusion.

Describing our experiment of using an acellular oxygen carrier in normothermic ex-situ perfusion of a vascularized composite allograft.