William P Adams's research while affiliated with American Society for Aesthetic Plastic Surgery and other places

Publications (131)

Article
The US FDA in response to concerns that patients undergoing breast implant surgery were not adequately informed about the risks of receiving an implanted medical device mandated a patient decision checklist (PDC) in October 2021. Breast implant manufactures communicated with plastic surgeons in 2022 regarding the use of the PDC as a condition for t...
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Background Capsular contracture (CC) remains the most common complication of implant based aesthetic and reconstructive breast surgery. With subclinical infection being proven to be the primary etiology, antimicrobial breast pocket irrigation has been recommended as the key step to reduce this complication. Despite the data of well proven of anti-m...
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Capsular contracture is the most common complication in aesthetic and reconstructive breast surgery resulting in a significant economic burden. While historically rates were as high as 50%, understanding the etiology for capsular contracture has contributed significantly to its significant reduction. With the development of antimicrobial breast poc...
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Numerous studies have explored the possibility of an association between breast implants and systemic symptoms potentially linked to exposure to silicone. Some studies show no direct association whereas others provide insufficient scientific evidence to prove or disprove an association. Nonetheless, some patients with breast implants remain concern...
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Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a distinct malignancy associated with textured breast implants. We investigated whether bacteria could trigger the activation and multiplication of BIA-ALCL cells in vitro. BIA-ALCL patient-derived BIA-ALCL tumor cells, BIA-ALCL cell lines, cutaneous ALCL cell lines, an immortal...
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Background: Breast Implant Illness (BII) is a term used to describe physical and psychological symptoms experienced by some women following breast implant surgery. Few studies have examined the experiences of women with BII - a poorly understood condition with no clear cause or treatment. Objectives: To explore women's experiences of BII, includ...
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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a complex topic with evolving classification and etiology. Commonalities between BIA-ALCL and lymphoproliferative disorders exist, suggesting that BIA-ALCL may be better represented on a spectrum of disease from benign effusion to malignant metastatic lymphoma. Meticulous steril...
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Breast implant‒associated anaplastic large cell lymphoma (BIA-ALCL) is a CD30-positive, anaplastic lymphoma kinase‒negative T-cell lymphoma. Where implant history is known, all confirmed cases to date have occurred in patients with exposure to textured implants. There is a spectrum of disease presentation, with the most common occurring as a seroma...
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Introduction Breast implant surgery is the most common plastic surgery procedure performed globally. A subset of women with breast implants report experiencing a myriad of disabling and distressing physical and psychological symptoms attributed to their implants. Social media groups have coined the condition ‘Breast Implant Illness’ (BII). Little t...
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Background Granzyme B (GrB) is a serine protease secreted by cytotoxic lymphocytes along with pore forming perforin to mediate apoptosis in target cells. GrB has been detected in tumor cells associated with systemic and breast implant associated anaplastic large cell lymphoma (BIA-ALCL) but its potential use for detection of early BIA-ALCL has not...
Chapter
Augmentation mastopexy remains a popular procedure for patients and surgeons. Over the past several decades, the techniques for single stage augmentation mastopexy have greatly evolved; however, even though new knowledge has improved the process, it still has a high revision rate and decreased patient satisfaction scores. The real time tissue dilem...
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Background Despite the rapid rise of publications pertaining to COVID-19, there is a lack of data examining patient outcomes following elective procedures performed during this pandemic. Objectives The purpose of this investigation is to: 1) examine the postoperative outcomes of patients that underwent elective procedures in an ambulatory surgery...
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The choice between anatomical and round implants is an important decision in breast augmentation surgery; however, both have their place and the decision between them that should be made on a patient-by-patient basis, taking into account the patient's desires, anatomy, and surgical history. In some individuals, there are clear indications for using...
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Background Specific antimicrobial breast pocket irrigations have been proven to reduce capsular contracture by 10x over the past 20 years, and with the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and its link to bacteria/technique there has been a renewed interest in different ant-microbial breast pocket prepara...
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Background More than 700 women have developed an anaplastic large T cell lymphoma (ALCL) surrounding textured surface breast implants, termed breast implant-associated ALCL (BIA-ALCL). Most patients with BIA-ALCL present with an accumulation of fluid (delayed seroma) around the implant. However, benign seromas without malignant cells complicating s...
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Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) has been included as a provisional entity in the revised version of the WHO Classification of Tumors of Haematopoietic and Lymphoid Tissue. To increase opportunities to intervene with early diagnosis, treatment and possible prevention, it is important to consider that BIA-ALCL may...
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With the recent voluntary recall by Allergan of their Biocell textured implants, many plastic surgeons are left with questions of how to best manage asymptomatic patients who have concerns about having these devices. We realized that there is no clear, published recommendations or scientific data to guide surgeons on how to discuss options with the...
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Breast augmentation with anatomical implants offers several potential advantages. Tissue-based planning is patient specific and essential in choosing the correct dimensions of an implant, thereby providing greater control in breast shape following augmentation. This video vignette demonstrates tissue-based planning in a patient with a constricted b...
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The link between breast implants and systemic disease has been reported since the 1960s. Although many studies have looked at either supporting or refuting its existence, the issue still persists and has now been labeled "breast implant illness." The rise of patient advocacy and communication through social media has led to an increasing number of...
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Background The number of patients seeking augmentation mastopexy has increased over the last several decades. The conflicting goals of augmentation (tissue expansion) and mastopexy (tissue reduction) have led to higher revision rates, decreased patient satisfaction and pending litigation. Some have even argued for staging of all augmentation mastop...
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Background: The introduction of texture to the outer shell of breast implants was aimed at increasing tissue incorporation and reducing capsular contracture. It has also been shown that textured surfaces promote a higher growth of bacteria and are linked to the development of breast implant-associated anaplastic large cell lymphoma. Methods: The...
Article
More than 500 women worldwide have developed a CD30+ T-cell lymphoma around breast implants, strongly suggesting a cause and effect relationship, and designated as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). The mechanism of lymphomagenesis is unknown. Recently, a bacterial biofilm containing gram negative bacilli was disco...
Article
In the fourth quarter of 2017, the US FDA reviewed and approved a request by one of the breast implant manufacturers for a change in the Directions for Use (DFU) that removed warnings regarding the use of Betadine (povidone-iodine [PI] 10% solution, 1% available iodine [Purdue Frederick Company, Stamford, CT], also available in generic formulations...
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Background Mastopexy and reduction mammoplasty are often limited by the patient’s poor native soft tissue quality, resulting in ptosis recurrence and loss of rejuvenated surgical results. Surgical scaffolds and acellular dermal matrices are used in these procedures to provide physical and mechanical stabilization of weakened or compromised tissue....
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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon neoplasia occurring in women with either cosmetic or reconstructive breast implants. The actual knowledge about BIA-ALCL deriving from the literature presents several limits, and it remains difficult to make inferences about BIA-ALCL epidemiology, cause, and pathogen...
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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) continues to be a rare and elusive malignancy. Because BIA-ALCL does not behave like traditional lymphomas, additional research needs to be conducted to further delineate the lymphoproliferative nature of BIA-ALCL. An estimated 35 million women worldwide have breast implants and th...
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Background: Clinical trials have demonstrated through core and independent studies that anatomical devices are safe and effective with low complication rates. The rotation rate of shaped breast implants in the literature is 0 to 8.2%. Currently there are no studies evaluating the efficacy of in office ultrasound or clinical rotation vs actual rota...
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Background: Bra sizing is a common method to preoperatively select implants for breast augmentation; however, no series has analyzed the accuracy of this modality postoperatively. Alternatively, previous investigations have validated the accuracy and utility of three-dimensional (3D) imaging for preoperative simulation in breast augmentation. Obj...
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Background: The ptotic breast is surgically rejuvenated through a mastopexy procedure. Recurrent ptosis or other negative changes to the breast shape are not uncommon following mastopexy, as the tissue laxity and skin quality that contributed to ptosis are not surgically corrected. The purpose of this study was to assess the postsurgical changes in...
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Background: For primary breast augmentation, several implant selection systems have been described to guide the surgeon with choosing from a variety of manufactured implant dimensions and properties. Controversy exists regarding the most efficacious method of selecting an appropriate implant size that best matches the patient's breast. Methods:...
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Resolution of ptosis is a key step to the success of many plastic surgery procedures. Ptosis is a manifestation of tissue stretch. Tissue stretch can occur as a result of the natural aging process or health of the patient, or tissue may stretch under added weight or volume, such as when implants are placed. Surgical rejuvenation of ptotic tissues i...
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In a recent letter to the Aesthetic Surgery Journal , “Can We Really Control the Inframammary Fold (IMF) in Breast Augmentation?” Dr Swanson made claims regarding the inability to control the IMF during primary breast augmentation.1 We were surprised by the comment and almost decided not to respond, however, we decided to offer the following. Cont...
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Almost 200 women worldwide have been diagnosed with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). The unique location and specific lymphoma type strongly suggest an etio-pathologic link between breast implants and BIA-ALCL. It is postulated that chronic inflammation via bacterial infection may be an etiological factor. BIA-AL...
Article
Breast augmentation remains one of the most commonly performed plastic surgical procedures worldwide; however, Food and Drug Administration clinical trials have suggested that this procedure has a reoperation rate of 14% to 24% after 3 years. Recent literature has proposed that breast augmentation should not only be a surgical procedure but ultimat...
Article
Previous reports have suggested that inferior implant malposition following primary breast augmentation is secondary to violation of the inframammary fold (IMF) and subsequent poor reconstitution of the scaffold during the initial surgical procedure.1 Additionally, inferior malposition may be related to occult weakness at the level of the IMF incis...
Article
Choosing between round and anatomical form-stable implants is a key decision in the process of breast augmentation. Anatomical devices have been subject to a number of misconceptions that have limited their use. However, in optimal clinical practice, the benefits and risks of both anatomical and round implants should be considered for any given pat...
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We were surprised to receive a Letter to the Editor on our manuscript even prior to the print publication of the study (based on OnlineFirst publication), another sign of the increasing reach and visibility of Aesthetic Surgery Journal . When we initially saw Dr Swanson's letter,1 we thought it was an editorial on 3D imaging rather than a Letter to...
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Background: Among the most exigent operations in plastic surgery is the combination of augmentation and mastopexy. The surgical challenge is related to oppositional forces that complicate the operative predictability. The purpose of this study was to investigate use of the tissue-based triad process approach in patients undergoing augmentation mast...
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Background: For patients considering breast augmentation, 3-dimensional (3D) imaging provides a preoperative simulation of the postoperative result. However, the clinical accuracy of these simulations has not been assessed. Objective: The authors compared preoperative simulations with postoperative results of breast augmentation to permit more i...
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It is my pleasure to discuss the article entitled “Clinical Trial Outcomes of High- and Extra High–Profile Implants.” To begin, I must disclose that I personally know several of the authors of the article, and my comments are directed at the scientific validity of this study; I hope my constructive criticism is taken at face value. I must also say...
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“Effect of Incision Choice on Outcomes in Breast Augmentation,” by Jacobson et al,1 is an interesting article providing us with additional insight into capsular contracture (CC). For the past 50 years, plastic surgeons have been plagued by CC and its effects on aesthetic and reconstructive breast implant patients. It is important for the reader to...
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Anecdotal reports and one case-control study suggested an association, without evidence of causation, between breast implants and anaplastic lymphoma kinase-negative anaplastic large T-cell lymphoma (ALCL), a rare non-Hodgkin's lymphoma. This review summarizes the published evidence, including case reports and epidemiologic studies. A PubMed search...
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Lengthening the short nose is a challenging area of rhinoplasty. The short nose can be a naturally occurring aesthetic disproportion, or the result of a congenital abnormality or traumatic deformity. The surgical approach depends mostly on the quality of the lining, skeleton, overlying skin, and the amount of correction desired.
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This report summarizes the opinions advanced by an international panel of acknowledged expert plastic surgeons convened to discuss women's attitudes about aesthetic breast surgery. To inform the discussions, a survey was undertaken to explore women's attitudes and opinions. The survey showed that significant numbers of women take the initial steps...
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For more than 40 years capsular contracture has plagued plastic surgery as the most common complication of aesthetic and reconstructive breast surgery. This article reviews the basis for capsular contracture and defines the methods to prevent it and treat it when it occurs. Capsular contracture is most commonly a result of a subclinical colonizatio...
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Breast augmentation has been an integral part of plastic surgeons' practices for over 40 years. Although devices have evolved, patient outcomes are still not ideal, as documented in multiple premarket approval clinical trials. Unlike many other areas of surgery, the practice of breast augmentation has suffered from the lack of a defined process for...
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Despite popularity, breast augmentation has not advanced significantly in 20 years. The re-operation data for breast augmentation has been excessive at 15% to 20% in every Federal Drug Administration pre-market approval study for the past 15 years. Recently, a more scientific approach to breast augmentation has described a true process approach to...
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Aesthetic surgery is an essential component of plastic surgery and has become increasingly popular in American society. In 2002, 1.8 million surgical cosmetic procedures were performed in the United States, representing a 294 percent increase from 1992. The 1992 U.S. Food and Drug Administration moratorium on silicone breast implants arose in respo...
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Capsular contracture remains one of the most commonly reported complications in aesthetic and reconstructive breast patients. Previous in vitro studies from the authors' laboratory have recommended a new triple antibiotic povidone-iodine irrigation (2000) and subsequently a triple antibiotic non-povidone-iodine-containing irrigant (2001) to optimiz...
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Surgeons' decisions impact patient outcomes and implant effects on tissues over time. Tissue assessment systems that provide quantitative, objective data enable objective rather than subjective decisions. First-generation dimensional systems for breast augmentation defined a desired result dimensionally and recommended an implant to force tissues t...
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During the "Hot Topics" seminar at The Aesthetic Meeting 2006, authors polled participants to gain insight into how plastic surgeons evaluate current hot topics. Here are the results as well as the authors' notes on additional presentations.
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Autogenous fat transfer with lipoinjection for soft-tissue augmentation is a commonly used technique without a universally accepted approach. The high percentage and variable amount of fat resorption reduce the clinical efficacy of this procedure and often result in the need for further grafting. The purposes of this study were to evaluate the effe...
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Capsular contracture remains one of the most common complications involving aesthetic and reconstructive breast surgery; however, its cause, prevention, and treatment remain to be fully elucidated. Presently, there is no accurate and reproducible pathologic in vitro or in vivo model examining capsular contracture. The purpose of this study was to e...
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The determination of human skin thickness has been achieved through various methods, both in vivo and in vitro. Ultrasound and histometric analyses have been the most commonly used. However, absolute values of epidermal and dermal thicknesses have demonstrated variability among the different modalities, leaving questions regarding the ability to st...
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An abstract is unavailable. This article is available as HTML full text and PDF.
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During the U.S. Food and Drug Administration's advisory panel hearings to evaluate the premarket approval for conventional silicone gel implants on October 14 and 15, 2003, panel members and patient advocate representatives focused on four specific areas of concern: reoperation rates in primary breast augmentation; levels, depth, and methods of pat...
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The latissimus dorsi flap is highly versatile and reliable, making it a commonly transferred muscle flap. This study evaluated the subjective donor site morbidity, with special attention to activities of daily living. A review of 85 consecutive female patients who underwent latissimus dorsi muscle transfer was performed. Patients were mailed detail...
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The latissimus dorsi muscle flap is a versatile flap used in a variety of reconstructive procedures. The major complication reported with its use is donor-site seroma, reported to occur in 20 to 79 percent of cases. A retrospective review of 47 patients undergoing latissimus dorsi muscle harvest from April of 1998 through May of 2002 was performed....
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A precise and reproducible lateral osteotomy is a requirement for successful rhinoplasty. Two basic techniques have evolved: the external perforated method and the internal continuous method. The literature supporting the external perforated technique maintains that it contributes to a controlled, stable fracture and produces less nasal airway narr...
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Learning objectives: After studying this article, the participant should be able to: 1. Describe the anatomic differences in the subciliary versus the subtarsal approach. 2. Discuss the difference between the "skin-only" and the "skin-muscle flap" variations of the subciliary approach. 3. Discuss the potential complications of both approaches. 4....
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Gynecomastia, or excessive male breast development, has an incidence of 32 to 65 percent in the male population. This condition has important physical and psychological impacts. Advances in elucidating the pathophysiology of gynecomastia have been made, though understanding remains limited. Recommendations for evaluation and workup have varied and...
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The deviated nose presents a particular challenge to the rhinoplasty surgeon because, frequently, both a functional problem (airway obstruction) and an aesthetic problem must be addressed. An approach to the deviated nose is presented that relies on accurate preoperative planning and precise intraoperative execution of corrective measures to return...
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Surgical treatment of pyogenic flexor tenosynovitis traditionally consists of open drainage (OD) and irrigation of the flexor tendon sheath. An alternative, less traumatic method of closed-catheter irrigation (CCI) has been advocated, but no comparative studies have been reported. The authors reviewed 47 cases of pyogenic flexor tenosynovitis to de...
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The anatomy of the midcheek has not been satisfactorily described to adequately explain midcheek aging and malar mounds, nor has it suggested a logical approach to their correction or provided sufficient detail for safe surgery in this area. This cadaver study, which was complemented by many operative dissections, located a missing link: a glide pl...
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Because of concerns that exposure to povidone-iodine (Betadine) may lead to early breast implant failure, the Food and Drug Administration announced in 2000 that any contact between implants and Betadine is contraindicated. The evidence cited by the Food and Drug Administration primarily referred to Betadine added to saline implant filler solution...