The Use of Monsel's Solution to Reduce Postoperative Bleeding From Paramedian Forehead Flap Pedicles No abstract available

Lateral Superficial Muscular Aponeurotic System Stacking/Superficial Muscular Aponeurotic Systemectomy With Orbicularis–Malar Fat Repositioning: A Procedure Tailored for Female Asian Patients BACKGROUND Important differences in facial anatomy and how faces age must be considered when performing facelifts in Asian populations. Few facelift methods are specifically designed for Asian patients. OBJECTIVE This study evaluated the efficacy of lateral superficial muscular aponeurotic system (SMAS)-stacking/SMAS-ectomy with orbicularis–malar fat repositioning. MATERIALS AND METHODS Between February 2013 and December 2016, 62 women underwent the evaluated technique and completed the follow-up (15 months, ranging from 3 to 38.5 months). Three blinded, independent observers graded wrinkles, laxity, nasolabial fold depth, malar prominence, and tear trough deformity using quantitative comprehensive grading scales. FACE-Q scale items were assessed, and complications were recorded. RESULTS The mean postoperative scores for wrinkles, laxity, nasolabial fold depth, malar prominence, and tear trough deformity decreased from 2.64, 2.62, 2.01, 2.06, and 2.40 to 1.48, 1.34, 0.93, 1.21, and 1.27, respectively. The preoperative and postoperative scores differed significantly for all parameters (p < .05). The FACE-Q results showed that the patients were highly satisfied with their appearance, quality of life, adverse effects, and care. CONCLUSION The authors' technique allows midfacial and periorbital rejuvenation and offers dual benefits by correcting individual facial asymmetries and reshaping the jowls and neck contour in Asian patients. Address correspondence and reprint requests to: Daping Yang, MD, Department of Plastic Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China 150086, or e-mail: dapingyang1223@hotmail.com Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.dermatologicsurgery.org). The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

Combination Therapy of Microneedle Fractional Radiofrequency and Topical Poly-Lactic Acid for Acne Scars: A Randomized Controlled Split-Face Study BACKGROUND Acne scarring occurs at a young age and causes distress for many patients. Various treatment modalities have been tried. OBJECTIVE This study investigated the efficacy of combination therapy with topical poly-lactic acid and microneedle fractional radiofrequency (MFRF) for acne scars. MATERIALS AND METHODS Patients with acne scars on both the cheeks were included. Poly-lactic acid was applied to the acne scars on one side of the face before MFRF treatment. The other side of the face was treated with MFRF and normal saline. Patients received 3 treatment sessions and were evaluated based on visual assessment and patient satisfaction. After the last treatment, objective scar assessment of scar smoothness, size, brightness, and overall improvement was performed. RESULTS Both acne scar assessment scores and patient satisfaction were better with combination therapy (p = .036 and p = .009, respectively) than with monotherapy. Combination therapy resulted in significantly better efficacy for scar smoothness (p < .001), scar size (p = .003), and overall improvement (p < .001), but not for brightness (p = .151). CONCLUSION Combination therapy resulted in significantly better clinical outcomes, including better scar smoothness and smaller scar size. Therefore, we believe this combination therapy is a safe and effective treatment for acne scars. Address correspondence and reprint requests to: Kwang H. Kim, MD, PhD, Department of Dermatology, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang, Gyeonggi-do 14068, Korea, or e-mail: dermakkh@naver.com The authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

Patient Scar Assessment Correlates With Quality of Life After Mohs Micrographic Surgery No abstract available

Analysis of U.S. Food and Drug Administration Data on Soft-Tissue Filler Complications BACKGROUND With the rising popularity of dermal fillers, the number of complications associated with fillers has increased. OBJECTIVE To identify and review reports of adverse events involving cosmetic injectable soft-tissue fillers from the FDA Manufacturer and User Facility Device Experience (MAUDE) database from June 1993 to August 2014. MATERIALS AND METHODS The authors conducted a search of adverse events within the U.S. Food and Drug Administration database that involved injectable dermal fillers for soft-tissue augmentation from June 1993 to August 2014. Search terms included generic and trade names of commercially available soft-tissue fillers. RESULTS Three thousand seven hundred eighty-two complications involving dermal fillers were identified in the MAUDE database. Forty-four percent of complications implicated hyaluronic acid fillers, 40% involved poly-L-lactic acid fillers, 15% complications included calcium hydroxylapatite fillers, and <1% complications arose from polymethylmethacrylate fillers. Common adverse events included lumps, infection, allergic reaction, ischemia, and swelling. Rare events included trigger of autoimmune reactions, visual disturbances, and stroke. CONCLUSION Although complications with dermal fillers are infrequent in comparison with the growing number of filler procedures being performed in the United States every year, this study underscores the importance of appropriate skill and training when administering dermal fillers. Physicians using injectable dermal fillers should be trained to recognize potential complications and know how to appropriately manage them. Address correspondence and reprint requests to: Jusleen Ahluwalia, MD, 8899 University Center Lane, Suite 350, San Diego, CA 92122 juahluwalia@ucsd.edu A.E. Ortiz is a consultant for Alastin and Cutera. M.M. Avram is a consultant for Alastin, Allergan, Merz, Sciton, Sienna and Soliton. The remaining authors have indicated no significant interest with commercial supporters. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

Change in Sun-Protective Behavior After Dermatologic Surgery for Skin Cancer in High-Risk Patients No abstract available

Repair of a Deep Auricular Wound No abstract available

Reduction of Injection Site Pain in the Treatment of Axillary Hyperhidrosis With Botulinum Toxin: A Randomized, Side-by-Side, Comparative Study of Two Injection Patterns No abstract available

Representation of Women at American College of Mohs Surgery Annual Meetings From 2006 to 2019 No abstract available

Patient Concerns in the Immediate Postoperative Period After Mohs Micrographic Surgery BACKGROUND Postoperative concerns after Mohs micrographic surgery (MMS) are not well characterized. OBJECTIVE To better define patient concerns and contributing characteristics in the immediate postoperative period after MMS. MATERIALS AND METHODS A standardized telephone encounter template was implemented to better assess patient concerns in the 24-hour postoperative period. A review was then performed of patients undergoing MMS from October 2016 to July 2017 to assess for the most common patient concerns and association with clinical characteristics. RESULTS We included 307 patients. Overall, 60.6% of patients reported a concern. Fifty-four percent of patients reported pain. Most pain was characterized as “a little” (67.7%). On univariate analysis, flap repairs, location on the upper extremities, and swelling were associated with higher mean postoperative pain. Tumor type was not associated with increased pain. On multivariate analyses, patients with larger defects and associated edema were statistically significantly associated with higher degrees of pain. CONCLUSION Over half of patients experience postoperative concerns after MMS, most commonly pain. The immediate postoperative period may be an optimal time to identify patient concerns allowing for reassurance or early intervention when necessary. Address correspondence and reprint requests to: Erica H. Lee, MD, Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY 10022, or e-mail: leee@mskcc.org Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.dermatologicsurgery.org). The authors have indicated no significant interest with commercial supporters. C.N. Giordano and S. Mori contributed equally to this article. © 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.