I am one of only a few patients who have undergone reimplantation with breast implants directly after a diagnosis of breast implant associated-anaplastic large cell lymphoma (BIA-ALCL). This decision was a very personal...I am one of only a few patients who have undergone reimplantation with breast implants directly after a diagnosis of breast implant associated-anaplastic large cell lymphoma (BIA-ALCL). This decision was a very personal one and many may question why I would make such a rash decision so soon after being diagnosed. I am proof that this new type of man-made cancer, unknown until the mid-to-late 90s or early 2000s, developed as a result of textured breast implants. The objective of this article is to bring awareness to health care professionals about BIA-ALCL, provide a brief history of the United States Food and Drug Administration textured breast implant approvals and subsequent recall, and talk about the emotional rollercoaster this diagnosis brings to the patient.
Tumors of the head and neck can spread by direct extension, hematogenous spread, or lymphatic dissemination. However, a process known as perineural invasion (PNI) allows nerves to act as a direct conduit for tumor growth...Tumors of the head and neck can spread by direct extension, hematogenous spread, or lymphatic dissemination. However, a process known as perineural invasion (PNI) allows nerves to act as a direct conduit for tumor growth away from the primary site. Perineural invasion is a rare, atypical presentation of cutaneous squamous cell carcinoma of the head and neck that affects about 2.5%-14% of the population. It is known to be associated with an increased risk of local recurrent and distant metastasis, thus adversely affecting the patient's prognosis. The majority of PNI cases are asymptomatic, often discovered during pathological evaluation. We report the case of a patient who presented with a 1-year history of right-sided face pain and symptoms suggestive of trigeminal facial neuralgia. A skin biopsy taken from a lesion on his right cheek showed PNI secondary to cutaneous squamous cell carcinoma of the head and neck. We treated the patient with radiotherapy and chemotherapy and his clinical condition improved significantly. We are publishing this case report to increase awareness of practicing physicians and nurses to PNI as an atypical presentation of squamous cell carcinoma that may affect selection of treatment modality and the patient's prognosis.
Body image or how a person views their body and the way it functions ultimately influences their quality of life and functional well-being in their daily environments. The changes to appearance or to body structures and...Body image or how a person views their body and the way it functions ultimately influences their quality of life and functional well-being in their daily environments. The changes to appearance or to body structures and functions that occur as a result of cancer and its treatment can cause individuals to become dissatisfied with their body image where maladaptive emotions, thought processes, and behaviors develop and may lead to deleterious consequences including social avoidance and isolation. Although reconstructive surgery is restorative in nature, it does not guarantee the mitigation of body image dissatisfaction when treating adults with cancer. The majority of adults who undergo reconstructive surgery for the treatment of cancer demonstrate some level of body image dissatisfaction during or after the reconstructive process. Therefore, a need exists for nurses and other oncological team members to recognize and address body image dissatisfaction and the detrimental emotional and behavioral consequences associated with it. This article provides guidance for nurses to address body image by understanding the effects of cancer and its treatment on body image, by recognizing the impact of reconstructive surgery on body image when treating cancer in adults, and by integrating body image assessment and interventions into practice.
Hand and digit soft tissue defects are quite common and frequently require specialized reconstruction. When local flaps cannot be used to reconstruct a soft tissue defect, free flaps must be utilized. To overcome tissue...Hand and digit soft tissue defects are quite common and frequently require specialized reconstruction. When local flaps cannot be used to reconstruct a soft tissue defect, free flaps must be utilized. To overcome tissue volume and discrepancies in vessel diameter, arterialized venous free flaps from the forearm may provide an acceptable alternative. When using arterialized venous free flaps, surgeons should implement shunt restriction procedures to enhance flap viability.
In this article, we describe reconstruction of a large left-side medial cheek defect in a 78-year-old woman using a cervicofacial rotation advancement flap. To our knowledge, this is the second case of reconstruction of...In this article, we describe reconstruction of a large left-side medial cheek defect in a 78-year-old woman using a cervicofacial rotation advancement flap. To our knowledge, this is the second case of reconstruction of a large traumatic medial cheek defect using an anterior-based subcutaneous cervicofacial rotation advancement flap that has ever been reported. We applied retention sutures at the level of the jawline and zygomatic eminence using 3-0 nonabsorbable sutures between the subcutaneous tissue of the flap and the periosteum. Despite the limitation of having partially injured adjacent tissue available for reconstruction, meticulous dissection together with skilled postoperative nursing care yielded a good aesthetic outcome in this case.
The number of applications for facial recognition technology is increasing due to the improvement in image quality, artificial intelligence, and computer processing power that has occurred during the last decades. Algori...The number of applications for facial recognition technology is increasing due to the improvement in image quality, artificial intelligence, and computer processing power that has occurred during the last decades. Algorithms can be used to convert facial anthropometric landmarks into a computer representation, which can be used to help identify nonverbal information about an individual's health status. This article discusses the potential ways a facial recognition tool can perform a health assessment. Because facial attributes may be considered biometric data, clinicians should be informed about the clinical, ethical, and legal issues associated with its use.
Free flap reconstruction is a common procedure with success rates greater than 99%. However, vascular complications may occur, resulting in flap failure. For this reason, early detection of vascular compromise is crucial...Free flap reconstruction is a common procedure with success rates greater than 99%. However, vascular complications may occur, resulting in flap failure. For this reason, early detection of vascular compromise is crucial for flap salvage. Vascular complications may be detected early by monitoring tissue oximetry parameter changes using near-infrared spectroscopy (NIRS). This method of noninvasive monitoring can evaluate changes in flap oxygenation levels caused by arterial and venous thrombosis before surgical reexploration. The goal of this study was to assess the validity of using NIRS oximetry for monitoring free flaps. We conducted a prospective cohort observational study of 10 patients undergoing breast reconstruction. We used the INVOS 7100 cerebral oximetry monitoring system (Medtronic, Dublin, Ireland) to provide 24-hr continuous postoperative monitoring of flap perfusion and compared the data with clinical assessment findings. The median patient age was 57 years (range = 41-61 years). Patients underwent immediate breast reconstruction with deep inferior epigastric perforator (DIEP) flap surgery (n = 4), delayed reconstruction with DIEP flap surgery (n = 4), transverse upper gracilis flap surgery (n = 1), and latissimus dorsi flap with lipofilling (n = 1). We successfully monitored all 10 flaps for 24 hr postoperatively. The overall flap survival rate was 100%. Findings of clinical examination, Doppler studies, and surgical outcome were consistent with NIRS monitoring. In conclusion, NIRS tissue oximetry could potentially provide a noninvasive method for effective postoperative monitoring of free flaps.
Including the jawline in aesthetic assessment has become increasingly popular when using both surgical and nonsurgical techniques. Facial aging processes include bone resorption, fat pad atrophy, and a breakdown of the q...Including the jawline in aesthetic assessment has become increasingly popular when using both surgical and nonsurgical techniques. Facial aging processes include bone resorption, fat pad atrophy, and a breakdown of the quality of collagen and elastin in the skin. To provide optimal treatment of the jawline using nonsurgical techniques, it is important to consider all of these aspects before planning treatment. Men and women have different facial aging processes and ideal facial ratios that must be respected. The objective of this article is to discuss the use of botulinum toxin A and hyaluronic acid filler injectable treatments, deoxycholic acid injectable treatments, and cryolipolysis treatments and explain how these treatments can be utilized for optimal rejuvenation of the jawline and perioral area.