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Article: Modified Pedicled Internal Mammary Osteomyocutaneous Chimeric Flap for Salvage of Mandibular Reconstruction.

Morin, Samantha D / Gowda, Arvind U / Chaiyasate, Kongkrit

Plastic and reconstructive surgery. Global open

2023 Volume 11, Issue 12, Page(s) e5432

Abstract: The modified pedicled internal mammary osteomyocutaneous chimeric flap is a powerful option for head and neck reconstruction in patients not suitable for free tissue transfer. In this article, the senior author's (K.C.) technique for flap elevation is ... ...

Abstract	The modified pedicled internal mammary osteomyocutaneous chimeric flap is a powerful option for head and neck reconstruction in patients not suitable for free tissue transfer. In this article, the senior author's (K.C.) technique for flap elevation is described in the context of a patient with mandibular osteoradionecrosis resulting in severe crossbite and trismus after multiple failed attempts at reconstruction with free tissue transfer. The modified pedicled internal mammary osteomyocutaneous chimeric flap was chosen as it offered intraoral lining, extraoral soft tissue, and vascularized bone for mandibular reconstruction without requiring free tissue transfer. The flap dissection as well as the risks, benefits, and indications for this flap are described herein. The modified pedicled internal mammary osteomyocutaneous chimeric flap is a technically complex reconstructive option reserved for situations in which conventional methods have been exhausted. It offers an eloquent solution for patients who otherwise may have no options.
Language	English
Publishing date	2023-12-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000005432
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Zs.A 7091: Show issues

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Article ; Online: Rhinoplasty in the Older Adult.

Khetpal, Sumun / Gowda, Arvind U / Parsaei, Yassmin / Mozaffari, Mohammad Ali / Dinis, Jacob / Lopez, Joseph / Steinbacher, Derek

Aesthetic surgery journal

2021 Volume 41, Issue 11, Page(s) 1231–1241

MeSH term(s)	Aged ; Humans ; Middle Aged ; Nasal Septum/surgery ; Nose Deformities, Acquired/surgery ; Retrospective Studies ; Rhinoplasty/adverse effects ; Treatment Outcome
Language	English
Publishing date	2021-03-18
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	2087022-X
ISSN	1527-330X ; 1090-820X ; 1084-0761
ISSN (online)	1527-330X
ISSN	1090-820X ; 1084-0761
DOI	10.1093/asj/sjab140
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Zs.A 5721: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 570: Show issues

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Article ; Online: Perceived Age and Attractiveness Using Facial Recognition Software in Rhinoplasty Patients: A Proof-of-Concept Study.

Khetpal, Sumun / Peck, Connor / Parsaei, Yassmin / Duan, Kaiti / Gowda, Arvind U / Pourtaheri, Navid / Lopez, Joseph / Steinbacher, Derek

The Journal of craniofacial surgery

2022 Volume 33, Issue 5, Page(s) 1540–1544

Abstract: Abstract: Artificial intelligence (Al)-based analyses may serve as a more objective tool for measuring cosmetic improvements following aesthetic plastic surgery. This preliminary proof-of-concept study utilized a novel commercial facial recognition ... ...

Abstract	Abstract: Artificial intelligence (Al)-based analyses may serve as a more objective tool for measuring cosmetic improvements following aesthetic plastic surgery. This preliminary proof-of-concept study utilized a novel commercial facial recognition software to assess perceived changes in age and attractiveness among patients receiving rhinoplasty.This study was a retrospective evaluation of three-dimensional photographs of patients who underwent rhinoplasty by the senior author (DS). Both pre- and post-operative (> 12-month follow-up) Vectra three-dimensional images (Canfield Scientific, Parsippany, NJ) were assessed using Haystack AI Software (Haystack AI, New York, NY). Facial attractiveness (score 1-10) and apparent age were predicted. A retrospective chart review of demographic variables was additionally performed. Paired t tests were used to compare age and attractiveness scores before and after surgery. Multivariate linear regression was performed to identify factors associated with age and attractiveness scores.One hundred twenty-four patients receiving rhinoplasty met the study criteria (average age: 35.58). Overall, rhinoplasty was associated with increases in Al-rated attractiveness (+0.28, P = 0.03) and decreases in perceived age relative to the patient's true age (-1.03 years, P = 0.03). Greater decreases in postoperative perceived age were achieved in patients who appeared older than their actual age preoperatively ( P < 0.001).Facial recognition software was successfully used to evaluate improvements in perceived age and attractiveness in patients undergoing aesthetic rhinoplasty. Patients were perceived by the software as younger and more attractive following rhinoplasty. Age reversal was greatest among patients who appeared much older than their actual age at the time of surgery.Level of Evidence: IV.
MeSH term(s)	Adult ; Artificial Intelligence ; Beauty ; Esthetics, Dental ; Facial Recognition ; Humans ; Proof of Concept Study ; Retrospective Studies ; Rhinoplasty ; Software
Language	English
Publishing date	2022-03-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000008625
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Zs.A 3761: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 175: Show issues

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Article: Indications, Techniques and Complications of Labiaplasty.

Gowda, Arvind U / Chopra, Nikki / Khalifeh, Marwan

Eplasty

2015 Volume 15, Page(s) ic46

Language	English
Publishing date	2015-08-18
Publishing country	United States
Document type	Case Reports
ZDB-ID	2412803-X
ISSN	1937-5719
ISSN	1937-5719
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Article: Resolution of Vertical Gaze Following a Delayed Presentation of Orbital Floor Fracture With Inferior Rectus Entrapment: The Contributions of Charles E. Iliff and Joseph S. Gruss in Orbital Surgery.

Gowda, Arvind U / Manson, Paul N / Iliff, Nicholas / Grant, Michael P / Nam, Arthur J

Craniomaxillofacial trauma & reconstruction

2020 Volume 13, Issue 4, Page(s) 253–259

Abstract: Introduction: Orbital floor fractures occur commonly as a result of blunt trauma to the face and periorbital region. Orbital floor fractures with a "trapdoor" component allow both herniation and incarceration of contents through a bone defect into the ... ...

Abstract	Introduction: Orbital floor fractures occur commonly as a result of blunt trauma to the face and periorbital region. Orbital floor fractures with a "trapdoor" component allow both herniation and incarceration of contents through a bone defect into the maxillary sinus as the bone rebounds faster than the soft tissue, trapping muscle, fat, and fascia in the fracture site. In children, the fractured floor, which is often hinged on one side, tends to return toward its original anatomical position due to the incomplete nature of the fracture and elasticity of the bone. The entrapment of the inferior rectus muscle itself is considered a true surgical emergency-prolonged entrapment frequently leads to muscle ischemia and necrosis leading to permanent limitation of extraocular motility and difficult to correct diplopia. For this reason, prompt surgical intervention is recommended by most surgeons. In adults, true entrapment of the muscle itself is not as common because the orbital floor is not as elastic and fractures are more complete. Methods: We present an adult patient with an isolated orbital floor fracture with clinical and radiologic evidence of true entrapment of the inferior rectus muscle itself. Results: Despite the delayed surgical repair (4 days after the injury), the patient's inferior rectus muscle function returned to near normal with mild upward gaze diplopia. Conclusions: Inferior rectus entrapment in adults may more likely be associated with immobilization of the muscle without total vascular compression/incarceration significant enough to lead to complete ischemic necrosis.
Language	English
Publishing date	2020-11-18
Publishing country	United States
Document type	Journal Article
ISSN	1943-3875
ISSN	1943-3875
DOI	10.1177/1943387520965804
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Article ; Online: Risk Factors for Lymphedema After Breast Conservation Therapy and Oncoplastic Reduction.

Gowda, Arvind U / Nie, James / Mets, Elbert / Alperovich, Michael / Avraham, Tomer

Annals of plastic surgery

2020 Volume 87, Issue 3, Page(s) 248–252

Abstract: Background: Lymphedema is a known complication after the surgical management of breast cancer, yet the incidence is poorly defined after breast conserving therapy and oncoplastic reduction. The primary aim of this study was to define lymphedema ... ...

Abstract	Background: Lymphedema is a known complication after the surgical management of breast cancer, yet the incidence is poorly defined after breast conserving therapy and oncoplastic reduction. The primary aim of this study was to define lymphedema incidence in this population. Furthermore, we sought to correlate demographic factors, surgical approach, and complementary treatment modalities with incidence. Methods: Data were collected retrospectively on patients who underwent breast conserving therapy at our institution from 2012 to 2015 with greater than 1 year of follow-up. Patients were excluded if they underwent breast surgery before treatment, completion mastectomy, delayed breast reconstruction, or delayed breast reduction. Results: Five hundred and eighty-four patients met study criteria with a 11% lymphedema rate. Patients developing lymphedema had higher preoperative body mass index (P = 0.02), larger breast mass resection volume (P < 0.01), higher rate of axillary dissection (P < 0.01), increased rate of adjuvant whole-breast radiation (P = 0.03), supraclavicular radiation (P < 0.01), axillary radiation (P < 0.01), and neoadjuvant medical therapy (P < 0.01). Multivariate analysis showed breast specimen mass, axillary radiation, and neoadjuvant medical therapy, which were associated with lymphedema (P < 0.05). There was no difference in lymphedema incidence between partial mastectomy and oncoplastic reduction cohorts with independent multivariate analyses for each showing axillary radiation and neoadjuvant medical therapy were significantly associated with lymphedema (P < 0.05), although breast specimen mass was not. Conclusions: Elevated preoperative body mass index, radiation, axillary dissection, and neoadjuvant medical therapy are associated with an increased risk of lymphedema after breast conserving surgery. Oncoplastic reconstruction is not a risk factor for lymphedema.
MeSH term(s)	Axilla ; Breast Neoplasms/surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphedema/epidemiology ; Lymphedema/etiology ; Mastectomy ; Mastectomy, Segmental ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2020-11-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000002630
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Zs.A 1419: Show issues

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Article ; Online: Race-Based Differences in the Utilization and Timing of Secondary Cleft Procedures in the United States.

Peck, Connor J / Pourtaheri, Navid / Parsaei, Yassmin / Gowda, Arvind U / Yang, Jenny / Lopez, Joseph / Steinbacher, Derek M

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association

2021 Volume 59, Issue 11, Page(s) 1413–1421

Abstract: Primary CL/P repair, revisions, and secondary procedures-cleft rhinoplasty, speech surgery, and alveolar bone grafting (ABG)-performed from 2014-2018 were identified from the Pediatric National Surgical Quality Improvement Program (NSQIP) database. ... ...

Abstract	Primary CL/P repair, revisions, and secondary procedures-cleft rhinoplasty, speech surgery, and alveolar bone grafting (ABG)-performed from 2014-2018 were identified from the Pediatric National Surgical Quality Improvement Program (NSQIP) database. Utilization estimates were derived via univariable and multivariable logistic regression. A Kruskal-Wallis rank-sum test and multivariable linear regression were used to assess differences in timing for each procedure cohort. The primary outcome measures were the odds of a patient being a certain race/ethnicity, and the age at which patients of different race/ethnicity receive surgery. There were 23 780 procedures analyzed. After controlling for sex, diagnosis, and functional status, there were significant differences in utilization estimates across procedure groups. Primarily, utilization was lowest in patient who were Black for cleft rhinoplasty (OR = 0.70, Conclusions: Estimates of utilization and timing of secondary cleft procedures varied by race, particularly among patients who were Black (poor utilization) or Asian (high utilization). Further studies should identify the causes and implications of underutilized and/or delayed cleft care.
MeSH term(s)	Alveolar Bone Grafting/methods ; Alveoloplasty/methods ; Bone Transplantation ; Child ; Cleft Lip/surgery ; Cleft Palate/diagnosis ; Cohort Studies ; Delivery of Health Care ; Healthcare Disparities ; Humans ; Racial Groups ; Retrospective Studies ; Rhinoplasty ; Surgical Flaps ; United States
Language	English
Publishing date	2021-10-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	1069409-2
ISSN	1545-1569 ; 0009-8701 ; 1055-6656
ISSN (online)	1545-1569
ISSN	0009-8701 ; 1055-6656
DOI	10.1177/10556656211047134
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Zs.A 451: Show issues

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Article ; Online: The Geographic Availability of Certified Cleft Care in the United States: A National Geospatial Analysis of 1-Hour Access to Care.

Peck, Connor J / Parsaei, Yassmin / Lattanzi, Jakob / Gowda, Arvind U / Yang, Jenny / Lopez, Joseph / Steinbacher, Derek M

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

2021 Volume 79, Issue 8, Page(s) 1733–1742

Abstract: Purpose: Children with cleft lip and/or palate (CLP) require longitudinal multidisciplinary care. Travel distance to comprehensive cleft centers may be a barrier for some families. This study evaluated the geospatial availability of certified cleft ... ...

Abstract	Purpose: Children with cleft lip and/or palate (CLP) require longitudinal multidisciplinary care. Travel distance to comprehensive cleft centers may be a barrier for some families. This study evaluated the geospatial availability of certified cleft teams across the United States. Materials and methods: A geographic catchment area within a 1-hour travel radius of each American Cleft Palate-Craniofacial Association-certified cleft center was mapped using TravelTime distance matrix programming. The proportion of children located within each catchment area was calculated using county-level data from the National Kids Count Data Center, with aggregate estimates of patients with CLP based on state-level data from the Centers for Disease Control and Prevention. One-hour access was compared across regions and based on urbanization data collected from the US Census. Results: There were 182 American Cleft Palate-Craniofacial Association-certified centers identified. As per study estimates, 28,331 (27.3%) children with CLP did not live within 1-hour travel distance to any center. One-hour access was highest in the Northeast (84.2% of children, P < .001) and lowest in the South (65.7%) and higher in states with the greatest urbanization in comparison with more rural states (85.1 vs 37.4%, P < .001). Similar patterns were seen for access to 2 or more cleft centers. The number of CLP children-per-center was highest in the West (775) and lowest in the Northeast (452). Conclusions: Travel distances of more than 1 hour may affect more than 25,000 (1 of 4) CLP children in the US, with significant variation across geographic regions. Future studies should seek to understand the impact of and provide strategies for overcoming geographic barriers.
MeSH term(s)	Child ; Cleft Lip/epidemiology ; Cleft Palate/epidemiology ; Health Services Accessibility ; Humans ; United States
Language	English
Publishing date	2021-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	392404-x
ISSN	1531-5053 ; 0278-2391
ISSN (online)	1531-5053
ISSN	0278-2391
DOI	10.1016/j.joms.2021.02.043
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Article ; Online: Primary Cleft Palate Repair Among Older-Age Children and Adolescents in the United States.

Peck, Connor J / Gowda, Arvind U / Khetpal, Sumun / Lopez, Joseph / Shultz, Blake N / Parsaei, Yassmin / Wu, Robin T / Steinbacher, Derek M

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

2021 Volume 79, Issue 6, Page(s) 1339–1343

Abstract: Purpose: Older age cleft palate (CP) repair in international settings has been associated with increased surgical morbidity. This study assesses the prevalence and risks associated with late-age CP repair (age > 5 years) in the United States.: Methods! ...

Abstract	Purpose: Older age cleft palate (CP) repair in international settings has been associated with increased surgical morbidity. This study assesses the prevalence and risks associated with late-age CP repair (age > 5 years) in the United States. Methods: Primary CP repair patients less than the age of 18 years were identified in the National Surgical Quality Improvement pediatric database from 2012 to 2018. Total postoperative complications, readmissions, reoperations, duration of surgery, and length of stay were recorded. T-tests and χ Results: A total of 10,022 primary CP procedures were identified from 2012 to 2018, of which 868 (8.6%) received repair at age > 5 years. Hispanic patients constituted a larger proportion of CP repair from ages 11 to 17 years than repair at other ages (P < .001). In comparison with children treated from ages 0 to 5 years, children operated on between ages 6 and 10 or 11 and 17 years experienced no increases in unplanned readmissions, reoperations, or complication rates after surgery. Patients of ages 6-10 years and 11-17 years had decreased operating room time (P < .001) compared with younger patients. Patients of ages 11-17 years also had decreased hospital length of stay (P = .04). Conclusions: Many children in the United States received primary CP repair after the age of 5 years likely due to late treatment of submucosal clefts or delayed care among international immigrants/adoptees. Old age procedures were not associated with increased short-term surgical morbidity in comparison with surgery at earlier time points. The causes and implications of older age primary surgery warrant further study.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Cleft Lip/surgery ; Cleft Palate/epidemiology ; Cleft Palate/surgery ; Humans ; Infant ; Infant, Newborn ; Neurosurgical Procedures ; Postoperative Complications/epidemiology ; Reoperation ; Retrospective Studies ; United States/epidemiology
Language	English
Publishing date	2021-01-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	392404-x
ISSN	1531-5053 ; 0278-2391
ISSN (online)	1531-5053
ISSN	0278-2391
DOI	10.1016/j.joms.2021.01.021
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Article ; Online: Crushed Cartilage and Autologous Fat for Dorsal Nasal Refinement.

Gowda, Arvind U / Pourtaheri, Navid / Park, Kitae E / Allam, Omar / Maniskas, Seija / Parsaei, Yassmin / Steinbacher, Derek M

Aesthetic plastic surgery

2021 Volume 45, Issue 5, Page(s) 2271–2277

Abstract: Background: Dorsal contour irregularities remain a potential undesirable sequela of rhinoplasty. Use of dorsal onlay grafts can camouflage such irregularities. In this article, a novel technique for dorsal onlay grafting utilizing crushed cartilage ... ...

Abstract	Background: Dorsal contour irregularities remain a potential undesirable sequela of rhinoplasty. Use of dorsal onlay grafts can camouflage such irregularities. In this article, a novel technique for dorsal onlay grafting utilizing crushed cartilage mixed with autologous fat is described. This study aims to assess long-term graft retention and aesthetic outcomes with this technique. Methods: Patients with >18-month follow-up who underwent primary open rhinoplasty with the described technique were reviewed. Three-dimensional photographs taken at multiple timepoints were overlaid with volumetric subtraction used to quantify graft retention. The Rhinoplasty module of the FACE-Q was completed by each patient, and the Rhinoplasty Assessment Scale Photographic (RASP) was completed by surgeon reviewers. Pre- and postoperative changes in dorsal height as well as RASP scores were compared with paired t-tests. Changes in BMI, dorsal volume, and dorsal height were compared with linear regression. P values <0.05 were considered significant. Results: Fourteen patients were included, mean age 32. Mean intermediate and final follow-up was 17.8 months and 28.9 months, respectively. There were no statistically significant dorsal height change (mean = 0.0 mm, p = 0.91) and minimal dorsal volume change (mean = 0.02 cm Conclusion: Crushed septal cartilage mixed with autologous fat is an effective option for dorsal nasal onlay in rhinoplasty and is associated with excellent graft retention, patient satisfaction, and nasal aesthetics. Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
MeSH term(s)	Adult ; Cartilage/transplantation ; Esthetics ; Humans ; Nose/surgery ; Retrospective Studies ; Rhinoplasty ; Treatment Outcome
Language	English
Publishing date	2021-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	532791-x
ISSN	1432-5241 ; 0364-216X
ISSN (online)	1432-5241
ISSN	0364-216X
DOI	10.1007/s00266-021-02257-9
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