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Nasal reconstruction is considered the historic foundation of facial plastic surgery, and the forehead flap remains the workhorse of repair. To recreate both the aesthetic contour and function of the nose, all anatomic layers must be addressed-covering, lining, and structural support. This article reviews the noteworthy history underlying the development of the paramedian forehead flap as the primary tool in reconstruction of large nasal defects while highlighting its implications on modern nasal repair. Current developments in the use of 2-staged paramedian forehead flap reconstruction are examined and a modern technique is presented.

As the most prominent portion of the human body, the face embraces a multifaceted responsibility for functionality and survival while contributing to identity and self-image. Inopportunely, due to its distinctive anatomical location, the face as a unit is highly suspectable to trauma, particularly in warfare. As a result, facial injury creates a physical and psychological trauma that needs to be addressed immediately. In the following article, a detailed literature review was conducted to examine the interplay between facial injuries throughout multiple wars in Iraq and their management. The authors found a significant increase in facial injuries due to shell fragments corresponding with modern advances in warfare targeting mass casualties. The capacity to manage the magnitude and level of trauma observed in Iraq requires a substantial amount of resources and a systematic approach that unfortunately is unattainable in a country that is still struggling to rebuild after decades of oppression and war. Due to the circumstances, surgeons have to rely on training and experience to provide the best care for their patients and it is imperative that we continue to train our surgeons to rely on their skills and experience to ensure a high level of care with limited resources and lack of technology.

The industrialization of modern warfare dating back to WWI led to an increase in combat-related injuries with unprecedented levels of severity. The necessity of addressing the clinical challenges that ensued led to the emergence of modern reconstructive surgery and subsequently a robust healthcare initiative for veterans in the form of the Department of Veterans Affairs. In the following article, a literature review was conducted to examine the interplay between combat injuries, veterans' care, and reconstructive surgery. We found that the relationship between military trauma and reconstructive surgery has led to an increase in survival rates and advances in mass casualty response while allowing the survivors to maintain a high quality of life. The relationship between the Veterans Affairs hospitals and plastic surgery has only strengthened over time as these hospitals play a major role in training the next generation of plastic surgeons throughout the nation. It is imperative to maintain this cooperative relationship to ensure a high level of care for our veterans and a comprehensive training experience for plastic surgery residents.

In late 2019, a novel coronavirus strain, SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), also known as coronavirus disease 2019 (COVID-19), triggered a global pandemic as the virus spread from the Wuhan Province, China, across all continents. Although infrequent, severe respiratory infection and death caused by SARS-CoV-2 is disproportionately high amongst healthcare providers such as craniofacial surgeons who work in the head and neck region. Factors this impact SARS-CoV-2 transmission include: (1) high viral loads in the mucosa of the oral and nasopharynx, (2) limited and/or imprecise disease screening/confirmation testing, (3) access to and appropriate use of personal protective equipment (PPE).

Dorsal nasal augmentation is commonly performed for various aesthetic deficiencies and/or reconstructive defects such as the saddle nose deformity. However, the optimal technique for volume augmentation has yet to be identified. The senior author (F.P.) has since developed a new modified technique using wrapped diced cartilage within an AlloDerm. This novel construct provides the plastic surgeon a smooth, convenient, pliable option with similar operative times as compared with other popular techniques. In summary, this technique has been proven to be successful in achieving attractive, safe, and acceptable outcomes in nasal dorsal configuration and overall patient satisfaction.

Longitudinal follow-up data on development and school placement are presented for three groups of patients. Having had or not having had early surgical intervention and stimulation distinguishes the two groups of patients with craniosynostosis. The third group is patients with cleft lip and palate who received early intervention but did not achieve minimal criteria for communication by age 22 months. Educational placement (for patients 8 to 20 years of age) follows the pattern of distribution of students nationally for patients who had early intervention.

This is a discussion of the impact of distraction osteogenesis on the major function of communication as noted in oral motor control for expressive language. Our experience has been primarily with preadolescent and adolescent patients of school age whose expressive language skills are undergoing continuing development.

To determine the future needs in manpower for pediatric care as it relates to pediatric specialists, a study was conducted by the American Academy of Pediatrics to see the needs of manpower that will provide access of pediatric care to all. A pediatric plastic surgery survey was set in the form of a list of questions that was mailed to the respective societies with pediatric plastic surgeons as members. The survey was reviewed, and the results were studied. The outcome is presented in the form of findings related to the overall practice of plastic surgery. Based on the percentage of pediatric care that is provided, there were two types of pediatric plastic surgeons. Those with the high percentage of pediatric care tend to stay near health science centers; however, both groups tend to spend time (each to a different extent) tending to other plastic surgery problems. Today we have adequate access to care in the health system for pediatric plastic surgery problems despite the shift in the health care environment. Managed care continues to use the pediatrician as a "gatekeeper" in determining the overall access for patients with problems related to pediatric plastic surgery.