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Introduction: A total of 71,364 breast reductions were performed in 2022, which demonstrates a 54% increase from 2019. Women most often seek breast reduction surgery for pain, but psychological symptoms may be equally distressing, particularly those who are younger. These women may also suffer low self-esteem, inhibitions in intimacy, and reluctance to exercise, which may contribute to depressive symptoms., Methods: A systematic review was conducted using PRISMA guidelines and registered on PROSPERO (CRD42023456884). Cochrane Library, Embase, and Pubmed were searched for RCTs in English irrespective of timeframe. The studies were screened using the RoB2 tool, and data was extracted using standardized tables., Results: The search strategy yielded 84 references, and only three were eligible for inclusion. The sample size collectively amounted to 193. The tools used to assess depressive symptoms were the Beck Depression Inventory, a modification of this tool, and the Hospital Anxiety Depression Score. All three studies showed a significant reduction in depression scores., Conclusions: Breast hypertrophy may cause impairment in several key psychological domains including depression, which may be relieved with surgery. Standardized assessment tools and scoring systems may enable more comprehensive evaluation and potentially lead to guidelines defining broader criteria as indications for surgery. Further investigation into the differences between women who seek breast reduction surgery versus those who do not may provide insights into other contributing factors that may be at play. Further trials should be designed with longer durations of follow-up to investigate the long-term effects of breast reduction surgery., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

An individual's face undergoes numerous changes throughout life. Since mid-face aesthetic units are key areas for rejuvenation procedures, their comprehensive assessment is essential for the development of any aesthetic management plan. Despite the availability of many evaluation criteria for treatment of mid-face ageing, there are discrepancies existing in both assessment and management approaches. The goal of this study was to determine if there are any identifiable profiles of clinical judgements and approaches related to the level of surgeon's experience. Forty seven standardised non-digital and not altered natural size photographic images of patients' faces (front and profile) were presented to eight senior board certified plastic surgeons, eight junior non-board certified plastic surgeons and eight plastic surgery residents from an independent program. Surveyed physicians were 'blinded' from each other and asked to assess five different major features characterising ageing mid-face. An interclass correlation data analysis was performed and the Cronbach coefficient alpha values were computed for each category. Responses obtained from senior plastic surgeons were consistently characterised by higher Cronbach coefficient alpha values indicating higher concordance. The highest agreement levels were obtained for the assessment of rhytids and jowls across all groups and the lowest agreement levels were obtained for the assessment and recommendation of upper lip management. This study illustrated that discrepancies in clinical assessments and surgical management exist among surgeons involved in the aesthetic surgery of the mid-face ageing. It appears that the level of surgeon's experience significantly impacts the inter-rater reliability and consensus in assessment and treatment of mid-face ageing. The most senior plastic surgeons' assessment and recommendations had the highest level of concordance while the junior non-board certified plastic surgeons and the residents group produced variations with less consistency., (Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

High-voltage electrical burns are rare but cause devastating injuries, resulting in potential limb loss and major morbidity and mortality. These injuries are more insidious than flame burns in that the extent of the injury is not obvious at first glance. Damage to underlying muscle, nerve, and vessels may occur, resulting in limb-threatening ischemia and delayed hemorrhage. The management of such injuries remains controversial and can be challenging for the vascular and reconstructive surgeon. We present a case of high-voltage electrical injury to bilateral upper extremities resulting in limb-threatening ischemia, review the literature on the management of such injuries, and propose an algorithm to guide the management of these devastating injuries., (Copyright 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.)

The purpose of this study was to compare the maxillary arch morphology in 5-year-old children treated for unilateral cleft lip and palate (UCLP) with early gingivoplasty (EGP) and without this procedure (non-EGP). Three-dimensional (3-D) imaging was used to verify which measurements and to what degree specific orthodontic parameters differ in both groups. The study included 120 non-syndromic 4.5-5.5-year-old children treated surgically at the age of 6-18 months. Fifty-six children underwent EGP utilising a Skoog-type of technique. The (non-EGP) group consisted of 64 patients. Patients in both groups were treated without nasoalveolar moulding prior to cleft lip repair. The maxillary arch models were obtained and subjected to the 3-D computer-aided imaging procedure and metric analysis. Ten selected orthodontic measurements were calculated based on imaging landmarks. The computed data derived from models in both (EGP and non-EGP) groups were compared. The differences between groups were statistically analysed using Student's test. Five orthodontic measurements: the angle of the lesser segment inclination, dental arch radius of this segment, anterior palatal depth, palatal surface and length of dental arch demonstrate more severe maxillary underdevelopment in patients with previous EGP. The results reaffirm the negative impact of EGP with wide undermining of periosteal flaps on maxillary development and suggest that these five parameters may be the most sensitive early indicators of growth alteration.

The aim of the study was to investigate the relationship between the static thermography figure of merit DeltaT (the difference in mean values of skin area temperature for the burn wound area and the unaffected reference skin area) and a means of burn classification which would be most suitable for the choice of treatment. The work was an in vivo animal experiment. Statistical analysis showed a high correlation between the DeltaT parameter and histopathological assessment. With regard to the choice of treatment, the most useful correlation was found to be that between DeltaT and the classification of burn wounds into those healed in 3 weeks and those unhealed. The results of this study have revealed a quantitative criterion DeltaT for burn classification. The study suggests that particular burn centres using static thermography use a DeltaT parameter based on their own values for burn classification so as to group burn wounds into those that healed in 3 weeks and those that did not heal. This criterion should be independent of and replace other classification systems. A criterion for the proper choice of burn treatment would then be made more readily available.