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The article provides information on the legal obligation of health insurance companies for incurring insured persons medical costs for aesthetic surgery for surgical breast augmentation using breast augmentation plastic surgery, wound healing disorders and inpatient treatment. It points out to prosthesis implantation and costs of inpatient hospital treatment.

Study Question: What are the levels of breast development and satisfaction in women with a Disorder/Difference of Sex Development (DSD)?Summary Answer: Compared with normative data, women with DSD reached lower Tanner stages and reported less breast satisfaction.What Is Known Already: Women with DSD may have chromosomal and hormonal variations that can impact typical breast development. While much emphasis is placed on genital development in this group, little is known about breast development, satisfaction and their association.Study Design, Size, Duration: Data collection was part of the cross-sectional European multicenter dsd-LIFE study. Fourteen recruiting sites included 1040 participants between February 2014 and September 2015.Participants/materials, Setting, Methods: A total of 695 female-identifying participants were included (Turner n = 332, 46,XY DSD n = 141 and congenital adrenal hyperplasia n = 222), with a median age of 28 years. Clinical (i.e. history of hormone and surgical treatments, Tanner breast examination) and patient-reported (i.e. breast satisfaction, relationship status, sexual satisfaction and experienced femininity) data was collected by independent trained research staff. The relationship between breast development, satisfaction and femininity was assessed. Control data on breast development and satisfaction in women without DSD was retrieved from the literature.Main Results and the Role Of Chance: Of the 695 participants, 61% had received estrogen replacement and 51% puberty induction therapy, whereas 2% had received breast augmentation surgery. Approximately 65% of participants had reached Tanner breast stage 5, which is substantially less than the general population (90%). Breast satisfaction was lower than normative data as well (P < 0.001, Cohen's d = 0.45). Breast size and breast satisfaction were associated with feelings of femininity.Limitations, Reasons For Caution: Limitations include the sample representativeness (e.g. regarding the clinical heterogeneity) and the limited in-depth knowledge on (prior) hormonal regimens. Furthermore, no (matched) control data was collected as part of this study.Wider Implications Of the Findings: In order to support the psychosexual well-being of women with DSD, enhancing breast development by sufficient hormone replacement and possible augmentation surgery is advocated. The scope of DSD management should be beyond genital development only and consider breasts as well.Study Funding/competing Interest(s): The study was funded by the European Union Seventh Framework Program (FP7/2007-2013) under grant agreement no. 305 373. There are no competing interests.Trial Registration Number: German Clinical Trials Register: Registration identification number: DRKS00006072. [ABSTRACT FROM AUTHOR]

Quick absorption of adipose tissue grafts makes the outcomes less satisfactory for clinical applications. In the current study, adipose tissue grafts were mixed with adipose tissue-derived stem cells (ASCs) to improve retention of adipose tissue grafts and to make the clinical outcomes of fat grafting more reliable. Adipose tissue was either injected alone (conventional group) or mixed with ASCs (stem cell group) before injection. In both groups, adipose tissue was injected at the site of contour throughout layers of tissues till visual clinical symmetry with the opposite side was achieved. The volume of injected fat graft was measured after 72 hours and 6 months using a B-mode ultrasound device connected with a 12 MH frequency probe. The percentage reduction in the volume of injected fat, physician satisfaction scores (Ph-SCs), and patient satisfaction scores (P-SCs) were also recorded. After 6 months, there was significantly lower fat absorption in the stem cell group as compared to the conventional group. Mean physician and patient satisfaction scores were significantly improved in the stem cell group. No significant adverse effects were noted in any patient. Significantly lower absorption of graft due to the use of ASCs improves the clinical outcomes of conventional fat grafting for contour deformities of the face. The current preenrichment strategy is noninvasive, safe and can be applied to other diseases that require major tissue augmentation such as breast surgery. This trial is registered with NCT02494752. [ABSTRACT FROM AUTHOR]

Breast augmentation remains one of the most commonly performed aesthetic procedures in the United States and worldwide. Throughout the last few decades, the implants used for this procedure have undergone significant advancements, which has allowed surgeons to provide safer and more aesthetically pleasing outcomes. This article discusses the history of breast implants since their invention in 1962. Particular emphasis is given to the evolution of silicone implants with its many challenges, which has resulted in the development of the currently used fourth- and fifth-generation devices. Knowledge of these advances will allow physicians to more critically evaluate their results, and also will encourage them to provide more up-to-date scientific data on these devices to further improve the clinical outcomes of their patients. [ABSTRACT FROM AUTHOR]

Purpose: Giving an additional radiation dose to the incision or chest wall has been a practice, but it has never been studied in a randomized setting, and it might lead to inferior cosmetic outcomes. This study aims to evaluate whether delivery of a chest wall boost (CWB) to the mastectomy scar or chest wall is independently associated with reconstruction complications and to assess its disease control efficacy in the setting of breast reconstruction.Methods and Materials: We conducted a retrospective chart review of 746 patients with breast cancer who underwent mastectomy, breast reconstruction, and PMRT; all underwent treatment at our institution during 1997 to 2016. Various reconstruction techniques were used among this cohort including autologous reconstruction, single-stage direct-to-implant reconstruction, and 2-stage tissue expander implant. Cohorts were divided by administration of CWB. The primary objective was comparing the rate of reconstruction complications including skin necrosis, fat necrosis and infection between groups. Subgroup analysis for patients with implant-based reconstruction was performed to evaluate the effect of CWB on implant-related complications such as capsular contracture, implant exposure, and implant failure. The secondary objective was comparison of the cumulative incidence of local failure between groups overall and within clinically high-risk subgroups.Results: The median follow-up was 5.2 years. Most clinicopathologic features were well balanced between the 379 (51%) patients who received CWB and the 367 (49%) who did not. On multivariate analysis, CWB was significantly associated with infection, skin necrosis, and implant exposure. For implant reconstruction patients, CWB independently increased risks of implant failure. CWB administration was not associated with local tumor control benefits, even in high-risk subgroups.Conclusions: Our findings suggest that omission of chest wall boost in postmastectomy radiation improves breast reconstruction outcomes without compromising local tumor control. [ABSTRACT FROM AUTHOR]

Breast augmentation with various injectable materials has been performed for decades. Aquafilling was developed in 2005 as soft tissue filler for facial contouring and recently its use for breast augmentation has gained speed in several countries. Its declared composition is 98% water and 2% copolyamide. Although not approved by the U.S. Food and Drug Administration, the procedure is increasingly applied in Turkey. Thus, familiarity with specific imaging findings and complications of this entity is important for the correct diagnosis. Possible migrated material should especially be sought for when reporting these cases. Hereby, we present two cases with a history of breast augmentation with Aquafilling, with special emphasis on MRI findings. Two female patients (ages 28 and 32) were referred for breast ultrasonography (US) with progressive swelling of the right breast (4 years after Aquafilling) and mastalgia (1 year after Aquafilling). Breast MRI at 1.5T (Siemens Espree) with 4-channel breast coil was performed. High-resolution non-fat sat T1- and T2-weighted (W) images, time of repetition-independent multislice (TRIM), and diffusion-weighted imaging (DWI), and for the silicone assessment, water-suppressed and fat-suppressed (WS-FS) sequences, were used. No contrast was administrated. Knowledge of the radiologic characteristics and migration patterns of Aquafilling material as well as related complications is very useful to make an accurate diagnosis. Level of Evidence: Level V, diagnostic study. [ABSTRACT FROM AUTHOR]

Background: Post-burn breast deformities are not an uncommon condition after severe second-degree or third-degree burn and present as severe asymmetry of the breast as compared to the opposite side, displacement of nipple-areola complex, obliteration of inframammary fold, and reduced breast projection. Based on deformities especially for lower pole breast contracture, we propose a new classification to describe breast contracture. There is no tailor-made approach described to deal such deformities. Various options are available ranging from skin graft to different flaps. We present reconstruction by TDAP flap after the release of breast contracture grades I and II. This study aimed to classify the lower pole breast contracture according to its severity and to evaluate the outcome of TDAP flap reconstruction and augmentation of the lower pole of the breast in terms of symmetry and aesthesis. Methods: This is a descriptive retrospective study of 10 patients with 15 post-burn contracted breast affecting the inferior pole of the breast and inframammary fold within a period of January 2012 to March 2016 in Kasralainy hospital, Cairo. All cases were evaluated according to flap vascularity, donor site morbidity, symmetry, and esthetic outcome. Results: All flaps survived completely. Flap dimension ranged from 18 × 10 to 22 × 12 cm. The muscle sparing design had been used in three patients due to lack of reliable perforators. Patients were evaluated for their satisfaction, and all of them were satisfied. Conclusions: It is essential to classify the grade of post-burn lower pole breast contracture according to the proposed classification. TDAP is a valuable option in case of grade I and II deformities only. For severe grade III breast contracture, more volume restoring procedure is advisable. Level of Evidence: Level IV, therapeutic study. [ABSTRACT FROM AUTHOR]

Background: Cosmetic surgery (CS) is a rapidly growing subspecialty in Nigeria. Nurses are indispensable part of successful cosmetic surgery practice and thus plays important role in promoting the practice. Objective: To evaluate the level of awareness, attitude and practice of CS among nurses in selected secondary and tertiary hospitals in Ebonyi state, southeast Nigeria. Methods: A cross sectional survey was done among randomly selected nurses in the tertiary and secondary health facilities in Abakaliki between 1st September, and 30th November 2019. Data obtained was analyzed using IBM SPSS version 20 Results: The mean age of the respondents and year of practice were 36.80 ± 9.46 years and 11.35 (95%CI 10.59 - 12.12) respectively. The majority (96.3%) of the respondents were aware of CS and the main source of information was from lectures received while in the nursing school. Breast augmentation and breast reduction were the commonest types of CS known. Only 17% of the respondents correctly identified that CS should be done by the aesthetic/cosmetic surgeon. Nurses in the teaching hospital had a higher propensity of recommending cosmetic surgery to a client than nurses in the secondary healthcare institutions (OR = 2.07 95% CI 1.255-3.45). Only about a quarter of the respondents will accept CS even when offered free to them Conclusion: Our study shows a good awareness of cosmetic surgery among the respondents. Their attitude towards the CS was poor. There is need to improve attitude to CS among nurses as this can assist in improving societal acceptance of CS. [ABSTRACT FROM AUTHOR]

Background/Aim. Complications of breast augmentation, as one of the most common cosmetic surgery, may be different. Besides usual early, local postoperative complicatons, the most common late complication is capsular contracture. As a specific complication of skin functions after this operation only disturbance of sensibility is described. Since the skin has other functions as well, and because there are no literature data available, the aim of this research was measuring the skin temperature before and after surgery. Methods. A prospective intervential study was done in 49 adult women. Bilateral augmentative mammaplasty was performed for breast hypoplasia or on the personal request of a patient with autrophic breasts. Measuring the temperature of the breast skin was done in two points, before the operation, and seven days and three months after surgery. The temperature measurement was done by the infrared thermometer (Pyrometer TROTEC BP21). Statistically significant difference was determined using the t-test for related samples. Differences were considered statistically significant if p was less than 0.05. Eta squared coefficient was use to determine the import size and according to the Cohen criteria everything over 10:14 signified a major impact. The data were analyzed by the IBP SPSS Statistics v20. Results. In a majority of patients the breasts were hypoplastic (69.39%). The most commonly used implants were 275--500 mL volume (46.94%), and the least common implants were over 500 mL (16.33%). In a little less than 2/3 of the patients submammary incision was used (61.22%). In a majority of patients (67.35%) the prosthesis were placed subglandularly. The average value of the temperature before the operation at the point 1 was 34.49ºC, seven days after surgery 34.81ºC, and three months after surgery 34.10ºC; and at the point 2: 34.60 ºC, 34.91ºC and 34.19ºC in the same time intervals. In relation to the size of the breasts before operation and the size of the implant manufacturer, the localization of the incision and placement of the localization of the prosthesis, no statistically significant differences in the temperature of the skin of the breast before and after surgery was observed. Conclusion. Our results on the change of skin temperature after the breast augmentation could be significant preoperative information for the patients. [ABSTRACT FROM AUTHOR]

Audit of contrast-enhanced breast MRI performed over a 3-year period in a single institution to describe and summarise the changes seen after surgery and radiation therapy for primary breast cancer, breast augmentation and oncoplastic surgery. Seventy women were identified and reviewed (100 breast MRIs in total). The most common change seen was haemosiderin deposition. The early changes of skin thickening, oedema, seroma and background parenchymal enhancement decreased with time leaving residual breast shrinkage, haemosiderin/calcification and architectural distortion due to fibrosis and scarring. [ABSTRACT FROM AUTHOR]

Background: Hyaluronic acid fillers have become popular soft tissue filler augmentation agents over the past several years. Q.O.Fill (JW Pharmaceutical Co., Ltd., Seoul, Korea) is a newly developed soft tissue augmentation agent using Tissuefill (hyaluronic acid derivatives) mixed with platelet-rich plasma (PRP). The purposes of this study were to describe the Q.O.Fill method and evaluate the outcome of face augmentation. Methods: A retrospective chart review was performed over a 2-year period. Seventy-five Asian participants with a mean age of 43.5 years were enrolled in the study. Mean total injection volume (baseline and touch-up) per participant was 8.9 mL. All participants underwent injection of Tissuefill mixed with PRP, Q.O.Fill. The results were evaluated using photographs and according to patients' satisfaction. Results: Six months after the last injection, 100% of participants had improvement. At month 6, 97.3% of participants remained least improved over the baseline, and 90.7% felt much better or a little better until 2 years after the injection. The incidence of complications was low. Conclusions: The study showed that Q.O.Fill injection resulted in a very good aesthetic outcome and few adverse events. We believe that a facial augmentation with Tissuefill mixed with PRP is a safe and effective treatment method. [ABSTRACT FROM AUTHOR]

To evaluate the possibility of regenerating bone around endosseous dental implants, 3t implants were placed into postextraction sockets or other bony defects, and human demineralized freeze-dried cortical bone powder (DFDB) mixed with tetracycline was packed around the exposed parts. Implants were covered with expanded polytetrafluoroethylene (e-PTFE) membranes for 4 to 6 months until abutment connection, unless the membranes were prematurely exposed and had to be removed. Bone biopsies from nonsupporting regenerated bone were taken from some of the patients and examined histologically. Whenever complete coverage was maintained throughout the healing period (4 to 6 months), complete bone regeneration resulted. Early membrane removal mainly resulted in partial bone regeneration. Histologically, regenerated bone consisted of particles of devitalized bone in contact with newly formed woven or lamellar bone with some connective tissue around them. Osteogenic activity was even present 1 year post-grafting. Thus, DFDB is capable of promoting bone formation around dental implants if complete flap coverage and the membrane presence can be maintained throughout the healing phase. [ABSTRACT FROM AUTHOR]

Acellular dermal matrices (ADMs) have ushered in a paradigm shift in prosthetic breast reconstruction; however, there has hitherto been no reported use of Braxon® ADM in aesthetic breast surgery. Here, we describe the case of a 42-year-old woman who presented for revision of her bilateral aesthetic augmentation-mastopexy following multiple revision surgeries. The predominant concerns were persistent pain, implant malposition and a wide intermammary distance. Her predicament was worsened by inability to tolerate monopolar diathermy owing to a spinal stimulator—the least invasive operation was sought and Braxon® ADM met this criterion. The procedure was a success, and she remains symptom-free, with soft breasts and stable implant positions. Braxon® ADM, with its preformed shape, total implant-wrapping design and easy suture fixation, lends itself to easy use in cosmetic breast surgery. Its role in cosmetic breast surgery has yet to be established, but this case marks the beginning of this endeavor. [ABSTRACT FROM AUTHOR]

Objective To explore the application effect of autologous fat granule transplantation in the prosthetic breast augmen­tation. Methods From January 2016 to November 2019, 9 patients with poor morphology after prosthetic breast augmentation in group A underwent autologous fat granule transplantation; 13 patients with micromastia or breast atrophy in group B underwent autologous fat gran­ule transplantation to increase the thickness of chest wall then underwent prosthetic breast augmentation. The clinical data of patients in both groups were summarized and analyzed. Results In group A, the morphology of bilateral breasts was significantly improved. Breasts of both sides were basically symmetrical and the appearance was more natural and soft than that before operation. In group B, the appearance of breast was good after operation. Breasts of both sides were soft and basically symmetrical. The ultrasound mammography was performed in patients of both groups at 6 months after operation. All patients were followed up from 3 months to 3 years. No adverse reactions such as in­duration, mass and fat liquefaction occurred. All patients were satisfied with the results. Conclusion The application of autologous fat gran­ule transplantation before and after prosthetic breast augmentation could significantly improve the surgical efficacy and patients' satisfaction. [ABSTRACT FROM AUTHOR]

Background  One aim of unilateral postmastectomy breast reconstruction (BR) is to restore symmetry with the contralateral breast. As such, unilateral prosthetic reconstruction often requires a contralateral symmetry procedure (CSP). There is sparse literature on the impact of CSPs on long-term patient-reported outcomes (PROs) such as satisfaction and health-related quality of life (HRQoL). This study aims to describe PROs following CSPs, using a validated PRO tool, BREAST-Q. The hypothesis is that CSPs are associated with greater patient-reported satisfaction and HRQoL. Methods  This study is a single institutional analysis of prospectively collected BREAST-Q scores of patients who underwent unilateral prosthetic BR during 2011 to 2015. Women 18 years and older with BREAST-Q scores measured ≥ 9months after BR with or without CSP(s) at the time of expander replacement were included. Patients were classified into four subcohorts: augmentation, mastopexy, reduction, and no symmetry procedure (controls). Sociodemographic, clinical characteristics, and BREAST-Q scores were analyzed. Multivariable linear regression was performed. Results  Of 553 patients, 67 (12%) underwent contralateral augmentation, 68 (12%) mastopexy, 93(17%) reduction, and 325 (59%) were controls. Mean follow-up time was 52 months. Satisfaction with breast and outcomes were higher in the augmentation compared with the control groups (p  = 0.01). On multivariable analysis, augmentation remained an independent predictor of satisfaction with breast (p  = 0.04). Physical well-being scores were lower for contralateral mastopexy and reduction compared with the controls with a trend toward statistical significance on multivariable models. Psychological and sexual well-being was similar across groups. Conclusion  Prosthetic reconstruction with contralateral breast augmentation was associated with greater satisfaction with breast and reconstructive outcome. In contrast, breast reduction and mastopexy procedures demonstrated equivalent satisfaction with breasts compared with controls but may be associated with lower physical well-being. Such information can be used to improve the shared decision-making process for women who choose unilateral prosthetic BR. [ABSTRACT FROM AUTHOR]

Purpose: Breast augmentation is the most commonly performed aesthetic operation in the Unites States annually. With the increasing popularity of gel implants, optimal incisional length for specific implant volumes becomes a factor to consider. Our study is the first, to date, to measure optimal incisional length for increasing Mentor smooth, round, moderate plus silicone implant volumes. Method: Three cadaver breasts were dissected in our anatomy laboratory. After dissection of a subpectoral pocket via an inframammary fold incision, time of implant insertion was measured for increasing volumes with the use of increasing incisional site lengths. Results: Values for increased incisions are as follows: 2.5-cm incision facilitated 100-cm3 implant (average time [AvgT] 76 seconds); 3-cm incision 100-cm3 implant (AvgT 32 seconds), 200 cm3 (AvgT 84.33 seconds); 3.5-cm incision 100-cm3 implant (AvgT 13.00 seconds), 200 cm3 (AvgT 22.00 seconds), 300 cm3 (AvgT 33.67 seconds); 4-cm incision 100-cm3 implant (AvgT 5.67 seconds), 200 cm3 (AvgT 11.33 seconds), 300 cm3 (AvgT 21.33 seconds), 400 cm3 (AvgT 26 seconds); 4.5-cm incision 100-cm3 implant (AvgT 5 seconds), 200 cm3 (AvgT 15.17 seconds), 300 cm3 (AvgT 19.67 seconds), 400 cm3 (AvgT 26 seconds), 500 cm3 (AvgT 39.67 seconds), 600 cm3 (AvgT 59.33 seconds), 700 cm3 (AvgT 78.67 seconds); 5-cm incision 100-cm3 implant (AvgT 1 second), 200 cm3 (AvgT 3.67 seconds), 300 cm3 (AvgT 8 seconds), 400 cm3 (AvgT 13 seconds), 500 cm3 (AvgT 19.33 seconds), 600 cm3 (AvgT 23.33 seconds), 700 cm3 (AvgT 28 seconds), 800 cm3 (AvgT 33 seconds). Conclusion: Based on our results, the optimal incision size for increasing Mentor smooth, round, moderate plus volumes is as follows: 2.5 cm for 100-cm3 implant, 3 cm for 200-cm3 implant, 3.5 cm for 300-cm3 implant, 4 cm for 400-cm3 implant, 4.5 cmfor 500- to 700-cm3 implant, and 5 cm for 800-cm3 implant. This guideline can be used to provide the most aesthetic results without tissue compromise. [ABSTRACT FROM AUTHOR]

Initial Phase 3 studies demonstrated liposomal bupivacaine was superior to placebo for pain control after bunionectomy and hemorrhoidectomy.19,20 Later studies compared liposomal bupivacaine with active comparators within other surgical disciplines. The only true contraindication to the use of liposomal bupivacaine is for obstetric paracervical block anesthesia, due to the observation that bupivacaine HCl used for this indication has resulted in fetal bradycardia and death.18 However, liposomal bupivacaine should be avoided in all pregnant women due to effects observed during embryogenesis in animal studies. As with bupivacaine HCl, there appears to be a prolonged duration of action of liposomal bupivacaine when used for regional nerve blocks compared with local infiltration. Ultrasound-guided subcostal transversus abdominis plane blocks with liposomal bupivacaine vs. non-liposomal bupivacaine for postoperative pain control after laparoscopic hand-assisted donor nephrectomy: a prospective randomised observer-blinded study. [Extracted from the article]

Breast animation deformity (BAD) has been reported to occur after submuscular implant placement following breast augmentation and immediate breast reconstruction. Despite its apparent impact on patients' quality of life, BAD has only recently become a topic of general concern. Its incidence and etiology have yet to be established. The aim of this systematic review was to identify papers that clearly defined and classified BAD and described how the degree of animation was assessed. We performed a search in PubMed and Embase. Studies meeting the inclusion criteria that described BAD after implant-based breast augmentation or immediate breast reconstruction were included. After screening 866 publications, four studies were included: three describing BAD after breast augmentation and one describing BAD after immediate breast reconstruction. The median percentage of patients with some degree of BAD was 58%. The highest percentages were found in patients operated on using the Regnault technique or the dual-plane technique (73%-78%). The lowest percentages were found following the dual-plane muscle-splitting technique (30%) and the triple-plane technique (33%). We found no studies meeting the inclusion criteria that analyzed BAD after prepectoral implant placement. This review of the current literature suggests that the degree of BAD is proportional to the degree of muscle involvement. Evidence is scarce, and the phenomenon seems to be underreported. Future comparative studies are warranted. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • E. coli and R. erythropolis were infiltrated into the air-dried columns. • E. coli and R. erythropolis transport enhanced in the wettable sand. • E. coli retention enhanced in the water repellent sand. • R. erythropolis can be used for bioaugmentation practices in the dry vadose zone. Abstract Water protection and bioremediation strategies in the vadose zone require understanding the factors controlling bacterial transport for different hydraulic conditions. Breakthrough experiments were made in two different flow conditions: i) an initial bacteria pulse under ponded infiltration into dry sand (−15,000 cm); ii) a second bacteria pulse into the same columns during subsequent infiltration in constant water content and steady-state flow. Escherichia coli (E. coli) and Rhodococcus erythropolis (R. erythropolis) were used to represent hydrophilic and hydrophobic bacteria, respectively. Equilibrium and attachment/detachment models were tested to fit bromide (Br−) and bacteria transport data using HYDRUS-1D. Derjaguin-Landau-Verwey-Overbeek (DLVO) and extended DVLO (XDLVO) interaction energy profiles were calculated to predict bacteria sorption at particles. Adsorption of bacteria at air-water interfaces was estimated by a hydrophobic force approach. Results suggested greater retention of bacteria in water repellent sand compared with wettable sand. Inverse parameter optimization suggested that physico-chemical attachment of both E. coli and R. erythropolis was thousands of times lower in wettable than repellant sand and straining was 10-fold lower in E. coli for wettable vs repellant sand compared to the exact opposite by orders of magnitude with R. erythropolis. HYDRUS did not provide a clear priority of importance of solid-water or air-water interfaces in bacteria retention. Optimized model parameters did not show a clear relation to the (X)DLVO adsorption energies. This illustrated the ambivalence of (X)DLVO to predict bacterial attachment at solid soil particles of different wetting properties. Simultaneous analysis of mass recovery, numerical modeling, and interaction energy profiles thus suggested irreversible straining due to bacteria sizing as dominant compared to attachment to liquid-solid or liquid-air interfaces. Further studies are needed to distinguish straining mechanisms (i.e. pore structure or film straining) in different hydraulic conditions. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Bio-based VFA production is getting attention due to wide range usage area. • VFA production and recovery were reviewed in different aspects. • Enhanced VFA production and efficient recovery from waste are main challenges. • Bio-augmentation and in-line VFA recovery are seen as promising approaches. Abstract Bio-based volatile fatty acid (VFA) production from waste-stream is getting attention due to increasing market demand and wide range usage area as well as its cost-effective and environmentally friendly approach. The aim of this paper is to give a comprehensive review of bio-based VFA production and recovery methods and to give an opinion on future research outlook. Effects of operation conditions including pH, temperature, retention time, type of substrate and mixed microbial cultures on VFA production and composition were reviewed. The recovery methods in terms of gas stripping with absorption, adsorption, solvent extraction, electrodialysis, reverse osmosis, nanofiltration, and membrane contractor of VFA were evaluated. Furthermore, strategies to enhance bio-based VFA production and recovery from waste streams, specifically, in-line VFA recovery and bioaugmentation, which are currently not used in common practice, are seen as some of the approaches to enhance bio-based VFA production. [ABSTRACT FROM AUTHOR]

Background: an increase in the number of massive weight loss patients resulted in increase of body contouring surgery including breast reshaping. Aim of the study: it was to compare two procedures of augmentation skin mastopexy augmentation skin glandular mastopexy with analysis and evaluation of the final aesthetic results. Patients and Methods: forty female patients after massive weight loss patients were included in this study, divided in to two groups. 20 patients underwent augmentation skin mastopexy (A) and the other 20 patients underwent augmentation skin-glandular mastopexy (B). Augmentation was done through implant. Breast measurements and aesthetic outcome were assessed. Results: both groups showed well improvement in breast shape, volume, and projection with no significant difference regards patient satisfaction and expectations and measurements. Conclusion: augmentation mastopexy as a combined procedure is a good solution for breast ptosis after massive weight loss. Skin glandular mastopexy is the same as skin mastopexy but it showed fewer complications, no revision, and more satisfaction than skin mastopexy. [ABSTRACT FROM AUTHOR]

Three up-flow anaerobic sludge blanket bioreactors treating wastewater containing 2 mg L −1 oxytetracycline (OTC) were used to examine the enhancement of bio-augmentation (BA) tactics on the resistance and resilience of the anammox performance. The BA tactics were carried out by the BA-addition and BA-exchange modes, and the optimized mode was first proposed. The results showed that prior to OTC suppression, excellent anammox performance was observed in the reactors, with a total nitrogen removal efficiency (TNRE) above 92.0% and a nitrogen removal rate (NRR) greater than 3.3 kg N m −3  d −1 . Upon inhibition by continuous OTC, the NRR decreased to 2.0 ± 0.6 kg N m −3  d −1 without BA assistance, 2.3 ± 0.6 kg N m −3  d −1 for BA-addition mode assistance and 2.8 ± 0.3 kg N m −3  d −1 for the BA-exchange mode one. Redundancy analysis indicated that BA mode regulation may maintain system stability by microbial communities gradual acclimation and thus functional bacteria to be potential antibiotic resistance species is the main reason for performance stabilization. Our findings elucidate for the first time that the BA-exchange mode is feasible to remit 2 mg L −1 OTC-stressed anammox performance. [ABSTRACT FROM AUTHOR]

Science fiction often portrays future AI technology as having sophisticated emotional intelligence skills to the degree where technology can develop compassion. But where are we today? The authors provide insight into artificial emotional intelligence (AEI) and present three major areas of emotion—recognition, generation, and augmentation—needed to reach a new emotionally intelligent epoch of AI. [ABSTRACT FROM AUTHOR]

Background: The medical tourism industry, and in particular cosmetic tourism for breast augmentation, is becoming an increasingly popular global phenomenon. The objective of this study is to determine the extent of medical literature and the patient risk profiles associated with cosmetic tourism for breast augmentation both locally and abroad. Data sources: OVID MEDLINE, OVID Embase, Cochrane Central and Proquest electronic databases. Methods: The search was conducted through to April 2017. Studies pertaining entirely or partly to cosmetic tourism for breast augmentation were considered for inclusion. Exclusion criteria included non‐English articles, studies relating to non‐cosmetic or non‐implant breast augmentation, and studies that did not separately report on findings associated with breast augmentation abroad. Results: We identified 17 observational studies. Common destinations included Europe, South America and South East Asia. Infectious complications were common. Wound dehiscence and aesthetic dissatisfaction also featured. Catastrophic outcomes such as sepsis, intubation and ventilation, radical bilateral mastectomy, irreversible hypoxic brain injury and death were also reported. There were expectations that home country health systems would treat complications and provide non‐medically indicated revision procedures. The burden on home country health systems was evident from a public health perspective. Conclusion: Determining the extent of cosmetic tourism for breast augmentation, including outcomes and complications, will help to inform Australian patients who this seek procedure abroad. Furthermore, it will aid in better understanding the health system implications and may help to guide future research and public health interventions both locally and internationally. [ABSTRACT FROM AUTHOR]

BACKGROUND: Implant-based breast augmentation is one of the most frequently performed operations in plastic surgery worldwide, for aesthetic and reconstructive reasons. Capsular fibrosis is the most common long-term foreign body response after breast implant augmentation. OBJECTIVE: To compare the occurrence of capsular contracture in aesthetic and reconstructive-cancer patients, including those patients who received radiotherapy prior to breast reconstruction with implants. METHODS: We conducted a retrospective evaluation of 319 patients who underwent breast implant revision between Jan 2000 and Oct 2016. The patient group was comprised of 175 reconstructive-cancer patients and 144 patients who underwent operation for aesthetic reasons. The occurrence of capsular fibrosis, other complications and the time-period between implantation of breast implants and revision surgery (TP) was analyzed. RESULTS: For all 319 patients the mean TP was 7.9 years (7.86±0.45). The most common complication in all revisions was capsular fibrosis (65.1% of all revisions). In aesthetic patients with capsular fibrosis the mean TP was 11.9 years (11.89±0.95, p < 0.001). This mean TP was significantly higher than the mean TP of 6.1 years (6.13±0.56, p < 0.001) in breast cancer patients with capsular fibrosis. Preoperatively irradiated cancer patients had a mean TP of 6.2 years (6.17±0.95), compared to a mean TP of 5.1 years (5.07±0.19, p = 0.051) in non-irradiated cancer patients, which was not significantly different. CONCLUSIONS: We found that aesthetic patients exhibit a significantly higher mean TP compared to breast cancer patients, suggesting that reconstructive-cancer patients in general develop capsular fibrosis earlier. Despite the literature, we did not find a significant influence of preoperative radiotherapy on the occurrence of capsular fibrosis in reconstructive-cancer patients. Further clinical studies need to be conducted to identify methods to decrease the risk of developing capsular fibrosis. [ABSTRACT FROM AUTHOR]

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Background This analysis presents patient-reported outcomes of breast augmentation procedures performed in Singapore using an inframammary fold incision and the "5 Ps" best practice principles for breast augmentation. These data are the first of their kind in Southeast Asian patients. Methods Through a retrospective chart review, patients who underwent primary breast augmentation with anatomical form-stable silicone gel breast implants using an inframammary fold incision were followed for ≥6 months postoperatively. The BREAST-Q Augmentation Module (scores standardized to 0 [worst] - 100 [best]) and Patient and Observer Scar Assessment Scale (POSAS; 1 [normal skin] to 10 [worst scar imaginable]) were administered. Responses were summarized using descriptive statistics. Patient-reported events were collected. Results Twenty-two Southeast Asian patients (mean age, 35.1 years) completed ≥1 postoperative BREAST-Q and POSAS assessment and were assessed 11 months to 5.5 years postoperatively. The mean postoperative BREAST-Q satisfaction with breasts and psychosocial well-being scores were 69.2 and 84.0, respectively. The mean POSAS score for their overall opinion of the scar was 4.2; the mean scores for all scar characteristics ranged from 1.2 to 4.2. Over 90% of patients (20/22) said that they would recommend the procedure. Patient complaints following surgery included anisomastia (possibly pre-existing; n=2), sensory loss at the nipple (n=2) or around the nipple (n=3), scarring (n=4), and slight capsular contracture (n=1). No patients required reoperation. Conclusions Southeast Asian patients reported high long-term satisfaction scores on the BREAST-Q scale and with their scar characteristics following breast augmentation using an inframammary fold incision, and nearly all said they would recommend this procedure. No reoperations were necessary in patients assessed for up to 5.5 years postoperatively. [ABSTRACT FROM AUTHOR]

Many attempts have been made to augment breasts using injectable materials; however, various complications are associated with these materials. Aquafilling gel (Aquafilling, Poděbrady, Czech Republic) is a new soft tissue filler that has been used as an implant material for the face and lip and recently for breast augmentation. This article describes 3 cases of augmentation mammoplasty using Aquafilling gel, focusing on their complications and radiologic features. [ABSTRACT FROM AUTHOR]

Stem cell-based therapies have been widely used for their abilities to repair and regenerate different types of tissues and organs in cosmetic and plastic surgeries. It involves the clinical application of different types of stem cells. Different stem cells have been reported to be applicable in different areas of cosmetic surgeries like face lipoatrophy, skin rejuvenation, breast enhancement, and body contouring. However, adipose-derived stem cells remain the most widely used by cosmetic surgeons as they have the potential and capability to differentiate into mesenchymal, ectodermal, and endodermal lineages and are easily accessible to harvest. The purpose of this review is to summarize available applications of stem in cosmetic and plastic surgeries. [ABSTRACT FROM AUTHOR]

Summary Concepts regarding the best way to treat a surgical wound vary, in literature, ranging from no dressing use to dressing maintenance for 24 to 48 hours or until suture removal. This study aimed to evaluate the influence of the length of dressing maintenance after breast augmentation with implants on cutaneous colonization and surgical site infection. This is a two-arm, parallel group, randomized clinical trial. Eighty patients who were candidates for augmentation mammoplasty with silicone implants were randomly allocated to two groups, in which the dressing was removed on postoperative day 1 (group A, n = 40) or postoperative day 6 (group B, n = 40). Cutaneous colonization was examined by culturing samples collected before and after dressing removal. The criteria defined by the Centers for Disease Control and Prevention were used to assess surgical site infection. No significant difference regarding cutaneous colonization was observed between groups before dressing application. On postoperative day 6, significantly more bacterial growth was observed in group A ( p  = 0.01). No surgical site infection occurred. We concluded that maintaining the dressing for 6 days led to a lower cutaneous colonization but did not influence surgical site infection rates. [ABSTRACT FROM AUTHOR]

Background: cosmetic breast procedures, as well as implants, are increasingly being performed and many women who had undergone cosmetic operation present for mammographic screening. There are three general categories of cosmetic surgery performed on the breast including breast augmentaion, breast reduction and breast reconstruction. A wide variety of breast implants which being used in most of augmentation surgeries are available on the market and are broadly categorized by lumen number, filler type, and surface contour. Aim of the work: this study aimed to illustrate the role of different imaging modalities in postoperative cosmetic breast surgery. Results: MRI is the modality of choice for evaluation of silicone breast implant integrity. MRI is not recommended as a screening modality for implant rupture in asymptomatic women with breast implants. Conclusion: Since the number of cosmetic breast surgeries is increased with increased number of patients present for assessing the operation as example; implant integrity; a radiologist should be familiar with the spectrum of appearances of the complications. The imaging appearances of the cosmetic breast as common breast implants and their complications using different radiological modalities as mammogram, ultrasound and MRI are varied. Recommendations: In symptomatic patients, after an initial evaluation with mammography and USG, non-contrast MRI is recommended to rule out the diagnosis of rupture. Dynamic contrast-enhanced MRI could be indicated in patients with breast reconstruction surgeries after mastectomy for breast cancer or in breast implant patients with suspicious masses. [ABSTRACT FROM AUTHOR]

Breast augmentation with silicone-gel implants is one of the most commonly performed plastic surgery procedures. Breast implant rupture is one of the possible late complications after both augmentation and reconstruction procedures. In this paper, we would like to discuss 4 case reports of silicone-gel implant rupture following reconstructive and cosmetic breast surgery. [ABSTRACT FROM AUTHOR]