162 results on '"Brett T, Phillips"'
Search Results
2. 35. Linguistic Analysis of Race and Gender Bias in Narrative Letters of Recommendation for Plastic Surgery Residency Applicants
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Victoria N. Yi, BA, J. Eleanor Seo, BS, Colleen McDowell, AA, Brett T. Phillips, MD, MBA, Kristen M. Rezak, MD, FACS, Alexander C. Allori, MD, MPH, and Ashit Patel, MB ChB, FACS
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Surgery ,RD1-811 - Published
- 2024
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3. Flipping Tradition on Its Head: A Single-Institution Study on United States Medical Licensing Examination Step Order
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Steven L. Zeng, BA, Raiven Harris, BA, William M. Tian, BS, Emmanuel O. Emovon, BS, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Abstract
Summary:. Given the recent change in Step 1 grading, medical students are faced with decisions surrounding the optimal Step examination order and timing. There is a current lack of guidance outside commonly used United States Medical Licensing Examination study blogs. The aim of this study was to characterize current practices in Step examination order and understand the factors influencing student examination preference. To gather data, we used a 24-item survey and electronically distributed it through three separate email requests to medical students. Participants included medical students (MS1-4) attending a single institution, interested in a surgical residency. In total, 56 students responded to the survey (response rate of 20%). Most students (63.6%) opted to take Step 2 before Step 1. Justifications included the perceived importance of Step 2 for residency applications (33.3%), the change to pass/fail grading (27.0%), the relevance of Step 2 after rotations (27.0%), and a desire to obtain a Step 2 score earlier (7.9%). Step examination order did not lead to differences in Step 2 score (P = 0.459), time used to prepare for Step 1 (P = 0.396), or time used to prepare for Step 2 (P = 0.078). Due to the perceived importance of Step 2, most medical students at our institution who are interested in pursuing a surgical residency are reversing the traditional Step examination order. As this may represent a national trend, additional work needs to be done to provide guidance to medical students and identify the optimal step examination testing strategy.
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- 2024
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4. Synchronous Abdominal Wall and Small Bowel Transplantation: Critical Insights at 4-Year Follow-up
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Nicholas C. Oleck, Ralph F. Erdmann, Kadiyala V. Ravindra, Debra L. Sudan, Brett T. Phillips, Suhail K. Mithani, Detlev Erdmann, and Andrew Atia
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abdominal wall transplant ,VCA ,abdominal wall reconstruction ,Surgery ,RD1-811 - Abstract
This 4-year follow-up of synchronous abdominal wall vascular composite allotransplantation (AW-VCA) and small bowel transplantation reveals novel insights and innovations in abdominal wall VCA. The case, involving a 37-year-old male Army veteran, showcases the benefits of AW-VCA in addressing loss of abdominal domain in intestinal transplantation (ITx). The events leading to ultimate rejection of both the AW-VCA and small bowel graft at 4 years highlights the complex interplay between graft survival, patient compliance, and immunosuppressive management. Notably, a significant discordance between AW-VCA and ITx rejection patterns was identified, questioning the reliability of skin components in AW-VCA as early indicators of ITx rejection. Furthermore, the behavior of the vascularized abdominal fascia, observed postexcision of the small bowel graft, offers new understanding of the immunologic response to fascia-only grafts. This follow-up emphasizes the complexities of graft survival, patient compliance, and immunosuppressive management, underscoring the need for ongoing research and innovation in the field.
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- 2024
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5. D66. Linguistic Analysis of Race and Gender Bias in Narrative Letters of Recommendation for Plastic Surgery Residency Applicants
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Victoria N. Yi, BA, J. E. Seo, BS, Colleen McDowell, AA, Brett T. Phillips, MD, MBA, Kristen Rezak, MD, Alexander C. Allori, MD, MPH, and Ash Patel, MB ChB, FACS
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Surgery ,RD1-811 - Published
- 2024
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6. Defining Predictors of Future Academic Productivity in Plastic Surgery Residency
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Victoria A. Wickenheisser, MD, Sonali Biswas, MS, Caitlin Marks, MD, Yisong Geng, PhD, MBA, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Abstract
Background:. Research is a valued component of applications to plastic surgery residency. No prior studies have explored factors associated with increased resident research productivity. This study aims to compare the academic productivity levels of plastic surgery residency graduates based on their pre- and postresidency experiences. Methods:. Residents graduating in 2019 and 2020 were identified from integrated programs. Metrics collected included the number of publications in medical school and residency. Descriptive statistics were completed along with linear regressions to evaluate the impact of these on academic productivity. Results:. A total of 221 residents from the classes of 2019 and 2020 were included. Most residents completed fellowship (75.9%) although less than half went on to academic practice (42.3%). Approximately one in five residents obtained secondary degrees (17.4%). Subjects averaged 3.15 (N = 208, SD = 4.51) publications while in medical school and 8.1 publications during residency (N = 209, SD = 10.0). For h-index calculated at the end of residency, having dedicated medical school research time was the only statistically significant factor (coefficient = 2.96, P = 0.002). Conclusions:. Plastic surgery residents published more often as first authors and overall during residency than medical school, indicating increased research involvement and leadership. The present study builds upon prior studies by confirming the importance of dedicated medical school research time and its lasting impact. Understanding the associations of academic factors with increased research productivity in residency is relevant for both applicants and programs evaluating residency candidates.
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- 2023
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7. Social Media Usage by United States Plastic Surgery Subspecialty Fellowship Programs
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William M. Tian, BSE, Amanda R. Sergesketter, MD, Victoria N. Yi, BA, J. Alexander Sizemore, BS, Sydney M. Record, BA, Steven L. Zeng, BA, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Abstract
Background:. Social media can be a powerful tool for plastic surgery training programs. Previous studies have shown the value social media may have in integrated residency program recruitment and program reputation. These findings may generalize to fellowship programs, but this space has not been comprehensively studied to date. Therefore, this study aims to characterize plastic surgery fellowship programs’ social media usage and identify subsequent opportunities for program leadership to generate engagement. Methods:. United States plastic surgery fellowship programs in four major subspecialties (hand, microsurgery, craniomaxillofacial, and aesthetic) were identified and evaluated for social media presence on Instagram, Facebook, and Twitter. Platform-specific parameters were collected and statistically analyzed in aggregate. Results:. There were a total of 25 Instagram accounts, four Facebook accounts, and three Twitter accounts across all investigated subspecialties. Hand surgery had the greatest social media presence on Instagram (19.5%) and Twitter (3.4%). Microsurgery had the greatest presence on Facebook (4.7%). Between 2015 and 2022, Instagram was the platform with the greatest increase in adoption by fellowship programs. Geographically, microsurgery and craniomaxillofacial accounts were primarily owned by Midwest programs (66.7%, 100%), and aesthetic primarily by programs in the South (83.3%). Number of Instagram posts and followers were not significantly correlated with hospital reputation (P = 0.12, P = 0.63). Conclusions:. Social media is underutilized by plastic surgery fellowship programs. While Instagram metrics such as posts and followers are not correlated with hospital reputation, the skewed distributions of fellowship accounts, both geographically and across platforms, represent areas of potential growth.
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- 2023
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8. Complications and Hardware Failure Following Synthetic Cranioplasty Implants and Free Flap Coverage
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Nicholas C. Oleck, MD, Kevin K. Zhang, BA, Kristina Dunworth, B.S., Ronnie L. Shammas, MD, Jonas A. Nelson, MD, MPH, Robert J. Allen, Jr., MD, Evan Matros, MD, MMSc, Amanda R. Sergesketter, MD, Hani I. Naga, MD, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2024
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9. Virtual Subinternships in the COVID Era: Lessons Learned from Three Institutional Experiences
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Meera Reghunathan, MD, Paige K. Dekker, BA, Caitlyn C. Belza, BS, Kevin G. Kim, BS, Brett T. Phillips, MD, Kenneth L. Fan, MD, David A. Brown, MD, PhD, Amanda A. Gosman, MD, and Samuel H. Lance, MD
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Surgery ,RD1-811 - Abstract
After the cessation of all in-person visiting rotations during the coronavirus 2019 pandemic, many programs developed virtual rotations as an alternative for the recruitment and education of prospective applicants. In this study, we developed a consortium of three institutions each with a unique virtual subinternship and prospectively surveyed participating students in order to reflect and improve upon future rotations. All students participating in virtual subinternships at three institutions were administered the same pre subinternship and post subinternship electronic surveys. Subinternship curricula were developed independently at each respective institution. Fifty-two students completed both surveys, for an overall response rate of 77.6%. Students’ primary objectives were to evaluate their fit with the program (94.2%), interact with residents (94.2%), gain faculty mentorship (88.5%), and improve didactic knowledge (82.7%). Postrotation surveys revealed that over 73% of students reported having met all of these objectives over the course of the rotation. On average, students ranked programs 5% higher overall after the rotation (P = 0.024). Postrotation results showed that the majority (71.2%) of students perceived the virtual subinternship as slightly less valuable than in-person subinternships but that all students would participate in a virtual subinternship again. Student objectives can be successfully met using the virtual format for subinternships. The virtual format is also effective in enhancing the overall perception of a program and its residents. Although students still prefer in-person subinternships, our results suggest that virtual rotations are more accessible and very capable of meeting student goals.
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- 2023
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10. Early Simultaneous Cross Facial Nerve Graft and Masseteric Nerve Transfer for Facial Paralysis after Tumor Resection
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Amanda R. Sergesketter, MD, Ronnie L. Shammas, MD, Lisa A. Massa, PT, WCS, Brett T. Phillips, MD, MBA, and Jeffrey R. Marcus, MD
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Surgery ,RD1-811 - Abstract
Background:. We describe a new approach for facial reanimation after skull base tumor resection with known facial nerve sacrifice, involving simultaneous masseter nerve transfer with selective cross facial nerve grafting (CFNG) within days after tumor surgery. This preliminary study compared outcomes of this approach versus a staged procedure involving a masseter nerve “babysitter” performed in a delayed timeline. Methods:. Patients undergoing masseter nerve transfer and CFNG for facial paralysis after skull base tumor resection were consented to participate in video interviews. Facial Clinimetric Evaluation (FaCE) Scale (0–100) patient-reported outcome, eFACE, and Facial Grading Scale scores were compared. Results:. Nine patients had unilateral facial paralysis from resection of a schwannoma (56%), acoustic neuroma (33%), or vascular malformation (11%). Five underwent early simultaneous CFNG and masseter nerve transfer (mean 3.6 days after resection), whereas four underwent two-stage reanimation including a babysitter procedure (mean 218 days after resection). Postoperative FaCE scale and Facial Grading Scale scores were similar in both groups (P > 0.05). Postoperative mean eFACE scores were similar for both groups for smile (early: 71.5 versus delayed: 75.5; P = 0.08), static (76.3 versus 82.1; P = 0.32), and dynamic scores (59.7 versus 64.9; P = 0.19); however, synkinesis scores were inferior in the early group (76.4 versus 91.1; P = 0.04). Conclusions:. Early simultaneous masseter nerve transfer and CFNG provides reanimated movement sooner and in fewer stages than a staged approach in a delayed timeline. The early technique appears to result in similar clinician- and patient-reported outcomes compared with delayed procedures; however, in this preliminary study, the early approach was associated with greater synkinesis, meriting further investigation.
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- 2023
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11. Down with the Bean Bag: A Multi-institutional Experience with Total Latissimus Muscle Free Flap Harvest in the Supine Position
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John W. Shuck, MD, John A. Felder, MD, Ronnie L. Shammas, MD, Edward I. Chang, MD, Jesse C. Selber, MD, and Brett T. Phillips, MD
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Surgery ,RD1-811 - Abstract
Summary:. The latissimus muscle continues to be a head to toe workhorse in free tissue transfer for coverage of large defects. Traditional full muscle harvest is performed in the lateral decubitus position which is frequently suboptimal or requires position change based on the recipient site and laterality. We present a multi-institutional case series of full muscle flap harvest from the supine position for a range of defects in 32 patients. The relevant operative setup and technique are described. In our experience, supine harvest has become the preferred open harvest technique compared to lateral positioning for both optimal exposure of the pedicle and reduction in operating time.
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- 2023
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12. Predicting Final Implant Volume in Two-stage Prepectoral Breast Reconstruction
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Andrew N. Atia, MD, Amanda R. Sergesketter, MD, Miranda X. Morris, MEng, Sonali Biswas, BS, Gloria Zhang, BS, Hannah C. Langdell, MD, Andrew W. Hollins, MD, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Abstract
Background:. Two-stage implant-based breast reconstruction remains the most commonly performed reconstructive modality following mastectomy. Although prior studies have explored the relationship between tissue expander (TE) features and permanent implant (PI) size in subpectoral reconstruction, no such study exists in prepectoral reconstruction. This study aims to identify pertinent TE characteristics and evaluate their correlations with PI size for prepectoral implant-based reconstruction. Methods:. This study analyzed patients who underwent two-stage prepectoral tissue expansion for breast reconstruction followed by implant placement. Patient demographics and oncologic characteristics were recorded. TE and PI features were evaluated. Significant predictors for PI volume were identified using linear and multivariate regression analyses. Results:. We identified 177 patients and 296 breast reconstructions that met inclusion criteria. All reconstructions were performed in the prepectoral plane with the majority using acellular dermal matrix (93.8%) and primarily silicone implants (94.3%). Mean TE size was 485.4 cm3 with mean initial fill of 245.8 cm3 and mean final fill of 454.4 cm3. Mean PI size was 502.9 cm3 with a differential fill volume (PI-TE) of 11.7 cm3. Multivariate analysis identified significant features for PI size prediction, including TE size (R2 = 0.60; P < 0.0001) and TE final fill volume (R2 = 0.57; P < 0.0001). The prediction expression for TE final fill and TE size was calculated as 26.6 + 0.38*(TE final fill) + 0.61*(TE size). Conclusions:. TE size and final expansion volume were significant variables for implant size prediction. With prepectoral implant placement gaining popularity, the predictive formula may help optimize preoperative planning and decision-making in prepectoral reconstructions.
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- 2023
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13. Defining the Value of Breast Reconstruction Surgeons: Quantifying Clinical Encounter and Operative Volume at an Academic Center
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Amanda R. Sergesketter, MD, Lily R. Mundy, MD, Hannah C. Langdell, MD, Ronnie L. Shammas, MD, Yisong Geng, MD, PhD, MBA, Kristen Rezak, MD, Geoffroy C. Sisk, MD, Brett T. Phillips, MD, MBA, and Scott T. Hollenbeck, MD
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Surgery ,RD1-811 - Abstract
Background:. Despite growing rates of postmastectomy breast reconstruction, the time contribution of breast reconstruction surgeons in comprehensive breast cancer care is often poorly accounted for by hospital and healthcare systems. This study models encounter volume and operative time utilization of breast reconstruction surgeons among patients undergoing postmastectomy breast reconstruction. Methods:. All clinical encounters and operative time from a consecutive sample of breast cancer patients undergoing mastectomy and reconstruction were analyzed. Encounter volume and operative time utilization less than or equal to 4 years after diagnosis were modeled over time. Results:. A total of 5057 breast cancer encounters were analyzed. Mean (SD) clinical encounter volume was 45.9 (28.5) encounters per patient, with encounter volume varying by specialty [plastic surgery: 16.5; medical oncology: 15.9; breast surgery: 7.2; radiation oncology: 6.3 mean encounters]. Receipt of adjuvant radiation, neoadjuvant chemotherapy, and major complications during reconstruction predicted higher encounter volume. Mean (SD) operative time utilization was 702 (317) minutes per patient [plastic surgery: 547 (305); breast surgery: 155 (71) minutes]. While both encounter volume and operative time for radiation oncologists and breast surgeons, respectively, were concentrated in the first year after diagnosis, medical oncologists and plastic surgeons sustained high clinical and operative time utilization 3 years after breast cancer diagnosis. Conclusions:. Encounter volume and operative time utilization with breast reconstruction surgeons persist 3 years after a breast cancer diagnosis and are tied to treatment characteristics and incidence of reconstruction complications. Institutional- and system-level resource allocation must account for the complex and lengthy duration of care inherent to breast reconstruction care.
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- 2022
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14. 50. Evidence-based Medicine: Systemic Perioperative Antibiotic Prophylaxis for Prevention of Surgical-site Infections in Plastic and Reconstructive Surgery
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Kevin M. Klifto, DO, PharmD, Alexandria C. Rydz, PharmD, Sonali Biswas, MPHS, Charles Scott Hultman, MD, MBA, Detlev Erdmann, MD, PhD, MHS, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2023
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15. Textbook Outcomes in DIEP Flap Breast Reconstruction: An International Delphi Study to Establish an Expert-Based Consensus
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Ronnie L. Shammas, Geoffroy C. Sisk, Christopher J. Coroneos, Anaeze C. Offodile, II, Rene D. Largo, Sonali Biswas, Nicholas L. Berlin, Summer E. Hanson, Adeyiza O. Momoh, Jonas A. Nelson, Evan Matros, Kristen Rezak, and Brett T. Phillips
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Surgery ,RD1-811 - Published
- 2023
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16. 38. Social Media Usage by Plastic Surgery Fellowship Programs: Are There Gaps in Opportunities for Engagement?
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William M. Tian, BSE, Alex Sizemore, BS, Victoria Yi, BA, Steven L. Zeng, BS, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2023
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17. Guideline Awareness Disparities in Plastic Surgery: A Survey of American Society of Plastic Surgeons
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Jess D. Rames, MD, MEng, Whitney O. Lane, MD, and Brett T. Phillips, MD, MBA, FACS
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Surgery ,RD1-811 - Abstract
Background:. The American Society of Plastic Surgeons (ASPS) clinical practice guidelines were constructed to help direct evidence-based surgical management in plastic surgery. Societal member awareness of the recommendations for breast reconstruction has yet to be studied among ASPS members. Methods:. Univariate and multivariate analyses were performed using electronic survey data from 243 ASPS members. Characteristics, including respondent demographics, practice distribution, and geographic locations, were correlated to the awareness of autologous and expander/implant-based reconstruction guidelines. Results:. Of the respondents, 52% and 35.7% reported awareness for autologous breast reconstruction and expander/implant-based reconstruction guidelines, respectively. Surgeons who performed more general and autologous breast reconstruction were more likely to be aware of autologous breast reconstruction and expander/implant-based guidelines (P = 0.0034 and 0.032). Autologous breast reconstruction guideline awareness was geographically disparate (P = 0.031), with greater awareness in the Northeast (OR, 4.5; 95% CI, 1.63–12.53; P = 0.01) and Southwest (OR, 3.91; 95% CI, 1.18–13.83; P = 0.01). Respondents with larger practice percentages of breast reconstruction and those with higher annual academic meeting attendance reported greater awareness of expander/implant-based guidelines (P = 0.044 and 0.040). Meeting attendance (OR, 2.14; 95% CI, 1.15–8.91; P = 0.022) and practice-based (OR, 3.14; 95% CI, 1.52–8.91; P = 0.027) awareness disparities were also appreciated on multivariate analysis. Conclusions:. Guideline awareness in plastic surgery varies by practice composition and geography. These findings can be used to help inform more targeted educational and implementation strategies in breast reconstruction. Clinical Question/Level of Evidence:. Quality Improvement/Level IV
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- 2022
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18. 26. Defining Predictors of Academic Productivity in Plastic Surgery Residency
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Victoria A. Wickenheisser, MD, Sonali Biswas, MS, Caitlin Marks, MD, Yisong Geng, PhD, MBA, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2023
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19. Consequences and Predictors of Prolonged Tissue Expander Duration in Breast Reconstruction
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Hannah C. Langdell, Amanda R. Sergesketter, Sonali Biswas, Miranda Morris, Gloria Zhang, Andrew Atia, and Brett T. Phillips
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Surgery ,RD1-811 - Published
- 2023
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20. An Ounce of Prediction is Worth a Pound of Cure: Risk Calculators in Breast Reconstruction
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Nicholas C. Oleck, MD, Sonali Biswas, BS, Ronnie L. Shammas, MD, Hani I. Naga, MD, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Abstract
Background:. Preoperative risk calculators provide individualized risk assessment and stratification for surgical patients. Recently, several general surgery–derived models have been applied to the plastic surgery patient population, and several plastic surgery–specific calculators have been developed. In this scoping review, the authors aimed to identify and critically appraise risk calculators implemented in postmastectomy breast reconstruction. Methods:. A systematic review of the literature was conducted. Included studies described the development of a novel risk calculator, or validation of an existing calculator, in postmastectomy breast reconstruction. Results:. In total, 4641 studies met criteria for title and abstract screening. Forty-seven were eligible for full-text review, and 28 met final inclusion criteria. The most common risk calculators included the Breast Reconstruction Risk Assessment score (n = 6 studies), modified frailty index (n = 3), Caprini score (n = 3), and ACS NSQIP calculator (n = 2). Calculators were applied to institutional data (n = 17), NSQIP (n = 6), and Tracking Outcomes in Plastic Surgery (n = 1) databases. Predicted outcomes included general postoperative complications (n = 17), venous thromboembolism/pulmonary embolism (n = 4), infection (n = 2), and patient reported outcomes (n = 2). Model accuracy was reported in 18 studies, and it varied significantly (accurate risk calculator 0.49–0.85). Conclusions:. This is the first study to provide a systematic review of available risk calculators for breast reconstruction. Models vary significantly in their statistical basis, predicted outcomes, and overall accuracy. Risk calculators are valuable tools that may aid in individualized risk assessments, preoperative counseling, and expectation management in breast reconstruction.
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- 2022
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21. Patient demand for plastic surgeons for every US state based on Google searches
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Jared A. Blau, Heather A. Levites, Brett T. Phillips, and Scott T. Hollenbeck
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Internet search ,Google ,Popularity ,Surgery markets ,Surgery ,RD1-811 - Abstract
Introduction: As a profession, plastic surgeons must meet the public demand for esthetic and reconstructive procedures. Patients search for physicians using Google, which offers insights into patient needs through their search history. Methods: The Google Trends Relative Search Volumes (RSV) were pulled for all searches for “plastic surgery” over 12 months. The number of active plastic surgeons per state was divided by Census Bureau population estimates to calculate the surgeons-per-capita value, or “surgical concentration.” The Google score divided by this concentration yields a “surgical demand index” for each state. Results: Florida, New York, and Connecticut had the greatest concentration of surgeons per ten-thousand people (0.220, 0.217, and 0.209, respectively), while Wyoming, Arkansas, and Vermont had the smallest (0.051, 0.071, 0.080). California exhibited the greatest number of Google searches (RSV=100), followed by Florida and Hawaii (RSV=95). Oregon (RSV=38), Virginia (RSV=52), and Alaska (RSV=58) had the fewest searches. The “surgical demand index” was greatest in Wyoming (1187.778), Oklahoma (993.751), and Arkansas (974.664) and smallest in Oregon (264.682), Virginia (320.716), and Connecticut (354.872). Conclusion: The distribution of US plastic surgeons is not homogeneous. The Google data suggest that some markets (e.g. Oregon) are saturated while others (e.g. Wyoming) have significant demand that is not met by the number of plastic surgeons in those states.
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- 2020
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22. Plastic Surgery Diversity through the Decade: Where We Stand and How We Can Improve
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J. Andres Hernandez, MD, MBA, Carmen I. Kloer, BA, Denisse Porras Fimbres, BS, RD, Brett T. Phillips, MD, MBA, and Linda C. Cendales, MD
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Surgery ,RD1-811 - Abstract
Background:. Several studies over the past decade have investigated diversity within the field of plastic surgery, yet it remains unclear if an increase has resulted. This study sought to review the status of diversity within plastic surgery over the last decade and form strategies for residency programs to increase diversity recruitment. Methods:. Data analysis of racial demographics from the Association of American Medical Colleges databases was completed for all medical students, integrated plastic surgery residency applicants, integrated plastic surgery residents, and academic faculty from 2010 to 2020. Proportional averages were analyzed comparing 5 year durations with heteroscedastic t-tests. Interviews were then conducted with medical school diversity and inclusion officers across the country and subsequent thematic analysis was completed. Finally, diversity recruitment recommendations were synthesized from interview data. Results:. There was no significant change in demographics of integrated plastic surgery applicants between 2010–2014 and 2015–2020. The only significant finding among integrated plastic surgery residents yielded a reduction in the “Hispanic/ Latino” group (4% -3%, P = 0.01). Faculty data showed an increase in “Hispanic/ Latino” (4% -5%, P < 0.01) and “other” (4% -5%, P = 0.02) groups with a reduction in “White” faculty members (74% -70%, P < 0.01). Final recommendations for diversity recruitment were then formed from diversity and inclusion officer interviews. Conclusions:. Continuous and sustainable work with respect to diversity and inclusion within plastic surgery has an opportunity for growth. Implementation of key recommendations by residency programs can change the face of our specialty going forward.
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- 2022
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23. 19. Augmenting our Training Paradigm: Formalizing Business Education during Plastic Surgery Residency
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Alexandria Mullikin, BS, Janel Ramkalawan, BA, Tara Thomason, BS, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2023
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24. Staying Close to Home: The Effects of COVID-19 on the Plastic Surgery Residency Match
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Andrew W. Hollins, MD, Gloria X. Zhang, BS, Jenna R. Stoehr, MD, Andrew Atia, MD, Amanda R. Sergesketter, MD, Victoria A. Wickenheisser, MD, Jason H. Ko, MD, MBA, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Abstract
Background:. The 2019 novel coronavirus created unique challenges for the integrated plastic surgery match. The goal of this study was to evaluate the trends of the 2020 and 2021 integrated plastic surgery match specifically related to the 2019 novel coronavirus. Methods:. Three separate individual surveys were designed for integrated plastic surgery program directors and applicants from the 2021 to 2020 match. The surveys were distributed to the email addresses of applicants that applied to our institution’s integrated residency program. Information of current interns and newly matched applicants from program websites and certified social media accounts were recorded. Results:. We received completed surveys from 19 of the 69 program directors for a response rate of 27.5%. The survey for the 2020 and 2021 match applicants was completed by 25 and 68 applicants, respectively, for a response rate of 6.1% and 21.9%. There was a significant difference in the average number of completed virtual subinternships between applicants that did and did not successfully match into plastic surgery (1.48 versus 0.36, P = 0.01). The rate of students matching at their home institution was the highest in 2021 at 26% compared to 2020 (18%) and 2019 (15%). Conclusions:. The results of this study demonstrate that applicants were more likely to match at programs with which they had established previous connections, including home institutions. Applicants also had a higher likelihood to match if they completed a virtual subinternship during the 2021 match. Learning points can be applied to the upcoming application cycle to improve the overall experience.
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- 2021
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25. Microscope-integrated Optircal Coherence Tomography Accurately Predicts Anastomotic Patency
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Jared A Blau, MD, MEd, Andrew Atia, MD, William Raynor, BS, Cynthia Toth, MD, Joseph Izatt, PhD, Anthony N Kuo, MD, and Brett T Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2022
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26. Trends in Patient-Reported Outcomes Reporting in Breast Reconstruction
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Sonali Biswas, Alexandria Mullikin, and Brett T. Phillips
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Surgery - Published
- 2023
27. Location, Location, Location: The Geographic Impact of Medical School on the Plastic Surgery Match
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Adam D. Glener, MD, Michael Lebhar, BS, J. Andres Hernandez, MD, MBA, Amanda R. Sergesketter, MD, Ronnie L. Shammas, MD, Roger W. Cason, MD, Sonali Biswas, BS, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Abstract
Background:. This resident application cycle posed academic leadership and applicants with an unprecedented challenge: how to virtually match applicants to mutually beneficial programs. The authors sought to refer to previous years' data, specifically geographic trends, to better inform both program directors and applicants. The authors hypothesized that geography, as it pertains to the transition from medical school to residency, impacts match patterns. Methods:. The study was designed as a cross-sectional analysis including all current integrated plastic surgery residents. The independent websites of all accredited integrated plastic surgery programs were then queried for the desired demographic resident information. Additionally, as an illustrative endpoint, geospatial heat maps were generated to better understand geographic trends. Results:. All (n = 78) integrated plastic surgery programs and 953 residents were included in the study. Nearly half (47.2%) of current residents remain in the same geographic region in which they obtained their medical degree, with 26% and 17% remaining in the same state and institution, respectively. Students within all regions (North, South, Midwest, West) were more likely to stay within that region for residency (OR 2.59, 2.39, 2.09, 3.80, respectively). Students attending medical schools with affiliated integrated plastic surgery residencies have matched to programs with significantly higher Doximity rankings (p < 0.0001). Conclusions:. Matched integrated plastic surgery applicants are more likely to continue their training at institutions in closer geographic proximity to their medical schools. Students graduating from medical schools without affiliated integrated plastic surgery programs appear to be at a disadvantage during the match process.
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- 2021
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28. 5. PREDICTING ACADEMIC PERFORMANCE DURING PLASTIC SURGERY RESIDENCY: CAN STEP 2 SCORES RELIABLY REPLACE STEP 1?
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Amanda R. Sergesketter, MD, Ronnie L. Shammas, MD, Hannah C. Langdell, MD, Yisong Geng, MD, PhD, MBA, Kyle R. Eberlin, MD, Paige Fox, MD, Jason H. Ko, MD, MBA, Scott D. Lifchez, MD, Adeyiza O. Momoh, MD, Vu Nguyen, MD, Marissa Tenenbaum, MD, Vishal Thanik, MD, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2022
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29. P3. TRACKING COMPLICATIONS AND UNPLANNED HEALTHCARE UTILIZATION IN AESTHETIC SURGERY: A NATIONWIDE ANALYSIS OF 221,584 PATIENTS USING THE TOPS DATABASE
- Author
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Amanda R. Sergesketter, MD, Ronnie L. Shammas, MD, Shen Yin, PhD, Howard Levinson, MD, Evan Matros, MD, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2022
- Full Text
- View/download PDF
30. Tracking Complications and Unplanned Healthcare Utilization in Aesthetic Surgery: An Analysis of 214,504 Patients Using the TOPS Database
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Amanda R. Sergesketter, Ronnie L. Shammas, Yisong Geng, Howard Levinson, Evan Matros, and Brett T. Phillips
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Surgery - Published
- 2023
31. Delphi survey of intercontinental experts to identify areas of consensus on the use of indocyanine green angiography for tissue perfusion assessment during plastic and reconstructive surgery
- Author
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Rutger M. Schols, Fernando Dip, Emanuele Lo Menzo, Nicholas T. Haddock, Luis Landin, Bernard T. Lee, Paloma Malagón, Jaume Masia, David W. Mathes, Maurice Y. Nahabedian, Peter C. Neligan, Martin I. Newman, Brett T. Phillips, Gemma Pons, Tim Pruimboom, Shan Shan Qiu, Lucas M. Ritschl, Warren M. Rozen, Michael Saint-Cyr, Seung Yong Song, René R.W.J. van der Hulst, Mark L. Venturi, Apinut Wongkietkachorn, Takumi Yamamoto, Kevin P. White, Raul J. Rosenthal, MUMC+: MA Plastische Chirurgie (9), RS: NUTRIM - R2 - Liver and digestive health, Plastische Chirurgie (PLC), MUMC+: MA AIOS Heelkunde (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, and MUMC+: MA Plastische Chirurgie (3)
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Indocyanine Green ,Perfusion ,Reconstructive Surgical Procedures/methods ,Angiography ,Humans ,Female ,Breast Neoplasms ,Surgery ,Plastic Surgery Procedures ,Angiography/methods ,Mastectomy - Abstract
BACKGROUND: In recent years, indocyanine green angiography (ICG-A) has been used increasingly to assist tissue perfusion assessments during plastic and reconstructive surgery procedures, but no guidelines exist regarding its use. We sought to identify areas of consensus and non-consensus among international experts on the use of ICG-A for tissue-perfusion assessments during plastic and reconstructive surgery.METHODS: A two-round, online Delphi survey was conducted of 22 international experts from four continents asking them to vote on 79 statements divided into five modules: module 1 = patient preparation and contraindications (n = 11 statements); module 2 = ICG administration and camera settings (n = 17); module 3 = other factors impacting perfusion assessments (n = 10); module 4 = specific indications, including trauma debridement (n = 9), mastectomy skin flaps (n = 6), and free flap reconstruction (n = 8); and module 5 = general advantages and disadvantages, training, insurance coverage issues, and future directions (n = 18). Consensus was defined as ≥70% inter-voter agreement.RESULTS: Consensus was reached on 73/79 statements, including the overall value, advantages, and limitations of ICG-A in numerous surgical settings; also, on the dose (0.05 mg/kg) and timing of ICG administration (∼20-60 seconds preassessment) and best camera angle (61-90o) and target-to-tissue distance (20-30 cm). However, consensus also was reached that camera angle and distance can vary, depending on the make of camera, and that further research is necessary to technically optimize this imaging tool. The experts also agreed that ambient light, patient body temperature, and vasopressor use impact perfusion assessments.CONCLUSION: ICG-A aids perfusion assessments during plastic and reconstructive surgery and should no longer be considered experimental. It has become an important surgical tool.
- Published
- 2022
32. Is Tissue Expansion Worth It? Comparative Outcomes of Skin-preserving versus Delayed Autologous Breast Reconstruction
- Author
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Brett T. Phillips, MD, MBA, Genevieve Mercier-Couture, MD, Amy S. Xue, MD, Carrie K. Chu, MD, MS, Mark V. Schaverien, MD, Jun Liu, PhD, Patrick B. Garvey, MD, Donald P. Baumann, MD, Charles E. Butler, MD, and Rene D. Largo, MD
- Subjects
Surgery ,RD1-811 - Abstract
Background:. The requirement for postmastectomy radiation therapy (PMRT) at the time of mastectomy is often unknown. Autologous reconstruction is preferred in the setting of radiotherapy by providing healthy vascularized tissue to the chest. To maximize mastectomy skin preservation, tissue expander (TE) placement maintains the breast pocket until definitive reconstruction. This study aims to compare outcomes of skin-preserving delayed versus standard delayed autologous breast reconstruction in the setting of PMRT. Methods:. A retrospective review of a prospective database was performed of two patient cohorts at a single center between 2006 and 2016. Inclusion criteria were locally advanced breast cancer patients who completed PMRT and free autologous reconstruction. Primary outcomes were major intraoperative and postoperative TE and flap complications. Results:. Over 10 years, 241 patients underwent mastectomy and PMRT. Standard delayed autologous breast reconstruction was performed in 131 breasts (non-TE group). Skin-preserving delayed autologous reconstruction was performed in 113 breasts (TE group). The TE group was associated with a higher incidence of intraoperative complications during flap reconstruction (P = 0.002) and had a higher venous thrombosis incidence than the non-TE cohort (P = 0.007). Other major postoperative complications were not significantly different between the two groups. TE patients had 7.5 times higher risk of intraoperative complications and an 18.6% TE loss rate. Conclusions:. We identified higher intraoperative flap complications and a high rate of TE loss in patients who underwent skin-preserving delayed autologous breast reconstruction. The benefit of mastectomy skin preservation needs to be weighed against the increased risk of TE loss and higher rates of flap thrombosis.
- Published
- 2020
- Full Text
- View/download PDF
33. Optimizing Intraoperative Evaluation of Mastectomy Skin Flap Viability
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Lily R. Mundy, MD, Amanda R. Sergesketter, MD, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2020
- Full Text
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34. Textbook outcomes in DIEP flap breast reconstruction: a Delphi study to establish consensus
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Ronnie L. Shammas, Geoffroy C. Sisk, Christopher J. Coroneos, Anaeze C. Offodile, Rene D. Largo, Arash Momeni, Nicholas L. Berlin, Summer E. Hanson, Adeyiza O. Momoh, Jonas A. Nelson, Evan Matros, Kristen Rezak, and Brett T. Phillips
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Cancer Research ,Oncology - Published
- 2022
35. 24. Location, Location, Location: The Geographic Impact of Medical School on the Plastic Surgery Match
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Adam D. Glener, MD, Michael Lebhar, BS, J. Andres Hernandez, MD, MBA, Amanda R. Sergesketter, MD, Ronnie L. Shammas, MD, Roger W. Cason, MD, Sonali Biswas, BS, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2021
- Full Text
- View/download PDF
36. Ethical, Legal, and Financial Considerations of Artificial Intelligence in Surgery
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Miranda X, Morris, Ethan Y, Song, Aashish, Rajesh, Malke, Asaad, and Brett T, Phillips
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General Medicine - Abstract
Machine learning systems have become integrated into some of the most vital decision-making aspects of humanity, including hiring decisions, loan applications, and automobile safety, to name just a few. As applications increase in both gravity and complexity, the data quality and algorithmic interpretability of the systems must rise to meet those challenges. This is especially vital for navigating the nuances of health care, particularly among the high stakes of surgical operations. In addition to inherent ethical challenges of enabling a “black box” system to influence decision-making in patient care, the creation of biased datasets leads to biased algorithms with the power to perpetuate discrimination and reinforce disparities. Transparency and responsibility are paramount to the implementation of artificial intelligence in surgical decision-making and autonomous robotic surgery. Machine learning has been permeating health care across diverse clinical and surgical contexts but continues to face sizable obstacles, including apprehension from patients and providers alike. To integrate the technology fully while upholding standard of care and patient-provider trust, one must acknowledge and address the ethical, financial, and legal implications of using artificial intelligence for patient care.
- Published
- 2022
37. Abstract 9: The Association between Sub-Internships and Match Rank Order for Integrated Plastic Surgery Programs
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Amanda R. Sergesketter, MD, Adam Glener, MD, Vu T. Nguyen, MD, Jason H. Ko, MD, MBA, Scott D. Lifchez, MD, Adeyiza Momoh, MD, Jeffrey R. Marcus, MD, Scott T. Hollenbeck, MD, and Brett T. Phillips, MD, MBA
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Surgery ,RD1-811 - Published
- 2020
- Full Text
- View/download PDF
38. Evidence-Based Medicine: Systemic Perioperative Antibiotic Prophylaxis for Prevention of Surgical-Site Infections in Plastic and Reconstructive Surgery
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Kevin M. Klifto, Alexandria C. Rydz, Sonali Biswas, C. Scott Hultman, Detlev Erdmann, and Brett T. Phillips
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Surgery - Published
- 2023
39. Virtual Subinternships in the COVID Era: Lessons Learned from Three Institutional Experiences
- Author
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Meera Reghunathan, Paige K. Dekker, Caitlyn C. Belza, Kevin G. Kim, Brett T. Phillips, Kenneth L. Fan, David A. Brown, Amanda A. Gosman, and Samuel H. Lance
- Subjects
Surgery - Abstract
After the cessation of all in-person visiting rotations during the coronavirus 2019 pandemic, many programs developed virtual rotations as an alternative for the recruitment and education of prospective applicants. In this study, we developed a consortium of three institutions each with a unique virtual subinternship and prospectively surveyed participating students in order to reflect and improve upon future rotations. All students participating in virtual subinternships at three institutions were administered the same pre subinternship and post subinternship electronic surveys. Subinternship curricula were developed independently at each respective institution. Fifty-two students completed both surveys, for an overall response rate of 77.6%. Students' primary objectives were to evaluate their fit with the program (94.2%), interact with residents (94.2%), gain faculty mentorship (88.5%), and improve didactic knowledge (82.7%). Postrotation surveys revealed that over 73% of students reported having met all of these objectives over the course of the rotation. On average, students ranked programs 5% higher overall after the rotation (P = 0.024). Postrotation results showed that the majority (71.2%) of students perceived the virtual subinternship as slightly less valuable than in-person subinternships but that all students would participate in a virtual subinternship again. Student objectives can be successfully met using the virtual format for subinternships. The virtual format is also effective in enhancing the overall perception of a program and its residents. Although students still prefer in-person subinternships, our results suggest that virtual rotations are more accessible and very capable of meeting student goals.
- Published
- 2023
40. Vein Grafts in Free Flap Reconstruction: Review of Indications and Institutional Pearls
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Hannah C. Langdell, Ronnie L. Shammas, Andrew Atia, Edward I. Chang, Evan Matros, and Brett T. Phillips
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Microsurgery ,Postoperative Complications ,Humans ,Surgery ,Plastic Surgery Procedures ,Free Tissue Flaps ,Article ,Veins - Abstract
Vein grafts enable soft-tissue reconstruction in cases of insufficient pedicle length, a lack of nearby recipient vessels, and a wide zone of injury caused by trauma or radiation therapy. The purpose of this article is to provide a comprehensive review of vein grafts in free flap reconstruction focusing on the timing of arteriovenous loops, complications, and surgical technique. Vein graft indications, types of vein grafts, and location-specific considerations are also reviewed. Three reconstructive microsurgeons at high-volume centers were asked to offer institutional pearls on the order of anastomosis, selection of donor veins, and timing of arteriovenous loops. In terms of gap length, vessel gaps less than 10 cm may be reconstructed with an interposition or transposition vein graft. For longer gaps, surgeons should consider the use of arteriovenous loops, transposition arteriovenous loops, or flow-through flaps. Both one and two-stage arteriovenous loops are used, depending on patient comorbidities, potential exposure of critical structures, and surgeon preference. Although one-stage arteriovenous loops expedite the reconstructive process, two-stage arteriovenous loops require shorter operations and help identify patients at risk of flap failure. Although whether the use of vein grafts increases flap failure rates is controversial, complications are highest in lower extremity reconstruction, cases of a prolonged interval between stages in two-stage arteriovenous loops, and unplanned vein grafts.
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- 2023
41. Spotlight in Plastic Surgery: October 2022
- Author
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Brett T. Phillips, Mario Alessandri-Bonetti, Murad Karadsheh, Aneesh Karir, Siddharth Mendiratta, Kerry A. Morrison, Miguel Ribeiro Matias, Tyler Safran, Benjamin R. Slavin, Yoshiko Toyoda, Otto R. Ziegler Rodríguez, and Arun K. Gosain
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Surgery - Published
- 2022
42. A Comparison of Complications in Therapeutic versus Contralateral Prophylactic Mastectomy Reconstruction: A Paired Analysis
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Amanda R. Sergesketter, Caitlin Marks, Gloria Broadwater, Ronnie L. Shammas, Rachel A. Greenup, Sharon Clancy, Jennifer K. Plichta, Scott T. Hollenbeck, and Brett T. Phillips
- Subjects
Postoperative Complications ,Prophylactic Mastectomy ,Mammaplasty ,Humans ,Breast Neoplasms ,Female ,Surgery ,Mastectomy ,Retrospective Studies - Abstract
Although breast reconstruction after bilateral mastectomies including a contralateral prophylactic mastectomy is known to have a higher overall complication profile, whether reconstructive complication rates differ between the therapeutic mastectomy and contralateral prophylactic mastectomy sides remains unclear.Women undergoing bilateral mastectomies with autologous or implant-based breast reconstruction for a unilateral breast cancer at a single institution were identified (2009 to 2019). Postoperative complications were stratified by laterality (therapeutic mastectomy versus contralateral prophylactic mastectomy). Paired data were analyzed to compare the risks of complications between prophylactic and therapeutic reconstruction sides in the same patient.A total of 130 patients (260 reconstructions) underwent bilateral autologous or implant-based reconstruction. Although most women underwent a simple mastectomy, a higher proportion of therapeutic mastectomies were modified radical mastectomies including axillary lymph node dissections compared to contralateral prophylactic mastectomies (15.4 percent versus 0 percent). Forty-four percent of women completed postmastectomy radiation therapy of the therapeutic side before definitive reconstruction. Overall, both therapeutic and prophylactic reconstructions had a similar incidence of reconstructive failure (p = 0.57), return to the operating room (p = 0.44), mastectomy skin flap necrosis (p = 0.32), seroma (p = 0.82), fat necrosis (p = 0.16), wound infection (p = 0.56), and cellulitis (p = 0.56). Nearly one-fifth of patients experienced complications limited to the prophylactic side [contralateral prophylactic mastectomy reconstruction complications, n = 26 (20.0 percent); therapeutic mastectomy reconstruction complications, n = 15 (11.5 percent)].Despite a history of local radiation therapy and more extensive oncologic surgery on the therapeutic side, there are no significant differences in the incidence of postsurgical complications on the therapeutic mastectomy and contralateral prophylactic mastectomy sides after bilateral reconstruction.Risk, II.
- Published
- 2022
43. The Influence of Topical Vasodilator-Induced Pharmacologic Delay on Cutaneous Flap Viability and Vascular Remodeling
- Author
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Zi Jun Wu, Mohamed M. Ibrahim, Amanda R. Sergesketter, Ryan M. Schweller, Brett T. Phillips, and Bruce Klitzman
- Subjects
Male ,Disease Models, Animal ,Vasodilator Agents ,Graft Survival ,Minoxidil ,Animals ,Surgery ,Iloprost ,Vascular Remodeling ,Administration, Cutaneous ,Article ,Surgical Flaps - Abstract
Surgical delay is a well-described technique to improve survival of random and pedicled cutaneous flaps. The aim of this study was to test the topical agents minoxidil and iloprost as agents of pharmacologic delay to induce vascular remodeling and decrease overall flap necrosis as an alternative to surgical delay.Seven groups were studied (n = 8 in each group), including the following: vehicle, iloprost, or minoxidil before treatment only; vehicle, iloprost, or minoxidil before and after treatment; and a standard surgical delay group as a positive control. Surgical flaps (caudally based modified McFarlane myocutaneous skin flaps) were elevated after 14 days of pretreatment, reinset isotopically, and observed at various time points until postoperative day 7. Gross viability, histology, Doppler blood flow, perfusion imaging, tissue oxygenation measurement, and vascular casting were performed for analysis.Pharmacologic delay with preoperative application of topical minoxidil or iloprost was found to have comparable flap viability when compared to surgical delay. Significantly increased viability in all treatment groups was observed when compared with vehicle. Continued postoperative treatment with topical agents had no effect on flap viability. The mechanism of improved flap viability was inducible increases in flap blood volume and perfusion rather than the acute vasodilatory effects of the topical agents or decreased flap hypoxia.Preoperative topical application of the vasodilators minoxidil or iloprost improved flap viability comparably to surgical delay. Noninvasive pharmacologic delay may reduce postoperative complications without the need for an additional operation.Preoperative use of topical vasodilators may lead to improved flap viability without the need for a surgical delay procedure. This study may inform future clinical trials examining utility of preoperative topical vasodilators in flap surgery.
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- 2022
44. Leadership and Advanced Degrees
- Author
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Bryan J. Pyfer, Jorge A. Hernandez, Adam D. Glener, Roger W. Cason, Howard Levinson, and Brett T. Phillips
- Subjects
Surgeons ,Leadership ,Faculty, Medical ,Humans ,Internship and Residency ,Surgery ,Surgery, Plastic ,United States - Abstract
There are increasingly prevalent formal educational programs for physicians who seek to be better trained to advance their fields. Although higher education and advanced degrees are not necessarily linked to leadership, we hypothesize that leaders in plastic surgery commonly have dual degrees. We sought to evaluate the prevalence of and association between additional advanced degrees in academic plastic surgery and plastic surgery leadership.Plastic surgery faculty from 96 academic training programs and all executive committee and board of directors' members from national, regional, and local plastic surgery societies were evaluated. Surgeons' institutional online profile pages, personal web pages, societal websites, and LinkedIn profiles were all evaluated for current/past leadership roles, as well as for advanced degree. Odds ratios (ORs) were used to determine if the presence of extra degrees increased their likelihood of leadership roles.A total of 1036 plastic surgeons were evaluated. Sixteen percent of academic faculty have a dual degree. Furthermore, 25.5% of plastic surgeons holding formal academic leadership roles have a dual degree (OR, 2.15; P = 0.043), as do 34.4% of those serving on the executive committee or board of directors in national plastic surgery societies (OR, 2.23; P = 0.026) and 29.2% of those serving in local/regional societal leadership roles (OR, 1.96; P = 0.043). Among all dual degrees, Masters in Business Administration has the highest association with leadership roles (OR, 3.45; P = 0.002).Academic plastic surgeons with dual degrees are approximately twice as likely to hold a formal academic or societal leadership role. Additional studies are needed to determine if causative relationships exist.
- Published
- 2022
45. Spotlight in Plastic Surgery: January 2023
- Author
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Brett T. Phillips, Jessica D. Blum, Valeria P. Bustos, Eliana Camacho, Alberto De Anda Coronado, Riley A. Dean, Abbas M. Hassan, Garrison Leach, Benjamin B. Massenburg, Nicholas C. Oleck, Sammy Othman, Ricardo A. Torres-Guzman, and Arun K. Gosain
- Subjects
Humans ,Surgery ,Surgery, Plastic ,Plastic Surgery Procedures - Published
- 2022
46. Spotlight in Plastic Surgery: August 2022
- Author
-
Brett T. Phillips, Jonathan T. Bacos, Mimi R. Borrelli, Caitlin A. Francoisse, Daniel De Luna Gallardo, Nirbhay S. Jain, Nisha Parmeshwar, Luis T. Pedroza, Tiam Mana Saffari, Alexander H. Sun, Keith Sweitzer, and Arun K. Gosain
- Subjects
Surgery - Published
- 2022
47. ASO Author Reflections: Optimal Timing of Autologous Breast Reconstruction Should Incorporate Patient Perspectives When Balancing the Increased Risks of a Staged Approach
- Author
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Ronnie L, Shammas and Brett T, Phillips
- Published
- 2022
48. Defining Our Terms: Are Postoperative Complications Adequately Defined in the Rhinoplasty Literature?
- Author
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Nicholas C. Oleck, Roger W. Cason, J. Andres Hernandez, Jeffrey R. Marcus, and Brett T. Phillips
- Subjects
Surgery - Published
- 2022
49. Dissatisfaction After Post-Mastectomy Breast Reconstruction: A Mixed-Methods Study
- Author
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Rachel A. Greenup, Sachi Oshima, Ronnie L. Shammas, Clara N. Lee, Laura J. Fish, Amanda R. Sergesketter, Scott T. Hollenbeck, Anaeze C. Offodile, and Brett T. Phillips
- Subjects
Weakness ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,Adult women ,Oncology ,Feeling ,Post mastectomy ,medicine ,Physical therapy ,Surgery ,Implant ,medicine.symptom ,business ,Breast reconstruction ,Psychosocial ,Mastectomy ,media_common - Abstract
Breast reconstruction is associated with improved patient well-being after mastectomy; however, factors that contribute to post-surgical dissatisfaction remain poorly characterized. Adult women who underwent post-mastectomy implant-based or autologous breast reconstruction between 2015 and 2019 were recruited to participate in semi-structured interviews regarding their lived experiences with reconstructive care. Participants completed the BREAST-Q, and tabulated scores were used to dichotomize patient-reported outcomes as satisfied or dissatisfied (high or low) for each BREAST-Q domain. A convergent mixed-methods analysis was used to evaluate interviews for content related to satisfaction or dissatisfaction with breast reconstruction. Overall, we interviewed 21 women and identified 17 subcodes that corresponded with the five BREAST-Q domains. Sources of dissatisfaction were found to be related to the following domains: (a) low breast satisfaction due to asymmetry, cup size, and lack of sensation and physical feeling (n = 8, 38%); (b) poor sexual well-being due to shape, look and feel (n = 7, 78% [of 9 who discussed sexual well-being]); (c) reduced physical well-being of the chest due to persistent pain and weakness (n = 11, 52%); (d) reduced abdominal well-being due to changes in abdominal strength, numbness, and posture (n = 6, 38% [of 16 who underwent abdominally based reconstruction]); and (e) low psychosocial well-being impacted by an unexpected appearance that negatively influenced self-confidence and self-identity (n = 13, 62%). Patients may be unprepared for the physical, sexual, and psychosocial outcomes of breast reconstruction. Targeted strategies to improve preoperative education and shared decision making are needed to mitigate unexpectedness associated with breast reconstruction and related outcomes.
- Published
- 2021
50. Assessment of Plastic Surgery Residency Applications without United States Medical Licensing Examination Step 1 Scores
- Author
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Vu T. Nguyen, Brett T. Phillips, Kyle R. Eberlin, Timothy J. Irwin, Jason H. Ko, and Jeffrey B. Friedrich
- Subjects
03 medical and health sciences ,Medical education ,Plastic surgery ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Medicine ,Surgery ,Review process ,030230 surgery ,business ,United States Medical Licensing Examination - Abstract
SUMMARY The United States Medical Licensing Examination announced the changing of Step 1 score reporting from a three-digit number to pass/fail beginning on January 1, 2022. Plastic surgery residency programs have traditionally used United States Medical Licensing Examination Step 1 scores to compare plastic surgery residency applicants. Without a numerical score, the plastic surgery residency application review process will likely change. This article discusses advantages, disadvantages, and steps forward for residency programs related to the upcoming change. The authors encourage programs to continue to seek innovative methods of objectively and holistically evaluating applications.
- Published
- 2021
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