Calcitriol-mediated hypercalcemia secondary to granulomatous disease caused by soft-tissue filler injection: a case report.

Soft-tissue filler (STF) injections have been used worldwide for cosmetic reasons. In most cases, they are not approved by the United States Food and Drug Administration (FDA). Regulatory boards in Latin American countries do not allow the medical use of STF injections; however, these injections are still widely used. A case of calcitriol-mediated hypercalcemia with ectopic calcifications, chronic kidney disease, nephrolithiasis and calcinosis is presented. The reported case highlights the consequences of STF use, including calcitriol-mediated hypercalcemia secondary to granulomatous reactions years after an esthetic procedure.

Artificial Intelligence in Plastic Surgery: Insights from Plastic Surgeons, Education Integration, ChatGPT's Survey Predictions, and the Path Forward.

Background: Artificial intelligence (AI) is emerging as a transformative technology with potential applications in various plastic surgery procedures and plastic surgery education. This article examines the views of plastic surgeons and residents on the role of AI in the field of plastic surgery. Methods: A 34-question survey on AI's role in plastic surgery was distributed to 564 plastic surgeons worldwide, and we received responses from 153 (26.77%) with the majority from Latin America. The survey explored various aspects such as current AI experience, attitudes toward AI, data sources, ethical considerations, and future prospects of AI in plastic surgery and education. Predictions from AI using ChatGPT for each question were compared with the actual survey responses. Results: The study found that most participants had little or no prior AI experience. Although some believed AI could enhance accuracy and visualization, opinions on its impact on surgical time, patient recovery, and satisfaction were mixed. Concerns included patient privacy, data security, costs, and informed consent. Valuable AI training data sources were identified, and there was agreement on the importance of standards and transparency. Respondents expected AI's increasing role in reconstructive and aesthetic surgery, suggesting its integration into residency programs, addressing administrative challenges, and patient complications. Confidence in the enduring importance of human professionals was expressed, with interest in further AI research. Conclusion: The survey's findings underscore the need to harness AI's potential while preserving human professionals' roles through informed consent, standardization, and AI education in plastic surgery.

Arthroscopic resection of dorsal wrist ganglia: 114 cases with minimum follow-up of 2 years.

PURPOSE: The objective of this study was to review the results of arthroscopic resection of dorsal wrist ganglion (DWG), as well as to describe the senior author's technique and technical details to minimize potential complications. METHODS: Between September 1999 and May 2004, 114 patients underwent arthroscopic resection of DWG with a minimum follow-up of 24 months. We describe the surgical technique and discuss our results and complications. RESULTS: A total of 114 patients (87 female patients and 27 male patients) with a mean age of 33.1 years were treated with our operative technique. The symptoms at presentation were unsightly appearance in 63 (55.2%), pain in 33 (28.9%), and both unsightly appearance and pain in 18 (15.8%). The patients presented between 1 and 96 months before surgery (mean, 17.81 months). Of the patients, 66 (57.9%) had been treated previously with nonsurgical modalities (aspiration) and 1 had undergone open surgery. The origin of the DWG was more commonly related to the midcarpal joint (85 patients [74.6%]). Our surgery brought about a significant improvement in flexion and extension after surgery (P < .005). Similarly, our surgery brought about a significant improvement in grip strength (P < .005). In patients with preoperative pain, treatment also showed a significant impact. At 2 years' follow-up, there were 14 recurrences (12.3%), diagnosed at a mean of 16.86 months after surgery (range, 2 to 25 months). Complications were identified in 6 patients (5.26%), and the mean time off work was 11 days, with a majority of patients returning in less than 1 week. CONCLUSIONS: Arthroscopic DWG resection showed an improvement in functional measurements in addition to relief of pain in a significant proportion of patients. Complications related to the operative technique did not cause any significant long-term functional deficit. The recurrence rate was 12.3%, and patient satisfaction was high. Arthroscopic technique allows patients to use their hand immediately. The results of this study support the use of arthroscopy as primary treatment for DWG resection. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Rhinoschleroma.

A 39 year-old man came to our institution because of a five-year history of a progressive painful growing mass on his left nostril, which cause airway obstruction with ulceration. Because of a suspicion of malignancy, surgery (mass resection and subtotal nasal reconstruction) was performed. Histologic samples ruled out malignancy, and tissue cultures for fungus and mycobacteria were negative, but regular aerobic cultures were positive for Klebsiella rhinoscleromatis. The patient was given a six-month regimen of ciprofloxacin, and a dramatic improvement was observed.

Magnetic resonance imaging assessment of gluteal fat grafts.

BACKGROUND: One goal of lipoplasty is to create a round and projected buttock contour. Despite multiple papers evaluating lipoinjection, controversies still remain. METHODS: This report describes a series of patients who underwent liposuction, gluteal lipoinjection, and evaluation with magnetic resonance imaging (MRI). From January 2003 to January 2004, the patients scheduled for contour surgery by the investigators were evaluated using MRI, photographic records, and gluteal circumference measurement 1 week before surgery, then 2 weeks and 3 months after the procedure. A statistical analysis was performed for 10 patients who received, on the average, a 350-ml injection of fat obtained during liposuction. RESULTS: Gluteus muscle volume increased, reaching a higher level 2 weeks after the injection than the level 3 months afterward (p < 0.001). The gluteal circumference, modified 2 weeks after surgery by about 1 to 3 cm, came back to previous values 3 months after the procedure (p < 0.05), a phenomena interpreted as reabsorption and resolution of the postoperative edema. There is no correlation between the gluteus muscle volume obtained by MRI and the gluteal circumference (p > 0.05). CONCLUSIONS: The findings led to the conclusion that enhancement of the gluteal contour after fat injection results from survival of the injected tissue 3 months after the surgery, which was objectively evaluated by MRI as having a calculated reabsorption rate of 24% to 36%.