Animal models in plastic and reconstructive surgery simulation-a review.

BACKGROUND: The use of live and cadaveric animal models in surgical training is well established as a means of teaching and improving surgical skill in a controlled setting. We aim to review, evaluate, and summarize the models published in the literature that are applicable to Plastic Surgery training. MATERIALS AND METHODS: A PubMed search for keywords relating to animal models in Plastic Surgery and the associated procedures was conducted. Animal models that had cross over between specialties such as microsurgery with Neurosurgery and pinnaplasty with ear, nose, and throat surgery were included as they were deemed to be relevant to our training curriculum. A level of evidence and recommendation assessment was then given to each surgical model. RESULTS: Our review found animal models applicable to plastic surgery training in four major categories namely-microsurgery training, flap raising, facial surgery, and hand surgery. Twenty-four separate articles described various methods of practicing microsurgical techniques on different types of animals. Fourteen different articles each described various methods of conducting flap-based procedures which consisted of either local or perforator flap dissection. Eight articles described different models for practicing hand surgery techniques. Finally, eight articles described animal models that were used for head and neck procedures. CONCLUSIONS: A comprehensive summary of animal models related to plastic surgery training has been compiled. Cadaveric animal models provide a readily available introduction to many procedures and ought to be used instead of live models when feasible.

The Rainbow Scale for Assessing Breast Ptosis: Validation of Three Different Views.

BACKGROUND: Photographic scales have become an increasingly used tool in objectively assessing outcomes in aesthetic surgery. However, no online photographic scale for assessing breast ptosis has been developed yet that is readily available. OBJECTIVES: This study was designed to validate the online Rainbow Scale for the assessment of breast ptosis for the anterior-posterior (AP), lateral, and oblique views. METHODS: For the five grades of the Rainbow Scale format, standardized reference photographs were selected. Six plastic surgeons rated 15 photographs for each view three times. Intra- and inter-observer agreements were calculated by using the weighted kappa coefficient and differences in intra- and inter-observer agreements between the three views were assessed for statistical significance using the Kruskal-Wallis test. RESULTS: The mean intra-observer agreements were 0.91 (range, 0.82-0.98) for the AP view, 0.88 (range, 0.77-1.00) for the oblique view, and 0.86 (range, 0.74-0.97) for the lateral view and did not vary significantly between all three views. The mean inter-observer agreements were 0.88 (range, 0.77-0.95) for the AP view, 0.84 (range, 0.72-0.94) for the oblique view, and 0.82 (range, 0.58-0.95) for the lateral view. The mean inter-observer agreements of the AP view varied significantly from the oblique view (P = .012) and the lateral view (P = .001). CONCLUSIONS: The Rainbow Scale for breast ptosis has been validated for the AP view, the lateral view, and the oblique view and is reproducible and reliable for the assessment of breast ptosis in three different views in an online setup. LEVEL OF EVIDENCE: 4 Diagnostic.

The chicken foot digital replant training model.

A simple, readily available digital replantation model in the chicken foot is described. This high fidelity model will hopefully allow trainees in hand surgery to gain further experience in replant surgery prior to clinical application.

An improved dual approach to post bariatric contouring - Staged liposuction and modified medial thigh lift: A case series.

OBJECTIVE: Following massive weight loss (MWL) medial contouring of the thigh is frequently requested to improve appearance and function. Thigh lifting can be associated with significant complications. We present a case series of post bariatric patients undergoing thigh lift using staged the liposuction, a modified T incision and a buried de-epithelialised dermal flap. MATERIALS AND METHODS: From January to December 2012, 21 consecutive patients underwent a modified medial thigh lift. A retrospective review of the case notes was performed to assess complications that occurred. RESULTS: There were no major post-operative complications in terms of reoperation, hematoma, thromboembolism and no seromas. Seven patients, all of which were smokers had minor superficial wound healing complications. Aesthetic outcomes were satisfactory for all patients at a minimum follow-up of 6 months. CONCLUSIONS: The modified 'T' incision with staged liposuction is described. We have found the technique to be useful for a variety of different thighs. It is a reproducible method for contouring the medial thigh in MWL patients. In this series, our overall complications were low, and no seromas occurred.