With breast augmentation and tumor removal the #1 procedures in cosmetic surgery and reconstructive surgery, respectively, according to latest ASPS information, this issue on breast augmentation presents discussion of procedures for cosmetic enhancement and for breast reconstruction. The first section includes topics such as: Evolution and Future Development of Breast Implants; Standardization of the Bra Cup; Process of Breast Augmentation with Special Focus on Patient Education, Patient Selection and Implant Selection; Etiology & Prevention of Capsular Contracture; 3-D Imaging and Simulation in Breast Augmentation: What is the Current State of the Art?; Fresh Look at the Anatomy of the Chest Wall with Special Attention to the Pectoralis Major and Infra-Mammary Fold with Implications to Breast Surgery; Differences between Saline & Silicone Implants that Most Plastic Surgeons Don't Know; Shapes, Sizes, Shells and Surface and the Selection Process of Breast Implants; Shapes, Proportions and Variations in Breast Aesthetic Ideals - definition of breast beauty: analysis and surgical practice. The next section presents surgical approaches and techniques for breast implant surgery: Teaching Breast Augmentation What are the Critical Intra Operative Steps & Decision Making: Maximizing Results and Minimizing Revisions; Mastering the Nuances of Highly Cohesive Shaped Breast Implants; Strategies, Challenges and Solutions in Augmentation Mastopexy Patients: The Most Difficult Primary Breast Procedure; Use of Scaffold Support of the Breast in Primary Augmentation Mastopexy; Considerations and Improvement of Breast Asymmetry in Primary Augmentation; Surgical Strategies in the Correction of the Tuberous Breast; Subfascial Apprach to Breast Augmentation with Lipofilling of the Breast; Surgical Approaches to Breast Augmentation: Surgical Options for Incisions & Planes; Fat Grafting / Fat Transfer to the Breast; Use of Barbed Sutures in Primary Augmentation and Mastopexy. The final section presents special situations in surgical procedures: High Resolution Ultrasound and the Detection of Breast Implant Shell Failure; Breast Implant Associated ALCL.

Topics include: Defining the problem/proof of concept; The reconstructive model; Do ADM’s change the rationale for immediate vs. delayed?; Direct to implant reconstruction; Capsular contracture and ADM’s; Pocket reinforcement/bottoming out; ADM’s in the irradiated breast; Emerging applications; Comparison of different ADM materials; Tips and pearls; Economic considerations

This issue of Clinics in Plastic Surgery, guest edited by Drs. Robert F. Centeno and Constantino G. Mendieta, is devoted to Gluteal Augmentation. Articles in this outstanding issue include: Gluteal Aesthetic Evaluation and Classification; Clinical Anatomy in Aesthetic Gluteal Augmentation; Complications in Aesthetic Gluteal Augmentation; Practice-Based Patient Management Strategies in Gluteal Augmentation; Sub-fascial Gluteal Implant Augmentation; Sub-muscular Gluteal Augmentation; Intramuscular Gluteal Augmentation with Implants; Intramuscular Gluteal Augmentation: The XYZ Method; Gluteal Augmentation and Contouring with Autologous Fat Transfer; Autologous Flap Augmentation: Island Technique; Autologous Flap Augmentation: Moustache Technique; Autologous Flap Gluteal Augmentation: Split Gluteal Flap Technique; Autologous Flap Gluteal Augmentation: Purse-String Technique; Excisional Buttock Lifting and Revisional Procedures.

Outcomes . . .familiar in medicine fields, but only in recent decades becoming more of an issue for surgeons . . .the highly subspecialized nature of the surgical profession and breadth of procedures along with variance in patient population creates a challenge in achieving useful, informative outcomes. Here, in this issue of Clinics in Plastic Surgery, the focus is on evidence-based practice and outcomes in plastic surgery, spanning the major areas of cosmetic and reconstructive surgery. Outcomes as guidance for the surgeon’s decision regarding approaches and techniques for procedures is the approach. Some of the topics covered are: Measuring Outcomes in Aesthetic Surgery; Measuring Outcomes in Craniofacial and Pediatric Surgery; Measuring Outcomes in Hand Surgery; How to Link Outcomes Data to Quality Initiatives in Plastic Surgery; along with How to Use the Outcomes Questionnaire, Pearls and Pitfalls; among others. Guest Editors Kevin Chung and Andrea Pusic lead this review. Dr. Chung is involved with structuring evidence-based practice and research in hand surgery to derive the best evidence to guide treatment for upper extremity conditions and he developed the Michigan Hand Outcomes Questionnaire. Dr Pusic developed the BREAST-Q, which measures satisfaction and quality-of-life outcomes among breast reconstruction patients. Out of the BREAST-Q has come the FACE-Q, which provides a clinically useful patient-reported outcome measure of satisfaction and quality of life following elective surgical and non-surgical facial rejuvenation.

In this issue of Clinics in Plastic Surgery, guest editor Dr. Neil Tanna brings his considerable expertise to the topic of Breast Reconstruction. Top experts in the field cover key topics such as modern approaches to oncoplastic surgical treatment; modern approaches to implant-based breast reconstruction; pre-pectoral breast reconstruction; breast implant-associated anaplastic large cell lymphoma; operative efficiency; and more. - Contains 18 relevant, practice-oriented topics including preoperative assessment of the breast reconstruction patient; revision of implant-based breast reconstruction; modern approaches to abdominal flap-based breast reconstruction; the hybrid breast reconstruction; robotic breast surgery and robotic breast reconstruction; and more. - Provides in-depth clinical reviews on breast reconstruction, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

This issue of Clinics in Plastic Surgery, devoted to Complications in Breast Reduction, is guest edited by Dr. Dennis C. Hammond. Articles in this issue include: Assessing Risk and Avoiding Complications in Breast Reduction; Management of Shape Distortion After Vertical Breast Reduction; Management of Shape Distortion After Wise Pattern Breast Reduction; Management of Shape Distortion After SPAIR Mammaplasty; Management of the Ischemic NAC After Breast Reduction; Nipple Reconstruction After NAC Necrosis Following Breast Reduction; Management of Recurrent Macromastia; Management of Occult Cancer After Breast Reduction; Mammographic Management of the Post-reduction Breast; Management of Asymmetry After Breast Reduction; Management of the High Riding Nipple After Breast Reduction; Breast Reduction in the Burned Breast; Avoiding Complications in Gigantomastia; and Avoiding Medicolegal Risk in Breast Reduction.

This issue of Clinics in Plastic Surgery, guest edited by Drs. Jin Bo Tang and Michel Saint-Cyr, is devoted to Microsurgery: Global Perspectives, An Update. This issue will include updates on topics such as: A Global View of Digital Replantation and Revascularization; Severe Crush Injury to the Forearm and Hand; Medial Femoral Trochlea Osteochondral Flap; Vascularized Small-Bone Transfers for Fracture Nonunion and Bony Defects; Microvascular Tissue Transfers for Severe Upper Extremity Trauma; Compound or Specially Designed Flaps in the Lower Extremities; Complex Microsurgical Reconstruction After Tumor Resection in the Trunk and Extremities; Pediatric Microsurgery; Innovations and Future Directions in Head and Neck Microsurgical Reconstruction; Microsurgical Tissue Transfer in Breast Reconstruction; Maximizing the Utility of the Pedicled Anterolateral Thigh Flap for Locoregional Reconstruction; Keystone and Pedicle Perforator Flaps in Reconstructive Surgery; Unique Techniques or Approaches in Microvascular and Microlymphatic Surgery; and Microsurgical Reconstruction of Neck, Trunk, and Extremities.

The scope of use of local anesthetics in procedures in plastic surgery is covered in this issue of Clinics in Plastic Surgery. Discussion centers on plastic surgeons in private practice in ambulatory facilities and those scheduling time for OR in hospital facilities using local anesthetics while accommodating patient comfort and absence of side-effects post general anesthesia. Presented in this publication are the most common plastic surgeries that can be done under local anesthesia, each with a discussion of the optimal anesthetic, method of administration, and dosage. Video of the procedure or portion of the procedure, as applicable, accompanies the techniques along with a surgical case. The goal of this issue is to provide a concise reference for surgeons’ planning surgeries to review and perhaps adapt currently used methods with this latest information on local anesthetics. Surgical Technique is provided in detail with full analysis of Patient Selection and Planning, Complications and Post-procedure Care. Contents include Complications; Basic Science of Locals; Skin Grafts and Flaps; Peripheral Nerve; Foot Surgery; Breast Surgery; Liposuction; Hand Trauma; Oculoplastic Surgery; Ear Surgery; Hair Transplantation; among others.

This issue of Clinics in Plastic Surgery, guest edited by Loren Schechter and Bauback Safa, is devoted to Gender Confirmation Surgery. Articles in this issue include: Multidisciplinary Care and The Standards of Care for Transgender and Gender Non-conforming Individuals; Primary Care of Transgender and Gender Non-conforming Individuals; Mental Health Evaluation for Transgender and Gender Non-conforming Individuals; Hormonal Management for Transfeminine Individuals; Hormonal Management for Transmasculine Individuals; Facial Feminization; Breast and Body Contouring for Transgender and Gender Non-conforming Individuals; Penile inversion; Intestinal Vaginoplasty; Vaginoplasty Complications; Chest Surgery for Transgender and Gender Non-conforming Individuals; Metoidioplasty; Introduction to Phalloplasty; Radial Forearm; AnteroLateral Thigh flap (ALT); Penile Prostheses; Flap-related Complications; Urologic Complications; and Sexual Health after Surgery.

This issue of Clinics in Plastic Surgery offers the surgeon information on the most recent approaches to body contouring, primarily focused on this procedure performed after massive weight loss. Gastric bypass surgery practically foretells abdominoplasty, with ~75% of patients undergoing plastic surgery following gastric bypass. A total of almost one-half million body contouring procedures are performed annually by plastic surgeons according to ASPS statistics. Topics in this issue include: Assessing outcomes in body contouring; Preoperative evaluation of the body contouring patient; What happens to the skin after weight loss; Effect of further weight loss following body contouring; Effect of weight gain following body contouring; Anesthesia considerations; Procedures for Brachioplasty; Bra line back lift; Breast contouring; Abdomen contouring; the Fleur Di Lis Abdominoplasty; Extended abdominoplasty; Medial thigh lift; Buttock contouring; Truncal contouring; Lower body lift; and Prevention and management of complications.