Augmentation mammaplasty is one of the most commonly performed plastic surgery procedures. Infection, still one of the most feared complications of the procedure, usually is caused by skin commensal organisms. A wide variety of other organisms also may be responsible for these postoperative infections, including atypical mycobacteria. A case of a prosthetic breast implant infected with Mycobacterium cheloneae is presented, and the presenting signs and symptoms, diagnosis, and treatment options of such an infection are discussed. The importance of promptly isolating the pathogen for potential salvage of the prosthesis also is stressed, as well as the operative intervention necessary when conservative therapy fails.

Adult↗

PubMedDate not supplied

The use of celecoxib for reduction of pain after subpectoral breast augmentation.

A study was conducted to determine whether a single 400-mg dose of oral celecoxib administered 30 min before surgery reduces the opioid requirement for patients undergoing aesthetic subpectoral breast augmentation. A total of 695 patients undergoing breast augmentation were randomly selected into either a placebo or a treatment group. The findings showed that patients who received 400 mg of celecoxib 30 min before surgery required significantly fewer opioid analgesics after the operation than those given a placebo (p < 0.001). It also was found that nonsmokers and multiparous women required significantly fewer opioids than smokers and nulliparous women (p < 0.001). On the basis of this prospective study, the authors recommend a single 400-mg dose of celecoxib administered 30 min before surgery to decrease opioid analgesic requirements after subpectoral breast augmentation.

Adolescent↗

PubMedDate not supplied

Reconstituted botulinum type A neurotoxin: clinical efficacy after long-term freezing before use.

Botulinum neurotoxin type A (BoNT/A) is injected into muscles of facial expression for treatment of facial wrinkles. Manufacturers' recommendations state that the product should be used within 4 h of reconstitution to prevent loss of effectiveness. A prospective study was undertaken to evaluate the effectiveness of reconstituted BoNT/A when preserved in a frozen state for up to 6 months, as compared with nonfrozen BoNT/A used within 4 h after reconstitution. Treatment of 118 sites in 80 patients was performed and evaluated for aesthetic efficacy. Excellent results were observed in 94.8% of sites treated with nonfrozen BoNT/A and in 93.3% of the sites treated with frozen and thawed BoNT/A (p = 1). Minor side effects were rare and transient in both groups. In contrast to common belief, reconstituted BoNT/A may be frozen, thawed, and injected without losing its potency for up to 6 months, with efficacy equivalent to that of freshly prepared BoNT/A.

Adult↗