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Gregory L Borah

Publications and source records attributed to Gregory L Borah.

4 recordsLinked to original sources
PubMed2005

Maximizing outcomes in breast reduction surgery: a review of 518 consecutive patients.

BACKGROUND: Economic constraints and diminished healthcare resources mandate increased efficiency in labor-intensive plastic surgical procedures, such as reduction mammaplasty. The evolution to our current approach over a 9-year period was reviewed. METHODS: From 1992 to 2001 a total of 518 patients underwent bilateral reduction mammaplasty by a single plastic surgeon. Since 1992, a bilateral simultaneous approach to reduction mammaplasty was used, with the primary surgeon (Scott) performing the preoperative markings and determining the final resection. An inferior pedicle, "inverted T" technique using a Wise pattern was used for all cases. The initial 2-year period (113 consecutive patients from 1992 to 1994) was compared with the later 2-year period (103 patients from 1999 to 2001). Variables that decreased operative times and resources were identified. RESULTS: Length of stay (from admission to discharge) was initially 27 hours (overnight admission at a hospital) in the early review and decreased to 5 hours (outpatient surgery center) in the recent series. Drains were used in 100 percent of the earlier cases and in 7 percent in the recent series. Major complications occurred in 3 percent of the entire series. Minor complications occurred in 20 percent of all patients. In the recent series 97 percent of patients received complete relief of their preoperative symptoms and expressed satisfaction with their results. Operative times decreased from 120 to 102 minutes. Beginning in 1999, Dermabond skin adhesive was used in all patients. CONCLUSIONS: An evolutionary approach to bilateral reduction mammaplasty with low complication rates and high patient satisfaction is presented. Optimization of technique leads to decreased operative times, shortened lengths of stay, and contributes to efficient use of surgeon and operating room resources.

Adolescent↗
PubMed2004

Frontal bone periosteal osteomas.

Osteomas are the most common tumors of the cranial vault and facial skeleton. Osteomas are usually benign in nature, commonly presenting with symptoms of facial deformity, facial pain, and headaches. Although the frontal sinus is the most frequent location of cranial osteomas, they are also occasionally seen involving only the frontal bone periosteum. This study is a retrospective series investigating the characteristics, management, and outcomes of five patients with frontal bone periosteal osteomas surgically treated with superficial osteotomies with primary closure. Medical charts were reviewed focusing on symptoms, size, radiographic findings, and disease of the periosteal osteomas. The chief complaint primarily involved a palpable deformity, which led to surgical evaluation. Radiographic studies were obtained to evaluate size and location of the frontal osteomas. Microanalysis of the specimens confirmed the presence of mature cancellous and/or cortical bone. Postoperative follow-up revealed no evidence of recurrence or complications. The superficial ostectomy technique with primary closure offers a simple, effective method for removal of frontal bone periosteal osteomas with minimal side effects.

Adult↗
PubMed2003

Perceived functional impact of abnormal facial appearance.

Functional facial deformities are usually described as those that impair respiration, eating, hearing, or speech. Yet facial scars and cutaneous deformities have a significant negative effect on social functionality that has been poorly documented in the scientific literature. Insurance companies are declining payments for reconstructive surgical procedures for facial deformities caused by congenital disabilities and after cancer or trauma operations that do not affect mechanical facial activity. The purpose of this study was to establish a large, sample-based evaluation of the perceived social functioning, interpersonal characteristics, and employability indices for a range of facial appearances (normal and abnormal). Adult volunteer evaluators (n = 210) provided their subjective perceptions based on facial physical appearance, and an analysis of the consequences of facial deformity on parameters of preferential treatment was performed. A two-group comparative research design rated the differences among 10 examples of digitally altered facial photographs of actual patients among various age and ethnic groups with "normal" and "abnormal" congenital deformities or posttrauma scars. Photographs of adult patients with observable congenital and posttraumatic deformities (abnormal) were digitally retouched to eliminate the stigmatic defects (normal). The normal and abnormal photographs of identical patients were evaluated by the large sample study group on nine parameters of social functioning, such as honesty, employability, attractiveness, and effectiveness, using a visual analogue rating scale. Patients with abnormal facial characteristics were rated as significantly less honest (p = 0.007), less employable (p = 0.001), less trustworthy (p = 0.01), less optimistic (p = 0.001), less effective (p = 0.02), less capable (p = 0.002), less intelligent (p = 0.03), less popular (p = 0.001), and less attractive (p = 0.001) than were the same patients with normal facial appearances. Facial deformity caused by trauma, congenital disabilities, and postsurgical sequelae present with significant adverse functional consequences. Facial deformities have a significant negative effect on perceptions of social functionality, including employability, honesty, and trustworthiness. Adverse perceptions of patients with facial deformities occur regardless of sex, educational level, and age of evaluator.

Adolescent↗