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PRSonally Speaking
Wednesday, October 30, 2013
Articles of Interest Sneak Peak: The Double Bubble Deformity: Etiology, Prevention and Treatment
 
At least twice a month, PRSonally Speaking posts full abstracts of interesting or potentially controversial articles from a future issue. This 'sneak preview' of a hot article is meant to give you some food for thought and provide you with topic for conversation among colleagues.
 
When the article is published in print with the December issue, it will be FREE for a period of Two Months, to help the conversation continue in the PRS community and beyond. So read the abstract, join the conversation and spread the word.
 
This week we present the introduction to "The Double Bubble Deformity: Etiology, Prevention and Treatment" by Handel et al.

Abstract
Background: The "double bubble" is a widely recognized complication of breast augmentation but there have been very few articles in the peer-reviewed literature devoted exclusively to this topic.

Methods: Prior publications addressing the anatomy of the inframammary fold (IMF) and its relationship to the double bubble deformity are systematically reviewed. Disagreements among authorities regarding the precise anatomical structure of the IMF are addressed. The etiology and surgical correction of the double bubble are discussed in detail as they relate to the anatomy of the fold.

Results: The key to understanding the causes and correction of the double bubble lies in an appreciation of the anatomy of the IMF. Correction of the deformity varies depending on whether or not patients had pre existing anatomical features predisposing them to development of a double bubble.

Conclusions: A variety of surgical strategies, including use of a dual plane pocket, form stable shaped implants, capsulorrhaphy, pocket plane conversion and use of acellular dermal matrices can play a role in prevention and treatment of the double bubble deformity.
 
In a type III dual plane pocket, the origins of the pectoralis muscle are divided across the inframammary fold and the retromammary plane is dissected to the superior border of the areola.
 
The full article will be published with the December 2013 issue of PRS, and will be free online for non-subscribers. Until then, we hope this "sneak peek" will pique your interests and start a healthy, meaningful conversation.
About the Blog

Plastic and Reconstructive Surgery

PRSonally Speaking is the official blog of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. Visit our blog for exclusive previews of and discussions on hot topics in plastic surgery as well as insider-tips on open access content. PRSonally Speaking is now powered by frequent contributions from the American Society of Plastic Surgeons’ Young Plastic Surgeons Forum (YPS); these practicing plastic surgeons provide the personal side of the plastic surgery story, from daily challenges to unique insights. PRSonally Speaking is home to lively, civil debate on hot topics and great discussions pertaining to our field. So, bookmark us, subscribe to the RSS feed and join in the on-going conversation with Plastic and Reconstructive Surgery. This is your Journal; have fun, be respectful, get engaged and interact with the PRS community.

The views and recommendations of guest contributors do not necessarily indicate official endorsements or opinions of the Journal, PRS, or the ASPS. All views are those of the authors and the authors alone.

Contributors

Anureet K. Bajaj, MD is a practicing plastic surgeon in Oklahoma City. She completed residency and fellowship in 2004, had a brief stint in academia at the University of Cincinnati, and then chose to join her father (Paramjit Bajaj MD, also a practicing plastic surgeon) in private practice in OKC, where she focuses on breast reconstruction and general cosmetic surgeries.

Devra B. Becker, MD, FACS, is an Assistant Professor of Plastic Surgery in the Department of Plastic Surgery at University Hospitals/Case Western Reserve University School of Medicine in Cleveland, Ohio. She completed Plastic Surgery residency at Washington University School of Medicine in St. Louis, and completed fellowships with Daniel Marchac and with Bahman Guyuron. She currently has a primarily reconstructive practice.

Henry C. Hsia, MD, FACS is at Robert Wood Johnson Medical School of Rutgers University in New Brunswick, New Jersey and also holds an appointment at Princeton University.  When he’s not working hard trying to be a good father and husband, he runs a practice focused on reconstructive surgery and wound care as well as a research lab focused on wound biology and regenerative medicine.

Stephanie K. Rowen, MD is a senior physician at The Permanente Medical Group in San Jose, California.  She joined TPMG upon finishing residency and a hand surgery fellowship in 2005.  She has a primarily reconstructive practice, about 50% hand surgery.  Outside of work she enjoys participating in triathlons and spending time with her family.

Jon Ver Halen, MD is currently Chief of plastic surgery, Baptist Cancer Center; Research member, Vanderbilt- Ingram Cancer Center; Adjunct clinical faculty, St. Jude Children's Research Hospital. He also acts as Program Director for the plastic surgery microvascular surgery fellowship. His practice focuses on oncologic reconstruction.

Tech Talk Bloggers

Adrian Murphy is a plastic surgery trainee in London, England. He studied medicine in Dublin, Ireland and has trained in Ireland, Boston, MA and the United Kingdom. He is a self-confessed geek and gadget aficionado.

Ash Patel, MD is Assistant Professor of Plastic Surgery and Associate Program Director at Albany Medical College, in Albany NY. His practice is primarily reconstructive.

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