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In This Issue of JAMA Facial Plastic Surgery
Jul/Aug 2019


JAMA Facial Plast Surg. 2019;21(4):269. doi:10.1001/jamafacial.2018.1339

Demesh and coinvestigators performed a biomechanical clinical study with a retrospective medical record review to evaluate the behavior and outcomes of a vertically oriented box plate vs traditional rigid internal fixation plating techniques for mandibular body fracture. In the biomechanical analysis, they found the vertical box plate provided greater stability and 150% of the resistance against torsional forces when compared with traditional linear plating. Clinically, the vertical box plating technique was also associated with a lower incidence of postoperative complications and with reduced operative time compared with traditional plating techniques. Humphrey and Kreit provide an Invited Commentary.

Invited Commentary.

Olds and colleagues conducted a population-based cohort study assessing the prevalence of immediate and long-term postoperative opioid use after plastic and reconstructive surgery procedures. This study cohort consisted of 466 677 patients who underwent 5 classes of plastic and reconstructive procedures (nasal, eye, breast, abdomen, and soft-tissue reconstruction). The authors found that patients who filled opioid prescriptions perioperatively were at increased risk of persistent opioid use compared with those who did not. This was particularly true for patients who underwent breast and abdominal procedures, as well as those with a history of mental health diagnoses, substance use, and chronic pain.

Buziashvili and coauthors performed a retrospective case series study to examine the patterns of bony changes in the aging face experienced by black individuals observed over time. They evaluated the medical records of 20 patients treated at an urban tertiary medical center and with at least 2 facial computed tomographic (CT) images obtained at least 6 years apart. Facial CT scans were analyzed for 2-dimensional measurements to document changes in glabellar angle, bilateral maxillary angles, frontozygomatic junction width, orbital width, and piriform width. Although they found significant longitudinal changes in the facial skeleton in black individuals, the changes were less dramatic than those found in previous studies of white individuals.

In this cohort study, Fuller and colleagues sought to evaluate the association of functional septorhinoplasty (FSRP) using spreader graft placement with patient satisfaction with nasal appearance postoperatively because there is concern that spreader grafts may have an aesthetic penalty of widening the nasal dorsum. Demographics, nasal history, and patient-reported and objective outcomes were analyzed in the cohort of 154 patients. When separated into those patients with only spreader grafts (n = 89) and those patients with spreader grafts plus other graft types (n = 65), there was no significant difference between score improvements in the 2 groups. There were no significant differences in final nasal appearance scores between patients undergoing functional vs dual functional and cosmetic FSRP.