Editor's Choice: September 2012

Dear Readers,

I would like to share my thoughts on four articles from our September 2012 issue and highlight their value to the literature. The articles I’ve selected cover a variety of topics and I am sure they will be applicable to many of you in clinical practice.

The first article on my Editor’s Choice list is “Determinants of Breast Appearance and Aging in Identical Twins,” by Soltanian, Liu, Cash, and Iglesias. To elucidate the role of “exogenous factors” on breast appearance, the authors studied 161 pairs of identical female twins. Twins who had received hormonal replacement therapy had more attractive breasts, while twins who smoked, consumed alcohol, had a higher body mass index, and who had greater number of pregnancies tended to have less attractive breasts. These findings should serve as a guide for us to advise our patients on how to maintain the attractiveness of their breasts.

The second article, entitled “Two Year Outcomes with a Novel, Double-Lumen Saline-Filled Breast Implant” and written by Nichter and Hamas, includes 2-year data from a 10-year clinical trial evaluating the safety and effectiveness of a new double-lumen saline implant designed to control saline movement through an internal support system with a baffle structure. The authors report a lower rate of wrinkling and capsular contracture at 2 years compared to single-lumen saline implants at 1 year. These promising early results are encouraging, suggesting that the design of these implants will improve the feel and overall performance of saline implants.

My third choice is a special topic entitled “Fat Grafting’s Past, Present, and Future: Why Adipose Tissue is Emerging as a Critical Link to the Advancement of Regenerative Medicine,” by Drs. Hsu, Stransky, Bucky, and Percec. This timely paper is a review of the current state of the art in fat grafting and adipose tissue engineering. It includes valuable information for all of us involved in fat transplantation on a daily basis.

My final choice for this month is entitled “Prevention of Biofilm-Induced Capsular Contracture with Antibiotic-Impregnated Mesh in a Porcince Model,” by Dr. Anita Jacombs and colleagues from Australia. Current research suggests that the presence of bacterial biofilms resulting in subclinical infection around the breast implants is the major cause of capsular contracture. In this porcine study, the authors demonstrate the efficacy of the impregnated antibiotic mesh in prevention of capsular contracture.

I hope you enjoy this issue and, as always, I welcome your feedback. You can reach the Editorial Office at journal@surgery.org to submit papers, subscribe to the journal, or ask questions.

Best wishes,

Foad Nahai, MD

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