Akademikliniken

Aesthetic breast surgery remains among the most requested procedures in plastic surgery. Since their introduction, breast implants have significantly evolved in terms of composition, surface, and shape. Due to the wide variability in patient anatomy and expectations, no single implant type can universally address all clinical scenarios. Therefore, achieving the best outcome requires a tailored approach. This study presented a decision-making model developed by the first author (P.M.). The model aims to obtain fully personalized outcomes using the Polytech implant catalog, which offers an extensive range of different breast implant types (such as microtextured, polyurethane, smooth, and lightweight implants), allowing tailored solutions to meet individual patient needs. The model is based on the "Akademikliniken method" by Hedén, a biodimensional method that promotes a nonvolumetric, proportion-oriented approach to breast augmentation. Supported by a comprehensive implant portfolio, it enables tailored surgical planning for primary augmentations, revision procedures, and combined procedures such as mastopexy. The structured algorithm guides surgeons in selecting the most appropriate implant based on individual clinical parameters. The decision-making model described provides a practical and adaptable framework to support surgeons in optimizing surgical outcomes. The breadth of the Polytech portfolio is key to delivering truly personalized outcomes: it not only enhances procedural precision by offering a wide range of tools and options, but also supports professional development through informed, case-specific choices.

Breast augmentation may be performed using round or anatomical shaped implants, and since their introduction in 1993, the indications and outcomes of anatomical implants have been under scrutiny. In fact, due to their asymmetric shape, these devices have a unique risk of rotation. We have previously described our indications and rationale for using anatomical implants as well as a discussion of surface textures and BIA-ALCL. In this review, we primarily address our experience of dealing with clinically evident rotation. All consecutive female patients operated for primary breast augmentation by the first author, who had anatomical implants and had at least 6months follow-up, were included in this study. Of 1527 female patients operated, 1126 patients with 2252 breast implants met the inclusion criteria. The mean implant volume was 310.9cc, and the mean follow-up was 18.8months. 1.8% of implants (n = 41) were found to be clinically rotated at a mean of 14.9months after surgery. A statistically significant higher incidence rate was found on the left side. Rotation of anatomical implants is often stated as a reason to avoid their use. Our data suggest that despite a short learning curve, it is not an insurmountable problem and with attention to the etiology, its incidence can be consistently minimized.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The inframammary fold (IMF) is an important landmark in breast aesthetic surgery. In augmentation mastopexy procedures, secure and accurate placement of the IMF is essential to aesthetic outcomes and to allow the new IMF to heal in the correct position without displacement. The authors present a simple and efficient four-layer wound closure technique using barbed sutures for closure of the repositioned IMF in augmentation mastopexy procedures. This method was previously described by the first author for reset of the IMF in breast augmentation surgery and has been adapted to the longer IMF incision in augmentation mastopexy procedures. A retrospective review was undertaken of 335 patients who underwent bilateral breast augmentation mastopexy procedures with a Wise pattern technique at a single unit. The newly reset IMF was closed using barbed sutures and a four-layer closure technique. There were no cases of complications related to wound healing or wound dehiscence. One patient required explantation for an infected implant. The four-layer wound closure technique with barbed sutures provides a quick and efficient method for accurate closure of the newly reset IMF, with positive outcomes related to wound healing. Secure and accurate placement of the inframammary fold is crucial in augmentation mastopexy procedures. The use of a four-layer wound closure technique with barbed sutures provides an efficient method for accurate closure of the newly reset inframammary fold. This method was previously described by the first author for reset of the IMF in breast augmentation surgery and has been adapted to the longer IMF incision in augmentation mastopexy procedures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Aim: Tinnitus is a common symptom in dental patients presenting with Temporomandibular Disorders (TMD). In this study, 66 patients were examined and underlying variations in dental appearance, jaw position, jaw joint health, radiographic findings, and symptoms were recorded. The patients were randomly placed into either an intervention or a control group to assess the effectiveness of a relaxation device aiming to reduce tinnitus. Method: 100 patients referred for TMD problems and suffering from tinnitus were asked to participate in the study. 66 patients completed two questionnaires before the first consultation with a specialist in orofacial pain and function and 46 of them completed the randomised trial. Results: TMD patients most likely to be suffering from tinnitus had experienced stress, felt tension in the jaw or presented with neck problems. Clinical dental examinations revealed that these patients displayed a deep bite, had a click or scrape sound from their jaw joints and/or had parafunctional habits (grinding or clenching their teeth). Patients in the relaxation device group reported significant improvement at p<0.01 compared with control group after 4 months treatment. Conclusion: This study presents general clinical signs and criteria that also non-dental medical professionals can use as a guide for referring tinnitus patients for specialist dental care. Patients under stress who are clenching or grinding their teeth, have missing teeth, midline shift and experience sounds from their jaw joints could benefit from examination by a dental specialist and the use of a relaxation device.

Primary breast augmentation is one of the most commonly requested aesthetic procedures. Considering the large number of procedures performed in connection with a high demand, it is crucial to prevent complications. For this reason, finding and avoiding possible sources of complications is decisive. Between January 2010 and December 2021, 1625 female patients underwent an aesthetic breast augmentation performed by a single surgeon. The data collected were analyzed through a machine learning technique for binary recursive partitioning. This made it possible to detect unknown sources of a complication and determine a vertex for the various features. When analyzing the data, for most features a high importance score with low entropy was achieved, concluding a high significance. In addition, reproducibility was demonstrated through detailed testing and training accuracies in the algorithm. With this procedure, in addition to known risks such as a high BMI and round implant shape, a larger than A preoperative bra-cup size (OR: 2.7) and a taller body could also be identified as most significant influencing factors for complications. Preoperative breast size plays an exceptionally important role in the occurrence of complications and should be a factor held in a surgeon's considerations. In addition, this study shows ways to transfer artificial intelligence into plastic surgery to increase medical quality. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

In patients with short nipple to inframammary fold (N-IMF) distance, as in tuberous breast, the cohesivity and gel distribution of shaped implants work as a controlled tissue expander, progressively adapting the tissues to the implant's shape. This phenomenon translates into a gradual increase of the N-IMF distance over time, but the true extent to which this occurs has not been quantified to date. This study aims to quantify the postoperative variation of the N-IMF distance in tuberous breast treated with shaped cohesive silicone breast implants. We did a retrospective review of a prospective maintained database of all consecutive patients with bilateral Groulleau I and II tuberous breasts who underwent primary breast augmentation between April 2017 and May 2018 at our institution. To quantify the lower mammary pole's morphological changes, we evaluated the N-IMF distance under maximal stretch as an endpoint. We recorded this value at time 0 (preoperative), immediate post-op (equivalent to the distance planned preoperatively) and at month 1, month 6 and 1-year post-op. Then we calculated the average N-IMF distance variation of our sample of patients with a 99% interval of confidence for each breast obtained. Comparisons were performed using the Sign test and the Mann-Whitney U test. The average implant weight was 353g (range 290-450; SD ±46.147). Of the 54 breasts analyzed, the immediate post-op N-IMF distance was on average 2.43 cm longer than the preop IMF with a 99% confidence interval between 2.01 and 2.86 and SD of ±1.22. The mean difference between the preop N-IMF distance and after 1, 6 and 12 months was respectively 2.78cm (SD,1.56) (99% CI, 2.24-3.34), 3.08 cm (SD, 1.57) (99% CI, 2.53-3.64), and 3.36 (1.55) (99% CI, 2.82-3.91) Comparing immediate postoperative nipple to inframammary fold distance (N-IMF) to the 1, 6 and 12 months N-IMF values, an average of 4.23% (CI 1.3-7.16), 7.74% (CI 4.25-11.23) and 10.84% (CI 7.21-14.49) of skin length, was gained respectively. According to implants' weight, subgroup analysis showed that implants > 400g were associated with significantly higher N-IMF distance increase (p <0.05) compared to implants < 400g. Our findings suggest that a significant progressive postoperative increase in N-IMF distance should be expected in all cases of tuberous breast augmentation with anatomical implants over a 1 year period. This aspect may have an important implication on the IMF incision and the new fold position preoperative planning. LEVEL OF EVIDENCE IV.

Pandemi covid 19 telah memaksa pendidik dan peserta didik untuk melakukan transformasi pembelajaran dari pembelajaran tatap muka/luar jaringan kepada pembelajaran tatap maya/dalam jaringan. Dirjen GTK Kemdikbud RI. Iwan Syahril dalam paparannya saat menjadi Narasumber dalam Webinar Guru Abad 21 mengatakan “…pandemi telah memaksa kita untuk akrab dengan teknologi dan guru adalah orang pertama yang dituntut untuk menguasai teknologi pembelajaran...pandemi di satu sisi memantik kreatifitas guru”. Padlet adalah salah satu platform pembelajaran daring yang bisa menjadi pilihan guru untuk tetap melaksanakan pembelajaran dengan menarik dan efektif. Kehadiran padlet menambah pilihan bagi guru untuk menyajikan pembelajaran daring. Dengan berbagai kelebihan-kelebihan yang dimiliki padlet sebagai platform pembelajaran daring diharapkan agar pembelajaran dapat terlaksana dengan efektif walaupun dalam masa pandemi covid 19. Lebih lanjut, penggunaan padlet dalam pembelajaran dapat dijadikan sebagai wadah kolaborasi antar guru baik sesama guru mata pelajaran maupun antar mata pelajaran. Hal ini juga relevan dengan “silent revolution” yang menjadi ciri komunitas belajar dalam Lesson Study for Learning Community/LSLC).