Li, Rena A.

Background: Skin cancer patients who undergo Mohs surgery may require subsequent reconstructive rhinoplasty for large nasal defects. Autologous cartilage is the primary source of supporting cartilage grafts, but carries the risk of potential donor-site complications. In this study, we demonstrate the safety and efficacy of nonterminally irradiated fresh frozen human costal cartilage allografts (CCAs) in reconstructive rhinoplasty after skin cancer removal. Methods: A retrospective chart review of 25 patients who underwent reconstructive rhinoplasties using human CCA after basal cell carcinoma resection was conducted. Human CCA undergoes a process of sterilization without terminal irradiation and is stored frozen (−40°C to −80°C). Anthropometric measurements were taken on pre- and postoperative photographs to evaluate nasal tip projection. Adverse events were evaluated. Results: There were 25 participants, with an average age of 71 years at the time of surgery (range: 42–90). The average follow-up duration was 12 months (range: 3–66 mo). Types of grafts used included alar batten graft (n = 17, 68%), nasal tip graft (n = 7, 28%), and alar batten graft with nasal tip graft (n = 1, 4%). Measurements on the 2-dimensional photographs of the patients showed no significant resorption or deviation at the 6- or 12-month follow-up. No significant complications related to the use of the cartilage were noted. Conclusions: Our data highlight the low complication rate and aesthetically positive outcomes from using nonterminally irradiated human CCA for reconstructive rhinoplasties in post-Mohs surgery for older patients. This approach offers a reliable source of high-quality cartilage for reconstruction.

Abstract This historical narrative presents a comprehensive historical journey delving into the diverse facets of gender identity and expression across ancient cultures. It explores these civilizations' perspectives on gender diversity, highlighting instances that challenged conventional gender norms. Transitioning to the modern era, the narrative examines the dynamic landscape of LGBTQ+ and trans movements, spotlighting influential figures whose advocacy has significantly influenced societal perceptions and advanced the rights of gender diverse individuals. Their contributions continue to shape contemporary affirming care practices. Exploring the emergence of gender-affirming surgery, the narrative highlights pioneering surgeons and original techniques employed in these transformative procedures. It shows the courage and innovation of early surgeons who laid the groundwork for contemporary practices. At the core of this historical narrative lies the pivotal role of plastic surgeons in gender-affirming care. It emphasizes the significance of a collaborative multidisciplinary approach among medical professionals to ensure comprehensive and patient-centered care for transgender individuals seeking affirming interventions. However, intertwined with this narrative are legislative barriers that have hindered progress in gender-affirming care. The narrative navigates these obstacles, highlighting their complexities and emphasizing the urgent need for sustained medical advocacy and legislative reforms to foster an inclusive healthcare landscape. Ultimately, this narrative stands as a testament to the ongoing struggle and resilience within the realm of gender-affirming care, shedding light on its profound impact on individuals' lives, emphasizing the ongoing need for compassionate, comprehensive, and inclusive healthcare practices.