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Page 4 of 17 Plast Aesthet Res 2018;5:6 I http://dx.doi.org/10.20517/2347-9264.2018.08

tissue expander (6) or implant (2) placement. One patient required take-back to the operating room
for hematoma evacuation. Three NAC’s demonstrated partial necrosis; all were successfully treated
with local wound care. No NAC loss, T-junction breakdown, wound dehiscence, infection or implant
extrusion/exposure was noted.

Conclusion: Wise-pattern skin incision with NAC repositioning and immediate, implant-based reconstruction
is a safe and useful technique for managing large, ptotic breasts during NSM. In carefully selected patients,
it has a high success rate and provides optimal aesthetic results.

6. Cherubism in a 4-year-old boy managed with tumor debulking and mandibular

osteotomies and repositioning

Rhett Willis, Jared Garlick, Daniel Donato, Barbu Gociman

The University of Utah

Cherubism is a hereditary, disfiguring growth of the mandibles/maxilla in young children. It is
characterized by significant loss of medullary bone which is replaced by excessive amounts of fibrous
tissue. It is an extremely rare (300 reported cases), autosomal dominant disease. Although generally
self-limiting, when severe, can cause significant functional and psychosocial impairment for the
patient. Current literature advocates a "wait and watch approach", as majority of these will partially
or completely remit after puberty. A 4-year old boy presented with rapidly enlarging mandible and
maxilla causing significant change in the facial contour, malocclusion and phonation difficulties. He
was treated with aggressive tumor debulking. In addition, using a piezo-electric saw, the lateral cortexes
of the mandibular rami, angles and bodies were osteotomized and repositioned bilaterally. This allowed
the obliteration of the grotesquely enlarge medullary spaces and restoration of a normal mandibular
anatomy. At 8 months postoperatively, the patient had significant improvement in facial contouring and
a normal outward appearance and stable dentition. A CT scan showed significant ossification around
the molars at the site of mandibular bone repositioning. Although in the majority of cherubism cases
there is spontaneous regression after puberty, the sequela of this disfiguring condition in the patient’s
formative years can cause a lifetime of psychological and physical stress in addition to permanent soft
tissue and dental abnormalities. Based on our experience, we recommend that early surgical intervention
in severe cherubism cases be strongly considered.

7. Beauty and the bull: traumatic rupture of a breast implant in Pamplona, Spain

Nicole Kurnik, Alanna Rebecca, Lyndsey Bryant

Mayo Clinic - Arizona

Aim: Bullhorn injuries are more common in Ibero-American countries where bulls are involved in sport.
There is a lack of information in the literature regarding these injuries. The purpose of this study is to present
a case of a bullhorn injury to the thorax causing a ruptured and infected breast implant and a review the
literature.