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Plast Aesthet Res 2018;5:6 I http://dx.doi.org/10.20517/2347-9264.2018.08 Page 11 of 17

17. Predicting success in breast augmentation: sizes, shapes and subjectivity

Hunter Moyer

Regional Health, Rapid City

Aim: It remains difficult to define what women desire for breast augmentation. Accepted re-operation rates
after primary breast augmentation remain over 20% in large studies, and implant exchange is one of the
leading causes.

Methods: This study is a computer-generated, visual survey of eight female models with Vectra simulated
augmentations using varying sizes of round and anatomic implants. A total of 314 females and 137 males
rated the augmentations from best to worst for a total 1967 individual ratings.

Results: Natural, conservative and full are words associated positively with a successful breast augmentation.
A review of current literature estimates the average breast implant volume in the United States between 350
and 374 mL. In this study, the highest rated implant was a 457 mL round device. A normal distribution
simulating the best ratings has an average of 416 mL (standard deviation = 48 mL) (P = 0.00000001 vs.
current literature average augmentation volume). Round implants were rated better than anatomic over the
entire volume range (3.47 vs. 3.54, P = 0.00002), and within the central portion of higher rated volumes (2.67
vs. 3.01, P = 1.6e-12). There was no difference in preference of shape or volume between men and women or
between respondents of varying ages, socioeconomic status or geographic location.

Conclusion: While patients describe the ideal breast augmentation as natural and conservative, they
universally choose an implant that is 20% greater than bio-dimensional planning. Round implants were
rated better, and there is no difference in preference between men and women.

18. The use of bilateral paraspinous muscle flaps and bilateral composite latissimus dorsi
and gluteus maximus flaps for closure of lumbosacral myelomeningocele defects in
infants

Kathleen Holoyda, John Kestle, Barbu Gociman, Faizi Siddiqi

University of Utah

Aim: Robust, reliable and reproducible closure of lumbosacral myelomeningocele defects remains a
challenge. Closure of spinal defects following neurosurgical procedures with well-vascularized flaps in high-
risk patients has been shown to reduce complications in the adult population. In infants with lumbosacral
myelomeningocele, in addition to the relatively standard neurosurgical repair that consists of placode
tubularization and dural repair, multiple methods of soft tissue coverage have been described. These include
various cutaneous, fascial and muscle flaps and grafts. We present here our closure technique with well-
vascularized flaps following lumbosacral myelomeningocele repair.

Methods: After the neurosurgical repair of lumbosacral myelomeningocele is completed bilateral composite
latissimus dorsi muscleocutanous and gluteus maximus fasciocutanous flaps are elevated. The paraspinous
muscle flaps are then elevated and medialized based on the lateral row arterial perforators to provide