Plastics

• 1988 – 1992

Vanderbilt University, Nashville, TN - B.A., European History (High honors in History), Minor Degree in Studio Art, Magna Cum Laude

• 1992 – 1996

Tulane University Medical School, New Orleans, LA, Doctor of Medicine

• 1996 – 1998 Categorical Surgical Resident

New York Presbyterian Hospital, Weill-Cornell Medical Center, Department of Surgery, New York, NY

• 1998 – 2001 Research Fellow

Massachusetts General Hospital, Harvard Medical School, Department of Surgery, Boston, MA

• 2001 – 2003 Categorical Surgical Resident

New York Presbyterian Hospital, Weill-Cornell Medical Center, Department of Surgery, New York, NY

• 2003 – 2004 Chief Resident and Clinical Instructor in General Surgery

New York Presbyterian Hospital, Weill-Cornell Medical Center, Department of Surgery, New York, NY

• 2004 – 2006 Resident in Plastic and Reconstructive Surgery

University of Texas, Southwestern Medical Center, Department of Plastic and Reconstructive Surgery, Dallas, TX

Mathes Publications Link

Skin closure 3-0, 4-0 monocryl. Does not “cross midline of the patient or breast” with closing sutures.
For dressings he uses steri-strips and mastisol and he puts the mastisol right on the incisions.

Sutures: for incision use 3-0 and 4-0 monocryl. Stab incisions for liposuction or fat grafting closed with 5-0 fast gut
Dressings: Bra with ABD pads, Binder with ABD pads, Mastasol (NOT benzoin) and steri strips over incisions, steri strip over stab incisions. No need to wrap/compress liposuction sites. Okay for DERMABOND® PRINEO® Skin Closure System.
Equipment: Uses silk tie with two mosquitos for measuring symmetry. 5 staplers.
Markings: Standard breast markings. Mark midline by sternal notch and introits.
Prep: Chloraprep

Marking and Sizing the Nipple: Sit patient up once all incisions are stapled closed. Mark nipple position at area of greatest projection. Lie patient back flat and remove the staples within the marked nipple circle. With the same nipple sizer, make a new circle in the center of the prior marked circle. This smaller circle is now the new nipple position. De-epithelialize the skin within the circle and then cruciate the dermis. Pull nipple through and secure with interrupted 3-0 monocryl and then running 4-0 monocryl. ***Mathes does not like 4-0 suture to cross T-junctions. Do individual running sutures for each limb.

Ties a 3-0 nylon suture the the internal medial and lateral walls of the umbilicus and leaves long tails (this is both to assist in incising and later orienting the umbilicus. Pull up on the 2 sutures and mark a small circle around the umbilicus for incision. Incise down to subQ tissue and stop. He likes to divide the inferior pannus in half and extend it up to the umbilicus incision then get around the stalk while holding the panniculus skin flaps in the other hand. When closing the abdomen pull the 2 sutures on the umbilicus out through the inferior incision. Before completely closing the incision, find the umbilical stalk and make a mark on the overlying skin. Cut out a 2x1cm circle and pull the sutures through, making sure orientation is good. Secure umbilicus with interrupted 3-0 monocryl and ½ buried 4-0 horizontal mattress sutures as needed. Dermabond. (Mathes will also sometimes do an inferior flap incision for the new umbilicus location. It looks like an upside-down shield.)

Intraoperative antibiotics. Antibiotics for home Sutures: 3-0 PDS for TE and alloderm, 3-0 monocryl deep dermal, 4-0 monocryl subcuticutlar, mastisol and steris

Pre-Pec- 2 pieces of alloderm sew into IMF and circumferentially at Breast “SFS” dont really sew into muscle Horizontal mattress sutures to secure alloderm, make sure expander is as low as can go the lower the better. Sew alloderm in first superior and inferior than place TE secure inferior and lateral and if can get medial as well. then sew both alloderms together. Place drain. Close

Intraoperative antibiotics. No antibiotics for home. Sutures: 3-0 vicryl for capsule, 3-0 monocryl deep dermal, 4-0 monocryl subcuticutlar

Intraoperative antibiotics. 1 week of Keflex for home. Close stab incisions with 5-0 fast gut. Steri strip dressing.

“Mark midline once patient is on table but BEFORE prepping If no CT scan, make sure you doppler out perforators BEFORE prepping”

Only remove A FEW staples if you think there is venous congestion. Hematoma should be handled in OR