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Plastic Surgeon
13 years of experience
Video profile
Accepting new patients

Education ?

Medical School Score Rankings
University of Michigan Medical School (1997)
  • Currently 4 of 4 apples
Top 25%
Fellowship
Manhattan Eye, Ear & Throat Hospital (2006) *
Plastic Surgery
* This information was reported to Vitals by the doctor or doctor's office.

Awards & Distinctions ?

Awards  
Patients' Choice Award (2010 - 2014)
Compassionate Doctor Recognition (2010 - 2013)
On-Time Doctor Award (2014)
Associations
American Board of Plastic Surgery
American Society of Plastic Surgeons

Affiliations ?

Dr. Jejurikar is affiliated with 11 hospitals.

Hospital Affilations

Score

Rankings

  • Texas Health Harris Methodist Hospital Southwest Fort Worth
    6100 Harris Pkwy, Fort Worth, TX 76132
    • Currently 4 of 4 crosses
    Top 25%
  • Harris Methodist H E B
    1600 Hospital Pkwy, Bedford, TX 76022
    • Currently 4 of 4 crosses
    Top 25%
  • Baylor University Medical Center *
    3500 Gaston Ave, Dallas, TX 75246
    • Currently 4 of 4 crosses
    Top 25%
  • Texas Health Harris Methodist Hospital Azle
    108 Denver Trl, Azle, TX 76020
    • Currently 3 of 4 crosses
    Top 50%
  • Texas Health Presbyterian Hospital Of Dallas *
    8200 Walnut Hill Ln, Dallas, TX 75231
    • Currently 3 of 4 crosses
    Top 50%
  • Medical Center Of Plano *
    3901 W 15th St, Plano, TX 75075
    • Currently 2 of 4 crosses
  • Presbyterian Hospital
  • Texas Health Dallas
  • Pine Creek Medical Center
    9032 Harry Hines Blvd, Dallas, TX 75235
  • Harris Methodist - Springwood
    1608 Hospital Pkwy, Bedford, TX 76022
  • Harris Continued Care Hospital
    1301 Pennsylvania Ave, Fort Worth, TX 76104
  • Publications & Research

    Dr. Jejurikar has contributed to 10 publications.
    Title Immediate, Optimal Reconstruction of Facial Lentigo Maligna and Melanoma Following Total Peripheral Margin Control.
    Date October 2007
    Journal Plastic and Reconstructive Surgery
    Excerpt

    BACKGROUND: Peripheral margin control of lentigo maligna and melanoma on the head and neck can be problematic. Frozen sections are unreliable, and conventional histopathology cannot examine the entire margin. Customary treatment involves wide excision and dressing care or skin graft coverage until histopathologic evaluation is complete, as reexcision is frequently required because of positive margins. Wound contraction, donor-site morbidity, and additional procedures before reconstruction are inherent disadvantages to this approach. METHODS: After excisional biopsy of facial lentigo maligna and thin (<1 mm) lentigo maligna melanoma, peripheral margin control was performed in the office by means of excision of 2-mm-wide linear strips of skin, 5 to 10 mm from the biopsy site, combined with simple wound closure. Total margins were evaluated by means of permanent sections. Repeated margin excision was performed until clear. Definitive excision of the lesion was then performed and, with confidence of negative peripheral margins, the optimal reconstructive option was pursued immediately. RESULTS: Fifty-one lesions underwent "square" peripheral margin control, with lentigo maligna melanoma present in nine lesions (average Breslow depth, 0.65 mm). Margins required for clearance of lentigo maligna and lentigo maligna melanoma averaged 1.0 and 1.3 cm, respectively. No recurrences were identified with long-term follow-up. Reconstruction using the optimal procedure was performed immediately in all cases. CONCLUSIONS: Use of the square technique in the management of lentigo maligna and lentigo maligna melanoma improves the certainty of peripheral margin control before definitive excision. Immediate reconstruction can be performed, thereby avoiding temporizing procedures or open wounds and providing for optimal aesthetic and functional results.

    Title Aging Increases the Susceptibility of Skeletal Muscle Derived Satellite Cells to Apoptosis.
    Date January 2007
    Journal Experimental Gerontology
    Excerpt

    The mechanisms causing the impaired regenerative response to injury observed in skeletal muscle of old animals are unknown. Satellite cells, stem cell descendants within adult skeletal muscle, are the primary source of regenerating muscle fibers. Apoptosis may be a mechanism responsible for the depletion of satellite cells in old animals. This work tested the hypothesis that aging increases the susceptibility of satellite cells to apoptosis. Satellite cells were cultured from the extensor digitorum longus muscles of young (3-month-old), adult (9-month-old), and old (31-month-old) Brown Norway rats. Satellite cells were treated for 24h with the pro-apoptotic agents TNF-alpha (20 ng/mL) and Actinomycin D (250 ng/mL). Immunostaining for activated caspases and terminal deoxynucleotydil transferase-mediated dutp nick-end labeling (TUNEL) was performed to identify apoptotic satellite cells. Quantity of the anti-apoptotic protein bcl-2 was determined by Western blot analysis. Satellite cells from old animals demonstrated significantly higher percentages of cells with activated caspases and TUNEL-positive cells, and significantly lower amounts of bcl-2 compared to young and adult animals. These data support the hypothesis that aging increases satellite cell susceptibility to apoptosis. In old muscle, apoptosis may play a causative role in the depletion of satellite cells, impairing the regenerative response to injury.

    Title Satellite Cell Depletion in Degenerative Skeletal Muscle.
    Date July 2004
    Journal Apoptosis : an International Journal on Programmed Cell Death
    Excerpt

    Adult skeletal muscle has the striking ability to repair and regenerate itself after injury. This would not be possible without satellite cells, a subpopulation of cells existing at the margin of the myofiber. Under most conditions, satellite cells are quiescent, but they are activated in response to trauma, enabling them to guide skeletal muscle regeneration. In degenerative skeletal muscle states, including motor nerve denervation, advanced age, atrophy secondary to deconditioning or immobilization, and Duchenne muscular dystrophy, satellite cell numbers and proliferative potential significantly decrease, contributing to a diminution of skeletal muscle's regenerative capacity and contractility. This review will highlight the fate of satellite cells in several degenerative conditions involving skeletal muscle, and will attempt to gauge the relative contributions of apoptosis, senescence, impaired proliferative potential, and host factors to satellite cell dysfunction.

    Title Evaluation of Plastic Surgery Information on the Internet.
    Date February 2003
    Journal Annals of Plastic Surgery
    Excerpt

    The Internet allows vast access to medical information. Unlike most plastic surgery literature, the Internet is a quagmire of unfiltered information, not subject to peer review. To assess the accuracy of medical information on the Internet the authors studied one commonly performed elective procedure, classifying and defining the information retrieved. Using the keyword "breast augmentation," the authors compiled a list of the first 300 web sites, obtained from six distinct search engines, yielding 215 unique sites. They devised an instrument to evaluate each site for its accessibility, relevance, and accuracy. Of the 215 unique web sites evaluated, 20 were inaccessible, 24 were irrelevant, and 41 contained no medical information. Of the remaining 130 sites, almost 34% contained false or misleading information. Errors pertained most often to the technical details of the operation, potential benefits, and risks. In addition, exaggerated claims concerning alternative breast enhancement regimens, adverse sequelae of silicone breast implants, and potential effects on lactation were also seen commonly. A considerable amount of information regarding breast augmentation on the Internet was either misleading or inaccurate. Physicians can assist their patients with specific guidelines to allow them to process information discerningly, thereby diminishing the likelihood that medical decisions are based on misinformation.

    Title Skeletal Muscle Denervation Increases Satellite Cell Susceptibility to Apoptosis.
    Date July 2002
    Journal Plastic and Reconstructive Surgery
    Excerpt

    Peripheral motor nerve trauma severely compromises skeletal muscle contractile function. Satellite cells respond to denervation by dividing multiple times, ultimately fusing with other satellite cells or myocytes to form new muscle fibers. After chronic denervation, satellite cell numbers decline dramatically, impairing the ability to regenerate and repair myofibers. This satellite cell depletion may contribute to the mechanical deficit observed in denervated or reinnervated muscle. Apoptosis, an evolutionarily conserved form of cell suicide, is a potential mechanism for satellite cell depletion in denervated skeletal muscle. This work tested the hypothesis that skeletal muscle denervation increases satellite cell susceptibility to apoptotic cell death. Adult rats underwent sciatic nerve transection to denervate the distal hindlimb musculature; rats of similar age without the operation served as controls. Two, 6, 10, or 20 weeks after denervation (n = 6 each group), the gastrocnemius and soleus were excised, enzymatically digested, and plated for satellite cell culture. After reaching 95 percent confluence, satellite cells were treated for 24 hours with tumor necrosis factor-alpha (20 ng/ml) and actinomycin D (250 ng/ml), known pro-apoptotic agents. Immunostaining for activated caspases, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), and hematoxylin and eosin staining were performed to identify apoptotic satellite cells. Percentages of apoptotic cells were quantified histomorphometrically. In addition, the presence or absence of bcl-2 and bax was determined by Western blot analysis of control, 6 weeks of denervation, and 10 weeks of denervation specimens. At 6 and 10 weeks after nerve transection, TUNEL and caspase activity were increased more than two-fold in satellite cells isolated from denervated muscle compared with those isolated from control muscle (p < 0.05). In all experimental groups, retention of adherence to the collagen-coated substrate was strongly associated with satellite cell survival. Western blot analysis revealed that adherent satellite cells from all groups expressed both bcl-2 and bax. These data support the authors' hypothesis that skeletal muscle denervation increases satellite cell susceptibility to apoptotic cell death. Apoptosis may play a causative role in the depletion of satellite cells in long-term denervated skeletal muscle.

    Title The Effect of Two Episodes of Denervation and Reinnervation on Skeletal Muscle Contractile Function.
    Date January 2002
    Journal Plastic and Reconstructive Surgery
    Excerpt

    Sensory or motor "baby-sitting" has been proposed as a clinical strategy to preserve muscle integrity if motion-specific axons must regenerate over a long distance to reach denervated target muscles. Denervated muscles are innervated temporarily by using axons from nearby sensory or motor nerves. After motion specific motor axons have reached the target, the baby-sitter nerve is severed and motion-specific axons are directed to the target. Although this strategy minimizes denervation time, the requisite second episode of denervation and reinnervation might be deleterious to muscle contractile function. This study was designed to test the hypothesis that two sequential episodes of skeletal muscle denervation and reinnervation result in greater force and power deficits than a single peripheral nerve injury and repair. Adult Lewis rats underwent either transection and epineurial repair or sham exposure of the left peroneal nerve. After a 4-month recovery period, the contractile properties of the extensor digitorum longus muscle of the sham exposure group (control, n = 9) and one of the nerve division and repair groups (repair group 1, n = 9) were evaluated with measurements of the maximum tetanic isometric force, peak power, and maximal sustained power. A third group of rats underwent a second cycle of nerve division and repair (repair group 2, n = 9) at this same time point. Four months postoperatively, contractile properties of the extensor digitorum longus muscles were evaluated. Maximum tetanic isometric force and peak power were significantly reduced in repair group 2 rats as compared with repair group 1 and control rats. Maximal sustained power was not significantly different between the groups. These data support our working hypothesis that skeletal muscle contractile function is adversely affected by two cycles of denervation and reinnervation as compared with a single episode of nerve division and repair.

    Title A Specific Force Deficit Exists in Skeletal Muscle After Partial Denervation.
    Date January 2002
    Journal Muscle & Nerve
    Excerpt

    Skeletal muscle demonstrates a specific force deficit after repair of injured peripheral nerves, microneurovascular muscle transfer, and normal aging. Because atrophy cannot account for deficits in specific force, other, unknown, mechanisms are responsible for the resulting muscle contractile dysfunction under these circumstances. We tested the hypothesis that a subpopulation of denervated fibers is partially or completely responsible for the specific force deficit after partial denervation of the rat extensor digitorum longus muscle (EDL). Adult Fisher rats underwent either sham exposure or partial transection of 80% of the cross-sectional area of the left deep peroneal nerve. After a 2-week recovery period, maximum isometric force (F(0)) was measured in situ and maximum specific force (sF(0)) was calculated for EDL from both control (n = 8) and partial denervation (n = 7) groups. Innervated fiber cross-sectional area (CSA(inn)) was measured directly from whole EDL cross sections after immunohistochemical labeling for neural cell adhesion molecule (NCAM), a marker of muscle fiber denervation. A corrected specific force value (sF(0-inn)) was calculated by normalizing F(0) to CSA(inn). Partial skeletal muscle denervation resulted in significant reductions in muscle mass, F(0), and sF(0). The percentage of muscle fibers expressing NCAM in the extrajunctional sarcolemma increased from 1.0 +/- 0.8% in control to 49 +/- 15% in partially denervated EDL muscles. A 62.7% deficit in EDL specific force was observed after partial denervation. Denervated muscle fibers accounted for 59.3% of this deficit, but sF(0-inn) still differed significantly between control and partially denervated muscles, with a 25.5% difference between groups. In partially denervated muscles, the specific force deficit is partially but not fully explained by a subpopulation of noncontractile, denervated fibers.

    Title Range of Motion Physiotherapy Reduces the Force Deficit in Antagonists to Denervated Rat Muscles.
    Date August 2001
    Journal The Journal of Surgical Research
    Excerpt

    BACKGROUND: We used a rat hindlimb model of tibial nerve transection to determine if a loss of mechanical function exists in innervated antagonists compared with denervated muscles. We tested two hypotheses: (1) denervation of the rat ankle plantar flexors results in decreased force production of the ankle dorsiflexors, and (2) daily passive ankle range of motion (ROM) physiotherapy prevents or reduces the force deficit. METHODS: Adult Lewis rats were assigned to one of three groups: (1) a sham (S) group, in which the tibial nerve was exposed but not transected; (2) a no rehabilitation (NR) group, in which a 2-cm segment of tibial nerve was excised at midthigh to denervate the ankle plantar flexors; or (3) a rehabilitation (R) group, in which a 2-cm segment of tibial nerve was excised and the animals were subjected to ankle passive ROM physiotherapy for two 5-min sessions each day. After 14 days, maximum isometric tetanic force (F(0)) and specific force (sF(0)) were measured in the extensor digitorum longus (EDL) muscle, an ankle dorsiflexor. RESULTS: Compared with those from animals in the S group, EDL muscles from animals in the NR group demonstrated a 22% decrease in both F(0) and sF(0). In the EDL from animals in the R group, daily passive ROM physiotherapy diminished the deficit in F(0) but not in sF(0). CONCLUSIONS: These data support the hypotheses that nerve injuries result in impaired mechanical function in the innervated antagonists to denervated muscles and that passive ROM physiotherapy can improve force production in these muscles.

    Title Recurrence of Pyoderma Gangrenosum Within a Chronic Wound Following Microvascular Free-tissue Transfer.
    Date March 2001
    Journal Journal of Reconstructive Microsurgery
    Excerpt

    The authors present a 29-year-old woman with a chronic foot wound that failed to heal, despite extensive medical and surgical therapy. The diagnosis of pyoderma gangrenosum was ultimately made, and the patient was started on systemic cyclosporine therapy. In the absence of apparent active disease, surgical debridement and microvascular free flap reconstruction were performed to achieve wound closure. Six weeks postoperatively, recurrence of the pyoderma gangrenosum was identified in the free flap, resulting in partial, superficial, flap necrosis. Laboratory evaluation at that time demonstrated subtherapeutic cyclosporine levels. Once the cyclosporine level was increased to the therapeutic range, the wound healed, and the microvascular free flap was salvaged. Because of the relative lack of precision in both the clinical and pathologic determination of acuity level, as well as the tendency toward pathergy, surgical treatment of any form poses many potential risks for these patients. For this reason, surgery should serve only as an adjunct to medical therapy, which remains the mainstay for treatment of pyoderma gangrenosum.

    Title Induction of Angiogenesis by Lidocaine and Basic Fibroblast Growth Factor: a Model for in Vivo Retroviral-mediated Gene Therapy.
    Date April 1997
    Journal The Journal of Surgical Research
    Excerpt

    A strategy of direct, in vivo retroviral-mediated gene therapy targeting capillary endothelial cells must provide an environment of active angiogenesis. Both lidocaine and basic fibroblast growth factor (bFGF) promote angiogenesis, but the angiogenic response invoked by these substances in normal skeletal muscle has not been fully characterized. We sought to characterize these agents' angiogenic effects in anterior tibialis muscles of male Sprague-Dawley rats. An injection of either 1% lidocaine with 1:100,000 epinephrine or alternate-day injections of bFGF (0.025 or 0.25 microgram) with or without heparin were tested (n = 6 muscles/condition). Rats were sacrificed 4, 7, 10, or 12 days later and muscles were evaluated histologically to determine the number of proliferating cells using 5-bromo-2'-deoxycytidine (BrdC) and evaluated for capillary density using Griffonia simplicifolia I (GSI) lectin. At all time points, lidocaine produced at least 20-fold greater capillary density and cellular proliferation than PBS control (P < 0.0001). Injections of high-dosage bFGF produced more than fivefold greater capillary density than control injections at 7 and 10 days (P < 0.001), and more than twofold greater proliferation at 4, 7, and 12 days (P < 0.001). Capillary density returned to control levels 12 days following bFGF administration, whereas it remained well above control levels for 12 days after lidocaine administration. To confirm that lidocaine can be utilized in gene therapy strategies targeting vascular endothelium and skeletal muscle fibers, concentrated pLJ retrovirus containing cDNA for the heat-stable human placental alkaline phosphatase (hpAP) marker gene was infused into the rat hindlimb vasculature 4 days post-lidocaine administration. Rats receiving pLJhpAP retrovirus demonstrated significant hpAP transgene expression in endothelial cells and myocytes 21 days after the lidocaine injection (n = 6 muscles). In contrast, controls receiving pLJhpAP infusion without prior lidocaine administration failed to demonstrate any hpAP transgene expression. Lidocaine treatment evokes a substantially higher proliferative response than bFGF and, importantly, a durable angiogenic response in skeletal muscle. Thus, lidocaine is an ideal agent to induce angiogenesis in preparation for direct in vivo retroviral-mediated gene therapy targeting vascular endothelium.

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