1. Dr Carstens is a Clinical Associate Professor of Plastic Surgery, Saint Louis University, St. Louis, MO; and a Professor of Plastic Surgery, National University of Nicaragua in Leon, Nicaragua. Dr Mendieta is a plastic surgeon in private practice in Managua, Nicaragua. Dr Pérez is a radiologist in private practice in Managua, Nicaragua. Dr Villareal is a physiatrist in private practice in Managua, Nicaragua. Mr Garcia is a physical therapist in private practice in Managua, Nicaragua.