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Plastic and Reconstructive Surgery. Global Open

Kyle S Gabrick, Nickolay P Markov, Fouad Chouairi, Robin Wu, Sarah M Persing, Paul Abraham, Tomer Avraham, Michael Alperovich
Background: Two-stage tissue expander (TE)/permanent implant (PI) breast reconstruction remains the most commonly performed technique in breast reconstruction. Predictions for the PI size preoperatively impact on the number and range of implants made available at TE exchange. This study aims to identify critical preoperative variables and create a predictive model for PI size. Methods: Patients who underwent 2-stage implant breast reconstruction from 2011 to 2017 were included in the study...
May 2018: Plastic and Reconstructive Surgery. Global Open
Martha Fang, Eqram Rahman, Krishan Mohan Kapoor
Hyaluronic acid dermal fillers are becoming popular all over the world, but due to the presence of many blood vessels in the face, there is always a small possibility of vascular complications. We present a case with the ischemic involvement of chin and neck skin after accidental submental artery involvement after hyaluronic acid filler injection for chin region. Impending skin necrosis on the chin and upper neck on the right side was diagnosed quickly by observing the skin changes in the immediate postfiller phase...
May 2018: Plastic and Reconstructive Surgery. Global Open
Jacqueline S Israel, Aaron M Dingle, Ruston J Sanchez, Sahil K Kapur, Sarah Brodnick, Thomas J Richner, Jared P Ness, Joseph Novello, Justin C Williams, Samuel O Poore
Symptomatic neuroma after major extremity amputation is a challenging clinical problem for which there are many described treatment options. Neuroma excision and implantation into the medullary canal of long bones offers durability and insulation, and minimizes chronic pain. Another challenge in amputees is impaired function and an ongoing need for accessible and functional prostheses that are "bidirectional," in that they provide both fine motor control and sensory feedback. Drawing on clinical experience with neuroma implantation into the medullary canal of long bones, the authors propose a novel neural interface whereby a terminal nerve end is redirected into the medullary canal of a nearby long bone and interfaced with an electrode array...
May 2018: Plastic and Reconstructive Surgery. Global Open
Libby R Copeland-Halperin, Lauren Smith, Michelle Copeland
Background: Limited scar Lejour technique for breast reduction is conventionally used to remove less than 500 g of breast tissue per breast, but is effective for greater macromastia. Plastic surgery residents gain limited experience with this technique, and it is infrequently performed in the United States. To understand technique selection, we surveyed board-certified plastic surgeons and compared outcomes with the Lejour technique in 1 practice to those with other methods. Methods: We surveyed American Society of Plastic Surgeons members about techniques for breast reduction and compared outcomes with procedures performed by various techniques by a single surgeon (M...
May 2018: Plastic and Reconstructive Surgery. Global Open
Lawrence J Oh, Eugene Wong, Sol Bae, Angelo Tsirbas
Background: Repair of blepharoptosis from the posterior eyelid approach has usually been done utilizing a Müller's muscle-conjuctival resection (MMCR) or an "open sky" technique. We present a new technique to advance the levator muscle from the posterior-approach in a closed fashion that can be used in patients with severe involutional ptosis. Methods: A retrospective chart review was performed for consecutive patients with severe involutional blepharoptosis during a 6-year period treated by a single surgeon with a Closed Posterior Levator Advancement...
May 2018: Plastic and Reconstructive Surgery. Global Open
William P D Chen
The video illustrates the steps of Asian blepharoplasty of the upper eyelids, using the author's principle of beveled approach and trapezoidal debulking of preaponeurotic platform to allow safe access, minimization of wound injury, and creating a physiologically dynamic crease, without resorting to the use of buried sutures.
May 2018: Plastic and Reconstructive Surgery. Global Open
Jean-Claude Schwartz
Nipple-sparing mastectomy (NSM) and reconstruction is challenging in ptotic patients with additional risk factors. Here, these problems are addressed with a staged strategy that extends NSM and reconstruction to patients with grade 3 ptosis and additional risk factors of diabetes, obesity, and macromastia. Three stages are used to perform a mastectomy, reposition the nipple, and reduce the skin envelope using the Wise pattern. This is followed by definitive implant placement in a final fourth stage. All patients successfully completed their reconstructions without a single instance of implant loss...
May 2018: Plastic and Reconstructive Surgery. Global Open
Shingo Kawabata, Norikazu Kanda, Yasushi Hirasawa, Kazuo Noda, Yoshitaka Matsuura, Shigehiko Suzuki, Katsuya Kawai
Cutaneous ulcers are treated with dressing materials and/or ointments to keep the wound in an appropriately moist environment. However, chronic cutaneous ulcers commonly have bacterial colonization that can cause local infection in such an environment. Therefore, the dressing materials and/or ointments should have antibacterial potency to treat chronic ulcers. Acute cutaneous wounds, by contrast, heal rapidly without local infection. The aim of treating acute cutaneous wounds is therefore not only wound closure but also preventing scar contracture after wound healing...
May 2018: Plastic and Reconstructive Surgery. Global Open
Kirin Tan, Aaron H J Withers, Swee T Tan, Tinte Itinteang
The pathogenesis of Dupuytren's disease (DD) remains unclear although there is increasing evidence supporting the role of stem cells in this and other fibrotic conditions. This review examines the role of DD tissue-associated embryonic stem cells (ESCs) and mesenchymal stem cells (MSCs), and circulating fibrocytes and circulating MSCs, in the biology of DD. It is exciting to infer that dysfunction of an upstream ESC-like population within the affected tissue leads to the downstream development and proliferation of aberrant myofibroblasts through a putative MSC intermediate...
May 2018: Plastic and Reconstructive Surgery. Global Open
Jay Bowling, Darrell D Davidson, Sunil S Tholpady, Kinam Park, George J Eckert, Terrence Katona, Tien-Min G Chu, Clark T Barco
Background: Soft-tissue deficiencies pose a challenge in a variety of disease processes when the end result is exposure of underlying tissue. Although multiple surgical techniques exist, the transposition of tissue from one location to another can cause donor-site morbidity, long incisions prone to dehiscence, and poor patient outcomes as a result. Use of tissue expansion prior to grafting procedures has been shown to have success in increasing available soft tissue to aid in repairing wounds...
May 2018: Plastic and Reconstructive Surgery. Global Open
Roberto Amore, Domenico Amuso, Vincenza Leonardi, Andrea Sbarbati, Giamaica Conti, Maria Albini, Francesco Leva, Ferdinando Terranova, Antonio Guida, Konstantinos Gkritzalas, Liya Gavashely, Roman Velichenko
Background: Cellulite can be seen on the skin in widespread alterations of the skin surface and dimpling. The purpose of this study was to assess the effectiveness and safety of the manual subcision technique to treat dimpling from cellulite, using a specific class IIA medical device (Celluerase). Methods: The multi-center observational study assessed 200 women treated in a single session for different dimpling, using manual subcision administered by Celluerase...
May 2018: Plastic and Reconstructive Surgery. Global Open
Kumiko Matsumoto, Jun Kosaka, Hiroo Suami, Yoshihiro Kimata
Background: The morphologic and histologic behavior of lymphatic vessels in lymphedema has not been well analyzed using laboratory animals. The purpose of the present study was to elucidate the regeneration process of lymphatic vessels after acute lymphedema in a rat model. Methods: The acute lymphedema was induced by an amputation and a replantation surgery on a rat hind limb. Recovery of lymphatic flow was traced using fluorescent lymphography with dye injection...
May 2018: Plastic and Reconstructive Surgery. Global Open
Yea-Ling Yang, Ellen Wen-Ching Ko, Yu-Ray Chen, Chiung Shing Huang
Background: Sensory retraining could ameliorate neurosensory disturbance (NSD) resulting from the injury of the inferior alveolar nerve after a bilateral sagittal split osteotomy (BSSO). The aim of this study was to measure the effects of sensory retraining on NSD. Methods: A randomized, prospective, single-blinded clinical trial was conducted on consecutive patients with NSD resulting from a BSSO to correct skeletal class III malocclusion. The outcome measurement of sensory recovery was performed using a patient-centered survey assessed by the total score of questionnaire (TSQ) and visual analogue scale (VAS) at preoperation (T0), 1 week after surgery (T1), each month from 1 to 6 months after surgery (T2-T7), and 1 year after surgery (T8)...
May 2018: Plastic and Reconstructive Surgery. Global Open
Philipp Schoenle, Emre Gazyakan, Thomas Kremer, Leila Harhaus, Ulrich Kneser, Christoph Hirche
Traumatic soft tissue and bone defects are demanding challenges for the reconstructive microsurgeons. Common and safe workhorses for these reconstructions are free microvascular flaps based on the subscapular system. In this article, we want to demonstrate the versatility of the serratus anterior muscle combined with other components of the subscapular system for reconstruction of complex lower extremity defects. Three patients with traumatic soft tissue and bone defects of the lower extremity were planned for reconstruction...
May 2018: Plastic and Reconstructive Surgery. Global Open
April C Cockcroft, Alexey M Markelov
Background: Trapeziectomy with interpositional arthroplasty using Repriza acellular dermal matrix is a novel technique to treat primary and secondary carpometacarpal joint arthritis. Early studies with nonautograft interposition indicate promising post-trapeziectomy space maintenance with results similar to ligament reconstruction with tendon interposition, without the potential risks and increased operating time of harvesting a tendon autograft. Methods: Eleven patients in a retrospective cohort were followed for a minimum of 6 weeks (mean, 12)...
May 2018: Plastic and Reconstructive Surgery. Global Open
Mauricio Mendieta, Rodrigo Cabrera, Armando Siu, Roderick Altamirano, Sandra Gutierrez
Background: Local propeller flaps preserve the main vascular arteries of the lower extremity and muscle function, avoiding the need for a microsurgical anastomosis and the benefit of providing a "like with like" coverage. Our goal in this study was to demonstrate the versatility, safety, and complications of the local propeller flaps for lower extremity reconstruction. Methods: We present a series of 28 patients in whom we used local propeller flaps to restore small-to-medium soft-tissue defects of the lower limb in different hospitals of Managua, Nicaragua...
May 2018: Plastic and Reconstructive Surgery. Global Open
Luiz Toledo, Lee L Q Pu
No abstract text is available yet for this article.
May 2018: Plastic and Reconstructive Surgery. Global Open
Alain Joe Azzi, Roy Hilzenrat, Alex Viezel-Mathieu, Thomas Hemmerling, Mirko Gilardino
Background: The utility and efficacy of 3-dimensional representation have been proven in bony reconstruction; however, its role in soft-tissue reconstruction remains limited. There is currently no reliable gold standard to objectively measure flap volume. This systematic review aims to summarize the available techniques used to objectively measure flap volume in reconstructive surgery. Methods: A systematic literature search was performed to identify all relevant articles describing objective techniques to quantify flap volume...
May 2018: Plastic and Reconstructive Surgery. Global Open
Héctor César Durán-Vega, Arturo Ramírez-Montañana, Octavio Gonzalez Galindo, Andrés Medina Gutierrez, Adriana Zapata González, Evangelina Gonzalez Galindo, Iván Arturo Arellano Silva
Background: Breast augmentation surgery is still 1 of the most popular procedures in plastic surgery. Like other surgical procedures, it has been traditionally handled with nonsteroidal anti-inflammatory drugs and narcotics, which had many adverse effects; therefore, alternatives with the same effectiveness are being researched. The aim of this study was to investigate the efficacy of ropivacaine breast pocket irrigation during primary breast augmentation surgery to control pain during the first postoperative hours...
May 2018: Plastic and Reconstructive Surgery. Global Open
Allen Gabriel, G Patrick Maxwell
Background: AlloDerm Ready To Use (RTU) is a sterile version of AlloDerm regenerative tissue matrix, developed in response to concerns regarding the potential risk of infectious complications with the latter aseptic matrix. Clinical data on AlloDerm RTU use is, however, limited, particularly with respect to histologic evidence of graft integration and clinical outcomes. Methods: Consecutive patients who underwent tissue-expander/implant reconstruction with the use of AlloDerm RTU from March 2011 to September 2012 were included in this analysis...
May 2018: Plastic and Reconstructive Surgery. Global Open
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