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Plastic and Reconstructive Surgery. Global Open

Itaru Tsuge, Tatsuki Enoshiri, Susumu Saito, Shigehiko Suzuki
Supplemental Digital Content is available in the text.
September 2017: Plastic and Reconstructive Surgery. Global Open
Masahide Fujiki, Mine Ozaki, Akiko Kai, Akihiko Takushima, Kiyonori Harii
Penile amputation is a rare emergency, but the best method for its repair is required due to the organ's functional and societal role. Since the first successful microsurgical replantation of the amputated penis, microsurgical techniques have matured and become the standard treatment for the penile replantation. However, the successful second microsurgical replantation for amputated penis has been rarely reported. We present the case of a 40-year-old man with schizophrenia who had a past history of penile self-mutilation and successful replantation at another hospital 2 years ago...
September 2017: Plastic and Reconstructive Surgery. Global Open
James C Yuen
Remote monitoring capability does not currently exist for Periflux (Perimed AB, Järfälla, Sweden) laser Doppler and other perfusion monitors. Two simple adaptations using free apps (applications) and smart devices can enable transmission of the perfusion readout to the surgeon's smartphone. A literature review was conducted to identify reports relating to remote free flap monitoring. In addition, 2 wireless methodologies are devised: One method uses a free app that converts a smart device into a camera, stationed next to the perfusion monitor, to stream live video of the laser Doppler readout to the surgeon's smartphone; a second method uses a free app installed on a bedside laptop computer, which is connected to the laser Doppler flowmeter via a data cord...
September 2017: Plastic and Reconstructive Surgery. Global Open
Kenneth L Fan, Michael V DeFazio, Francis D Graziano, Jocelyn Lu, David H Song
No abstract text is available yet for this article.
September 2017: Plastic and Reconstructive Surgery. Global Open
Masamitsu Kuwahara, Satoshi Yurugi, Yuji Yamanaka, Chikako Sasaki, Takashi Nakanishi
It is difficult to totally reconstruct the lip, achieving good functional and aesthetic results. There have been few reports of reconstructing complete lip defects. Moreover, upper and lower lip necrosis by purpura fulminans has not been reported. We present a case of a 60-year-old male purpura fulminans patient with upper and lower lip necrosis. Fortunately, our patient had retained his oral commissure function. We reconstructed this defect with an orbicularis oris muscle-skin-mucosal pedicled flap derived from the region between the nasolabial folds for upper lip; a similar bipedicled flap for the lower lip and the donor site was closed with a dual-skin paddled anterolateral thigh flap...
September 2017: Plastic and Reconstructive Surgery. Global Open
Koreyuki Kurosawa, Yukinori Asada, Ko Matsumoto, Takayuki Imai, Kazuto Matsuura, Takahiro Goto
Reconstruction following total laryngopharyngectomy with total glossectomy (TLPTG) is challenging. To reconstruct this extended range of mucosal defect, it is necessary to overcome the remarkable discrepancy of apertures of oral and esophageal sides. We report a case of reconstruction surgery for total laryngopharyngectomy with total glossectomy with a funnel-shaped rectus abdominis musclocutaneous flap. The patient recovered without major complications and could keep a relatively good swallowing function. We believe this simple method should contribute to cases with complicated ablation...
September 2017: Plastic and Reconstructive Surgery. Global Open
Safvet Ors
BACKGROUND: Migraine headache is a primary neurologic disease affecting millions of people worldwide. As a consequence, quality of life is diminished, productivity suffers (through loss of work force), and treatment costs are substantial. The occurrence rate in the general population is quite high, with women accounting for 3 of every 4 cases. METHODS: Between January 2011 and May 2012, a total of 221 patients received hair transplants. Another 590 patients underwent hair transplantation between June 2012 and December 2016...
September 2017: Plastic and Reconstructive Surgery. Global Open
Cheol Ho Chang, Myung Kyu Cha
To treat tear trough deformities in young patients, transconjunctival orbital fat repositioning has been widely used. Although internal fixation of transposed fat enables more secure and stable fixation than the externalized percutaneous suture method, the latter is used more commonly because of the narrow operation field and consequent technical difficulty of the internal fixation method. We describe a novel technique using a newly devised needle (Chang's needle) that facilitates internal fixation of transposed fat pedicles...
September 2017: Plastic and Reconstructive Surgery. Global Open
Motoi Kato, Shoji Watanabe, Reiko Kato, Hiroshi Kawashima, Takuya Iida, Azusa Watanabe
BACKGROUND: A lymphangioma, also called a lymphatic malformation, is a congenital condition that frequently occurs in young children. It is classified into 3 groups depending on the size of the cysts (macrocystic, microcystic, and mixed). Spontaneous regression occurs in some cases; however, the characteristics of patients who show regression have not been studied previously. Furthermore, the types and the timing of the initial treatment are still controversial. Therefore, we statistically analyzed the occurrence of short-term spontaneous regression, patient age at original occurrence, cyst types, cyst sizes, and cyst locations in patients diagnosed with peripheral localized lymphangiomas in a single children center over 34 years...
September 2017: Plastic and Reconstructive Surgery. Global Open
Kasandra R Dassoulas, Traci L Hedrick, Chris A Campbell
Low-lying rectal cancers are being treated more frequently with robotic-assisted abdominoperineal resection, obviating the need for laparotomy and the ability to raise vertical rectus abdominis musculocutaneous flaps. For female patients, posterior vaginectomy often accompanies the resection. Combined pudendal thigh flaps as an extension of bilateral gluteus advancement flaps allow for posterior vaginal resurfacing with thin pliable fasciocutaneous flaps, which rest on the gluteal flap soft-tissue bulk that obliterates the pelvic dead space...
September 2017: Plastic and Reconstructive Surgery. Global Open
Sergi Barrera-Ochoa, Jose Manuel Collado-Delfa, Andrea Sallent, Alejandro Lluch, Roberto Velez
Resection of tumors affecting the hip abductors can cause significant decrease in muscle strength and may lead to abnormal gait and poor function. We present a case report showing full functional recovery after resection of a synovial sarcoma affecting the right gluteus medius and minimus muscles with reconstruction free neurovascular latissimus dorsi muscle transplantation. The latissimus dorsi muscle was harvested following standard technique and fixed to the ilium and the greater trochanter. Receptor vessels were end-to-end anastomosed to the subscapular vessels followed by an end-to-end epineural suture between the superior gluteal nerve and the thoracodorsal nerve...
September 2017: Plastic and Reconstructive Surgery. Global Open
Ashish Francis, Shawna R Kleban, Linda L Stephenson, Patrick S Murphy, Peter R Letourneau, Xin-Hua Fang, Wei Z Wang, Richard C Baynosa
BACKGROUND: Ischemia-reperfusion (IR) injury is seen in many settings such as free flap salvage and limb replantation/revascularization. The consequences-partial/total flap loss, functional muscle loss, or amputation-can be devastating. Of the treatment options available for IR injury, hyperbaric oxygen (HBO) is the most beneficial. HBO inhibits neutrophil-endothelial adhesion through interference of CD18 neutrophil polarization in IR, a process mediated by nitric oxide. The purposes of this study were to examine the involvement of vascular endothelial growth factor (VEGF) in the beneficial HBO effect on CD18 polarization and neutrophil adhesion and investigate the effect of plasmin on VEGF expression in skeletal muscle following IR injury...
September 2017: Plastic and Reconstructive Surgery. Global Open
Hsiang Huang, Yu-Shan Lin
A new type of needle system combines 2 parts, an inner needle and an outer needle. The inner needle is used for filler injection and the outer needle acts as a guiding needle that can observe blood reflow when inserting into the vessel lumen during injection process. This new needle system can be used for all kinds of filler, providing real time monitoring for physician and preventing intravascular injection of any filler.
September 2017: Plastic and Reconstructive Surgery. Global Open
Martin Ulloa, Mauricio Coronel Banda
Painful neuropathies can be caused by nerve compression or neuromas. Nerve compressions can arise from scar adhesions causing painful posttraumatic entrapment of nerve branches via fibrosis. The classical treatment methods include neurolysis and nerve transposition. In this case, we present the treatment of recurrent scar entrapment of the saphenous nerve with percutaneous neurolysis and lipofilling in a patient who had previously undergone an open neurolysis procedure. Resolution of the condition without any complications was noted during the 2-month clinical follow-up...
September 2017: Plastic and Reconstructive Surgery. Global Open
Dmytro Unukovych, Edward J Caterson, Matthew J Carty, Jessica Erdmann-Sager, Eric Halvorson, Stephanie A Caterson
BACKGROUND: The incidence of bilateral mastectomies is increasing along with the rates of breast reconstructions. A substantial number of patients will present with abdominal scars after Cesarean section, laparoscopy, laparotomy, and so on. The aim of this study was to evaluate the impact of prior abdominal scars on complication rates in abdominal bilateral free flap breast reconstruction. METHODS: All consecutive patients with autologous free flap breast reconstruction between 2007 and 2014 were eligible...
September 2017: Plastic and Reconstructive Surgery. Global Open
Colton H L McNichols, Silviu Diaconu, Sara Alfadil, Jhade Woodall, Michael Grant, Scott Lifchez, Arthur Nam, Yvonne Rasko
BACKGROUND: Over the past decade, plastic surgery programs have continued to evolve with the addition of 1 year of training, increase in the minimum number of required aesthetic cases, and the gradual replacement of independent positions with integrated ones. To evaluate the impact of these changes on aesthetic training, a survey was sent to residents and program directors. METHODS: A 37 question survey was sent to plastic surgery residents at all Accreditation Council for Graduate Medical Education-approved plastic surgery training programs in the United States...
September 2017: Plastic and Reconstructive Surgery. Global Open
Amy S Colwell, Erin Taylor, Michelle Specht, Jay S Orringer
BACKGROUND: The best treatment for nipple malposition following nipple-sparing mastectomy is prevention. This article reviews basic elements for success in nipple-sparing mastectomy and offers an option to patients with grade 2-3 breast ptosis who strongly desire to preserve the nipple. METHODS: Retrospective review identified patients undergoing nipple-sparing mastectomy and immediate reconstruction. RESULTS: Patient selection centered on realistic goals for postoperative breast size, nipple position, and when not to save the nipple...
September 2017: Plastic and Reconstructive Surgery. Global Open
Thomas C Lam, Frank Hsieh, James Salinas, John Boyages
BACKGROUND: Two-stage prosthetic breast reconstruction with initial insertion of a tissue expander followed by an implant after a period of inflation is a well-established breast reconstruction option. Most of the current literature concentrates on the immediate setting, and there are only a few reports into delayed cases, especially after postmastectomy radiotherapy (RT). We performed a retrospective review of our experience over a 12.5-year period. METHODS: Between June 1998 and December 2010, a total of 671 patients received prosthetic-only breast reconstruction...
September 2017: Plastic and Reconstructive Surgery. Global Open
Lyndsey Highton, Richard Johnson, Cliona Kirwan, John Murphy
BACKGROUND: The development of acellular dermal matrices (ADMs) has facilitated single-stage implant breast reconstruction (IBR) following skin-sparing mastectomy. The conventional approach of postpectoral implant placement with lower pole ADM confers a good cosmetic result by improving lower pole projection and control, while minimizing issues of implant visibility, palpability, and rippling. This is balanced with potential disadvantages including pain, disruption of pectoral muscle function, and animation...
September 2017: Plastic and Reconstructive Surgery. Global Open
Daniel Nunes E Silva, Cíntia Gründler, Maria das Graças de Melo Teixeira Spengler, Alex Magno Coelho Horimoto, Mariana Albuquerque Machado, Isadora Carvalho Frazão, Luiz Carlos Takita
Generally, the main complications of silicone implantation are local symptoms. However, some patients develop late-onset systemic symptoms often associated with a rare form of hyperactive immune response, as part of a syndrome known as autoimmune syndrome induced by adjuvants (ASIA). Reported cases of ASIA have shown resolution with explantation, but not with immunomodulatory therapy. In this report, we described a case of a previously healthy 23-year-old woman, who has undergone silicone breast implant augmentation, for aesthetic reasons, and developed localized cutaneous impairment 3 years postsurgery...
September 2017: Plastic and Reconstructive Surgery. Global Open
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