In Pursuit of Effective Volume Reduction and Enhanced Aesthetics for Treatment of Gigantomastia Using Superior Dermoglandular Pedicle.

Background: Gigantomastia is defined as extreme hypertrophy of the female breast. It is a disabling condition that presents unique challenges to plastic surgeons. Initial breast volume is an important factor affecting the success of the reduction.

Platelet-rich plasma and hyaluronic acid - an efficient biostimulation method for face rejuvenation.

Background: Cosmetic applications of platelet-rich plasma (PRP) are new, and reports are scarce and dispersed in the literature. There are a variety of commercially available kits and injection techniques, and the number and intervals of injections vary. New investigations should focus on developing a standardized procedure for PRP preparation and application methods to augment its efficacy and potency.

Allograft mass as a possible contributing factor to the skin transplant outcome.

Background: A composite tissue consists of tissues derived from ectoderm and mesoderm typically containing skin, fat, muscle, nerves, lymph nodes, bone, bone marrow or any combination of these. Solid organ transplants possessing larger allograft mass were reported to survive better. As for the vascularized composite tissues however, thus far no study has comparatively studied the survival of grafts possessing different tissue burdens.

Salvage of a complicated penis replantation using bipedicled scrotal flap following a prolonged ischaemia time.

Microsurgical replantation is the standard method to treat penile amputation. The loss of variable area of skin is a common complication following penile replantation due to prolonged ischaemia time, postoperative venous congestion, oedema and wound infection. There is limited literature available on the management of complications following replantation.

Modified retrograde-flow medial plantar island flap for reconstruction of distal dorsal forefoot defects--two case reports.

Soft tissue reconstruction of the distal forefoot and toes poses a difficult problem. Skin grafts are not suitable when deep structures are exposed. Local flaps are not available, particularly for defects of the toes.

Long-term outcomes of composite auricle as a neurosensorial facial subunit allotransplant.

A total of 22 composite auricle transplantations were performed in allogeneic experimental (group I, n = 10), allogeneic control (group IIa, n = 5), and isogeneic control (group IIb, n = 7) groups. Allotransplantations were carried out across major histocompatibility complex barrier from Lewis Brown Norway rats to Lewis rats. Isotransplantations were performed between Lewis rats.

Anatomical and technical aspects of harvesting the auricle as a neurovascular facial subunit transplant in humans.

Background: Auricular transplants from cadaveric sources may be a viable alternative for difficult auricular reconstruction once immunologic problems are largely solved. The authors report on the neurovascular anatomy and technical details of harvesting the auricle as a single facial subunit.

Methods: Nine auricles were studied in latex-injected (n = 5) and fresh cadaveric heads (n = 4).

The advantages of free tissue transfer in the treatment of posttraumatic stiff knee.

Background: Open fractures of the distal femur involving the joint, surrounding ligament, and soft tissues are among the worst types of injuries that may eventually lead to stiff knee. Release procedures have been described as the common treatment option for posttraumatic stiff knee. However, the importance of simultaneously applied free flaps to replace the pliable soft tissue around the knee joint has not been discussed previously.

Free lateral arm flap for 1-stage reconstruction of soft tissue and composite defects of the hand: A retrospective analysis of 118 cases.

In this article, the long-term outcomes of hand defects after 1-stage reconstruction with lateral arm flap were retrospectively analyzed in a large series. Between the years 1990 and 2004, 118 traumatic hand defects were reconstructed using lateral arm fasciocutaneous flap (n = 104), lateral arm fascial flap (n = 6), and composite lateral arm flap (n = 8) in Chang Gung Memorial Hospital. There were 22 females and 96 males with an average age of 32.

Nipple reduction using the modified top hat flap.

Background: Large nipples, disproportionate to the small areola and breast size, are an ethnic characteristic frequently encountered among Asian female patients. Patients seek correction to improve cosmesis and alleviate psychological and physical discomfort. The authors present a new technique of nipple reduction and describe its potential advantages over other techniques.

Simultaneous endoscope-assisted contralateral breast augmentation with implants in patients undergoing postmastectomy breast reconstruction with abdominal flaps.

Background: Unilateral breast reconstruction after mastectomy provides the challenge of achieving symmetry with the opposite side. Reduction mastopexy is a common balancing procedure for the contralateral breast used to achieve pleasing and symmetrical breasts. Although symmetry is the ultimate goal, some women have a hypoplastic and/or ptotic contralateral breast, and the recreation of this shape would therefore not be desirable.

Collaboration with microsurgery prevents arterial complications and provides superior success in partial liver transplantation.

Hepatic artery thrombosis is the most common technical complication in liver transplantation. The objective of this study was to investigate the arterial complications of partial liver transplantation using microsurgical technique. At a period of 31-months, we participated in a total of 42 right lobes, 7 left lobes, and 1 whole-liver liver transplantations from cadaveric (n = 20) or living (n = 30) donors.

[Intraoperative planning and inset principles of fibula osteoseptocutaneous flap in compound or composite oromandibular defect reconstruction].

Objectives: The use of free fibular osteocutaneous flap was evaluated in the reconstruction of compound and composite mandibular defects.

Patients And Methods: The study included 30 patients (27 males, 3 females, mean age 52.6 years; range 42 to 66 years) who received free osteoseptocutaneous fibular flap for the reconstruction of compound or composite oromandibular defects following surgical tumor ablation.

Behavior of the different implant materials in acute infection and efficacy of antibiotherapy: experimental study in rats.

In this study, we propose a comparison of the behaviors of four different implant materials in case of acute infection: expanded polytetrafluoroethylene (e-PTFE), porous high density polyethylene (PHDPE), silicone, and autogenous cartilage tissue. The efficacy of prophylactic and therapeutic antibiotic therapies was also investigated in a rat model as four groups: group A, acute infection and no antibiotic therapy (n = 24); group B, acute infection and prophylactic antibiotic therapy (n = 24); group C, acute infection and therapeutic antibiotic therapy (n = 24); and control, no infection and no antibiotic therapy (n = 24). All materials with dimensions of approximately 1 x 1 cm(2) diameter were implanted separately under the dorsal skin of rats.

Comparisons of resource costs and success rates between immediate and delayed breast reconstruction using DIEP or SIEA flaps under a well-controlled clinical trial.

Background: Every year many patients diagnosed with breast cancer are subjected to mastectomy. Some of them choose to undergo breast reconstruction to restore their body image. Immediate or delayed reconstruction is possible, depending on medical, financial, and emotional considerations.

Reverse first dorsal metatarsal artery flap for reconstruction of traumatic defects of dorsal great toe.

Background: Soft-tissue defects of the great toe that include exposed tendon and bone present a reconstructive challenge for plastic surgeons. This study investigates the feasibility and reliability of reverse first dorsal metatarsal artery flap (FDMA) for reconstruction of the dorsal great toe soft-tissue defects.

Methods: Six male patients with dorsal great toe defects (mean 2.

Breast reconstruction using the entire transverse abdominal adipocutaneous flap based on unilateral superficial or deep inferior epigastric vessels.

Background: Among various alternatives for autologous breast reconstruction, the superficial inferior epigastric artery abdominal flap provides the least donor-site morbidity, as dissection of the rectus abdominis sheath and muscle is not required. However, because of inconsistencies in the existence and size of the superficial inferior epigastric artery, its use is limited. In addition, whether the perfusion from the superficial system is adequate across the midline is still a question to be answered.

The effect of A2A adenosine receptor agonist on composite tissue allotransplant survival: an in vivo preliminary study.

Background: In vitro experimental studies showed that A2a receptor agonists reduce allostimulatory functions of the dendritic cells through modulation of surface expression of the costimulatory molecules and down-regulation of cytokines. Similar suppressive effects on dendritic cells have also been observed with Cyclosporine A (CsA). In this study we sought to explore if combined use of these two drugs in vivo could prolong the survival of composite tissue allografts across MHC barriers.

Reconstruction of foot defects with free lateral arm fasciocutaneous flaps: analysis of fifty patients.

In this article, long-term outcomes of foot reconstruction with free lateral arm fasciocutaneous flaps were retrospectively analyzed in 50 patients. The patients, 38 men and 12 women, ranged in age from 7-73 years (mean, 43.5 years).

Temporary assisting suspension suture technique for successful microvascular anastomosis of extremely small and thin walled vessels for mice transplantation surgery.

Dissection and microsurgical anastomosis in small and thin-walled vessels is challenging. Temporary assisting suspension suture technique was developed to overcome those difficulties in establishing successful composite tissue allotransplantation in mice. The operations were performed in 12- to 16-week-old Balb/c mice weighing 25 to 30 grams as both donor and recipient animals.

Deep inferior epigastric perforator flap for successful simultaneous breast and chest wall reconstruction in a Poland anomaly patient.

Breast reconstruction in female Poland anomaly remains a surgical challenge with variable chest wall deformity and nipple position. Pedicled latissimus dorsi myocutaneous flap with implant reconstruction may have several drawbacks and complications. Free deep inferior epigastric flap (DIEP) flap is a reliable option for postmastectomy breast reconstruction, but rarely reported in Poland anomaly.