Abdominal-Based Microsurgical Breast Reconstruction: How to Inset the Flap to Maximize the Aesthetic Result-A Systematic Review.

Nowadays, the ultimate goal of microsurgical breast reconstruction is not merely the effective transfer of vascularized tissue but the achievement of a natural, symmetric appearance. The aim of this present study was to systematically summarize the published evidence on abdominal-based free flap inset for breast reconstruction in order to provide principles and classification that could guide the surgeon in choosing the most appropriate inset technique based on patient and flap characteristics. A comprehensive review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, looking for articles on the insetting technique for free flap breast reconstruction.

Long-term evaluation of Nipple-Areolar complex changes in inferior versus superomedial pedicle reduction mammoplasty: A comparative study.

Background: In breast reduction, traditionally the inferior pedicle (IFP) technique is considered the most performed by plastic surgeons. A growing interest for the superomedial pedicle (SMP) mammoplasty technique has been documented in literature and clinical practice. Sensory recovery of the nipple-areolar complex (NAC), final areolar shape and scarring may also have a significant impact on patient satisfaction.

Lower limb reconstruction involving osteosynthesis material: A retrospective study on propeller flaps outcomes.

Introduction: Reconstruction of soft tissue defects in lower limb fractures requiring internal fixation remains a challenging scenario with the optimal surgical treatment still debated. This study aims to recommend, and eventually redefine, surgical indications for propeller flaps reconstruction in the distal lower limb, with a particular focus on the presence or not of metalwork.

Methods: A retrospective study of lower limb soft tissue reconstructions performed between January 2015 and July 2018 was carried out including all patients treated with a propeller perforator flap (PPF) with at least 6-month follow-up.

Dermal Triangular Flaps to Prevent Pseudoptosis in Mastopexy Surgery: The Hammock Technique.

Unlabelled: Mastopexy is one of the most performed cosmetic surgery procedures in the United States. Despite the numerous mastopexy techniques that were published in the past decades, preventing pseudoptosis to ensure longer lasting results remains the principal challenge.

Objectives: This paper describes a new mastopexy technique developed for moderate to severe ptosis/pseudoptosis associated with upper pole deflation.

A Systematic Review of Outcomes After Genital Lymphedema Surgery: Microsurgical Reconstruction Versus Excisional Procedures.

Introduction: Genital lymphedema (GL) surgery can be either palliative or functional. Palliative procedures involve excision of the affected tissue and reconstruction by either local flaps or skin grafts. Reconstructive procedures aim to restore lymphatic flow through microsurgical lymphaticovenous anastomoses (LVAs).

Central round block repair of large breast resection defects: oncologic and aesthetic outcomes.

Background: The central round block repair is a volume displacement technique to reconstruct large wide local excision (WLE) defects in breasts with moderate ptosis or hypertrophy. There are limited published data on the outcomes of this technique.

Methods: Data were collected prospectively for 57 consecutive patients and follow up information obtained from patient records.

Perforator mapping reduces the operative time of DIEP flap breast reconstruction: A systematic review and meta-analysis of preoperative ultrasound, computed tomography and magnetic resonance angiography.

Background: Prior to DIEP flap breast reconstruction, mapping the perforators of the lower abdominal wall using ultrasound, computed tomography angiography (CTA) or magnetic resonance angiography (MRA) reduces the risk of flap failure. This review aimed to investigate the additional potential benefit of a reduction in operating time.

Methods: We systematically searched the literature for studies concerning adult women undergoing DIEP flap breast reconstruction, which directly compared the operating times and adverse outcomes for those with and without preoperative perforator mapping by ultrasound, CTA or MRA.

A single-centre, retrospective proof-of-concept review of salvage of infected or exposed implant breast reconstructions with explantation and one-stage free flap replacement.

Introduction: Implant-based breast reconstruction has relatively high complication rates. Removal of infected implants and immediate autologous reconstruction is a safe single-stage procedure that preserves the native breast skin envelope.

Methods: A single-centre, retrospective proof-of-concept review of all salvage procedures performed for acute/chronic infected or exposed implant-based reconstructions by a single surgeon over a 6-year period.

Use of acellular dermal matrix (ADM) in nipple reconstruction: the 'central-pillar technique'.

Nipple reconstructions are prone to a variable and unpredictable degree of flattening, which in some cases lead to secondary reconstruction. The use of an acellular dermal matrix (ADM) augmentation may be appropriate in cases with very thin dermis that are particularly prone to flattening or in revision cases where the first procedure has already failed. The authors present a series of 13 nipple reconstructions in ten cases.

Spontaneous regression of metastatic melanoma - clinical evidence of the abscopal effect.

Introduction: Metastatic melanoma is poorly understood. Regression of primary lesions has been associated with poor prognosis, but spontaneous regression of all metastatic disease is clearly beneficial. A patient's own immune responses occasionally appear to stimulate spontaneous regression of metastatic disease in melanoma.

A new continuous suture technique in ear reconstruction with full-thickness skin grafts.

Ear reconstruction with full-thickness skin grafts can be a challenging task for plastic surgeons. It is often necessary to remove the underlying cartilage with the skin lesion and the resultant defect may be deeply concave. We present a short clinical report to describe an improved technique that we find useful in reducing the diameter and depth of anterior pinna contour defects, in improving graft take, and in reducing the size of the donor-site scar.

A review of 58 patients with periorbital haemangiomas to determine appropriate cases for intervention.

Background: Periorbital haemangiomas cause severe effects on visual development. They can be treated with some success, but there is currently no literature on the selection of patients for intervention. Our study aims to review all periorbital haemangioma cases in Edinburgh over the past 20 years, to set more stringent guidelines regarding the appropriate selection of patients for treatment and determine prognostic indicators of visual outcome.

Metabolism of DDT analogues by a Pseudomonas sp.

A Pseudomonas sp. rapidly metabolized several nonchlorinated analogues of DDT, with the exception of 2,2-diphenylethanol, as the sole carbon source. Several of the mono-p-chloro-substituted diphenyl analogues were also metabolized as the sole carbon source by the bacterium.