Comparison of unipedicled and bipedicled TRAM flap breast reconstructions: assessment of physical function and patient satisfaction.

Many variations of the transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction have been attempted since the procedure was first described. One common modification involves the use of both rectus muscles, which may accommodate a bilateral reconstruction or provide a more reliable blood supply to a unilateral reconstruction. Objective studies measuring various aspects of physical strength after bilateral rectus harvest and subjective reports of various physical symptoms have challenged the morbidity of a double-rectus harvest.

The sit-up position in breast surgery.

Breast shape is best evaluated while the patient is in an upright position. However, many surgeons are reluctant to have a patient sit upright during surgery because of concerns over the patient's hemodynamic instability. Therefore, the purpose of this study was to prospectively measure cardiovascular parameters, including heart rate and mean arterial pressure, in a series of 30 patients who were placed upright during various aesthetic and reconstructive breast procedures.

Microsurgical replantation of the amputated nose.

A case of successful replantation of the nose is presented. Two arteries and one vein were anastomosed, providing a stable framework for direct revascularization of the amputated nasal segment. This resulted in complete survival of the nose, with an excellent aesthetic result.