Sub-muscular Breast Augmentation Using Tumescent Local Anesthesia.

Background: Tumescent local anesthesia (TLA) consists of infiltration of saline solution with lidocaine and epinephrine into the tissues to obtain regional anesthesia and vasoconstriction. The use of TLA in augmentation mammoplasty has been described for sub-glandular positioning. We describe a modified TLA technique for primary sub-muscular breast augmentation reporting our experience during the past 7 years.

Skin cancers and dermal substitutes: Is it safe? Review of the literature and presentation of a 2-stage surgical protocol for the treatment of non-melanoma skin cancers of the head in fragile patients.

Non-melanoma skin cancers (NMSC) represent the most common skin tumours of the head region. We describe the use of dermal substitute in a 2-stage surgery protocol for selected fragile patients to remove NMSC of the head region. A review of the literature focusing on dermal substitutes' safety after skin tumours excision is provided.

RE: Prosthetic Breast Implant Rupture: Imaging-Pictorial Essay : Full Cooperation Between Surgeon and Radiologist: "The Best of Both Worlds".

Cooperation between plastic surgeons and radiologists is fundamental when breast prosthesis rupture is suspected. We describe our experience managing the case of suspected implant rupture in a patient that underwent CT scan imaging for thoracic pain. Poor clinical information given to radiologists leads to wrong diagnosis: during surgery, both prostheses were checked revealing no signs of rupture.

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease presenting with painful nodules, abscesses, sinus tracts, and scarring primarily affecting apocrine gland-rich intertriginous areas. HS prevalence ranges from 0.05 to 1%.

Tuberous breast and predisposition to breast deformity in consanguineous.

Tuberous breast deformity is a pathologic condition of the breast consisting of a constricting ring at the breast base, reduction in the volume of the breast parenchyma, and herniation of breast tissue through the nipple-areola complex with areola enlargement. This pathology is generally congenital and has an unknown etiopathogenesis. We report the first observation of tuberous breast deformity in consanguineous.

An Alternative Treatment Strategy for Complicated Chronic Wounds: Negative Pressure Therapy over Mesh Skin Graft.

Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT), applied before skin grafting, promotes granulation tissue growth.

One-stage breast reconstruction techniques in elderly patients to preserve quality of life.

Objective: The aim of this study was to review one-stage breast reconstruction techniques performed in elderly patients at our institution to identify the criteria of selection of each in terms of outcomes and quality of life.

Patients And Methods: Patients older than 65 years who underwent one-stage breast reconstruction between January 2004 and July 2014 at our hospital were included. Patients and procedure-related data were collected from the medical records.

Microsurgical Training with the Three-Step Approach.

 Microsurgery is very challenging, requiring a high degree of dexterity and manual skills that should be fully trained outside of the operating room. Common microsurgery courses usually follow a stepwise training approach beginning practice on nonliving models and proceeding with live rats. However, training on live rats raises certain issues, including ethical concerns as well as the associated costs.

Surgical treatment of nasal non-melanoma skin cancer in elderly patients using dermal substitute.

Conclusions: The nose is often involved by non-melanoma skin cancer (NMSC) and the increase in the incidence of such tumors, the morbidity and treatment-related costs represent a significant burden to healthcare systems. A bioresorbable dermal substitute (Hyalomatrix) has been used for immediate dermal coverage and nose restoration after excision of infiltrating nasal NMSCs in elderly ASA III patients. Further studies on dermal substitutes are needed to improve benefit to patients.

The use of the Alexis(®) device in breast augmentation to improve outcomes: a comparative randomized case-control survey.

Background: We present our experience in using a disposable wound retractor commonly used in abdominal surgery named Alexis(®) (Applied Medical Resources Corporation, Rancho Santa Margarita, CA, USA), during breast augmentation in order to improve outcomes, particularly final scar length.

Methods: Between January 2010 and November 2012, 40 patients undergoing breast augmentation with an inframammary approach were enrolled in the present study. Patients were randomly assigned to two groups: group 1 underwent breast augmentation with the standard technique; group 2 underwent breast augmentation by using the Alexis(®) (Applied Medical Resources Corporation) device.

Coverage of exposed hardware after lower leg fractures with free flaps or pedicled flaps.

Objective: The placement of osteosynthetic materials in the leg may be complicated by hardware exposure. Successful soft tissue reconstruction often provides a critical means for limb salvage in patients with hardware exposure in the leg. Free flaps are currently considered the standard surgical procedure for soft tissue coverage of the wounds with internal hardware exposure.

Surgical strategies for cutaneous neoplasm of the scalp. State of art.

Aim: Scalp reconstruction has always been a challenging task, in particular after oncological demolition and this article gives an overview on the state of the art in scalp reconstruction strategies.

Material Of Study: We elaborated a systematic algorithm for scalp reconstruction based on location and size defects, presence or absence of periosteum, bone involvement, the quality of surrounding scalp tissue, the presence or absence of hair, location of the hairline, patient comorbidities and different procedures commonly used in plastic surgery.

Results: Our algorithm allows plastic surgeons to perform scalp reconstruction after the most devastating of defects.

Evidence-based evaluation technique to assess augmentation mammaplasty results: a simple method to objectively analyze mammary symmetry and position.

Background: Despite the great variety of mammaplasty techniques, outcome assessment remains a challenging issue.

Objectives: The authors devised an objective method to evaluate mammary symmetry based on statistical analysis of objective manual breast measurements and validated the method by applying it to results of a randomized controlled trial on the correction of breast asymmetry.

Methods: Sixty consecutive patients with hypoplastic breasts and small-volume asymmetry were enrolled in the study and randomly assigned to 1 of 2 groups.

The use of cultured autologous oral epithelial cells for vaginoplasty in male-to-female transsexuals: a feasibility, safety, and advantageousness clinical pilot study.

Various vaginoplasty methods in male-to-female transsexuals have been described, but none is ideal. The use of cultured autologous oral epithelium to cover the neovagina walls is presented. Six patients were operated on.

Transverse upper gracilis flap with implant in postmastectomy breast reconstruction: a case report.

Autologous flaps can be used in combination with prosthesis in postmastectomy breast reconstruction. The deep inferior epigastric perforator (DIEP) flap is considered the preferred choice among autologous tissue transfer techniques. However, in patients with a peculiar figure (moderately large breasts and large thighs with flat stomach), who cannot use their abdominal tissue, the transverse upper gracilis (TUG) flap with implant is investigated as a further option for breast reconstruction.

Parosteal lipoma. Report of 15 new cases and a review of the literature.

The lipoma is the most common tumor of the body and can be found in virtually every tissue or organ. However, a parosteal lipoma is a rare benign fatty neoplasm having an intimate relationship to the periosteum. The incidence of this tumor is 0.

Correction of tuberous breast with small volume asymmetry by using a new adjustable implant.

Background: The tuberous breast syndrome is a rare anomaly of breast shape, which can be associated to volume breast asymmetry. We report our caseload in the correction of tuberous breasts with small volume asymmetry by using the Muti's technique associated to the implantation of a new adjustable implant.

Aim: Purpose of the study is to evaluate the efficacy of treating tuberous breast deformity with two different types of implants (a textured round high profile cohesive I implant in the larger breast and a Spectra™ implant in the smaller breast).

Association between abdominal separation and inguinal or crural hernias: our experience and surgical indications.

Abdominal wall weaknesses present several causative factors, both local and systemic and, as a consequence, abdominal hernias may develop in more than one site. Also, simultaneous hernia repair has been rarely reported in published reports. In the present study, the association of multiple weaknesses of the abdominal wall in patients undergoing conventional abdominoplasty or hernia repair were evaluated, and the advantages of simultaneous repair in a single operation are discussed.

New head-mounted miniaturized microscope in hypospadia surgical correction.

Aim: The aim of this paper was to report our experience using VarioscopeÒM5 in hypospadia surgical correction. To suggest the use of microsurgical principles that can result in the successful repair of hypospadias with a few complications.

Methods: Forty-three patients (age 12-16 months), affected by hypospadia, underwent longitudinal dorsal preputial island flap (Scuderi's technique) surgical procedure.

Retention of polyurethane foam fragments during VAC therapy: a complication to be considered.

Vacuum-assisted closure (VAC) therapy is a closed-loop, non-invasive active system, characterised by a controlled and localised negative pressure applied on porous polyurethane absorbent foams. It promotes healing of acute and chronic wounds. Therapeutic effects of VAC therapy have been proved and demonstrated; however, this method can have some disadvantages.