Use of the orbicularis muscle flap for complex lower lid problems: a 6-year analysis.

There are several groups of patients seeking lower lid blepharoplasty who present with the potential for unsatisfactory postoperative results, such as those presenting with atonic eyelids, patients with severe blepharochalasis alone or with large fat bags, patients with festoons, those with abnormal anatomy, and patients with deformity due to prior surgery. The orbicularis muscle flap technique provides good results in patients with potentially problematic lower eyelids. Of 600 blepharoplasties, 8.

Breast reduction for asymmetrical hypertrophy.

Design details of reduction of asymmetrical hypertrophy of the breasts are discussed. The concepts apply to nearly any breast reduction technique, although here they are presented in the context of the inferior segment method, which we favor. Although most of these points may seem self-evident to the experienced plastic surgeon, there has been little written about the details.

Surgical considerations in managing the remaining breast during postmastectomy breast reconstruction.

The age and general condition of the patient, size and shape of the remaining breast, various risk factors such as the histologic type of carcinoma, and family history are all critical in governing the definitive management of the remaining breast during postmastectomy breast reconstruction. The philosophy, timing, and method of dealing with the remaining breast must be discussed carefully with the patient. The psychological, social, and physical status of the patient must be addressed, with special emphasis in regard to her future and the degree of risk involved.

Fasciocutaneous flap, secondary axial pattern flap, and microvascular free flap in socket reconstruction.

Three techniques are described to rebuild a missing or recurrently contracted socket, the selection of which is based on the anatomy of the periorbital tissue and vascular supply. When the superficial temporal vessels are present, the ipsilateral fasciocutaneous postauricular flap is used. When the vessels are present but the postauricular flap has been used, a secondary axial pattern flap is used.

The lower trapezius myocutaneous flap for head and neck reconstruction.

The lower trapezius myocutaneous flap has proved to be another useful adjunct in the reconstructive armamentarium of the head and neck surgeon. The flap is based on the descending branch of the transverse cervical artery and vein. Providing these structures are protected during neck dissection, this flap may well become the first consideration of flaps for reconstruction of extensive defects of the head and neck.

Muscle flaps and the vascular detour principle: the soleus.

We present a concept in muscle and myocutaneous flap transfer whereby distally based flaps can, under very special circumstances, be transferred with an augmented arc of rotation and more reliable circulation. The concept is the inclusion of adjacent longitudinal vessels in the elevation, within which vessels the flow is reversed. To our knowledge this concept has not been previously described.

The role of the rectus abdominis myocutaneous flap in breast reconstruction.

The rectus abdominis myocutaneous flap has been used in 10 patients requiring the importation of skin, subcutaneous tissue, and muscle for postmastectomy reconstruction. It was preferred to the latissimus dorsi myocutaneous flap under the circumstances highlighted in Table I. The flap has proved reliable and easy to raise, with a consistent anatomic location of the arterial venous pedicle.

Anhidrotic ectodermal dysplasia.

A diagnosis of anhidrotic ectodermal dysplasia should be considered for patients with an undeveloped breast or other deformities. Recognition of the syndrome can lead to necessary and helpful genetic counseling and will ensure that other members of the family, who may also be affected by the syndrome, are under proper care.

Long-term follow-up of clefts of the secondary palate repaired by von Langenbeck's method.

In analysing our small series with caution we tend to support the findings of Lindsay (1971) and Blocksma et al. (1975). Thus the combination of no facial growth deformity and a reasonable rate of velopharyngeal competence has encouraged us to continue using this simple and safe procedure for the treatment of cleft palates with intact lip and alveolus.

A clinical trial of BCG immunotherapy as an adjunct to surgery in the treatment of primary malignant melanoma.

A preliminary analysis of a controlled trial of BCG immunotherapy as an adjunct to surgery in the treatment of primary malignant melanoma has been carried out. The length of follow-up varied from 5 years to 6 months. No obvious benefit from BCG immunotherapy has been found so far.

Experience with a "continuous" laser in the treatment of suitable cutaneous conditions: preliminary report.

A clinical trial with a "continuous" CO2 laser in the treatment of cutaneous lesions was instituted 2 1/2 years ago. The laser was used as a "light" knife for excision and for gross destruction of some lesions directly. Details of technique and a preliminary report assessing clinical results and general effects are given.