Multi-Subunit Repair With the Nasolabial Burow's Advancement Flap.

Aim: We will describe the use of nasolabial Burow's advancement flaps (perialar crescentic advancements) to repair multi subunit defects of the nasal sidewall including the adjacent cheek, dorsum, tip, and ala without the need of additional flaps.

Methods: This retrospective single centre study analyzed 6 month postoperative photographs using the Manchester Scar scale. The operative technique is described in detail.

Breast Autologous Fat Transfer Entirely Under Tumescent Anesthesia: Safety and Efficacy.

Background/objectives: The prior use of external expansion has been described in the literature as a tool to allow reliable grafting of more than 200 mLs of autologous fat under general anesthesia. The purpose of this study was to determine whether breast autologous fat transfer entirely under tumescent anesthesia (BAFTEUTA) is a safe and effective technique.

Methods: After institutional board approval, 22 consecutive patients were enrolled in this single-cohort, prospective study.

The winning score.

Incision lines placed at cosmetic boundaries and/or in rhytids during surgical procedures provide ideal concealment of scars. We suggest the use of a 30-gauge, half-inch needle or alternatively the back edge of a #15 scalpel blade to superficially score the skin to provide markings, which are fine enough to lie exactly within rhytids or at exact cosmetic boundaries such as the nasolabial fold or the junction of the cutaneous and vermillion lip. We measured the average depth of these scores to demonstrate that they are shallow enough to heal without scarring.

Artificial intelligence in the detection of skin cancer.

Recent advances in artificial intelligence (AI) in dermatology have demonstrated the potential to improve the accuracy of skin cancer detection. These capabilities may augment current diagnostic processes and improve the approach to the management of skin cancer. To explain this technology, we discuss fundamental terminology, potential benefits, and limitations of AI, and commercial applications relevant to dermatologists.

A review of the evidence for Mohs micrographic surgery. Part 2: basal cell carcinoma.

Mohs micrographic surgery (MMS) is considered the gold-standard treatment for basal cell carcinoma (BCC) particularly for sites with a high-risk of incomplete excision such as the central face, for tumours with an aggressive growth pattern and consequent unpredictable subclinical extension and for recurrent tumours. However, the process is more time-consuming than for standard excision (SE), and the magnitude of benefit is uncertain. This article aims to provide a more complete picture of current evidence, including a review of cosmetic outcomes, tissue-sparing ability and cost-effectiveness of MMS.

Evaluation of Intraoperative Triamcinolone Injection or Primary Lobe Tacking (Pexing) Sutures for Preventing Pincushioning in Bilobed Transposition Flaps.

Background: Bilobed transposition flaps are prone to pincushioning (trapdooring), whereby contraction of the flap over the wound bed may produce an unsatisfactory functional and aesthetic outcome. There are several proposed methods to prevent this, but there is currently no clear consensus on the ideal technique.

Objective: To compare primary lobe pexing sutures versus intraoperative triamcinolone (TAC) injection as methods to prevent pincushioning in bilobed transposition flaps.

Periorbital desmoplastic squamous cell carcinoma.

Desmoplasia is the formation of a dense collagenous stroma around a neoplasm. It occurs in a variety of malignancies including squamous cell carcinoma (SCC). While desmoplasia is uncommonly seen in cutaneous SCC, it is an independent risk factor for recurrence and metastasis.

Sclerosing squamous cell carcinoma of the skin, an underemphasized locally aggressive variant: a 20-year experience.

Background: Desmoplastic (sclerosing) responses to a variety of neoplasms have been documented but rarely evaluated in association with primary cutaneous squamous cell carcinoma (SCC). We report a distinctive variant of SCC demonstrating an infiltrative growth pattern and stromal desmoplasia.

Methods: Cases were identified through a retrospective review of our dermatopathology and dermatologic surgery databases.

The rotating island pedicle flap: an aesthetic and functional improvement on the subcutaneous island pedicle flap.

Background: The subcutaneous island pedicle flap is a useful closure in many areas on the face, particularly the cheek and upper lip. One disadvantage can be that the advancing edge of the flap leaves a scar at right angles to the local lines of relaxed skin tension. Tension on free edges such as the lid can also be a problem, but may be mitigated by incorporating an element of rotation into the closure.