Basic Photographic Standards for Abdominal Contouring Procedures and Abdominoplasty/Lipectomy.

Standardized reliable medical photographic documentation should be made by every plastic surgeon for valid comparisons of preoperative and post-operative illustrations. However, photographic documentation in aesthetic surgery has also an important medico-legal impact as if not performed accurately it can result in severe legal ramifications. Therefore, we evaluated and redefined the existing photographic standards for abdominal contouring procedures and abdominoplasty/lipectomy further, to achieve consistent detailed photographs without any corresponding distortion or distraction.

Defect closure in the paranasal region: an enduring challenge.

Background: The paranasal region constitutes a demanding issue for the reconstructive surgeon. Its complex anatomy, with concavity in close contact with convexity, and a high density of functional and aesthetically important facial components demands specific concern. Due to such complexity, numerous procedures for the reconstruction of paranasal defects have been published, including skin grafts and flaps in random pattern or axial style from the glabella, upper lid, nasal root, or cheek.

Second-degree burn within a tattoo after intense-pulsed-light epilation.

The use of high energy light sources [laser, intense pulsed light (IPL)] is booming in aesthetic surgery. A trend, especially concerning usage of photoepilation in cosmetic institutes, is detectable. Photoepilation works through selective photothermolysis, by heating the chromophore melanin within the hair follicles.

Neoadjuvant radiotherapy of head and neck carcinoma: an obstacle for plastic reconstruction?

Head and neck carcinomas often are at an advanced stage at the time of diagnosis and therefore frequently primarily hardly operable. A downstaging achieved by neoadjuvant radiotherapy can facilitate a radical tumor resection. Because of radiogenic tissue alterations like scarring and impairment of blood supply, elaborate operations, such as microsurgical reconstructions, are aggravated to a degree, and most surgeons consider them impossible.

Complete excision of nonmelanotic skin cancer: a matter of surgical experience.

Nonmelanotic skin cancer is the most common human neoplasia and its incidence is rising. The completeness of resection is the most important quality feature of surgical treatment of nonmelanotic skin cancer, as a complete resection distinctly reduces local recurrence. In this trial, we analyze the incomplete resection rate of nonmelanotic skin cancer (N = 524) through plastic surgery assistant doctors in the first 3 years of surgical training.

Management of complications following aesthetic procedures can lead to significant additional cost.

Liposuction is one of the most common surgical interventions in aesthetic surgery, technically easy to perform and is also carried out by many non-plastic surgeons. However, this operation can have severe complications, and dealing with them can impose a great financial burden on the tax payer-supported national health-care systems. We report here about a patient, who was hospitalised for complications after a failed office-based liposuction.

Aesthetic improvements of skin grafts in nasal tip reconstruction.

Defect closure on the nasal tip subunit still remains challenging. Full-thickness skin transplantation still is used despite its poor outcome in terms of the nasal tip contour caused by lack of dermal tissue. To avoid subsidence deformities associated with nasal tip reconstruction with skin transplants, this study analyzed methods using combined epidermal and dermal replacement.

Retroauricular pull-through island flap for defect closure of auricular scapha defects--a safe one-stage technique.

The anatomy and tissue characteristics of the ear render reconstructive procedures addressing local defects on the scapha challenging. Twenty patients with variously caused defects on the scapha underwent a one-stage reconstruction with retroauricular pedicled flaps raised without axial vessels. Flap elevation, followed by incision and tunnelling of the cartilage, enables easy access to the defects at the centre of the external surface of the concha.

The toothpick-tale - Take your patient seriously: a decade of pain and immobilization caused by an unrecognized toothpick!

We report here about a 26-year-old female patient with a 10-year-long saga of pain caused by a toothpick that had pierced through the skin and lodged in her foot but had defied detection for this long period of time. In our department the patient underwent surgery under general anesthesia to remove the foreign body. A 3.

The bipedicled and bipartite latissimus dorsi free and perforator flap: an anatomic study.

Background: The purpose of this study was to search for an enhanced blood supply in the distal one third of the latissimus dorsi and, thus, to have a closer look at the muscular branches of the intercostal vessels.

Methods: The muscle branches to the latissimus dorsi muscle arising in the "costal groove" segment of the three lowermost intercostal vessels (ninth to eleventh interspaces) were identified bilaterally in 28 fixed hemithoraces (84 interspaces). In the interspaces, the perforators 0.

[A body mass index related scale for reconstructive breast reduction].

Purpose: Breast reduction is a highly emotional theme and bears conflicting interest groups: 1) women who are suffering from symptomatic macromastia and therefore would wish to have their breast reduction paid by the insurers, irrespective of the amount of resection weight, 2) the insurance companies, who are ready to cover only really medically indicated operations and due to a lack of objective parameters often apply the very strict, arbitrary criterium for a minimum resection weight of 500 g per breast and 3) the surgeons who try to provide a fair, scientific basis for the differentiation between cosmetic and reconstructive indications for breast reductions for the sake of both the patients and the insurance parties. Concerned about such a generalizing rule we undertook a retrospective review of our patients' charts with both, cosmetic and reconstructive indications to judge the available, more-level minimum resection weight standards and see wether they were appropriate to use, or to provide an objective and measurable guideline for a scaled amount of breast reduction beyond the 500 g-resection-rule, adapted to the individual woman's body proportions.

Methods: 136 women could be included in the study.

The thoracoacromial vessels as recipient vessels in microsurgery and supermicrosurgery: an anatomical and sonographic study.

The purpose of this study was to investigate the presence and the precise course of the pectoral branch of the thoracoacromial vessels on the underside of the pectoralis major muscle by anatomical dissection and by color Doppler ultrasound. A further goal was to determine whether these vessels were suitable as recipient vessels in microsurgery and supermicrosurgery for breast reconstruction. In 18 cadavers, the pectoral branch of the thoracoacromial vessels was followed caudally until the diameter of the artery diminished to 1 mm.

The transareolar incision for breast augmentation revisited.

Of the various possible incisions for breast augmentation, the transareolar access has gained only limited popularity. The potential side effects of this incision are said to be altered nipple sensation, impaired lactation, an increased rate of infections with capsular fibrosis, well visible scar formation with hypopigmentation, and the need for an additional access in case a breast ptosis correction should prove necessary at a later date. The purpose of this retrospective study was to judge advantages and limitations of transareolar breast augmentation, and to verify whether the reluctant attitude toward this surgical approach is justified.

Comparison of the incidence and predicted risk of early surgical site infections after breast reduction.

In plastic surgery, clean, elective operations such as breast reductions are anticipated to have low risk factors for infections (1.1-2.1%).

The cartilage-sparing versus the cartilage-cutting technique: a retrospective quality control comparison of the Francesconi and Converse otoplasties.

From a total of 281 patients with protruding ears who underwent a bilateral otoplasty between 1990 and 2001, a group of 28 (10%) was selected for a retrospective quality control study. The goal was to compare two methods of otoplasty, the Francesconi, a cartilage-sparing technique, and the Converse, a cartilage-cutting technique, in terms of objectively measurable and subjectively discernable differences in results. Objective parameters included measurement of the three cephaloauricular distances and the conchoscapal angle.