Autologous fat grafting as a minimally invasive technique to avoid cochlear implant extrusion.

Infection of the skin-muscle flap is one of the most severe risks of cochlear implantation. The aim of this paper is to describe a novel and minimally invasive procedure to avoid cochlear implant (CI) extrusion. A 79-year-old woman with severe comorbidities developed a pressure injury of the skin-muscle flap overlying the CI receiver/stimulator (R/S) nine years after surgery.

The Bicentenary of Bell's Description of the Neuroanatomical Basis of Facial Paralysis: Historical Remarks.

Charles Bell was a talented and versatile Scottish anatomist, neurophysiologist, artist, and surgeon. On July 12, 1821, he reported his studies regarding facial innervation in the essay "On the Nerves," read before the Royal Society in London. Since then, idiopathic peripheral facial paralysis has been named "Bell's palsy.

Adding Nanofat to Fat Grafting to Treat Velar Scarring in Velopharyngeal Incompetence.

Despite improved surgical techniques in palatoplasty a number of patients will present post-operatively with incomplete velopharyngeal closure due to several reasons including inherent shortness of the palate or midline scar contracture. This incomplete closure of the velopharynx during speech, known as velopharyngeal incompetence (VPI) causes hypernasality and nasal turbulence during speech. Treatment options in severe cases include revisions, pharyngeal flaps, and pharyngoplasties while in mild cases fat grafting has demonstrated its efficacy in improving velopharyngeal closure.

The First Pull-through Approach to a Tongue Tumor by Giorgio Regnoli in 1838.

The aim of this article is to describe the first report of a "pull-through" submental approach for excision of a tongue tumor, performed by Giorgio Regnoli in 1838 on a 14-year-old girl affected by a huge swelling of the tongue, which obstructed the upper airway and hindered swallowing and speech. Regnoli made a midline submental incision, divided the mylohyoid muscle and the oral mucosa, and entered the floor of the mouth. The tongue was pulled into the neck through the newly created opening, and the tumor was circumscribed by thread loops to prevent bleeding and was excised.

Management of Vocal Fold Scars by Concurrent Nanofat and Microfat Grafting.

Vocal fold scarring is the cause of severe dysphonia and represents a therapeutic challenge; dysphagia can also be present in case of soft tissue defect due to previous oncological surgery. The ideal surgical solution should concurrently provide vocal fold augmentation and re-establishment of tissue elasticity. Nanofat technique has given so far promising results in remodeling skin scars and improving tissue pliability.

Fat Grafting in the Management of War Injuries.

The healing potential of fat grafting was empirically noted by the surgeons who were confronted with the dramatic facial disfigurements resulting from World War 1. Fat was transplanted into the wounds either en bloc or in parcels to promote the healing capacity or to correct the uneven, depressed scars from gunshot wounds, enabling the poor soldiers to step back to society and families in a shorter period of time.The idea of transplanting fat into the wound of the facially disfigured started with Hippolyte Morestin (1869-1919), surgeon in chief at Val-de Grace Military Hospital in Paris and was widely adopted by HD Gillies (1882-1960), Erich Lexer (1867-1937), Gustavo Sanvenero Rosselli (1897-1974), and others, achieving amazing results.

Structural Fat Grafting to Improve Outcomes of Vocal Folds' Fat Augmentation: Long-term Results.

Objective Evaluating the long-term outcomes of vocal fold structural fat grafting. Study Design Case series with chart review. Setting University hospital.

Bergamo 3D Rhinoplasty Software: Select, Store, and Share Surgical Maneuvers in a Three-Dimensional Nasal Model.

Background: Rhinoplasty is considered the most challenging chapter of plastic surgery due to its variability and the continuing evolution of surgical maneuvers. Worksheets became essential to unequivocally record surgical steps and to demonstrate their reciprocal effects/interactions during the follow-up period. After 1989, no other software was created to upgrade the Gunter Rhinoplasty Diagrams, the forefather and benchmark of the rhinoplasty "virtual" worksheet maker.

Regenerative Approach to Velopharyngeal Incompetence with Fat Grafting.

Surgical management of velopharyngeal incompetence (VPI) aims at improving voice resonance and correcting nasal air escape by restoring a competent velopharyngeal sphincter. Assessment of VPI requires the examination of multiple variables. The dynamic study of movements of the velopharyngeal port during speech and the quantification of the closure gap, using flexible videonasoendoscopy and/or videofluoroscopy, is essential.

History of fat grafting: from ram fat to stem cells.

Fat injection empirically started 100 years ago to correct contour deformities mainly on the face and breast. The German surgeon Eugene Hollaender (1867-1932) proposed a cocktail of human and ram fat, to avoid reabsorption. Nowadays, fat injection has evolved, and it ranks among the most popular procedures, for it provides the physician with a range of aesthetic and reconstructive clinical applications with regenerative effects on the surrounding tissues.

History of reconstructive rhinoplasty.

Amputation of the nose was practiced as a sign of humiliation to adulterers, thieves, and prisoners of war by certain ancient populations. To erase this disfigurement, numerous techniques were invented over the centuries. In India, where this injury was common, advancement cheek flaps were performed (around 600 BC).

Facial clefts and facial dysplasia: revisiting the classification.

Most craniofacial malformations are identified by their appearance. The majority of the classification systems are mainly clinical or anatomical, not related to the different levels of development of the malformation, and underlying pathology is usually not taken into consideration. In 1976, Tessier first emphasized the relationship between soft tissues and the underlying bone stating that "a fissure of the soft tissue corresponds, as a general rule, with a cleft of the bony structure".

Management of tracheostomy scar by autologous fat transplantation: a minimally invasive new approach.

Background: Tracheotomy is a life-saving operation but may have bothersome sequelae. Because the defect resulting from tracheostomy is often allowed to repair spontaneously by secondary intention, hypertrophic scar formation is a frequent consequence. Furthermore, skin-to-trachea adhesions may develop, creating a "tracheal tug," that is, the skin movement in conjunction with the trachea, causing discomfort on swallowing.

Fat injections for the treatment of velopharyngeal insufficiency.

The aim of this article was to describe the technical details of a fat injection procedure for the treatment of mild to moderate velopharyngeal insufficiency (VPI). Before surgery, the velopharyngeal gap is assessed by means of flexible nasoendoscopy, and speech intelligibility, hypernasality, and nasal air escape are perceptually evaluated and scored by independent raters; nasal airflow during speech is objectively measured. The lipoaspirate is centrifuged at 1200g for 3 minutes to separate and remove blood, cell debris, and the oily layer.

Primary nasal tip surgery: a conservative approach.

Background: Rhinoplasty and rhinoseptoplasty are very important and complex surgical procedures because the nose plays a pivotal aesthetic role in the face and an important functional role in breathing. Mild bulbous, plunging, undefined tips are very common, and tip refining and repositioning often are required surgical procedures.

Methods: For 97 selected patients, the authors performed their personal technique consisting of a transcartilaginous approach, incomplete vertical interruption, and retrograde undermining of the lower lateral cartilages to improve tip projection and definition.

Treatment of velopharyngeal insufficiency by pharyngeal and velar fat injections.

The aim of this prospective study was to evaluate the effectiveness of fat injections in the treatment of velopharyngeal insufficiency (VPI). The study involved 10 patients (6 adults aged 19-48 years and 4 children aged 5-13 years) with mild/moderate VPI who were injected with 3.5 to 8 mL of fat in the posterior, lateral pharyngeal walls and soft palate under general anaesthesia.

EURAPS at 20 years. A brief history of European Plastic Surgery from the Société Européenne de Chirurgie Structive to the European Association of Plastic Surgeons (EURAPS).

By the end of WWI, plastic surgery had reached unexpected heights. The high quality of the work done for soldiers with facial injuries and burns, either as an emergency or as a delayed procedure, demonstrated that this new discipline was honourable, worthwhile and socially crucial, thus deserving official recognition and independence. The establishment of new plastic surgery centres, scientific societies and specialised journals were the key to success for the achievement of this goal.

Treatise on skull fractures by Berengario da Carpi (1460-1530).

Jacopo Berengario was born in Carpi, a medieval city close to Modena (northern Italy), circa 1460. He studied medicine at Bologna University and, in 1489, graduated in philosophy and medicine. He was appointed lecturer in anatomy and surgery at the same university, a position that he maintained for 24 years.