Journal of Cutaneous and Aesthetic Surgery最新文献

The triple advancement flap has traditionally been used on the trunk, but gained popularity for facial defects of the neck and temple. Advantages of this closure technique include evenly dispersed tension vectors, less need for extensive subcutaneous undermining and mobilization compared to standard facial reconstruction techniques. The nasal sidewall, root, and bridge often pose reconstructive challenges, with convergence of competing tension lines and surrounding anatomic landmarks. Our purpose is to introduce, describe, and illustrate application of the triple advancement flap for reconstruction of the nasal sidewall, bridge, and root. A triple advancement flap employs aspects of a purse-string closure and an advancement flap. Burow's triangles are excised from three equidistant points of a round defect. Tissue undermining is encouraged. A purse-string suture is used to approximate flap edges together along three tension lines. The central defect is subsequently allowed to heal either by secondary intention or with application of a Burow's graft. When applied appropriately, the triple advancement flap can provide pleasing cosmetic and functional results in areas that have traditionally posed a reconstructive challenge. This new application broadens the scope of the triple advancement flap and provides reconstructive surgeons with an additional tool when approaching nasal root, bridge, or sidewall defects.

This organic model can help develop essential skills required for vitiligo surgery in an affordable and sustainable manner. This study introduces an organic bench model using vegetables to teach and learn vitiligo surgery techniques. By using cucumbers , various techniques of dermabrasion and skin grafting were practiced. The model offers a versatile, cost-effective alternative to traditional simulators, enhancing practical skill acquisition.

Sclerotherapy has been commonly used for the treatment of arteriovenous (AV) malformation as a stand-alone technique or with surgical excision of the nidus. However, it can cause surrounding tissue necrosis and scarring. The lip is one of the most uncommon sites for AV malformation. Lip esthesis is of paramount importance. Hence, its reconstruction becomes a difficult task due to its specialized nature. In our technique, we have combined a labial mucosal advancement flap to reconstruct a scarred lip with dermofat grafting to provide an acceptable contour. Therefore, we have combined the principles of reconstruction of the lip with the aesthetic domain in a single stage to replicate a pinkish-red, smooth, and pliable lip with a pout.

Objectives: The objective of this study was to evaluate the efficacy and adverse effects of non-cultured, nontrypsinized dermabraded epidermal cell graft followed by narrowband ultraviolet B (NB-UVB) therapy for stable vitiligo.

Material and methods: A hospital-based and prospective interventional study was carried out on 45 patients (18-65 years) of both genders after approval from the Ethics Committee. The donor site was dermabraded after applying mupirocin ointment, and the material obtained was spread over the dermabraded recipient site. NBUVB phototherapy was initiated 3 weeks after the procedure and given for 3 months. Photographs were taken before the procedure and at the end of 3^rd month of phototherapy and assessed for extent, pattern, and color matching of repigmented area according to physician global assessment (PGA) score and patient satisfaction score (PSS). Dermoscopic improvement was also noted.

Results: Forty-five patients were enrolled in the study, out of which 43 patients completed the study. According to the intention to treat analysis, results were calculated in all 45 patients. Good to excellent response (50-100% improvement) was seen in 46.7% of patients according to the PGA score and in 57.8% of patients according to PSS. Most patients achieved the same color match with their normal skin at the end of the follow-up (73.3%). The most common repigmentation pattern was diffuse (46.7%), both clinically and dermoscopically. Among the clinical types, vitiligo vulgaris showed the maximum good to excellent repigmentation (61.3% and 77.4% of patients with PGA scores and PSS, respectively). Adverse effects were erythema, infection, and post-inflammatory hyper-pigmentation at the donor and recipient sites, whereas scarring was seen at the recipient site.

Conclusion: It is a safe, simplified, cost-effective, and less time-consuming technique than earlier techniques and provides good to excellent repigmentation in a considerable proportion of participants.

Background: The earlobe plays a significant role in framing the face and complementing the appearance of earrings, hairstyles, and other facial features. In addition to the growth of the earlobes with the aging process, other changes can compromise the shape, size, and overall youthful appearance of this region. The main changes are evidenced by the elongation and ptosis of the earlobes, loss, atrophy of soft tissues, and formation of wrinkles in addition to deformities produced by surgical procedures, placement of earrings, and piercings or earlobe gauging.

Objective: The authors describe the main changes in the earlobes and review the current treatment modality for earlobe rejuvenation and reconstruction, addressing the anatomy, common esthetic concerns, and various therapeutic approaches.

Methods: A narrative review of treatment options was performed. We searched PubMed databases. Based on the diagnosis of changes, less invasive surgical procedures, use of laser, and fillers with fat or hyaluronic acid represent therapeutic options.

Results: Significant improvement of the senile earlobe and correction of anatomical and esthetic deformities can be attenuated or corrected through different approaches. Proper diagnosis of the changes will determine the best treatment or even the combination of procedures.

Conclusion: Surgical procedures, laser rejuvenation, fat injection, and fillers represent simple and effective options for treating esthetic problems and acquired deformities of the earlobes.

A stable and less voluminous nail dressing is required after nail surgery over the nail unit. The bandage should take care of trauma, water and discharge from the wound. We described the use of two layered non-sticky and absorptive bandages. It was cut into dumbbell shape and wrapped over the toe with a nail, and tied at the base of the toe with moderate pressure. To observe the toe, a window is made in the center of the bandage.

Objectives: Stretch marks and post-surgical scar marks may have negative cosmetic and psychological impacts.. Thus, this study aimed to compare the efficacy and safety of microneedling monotherapy versus microneedling in combination with autologous platelet-rich plasma (PRP) for the treatment of stretch marks and post-surgical scars.

Material and methods: This was a prospective randomized non-controlled study. A total of 30 study participants with stretch marks and post-surgery scars were enrolled and randomly divided into two groups, each with 15 study participants. All received three treatment sessions using microneedling monotherapy (Group A) or autologous PRP with microneedling (Group B) at 4-week intervals. Clinical response to treatment was assessed at the end of 20 weeks by comparing clinical photographs, Manchester Scar scale (MSS) score, dermoscopy images, and patient satisfaction scores.

Results: At the end of the study, statistically significant esthetic improvement in terms of MSS scores was seen in Group B when compared to Group A. In Group A, 73.3% of the study participants were satisfied while in Group B, 86.6% were very satisfied with the results. Dermoscopy pictures substantiated the findings of clinical improvement. No major side effects were documented.

Conclusion: PRP in combination with microneedling has a better outcome as compared to microneedling monotherapy. Furthermore, dermoscopy is a non-invasive tool that can be used to evaluate therapeutic response.

Langer's lines, lines of cleavage, and biodynamic excisional skin tension (BEST) lines have been defined for cutaneous surgery to ensure excisional wound closure with the least tension on any part of the body and minimize scarring. This article describes nail unit incision lines (NUIL) with a similar perspective. NUIL are followed by nail surgeons to help regrowth of a normal nail; however, they are not widely understood or respected during nail surgery. Within the anatomically small nail unit, the orientation of these lines varies depending on the area being operated upon. Nail bed incisions should be oriented longitudinally, while nail matrix incisions should be oriented horizontally. Being the germinative portion, the nail matrix should be dealt with more cautiously, avoiding the lunular margin. Lateral nail fold incisions should be longitudinal, while proximal nail fold incisions should be radial. Distal nail fold (hyponychial) incisions should preferably be oriented parallel to the distal nail ridge. Knowledge and compliance with NUIL can help minimize scarring outcomes in nail surgery.