Introduction: Surgical removal of modeling substances is the treatment of choice in iatrogenic allogenosis. This is a disease caused by the injection of substances misnamed “biopolymers” with high antigenicity and low histocompatibility. Symptoms can be local or general, leading to a systemic inflammatory autoimmune syndrome induced by adjuvants. Method: A patient operated by open method for the surgical extraction of allogenic substances in the gluteal region is described. Results: A 46-year-old female patient with a history of injection of more than 1000 ml of liquid silicone in both buttocks and face 11 years ago is presented. Two years later, she presented erythema, increased consistency, pruritus, and hyperemia, associated with general symptoms that limited her daily activities. She was diagnosed with an adjuvant-induced systemic inflammatory autoimmune syndrome and was admitted for surgical removal of the causative agent. Surgical extraction of alloplastic material in the gluteal region was performed for the first time in Cuba without local postoperative complications. Conclusion: Surgical treatment by the open biopolymer extraction method is deforming, but it is the only solution to improve the symptoms of iatrogenic allogenosis.
{"title":"Open Method for Surgical Removal of Modeling Substance in a Patient with Iatrogenic Gluteal Allogenosis","authors":"Eyleen Vila Garcia","doi":"10.23880/ijtps-16000164","DOIUrl":"https://doi.org/10.23880/ijtps-16000164","url":null,"abstract":"Introduction: Surgical removal of modeling substances is the treatment of choice in iatrogenic allogenosis. This is a disease caused by the injection of substances misnamed “biopolymers” with high antigenicity and low histocompatibility. Symptoms can be local or general, leading to a systemic inflammatory autoimmune syndrome induced by adjuvants. Method: A patient operated by open method for the surgical extraction of allogenic substances in the gluteal region is described. Results: A 46-year-old female patient with a history of injection of more than 1000 ml of liquid silicone in both buttocks and face 11 years ago is presented. Two years later, she presented erythema, increased consistency, pruritus, and hyperemia, associated with general symptoms that limited her daily activities. She was diagnosed with an adjuvant-induced systemic inflammatory autoimmune syndrome and was admitted for surgical removal of the causative agent. Surgical extraction of alloplastic material in the gluteal region was performed for the first time in Cuba without local postoperative complications. Conclusion: Surgical treatment by the open biopolymer extraction method is deforming, but it is the only solution to improve the symptoms of iatrogenic allogenosis.","PeriodicalId":398291,"journal":{"name":"International Journal of Transplantation & Plastic Surgery","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129806350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The collective accomplishments of the liver transplant community have resulted in satisfactory 5- and 10-year patient and graft survival. Within the increasing cohort of transplant recipients, metabolic complications are becoming a main reason for non-graft related mortality. Post-liver transplantation diabetes mellitus (PLTDM) is a well-documented disorder, adversely affecting recipient survival, a main risk factor for cardiovascular disease (CVD) and CVD-related mortality. The incidence of PLTDM varies between 9-63%. Calcineurin inhibitors (CINs) and corticosteroids are the principal mediators in the pathogenesis of this disease. We performed a brief review of the literature and retrospectively analyzed our own experience. For immunosuppression we use standard protocol of corticosteroids, tacrolimus and mycophenolate mofetil. The frequency of PLTDM in our series is 20%. We did not find a connection between recipient age, BMI, lipid status, underlying liver disease or acute rejection episode with the development of sustained PLTDM.
{"title":"Post-Liver Transplantation Diabetes Mellitus: Concise Literature Review and Own Experience","authors":"R. Kostadinov","doi":"10.23880/ijtps-16000165","DOIUrl":"https://doi.org/10.23880/ijtps-16000165","url":null,"abstract":"The collective accomplishments of the liver transplant community have resulted in satisfactory 5- and 10-year patient and graft survival. Within the increasing cohort of transplant recipients, metabolic complications are becoming a main reason for non-graft related mortality. Post-liver transplantation diabetes mellitus (PLTDM) is a well-documented disorder, adversely affecting recipient survival, a main risk factor for cardiovascular disease (CVD) and CVD-related mortality. The incidence of PLTDM varies between 9-63%. Calcineurin inhibitors (CINs) and corticosteroids are the principal mediators in the pathogenesis of this disease. We performed a brief review of the literature and retrospectively analyzed our own experience. For immunosuppression we use standard protocol of corticosteroids, tacrolimus and mycophenolate mofetil. The frequency of PLTDM in our series is 20%. We did not find a connection between recipient age, BMI, lipid status, underlying liver disease or acute rejection episode with the development of sustained PLTDM.","PeriodicalId":398291,"journal":{"name":"International Journal of Transplantation & Plastic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128804065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The skin and nipple sparing mastectomy is a technique currently on the rise. It arises for the treatment of benign breast lesions; but with the high worldwide incidence of breast cancer, it is used in risk-reducing surgery and breast cancer. In this perspective, numerous technical modifications are described for the minimally invasive surgical approach through low visibility accesses in breast cancer surgery. Objective: To present a technical modification for the Skin-Sparing Modified Radical Mastectomy with preservation of the nipple areola complex and immediate reconstruction with implants by Minimally Invasive Surgery. Methods: We present three patients with left breast cancer operated on for Skin-Sparing Left Modified Radical Mastectomy with preservation of the nipple areola complex and immediate reconstruction with placement of retropectoral implants by minimally invasive surgery through a single periareolar incision. Results: Skin-Sparing Left Modified Radical Mastectomy was performed with preservation of the nipple areola complex and immediate reconstruction with retropectoral prosthesis by minimally invasive surgery in three patients. The evolution was favorable, with good clinical and aesthetic results, without complications and with a high degree of satisfaction according to the international Breast Q scale. Conclusion: Minimally invasive surgery with single periareolar access is safe and effective for Skin-Sparing Radical Mastectomy with preservation of the nipple areola complex, as well as the axilla approach and immediate reconstruction with the placement of retropectoral breast implants.
{"title":"Comprehensive Surgical Treatment of Breast Cancer by Minimally Invasive Surgery","authors":"Eyleen Vila Garcia","doi":"10.23880/ijtps-16000163","DOIUrl":"https://doi.org/10.23880/ijtps-16000163","url":null,"abstract":"Introduction: The skin and nipple sparing mastectomy is a technique currently on the rise. It arises for the treatment of benign breast lesions; but with the high worldwide incidence of breast cancer, it is used in risk-reducing surgery and breast cancer. In this perspective, numerous technical modifications are described for the minimally invasive surgical approach through low visibility accesses in breast cancer surgery. Objective: To present a technical modification for the Skin-Sparing Modified Radical Mastectomy with preservation of the nipple areola complex and immediate reconstruction with implants by Minimally Invasive Surgery. Methods: We present three patients with left breast cancer operated on for Skin-Sparing Left Modified Radical Mastectomy with preservation of the nipple areola complex and immediate reconstruction with placement of retropectoral implants by minimally invasive surgery through a single periareolar incision. Results: Skin-Sparing Left Modified Radical Mastectomy was performed with preservation of the nipple areola complex and immediate reconstruction with retropectoral prosthesis by minimally invasive surgery in three patients. The evolution was favorable, with good clinical and aesthetic results, without complications and with a high degree of satisfaction according to the international Breast Q scale. Conclusion: Minimally invasive surgery with single periareolar access is safe and effective for Skin-Sparing Radical Mastectomy with preservation of the nipple areola complex, as well as the axilla approach and immediate reconstruction with the placement of retropectoral breast implants.","PeriodicalId":398291,"journal":{"name":"International Journal of Transplantation & Plastic Surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126329095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case report aims to describe a usually overlooked diagnosis of orbital emphysema in a 29-year- old female patient with progressive palpebral edema, crepitus and restriction in the visual field. Orbital Emphysema is a condition that clinicians must be aware of since severe cases may even lead to blindness.
{"title":"An Overlooked Diagnosis: Orbital Emphysema","authors":"A. Ural","doi":"10.23880/ijtps-16000162","DOIUrl":"https://doi.org/10.23880/ijtps-16000162","url":null,"abstract":"This case report aims to describe a usually overlooked diagnosis of orbital emphysema in a 29-year- old female patient with progressive palpebral edema, crepitus and restriction in the visual field. Orbital Emphysema is a condition that clinicians must be aware of since severe cases may even lead to blindness.","PeriodicalId":398291,"journal":{"name":"International Journal of Transplantation & Plastic Surgery","volume":"C-33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126487493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Breast ptosis is one of the more common issues seen in cosmetic surgeons’ offices, particularly those performing a significant amount of aesthetic breast surgery. Patients with ptosis generally desire the same result – youthful and “perky” breasts. However, due to wide variations in breast volume and tissue quality, ultimate results vary with each patient, and as a result, preoperative management of expectations is critical. There are many surgical options that can be customized to patients’ needs, but these generally address repositioning of the glandular tissue and nipple areolar complex and management of skin excess. Scar patterns include circumareolar, circumvertical (including J or L scar variations), and inverted-T patterns. If author’s new concept can eliminate the remaining skin excess that occur from approximately preoperative markings of traditional mastopexy and can decrease the scar pattern (J or L scar variations and inverted-T patterns), they are interesting to bring an alternative to reduce complications and more satisfactory results. Objective: Author study the new concept of surgical techniques of mastopexy in severe ptotic breasts. The new concept is the changing steps of procedure that performs repositioning and reshaping of the glandular tissue and repositioning of nipple areolar complex before, follow by design and excise the excess skin flaps. Surgical result, main complications and patient satisfaction are evaluated. Methods: The study has performed in 11 patients who have severe ptotic breasts with author’s techniques of mastopexy since July 2017 to march 2018. The techniques including repositioning and reshaping of the glandular tissue and repositioning of nipple areolar complex, skin flaps are designed and excised accurately. Postoperative care makes as standard protocols. Results: Of 11 patients who underwent mastopexy with author’s techniques, all patients have symmetric, only short vertical scar and beautifully shaped breasts and 2 patients have superficial necrosis of skin which at junction of inferior edge of areola and vertical incision, both sides and right side respectively. Three breasts which have superficial skin necrosis, manage include death tissue was removed, dress wet wound every day and make delay primary wound closure in some areas. Nipple sensation is usually normal. Some patients have decrease sensation and fully recover within three months. Conclusion: Author’s surgical techniques change steps of standard mastopexy, as new concept for severe ptotic breast. Repositioning and reshaping of glandular tissue and repositioning of nipple areolar complex firstly, these will help surgeon design and excise the excess skin flaps more accurately. But surgeons do not over excise skin flap to prevent skin necrosis especially junction area. Accordingly, author’s technique can decrease frequent complications of mastopexy including asymmetry, improper of flap excision and undesired J or L, inverted T scar
{"title":"The New Concept of making the Excellent Result in Mastopexy","authors":"Opas Khomgongsuwan","doi":"10.23880/ijtps-16000161","DOIUrl":"https://doi.org/10.23880/ijtps-16000161","url":null,"abstract":"Background: Breast ptosis is one of the more common issues seen in cosmetic surgeons’ offices, particularly those performing a significant amount of aesthetic breast surgery. Patients with ptosis generally desire the same result – youthful and “perky” breasts. However, due to wide variations in breast volume and tissue quality, ultimate results vary with each patient, and as a result, preoperative management of expectations is critical. There are many surgical options that can be customized to patients’ needs, but these generally address repositioning of the glandular tissue and nipple areolar complex and management of skin excess. Scar patterns include circumareolar, circumvertical (including J or L scar variations), and inverted-T patterns. If author’s new concept can eliminate the remaining skin excess that occur from approximately preoperative markings of traditional mastopexy and can decrease the scar pattern (J or L scar variations and inverted-T patterns), they are interesting to bring an alternative to reduce complications and more satisfactory results. Objective: Author study the new concept of surgical techniques of mastopexy in severe ptotic breasts. The new concept is the changing steps of procedure that performs repositioning and reshaping of the glandular tissue and repositioning of nipple areolar complex before, follow by design and excise the excess skin flaps. Surgical result, main complications and patient satisfaction are evaluated. Methods: The study has performed in 11 patients who have severe ptotic breasts with author’s techniques of mastopexy since July 2017 to march 2018. The techniques including repositioning and reshaping of the glandular tissue and repositioning of nipple areolar complex, skin flaps are designed and excised accurately. Postoperative care makes as standard protocols. Results: Of 11 patients who underwent mastopexy with author’s techniques, all patients have symmetric, only short vertical scar and beautifully shaped breasts and 2 patients have superficial necrosis of skin which at junction of inferior edge of areola and vertical incision, both sides and right side respectively. Three breasts which have superficial skin necrosis, manage include death tissue was removed, dress wet wound every day and make delay primary wound closure in some areas. Nipple sensation is usually normal. Some patients have decrease sensation and fully recover within three months. Conclusion: Author’s surgical techniques change steps of standard mastopexy, as new concept for severe ptotic breast. Repositioning and reshaping of glandular tissue and repositioning of nipple areolar complex firstly, these will help surgeon design and excise the excess skin flaps more accurately. But surgeons do not over excise skin flap to prevent skin necrosis especially junction area. Accordingly, author’s technique can decrease frequent complications of mastopexy including asymmetry, improper of flap excision and undesired J or L, inverted T scar","PeriodicalId":398291,"journal":{"name":"International Journal of Transplantation & Plastic Surgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125464891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The healing is the result of the natural restoration of the organism before a corporal aggression produced by a surgical wound or trauma. Poor wound and injury healing represents a functional and aesthetic problem, which is why it deserves special attention. Objective: To evaluate the aesthetic results of the treatment of pathological scars with lipotransfer by nanofat. Method: A prospective longitudinal and descriptive study was carried out with 8 patients from Plastic Surgery Hospital ‘‘Hermanos Ameijeiras” with pathological scars, who received lipotransfer treatment by Coleman method and processing of adipose tissue by nanofat from January to June 2020. Results: 8 patients with ages between 25 and 50 years with a mean age of 39 years were included. The female sex predominated with 75%. The predominant skin color was grades 3 and 5 of the Fitzpatrick classification, both with 50%. The most frequent etiologies were post acne, postoperative and injection scars of allogenic substances, all with 25%. The main anatomical locations were the facial region and in the breasts with 3 patients each, followed by 2 cases in the gluteal region. The postoperative aesthetic results at three months were 100% good, observing macroscopic and microscopic positive changes with the nanograft. No patient presented complications. Conclusions: The treatment of pathological scars with lipotransfer by nanofat is an available, simple and reproducible option that offers objective improvement of the scar with rapid recovery.
{"title":"Treatment of Pathological Scars with Nanofat Lipograft at the Hermanos Ameijeiras Hospital","authors":"Eyleen Vila Garcia","doi":"10.23880/ijtps-16000160","DOIUrl":"https://doi.org/10.23880/ijtps-16000160","url":null,"abstract":"Introduction: The healing is the result of the natural restoration of the organism before a corporal aggression produced by a surgical wound or trauma. Poor wound and injury healing represents a functional and aesthetic problem, which is why it deserves special attention. Objective: To evaluate the aesthetic results of the treatment of pathological scars with lipotransfer by nanofat. Method: A prospective longitudinal and descriptive study was carried out with 8 patients from Plastic Surgery Hospital ‘‘Hermanos Ameijeiras” with pathological scars, who received lipotransfer treatment by Coleman method and processing of adipose tissue by nanofat from January to June 2020. Results: 8 patients with ages between 25 and 50 years with a mean age of 39 years were included. The female sex predominated with 75%. The predominant skin color was grades 3 and 5 of the Fitzpatrick classification, both with 50%. The most frequent etiologies were post acne, postoperative and injection scars of allogenic substances, all with 25%. The main anatomical locations were the facial region and in the breasts with 3 patients each, followed by 2 cases in the gluteal region. The postoperative aesthetic results at three months were 100% good, observing macroscopic and microscopic positive changes with the nanograft. No patient presented complications. Conclusions: The treatment of pathological scars with lipotransfer by nanofat is an available, simple and reproducible option that offers objective improvement of the scar with rapid recovery.","PeriodicalId":398291,"journal":{"name":"International Journal of Transplantation & Plastic Surgery","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125991041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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