Titanium mesh (TM) is frequently used in cranioplasty. Exposure to the implant is a complication that adversely affects patient outcomes. Reducing the pressure applied by decreasing the contact of sharp edges with the skin reduces this risk. In this study, we aimed to explain the details of a simple method (circumferential groove technique) that reduces the risk of exposure. An 80-year-old male patient presented with a squamous cell carcinoma on the scalp. After tumor excision, it was planned to use free anterolateral thigh flap for soft-tissue reconstruction, tensor fascia lata graft for dura reconstruction, and TM for bone reconstruction. The implant was fixed with the mentioned technique. No exposure was observed at the follow-up 1 year.
{"title":"A novel method to minimizing risk of titanium mesh exposure in cranioplasty: Circumferential groove technique","authors":"C. Demir, E. Yaşar, M. Alagoz","doi":"10.4103/tjps.tjps_62_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_62_22","url":null,"abstract":"Titanium mesh (TM) is frequently used in cranioplasty. Exposure to the implant is a complication that adversely affects patient outcomes. Reducing the pressure applied by decreasing the contact of sharp edges with the skin reduces this risk. In this study, we aimed to explain the details of a simple method (circumferential groove technique) that reduces the risk of exposure. An 80-year-old male patient presented with a squamous cell carcinoma on the scalp. After tumor excision, it was planned to use free anterolateral thigh flap for soft-tissue reconstruction, tensor fascia lata graft for dura reconstruction, and TM for bone reconstruction. The implant was fixed with the mentioned technique. No exposure was observed at the follow-up 1 year.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85987453","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}
Objective: The general public often equates plastic surgery with cosmetic surgery. This study was conducted to obtain information about the public perception of the discipline of plastic surgery in Turkey and evaluate their level of awareness about what they think a plastic surgeon does. Materials and Methods: A cross-sectional study was conducted between September 1, 2021 and December 31, 2021. It was composed of 23 questions. After filling their demographic information, participants were asked to select one treating expert for each medical condition. The collected forms were analyzed using SPSS version 25. Results: A total of 600 public members participated in this study. The mean age of the participants was 37.35 ± 13.26 years. The majority of them (39.7%) were university graduates. The medical conditions most commonly known to be treated by plastic surgeons were burns (44.5%), augmentation and reduction mammoplasty (59.8%), liposuction, and abdominoplasty and face-lift (57.2%). The medical conditions least known to be treated by plastic surgeons were hand and nerve injuries (12.8%). Conclusions: Depending on our findings, we conclude that many people in our society are unaware of the true scope of plastic surgery; therefore, better education of public members is needed.
目的:公众经常把整形手术等同于整容手术。本研究旨在了解土耳其公众对整形外科的看法，并评估他们对整形外科医生的认识程度。材料和方法:横断面研究于2021年9月1日至2021年12月31日进行。它由23个问题组成。在填写完他们的人口统计信息后，参与者被要求为每种疾病选择一位治疗专家。收集到的表格使用SPSS version 25进行分析。结果:共有600名市民参与了本研究。参与者平均年龄为37.35±13.26岁。他们中的大多数(39.7%)是大学毕业生。整形外科医生最常治疗的疾病是烧伤(44.5%)、乳房增大和缩小(59.8%)、吸脂、腹部整形和面部提升(57.2%)。被整形外科医生治疗的最不为人所知的疾病是手部和神经损伤(12.8%)。结论:根据我们的发现，我们得出的结论是，我们社会中的许多人都没有意识到整形手术的真正范围;因此，需要对公众成员进行更好的教育。
{"title":"Public perceptions of plastic surgery","authors":"Nevra Seyhan","doi":"10.4103/tjps.tjps_60_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_60_22","url":null,"abstract":"Objective: The general public often equates plastic surgery with cosmetic surgery. This study was conducted to obtain information about the public perception of the discipline of plastic surgery in Turkey and evaluate their level of awareness about what they think a plastic surgeon does. Materials and Methods: A cross-sectional study was conducted between September 1, 2021 and December 31, 2021. It was composed of 23 questions. After filling their demographic information, participants were asked to select one treating expert for each medical condition. The collected forms were analyzed using SPSS version 25. Results: A total of 600 public members participated in this study. The mean age of the participants was 37.35 ± 13.26 years. The majority of them (39.7%) were university graduates. The medical conditions most commonly known to be treated by plastic surgeons were burns (44.5%), augmentation and reduction mammoplasty (59.8%), liposuction, and abdominoplasty and face-lift (57.2%). The medical conditions least known to be treated by plastic surgeons were hand and nerve injuries (12.8%). Conclusions: Depending on our findings, we conclude that many people in our society are unaware of the true scope of plastic surgery; therefore, better education of public members is needed.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86537470","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: Autologous fat transplantation (AFT) for soft-tissue enhancement is a frequent procedure that lacks a widely approved method. Objective: The aim of this study is to evaluate AFT outcomes in facial reconstructive surgeries by using meta-analysis. Materials and Methods: An electronic databases search was done on PubMed, EMBASE, and Cochrane. We screened the results, then extracted the data. Meta-analysis was done using the Open Meta-analyst program. Results: We included 62 studies in our meta-analysis, which have various study designs, including cohort, case series, and trials. They included 2326 unique patients. Our meta-analysis revealed a high rate of the patient (91.7%) and surgeon (93.1%) satisfaction with AFT surgeries which is confirmed by high scores of 7.8 and 7.9, respectively. Complications resemble a minor ratio of 2.1%. Conclusion: In experienced hands, autologous fat transfer is an effective way to correct facial deformities and leads to greater patient and surgeon satisfaction, as well as a lower risk of complications.
{"title":"Adipose tissue transplantation in fascial reconstructive operations: A systematic review and meta-analysis","authors":"Hosang Jun, Xiao He, Min Wu, Qi Zhang, Yiping Wu","doi":"10.4103/tjps.tjps_64_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_64_22","url":null,"abstract":"Background: Autologous fat transplantation (AFT) for soft-tissue enhancement is a frequent procedure that lacks a widely approved method. Objective: The aim of this study is to evaluate AFT outcomes in facial reconstructive surgeries by using meta-analysis. Materials and Methods: An electronic databases search was done on PubMed, EMBASE, and Cochrane. We screened the results, then extracted the data. Meta-analysis was done using the Open Meta-analyst program. Results: We included 62 studies in our meta-analysis, which have various study designs, including cohort, case series, and trials. They included 2326 unique patients. Our meta-analysis revealed a high rate of the patient (91.7%) and surgeon (93.1%) satisfaction with AFT surgeries which is confirmed by high scores of 7.8 and 7.9, respectively. Complications resemble a minor ratio of 2.1%. Conclusion: In experienced hands, autologous fat transfer is an effective way to correct facial deformities and leads to greater patient and surgeon satisfaction, as well as a lower risk of complications.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79735416","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 cheek dimple is one of the characteristics of an attractive face. Cheek dimples can exist naturally in a person or have been caused by surgery. This article aims is to review the literature on the anatomical features, the cause of cheek dimples, surgical techniques for cheek dimples, and complications associated with this surgery. The authors performed a literature review that focused on cheek dimple surgery. PubMed, Embase, MEDLINE, Cochrane Library, and Google Scholar databases were searched through March 2022. There were multiple techniques described for cheek dimples surgery. The basic principle of cheek dimple creation is to create an adhesion between the buccinator muscle and dermis. The essential point in all methods is the accuracy in the site of mucosal incision; so that no damage is done to the Stensen's duct. Most complications associated with cheek dimple surgery are minor, easily controlled, and can be avoided by attention to surgical technique and understanding the regional anatomy.
{"title":"Cheek dimple surgery: A review of techniques and complications","authors":"Ahmad Vahednasiri","doi":"10.4103/tjps.tjps_73_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_73_22","url":null,"abstract":"The cheek dimple is one of the characteristics of an attractive face. Cheek dimples can exist naturally in a person or have been caused by surgery. This article aims is to review the literature on the anatomical features, the cause of cheek dimples, surgical techniques for cheek dimples, and complications associated with this surgery. The authors performed a literature review that focused on cheek dimple surgery. PubMed, Embase, MEDLINE, Cochrane Library, and Google Scholar databases were searched through March 2022. There were multiple techniques described for cheek dimples surgery. The basic principle of cheek dimple creation is to create an adhesion between the buccinator muscle and dermis. The essential point in all methods is the accuracy in the site of mucosal incision; so that no damage is done to the Stensen's duct. Most complications associated with cheek dimple surgery are minor, easily controlled, and can be avoided by attention to surgical technique and understanding the regional anatomy.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79227264","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}
C. Demirdover, S. Tuncer, Bulent Sacak, E. Konaş, U. Bingol, H. Guner, Y. Tiftikcioglu
{"title":"The role of plastic reconstructive and esthetic surgery discipline in earthquakes","authors":"C. Demirdover, S. Tuncer, Bulent Sacak, E. Konaş, U. Bingol, H. Guner, Y. Tiftikcioglu","doi":"10.4103/tjps.tjps_18_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_18_23","url":null,"abstract":"","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87363507","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}
S. Alpat, B. Kaya, Cem Çerkez, K. Kosemehmetoglu, S. Serel, S. Gultan
Background: Esthetic and reconstructive surgery routinely employs the utilization of silicone implants. Silicone's limited biocompatibility can lead to serious side effects, such as capsular contracture. A capsule forming around the implant is an inflammatory response to the presence of a foreign material; however, the precise cause of capsular contracture is unknown. This experimental study looks into the effects of the two most widely used powders in surgical gloves-talcum and cornstarch-on capsule formation. Materials and Methods: Three circular silicone implants, each 1.5 cm in diameter and 2 mm thick, were implanted into pockets developed on the dorsums of 12 female rats, which were then randomly assigned to one of three groups. Group 1 received no powder in their implant pockets; Group 2 received 1.5 mg of talcum powder; and Group 3 received 1.5 mg of cornstarch powder. The capsules around the implants were histopathologically evaluated, their thicknesses were measured, and overall scores were determined after 4 weeks. Results: Although there were no statistically significant differences in the average capsule thickness measured across all four quadrants (P = 0.368), there were significant differences in the capsule score distributions across the control, talcum, and cornstarch groups (P = 0.026). Conclusion: The results of the study projects that powdered gloves (talc or cornstarch) contribute to exacerbated capsular inflammation forming around silicone implants. Therefore, powder-free gloves would be highly recommended during breast augmentation and reconstruction surgeries while handling implants.
{"title":"The surgeon's touch: Impact of surgical glove powder on the formation of capsular contracture","authors":"S. Alpat, B. Kaya, Cem Çerkez, K. Kosemehmetoglu, S. Serel, S. Gultan","doi":"10.4103/tjps.tjps_6_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_6_23","url":null,"abstract":"Background: Esthetic and reconstructive surgery routinely employs the utilization of silicone implants. Silicone's limited biocompatibility can lead to serious side effects, such as capsular contracture. A capsule forming around the implant is an inflammatory response to the presence of a foreign material; however, the precise cause of capsular contracture is unknown. This experimental study looks into the effects of the two most widely used powders in surgical gloves-talcum and cornstarch-on capsule formation. Materials and Methods: Three circular silicone implants, each 1.5 cm in diameter and 2 mm thick, were implanted into pockets developed on the dorsums of 12 female rats, which were then randomly assigned to one of three groups. Group 1 received no powder in their implant pockets; Group 2 received 1.5 mg of talcum powder; and Group 3 received 1.5 mg of cornstarch powder. The capsules around the implants were histopathologically evaluated, their thicknesses were measured, and overall scores were determined after 4 weeks. Results: Although there were no statistically significant differences in the average capsule thickness measured across all four quadrants (P = 0.368), there were significant differences in the capsule score distributions across the control, talcum, and cornstarch groups (P = 0.026). Conclusion: The results of the study projects that powdered gloves (talc or cornstarch) contribute to exacerbated capsular inflammation forming around silicone implants. Therefore, powder-free gloves would be highly recommended during breast augmentation and reconstruction surgeries while handling implants.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75817598","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: This article aims to present an alternative technique for elevating distal, proximal, and inferior based perichondrioadipodermal (PAD) flaps along with traditional otoplasty to correct ear lobule protrusion, covering the Mustarde and Furnas sutures, and lowering the potential risk and complications. Materials and Methods: This study included undergoing primary otoplasties and had the prominence of ear lobule protrusion and both ears. It included as many as 61 patients (122 ears) who complained of prominent ear deformity with the protruding earlobe and were operated on between February 2015 and December 2020. Thirty-four patients were male and 27 patients were female. The mean age of patients was 26 (9–39). The perpendicular distance from the mastoid to the helical rim's middle part and the antitragus to the mastoid area were measured at the level of Frankfort's horizontal line preoperatively and at 6 months postoperatively. The value of auricular mastoid distance exceeding 20 mm in all situations preoperatively corresponded to a prominent ear. The distance between the antitragus and the mastoid area higher than 22 mm in any situation corresponded to a prominent lobule preoperatively. Results: The average width measured in the frontal view of the ear lowered from 29 ± 4 mm to 17 ± 3 mm postoperatively at 6 months. The average width measured in the lobules' frontal view postoperatively lowered from 27 ± 5 mm to 16 ± 4 mm at 6 months. A round, natural-looking, and durable shape were accomplished in all patients. No complications pertaining to prominent ear deformity or the lobule's correction were observed. No patient was found to experience suture extrusion, skin necrosis, hematoma, or wound infection either early or later at the postoperative period. Conclusion: This study presented a safe and effective three PAD flap technique combined with traditional otoplasty for addressing prominent ear deformity with protruding ear lobule. The advantages of this technique include round, durable, and natural-looking ear shape as well as a consequent natural-looking earlobe. Level of Evidence: V.
{"title":"Prominent ear correction: Three flap technique combined with conventional otoplasty","authors":"Alpay Duran, Oguz Cortuk, Sinem Eroglu","doi":"10.4103/tjps.tjps_64_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_64_21","url":null,"abstract":"Background: This article aims to present an alternative technique for elevating distal, proximal, and inferior based perichondrioadipodermal (PAD) flaps along with traditional otoplasty to correct ear lobule protrusion, covering the Mustarde and Furnas sutures, and lowering the potential risk and complications. Materials and Methods: This study included undergoing primary otoplasties and had the prominence of ear lobule protrusion and both ears. It included as many as 61 patients (122 ears) who complained of prominent ear deformity with the protruding earlobe and were operated on between February 2015 and December 2020. Thirty-four patients were male and 27 patients were female. The mean age of patients was 26 (9–39). The perpendicular distance from the mastoid to the helical rim's middle part and the antitragus to the mastoid area were measured at the level of Frankfort's horizontal line preoperatively and at 6 months postoperatively. The value of auricular mastoid distance exceeding 20 mm in all situations preoperatively corresponded to a prominent ear. The distance between the antitragus and the mastoid area higher than 22 mm in any situation corresponded to a prominent lobule preoperatively. Results: The average width measured in the frontal view of the ear lowered from 29 ± 4 mm to 17 ± 3 mm postoperatively at 6 months. The average width measured in the lobules' frontal view postoperatively lowered from 27 ± 5 mm to 16 ± 4 mm at 6 months. A round, natural-looking, and durable shape were accomplished in all patients. No complications pertaining to prominent ear deformity or the lobule's correction were observed. No patient was found to experience suture extrusion, skin necrosis, hematoma, or wound infection either early or later at the postoperative period. Conclusion: This study presented a safe and effective three PAD flap technique combined with traditional otoplasty for addressing prominent ear deformity with protruding ear lobule. The advantages of this technique include round, durable, and natural-looking ear shape as well as a consequent natural-looking earlobe. Level of Evidence: V.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88405303","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}
{"title":"Three-dimensional exoscope-assisted cleft palate surgery for training","authors":"Sare Demirtas, E. Erkol, Z. Tosun","doi":"10.4103/tjps.tjps_65_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_65_22","url":null,"abstract":"","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77219905","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}
Skin grafts may not always be possible for deep hand burns due to a possible exposure of tendons, ligaments, joints, nerves, vessels, and bones. Therefore, a free tissue transfer is required in complex cases. We present a case of a 72-year-old man with a fire burn injury to the dorsum of the hand and first and second fingers. The necrotic areas were debrided, and wide defect with exposed extensor tendons was covered with the serratus anterior-free fascia flap and split-thickness skin graft. Partial necrosis was developed. The exposed second metacarpophalangeal joint, proximal and middle phalanx was reconstructed with our long and narrow radial forearm-free flap (RFFF) design. The patient had no complications and was referred to physical therapy. Free tissue transfers in burn injuries are usually utilized in extensive defects. However, narrow defects that cannot be readily covered with adjacent tissue present unique challenges. Our long and narrow RFFF design can be a new and reliable option in these circumstances.
{"title":"Radial forearm snake flap for the reconstruction of a hand defect","authors":"B. Ozkan, S. Savran, Abbas Albayati, C. Uysal","doi":"10.4103/tjps.tjps_66_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_66_22","url":null,"abstract":"Skin grafts may not always be possible for deep hand burns due to a possible exposure of tendons, ligaments, joints, nerves, vessels, and bones. Therefore, a free tissue transfer is required in complex cases. We present a case of a 72-year-old man with a fire burn injury to the dorsum of the hand and first and second fingers. The necrotic areas were debrided, and wide defect with exposed extensor tendons was covered with the serratus anterior-free fascia flap and split-thickness skin graft. Partial necrosis was developed. The exposed second metacarpophalangeal joint, proximal and middle phalanx was reconstructed with our long and narrow radial forearm-free flap (RFFF) design. The patient had no complications and was referred to physical therapy. Free tissue transfers in burn injuries are usually utilized in extensive defects. However, narrow defects that cannot be readily covered with adjacent tissue present unique challenges. Our long and narrow RFFF design can be a new and reliable option in these circumstances.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79594293","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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