Pub Date : 2024-08-09DOI: 10.20517/2347-9264.2024.53
Marlie H. Fisher, David T. Greenspun
Despite its technical complexity, the lumbar artery perforator (LAP) flap remains a valuable asset in the realm of autologous breast reconstruction, providing an option for patients who may not be suitable candidates for abdominal flaps. The LAP flap offers dimensions and volume suitable for recreating a natural breast shape, including a sloping upper pole and optimal projection in the lower third. Harvesting LAP flaps can also lead to simultaneous improvement in body contour by lifting the buttocks and narrowing the waist, following the principles of aesthetic body lift procedures.
尽管技术复杂，腰动脉穿孔器（LAP）皮瓣仍是自体乳房重建领域的宝贵资产，为不适合使用腹部皮瓣的患者提供了一种选择。LAP 皮瓣的尺寸和体积适合再造自然的乳房形状，包括倾斜的上端和下三分之一的最佳突起。根据美体提拉术的原理，采集 LAP 皮瓣还能通过提拉臀部和缩小腰围来同时改善身体轮廓。
{"title":"Lumbar artery perforator free flaps for breast reconstruction","authors":"Marlie H. Fisher, David T. Greenspun","doi":"10.20517/2347-9264.2024.53","DOIUrl":"https://doi.org/10.20517/2347-9264.2024.53","url":null,"abstract":"Despite its technical complexity, the lumbar artery perforator (LAP) flap remains a valuable asset in the realm of autologous breast reconstruction, providing an option for patients who may not be suitable candidates for abdominal flaps. The LAP flap offers dimensions and volume suitable for recreating a natural breast shape, including a sloping upper pole and optimal projection in the lower third. Harvesting LAP flaps can also lead to simultaneous improvement in body contour by lifting the buttocks and narrowing the waist, following the principles of aesthetic body lift procedures.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"40 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924467","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}
Pub Date : 2024-08-08DOI: 10.20517/2347-9264.2023.119
Megan V Morisada, Clinton D. Humphrey, J. Kriet
Correction of a crooked nose after primary rhinoplasty is a not uncommon and often complex problem encountered by facial plastic surgeons. Adequate and lasting correction of the deformity requires a thorough assessment of the anatomy contributing to the deviation, as well as the application of robust techniques to correct the problem at each subsite, which is reviewed in this article. Finally, risk factors for failure and common pitfalls are discussed.
{"title":"Structural rhinoplasty for the persistently twisted nose","authors":"Megan V Morisada, Clinton D. Humphrey, J. Kriet","doi":"10.20517/2347-9264.2023.119","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.119","url":null,"abstract":"Correction of a crooked nose after primary rhinoplasty is a not uncommon and often complex problem encountered by facial plastic surgeons. Adequate and lasting correction of the deformity requires a thorough assessment of the anatomy contributing to the deviation, as well as the application of robust techniques to correct the problem at each subsite, which is reviewed in this article. Finally, risk factors for failure and common pitfalls are discussed.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"27 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141925740","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}
Pub Date : 2024-07-25DOI: 10.20517/2347-9264.2023.138
Mingjuan Tan, Angeline Anning Yong, Etienne Cho Ee Wang
Hair restoration surgery is an increasingly common treatment for androgenetic alopecia and may also address other forms of non-scarring and scarring alopecia. To optimise surgical outcomes, it is crucial to consider key pre-surgical factors and avoid diagnostic pitfalls. This review summarises the diagnostic and differential diagnostic approaches to alopecias, as well as a checklist for holistic patient assessment before hair transplantation.
{"title":"Hair restoration surgery: pre-surgical considerations and pitfalls","authors":"Mingjuan Tan, Angeline Anning Yong, Etienne Cho Ee Wang","doi":"10.20517/2347-9264.2023.138","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.138","url":null,"abstract":"Hair restoration surgery is an increasingly common treatment for androgenetic alopecia and may also address other forms of non-scarring and scarring alopecia. To optimise surgical outcomes, it is crucial to consider key pre-surgical factors and avoid diagnostic pitfalls. This review summarises the diagnostic and differential diagnostic approaches to alopecias, as well as a checklist for holistic patient assessment before hair transplantation.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"40 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141805239","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}
Pub Date : 2024-07-15DOI: 10.20517/2347-9264.2024.05
Ishith Seth, Damien Gibson, Bryan Lim, Jevan Cevik, G. Bulloch, Yi Xie, Gianluca Marcaccini, W. Rozen, Roberto Cuomo
The increasing adoption and widespread acceptance of negative pressure wound therapy (NPWT) have paralleled the expansion of its indications in clinical practice. The spectrum of indications for NPWT now extends to encompass soft tissue defects arising from trauma, infection, surgical wound care, and soft tissue grafting procedures. Recent advancements in NPWT devices have introduced various adjuncts, such as instillation of fluids or antibiotics into the wound. These additions empower surgeons to enhance the wound healing environment and contribute to combatting infections more effectively. This review delves into the latest literature addressing the proposed mechanisms underlying NPWT's action, its cost-effectiveness, its impact on patient quality of life, and the essential components necessary for its safe use. The review examines the evidence supporting NPWT's application in managing traumatic extremity injuries, controlling infections, and wound care. While NPWT generally exhibits a low complication rate, surgeons must remain aware of the potential risks linked to its utilization. Moreover, the review explores the widening scope of indications for NPWT, shedding light on prospective avenues for innovation and research in this field.
{"title":"Advancements, applications, and safety of negative pressure wound therapy: a comprehensive review of its impact on wound outcomes","authors":"Ishith Seth, Damien Gibson, Bryan Lim, Jevan Cevik, G. Bulloch, Yi Xie, Gianluca Marcaccini, W. Rozen, Roberto Cuomo","doi":"10.20517/2347-9264.2024.05","DOIUrl":"https://doi.org/10.20517/2347-9264.2024.05","url":null,"abstract":"The increasing adoption and widespread acceptance of negative pressure wound therapy (NPWT) have paralleled the expansion of its indications in clinical practice. The spectrum of indications for NPWT now extends to encompass soft tissue defects arising from trauma, infection, surgical wound care, and soft tissue grafting procedures. Recent advancements in NPWT devices have introduced various adjuncts, such as instillation of fluids or antibiotics into the wound. These additions empower surgeons to enhance the wound healing environment and contribute to combatting infections more effectively. This review delves into the latest literature addressing the proposed mechanisms underlying NPWT's action, its cost-effectiveness, its impact on patient quality of life, and the essential components necessary for its safe use. The review examines the evidence supporting NPWT's application in managing traumatic extremity injuries, controlling infections, and wound care. While NPWT generally exhibits a low complication rate, surgeons must remain aware of the potential risks linked to its utilization. Moreover, the review explores the widening scope of indications for NPWT, shedding light on prospective avenues for innovation and research in this field.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"35 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141645580","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}
Pub Date : 2024-07-10DOI: 10.20517/2347-9264.2024.27
Jacob B. Hammond, Katie G. Egan, Jesse C. Selber
The purpose of this manuscript is to fully characterize modern approaches to robotic breast reconstruction. The authors review and describe preoperative planning, operative anatomy & techniques, and clinical outcomes regarding robotic breast reconstruction. In the modern era of robotic surgery, many of the beneficial outcomes in other surgical specialties also apply to breast reconstruction. When comparing outcomes between traditional and robotic latissimus flap reconstruction, a robotic approach is associated with a shorter hospital length of stay, lower postoperative opioid requirements, and higher patient satisfaction. For robotic DIEP flap reconstruction, outcomes from several studies also report favorable results with no flap losses, intraabdominal complications, or postoperative hernia/bulge. Although barriers exist regarding this technology, robotic latissimus and DIEP flap reconstruction can be safely learned and applied with thoughtful patient selection and preoperative planning. Robotic breast reconstruction facilitates a minimally invasive approach that decreases donor-site morbidity, length of stay, and opioid requirements, and even improves patient satisfaction.
{"title":"Robotic approaches to breast reconstruction","authors":"Jacob B. Hammond, Katie G. Egan, Jesse C. Selber","doi":"10.20517/2347-9264.2024.27","DOIUrl":"https://doi.org/10.20517/2347-9264.2024.27","url":null,"abstract":"The purpose of this manuscript is to fully characterize modern approaches to robotic breast reconstruction. The authors review and describe preoperative planning, operative anatomy & techniques, and clinical outcomes regarding robotic breast reconstruction. In the modern era of robotic surgery, many of the beneficial outcomes in other surgical specialties also apply to breast reconstruction. When comparing outcomes between traditional and robotic latissimus flap reconstruction, a robotic approach is associated with a shorter hospital length of stay, lower postoperative opioid requirements, and higher patient satisfaction. For robotic DIEP flap reconstruction, outcomes from several studies also report favorable results with no flap losses, intraabdominal complications, or postoperative hernia/bulge. Although barriers exist regarding this technology, robotic latissimus and DIEP flap reconstruction can be safely learned and applied with thoughtful patient selection and preoperative planning. Robotic breast reconstruction facilitates a minimally invasive approach that decreases donor-site morbidity, length of stay, and opioid requirements, and even improves patient satisfaction.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"24 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141659648","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}
Pub Date : 2024-07-09DOI: 10.20517/2347-9264.2024.43
David G. Greenhalgh
The purpose of this paper is to provide the author’s view on basic techniques to optimize burn wound healing. For burns that are partial thickness, the goal is to optimize re-epithelialization to reduce the chance of hypertrophic scarring. For deeper burns, there are principles that lead to better outcomes. For very small burns, such as on the hand, full-thickness skin grafts can be performed in the outpatient setting. For burns requiring split-thickness skin grafts, thicker grafts tend to contract less than thinner ones. Using wider skin grafts or breaking up straight seams with darts also leads to improved results. Choosing donor sites that either minimize scarring or can be hidden should also be considered. For the massive burn, one must still prioritize better grafts for more functional or cosmetic areas (face, hands). Early excision and coverage should reduce scarring. Despite the availability of newer technologies, simple strategies to treat the burn wound still lead to excellent results.
{"title":"Basic techniques for optimizing burn wound healing: insights from clinical practice","authors":"David G. Greenhalgh","doi":"10.20517/2347-9264.2024.43","DOIUrl":"https://doi.org/10.20517/2347-9264.2024.43","url":null,"abstract":"The purpose of this paper is to provide the author’s view on basic techniques to optimize burn wound healing. For burns that are partial thickness, the goal is to optimize re-epithelialization to reduce the chance of hypertrophic scarring. For deeper burns, there are principles that lead to better outcomes. For very small burns, such as on the hand, full-thickness skin grafts can be performed in the outpatient setting. For burns requiring split-thickness skin grafts, thicker grafts tend to contract less than thinner ones. Using wider skin grafts or breaking up straight seams with darts also leads to improved results. Choosing donor sites that either minimize scarring or can be hidden should also be considered. For the massive burn, one must still prioritize better grafts for more functional or cosmetic areas (face, hands). Early excision and coverage should reduce scarring. Despite the availability of newer technologies, simple strategies to treat the burn wound still lead to excellent results.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141836047","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}
Pub Date : 2024-04-24DOI: 10.20517/2347-9264.2023.137
A. Caretto, S. Gentileschi
{"title":"Omental lymph nodes transfer for limb lymphedema","authors":"A. Caretto, S. Gentileschi","doi":"10.20517/2347-9264.2023.137","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.137","url":null,"abstract":"","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"20 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140660110","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}
Pub Date : 2024-04-22DOI: 10.20517/2347-9264.2023.101
İpek Berberoğlu, Katherine L. Burke, Paul Cederna, Stephen W. P. Kemp
Complications following amputation can be devastating for patients, including debilitating neuropathic pain, the inability to perform activities of daily living (ADLs) or gain meaningful employment. While prosthesis use allows patients to restore independence and reintegrate into daily activities, patients often abandon these devices. Despite the immense advancements in prosthetic technology, there is still a need for an interface that can provide a natural experience with accurate and reliable long-term control. The Regenerative Peripheral Nerve Interface (RPNI) is a simple surgical technique that offers real-time control of myoelectric prosthetic devices to restore extremity function. This stable, biological nerve interface successfully amplifies efferent motor action potentials, provides sensory feedback, and offers a more functional prosthetic device experience. Based on the principles of RPNI, novel surgical approaches have been developed to expand its applications and improve outcomes. This review article summarizes the utilization of the RPNI and its recent modifications of different neural interfaces in the setting of major limb amputation and musculoskeletal injuries.
{"title":"Regenerative peripheral nerve interfaces (RPNIs): an overview of innovative surgical approaches","authors":"İpek Berberoğlu, Katherine L. Burke, Paul Cederna, Stephen W. P. Kemp","doi":"10.20517/2347-9264.2023.101","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.101","url":null,"abstract":"Complications following amputation can be devastating for patients, including debilitating neuropathic pain, the inability to perform activities of daily living (ADLs) or gain meaningful employment. While prosthesis use allows patients to restore independence and reintegrate into daily activities, patients often abandon these devices. Despite the immense advancements in prosthetic technology, there is still a need for an interface that can provide a natural experience with accurate and reliable long-term control. The Regenerative Peripheral Nerve Interface (RPNI) is a simple surgical technique that offers real-time control of myoelectric prosthetic devices to restore extremity function. This stable, biological nerve interface successfully amplifies efferent motor action potentials, provides sensory feedback, and offers a more functional prosthetic device experience. Based on the principles of RPNI, novel surgical approaches have been developed to expand its applications and improve outcomes. This review article summarizes the utilization of the RPNI and its recent modifications of different neural interfaces in the setting of major limb amputation and musculoskeletal injuries.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"36 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674583","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}
Pub Date : 2024-04-12DOI: 10.20517/2347-9264.2024.06
S. Sarrami, Carolyn De La Cruz
Patients with breast cancer-related lymphedema (BCRL) commonly present with both debilitating upper extremity symptoms and the need for breast reconstruction. By combining autologous flaps with physiologic lymphatic surgery, postmastectomy patients with BCRL can obtain aesthetic breast reconstruction and lymphedema management in a single operation. Lymph node transfer to an area of lymphatic obstruction creates a healthy lymphatic bridge and restores physiologic flow. Early success and improved understanding of vascularized lymph node transfer (VLNT) physiology have led to the rapid development of numerous flap options and modalities. Several studies have shown the efficacy of combining autologous breast reconstruction with VLNT. Chimeric flaps using inguinal nodes, lateral thoracic nodes, or omentum aim to construct an aesthetic breast and improve lymphatic function. In this article, we will detail the surgical options that accomplish autologous breast reconstruction and restore the lymphatic network in a single operation.
{"title":"Two birds one stone: lymphatic and breast reconstruction with autologous tissue","authors":"S. Sarrami, Carolyn De La Cruz","doi":"10.20517/2347-9264.2024.06","DOIUrl":"https://doi.org/10.20517/2347-9264.2024.06","url":null,"abstract":"Patients with breast cancer-related lymphedema (BCRL) commonly present with both debilitating upper extremity symptoms and the need for breast reconstruction. By combining autologous flaps with physiologic lymphatic surgery, postmastectomy patients with BCRL can obtain aesthetic breast reconstruction and lymphedema management in a single operation. Lymph node transfer to an area of lymphatic obstruction creates a healthy lymphatic bridge and restores physiologic flow. Early success and improved understanding of vascularized lymph node transfer (VLNT) physiology have led to the rapid development of numerous flap options and modalities. Several studies have shown the efficacy of combining autologous breast reconstruction with VLNT. Chimeric flaps using inguinal nodes, lateral thoracic nodes, or omentum aim to construct an aesthetic breast and improve lymphatic function. In this article, we will detail the surgical options that accomplish autologous breast reconstruction and restore the lymphatic network in a single operation.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"31 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140709764","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}
Pub Date : 2024-02-29DOI: 10.20517/2347-9264.2023.100
Samantha Madala, Joy Li, Jeffrey Gluckstein, Sandy Zhang-Nunes
Injectable cosmetic fillers have dramatically risen in popularity in recent years. However, as the use of such fillers has become more common, there have been many reports of vision loss secondary to misplaced filler embolizing to the ophthalmic artery, resulting in ocular ischemia. Currently, there are no randomized control trials or widely validated clinical guidelines that dictate how injectors should manage ischemic complications of filler embolism. This review aims to explain the possible mechanisms by which a cosmetic filler embolus can occlude the ophthalmic artery and describe the types of treatments that have been attempted thus far. Additionally, this article uniquely delineates a possible stroke-like protocol that can be implemented in order to restore perfusion and recover vision after such ischemic complications have occurred.
{"title":"Management of visual complications of dermal filler injections","authors":"Samantha Madala, Joy Li, Jeffrey Gluckstein, Sandy Zhang-Nunes","doi":"10.20517/2347-9264.2023.100","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.100","url":null,"abstract":"Injectable cosmetic fillers have dramatically risen in popularity in recent years. However, as the use of such fillers has become more common, there have been many reports of vision loss secondary to misplaced filler embolizing to the ophthalmic artery, resulting in ocular ischemia. Currently, there are no randomized control trials or widely validated clinical guidelines that dictate how injectors should manage ischemic complications of filler embolism. This review aims to explain the possible mechanisms by which a cosmetic filler embolus can occlude the ophthalmic artery and describe the types of treatments that have been attempted thus far. Additionally, this article uniquely delineates a possible stroke-like protocol that can be implemented in order to restore perfusion and recover vision after such ischemic complications have occurred.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"1998 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140416937","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：