ABSTRACT
Necrotizing fasciitis (NF) is an aggressive soft-tissue infection involving the deep fascia and is characterized by extensive deterioration of the surrounding tissue. Immediate diagnosis and intensive treatment, including debridement and systemic antibiotics, represent the most important factors influencing the survival of NF patients. In this report, we present a case of NF in the abdomen due to an infection caused by a perforated small bowel after abdominal liposuction. It was successfully treated using negative-pressure wound therapy, in which a silicone sheet functioned as a barrier between the sponge and internal organs to protect the small bowel.
Subject(s)
Humans , Abdomen , Abdominal Wall , Anti-Bacterial Agents , Debridement , Diagnosis , Fascia , Fasciitis, Necrotizing , Lipectomy , Negative-Pressure Wound Therapy , Peritoneum , Porifera , Silicon , SiliconesABSTRACT
BACKGROUND: Capsular contracture is the most frequently reported complication after implant-based breast reconstruction. This study was first undertaken to present our experience with acellular dermal matrix for prevention of capsular contracture in implant-based immediate breast reconstruction with latissimus dorsi flap, and to assess the final aesthetic outcome. METHODS: We performed a retrospective review of all patients who underwent immediate latissimus dorsi flap breast reconstruction in combination with implant and acellular dermal matrix from January 2014 to December 2015. Demographics and clinical characteristics and postoperative complications, especially focused on capsular contracture, were assessed. They were also analyzed as the potential risk factors for the development of capsular contracture. The aesthetic outcome of the overall reconstruction and the final outcome of the inframammary fold were evaluated. RESULTS: During the study period, a total of 30 patients (30 breasts) were reviewed. The mean Baker grades for all 29 breasts (one breast was dropped out due to implant loss), evaluated at one year after reconstruction, was 1.21±0.49 capsular contracture. None of risk factors except seroma/hematoma (P=0.033) were significantly associated with the development of capsular contracture. Overall aesthetic outcome was 8.2±1.2 and aesthetic outcome of the inframammary fold was 3.5±0.6 for physician and 3.4±0.6 for patients. CONCLUSIONS: In this study, we have shown the ability of acellular dermal matrix to prevent capsular contracture observed in implant-based immediate breast reconstruction with latissimus dorsi flap and its use was proven to create superior aesthetic results.
Subject(s)
Female , Humans , Acellular Dermis , Breast Implants , Breast , Contracture , Demography , Mammaplasty , Postoperative Complications , Retrospective Studies , Risk Factors , Superficial Back Muscles , Surgical FlapsABSTRACT
Poly-L-lactic acid (PLLA) is a synthetic injectable medical agent for use as an effective soft tissue filler to treat facial fat volume loss, although complications including nodule formation do occur. We describe a case of foreign body granuloma formation in an immunocompetent patient who received PLLA in the periorbital region for soft tissue aesthetic enhancement and treated with surgical intervention by subciliary approach.
Subject(s)
Humans , Dermal Fillers , Granuloma, Foreign-Body , Lactic AcidABSTRACT
BACKGROUND: Thread lift is a minimally invasive procedure for facial rejuvenation, but complications of thread lift have been reported. The purpose of this study was to evaluate outcomes and safety associated with elastic lift in relation to midface and upper mandibular region lifting. METHODS: Thirty-eight patients with sagging and laxity of the facial skin treated with elastic lift from September 2015 to October 2015 were enrolled in this study. Treatment was performed following the manufacturer's recommended protocol that called for 300 treatment lines. To evaluate elastic lift safety, a retrospective chart review was conducted. We used an automatic skin diagnosis system to evaluate the efficacy of elastic lift. RESULTS: Thirty-seven patients were female, and one patient was male. The mean age of the patients was 40.4 years, and their mean follow-up period was 3 months. There were no major complications manifesting in removal of the elastic thread during the follow-up period. The median skin laxity grade score was 5 (3-6) before surgery; the median skin laxity grade score was 3 (2-4) 3 months post-surgery, resulting in a statistically significant difference in skin grade score (P<0.01). CONCLUSIONS: Facial rejuvenation using elastic lift is an effective and safe procedure in select patients with midface ptosis and moderate jowls.
Subject(s)
Female , Humans , Male , Diagnosis , Follow-Up Studies , Lifting , Rejuvenation , Retrospective Studies , SkinABSTRACT
Obesity (body mass index [BMI] > or = 30 kg/m2), one of the main risk factors for complications of breast reconstruction, makes surgeon hesitate to choose a single ideal surgical technique. Compared to transverse rectus abdominis myocutaneous flap and latissimus dorsi flap, standard methods for autologous breast reconstruction, local flaps have some advantages in terms of aesthetic results and surgical morbidity. A 55-year-old woman who had been undergone modified radical mastectomy, complaints of breast deformity and redundant both lateral chest wall soft tissue. We decided to perform the lateral thoracodorsal flap with implant considering obesity which can cause prolonged operating time and unpredictable results. No major complications were encountered and competent result was obtained when cosmetic analysis was conducted 6 months after surgery.