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La deformidad en equino del tobillo ocurre como consecuencia de múltiples entidades. Aunque la primera línea de tratamiento es la conservadora, las modalidades quirúrgicas son necesarias en la mayoría de los enfermos pediátricos. Estas últimas son las más empleadas por zonas del complejo músculo-tendinoso, en especial los alargamientos fraccionados y en forma de Z-plastia. El objetivo de este trabajo es actualizar y brindar información sobre los distintos procedimientos quirúrgicos en la corrección de la deformidad en equino del tobillo. En la búsqueda y análisis de la información se emplearon las siguientes palabras: equinus deformity, equino varus, equino valgus; drop foot deformity y Achilles tendon Z-lengthening. A partir de la información obtenida, se realizó unala revisión bibliográfica de un total de 187 artículos publicados en las bases de datos PubMed, Hinari, SciELO, EBSCO, Scopus, Medscape y Medline, mediante el gestor de búsqueda y administrador de referencias EndNote. De ellos se utilizaron 30, 28 de los últimos cinco años. Se hace referencia a la anatomía esencial de la zona, al igual que a la prueba de Silfverskiöld. Con relación a la imagenología, se describe la técnica para calcular la distancia del tendón a alargar. Se mencionan las técnicas quirúrgicas de alargamiento fraccionado, por Z-plastia, trasposición anterior del tendón de Aquiles y la hemiepifisiodesis.
Equinus deformity of the ankle occurs as a consequence of multiple entities. Although the first line of treatment is conservative, surgical modalities are necessary in most pediatric patients. The latter are the most used for areas of the muscle-tendinous complex, especially fractional and Z-plasty-shaped lengthening. The aim of this work is to update and provide information on the different surgical procedures in the correction of equinus deformity of the ankle. In the search and analysis of the information, the following words were used: equinus deformity, equinovarus, equinovalgus; drop foot deformity and Achilles tendon Z-lengthening. Based on the information obtained, a bibliographic review of a total of 187 articles published in PubMed, Hinari, SciELO, EBSCO, Scopus, Medscape and Medline databases was carried out using the search manager and reference administrator EndNote. Of these, 30 were used, 28 of the last five years. Reference is made to the essential anatomy of the area, as well as to the Silfverskiöld test. In relation to imaging, the technique to calculate the distance of the tendon to be lengthened is described. Fractional lengthening surgical techniques are mentioned, by Z-plasty, anterior transposition of the Achilles tendon and hemiepiphysiodesis.
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Objective@#To sum up the repair techniques of secondary alar deformity after the first phase reconstruction of alar defect.@*Methods@#From January 2010 to December 2017, 17 patients with secondary alar deformity were included. Secondary alar deformities after the first stage reconstruction of alar defect included the abnormalities of alar groove line, absence of alar-cheek groove and the notch of alar rim. Z-plasty, V-Y advanced flaps, local skin flap and other technologies were introduced to repair details.@*Results@#Infection was found in one case of the reconstruction of the alar-cheek groove and the wound was healed by treatment. There was no necrosis occurred in other flap. The shape of the alar was satisfactory and the anterior nostril was not narrow. Patients were followed up for 1 month to 1 year. The average follow-up time was 5 months. No recurrence of nasal alar tumor was found. The patients were satisfied with the appearance.@*Conclusions@#The symmetrical and satisfactory nasal shape can be obtained with local flaps such as Z-plasty, V-Y advancement of flaps for secondary alar deformities.
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Objective@#To explore the curative effect of ultra-delicate split-thickness skin graft in continuity with full-thickness skin flap combined with Z-plasty for correction of cryptotia.@*Methods@#Four cases (six ears) were corrected by ultra-delicate split-thickness skin graft in continuity with full-thickness skin flap combined with Z-plasty method from 2016 to 2017. Following ear release, the flap is rotated into the defect and donor site covered by a razor-thin graft raised in continuity with the flap, the posterior flap was advanced and sutured with Z-plasty.@*Results@#All corrected auricles four cases (six ears) were followed up from 3 months to 1 year and abtained satisfactory and stable appearance.@*Conclusions@#The shape of auricle is natural and satisfactory after operation. The method is simple and no skin grafting is needed. The adhesion of the hidden muscles and cartilages were sufficiently released.
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Objective: To investigate the effectiveness of levator muscle resection combined with Mustarde's double Z-plasty to correct blepharophimosis-ptosis-epicanthus inversus syndrome (BPES). Methods: Between March 2015 and June 2017, one-stage operation of levator muscle resection combined with Mustarde's double Z-plasty were performed on 26 children with bilateral BPES. There were 16 boys and 10 girls with an average age of 7 years (range, 4-14 years). All patients marked the four typical signs of BPES. There were 7 cases accompanied with a low nasal bridge, and 20 cases with amblyopia and strabismus. The length of eye fissure was (19.5±4.5) mm, the width of eye fissure was (2.5±1.6) mm, the diameter of inner canthus was (42.1±6.5) mm, and the muscular strength of levator palpebrae superioris was (5.5±1.3) mm. Results: All the incisions healed by first intention. Twenty-three patients were followed up 2-12 months, with an average of 10 months. Among which, 2 cases were less corrected, 3 cases were over corrected, 6 cases had poor curvature of the eyelid. No eyelid internal and external pronation or keratitis occurred. Amelioration of blepharoptosis and epicanthus was achieved in the other patients, and the double eyelid fold was naturally smooth. At 7 days after operation, the length of eye fissure was (27.2±1.9) mm, the width of eye fissure was (12.5±1.3) mm, and diameter of inner canthus was (29.4±2.6) mm, which were superior to preoperative values ( t=0.127, P=0.042; t=0.341, P=0.029; t=0.258, P=0.038). There was no angular deformity caused by the width and length regressions of eye fissures. Conclusion: The levator muscle resection combined with Mustarde's double Z-plasty can effectively correct BPES and obtain good effectiveness.
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Objective To evaluate the improved "reading-man" procedure (RMP) flap for closure of circular skin defect.Methods From January 2011 to June 2014,the improved RMP flap has been used for closure of the circular skin defects in 24 patients (14 men and 10 women) aged from 16 to 83 years.In this technique,the length of the central limb of the improved RMP flap was shorter than one of the RMP flap and the limb of the flap 1 was arc line.Then,the circular defect was closed by transposition of two skin flaps designed in an unequal Z-plasty manner.The first flap (hatchet) was transposed to the defect area whereas the second flap (triangle) was used for closure of the first flap's donor site.The perforator of the flap provided its vascular basis.Results Tension-free defect closure was obtained in all patients and the all flaps survived.A follow-up of 1-6 months revealed an esthetically acceptable scar formation in all patients.No tumor recurrence occurred,and the repaired tissues were well matched with surrounding tissue.The cosmetic results were satisfactory.Conclusions The improved RMP flap seems to be an easy going and useful alternative for the closure of circular skin defects with different sizes and locations.
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Objective To explore the clinical effect of three-point double eyelid blepharoplasty combined with correcting epicanthal folds by using asymmetric Z-plasty with a two curve design.Methods We retrospectively reviewed the application and effect of three-point double eyelid blepharoplasty combined with correcting epicanthal folds by using asymmetric Z-plasty with a two curve design between January 2015 and June 2016.There were 36 cases of severe epicanthus in this group,including 20 cases of thin eyelid,13 cases of mild swollen eye and 3 cases of moderate swollen eye.Results Follow-up by telephone or WeChat,satisfactory for the 26 cases,the basic satisfaction of 9 cases,1 case of dissatisfaction,moderate swollen eye and severe epicanthus.Conclusions In the case of severe epicanthus with a single eyelid and a mild swollen eyelid without thinning of the eyelid,the use of three-point double eyelid blepharoplasty combined with correcting epicanthal folds by using asymmet ric Z-plasty with a two curve design is one of good choices of methods for the correction of epicanthus.
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Frenum is a mucous membrane fold that attaches lips and cheek to the alveolar mucosa, gingiva, and the underlying periosteum. The maxillary frenum can contribute to esthetic problems and can compromise the orthodontic outcome in cases of midline diastema, thus leading to treatment relapse. In addition to this, it may jeopardize the health of the gingival, when it is attached too tightly to the gingival margin, by interference in the plaque control or owing to the muscle pull. These situations can be managed with the help of frenectomy. The presenting case report demonstrates the frenectomy of an anomalous labial frenum in a 20-year-old male using modified Z-frenuloplasty technique.
Subject(s)
Diastema/abnormalities , Diastema/epidemiology , Diastema/surgery , Humans , Labial Frenum/abnormalities , Labial Frenum/epidemiology , Labial Frenum/surgery , Male , Plastic Surgery Procedures/methods , Young AdultABSTRACT
Unilateral nostril hypoplasia is an extremely rare congenital malformation of unknown etiology, and only a few cases have been reported in literature. Owing to variability and complexity of the deformity, surgical correction of unilateral nostril hypoplasia represents one of the most significant reconstructive challenges to reconstructive plastic surgeons. We report a 7-year-old Vietnamese child with nasal and periocular deformity resembling a craniofacial cleft. Grossly, the right nostril was patent but with alar rim deformity, and the left nostril was not readily identifiable. A dystopic medial canthus was present on the left side as well. Closer inspection and palpation of the left side of nose revealed a patency through the soft tissue and underlying bony structure, Thus, a new alar rim were reconstructed with an irregularly shaped Z-plasty to create patency on the involved side. Simulatneously, a second Z-plasty was performed to address the medial canthal deformity. Postoperative appearance and function was sastisfactory at one-year follow up visit. In the treatment of patients with nostril hypoplasia, a careful preoperative physical examination is a prerequisite, and Z-plasty can be a valuable option for surgical correction.
Subject(s)
Child , Humans , Asian People , Congenital Abnormalities , Follow-Up Studies , Nose , Palpation , Physical ExaminationABSTRACT
Unilateral nostril hypoplasia is an extremely rare congenital malformation of unknown etiology, and only a few cases have been reported in literature. Owing to variability and complexity of the deformity, surgical correction of unilateral nostril hypoplasia represents one of the most significant reconstructive challenges to reconstructive plastic surgeons. We report a 7-year-old Vietnamese child with nasal and periocular deformity resembling a craniofacial cleft. Grossly, the right nostril was patent but with alar rim deformity, and the left nostril was not readily identifiable. A dystopic medial canthus was present on the left side as well. Closer inspection and palpation of the left side of nose revealed a patency through the soft tissue and underlying bony structure, Thus, a new alar rim were reconstructed with an irregularly shaped Z-plasty to create patency on the involved side. Simulatneously, a second Z-plasty was performed to address the medial canthal deformity. Postoperative appearance and function was sastisfactory at one-year follow up visit. In the treatment of patients with nostril hypoplasia, a careful preoperative physical examination is a prerequisite, and Z-plasty can be a valuable option for surgical correction.
Subject(s)
Child , Humans , Asian People , Congenital Abnormalities , Follow-Up Studies , Nose , Palpation , Physical ExaminationABSTRACT
BACKGROUND: Cryptotia correction by V-Y advancement of a temporal triangular flap was introduced in 2005. However, despite the several advantages of V-Y advancement, visible scars at the donor site are problematic. As a result, a Z-plasty technique was considered for skin deficiency in mild cases. Therefore, we introduce a new surgical scheme for cryptotia correction based on considerations of techniques and complications that arose in our clinic. METHODS: Between 2000 and 2013, 26 patients (35 cases) of cryptotia were treated. Seventeen patients had unilateral cryptotia and nine had bilateral cryptotia. Two corrective methods were used, Z-plasty or V-Y advancement, based on the severity. In mild cases, Z-plasty was used for correction and in severe cases, V-Y flap advancement was used for more skin supplement. RESULTS: Follow-up periods ranged from 6 months to 1.5 years. The results obtained were relatively favorable. Nine cases of mild deformity were corrected by Z-plasty, and the other 26 cases with mild or severe deformities were corrected by V-Y advancement. In Z-plasty cases, there was one hypertrophic scar and in V-Y advancement cases, seven resulted in visible scarring and three in skin sloughing. CONCLUSION: The main advantage of Z-plasty is a lower likelihood of visible scarring at the donor site. In mild cases, Z-plasty may be a good alternative, but in severe cases, V-Y advancement is probably the best option for more skin supplement.
Subject(s)
Humans , Cicatrix , Cicatrix, Hypertrophic , Congenital Abnormalities , Follow-Up Studies , Skin , Tissue DonorsABSTRACT
Objective To explore an effective and hidden incision scar method for epicanthus correction. Methods 80 patients of bi-lateral single eyelid with epicanthus were divided into group A,group B and group C. Twenty-five patients with 50 eyes of group A received“Z” plasty correction of epicanthus,25 cases with 50 eyes of group B received the traditional“Y-V” plasty correction of epicanthus,30 cases with 60 eyes of group C treated with modified “Y-V” plasty correction of epicanthus. The curative effective was observed. Results Three groups were followed up for 6~24 months, the appearances of 25 patients in group A were significantly improved,of whom 2 cases had uni-lateral recurrence,8 cases with obvious postoperative scar. The eyelid shapes of patients in group B were natural after surgery,12 cases with obvious scar. all patients in group C were found no postoperative hypertrophic scars. Conclusion The three surgical treatment were effec-tive for epicanthus,but the design approaches of“Z” plasty correction and“Y-V” plasty correction are more complex,and postoperative scar is obvious,meanwhile the modified “Y-V” plasty correction is simple with incision hidden good shape scar formation.
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AIM: To discuss the clinical applications of methods to localize nasal cut ends and the effects of Z-plasty in the surgeries for lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption. METHODS: From September, 2010 to October, 2013, a total of 37 patients ( 37 eyes ) with lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption were operated for anastomosis of lacrimal canaliculi disruption and suture of lower eyelid longitudinal. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi, such as “under a microscope directly”, “guided by probing needle” and“pigtail curved probe”. Then, to repair lower eyelid longitudinal laceration with Z-plasty transposition flaps. Follow up was 3mo~2a after operation. RESULTS: All nasal cut ends could be found successfully on 37 patients;Lacrimal duct unobstructed in 31 patients (83. 8%), improved in 5 patients (13. 5%), invalid in 1 patient (2. 7%),the overall successful rate was 97. 3%; the eyelids repair was satisfactory, small scars, the appearance and function was normal. CONCLUSION: The nasal cut ends can be found successfully by “directly under a microscope”, “guided by probing needle” and“pigtail curved probe”;the effect of silicone drainage tube used as lacrimal canaliculi bracket is satisfactory; most patients gained excellent recovery for both appearance and function after Z-plasty.
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Objective To evaluate the effect of double L-shape osteotomy combined bony Z-plasty for prominent malar complex.Methods Thirty-two patients with prominent malar complex were treated with double L shape osteotomy combined bony Z plasty for prominent malar complex.Width of lower face was observed during follow-up phase.Questionnaires were used to assess the patents' level of satisfaction at 6 months after operation.Results All wounds got primary intention healing and no severe complication in perioperative period.Postoperative appearance of all 32 cases showed that the width of middle face was efficiently reduced.All patients expressed high levels of satisfaction 6 months after operation.Conclusions Double L-shape osteotomy combined bony Z-plasty for prominent malar complex is an effective and safe method for the treatment of prominent malar complex.
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Las lesiones malignas de la cara se presentan como un reto para el cirujano oncólogo, que debe realizar grandes resecciones que garanticen control local, y mantener las funciones ocular, palbebral, y respiratorias, Así como, buscar adecuados resultados estéticos sin comprometer la radicalidad, intentamos mostrar la utilidad de los colgajos de piel cabelluda en la reconstrucción oncológica en 3 pacientes. Se realizó un estudio descriptivo retrospectivo de 3 casos en que se practicó resección de grandes lesiones: temporal, fronto-temporal y nasal, en pacientes que acudieron a la Clínica Docente los Jarales, entre enero 2009 y mayo de 2010. Todos tenían diagnóstico de carcinoma basocelular, uno de ellos tipo morfea, los procedimientos utilizados fueron: colgajo y Z plastia por lesión temporal de 3 cm de diámetro, otro una lesión nasal sin afección osteo-cartilaginosa se le realizó colgajo frontal pediculado con sección en 6 semanas, y por último una paciente con lesión temporo-frontal derecha y defecto pos resección de 10 cm de diámetro que se reconstruyó con gran colgajo parietal de rotación y avance, la evolución de los casos fue satisfactoria, sin complicaciones, sin secuelas funcionales y resultados estéticos excelentes, el tiempo quirúrgico promedio fue de 80 min y la hospitalización duró un máximo de 4 días. En nuestra experiencia se demuestra la gran utilidad de los colgajos de piel cabelluda en las econstrucciones faciales complejas con resultados tanto estéticos como funcionales favorable
The malignant lesions of the face is presented as a problem its been challenge for the surgical oncologist, since it has major resection to ensure local control, and maintain the eye functions, the palpebral, and the respiratory as well as seeking appropriate aesthetic results without any compromising radical. In these work we try to show the usefulness of the scalp flaps in the reconstruction posterior to surgery oncology in 3 patients. We conducted a retrospective study of three cases in which resection of major injuries: Temporal, frontal, temporal and nasal. In the patients who attended to the Jarales Teaching Clinic between January 2009 and May 2010. All patients had a diagnosis of basal cell carcinoma, morphea type one of them, the procedures used were: Z-plasty flap and temporary injury to 3 cm in diameter, the other a nose injury without evidence of osteo-cartilage was performed with pedicled forehead flap section in 6 weeks, and finally a patient with right frontal-temporal lesion and defect posterior resection 10 cm in his diameter, that was reconstructed with large parietal flap rotation and advancement, the development of all the cases was satisfactory, without complications, and functional consequences, excellent cosmetic results, surgical time averaged of 80 min and hospitalization lasted a maximum of four days. In our experience we demonstrate the usefulness of the scalp flaps in complex facial reconstructions with both aesthetic and functional favorable results
Subject(s)
Female , Middle Aged , Carcinoma, Basal Cell/pathology , Carcinoma, Basal Cell/therapy , Surgical Flaps , Skin Neoplasms/pathology , Facial Injuries/surgery , Surgery, Plastic/methods , Medical OncologyABSTRACT
PURPOSE: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. METHODS: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. RESULTS: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. CONCLUSION: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.
Subject(s)
Female , Humans , Airway Obstruction , Ambulatory Care Facilities , Brain , Cleft Palate , Dandy-Walker Syndrome , Follow-Up Studies , Fourth Ventricle , Hydrocephalus , Live Birth , Magnetic Resonance Imaging , Necrosis , Palate, Hard , Pediatrics , Physical Examination , Physical Therapists , Respiration , UvulaABSTRACT
PURPOSE: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. METHODS: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. RESULTS: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. CONCLUSION: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.
Subject(s)
Female , Humans , Airway Obstruction , Ambulatory Care Facilities , Brain , Cleft Palate , Dandy-Walker Syndrome , Follow-Up Studies , Fourth Ventricle , Hydrocephalus , Live Birth , Magnetic Resonance Imaging , Necrosis , Palate, Hard , Pediatrics , Physical Examination , Physical Therapists , Respiration , UvulaABSTRACT
We performed modified Z-plasty (N-plasty) in the patients with snapping hip syndrome arising from the iliotibial band whose pain and clicking sensation persisted despite conservative treatments. We analyzed clinical results to evaluate the effectiveness of this new technique. Among 51 patients (65 cases) who still felt pain and reported clicking sensation during daily life despite hospitalization for at least 2 months from January 1999 to November 2011, we evaluated a total of 32 patients (37 cases) who underwent N-plasty and followed up for more than 6 months. All patients were male whose average age was 24 years. Initial symptoms developed an average of 10 months before hospital visit. Surgery was defined success by postoperative 6 months at which time the patient could be able to carry on with daily life and to exercise without clicking sensation and pain, and defined failure when either clicking sensation or pain was present. We observed that the posterior portion of the iliotibial band was thickened by an average of 8.4 mm. Tenotomy of the iliotibial band lengthened the band by an average of 23mm and narrowed the width of the iliotibial band anterior to posterior. Success was in 33 cases (89%) after surgery. Failure was observed in 4 cases. Three were improved after resurgery and 1 was treated conservatively. We found that N-plasty performed in external type snapping hip patients was an effective method yielding a high success rate.
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Humans , Male , Hip , Hospitalization , Sensation , TenotomyABSTRACT
En la cara se encuentran estructuras con una función perfectamente delimitada, además de un componente estético muy importante. Intentamos mostrar la utilidad de colgajos de piel en la reconstrucción facial en dos pacientes con carcinoma basocelular. Se realizó un estudio descriptivo retrospectivo de dos casos en que se practicó resección de lesiones: nasal, en mejilla. En pacientes que acudieron al Centro Clínico Valentina Canabal, entre enero y diciembre 2009. Los dos pacientes tenían diagnóstico de carcinoma basocelular, los procedimientos utilizados fueron: colgajo pediculado y Z plastia, la evolución de los casos fue satisfactoria, sin secuelas funcionales y resultados estéticos excelentes, el tiempo quirúrgico promedio fue de 80 min. y la hospitalización duró un máximo de dos días. En nuestra experiencia se demuestra la gran utilidad de los colgajos en las reconstrucciones faciales con resultados tanto estéticos como funcionales favorables.
In the face the structures are well defined function, and have very important aesthetic component. We try to show the usefulness of skin flaps in facial reconstruction in two patients with diagnostic of basal cell carcinoma. We conducted a retrospective study of two cases in which resection of lesions nasal, and in the cheek. In patients who attended in the Center Clinical Valentina Canabal, between January and December 2009. Both patients had a diagnosis of skin basal cell carcinoma, the procedures used were pedicles flap and Z-plastic, the patient outcome was satisfactory, without complications, functional disability and excellent cosmetic results, the average surgical time was 80 minutes hospitalization lasted a maximum of two days. In our experience we demonstrates the usefulness of the flaps in the facial reconstruction, with favorable results and aesthetic and functional satisfactory to the patients.
Subject(s)
Humans , Male , Aged , Carcinoma, Basal Cell/pathology , Surgical Flaps , Skin Neoplasms/surgery , Facial Neoplasms/surgery , Facial Neoplasms/pathology , Nose Neoplasms/pathology , Eyelid Neoplasms/pathology , Plastic Surgery Procedures/methodsABSTRACT
PURPOSE: To correct breast ptosis, reduction mammoplasty and mastopexy have been developed in a way that minimizes complications. Recently, as the mean age of breast cancer occurrence is decreasing, the need for breast reconstruction in patients with breast cancer is rising. If mastopexy is performed with breast reconstruction at the same time, the size of the normal breast and the new one is not quite different. We decided to apply Z-plasty, which is a widely-used technique in plastic surgery to lengthen or change the direction of tension of the tissue. METHODS: From March 2008 to December 2009, we performed breast reconstruction in 6 patients with breast cancer and scar contracture. After breast reconstruction, mastopexy with Z-plasty was applied to correct the asymmetry. The new nipple-areolar complex is placed on the line connecting the midclavicle and the current nipple. The inferior border of the new areola corresponds with the inferior border of the original areola, and the superior border about 2 cm upward the original superior border. We drew two oblique lines connecting the medial end of the incision line lower to the nipple-areola complex and the lateral end of the inframammary fold for Z-plasty. The excess tissue between these two lines was removed and the new triangular flaps were put together. RESULTS: The average age of patients was 42.6 years, aged from 36.1 to 48.1 The weight of removed tissue was between 54g and 95 g, with the mean of 74 g. The average distance from the midclavicle to the nipple was 24 cm before surgery, and 21 cm after the surgery. The average operation time per patient (1 mastopexy) was 45 minutes, and the patients were satisfied with the size and shape. CONCLUSION: Applying Z-plasty for the mastopexy on the normal breast ptosis is a relatively simple way to achieve symmetry in patients who need breast reconstruction.
Subject(s)
Aged , Female , Humans , Breast , Breast Neoplasms , Cicatrix , Contracture , Mammaplasty , Nipples , Surgery, PlasticABSTRACT
PURPOSE: To report the results of patients with a Dupuytren's contracture treated with fasciectomy combined with straight line incision and multiple Z-plasty. MATERIALS AND METHODS: We performed retrospective study on 33 hands in 28 patients who had a Dupuytren's contracture between March 2006 to July 2009. Patients were males and the average age was 62-year-old ranging from 50 to 75. There were 15 single and 18 multiple digits involvement. Operation involved fasciectomy using straight skin incision combined with multiple Z-plasty. Postoperative assessment was based on the Honner's classification and range of motion of the involved fingers. RESULTS: According to Honner's classification, the clinical results were excellent in 19 cases, good in 11 and fair in 3. No complication was found except three patients who complained of pain for 6 months after the surgery. The mean range of motion of the involved fingers was 120degrees preoperatively and it increased to 205degrees postoperatively. Cold intolerance lasted for about 6 months in 5 patients but improved spontaneously. CONCLUSION: In patients with a Dupuytren's contracture, fasciectomy with a straight midline incision and multiple Z-plasty provides satisfactory recovery of finger motions.