study of the aesthetic patterns of the umbilicus among Egyptians with a new technique for umbilical reconstruction de novo

The umbilicus is an anatomical and aesthetic landmark in the middle of the abdomen. Modern plastic surgery of the abdominal wall is usually concerned with preservation of this landmark to achieve the best esthetic results. Preserving the umbilicus could be reached either by transposition or creation of a new umbilicus in cases with large hernias where the umbilicus is sacrificed to ensure proper hernia repair. In this work an anatomical study of the position, shape and dimensions of the umbilicus in normal Egyptian male and female volunteers of young age was done and different methods to locate the position of the umbilicus were evaluated. Four forms of umbilical shapes are prevalent among Egyptians, the rounded hooded, vertical, and transverse. Measuring umbilical position from the two anterior superior iliac spines was found to be most accurate. Moreover, the ASIS are easily located even in obese patients so, they should be used as reference points while relocating the umbilicus. A new technique for creation of new umbilicus is here described which proved simple, easy, reliable and with low rate of complications

Superdrained transverse rectus abdominis myocutaneous flap: a gold standard for immediate breast reconstrucion??

Pedicled transverse rescuts abdominis myocutaneous [tram] flap have been used with an increasing frequency in immediate breast reconstruction following mastectomy. The high incidence of venous compromise and partial flap necrosis rendered the outcome unsatisfactory in several patients. Cadaver studies that demonstrated presence of valves in the inferior epigastria vein that impede retrograde flow, led to the logic modification of performing a superdrainage augmentation of that vein into the thoracodrorsal vein. In the present study 20 conventional contralaeral tram flaps were used as a primary procedure for breast reconstruction with superdarinage augmentation. The 90% success rate suggests that this procedure that consumes very little abdominal operative renders the surgery much safer and markedly improves flap survival. It is strongly recommend to be in all tram rerconstructions

Different designs of the fabricated three dimensional cartilaginous framework in total auricular reconstruction by autologous costal cartilage grafts

Auricular reconstruction represents a meticulous reconstructive and aesthetic problem to the plastic surgeon. To compare the aesthetic outcome of the different framework designs to be used in auricular reconstruction, 27 ears were reconstructed in 25 patients using costal cartilage grafts. Three patterns of frameworks were used: The contour accentuated, the Tanzer's framework and a Cantilever pinnal framework. The best aesthetic results were obtained with the contour accentuated framework, which yielded good results in 100% of the cases. When using the Tanzer's framework, good results were obtained in 80% of the cases; while when using Cantilever pinnal framework, the results dropped to 76.9%. The results suggested that contour accentuated framework is the best framework design to be used in auricular reconstruction. As the construction of this type of framework needs a well-developed chest wall, it was recommended that auricular reconstruction should be attempted after the age of eight years