Rare complication of coupled VASER liposuction and Renuvion technologies: a case report.

This study presents the case of a women, who underwent VASER-assisted liposuction of the abdomen coupled with Renuvion skin tightening by J-Plasma for skin retraction. She developed pain and moderate surgical emphysema. Radiological findings showed moderate subcutaneous emphysema. There were no signs of viscus perforation, or pneumothorax.

The Ideal Applicant to the Saudi Plastic Surgery Residency Program.

Securing a plastic surgery position is a demanding task for students. Although many papers have been published internationally discussing the traits and features deemed important from the point of view of plastic surgery program directors, a gap exists in the literature where this aspect is not covered in Saudi Arabia. The aim of this study was to fill this gap. METHODS: In this cross-sectional study, a survey was developed targeting all current and former Saudi plastic surgery training program directors. SPSS was used to calculate frequencies and present percentages; independent t-test was done to look for mean differences. Ethical approval was obtained from a local institution. RESULTS: All current and former Saudi plastic surgery program directors participated (n = 17), including the 8 (47.1%) current directors. When asked to rank 7 items on a scale of importance, they scored a mean of 6.2, 5.8, 5.4, 4.88, 4.82, 4.6, and 3.7 for good impression on interviews, prior experience, research experience, the grade point average (GPA), oral or poster presentations on events, the Saudi Medical Licensing Examination (SMLE), and attaining a post-graduate degree, respectively. The majority [n = 7 (41%)] considers the mode of communication, such as phone calls, as the most important aspect in recommendations. They prefer candidates who took electives/rotations at their department [n = 12 (71%)] and give more value to high-quality publications [n = 9 (47%)]. Applicant's gender was not important. CONCLUSION: With early planning, this article could serve as a guide for medical students interested in plastic surgery to build their assets toward a successful interview.

Gestational gigantomastia on a Saudi woman: A case report on surgical removal and reconstruction and management of complications, KFSH&RC.

INTRODUCTION: Gestational gigantomastia (GG) is a rare condition manifesting as a fast and excessive growth of the breasts in pregnant women. Its etiology is still unclear, with theories ranging from hormonal imbalances, unregulated immune response, to hypersensitivity. Medical interventions are mainly surgical in nature, though some pharmacological medications are of debatable efficacy. CASE PRESENTATION: A 33-year old Saudi gravida 3 para 2 presents continuous breast enlargement since the start of her pregnancy. She complains of skin ulcerations and discharge which was initially treated conservatively with topical antibiotics. Days after she came back with worsening GG symptoms, and was admitted for bilateral skin sparing mastectomy and reconstruction, and successfully recovered. The patient came back with problems concerning the surgical implant and wound infection. Emergency operation was performed for implant removal and wound treatment. Labor induction was performed by the OB-GYN on her 39 week. The patient opted for autogenous reconstruction by bilateral latissimus dorsi flap months after delivery. After treatment of minor surgical complications, the patient successfully recovered. DISCUSSION: Surgery is one of the most effective interventions for GG. Total mastectomy is preferred due to lesser risk of recurrence in subsequent pregnancies. Reduction mammoplasty offers the breastfeeding option if conducted before the delivery, but poses higher risk of recurrence in future pregnancies. CONCLUSION: The patient's gestational gigantomastia condition was complicated by several ulcerations and infections. Surgery was conducted alongside antibiotic treatment. This report also highlights the importance of follow ups in managing complications.

Masson's tumor involving the hand: A case report.

INTRODUCTION: Masson's tumor or IPEH represents a rare exuberant endothelial proliferation within a thrombus through an uncomprehended phenomenon. Being reported for the 1st time in Saudi Arabia, plastic surgeons should keep it in the list of differential diagnosis. CASE: We report a case of 17-year-old-girl who presented with a 6-month-old, painful mass on the volar side of her left 4th MCP. Radiology was inconclusive. Histopathology reported Masson's tumor following surgical excision with good functional outcome and no recurrence. DISCUSSION: Comprising 2%-4% of overall skin vascular tumor and with no identifying clinical or radiological feature, IPEH poses as a diagnostic challenge. The literature reports similar tumors in the hand with different locations and presentations. Surgical excision remains the cornerstone of management, yet the role of radiotherapy remains undefined. Incomplete excision may result in recurrence, which requires a consensus on the extend of marginal excision. Rare cases of recurrence were reported. Histopathology is the only reliable method of diagnosis. CONCLUSION: We present the 1st reported case of IPEH involving the hand in Saudi Arabia. Plastic surgeons should be aware of such rare conditions and be able to differentiate them from relatively identical yet more sinister tumors, especially angiosarcoma.

Gillies elevation and percutaneous Kirschner wire fixation in the treatment of simple zygoma fractures: long-term quantitative outcomes.

BACKGROUND: The objective of zygoma fracture repair is to restore preinjury function and appearance. The optimal surgical technique represents a balance between accurate fracture reduction and soft-tissue morbidity. METHODS: Fifty patients were eligible for review after treatment for isolated simple zygoma fractures using a combination of Gillies elevation and percutaneous Kirschner wire fixation between 1992 and 2003. Fourteen patients were available for examination at a mean follow-up of 8.7 years. Quantifiable parameters, including orbitozygomatic complex position, ocular globe projection, and infraorbital nerve function, were measured. All patients underwent qualitative assessment by independent, blinded observers. Negative soft-tissue sequelae were recorded. RESULTS: The mean differences between injured and uninjured sides of the face for malar eminence projection, height, and lateral position were 2.5, 2.7, and 2.3 mm, respectively. The mean difference in ocular globe projection was 1.23 mm. When these results were compared with those previously published for open reduction and internal fixation, no statistically significant difference was noted. The qualitative observers were able to identify the affected side 12 percent of the time. Other than a small punctate scar noted in one patient at the Kirschner wire insertion site, no other negative cutaneous or eyelid sequelae were noted. CONCLUSIONS: This study objectively shows that Gillies elevation combined with percutaneous Kirschner wire fixation provides facial contour restoration that is not significantly different from that of open reduction and internal fixation, with less soft-tissue morbidity. The technique is safe, easy to learn, and easy to perform, and should be considered in cases of isolated simple zygoma fractures.

Sterile versus nonsterile clean dressings.

BACKGROUND: Many patients cannot afford sterile dressings. In St John, New Brunswick, clean dressings have been used instead of sterile dressings for years, with no apparent ill effects. No previous studies have compared the sterility and cost of clean versus sterile dressing materials. OBJECTIVES: THE GOALS OF THE PRESENT STUDY WERE TO ANSWER THE FOLLOWING QUESTIONS: how much more sterile are sterile dressings than clean dressings; and how much does this extra sterility cost? METHODS: Sterility and cost of sterile gauze, panty liners, sanitary napkins, diapers and Coban tape (3M, USA) were compared. Samples, 2 cm x 2 cm in size, were cut out of each material under aseptic conditions, and delivered to the microbiology laboratory in sterile urine containers. The samples were then cultured and organisms were identified using conventional means. RESULTS: The cost for one month, using one 20 cm x 5 cm wound dressing daily, was calculated and compared with panty liners ($2.43), sanitary napkins ($5.55), diapers ($9.39) and Coban tape ($0.66), which were much cheaper than sterile dressings ($16.50). How sterile were the dressings? None of the 20 sanitary napkins grew bacteria, one of the 20 panty liners grew bacteria (coagulase-negative Staphylococcus), two of 20 sterile dressings grew bacteria (one coagulase-negative Staphylococcus and one nonhemolytic Streptococcus), 15 of 20 diapers grew bacteria (all bacillus) and two of five Coban rolls grew bacteria (one bacillus and one coagulase-negative Staphylococcus). CONCLUSION: The panty liners, sanitary napkins and Coban tape studied were cheaper than, and had a comparible sterility with, the sterile gauze examined.