Athelia: case report and review of the literature.

The absence of nipple-areola complex is a rare entity and is always associated with other anomalies. This paper described a case of bilateral athelia without other alterations. The atrophy of the dense mesenchyme due to absence of parathyroid hormone-related protein produced in epithelium may lead to nipple involution. Further cases should be studied to corroborate this theory.

Estudo anatômico e morfométrico do retalho peritoneal da artéria epigástrica inferior profunda / Anatomic and morphometric study of the peritonal branch of the deep inferior epigastric artery

As reconstruções de defeitos de mucosa, nas regiões da cabeça e pescoço e região vaginal, assim como as lesões em mão e membros inferiores secun- dárias à ressecção de tumores, traumas e infecções, entre outros, constituem um desafio para o cirurgião plástico. Em 1990, Mixter descreveu a utilização do retalho composto fascioperitoneal, baseado no ramo perfurante peritoneal da artéria epigástrica inferior profunda (AEIP). Este retalho pode ser dissecado junto com o músculo reto abdominal e/ou associado a uma ilha de pele. O peritônio tem grande capacidade de metaplasia escamosa e é resistente à exposição à secreções gástricas e radiação. Foi realizado um estudo anatômico em 17 cadáveres, totalizando 34 regiões anatômicas, com os objetivos de determinar os parâmetros de dissecção deste retalho e o território vascular anatômico do ramo peritoneal da AEIP. Assim mesmo, foi realizado o estudo morfométrico do vaso. O retalho peritoneal da AEIP possui um pedículo vascular constante, de localização anatômica relativamente fixa, com um bom arco de rotação, e pode ser dissecado em dimensões que permitem a cobertura de defeitos de mediano e grande porte.

The reconstruction of mucosal defects in the regions of head and neck, and vaginal region, and secondary hand and lower limb defects after tumor resection, trauma and infections, among others, represent a challenge for the plastic surgeon. In 1990, Mixter described the use of the composed fascioperitoneal flap, based in the peritoneal branch of the deep inferior epigastric artery (DIEA). This flap can be dissected together with the rectus abdominis muscle and/or associate to a skin island. Peritoneum has great capacity of squamous metaplasia and is resistant to gastric secretions and radiation exposure. An anatomical study in 17 cadavers was carried through, totalizing 34 anatomical regions, with the objective to determine the dissection parameters of this flap and the anatomical vascular territory of the DIEA peritoneal branch. A morphometric study of the vessels was also done. The peritoneal branch of the DIEA has one constant vascular pedicle, with relatively permanent anatomical localization, with a good arc of rotation, and can be dissected in dimensions that allow coverage of medium and great size defects.

Treatment of the nasal hump with preservation of the cartilaginous framework.

Classically, nasal hump reduction is based on the partial resection of the cartilages and bones of the nose, as it was described by Joseph almost a century ago. The cartilaginous portion of the hump consists of a single unity formed by the two upper lateral cartilages and the septal cartilage. During hump reduction in the classic rhinoplasty, this structure is slashed in three pieces, which is the main cause of irregularities, shadows, and pinchings over the long-term results. Late follow-ups of the classical hump removal often show an inverted V-shaped shadow on the dorsum secondary to the destruction of the osseous-cartilaginous transition. The angle and relation between the septal and upper lateral cartilages are reduced, which may compromise the functional aspect. The destruction of the unique anatomy of the cartilaginous hump is one of the main causes of this functional and aesthetic sequela. Here, we present a technique that preserves the cartilaginous framework of the nasal hump by lowering it through the resection of a strip of septum, avoiding the problems described above.