Long-Term Results of Incisional Hernia Repair with Concomitant Abdominoplasty in Postbariatric Patients.

UNLABELLED: The aim of the study was evaluation of long-term results after simultaneous incisional hernia repair and abdominoplasty in patients following RYGB (Roux-en-Y Gastric By-pass) and estimation of quality of life before and after this complex operation. MATERIAL AND METHODS: We analyzed long-term results in 18 patients who underwent complex anterior abdominal wall surgery after massive weight loss, following previous RYGB. The patients were followed-up for at least 8 years. We compared the quality of life before and after hernia repair combined with abdominoplasty. RESULTS: Observed wide postoperative scar in 4 persons, permanent dysesthesia in one, and flaccidity of the anterior abdominal wall in three cases. Estimation of the quality of life revealed significant improvement in functional, aesthetic and psychological aspects after complex surgery. CONCLUSIONS: 1. Simultaneous incisional hernia repair and abdominoplasty resulted in satisfactory long-term postoperative results, which confirms the efficiency of complex anterior abdominal wall surgery in patients following RYGB after massive weight loss. 2. Surgery in patients afflicted with disfigurements of the anterior abdominal wall contributed to significant improvement in their life quality in functional, aesthetic and psychological aspects, as compared with preoperative estimations. 3. All persons confirmed positive influence of abdominal wall surgery on their possibility to take challenges in life, and fulfill plans. 4. Surgery of the anterior abdominal wall deformities, if needed after massive weight loss, should become an integral part of complex multidisciplinary treatment in postbariatric individuals.

Evaluation of the Surgical Treatment for Congenital Blepharoptosis Using Mustarde's Modified Method.

UNLABELLED: The aim of the study was evaluation of the results of surgical treatment of congenital blepharoptosis (CBP) using Mustarde's modified method. MATERIAL AND METHODS: Between 2005-2014 forty eight children with CBP underwent surgical correction of CBP by Mustarde's modified method. Basing on the results of ophthalmic and orthoptic examination, and standard measurements, we estimated postoperative difference in the position and symmetry of the upper eyelids, and postoperative complications in our patients. RESULTS: Very good results were obtained in all cases with mild, in 89.5% with moderate, and in 85.7% with severe unilateral CBP after correction by Mustarde's modified method. Lagophthalmos was seen in 6.25%, and undercorrection in 12.5% of cases. CONCLUSIONS: 1. Mustarde's modified method allows for obtaining very good functional and aesthetic results in CBP patients. 2. Mustarde's modified method is a valuable supplemental surgical technique in CBP, and contributes to a low rate and small range of lagophthalmos.

Results of auricular helical rim reconstruction with post-auricular tube flap.

UNLABELLED: The aim of the study was to present our experience with post-auricular tube flap (ptf) and clinical evaluation of the results following auricular helical rim reconstruction with this technique in patients after trauma. MATERIAL AND METHODS: We analyzed the results in 12 patients who underwent three-staged auricular helical rim reconstruction with ptf following trauma in the Department of Plastic, Reconstructive and Aesthetic Surgery between 2005-2014. The patients were followed-up for at least 1 year. We evaluated early and long-term results after surgery including plastic surgeon's and patient's opinion. RESULTS: Postoperative results were satisfactory (very good) in 10 cases, both in the opinion of the plastic surgeon and patients. Transient venous congestion of the helix occurred in two cases (16.6%). This complication did not have any influence on estimation of the results after surgery. Delayed wound healing in the poles of the reconstructed helical edge, as well as non-aesthetic helical scars with imperfections of helical rim, were seen in another two patients (16.6%). CONCLUSIONS: 1. Post-auricular tube flap reconstructions after helical rim trauma allowed for complete restoration of contour, size and orientation of the helix and the whole operated ear, which confirms the efficiency of the applied technique. 2. Reconstructive surgery with post-auricular tube flap in patients with auricular helical rim defects contributed to postoperative satisfaction in both patients and doctors' estimations.

Results of Auricular Conchal Bowl Reconstructions Following Cancer Resections with Postauricular Island Flap.

The aim of the study was to present our experience with the postauricular island flap (pif) and clinical evaluation of the results following auricular conchal bowl reconstructions with the pif in patients after carcinoma resections. MATERIAL AND METHODS: We analyzed results in 13 patients who underwent auricular conchal bowl reconstructions with pif following malignant tumor resection between 2000-2013. The patients were followed-up. We estimated early and long-term results after surgery including plastic surgeon's and patient's opinion. RESULTS: The malignancies were completely excised in all patients, and there were no recurrences within 2 years of follow-up. Observed complications of conchal bowl reconstructions were venous congestion in two cases (15.3 %), and pinning of the operated ear in two patients (15.3%). Postoperative result was very good in 11 cases (both in the opinion of plastic surgeon and patients), whereas in two patients with pinning of the operated ear was satisfied. CONCLUSIONS: 1. Postauricular island flap reconstructions after auricular conchal bowl resections allowed for complete removal of malignant tumors with no evidence of recurrence, and also preserved proper conchal shape in the reconstructed ear. 2. Reconstructions of auricular conchal bowl with the postauricular island flap resulted in very good postoperative results, which confirms the efficiency of the applied technique. 3. Reconstructive surgery with postauricular island flap of individuals with partial auricular conchal bowl defects contributed to postoperative satisfaction in both patients and doctors' estimations.

Long-Term Results of Partial Nasal Reconstructions with Indian Flap.

UNLABELLED: The aim of the study was clinical evaluation of the results following reconstruction with the Indian flap in patients with partial nasal defects, and estimation of their postoperative life quality in functional and aesthetic aspects. MATERIAL AND METHODS: We analyzed results in 38 patients who underwent reconstructions with the Indian flap in the Department of Plastic, Reconstructive and Aesthetic Surgery between years 2000­2013. The patients were followed-up for at least 2 years. We estimated their life quality in aesthetic and functional aspects after surgery. RESULTS: Observed complications of nasal reconstruction were alar asymmetry in 6 patients (15.8%), nasal obstruction in 6 persons (15.8%), wide postoperative scar in 4 (10.5%), and non-aesthetic appearance of the donor site in two cases (5.3%). Estimation of life quality post surgery in the examined group of patients revealed significant postoperative improvement in both functional and aesthetic aspects. CONCLUSIONS: 1. Reconstructions of nasal defects with the Indian flap resulted in satisfactory longterm postoperative results, which confirms the efficiency of the applied technique. 2. Reconstructive surgery with Indian flap of individuals with partial nasal defects contributed to significant postoperative improvement in both functional and aesthetic aspects and their life quality.

Selected methods of the chest wall reconstruction for sternal dehiscence after median sternotomy.

Dehiscence of a median sternotomy wound is a potentially devastating and life-threatening complication of cardiac procedures.Depending on the localization, extensiveness, and profoundness of the defect a variety of muscle flaps may be used to cover the frontal mediastinum, in particular: pectoralis major, rectus abdominisor latissimus dorsi. In spite of several options for restoration of sternal integrity we cannot avoid following serious local complications increasing patients morbidity. The aim of this paper is to report a method of sternal dehiscence management. Surgical technique and its results are presented on the example of two patients treated in Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University in Lódz because of sternal dehiscence after cardiovascular procedure with sternotomy. Our experience indicates that modified bilateral pectoralis major flap seems to be effective surgical method of sternal dehiscence treatment. Also it is worth to remember that surgical procedure in this complication should be performed as soon as possible to decrease patient's disability and to avoid following complications.

Surgical treatment of skin lesions in lupus erythematosus.

Lipodystrophies are a wide group of diseases with various etiology, mainly genetic, metabolic or autoimmune. The treatment of these diseases is chronic and not always effective. Major concerns for patients with lipodystrophies are also esthetic defects, especially deformities in the face, neck and upper limbs. There are many surgical methods that can be used to improve patient's appearance like fillers, autologous fat transfer and skin flaps. The aim of this paper is to present and discuss surgical techniques used for correction of lipoatrophy and other skin lesions present in lupus erythematosus. In the first presented patient, lipodermal grafts were performed in two stages (first - to both zygomatic areas, the second - to both nasolabial folds). Moreover, the patient was qualified for arm scar plasty. Deepithelialized skin in the affected area was covered with advanced local skin flaps. In the second patient, an extensive scarring lesion on the scalp was excised and the defect was closed with an expanded scalp flap. Patients with lipodystrophies may require aesthetic surgical procedures to improve their appearance. In patients with lupus erythematosus, autologous fat graft in the face area seems to be a safe and effective method of refilling the volume of atrophic tissues. On the basis of our experience, it is worth emphasizing that the process of fat graft resorption is typical. In patients with scalp scars, an effective method of their removal and hairline restoring is usage of the tissue expander.

[Evaluation of the results of surgical treatment for protruding ears]. / Ocena wyników operacyjnego leczenia odstajacych malzowin usznych.

INTRODUCTION: Protruding ears are the most common congenital deformity of external ear. Defect usually occurs bilaterally and it may be asymmetric. Popular term for prominent ears concur to psychological problems, especially for children. The optimal time for prominent ears correction fells between 10-14-years-old. There is a lot of techniques for surgical treatment of patients with prominent ears. AIM: Clinical evaluation of postoperative results in patients afflicted with prominent ears. MATERIAL AND METHODS: A retrospective review of 61 females and 15 males aged from 11 to 39, who underwent surgical corrections of protruding ears by Mustarde method. At the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz, between 2005-2010 was conducted. We estimated early and distant postoperative results in studied group. RESULTS: Aesthetic results of surgery were good and very good in patients (97.4%). Postoperatively wound bleeding was observed in 2 cases (2.6%) and in 1 case (1.3%) wound infection occurred. Long-lasting complications like keloids occurred in 2 patients (2.6%). CONCLUSIONS: 1. Surgical correction of protruding ears does not burden with any significant complications. 2. Surgery treatment by Mustarde method gives satisfactory aesthetic results. 3. We confirmed favourable influence of corrected ears on patent's mental status. 4. Severity of protruding ears, coexisting anomaly of external ears together with age of the patient determine individual surgical treatment.

[New modification of Reynwald macroglossia reduction]. / Modyfikacja wlasna metody Reynwalda operacji redukcyjnych przerosnietego jezyka.

INTRODUCTION: Macroglossia usually occurs as isolated malformation, however it can coexist with some of the hereditary defect. Enlargement of the tongue can cause cosmetic and functional difficulties. AIM: The aim of this paper was to analyzed patients with macroglossia operated with own modified Reynwald method. It was based on analysis of surgical treatment and rehabilitation of patients with: Down syndrome, oral-facial-digital syndrome and cerebral palsy, treated at the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz. MATERIAL AND METHODS: 63 patients (32 females and 31 males) with Down syndrome (60), oral-facial-digital syndrome (2) and cerebral palsy (1) were operated at the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz, because of hypertrophy of the tongue. 42 patients were operated with partial resection of macroglossia, 2 of them with additional correction of the tongue border and 21 patients with own modified Reynwald method. RESULTS: Postoperative treatment was non-complicated in all the patients. Early and long-lasting postoperative results were regard as satisfactory, and lead to improvement of basic physiological functions. CONCLUSIONS: 1. 3­6 years are the optimal age to partial macroglossia reduction. 2. Analyze of surgical macroglossia treatment showed effectiveness of methods based on partial resection of tongue. Surgical treatment with own modified Reynwald method lead to increase of number of satisfied postoperative results. 3. Partial resection of macroglossia influence on patients look, integration and environment acceptance; in children with deep retardation it simplify nursing.