ABSTRACT
Breast implant rupture is one of the most common complications in aesthetic and reconstructive surgery. Furthermore, this problem is closely linked to capsular contracture. It is therefore crucially important to effectively and promptly remove silicone leakage from breast pockets. Several techniques are described in the literature and have been typically used for this procedure. Hydrosurgical debridement (HD), which is usually applied in wound care to treat wounds, could be useful for the removal of the silicone leaked from prosthesis pockets after breast implant rupture. An entire periprosthetic capsule that contained a ruptured implant with silicone leakage was removed from a left breast. Half of the capsule was treated with HD, whereas the other half was left untreated as a control. Samples were processed by light microscopy and scanning electron microscopy for morphological analyses. light microscopy demonstrated that the nontreated tissues had a typical synovial-like structure with a middle layer of connective tissue in which there were numerous rounded empty spaces which contained silicone. In contrast, the superficial connective region of the treated tissues (T) had fewer and flattened spaces where the silicone was detected. Scanning electron microscopic analysis showed that in the T samples, the capsule thickness was compact compared with that of the nontreated tissues. Furthermore, the fibrous components appeared well organized with few and smaller silicone lacunae. HD is useful for the removal of silicone (ex vivo) from capsular surfaces after implant rupture. Because of its safety characteristics, this technique could be successfully used in vivo.
ABSTRACT
During breast reduction, pedicle de-epithelialization, as meticulous as possible, is necessary to ensure satisfying breast sculpting and to avoid any epidermoid cyst. To perform an effective and rapid de-epithelialization, a good tension of the skin is mandatory. Several techniques to improve skin tension of the breast are described in the literature. We report a cheap, effective, and easily reproducible method, based on the use of an oxygen tube with nasal cannula.
ABSTRACT
Total nasal reconstruction always represents a challenge for the plastic surgeon, who must deal both with the reconstructive procedure and compliance of the patient. This kind of reconstruction often requires more than one step. Therefore, more prolonged and emphasized scarring than normal can occur, thus resulting in a higher risk of nostril stenosis. Although several nasal retainers have been described, traditional premade retainers could be poorly tolerated by patients and need to be adequately customized to improve patient compliance. Herein, the authors propose a new, cheap, and reliable method to prepare customized nasal retainers which can be used after every step of nasal reconstruction.
ABSTRACT
BACKGROUND/AIMS: When facial trauma involves elderly patients, the possible presence of frailty and comorbidities in victims of trauma may worsen the posttraumatic symptoms and decrease quality of life. The aim of this multicenter study was to assess the quality of life following surgical or non-operative management of maxillofacial trauma in elderly patients. MATERIALS AND METHODS: This cohort study was based on the administration of validated self-administered questionnaires to all the geriatric patients (70 years or more) with facial fractures from the involved maxillofacial surgical units across Europe, since 1st January 2019 to 31st June 2019. The following questionnaires were administered: SF36 questionnaire; the VFQ-25 questionnaire; the Oral Health Impact Profile - 14 (OHIP14). Outcome variables were VFQ-25 and OHIP-14 results. RESULTS: A total of 37 patients (14 male and 23 female patients) met the inclusion criteria and were included in the study. Elderly patients had an improvement in almost all the categories examined by the SF-36 questionnaire 6 months after trauma, with the only exception of a worsening as for role limitations due to physical health. An improvement was observed in almost all the categories at SF-36 test. A worsening of scores of OHIP-14 for all the considered dimensions in the whole study population was observed too. CONCLUSIONS: Elderly patients following facial trauma experience significant emotional, social, and functional disturbances. We observed that emotional problems, energy/fatigue, social functioning, and generally social limitations played a great role in the decrease of QoL in elderly patients following maxillofacial trauma.
