A Study of the Morbidity Involved in Whole Rib Harvesting and In Situ Splitting Rib Harvesting Surgery.

BACKGROUND: Although there have been several reports that detail the in situ rib splitting harvesting surgical procedure, there are limited published studies evaluating this procedure and the traditional whole rib harvesting approach. In this study, the authors conducted a retrospective controlled study on the complications related to the 2 rib harvesting approaches. METHODS: From March 2012 to May 2014, 24 patients were treated with rib grating, of whom 9 patients received conventional rib harvesting surgery and 15 patients received in situ splitting harvesting surgery. In all patients, a 3-dimensional computed tomography study of the chest was performed 7 days postoperatively. Postoperative complications were assessed and postoperative pain was assessed using a visual analog scale after the first 24, 48, and 72 hours after the surgery. RESULTS: The complication rate for in situ splitting rib harvesting was 6.67% versus 44.44% for patients treated with whole rib grafting surgery. After 48 and 72 hours, the visual analog scale scores in patients treated with in situ splitting rib grafts were significantly lower than the patients treated with traditional surgery. CONCLUSION: The in situ splitting approach for obtaining a rib results in a clinically significant reduction in complications compared with the traditional approach.

Classification of nasolabial folds in Asians and the corresponding surgical approaches: By Shanghai 9th People's Hospital.

INTRODUCTION: One of the earliest signs of aging appears in the nasolabial fold, which is a special anatomical region that requires many factors for comprehensive assessment. Hence, it is inadequate to rely on a single index to facilitate the classification of nasolabial folds. Through clinical observation, we have observed that traditional filling treatments provide little improvement for some patients, which prompted us to seek a more specific and scientific classification standard and assessment system. METHODS: A total of 900 patients who sought facial rejuvenation treatment in Shanghai 9th People's Hospital were invited in this study. We observed the different nasolabial fold traits for different age groups and in different states, and the results were compared with the Wrinkle Severity Rating Scale (WSRS). We summarized the data, presented a classification scheme, and proposed a selection of treatment options. RESULTS: Consideration of the anatomical and histological features of nasolabial folds allowed us to divide nasolabial folds into five types, namely the skin type, fat pad type, muscular type, bone retrusion type, and hybrid type. CONCLUSION: Because different types of nasolabial folds require different treatments, it is crucial to accurately assess and correctly classify the conditions.

Reversed Z-plasty and its variations to release wide-scar contraction.

BACKGROUND AND AIM: Z-plasty is one of the most widely used techniques in plastic and reconstructive surgery. It is useful especially to release linear-scar contractures, yet difficult to use for wide scars. The aim of this study was to report on a new technique for the effective release of contractures for wide scars using reversed Z-plasty and its variations. METHODS: This report describes a novel technique to release contractures effectively for wide scars using reversed Z-plasty and its variation. The design is a reverse style of conventional Z-plasty. In our case series, the reversed three-flap, four-flap Z-plasty or its variation was chosen depending on the width of the contracted scar. RESULTS: We performed this technique on 28 patients. All wounds healed well and the scar contracture was satisfactorily released. CONCLUSION: This procedure is useful and practical for wide-scar contractures.

[Immediately mammaplasty after resection of large breast fibroadenoma].

OBJECTIVE: To explore an ideal technique for remodeling the breast after resection of large breast fibroadenoma. METHODS: Based on the principle of breast reduction, an operation plan was designed. The new locations of the nipple, and the areola and the area of the breast skin to be resected were marked. The preoperative-marked skin, epidermis, and the whole breast tumor were resected routinely. Then breast remodeling followed according to augmentation mammoplasty. Seven patients underwent this operation. RESULTS: The operative results were satisfactory in terms of multiple parameters during the follow-up period. CONCLUSIONS: This operation can effectively resect the breast tumor and remodel the breast simultaneously.