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Background: The umbilicus significantly contributes to abdominal aesthetics, with its reconstruction often necessary after certain procedures like umbilical herniorrhaphy, laparotomies, and abdominoplasty. Neoumbilicoplasty techniques have evolved, addressing various issues through approaches like skin and cartilage grafts, and local flaps. We are reporting our technique for neoumbilicoplasty. Methods: This study describes a novel neoumbilicoplasty technique implemented in 90 patients (88 women, two men) who underwent lipoabdominoplasty between February 2021 and June 2023. Exclusion criteria included procedures unrelated to neoumbilicoplasty. Surgical steps involved precise marking, dissection, and suturing to create a natural umbilical hood. Patient satisfaction was measured using the Global Aesthetic Improvement Scale. Results: The mean age was 37.7 years, with pre- and postoperative anatomics of 24.9 kg per m² and 24.2 kg per m², respectively. The average surgery duration was 84 minutes. No major complications occurred, but minor complications included dehiscence (6%), granuloma (5%), superficial infection (2%), bruising (1%), seroma (1%), and flattening (8%). Most complications were resolved with minor interventions. Patient satisfaction was high, with 96% of patients and the surgeon expressing significant satisfaction. Conclusions: House-roof neoumbilicoplasty is an innovative technique designed to effectively restore abdominal aesthetics through straightforward steps and timing, combined with high-definition lipoabdominoplasty.
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Incorporation of new technologies to assist the liposuction procedure is becoming increasingly common. These technologies allow for a softer technique, balanced shaping, elimination of excess adipose tissue, and skin tightening. Some of these technologies include ultrasound (US; US-assisted liposculpture, VASER-assisted liposuction), power suction (power-assisted liposuction), radiofrequency (RF; RF-assisted lipolysis), and laser (laser-assisted liposuction). In addition, some of these devices have been shown to reduce the incidence of hematomas/inflammation and shorten recovery time. We report our experience in high-definition liposculpture of the arms in addition to new technologies to improve skin retraction, comparing their results in terms of complications, satisfaction score, and aesthetic outcomes. We included patients with mild-to-moderate arm dermatochalasis (Duncan classification) fat deposits in the upper extremities who were considered candidates for third-generation US-assisted liposculpture, power-assisted liposuction, RF-assisted lipolysis/skin tightening, and laser-assisted liposuction. A total of 683 consecutive patients met the inclusion criteria for the study. Most of them were women (n = 605, 88%). Fat grafting was performed in 80 patients (11.7%). A significant portion of the patients were secondary cases (n = 223, 33%). Age ranged from 18 to 70 years (median = 38 years). BMI ranged from 17.8 to 34.8 kg/m2 (mean = 24.3 kg/m2). RF-assisted and laser-assisted high-definition liposculpture of the arms are both effective and reproducible techniques for patients who seek an athletic and slim arm contour. A low rate of complications and high satisfaction index support our findings.
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Background: Rib remodeling is a surgical technique for waist shaping in women and men. However, one of the main patient complaints is the scar. We aimed to describe a scarless, ultrasound-guided rib remodeling (RibXcar) technique that assessed the degree of angular variation of the fracture by ultrasound and the variation in waist measurement and patient satisfaction through a survey. Methods: The RibXcar technique was performed in 30 women aged 18-35 years in Peru, Colombia, and Mexico between October and December 2022 by three board-certified plastic surgeons trained in ultrasound and in this technique. The plastic surgeons measured costal angles before and immediately, 1 month, and 3 months after the surgery by ultrasound, as well as the waist in the same site and at these time points. Similarly, patient satisfaction was surveyed 3 months after the surgery, in which questions were asked about body aesthetics and the puncture site. Results: Ultrasound angular measurements before and immediately, 1 month, and 3 months after the surgical procedure were 168.00, 158.00, 160.00, and 160.43 degrees in the 10th rib, 170.50, 160.50, 152.50, and 163.50 degrees in the 11th rib, and 172.00, 162.00, 154.00, and 165.00 degrees in the 12th rib, respectively. The satisfaction survey showed that patients were satisfied with the aesthetic results of both the shape of the waist and the puncture site. Conclusions: RibXcar surgery maintains the angular variation over time. Similarly, waist measurements show a sustained reduction. Three months postoperatively, the patients were satisfied with the aesthetic results of the waist and the puncture site.
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Background: Breasts are considered one of the most physically and sexually appealing features of the female body. Reduction/augmentation techniques have greatly evolved in the last decades.We are reporting our experience with an innovative technique for mastopexy that recovers the aesthetics of the breast and avoids over-resection of its lower pole. Methods: Inclusion criteria were women who underwent kite mastopexy with or without implants between January 2018 and May 2022 in a single center (Bogota, Colombia). Exclusion criteria were patients with American Society of Anesthesiology score more than II, with any uncontrolled chronic illness and/or medical history of diabetic mellitus, metabolic syndrome, body mass index more than 32 kg per m2, and active smokers. Results: We found 133 consecutive female patients. Age range was 18 and 67 years (median 39). Breast implants were used for the purpose of kite mastopexy in 52% cases. Patients were divided into two groups: implants (group 1) versus no implants (group 2). Procedure 1 involved mastopexy without implants; procedure 2 included current implant users who underwent either implant removal or in whom implants were not used for the sake of mastopexy. Procedures 3 and 4 included patients who underwent either new implant placement or implant exchange, respectively. Average time of surgery was 1.5 hours. Minor complications were mostly related to wound dehiscence. No major complications were reported. Conclusions: Kite mastopexy restores the breast aesthetics by following specific markings, a new plication of breast pillars, and a reduced scar. Our technique demonstrates a very low rate of complications while entailing natural and appealing results.
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Radiofrequency is frequently used for skin rejuvenation, localized fat elimination and cellulite treatment. It prompts the expression of thermal shock proteins that lead to dermal thickening as a result of collagen synthesis. The authors report a histological and clinical analysis of the arm subdermal changes before and after bipolar radiofrequency treatment plus liposuction to determine their benefits for arm contouring. Methods: Inclusion criteria included patients with stage 1, 2a, and 2b brachial ptosis (Duncan classification) and upper limb fat deposits who were considered candidates for third-generation ultrasound-assisted liposculpture plus radiofrequency-assisted lipolysis/skin tightening. Arm subdermal tissue samples (5 mm³) were analyzed before and after the intervention. We used 10% formaldehyde for tissue fixation and stained each sample with hematoxylin/eosin, Masson trichrome, and antibody markers against the cell cycle Ki-67 protein. Results: We analyzed a total of 12 biopsies from six patients who meet the inclusion/exclusion criteria. Histological findings with hematoxylin/eosin revealed hyperplastic and metaplastic changes with focal distribution within the papillary and reticular dermis. Masson trichrome staining showed an increase of the characteristic basophilia of thin type-I and type-III collagen fibers. In contrast, molecular analysis reported an increase in fibroblast activity mediated by the activation of the heat shock protein HSP47. Conclusion: Radiofrequency may be a great alternative to improve skin retraction in patients with mild to moderate brachial dermatochalasis through the activation of HSP47 heat shock protein and the production of type-I and type-III collagen.
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Introducción y Objetivo. La infiltración de materiales como silicona en los tejidos blandos es una práctica clandestina documentada en varios lugares del mundo; estos materiales buscan mejorar la apariencia estética y se han vuelto populares entre la población en general. El objetivo del presente estudio es describir las características de individuos sometidos a infiltración de materiales extraños en tejidos blandos con fines estéticos entre los que se desarrolló una investigación judicial en Bogotá, Colombia. Material y Método. Presentamos una serie de 26 pacientes sometidos a investigación judicial por la Fiscalía General de la Nación en Bogotá, Colombia, por muerte o complicaciones asociadas a estos procedimientos entre 2005 y 2015. Resultados. La mayoría de los pacientes del grupo de estudio fueron mujeres (62%). El procedimiento realizado con mayor frecuencia fue el aumento de glúteos por un esteticista en clínicas de estética o centros de belleza. Del total de pacientes, el 58% falleció por embolismo pulmonar de silicona; entre los supervivientes, la complicación más frecuente fue la aparición de cicatrices inestéticas. Conclusiones. La infiltración de materiales extraños en tejidos blandos es un procedimiento que reporta complicaciones y alta frecuencia de mortalidad; la mayoría de estos procedimientos se realizan en lugares y con materiales no autorizados, y por personal no capacitado. De ahí la importancia de generar acciones que prevengan este tipo de prácticas (AU)
Background and Objective. Infiltration of materials such as silicone in soft tissues is a documented clandestine practice in several places around the world.These substances seek to improve the aesthetic appearance of the patient, and have become popular in the general population. The aim of this study is to describe the characteristics of individuals that were under infiltration of foreign materials in soft tissues for aesthetic purposes in which a judicial inquiry was conducted in Bogotá, Colombia. Methods. We present a case series of 26 patients who were part of a legal investigation by the Colombian General Prosecution in Bogotá, Colombia, due to death or complications associated to these procedures between 2005 and 2015. Results. Most of the patients in our clinical serie were women (62%). The most frequently performed procedure was buttock augmentation, mainly done by a beautician in aesthetic clinics or beauty centers. Of the total of patients 58% died due to pulmonary embolism of silicone; among the survivors, the most frequent complication was anesthetic scar. Conclusions. Infiltration of foreign materials into soft tissue is a procedure that reports complications and a high frequency of mortality; most of these procedures are performed in illegal places and with unauthorized materials, and done by unqualified personnel. Thus remarks the importance of generating actions that prevent this type of practices (AU)