The Double-reverse Wedge Excision Technique: A Novel Approach to Reconstruction of Stahl's Ear Deformity.

Stahl's ear deformity presents with an abnormal third crus of the antihelix and varying degrees of severity. This paper aims to describe a novel technique for reconstruction of Stahl's ear involving a double-reverse wedge excision of the third crus cartilage and skin, as well as use of Mustardé sutures to recreate the superior crus and Furnas sutures to complete the auricular setback. This novel technique for correction of Stahl's ear deformity produces a more stable aesthetic result versus classic otoplasty with desired auricular setback, minimal reduction in the size of the ear, and limited scarring on the anterior auricular surface. Reconstruction of Stahl's ear deformity can be accomplished using this double-reverse wedge excision technique of the third crus cartilage and skin with Mustardé and Furnas sutures to recreate the superior crus and complete auricular setback, effectively restoring anatomic harmony to the ear.

Bilateral Sciatic Neuropathy following Gluteal Augmentation With Autologous Fat Grafting.

As gluteal augmentation continues to gain in popularity among patients seeking aesthetic enhancements, a thorough knowledge of the postoperative complications associated with this procedure is crucial. This case report concerns a 31-year-old woman who suffered bilateral foot drop secondary to sciatic neuropathy and as a result was wheelchair-bound for several months, following gluteal autologous fat grafting in the Dominical Republic. One year later, the patient had persistent left foot drop and sensory deficits. This is a devastating but seldom reported complication that all plastic surgeons need to be aware of when performing this operation.

Spinal reconstruction for osteomyelitis with free vascularized fibular grafts using intra-abdominal recipient vessels: A series of three cases.

Reconstruction of bony defects in the surgical management of vertebral osteomyelitis is a challenging endeavor. Our objective is to report the use of intra-abdominal vessels as the recipient vessels for microanastomosis of vascularized bone graft and the use of a spinal cage for fixation. Three patients failed conservative treatment for vertebral osteomyelitis and suffered pathologic fracture. Their treatment consisted of staged posterior irrigation and debridement with segmental fixation, followed by a thoracoabdominal approach multiple-level corpectomy. Reconstruction was performed with a free vascularized fibular graft placed within a custom, expandable cage. The vascularized fibular graft was anastomosed to an intra-abdominal recipient vessel. All patients improved clinically with no neurologic deficits noted. All showed evidence of successful fusion. Free vascularized bone grafts continue to be an excellent option for multi-level spinal defects related to osteomyelitis. Intra-abdominal recipient vessels are appropriate recipient vessels, as their diameter, length, and accessibility allow vascularized bone graft reconstruction of vertebral column defects of the thoracolumbar region. These vessels are also easily accessible and the anastomoses can be performed in the superficial operating incision.