Reconstruction of a knee defect in a morbidly obese patient with a pedicled reverse anterolateral thigh flap.

The anterolateral thigh (ALT) flap is widely used in the reconstruction of a variety of soft tissue defects. Descriptions of patients with severe obesity in the literature are scarce. We report a case where a reverse pedicled fasciocutaneous ALT flap was successfully used for resurfacing of a knee defect measuring 12×6 cm in a patient with a body mass index (BMI) of 47.3. The flap was supercharged to the greater saphenous vein to optimise flap survival. Reconstruction of the soft tissue of the knee was achieved as planned. There were no flap or donor site complications.

[Body contouring surgery after massive weight loss].

Estimates purport, that the vast majority of patients who have undergone massive weight loss (MWL) desire body contouring surgery. In Denmark, public healthcare-financed MWL plastic surgery is to be granted, if the sequelae apply to criteria stated in the national specialist guidelines. Surgery is confined to MWL changes of moderate to high severity, if there is additional functional and psychosocial impairment, or if the changes are severe or abnormal compared to age. This review summarizes these indication criteria and highlights the basic concepts in commonly performed MWL body contouring surgery.

Dermal nipple-areola complex flap method in female to male gender affirming surgery.

Subcutaneous mastectomy plays a major role in female to male (FtM) gender affirming surgery, and obtaining a flattering chest contour remains a challenge to the surgeon. We present an operative method using a dermal nipple-areola complex (NAC) flap, with the aim to create a naturally masculine appearance, while reducing the risk of NAC complications by maintaining sufficient neurovascularisation. This case report describes how the novel approach may potentially be applied as an alternative to the traditionally performed free nipple graft technique in FtM gender confirming surgery. The technique is simple, provides an aesthetically appealing outcome and presumably poses a low risk of NAC complications. Intraoperatively, it allows for good exposure and a uniform removal of breast tissue, as well as repositioning and/or resizing of the NAC where required.