Revision abdominoplasty and proper umbilical positioning.

In the last decade, body contour surgery has advanced substantially. Abdominoplasty is the most frequent procedure in body contour aesthetic surgery. The surgeon who performs body rejuvenation procedures needs knowledge of anatomic, technical, and artistic concepts to assess and resolve the full spectrum of trunk deformities. The anatomical variations in abdomen types and the diversity of deformities make necessary a clear understanding so the surgeon can arrive at an accurate diagnosis and apply advanced techniques.

Functional characterization of highly adherent CD34+ keratinocytes isolated from human skin.

Compared to murine models, data on cells responsible for the homeostasis of human epidermis are scarce and often contradictory. Given the conflicting results and the availability of clinical grade protocols to purify CD34 cells from a given tissue, we pursued to phenotypically characterize human epidermal CD34+ population. After magnetic separation of whole skin CD34+ and CD34- cell fractions and selection for cells highly adherent to extracellular matrix, both CD34+/- fractions retained the ability to form a stratified epidermis in organotypic cultures and presented similar in vitro migratory phenotypes. However CD34- cells showed higher clonogenic potential and in vitro proliferative capacity. These results indicated that CD34- cell fraction contains stem/early progenitor cells, while CD34+ cells might be a transit-amplifying precursor for hair follicle (HF) sheath cells. The ability to isolate living cells using differential cell adhesion and surface markers provides an opportunity to study cells from different morphological regions of the HF.

Age-dependent depletion of human skin-derived progenitor cells.

A major unanswered question in autologous cell therapy is the appropriate timing for cell isolation. Many of the putative target diseases arise with old age and previous evidence, mainly from animal models, suggests that the stem/progenitor cell pool decreases steadily with age. Studies with human cells have been generally hampered to date by poor sample availability. In recent years, several laboratories have reported on the existence, both in rodents and humans, of skin-derived precursor (SKP) cells with the capacity to generate neural and mesodermal progenies. This easily obtainable multipotent cell population has raised expectations for their potential use in cell therapy of neurodegeneration. However, we still lack a clear understanding of the spatiotemporal abundance and phenotype of human SKPs. Here we show an analysis of human SKP abundance and in vitro differentiation potential, by using SKPs isolated from four distinct anatomic sites (abdomen, breast, foreskin, and scalp) from 102 healthy subjects aged 8 months to 85 years. Human SKP abundance and differentiation potential decrease sharply with age, being extremely difficult to isolate, expand, and differentiate when obtained from the elderly. Our data suggest preserving human SKP cell banks early in life would be desirable for use in clinical protocols in the aging population.

Circumferential approach to contouring of the trunk.

BACKGROUND: Body contouring usually involves the lower and upper abdomen, flanks, hips, and back. Several techniques are available with which to achieve suitable simultaneous correction of all these aesthetic units. OBJECTIVE: We review the techniques available for contouring of the trunk. Excisional procedures are abdominoplasty, abdominohemiflankplasty or extended abdominoplasty, abdominoflankplasty, and flankplasty. Indications for excisional surgery and its combination with ultrasound-assisted lipoplasty and conventional lipoplasty with excisional surgery are discussed. METHODS: A series of 102 consecutive patients underwent contouring surgery of the trunk between 1998 and 2003. Detailed preoperative evaluation of the entire trunk area was performed to determine the most appropriate surgical procedure for each patient. The key surgical principles defining the technique used included high lateral tension with minimal central tension, direct limited undermining to a central triangle, discontinuous cannula undermining, and anchoring of the scar so as to avoid migration. RESULTS: a circumferential approach to contouring of the trunk area offered excellent outcomes and a high level of patient satisfaction. Significant improvement in body contour was achieved, with a low rate of complications. CONCLUSIONS: Excisional techniques for body contouring involve major surgery that results in a relatively large scar. Carried out with maximal preoperative, intraoperative, and postoperative care, it offers a safe way to achieve significant improvement in body contour with minimal risk to the patient.