Women's aesthetic perceptions of the genitalia and their association with anatomical measurements.

BACKGROUND: The purpose of this study is to determine women's perceptions of the vulva with the criteria defined in the literature for the ideal vulva and determine their relationship with anatomical measurements to determine the extent to which women's perceptions of normal align with our aesthetic standards of normality. METHODS: First of all, a questionnaire was given to all participants. The items of the data collection form included personal information, obstetric and gynecological information, their perceptions of their external genitalia and any physical, sexual, psychological, and hygiene problems they experience. Then examination and measurements of the external genitalia were performed. RESULTS: The majority of participants considered their genitalia normal (n = 101, 89.4%), while 12 participants (10.6%) considered them abnormal. Statistical analyses showed that women's perception of their genitalia as normal in appearance and size was associated with labia minora asymmetry (p = 0.023 and p = 0.006, respectively) and hyperpigmentation (p = 0.010 and p = 0.047, respectively) but not with labia minora measurements or protrusion (p > 0.05). CONCLUSIONS: Although there is a tendency in the field of aesthetic surgery to define ideals and aesthetic standards for all parts of the body, our definitions of normality do not always coincide with those of the individual. The appearance of the genitalia is as personal as the face, and an individual's self-perception is more important than our ideal. LEVEL IV: Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.

The Effect of Dermal Suspension on Early Complications After Vertical Reduction Mammoplasty.

BACKGROUND: Reduction mammoplasty is frequently performed in plastic surgery clinics. The vertical technique can be performed using several different pedicles, including superior, superomedial, medial, and lateral. For patients with large breasts, using a medial pedicle is recommended as a safer approach. Superficial wound dehiscence is common with all breast reduction techniques. METHODS: The present study compared early complications in patients who underwent reduction mammoplasty with superior pedicle, medial pedicle, or medial pedicle with dermal suspension performed by the same surgeon. The patients were evaluated in terms of age, weight, height, pedicle type and technique used for vertical reduction mammoplasty, resected tissue mass, suprasternal notch (SSN) to nipple-areola complex (NAC) distance, NAC transposition distance, and drain duration. RESULTS: Pairwise comparisons revealed that wound dehiscence along the inframammary fold (IMF) was significantly less frequent in the superior pedicle group than the medial pedicle without suspension group (p = 0.018). Although not statistically significant, using the suspension method in medial pedicle procedures reduced the rate of IMF wound dehiscence from 32.4 to 25%. Delayed IMF wound healing was associated with the amount of resected tissue (p = 0.004) but not with age, BMI, SSN-to-NAC distance, NAC transposition distance, or drain duration. CONCLUSION: Suspending the medial pedicle from the chest wall reduced the rate of IMF wound dehiscence. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Distribution of skin cancers of the head and neck according to anatomical subunit.

PURPOSE: The skin tumors can occur on any part of the body, these anatomical subunits are considered prognostic factors for localized carcinomas. Tumor size is a prognostic criterion that also varies according to the anatomical location of these tumors. Head and neck region is the most common location. This study aimed to investigate the distribution of BCC, SCC, and MM in the anatomical subunits of the head and neck region and their relationships with these anatomical subunits. MATERIALS AND METHODS: Patients who underwent surgery for BCC, SCC, BSCC and/or MM in the head and neck region. The head and neck region was divided topographically into the following subunits: scalp, forehead, orbital region, ear and periauricular region, cheeks, nose, perioral region, and neck. Patients were analyzed according to age, sex, and tumor location, type, and size. RESULTS: The SCC group was found to have significantly larger mean tumor size than the BCC group (p = 0.003). SCC was more frequently located in the perioral region (p = 0.001), BCC was more frequently located on the nose (p = 0.001), and MM was more frequently located on the forehead and scalp (p = 0.034, p = 0.49) when compared with the other types. BCC was more frequently located in the orbital region than SCC (p = 0.018) CONCLUSIONS: In this study, we observed statistically significant differences in the distribution of BCC, SCC, and MM, the most common types of skin cancer, among the topographical subunits of the head and neck region.

The importance of preoperative imaging methods in reduction mammoplasty.

Breast reduction surgery is a common procedure in plastic surgery clinics, and there are varying practices regarding preoperative mammography and breast ultrasound in patients who have no history of cancer and no symptoms other than those caused by macromastia. In this study, we retrospectively analyzed the imaging findings of patients who presented to the plastic surgery outpatient clinic due to macromastia between January 1, 2006 and June 1, 2020 and underwent mammography and/or breast ultrasound for preoperative screening and breast magnetic resonance imaging for further examination. Patients with a history of breast cancer diagnosed prior to preoperative screening or any other breast disease were excluded. Radiologically suspicious findings were significantly more common in patients over 40 years of age and significantly less frequent in the group under 50 years of age. When the patients were grouped by the decade of life, the frequency of radiologically suspicious findings was significantly lower in the 20-29 group and significantly higher in the 40-49 and 50-59 groups. Malignancy was not detected by histopathological examination in any patient. Proliferative lesions were detected in 10 reduction mammoplasty specimens (2.4%) of 7 patients (3.1%). The correlation between radiological and histopathological findings may be weak in macromastia patients. Most suspicious radiological findings appear to be the population between 40 and 59 years of age .

Analysis of Basal Cell Carcinoma and Squamous Cell Carcinoma according to Nasal Subunit Location.

The nose is highly vulnerable to skin cancers due to the unavoidable sun exposure. The most common localization of skin cancers on the face is nose. Although the nose appears to be a single structure, it comprises many aesthetic units with different histological and anatomical properties. Our aim was to determine the relationship between the prevalence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), histologically and anatomically distinct nasal subunits. The study included patients who underwent excision and repair due to BCC or SCC of the nose. The lesions were classified according to their location in the following topographic subunits: tip, alar lobule, dorsum, sidewall, and medial canthal region. Patients were analyzed according to age, sex, topographic subunit, tumor type, and repair technique. There was no statistically significant difference in tumor location according to etiology (p > 0.05). The alar subunit was the most common location of BCC, while the dorsum was the most common location for SCC. There is no statistical relationship between the two most common skin cancers, BCC and SCC, and the aesthetic subunits of the nose. The only factor associated with the reconstruction method used was the subunit in which the tumor was located.

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps.

BACKGROUND: Ischemia-reperfusion injury plays an important role in flap failure. Ischemic preconditioning technique is the only proven method for preventing ischemia-reperfusion injury, but it is not used widely in daily practice because of difficulties such as prolonging the operation time, need for surgical experience, and increasing the risk of complications. This study has been performed with the assumption that piracetam may be a simple and inexpensive alternative to the preconditioning technique due to its antioxidant, antiaggregant, rheological, anti-inflammatory, antiapoptotic, cytoprotective, and immune modulating effects. METHODS: Thirty-two rats were divided into four groups and latissimus dorsi musculocutaneous flaps were raised. No extra procedure was applied, and no treatment was given to the control group. Four hours of ischemia was created by clamping the thoracodorsal pedicle in the second group. The animals in the third group were treated with 10 minutes of ischemia and reperfusion periods as a preconditioning procedure before the 4 hours of ischemia. Animals in the fourth group received systemic piracetam 30 minutes before and 6 days after reperfusion. Nitric oxide and myeloperoxidase levels in serum and tissue, acute inflammatory cell response, and vascular proliferation in tissue were examined at the postoperative 24th hour and 10th day. RESULTS: Myeloperoxidase activity in both preconditioning and piracetam groups, was significantly lower than the ischemia-reperfusion group. Acute inflammatory cell response was similarly decreased in both preconditioning and piracetam groups compared with ischemia-reperfusion group. Tissue measurements of nitric oxide were also significantly higher in both preconditioning and piracetam groups than in the ischemia-reperfusion group. However, vascular proliferation increased in the preconditioning group, while it did not show any significant change in the piracetam group. CONCLUSION: This study shows that systemic piracetam treatment provides protection against ischemia-reperfusion injury in musculocutaneous flaps and can offer a simple and inexpensive alternative to the preconditioning technique.

Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps

Background/aim: The aim of the study was to evaluate the protective effect of Botulinum A toxin injection against ischemia-reperfusion injury. Materials and methods: Thirty-two Sprague-Dawley rats were divided into: control, ischemia-reperfusion, ischemic preconditioning, and botulinum groups. In all groups the musculocutaneous pedicle flap was occluded for 4 h, and then reperfused to induce ischemia-reperfusion injury. Serum and tissue myeloperoxidase (MPO) and nitric oxide (NO) levels were measured at 24 h and at 10 days. Results: Tissue MPO levels did not differ significantly between the ischemic preconditioning and botulinum groups at 24 h but was significantly lower in the botulinum group at 10 days. Tissue NO levels were significantly higher in the ischemic preconditioning group compared to the botulinum group at 24 h and at 10 days. Serum MPO showed no significant difference between these two groups at 24 h but was significantly lower in the ischemic preconditioning group compared to the botulinum group at 10 days. Serum NO levels were not significantly different at 24 h but significantly higher in the botulinum group at 10 days. Conclusion: Findings show that botulinum has a protective effect against the ischemia-reperfusion injury via increased NO and decreased MPO levels in tissue. Based on tissue NO levels, ischemic preconditioning was significantly higher than botulinum.

Coincidence of Malignant Melanoma and an Incidently Discovered Parotid Mass Presenting a Diagnostic Challenge.

Parotid masses coincided with skin tumors in head and neck region may represent a serious diagnostic challenge. Conventional imaging modalities such as computed tomography, magnetic resonance imaging may help to determine nature of the masses. Positron emission tomography - computed tomography imaging is reported to be useful for the detection of malignancy in the parotid gland. But in some situations all of them become insufficient. We present a case of cheek malignant melanoma with an incidentally discovered parotid mass during the investigation. We describe the problems experienced in the course of differential diagnosis and decision making in terms of surgical management. As a result, the most reliable diagnosis of suspicious parotid lesions accompanying head and neck melanomas comes from frozen section analyses. The other diagnostic tools are not reliable enough to allow a safe surgical plan in terms of regional treatment; however, the significance of positron emission tomography - computed tomography in distant metastasis investigation should always be kept in mind.

Epidemiology of pediatric burn injuries in Istanbul, Turkey.

BACKGROUND: Many burns that occur in the first two decades of life are accidental and preventable. The aim of this study was to determine the demographic features, mortality, and other factors associated with pediatric burns in Istanbul, Turkey. METHODS: Our retrospective study included 375 hospitalized pediatric patients (225 male, 150 female; mean age 4.07±3.79; range 0.2 to 16 years) aged 16 years or less admitted between January 2005 and January 2009. Each child's medical record was reviewed and demographic features, mechanism of burn, place of residence, total body surface area (TBSA), surgical treatment, duration of hospital stay and mortality rates were analyzed. RESULTS: Scalding was the predominant cause among all pediatric age groups. There were no differences between the age groups with respect to mean TBSA. Length of hospital stay in infants and toddler age group was significantly lower than in other age groups (p<0.005). Sixteen (4.3%) patients died during the study period. Mortality rates associated with scalding, flame and electrical burns were 3.1%, 13.9% and 10%, respectively. Electrical burns and flame resulted in significantly higher mortality rates than scalding (p<0.05). CONCLUSION: Scalding was found to be the most important cause of burns and flame-related mechanisms resulted in the highest mortality rate among children. Only a specific preventive program for changing the traditional habits of Turkish parents would reduce burn injuries among children.