Lipograft in cicatricial ectropion.

AIM: Cicatricial ectropion is secondary to an excessive scar contraction after trauma, burns, skin conditions, scarring skin tumours, medication, allergies, blepharoplasty complications 1,2. The estimates for ectropion incidence following removal of eyelid lesions have been reported as varying from 2.5% to 7% 3. A variety of surgical techniques can be applied to achieve the correct shape and position of lower lid 4-7. Fat grafts in association with other technique are commonly used in orbital reconstruction in a variety of procedures 8 including of the correction of cicatricial ectropion 9,10. MATERIAL OF STUDY: The Authors propose the use of fat graft as only procedure for the correction of cicatricial lower eyelid ectropion. Two male patients with cicatricial ectropion were treated with this technique in two time and followed for 12 months. RESULTS: Lipofilling for cicatricial eyelid ectropion give excellent outcomes, with release of the scar without recurrence, 11. DISCUSSION: Autologous fat grafting has many clinical applications, and its use in Plastic Surgery is increasing: The key point is the presence into fat of Adipose stem cells (ASCs), that have been identified as an ideal source of cells for regenerative medicine, with potential and rapid improvement of healing process and complete recovery of tissue integrity after surgery to confirm the regenerative effect of fat graft. CONCLUSION: Lipografting can be considered a safe and effective alternative procedure 12,13. KEY WORDS: Defect of lower lid, Ectropion, Lipograft.

Elevator Muscle Anterior Resection: A New Technique for Blepharoptosis.

Blepharoptosis is a condition of inadequate upper eyelid position, with a downward displacement of the upper eyelid margin resulting in obstruction of the superior visual field. Levator resection is an effective technique that is routinely used to correct aponeurotic ptosis. The anterior levator resection is the procedure of choice in moderate blepharoptosis when there is moderate to good levator muscle function, furthermore, with an anterior approach, a greater resection can be achieved than by a conjunctival approach. The authors describe a modification in the Putterman technique with a resection done over a plicated elevator, plication that was suggested by Mustardè. The technique has been named as elevator muscle anterior resection. The elevator muscle anterior resection inspires from the Fasanella-Servat operation by the use of a clamp, making the operation simple and predictable.

Anatomical and aesthetical reconstruction of complex hair-bearing areas: a three-step procedure including implant of dermal regeneration templates, skin grafting, and hair micrografting.

Reconstructive surgery of complex hair-bearing skin defects often represents a challenge for the plastic surgeon; indeed, a multistage procedure is to be planned, including a first reconstructive step including local flaps, even if pre-expanded, or for larger defects, microsurgical flaps. To date, the implant of dermal regeneration templates has been proven an effective alternative. The authors relate their results of a complex hair-bearing reconstruction of a scalp and brow defect after a friction road burn with those reported in literature, concluding that a 3-staged reconstruction (dermal template implantation, skin grafting, and finally hair micrografting) can achieve good results in this complex kind of reconstruction. Histological specimens taken 2 years later confirmed a full anatomical reconstruction of the hair-bearing areas. Finally, this paper reports the first case of brow reconstruction performed with these techniques.

Triplane augmentation mammaplasty.

BACKGROUND: Sub-muscular positioning of breast implants requires interrupting as well as disinserting both the abdominal and sterno-chondral fibers of the pectoral muscle; this can produce a muscular strength reduction which reveal bothering and is often detected in some daily motions, such as cutting bread into slices. MATERIAL AND METHODS: The revision of anatomy and literature induced the authors to search for a conservative approach for breast augmentation. They describe a new technique defined "Tri-plane" where the muscular fibers are not cut but simply split to create the pocket for breast implants. RESULTS: Our experience evidenced that this technique gave good aesthetic results together with a more significant projection of the NAC without any strength diminution either in adduction or abduction of the arms. CONCLUSIONS: This technique is a valid alternative to other techniques of breast augmentation as it conjugates the advantages of sub-glandular and sub-muscular implants without muscular deficit.