Experience With High-Volume Buttock Fat Transfer: A Report of 137 Cases.

BACKGROUND: Buttock augmentation with fat transfer has become increasingly popular, with many patients seeking high-volume augmentations. Consensus is lacking as to the safe upper-limit of fat that can be transferred. Concern for risks such as fat necrosis and fat embolism may lead surgeons to limit the amount of fat to place. However, it is unclear if volume alone is associated with these complications. The author evaluated the outcomes of high-volume fat transfer. OBJECTIVES: The author sought to evaluate the safety and efficacy of high-volume buttock fat transfer. METHODS: A retrospective case review of all buttock fat transfers performed between 2014 and 2016 involving placement of 1000 mL or more per buttock was undertaken. Patients were monitored clinically and evaluated for their subjective assessment of satisfaction. RESULTS: A total of 137 patients were identified. A mean of 1331 mL of fat was placed in each buttock (range, 1000-1890 mL) and the mean age was 35.3 years (range, 19-56 years). One hundred eighteen patients (86.1%) were satisfied with their result. None complained of the buttocks having been made too large. Nineteen patients (13.9%) wanted the buttocks made larger. Eight patients underwent an additional fat transfer procedure. Twelve patients (8.8%) had minor cosmetic issues following surgery. Another 10 patients (7.3%) had minor medical complications. No patient suffered major complications such as fat embolism, venous thromboembolism, infection, or skin loss. CONCLUSIONS: High-volume buttock fat transfer is safe and effective in increasing the buttock volume. Complication rates appear to be low with careful surgical technique. No serious complications were noted in this case series.

Use of the Mayfield horseshoe headrest for management of burns of the neck.

Proper positioning of a patient facilitates access and decreases frustration during surgical debridement of circumferential burns of the neck. The Mayfield swivel horseshoe headrest (Integra, USA) provides cranial support in either the supine or prone position for excision and skin grafting of the circumferential burns of the neck. This headrest can also be used during reconstruction of the neck.

Le positionnement adéquat d'un patient facilite l'accès aux lésions et réduit la frustration lors du débridement chirurgical des brûlures circon-férentielles du cou. Un appui-tête pivotant de Mayfield en forme de fer à cheval (Integra, É.-U.) fournit le soutien crânien nécessaire en décubitus ventral ou dorsal pour l'excision et les greffes cutanées des brûlures cir-conférentielles du cou. Cet appui-tête peut aussi être utilisé durant la reconstruction du cou en chirurgie plastique.

Reflex sympathetic dystrophy syndrome associated with burns of the upper extremity.

Reflex sympathetic dystrophy syndrome is an ill-defined symptom complex with clinical manifestations of excessive pain, joint stiffness and soft tissue changes. It rarely manifests following burns. Diagnosis is usually made from clinical symptoms and ganglion block. Early diagnosis and institution of conservative management is required to control symptoms and disability.

Le syndrome de dystrophie sympathique réflexe forme un tableau clinique complexe encore mal défini qui s'accompagne de manifestations de douleur intense, de raideur articulaire et d'anomalies des tissus mous. Il apparaît rarement après des brûlures. Le diagnostic se fonde en général sur les symptômes cliniques et la ganglioplégie. Il faut sans tarder poser le diagnostic et instaurer un traitement conservateur pour maîtriser les symptômes et prévenir les incapacités.

Use of groin flap in the closure of through and through defect of a forearm: A case report.

The groin flap is a vascularized axial flap based on the superficial circumflex iliac artery arising from the femoral artery just below the inguinal ligament. It is used regularly by many reconstructive surgeons for covering soft tissue defects of the hand. Although the development of various fasciocutaneous free flaps during the 1980s decreased the attractiveness of the groin flap, these flaps can be used in reconstructing significant defects of the forearm and hand where free tissue transfer is not feasible.

Le lambeau inguinal est un lambeau axial vascularisé basé sur l'artère iliaque circonflexe, rameau de l'artère fémorale, juste sous le ligament inguinal. Les chirurgiens qui travaillent en reconstruction l'utilisent régulièrement pour corriger les anomalies affectant les tissus mous de la main. Bien que le développement de divers lambeaux libres fasciocutanés au cours des années 1980 ait rendu le lambeau inguinal moins attrayant, ce dernier peut néanmoins être utilisé pour la reconstruction d'anomalies importantes à l'avant-bras et à la main où il est impossible de transférer des tissus libres.