Anthropometric Measurements and Analysis for Objective Assessment of Gynecomastia Surgery Results.

Background: Gynecomastia surgery is one of the most common aesthetic procedures in males. There is a lack of objective analytical parameters to judge outcomes. In this study, the authors aim to introduce novel anthropometric measurements and analysis techniques for the objective assessment of surgical outcomes based on specific aesthetic targets. Objectives: To introduce quantification of gynecomastia surgery outcomes and compare the results among the different grades of gynecomastia. Methods: A total of 192 patients with gynecomastia were included. The patient cases were grouped according to grades and a set of anthropometric measurements were taken both before the operation and 6 months postoperatively. Liposuction and glandular excision were done through minimal incisions in all grades of gynecomastia, with the addition of ultrasound and nipple areola complex (NAC) lifting plaster in selected Grade 3 and all Grade 4 cases. Results: A statistically significant improvement in the perimeter of the triangular relationship of sternal notch and nipples, the elevation of the NAC, the reduction of the area of the NAC, and the correction of asymmetry of the chest were seen in all grades of gynecomastia, with increased differences in higher grades. Conclusions: A systematic objective analysis of the specific aesthetic targets helps to reliably compare results in a standard way and for carrying out improvisation of surgeons' techniques. Meanwhile, this approach helps identifying the need for customization, eventually providing symmetric and aesthetically pleasing surgical results.

Fingertip injury epidemiology: an Indian perspective.

Fingertip injuries result in significant morbidity. It is associated with pain, loss of work and recreational hours, financial burden, and distortion of body image. Although it is a common injury, the epidemiology of fingertip injury is a subject with scanty literature. This study is aimed at providing epidemiology of fingertip injury in India. Epidemiological data were collected and analysed through a retrospective review of all fingertip injuries over a period of four years treated in our department. In the paediatric population, among the 241 injuries in 221children, most occurred at home (98%). Most incidents were in children under five years of age (74%). The most commonly involved digit is the middle finger (29%) and door crush was the commonest reason (80%). Incomplete fingertip amputation with nail bed injury was seen in 80% of cases. In adults, there were 351 injuries in 290 patients, most of which occurred by jamming of the finger at a two-wheeler chain (22.5%). The second most common cause is cut by machine and associated with heavy machinery (17.6%). Complete amputation at the nailbed level was seen in 50% of the cases. Both children and adults need to be educated regarding the causation and effects of fingertip injuries. Damage to fingers can be prevented and reduced by observing safety measures both inside the home and at the workplace.

Three Dimensional Rhinoplasty and Nasal Airway Improvement in Cleft-Nose Deformity.

Septorhinoplasty is particularly challenging among revision surgeries for cleft sequelae. The challenge of cleft septorhinoplasty is mainly due to the complex anatomy of nose, deformity of each of its components and the difficulty and lack of clarity in surgical management. From 2014 to 2017, 26 patients with cleft lip nose deformity were operated by the same cleft team. The study was conducted to assess the improvement in nasal airway and appearance following secondary rhinoplasty with extracorporeal septoplasty. Post operatively each patient was evaluated using the standard modified rhinoplasty outcome evaluation questionnaire, a validated instrument that aids in stratifying patients according to their subjective response. All patients reported great relief of nasal obstruction and improved breathing. More than 80% of our patients were satisfied with improved aesthetics and reported better self-confidence. Secondary cleft rhinoplasty with extracorporeal septoplasty surgery significantly improves the cosmesis and nasal airway opening, subsequently giving them improved self-confidence.