Modified Internal Mastopexy Technique in Muscle Splitting Biplane Breast Augmentation.

BACKGROUND: The technique of muscle splitting biplane breast augmentation associated with internal mastopexy to correct breast hypoplasia, ptosis and asymmetry was reported in 2014. The purpose of this article is to present recent modifications and results of this technique. METHODS: Since 2016, 30 patients with breast hypoplasia associated with excessive or loose skin envelope or breast ptosis grade I have benefited from a new and improved technique of internal suture mastopexy combined with the muscle splitting biplane breast augmentation (muscle splitting biplane breast augmentation with internal mastopexy type II or MSBBA-IM2). RESULTS: Excellent long-term results have been obtained by using the muscle splitting biplane breast augmentation with internal mastopexy type II, which maintains a natural breast shape and a smooth transition between the soft tissue and implant in the upper pole by redraping the breast parenchyma both at the level of the upper pole and at the level of the lower pole of the breast. CONCLUSIONS: The new technique of muscle splitting biplane breast augmentation with internal mastopexy type II or MSBBA-IM2 offers improved long-term aesthetic results and is an effective alternative in selected patients requiring correction of breast hypoplasia associated with excessive or loose skin envelope or breast ptosis grade I. LEVEL OF EVIDENCE IV: 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.

Injectable calcium hydroxylapatite for correction of nasal bridge deformities.

BACKGROUND: Minimally invasive procedures for aesthetic surgery have become widely popular, and facial soft tissue augmentation is one of the most common procedures. Various kinds of fillers have been used, and recently the use of calcium hydroxylapatite was extended to cosmetic facial procedures. This article presents the authors' experience with primary and secondary nasal bridge correction using calcium hydroxylapatite (Radiesse). METHODS: This preliminary prospective study investigated the use of commercially available calcium hydroxylapatite (Radiesse) for correction of nasal bridge deformities. Calcium hydroxylapatite was injected on the plane of the periosteum in a retrograde fashion using a linear, threading, fanning, or crosshatching technique. The patients were followed for several months, with the outcome and side effects assessed both subjectively and objectively. RESULTS: Patients showed a persistence of benefit up to 1 year during the follow-up period, with pleasing long-term results. CONCLUSION: Calcium hydroxylapatite (Radiesse) is a useful injectable filler for correction of nasal bridge deformities. Further efficacy studies seem justified.

A case of posttraumatic thigh defect reconstructed using tissue expansion by elastic tube.

Reconstruction of major defects of the thigh is generally achieved by means of pedicled or free musculocutaneous flaps, and for less extensive defects, local flaps or skin grafts are currently used. In this case report we present a posttraumatic thigh defect reconstructed using tissue expansion by elastic tube. The defect was closed relatively easily without further problems, and a good result was obtained. Tissue expansion by elastic tube is reliable, easy to perform, and inexpensive. Its versatility allows its use for the reconstruction of many defects at varying locations.

Advantages and outcomes in subfascial breast augmentation: a two-year review of experience.

BACKGROUND: One of the most popular surgical cosmetic procedures, breast augmentation, has enjoyed large acceptance in the last few decades. One of the most important factors in the dynamics established between the implants and the soft tissues after breast augmentation is the pocket plane. Surgeons have been seeking the proper plane into which the implant might be placed. The subglandular approach resulted in implant edge visibility and was thought to result in a higher incidence of fibrous capsular contractures. Despite the advantage of concealing the implant edges using the subpectoral approach, implant displacement occurred with contraction of the pectoralis muscle. The use of the retrofascial plane seems to yield the benefits of both planes without the deficits. METHODS: Since 2006, 45 patients with hypomastia have undergone subfascial breast augmentation using anatomical contour profile gel cohesive III textured implants. RESULTS: Pleasing long-term results have been obtained by using subfascial breast augmentation, with maintenance of a natural breast shape and a smooth transition between the soft tissue and implant in the upper pole. There were no capsular contractures and no complaints regarding displacement of the implants with contraction of the pectoralis major muscle. CONCLUSIONS: The subfascial breast augmentation technique offers improved long-term aesthetic results because the dynamics between the implant and soft tissues have been optimized. This technique is extremely versatile and may also be used in patients requiring removal and replacement of breast implants.

A case of postmastectomy defect reconstructed using a laterothoracic bilaterally pedicled v-y advancement flap.

BACKGROUND: The reconstruction of major defects of the trunk is generally achieved by means of pedicled or free musculocutaneous flaps, but for less extensive defects, local flaps or skin grafts are currently used. The bilaterally pedicled V-Y advancement flap differs from the traditional V-Y advancement flap and was described for soft tissue reconstruction in the face. In our unit, the bilaterally pedicled V-Y advancement flap is the most used local flap for face reconstruction, and our aim was to use it in a different location. METHODS: In this case report we present a postmastectomy defect reconstructed with good results using the bilaterally pedicled V-Y advancement flap. RESULTS: The flap healed without further problems, and a good aesthetic result was obtained. CONCLUSION: The bilaterally pedicled V-Y advancement flap is reliable and easy to harvest, and not only for face reconstruction. Its versatility and plasticity allow its use for the reconstruction of many defects at varying locations.