Endoscopic transaxillary subglandular breast augmentation using silicone gel textured implants.

We present our experience with endoscopic transaxillary subglandular breast augmentation using textured silicon gel implants. Fourteen implants were placed in seven patients through a 4 cm axillary incision, in a subglandular pocket, with the help of a 10 mm, 30 degrees endoscope with a subcutaneous retractor and endoscopic diathermy. The implant was inserted with the help of a plastic bag. No drains were left in place. The duration of the procedure was 1 h 30 min in the most recent cases. Bleeding during surgery was kept to a minimum, and there were no complications such as capsular contracture, hematoma, or hypertrophic scar. Infection occurred in one implant and it was necessary to extract it. This technique is an excellent tool for patients requiring subglandular implants who prefer a distant incision. It provides good control over dissection and allows the use of silicone gel implants, thus avoiding the risk of deflation. In addition, recovery is faster and there is less bruising and pain.

Successful partial ear replantation after prolonged ischaemia time.

We present the case of a 34-year-old male patient who had successful replantation of upper pole of pinna 33 h after amputation. As no vein was anastomosed, systemic heparinisation and subcutaneous injection of heparin to the replanted ear were used to encourage outflow. Complications included arterial spasm and bleeding. Management of similar cases as planned urgent cases rather than emergency cases is discussed.

Perforator based V-Y advancement flaps in the leg.

We present a selected group of patients (18) who underwent excision of various malignant skin lesions in the leg, and had the defect resurfaced with V-Y advancement flaps. The mobility and reliability of this type of flap was enhanced by raising it as a fasciocutaneous flap based on one or two leg perforators. As patients were mobilised as soon as they recovered from the operation, there was minimal postoperative morbidity. This type of flap has the added advantage of leaving no significant donor defect and therefore better cosmesis.

Twin flap technique for nipple reconstruction.

A technique of nipple reconstruction using two local flaps is described. The central 'core' flap is surrounded by a peripheral 'wrap' flap, producing a natural nipple. Results of 24 nipple reconstructions in 22 cases are presented. This technique is useful when the neo-nipple location falls on the mastectomy scar.

Ameloblastic odontosarcoma: report of a case.

Ameloblastic odontosarcoma is an extremely rare malignant odontogenic tumor. To date only 8 cases have been reported in the literature. The case of a 12-year-old Hispanic-American boy with ameloblastic odontosarcoma of the mandible is presented. The patient had a tumor diagnosed previously as benign ameloblastic fibroma that underwent transformation to ameloblastic odontosarcoma. The patient has been followed for 19 years since the surgical removal of the tumor. Radiographic and clinical examination confirm that there is no evidence of recurrence. Periodic examination for the reappearance of the tumor will be continued.