Modern Plastic Surgery

Journal Information
ISSN / EISSN : 2164-5213 / 2164-5280
Published by: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 126
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Riham Al Ashkar, Sinan Alboudi, Anwar Alhassanieh
Modern Plastic Surgery, Volume 11, pp 63-69; https://doi.org/10.4236/mps.2021.113008

Abstract:
Background: Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts [1]. The aim of this study is to find the best approach in preventing fat herniation reccurnce in lower lid blepharoplasty. Methods: The patients in study were classified into three groups depending on the used surgical technique, to test the most effective technique associated with minimal rate of lower fat pad recurrence after surgery. Two of these techniques include a muscular flap suspension from the orbicularis oculae muscle. Results: The two surgical techniques that include orbicularis oculi muscle suspension are associated with no recurrence of lower herniated fat pads after blepharoplasty. Conclusions: The suspension of orbicularis oculi muscle has an important role in enhancing the lower orbital septum and prevents the recurrence of the lower herniated fat pads.
Sinan Alboudi, Ali Alrida Rahal, Israa Ali Haidar, Anwar Alhassanieh
Modern Plastic Surgery, Volume 11, pp 1-5; https://doi.org/10.4236/mps.2021.111001

Abstract:
Background: Breast reduction surgery is increasing in popularity, with so many techniques all around the world, and the community’s knowledge of the details of this procedure increases thanks to the Internet and easy access to information, which increases breast reduction reviews for plastic surgery clinics. Reduction mammaplasty is an established and effective technique to treat symptomatic macromastia. Variable rates of complications have been reported, and there is a continued need for better outcome assessment studies. Aim: The purpose of this study was to identify the complications occurred during the first year of breast reduction surgery. Materials and Methods: A prospective study over a 1-year period from October 2018 to October 2019, that included 32 patients who underwent breast reduction surgery using the same technique (inferior pedicle and inverted T scar) in the Department of Plastic Surgery at Al-Mouassat University Hospital, Damascus, Syria. Patients were followed through a whole year after surgery and complications that occurred were recorded. Results: Complications that occurred in 14 patients (43%), and, and were more common in patients with larger breasts and worse symptoms before surgery. The most common complication was delayed wound healing, and it was associated with breast volume before surgery and with smoking. In general, the most relevant factor influencing the incidence of complications was the weight of the resected breast tissue, which is mainly related to the size of the breast before surgery. Conclusion: The weight of the resected breast tissue was the most important factor influencing the occurrence of complications after breast reduction surgery. The most prevalent complication was delayed wound healing and it was associated with the weight of the removed tissue.
José Humberto Cardoso Resende, Murilo Calil Alves, Aline Correia Barbosa, Débora de Bortoli Verderio, Nathália Lima Sanchez, Sabrina De Castro Silva, Alexandre Jorge Rodrigues, Anthony Yuri Viana Pitanga, Emídio Silva Falcão Brasileiro
Modern Plastic Surgery, Volume 11, pp 49-56; https://doi.org/10.4236/mps.2021.113006

Abstract:
Obesity is termed as the pathology defined by excess body weight due to the increase in adipocytes. It can be visceral, close to the omentum, mesentery, and subcutaneous, accumulated in the hypodermis. It is a disease that entails metabolic, respiratory, locomotor, and cardiovascular problems, type II diabetes, cancer, and even mental problems. Established by the Body Mass Index (BMI) and defined from the relationship between weight (kg) and height (m) of individuals. In numerical terms, a person is considered obese when the BMI is equal to or greater than 30 kg/m. This retrospective study took into account the more than 30 years that the coordinator of this work has devoted to morbidly obese people and all his 47 years of experience in medicine. The first obese person of his career was 41 years old and weighed 210 kg. As soon as she arrived at the hospital, she said: “Doctor, I am here, because I need to enter a ‘workshop’, to repair my body”. From that moment on, the name “workshop” became part of a fantastic project with obese people called “Obese Workshop”. Over time, the number of patients with this comorbidity has only increased, reaching, once, the point of speaking to 325 interested parties in a single day and in the same hall. In order to achieve satisfactory results, we have established a number of tests, by which we could diagnose several reasons that cause obesity. We selected randomly 20 patients of both sexes, morbidly obese, operated in 2013. We do not take into account age, race, creed, or social status.
Ali Alrida Rahal, Sinan Alboudi, Mhd Husam Alhilbawi, Anwar Alhassanieh
Modern Plastic Surgery, Volume 11, pp 37-48; https://doi.org/10.4236/mps.2021.112005

Abstract:
Background: Abdominoplasty is still among the most popular surgeries in the world of cosmetic surgery, as many modifications have been implemented on this surgery to improve aesthetics and reduce the ratio of complication, especially seroma. Also, the duration to drain removal increases the risk of infection, and this can be avoided by preserving the Scarpa’s fascia. Methods: The study was performed from January 2018 to December 2020. The patients were divided into two groups: group A with patients who were performed in Supra-Scarpa’s fascia abdominoplasty, and group B who were performed in traditional abdominoplasty; then group A was divided into two subgroups (A1 with caesarean history and A2 with no caesarean history) that differ in caesarean history or not, while a comparison was done between the groups regarding early outcomes. Results: A total of 40 full abdominoplasties were preformed (group A, 19 patients; group B, 21 patients); then group A was divided into two subgroups (group A1, 13 patients; A2, 6 patients); we found that the time until drain removal and its drain output in group A is less with a statistical significance, and the seroma was less to happen in group A with no statistical significance. However, the operative time in group A is higher with statistical significance. In the subgroups A1 and A2, there was no statistically significant difference in the results. Conclusion: Preservation of the Scarpa’s fascia reduces the time until drain removal, total drain output and the occurrence of seroma and the caesarean scar doesn’t affect the efficacy of preserving the Scarpa’s fascia.
Wenliang Chen, Bingshui Deng, Jingjing Pu
Modern Plastic Surgery, Volume 11, pp 57-62; https://doi.org/10.4236/mps.2021.113007

Abstract:
Objective: Utilizing VISIA skin tester to quantitatively evaluate the effect of low energy far-infrared irradiation on healthy people’s facial skin. Methods: 60 volunteers were selected in hospital from September 2019 to June 2020, and the total score of face, skin spots, texture, wrinkles and pores were observed before and after low energy far-infrared irradiation treatment with VISIA skin tester. Results: After 2 weeks of low energy far-infrared irradiation treatment, the total skin score of volunteers increased significantly (P < 0.01). In the itemized statistics, the moisture value, stain value and wrinkle value increased significantly (P < 0.05). Conclusion: Low energy far-infrared irradiation can significantly improve the facial skin quality of healthy people.
Claas Spengler, Roland Mett, Frank Masberg, Peter M. Vogt, Tobias R. Mett
Modern Plastic Surgery, Volume 11, pp 22-35; https://doi.org/10.4236/mps.2021.111004

Abstract:
The aim of the study was to show significant differences regarding postoperative complications and outcomes using three different Acellular Dermal Matrices (ADM), namely Epiflex®, Strattice® and Braxon®, in immediate implant-based subpectoral breast reconstruction cases. Background: The use of Acellular Dermal Matrices for implant-based breast reconstruction cases continues to evolve. There is a wide variety of products which differ significantly in their biological features. It remains unclear if and how these differences manifest in clinical practice. Methods: 82 cases of primary breast reconstruction in the Department of Plastic and Aesthetic Surgery of HELIOS Clinics Schwerin, Germany between 2010 and 2018 were analyzed. 25 patients received Strattice® acellular dermal matrix (SADM), 22 cases Epiflex® acellular dermal matrix (EADM) and the remaining 35 cases Braxon® acellular dermal matrix (BADM). The mean follow-up was 1.8 years. Cases were analyzed regarding minor or major complications and rate of capsular contracture grade III or IV (Baker Classification). Results: The overall complication rate was 34.1% for all groups (SADM = 40%, EADM = 50%, BADM = 20%, p-value = 0.051). Of all cases, 6 patients underwent implant exchange or secondary autologous reconstruction due to capsular contracture (7.3%). The mean time between revision due to capsular contracture and reconstruction was 35.8 ± 14.4 months. 50% of patients, who developed capsular contracture, received postoperative radiation. Mean hospitalization time was 8.2 ± 3 days (SADM = 8 ± 3.2 days, EADM = 10 ± 2.8 days, BADM = 6 ± 1.3 days). There were no significant differences between all three groups for demographics, overall complication rate or capsular contracture. However, patients receiving Braxon® matrix showed significantly fewer minor complications (p-value = 0.01). Moreover, patients receiving Braxon® ADM showed a significantly lower time of hospitalization (p ® ADM showed significantly lower minor complication rates and hospitalization time. In addition, these matrices showed a trend towards lower capsular contracture rates. The low rate of capsular contracture hints at possible advantages of ADM-use in direct-to-implant cases.
Wei Jie He, Kyung Min Son, Fuquan Fan, Zhenzhen Fang, Bing Han
Modern Plastic Surgery, Volume 11, pp 14-21; https://doi.org/10.4236/mps.2021.111003

Abstract:
Objective: To explore the related factors of tension on wound skin healing and its solution. Methods: According to the analysis and discussion of 60 trauma patients admitted to the emergency department of our hospital, they were randomly divided into two groups, 30 patients in each group (Observation and control group). The other group was systematically studied for the related factors affecting wound healing and we gave the relevant nursing measures to the control group. Results: The healing rate of the two groups were compared after treatment and nursing. The observation group was better than the control group, and the difference was statistically significant (P < 0.001). Conclusion: Effective reduction of wound tension can induce immune response and have obvious effect on skin repair and regeneration. On the other hand, the prevention and treatment of abnormal hyperplasia and scar were also improved. Avoid other factors affecting wound healing, strengthen postoperative management, reduce scar formation and promote skin regeneration.
José Humberto Cardoso Resende, Ana Paula Rodrigues de Souza, Ellen Karoliny de Souza Arruda, Guilherme Portilho Soares, Gumercindo João de Morais Silva, Gustavo Ferreira Rocha, Pedro Martins Milani, Thiago Calandria Obeid, Tiesca Cândida de Melo, Emídio Silva Falcão Brasileiro
Modern Plastic Surgery, Volume 11, pp 6-13; https://doi.org/10.4236/mps.2021.111002

Abstract:
In this case report, we present a male patient who arrived at the hospital for the first time at the age of 8 with giant keloids in both ears and diagnosed by the Dermatology and Plastic Surgery as having the “Disease of Jorge Lobo”, which is a fungal infection due to the story of the endemic characteristics. After the first surgical intervention, he received guidance from the team for keloids and left the hospital using elastic mesh and a request to change the place where he lived to reduce his contact with the fungi. Fourteen years later, the patient returned to the Plastic Surgery Service having even larger keloids in both ears, twice the size than the first time. We did the second surgical intervention to remove it, but with the patient’s commitment that he would correctly comply with the guidelines determined by the surgical team. After finishing all the steps and a post-operative for the case, we observed the satisfaction and the increase of the patient’s mood, happier and without the embarrassment of that physical defect.
Sinan Al Boudi, Anwar Alhassanieh
Modern Plastic Surgery, Volume 11, pp 71-78; https://doi.org/10.4236/mps.2021.114009

Abstract:
Introduction: Breast reduction is one of the most prevalent plastic surgery procedures in Syria and the world, bottoming out on the other hand is one of the most happened disadvantages after breast reduction with inferior pedicle technique. Different techniques were used to prevent this deformity after inferior pedicle. In this study we tried to prevent bottoming out by using two crossed dermal flaps suspending the inferior pedicle to the periosteum of the 2nd rib. Methods and materials: 32 patients had breast reduction surgery using inferior pedicle technique at Almowassat University Hospital in Damascus. We divide them into 2 groups, 16 patients each. First group we used crossed dermal flaps with the inferior pedicle and the second group was without these flaps, the dermal flaps had a base on the side of the inferior pedicle base, crossed anterior to it in the middle point between the lower edge of the areola and the IMF and then sutured to the periosteum of the 2nd rib on each side. Results: Preoperatively, the average distance between the inframammary fold and areola was 14.5 cm (range, 11 - 18 cm) in the first group without dermal flaps and 14 cm in the second group with dermal flaps. The average amount of breast parenchymal resection was 790 g (range, 140 - 1600 g). The average distance between the inframammary fold and the lower border of the areola was 8.5 cm (range, 7.5 - 9 cm) on the postoperative first-year measurements in the group with flaps and 10.2 cm (8.6 - 11.4 cm) in the other group. Conclusion: Inferior pedicle suspension using crossed dermal flaps has a real role in preventing bottoming out, without using any allogenic or alloplastic materials, making it one of the considered ways in preventing bottoming after breast reduction.
José Humberto Cardoso Resende, Mattheus Duarte Da Veiga Jardim, Brena Thamyres De Andrade Irineu, Leydeane Rosa Gomes Gontijo, Lucas Radi Cruvinel, Zeno Augusto De Sousa Neto, Rodrigo Gonçalves de Oliveira, Daniel Soares de Araújo, Emídio Silva Falcão Brasileiro
Modern Plastic Surgery, Volume 10, pp 93-100; https://doi.org/10.4236/mps.2020.103011

Abstract:
Morbid obesity is regarded as a disease due to excess body weight, causing a silence of life as a whole and entailing the most varied disabilities for the person, such as: physical, social, psychological, affective, etc. It represents cases of “public health”, thereby involving competent bodies in the development of solutions that encompass various medical specialties and other health fields, in addition to influencing the mind of these people, causing depression that, due to metabolic involvement, can evolve to the death of the individual. The participation of multidisciplinary health focuses on weight loss, freely and spontaneously, or on the indication of bariatric surgery. We know how difficult it is to lose weight. In order to achieve successful procedures, we recommend the “Obese Workshop” or pre- and post-surgical follow-ups close to the patients, with a view to avoiding recurrences or the “accordion effect” (very common), which can interfere with the Body Mass Index (BMI). Everyone, males and females, complained of tiredness and the impossibility of any physical exercise, even the lightest and simplest to be performed, in addition to the fact that they cannot attend gyms and are unable to open a simple door handle.
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