Modern Plastic Surgery

Journal Information
ISSN / EISSN : 2164-5213 / 2164-5280
Current Publisher: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 114
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SHERPA/ROMEO
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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; doi: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.
Okumanin Nsaful Kwesi, Kwesi Okumanin Nsaful
Modern Plastic Surgery, Volume 10, pp 101-107; doi:10.4236/mps.2020.104012

Abstract:
Background: There are often situations that require the correction of facial defects. Local fasciocutaneous flaps provide a reasonable option for reconstruction of facial defects with good colour and texture match and good success rate. Among the various options of local flaps is the use of a rotation flap. Aim: The aim of this work is to demonstrate the reliability of the rotation flap in the correction of facial defects and its ability to achieve a good aesthetic outcome by applying the knowledge of facial aesthetic units. Case Presentation : This is a case report of a 28-year-old woman who suffered an avulsion injury to the face with loss of facial tissue resulting in exposure of the left zygomatic bone. The defect measured 5 cm × 6 cm. A rotation flap was used to cover the defect after the wound had been previously irrigated and debrided. Her wounds healed well. She suffered no facial nerve injury. The rotation flap resulted in a good colour match with no disruption of facial contour. Conclusion: The Rotation flap provides a reasonable option for reconstruction of facial defects with good colour and texture match.
Mohamed Elsayed Mohamed Mohamed, Fathy Mohamed Eldehn Ahmed, Ahmed Fathy Mohamed Eldehn
Modern Plastic Surgery, Volume 10, pp 1-8; doi:10.4236/mps.2020.101001

Abstract:
Background: Coverage of post-traumatic or post-oncosurgical nasal defects is a very challenging procedure. Small nasal defects may be covered by skin grafts or small local flaps while larger nasal defects require more complex flap coverage techniques as using tissue expanders, prefabricated flaps or free flaps. The forehead flap has been used for centuries and remains a workhorse flap for reconstruction of large and complex nasal defects. Aim: evaluate the feasibility and versatility of forehead flap for resurfacing nasal defects. Materials and Methods: 12 patients underwent coverage of nasal defects after trauma or tumor excision using forehead flaps. All flaps needed a second stage for flap separation 3 weeks after the time of operation. The size of the harvested flap, the harvesting time, results of transferred flaps, patient satisfaction and flap-related complications were analyzed. Results: 12 patients (10 males and 2 females) underwent reconstruction of different nasal defects using 12 forehead flaps. The overall complications occurred in 2 patients. The remaining 10 patients showed no complications and passed an uneventful follow-up period. 7 Patients were very satisfied, 4 were satisfied and only one patient was not satisfied as she was 23 years old young female and was subjected to human bite. Follow-up periods ranged from 6 to 12 months. Conclusion: Nasal defects can successfully be managed with the forehead flap. Probably, the flap provides the best result due to the good matching of the skin in terms of color, texture, and thickness. Also, despite the increasing use of free flaps, the forehead flap is still a valid and safe option for nasal defects coverage that allows good aesthetics and functional outcomes.
Ahmed Abdelmoez Alsayed
Modern Plastic Surgery, Volume 10, pp 23-30; doi:10.4236/mps.2020.102004

Abstract:
Background: Thigh lift is a common procedure in plastic surgery. Surgeon’s sense or tailor tacdundancy to bek is mainly the methods used for designing thigh lift currently. This article is an attempt to find a method/a reference point to define the exact amount of re excised. Introduction: Anthropometry reference measurements can be applied in designing thigh lift surgery. Classically, anthropometry binds the calf circumference with mid-thigh circumference and upper thigh (gluteal) circumference to make postoperative results more harmonious and natural. Method: To find out the anthropometrically referenced ratio of the calf circumference with mid-thigh circumference and upper thigh (gluteal) circumference, anthropometric databases and studies done on females addressing different ages, countries and races with average BMI (body mass index) were reviewed. Chosen studies should include the calf circumference, mid-thigh circumference and/or upper thigh (gluteal) circumference. Anthropometrically referenced upper and mid-thigh circumferences can be calculated preoperatively. Result: 64:92:100 was concluded as a pooled mean ratio out of nine different studies addressing the ratio of the calf circumference:mid-thigh circumference:upper thigh (gluteal) circumference. Conclusion: Postoperative anthropometrically referenced mid and upper thigh circumferences can be calculated by measuring the calf circumference and applying the 64:92:100 ratio. Markings are done intraoperatively using my innovated “Stab-Push-Pinch-Mark” or SPPM technique for drawing a rough surgical design, then tweaked using the anthropometrically referenced 64:92:100 ratio results.
Ahmed Abdelmoez Alsayed
Modern Plastic Surgery, Volume 10, pp 17-22; doi:10.4236/mps.2020.102003

Abstract:
Introduction: Intraoperative blood loss remains as a concern for all surgeons. Proper estimation of intraoperative blood loss is critical and can be challenging, especially if the blood is mixed with other fluids such as tumescent fluid in liposuction cases. In such cases, proper estimation of intraoperative blood loss will lead to fewer mistakes in fluid resuscitation. In this article, Tallquist Haemoglobin Scale was tried to estimate intraoperative blood loss in liposuction. Objectives: Proper estimation of intraoperative blood loss in liposuction cases. Method: Tallquist Haemoglobin Scale will be tried to estimate the approximate intraoperative blood loss in liposuction cases using a mathematical formula that considers total fluid loss, patient’s preoperative haemoglobin and the reading from Tallquist kit. Results: Tallquist Haemoglobin Scale can be considered as a valid method for proper estimation of intraoperative blood loss in liposuction cases, the thing that will lead to correct fluid resuscitation and fewer complications. Conclusion: Proper estimation of intraoperative blood loss leads to fewer mistakes in fluid resuscitation and fewer related complications of under or overcorrection. Tallquist Haemoglobin scale is a trusted, cheap and fast method for proper estimation of intraoperative blood loss in liposuction cases.
Medhat Emil, Anood Alqaydi, Dalal Almansoori, Dalia Medhat Habib, Marwa Alawadhi, Abrar Alteneiji, Omar Alameri
Modern Plastic Surgery, Volume 10, pp 75-81; doi:10.4236/mps.2020.103009

Abstract:
We report a case of blast injury to the left hand which resulted in fractures of the fingers with exposure of bones and joints of the phalanges. We used three reverse adipofascial cross finger flaps raised at the same time from 2 fingers to reconstruct adjacent fingers of the patient. The patient recovered well postoperatively and had good range of movement of the fingers. This avoided the complications of the use of regional or distal flaps. To our knowledge, this is the first case reported in which three reverse adipofascial cross fingers flaps are raised at the same time, two of them from an injured finger, to cover three raw areas on two fingers of a patient.
Medhat Emil, Dalia Habib, Omar Al Ameri, Dalal Al Mansoori
Modern Plastic Surgery, Volume 10, pp 56-61; doi:10.4236/mps.2020.103007

Abstract:
We report a case of 22 years old male patient who is a worker in a factory and sustained degloving injury of his left thumb in a machine while working. There was loss of the pulp of the thumb extending circumferentially to the dorsal aspect with loss of the skin of the terminal phalanx and part of the proximal phalanx. The nail and germinal matrix were lost with exposure of the bone and extensor pollicis longus tendon insertion. The thumb was totally covered with a combination of two flaps: Moberg flap with V-Y advancement was used to cover most of the volar surface of the thumb and reverse adipofascial cross finger flap from the adjacent index finger was used to cover the dorsal surface and the tip of the thumb. The reverse adipofascial cross finger flap was covered with split thickness skin graft. Three weeks later this flap was divided and the thumb was mobilized freely. The patient had a full range of movement of the thumb and index finger with few settings of physiotherapy postoperatively. We recommend combining both of these flaps to reconstruct degloving injury of the thumb as they provide near adjacent tissue of similar texture, preserve sensation at the volar aspect of the thumb and also avoid the complications of the distant flaps.
José Humberto Cardoso Resende, Cristine Mara Fragoso Dos Santos Oliveira, Heitor Dos Santos Leão, Bruno Viana Martins, Brenda Martins Fernandes, Valentina Ruvieri Silveira, Juliana Araújo Naves, Ítalo Julierme Barros Duarte, Emídio Silva Falcão Brasileiro
Modern Plastic Surgery, Volume 10, pp 82-92; doi:10.4236/mps.2020.103010

Abstract:
Before the 70s, in Brazil, each city had its morbidly obese, considered as the “excessive fats”, in very small numbers if we compare it with the current percentage. There was no classification of the degree of obesity by the body mass index (BMI) as we have today. By chance, on a Saturday in June 1975, at the Outpatient Clinic of the 23rd Infirmary of Santa Casa da Misericórdia Hospital in Rio de Janeiro, arrived the patient I. S., 41 years old, 1.70 m tall, supported by her two children, weighing 210 kg in weight body. Knowing that bariatric surgery only appeared in the 1980s, before that, patients with morbid obesity were left to their own devices, with hypertension and diabetes. The patient I. S. was hospitalized for 3 years in our Plastic Surgery Service, having received nutritional monitoring, had sporadic discharges and undergone 9 reparative plastic surgeries. She was discharged weighing 71 kg, with self-esteem recovered and happy to start a new life, without hypertension and diabetes.
Ahmed Abdelmoez Alsayed
Modern Plastic Surgery, Volume 10, pp 9-16; doi:10.4236/mps.2020.101002

Abstract:
Introduction: Breast cancer cases, mastectomy and following reconstruction procedures are growing in numbers. Despite being lifesaving, mastectomies have a destructive psychological impact on the patients. On the other hand, breast reconstruction improves psychological damages within the same population. Various techniques for nipple reconstruction were described in literature. Trillium flap is an innovative technique to reconstruct neo-nipple with several advantages that make it superior to other popular flaps. Objectives: To come up with an innovative design for reconstructing a neo-nipple post mastectomy, that is superior to other popular flaps. Results: The Trillium flap design has less visible and easily camouflaged scars, is geometry-based, specific, well-detailed and flexible to produce a tailored nipple with any desired height and diameter and ensures the flaps good vascularity and the neo-nipple projection sustainability. Conclusion: Trillium flap is an innovative technique to reconstruct neo-nipple with several advantages that make it superior to other popular flaps. The results shown in the study are for experimental procedures done on human tissue samples of excised flaps from abdominoplasties and brachioplasties. Further application on actual cases is needed with monitoring of neo-nipple projection sustainability on the long term.
Kwesi O. Nsaful, A. B. Paintsil, J. C. B. Dakubo, J. Nsaful, K. Appiah-Labi, E. Nartey
Modern Plastic Surgery, Volume 10, pp 62-74; doi:10.4236/mps.2020.103008

Abstract:
Introduction: Split thickness skin grafts are frequently employed to provide biological cover for extensive wounds. The take of the skin graft is traditionally estimated by observation and recorded as a percentage. The intent of this study was to ascertain the reliability of the observation method in comparison with the Image J digital programme. Materials and Methods: The study was a longitudinal study conducted on the wards of the National Reconstructive Plastic Surgery and Burns Centre (NRPSBC) at the Korle Bu Teaching Hospital (KBTH) on patients who were admitted during the period of the study with wounds who received split skin grafts. Image J®, an image analysis program, was employed in the calculation of the take of the grafts. These were compared to values obtained by estimation by observation. Results: There was no statistically significant difference between the estimation of graft take, made by observation and using Image J® digital programme. Conclusion: The estimation of graft take by observation is an acceptable practice.
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