Methods such as the subnasal skin excision and the vermillion advancement technique have been described, but both leave a visible scar. A no-scar lip-lift technique is necessary for a subset of patients who have a long upper lip and will not accept a visible scar. The upper lip is shortened via an intranasal incision and suspension suture that elevates the upper lip and anchors it to the anterior nasal spine.
A retrospective review of 92 patients who had undergone upper lip-lift with the no-scar suspension technique was performed. Three plastic surgeons assessed the pre- and postoperative results and determined the presence of improvement in four categories: lip shortening, lip projection, incisor show, and vermillion show. All the patients had improvement in at least one of the four categories.
Complications were experienced by two patients with a suture abscess and one patient with an unraveled suture. The overall lip contours improved after the lip suspension technique, most noticeably in terms of lip height and sagittal projection, and the scar was hidden intranasally.
Keywords Lip lift — Lip suspension — Lip aesthetics — Long upper lip — Ptotic upper lip Note upper lip elevation techniques have been described with or without skin excision. The lips need to look youthful with fullness and good angles. Suspension techniques maybe applicable in some cases.
Carotenoids are antioxidants that help soak up damaging compounds produced by the stresses and strains of everyday living, especially when the body is combating disease. Responsible for the red colouring in fruit and vegetables such as carrots and tomatoes, carotenoids are important for our immune and reproductive systems.
While this study describes work in Caucasian faces, the paper also describes a study that suggests the effect may exist cross culturally, since similar preferences for skin yellowness were found in an African population. Note: it is important to eat fresh vegetables and fruits to maximize your health and skin. Nipple necrosis can be minimized by incisions that maximize perfusion of surrounding skin and by avoiding long flaps.
A premastectomy surgical delay procedure improves nipple survival in high—risk patients. NSM can be performed safely with all types of breast reconstruction. Note: Relative to individual Cancer surgeons opinion. Moreover, it provides precise quantitative data for bridging the gap between virtual simulation and real surgery.
Recurrent breast ptosis is the main cause for revision after such a primary operation. Avoiding the need for reoperation and achieving long—term projection and upper pole fullness have been the main focus for the work of many authors. In this study, a new approach for a stable and lasting breast shape based on the use of the pectoral muscle was conceived. Augmentation mastopexy using a loop of the pectoral muscle to hold the implant is a new and effective way to obtaiin long—lasting projection and upper pole fullness.
Note: Breast augmentation and breast lift are procedures I am doing for over 20 years which have not required a Pectoralis Muscle loop. The study found that a person needed to look at least 10 years older than their actual age before assumptions about their health could be made.
Few people are aware that when physicians describe their patients to other physicians, they often include an assessment of whether the patient looks older than his or her actual age. For patients, it means looking a few years older than their age does not always indicate poor health status. The study found that when a physician rated an individual as looking up to five years older than their actual age, it had little value in predicting whether or not the person was in poor health. However, when a physician thought that a person looked 10 or more years older than their actual age, 99 per cent of these individuals had very poor physical or mental health.
Note: It is true looking older than your stated age is equated with poor health. I have seen many people over the years with severe weight loss who looked much older then there stated age. Scar dissatisfaction is rare 2.
With proper patient preparation and education, facial rejuvenation effectively meets patient expectations. These findings support the recommendation of surgical facial rejuvenation to patients who wish to look younger. A new PDS stitch I use under the neck appears to add results with little increase in down time. Laser doppler imaging has a promising role as a scar assessment tool. Note: I have never recommended the use of Vitamin E on wounds.
This study bears out my observations over 25 years. This study aimed to evaluate the clinical outcomes of IBR using permanent gel breast implants and Becker expandable breast implants after SSM. The mean patient age was 42 years range, 29—57 years. Aesthetic outcomes were assessed according to the breast volume, shape, and symmetry with the opposite breasts after a mean follow-up period of 44 months.
Results: The aesthetic outcomes were graded as excellent for 29 patients, good for 47 patients, fair for 12 patients, and poor for 8 patients. The overall complication rate was Conclusion: This study demonstrates that prosthetic breast reconstruction is a safe, reliable method with minimal complications and good to excellent aesthetic results for the majority of patients with early-stage breast cancer.
For selected patients, NAC-sparing mastectomy can be performed without increasing the risk of local recurrences. Success depends on patient selection, proper incision for SSM, total coverage of the prostheses with muscles, and careful intra- and postoperative management. Keywords — Breast implants — Breast neoplasms — Mammaplasty — Mastectomy.
Breast ptosis may be caused by several factors, including significant weight loss, pregnancy, long breastfeeding periods, and involution of the postmenopausal breast tissue. Breast ptosis may be associated with breast hypoplasia; thus, in case of a mastopexy with or without the use of implants being indicated, several considerations have to be taken into account: the wishes of the patient, age of the patient, degree of ptosis, parenchymal volume, covering tissue, quality of the tissue, pocket implant, shape and content of the implant, and resulting scars.
Keywords — Breast augmentation — Mastopexy Note: Breast ptosis or saggy baggies can be corrected with a breast lift — Mastopexy or sometimes with replacement of volume with an implant. An implant can be used with degrees of lifting that include a crescant lift, periareola lift, lollypop or inverted T.
There is a high degree of patient satisfaction with this procedure. We evaluated the efficacy on post-bariatric PB patients undergoing body-contouring abdominoplasty. We retrospectively evaluated PB patients undergoing abdominoplasty with flank liposuction and compared results to a matched group of TAP aesthetic patients. Outcomes evaluated were the analgesic requirements during the early postoperative days. Fifty-one patients PB n? No complications were observed.
All PB patients required analgesia until the second postoperative day contrarily to most aesthetic ones. Patients with greater flap resected and higher pre-abdominoplasty BMI had greater morphine consumptions. In PB patients, the larger amount of tissues resected corresponded to a greater stimulation of pain fibres that cannot be paralleled by a concomitant increase of the local anesthetic administered.
Keywords — Transversus abdominis plane — Pain — Locoregional analgesia — Abdominoplasty — Body contouring — Obesity surgery — Bariatric surgery. Note: My patients with abdominoplasty usually go home the same day of surgery. They do well with oral pain medications. Background: The potential for donor site morbidity associated with bilateral pedicled TRAM flap breast reconstruction has led to the popularization of DIEP flap reconstruction.
Medical records were reviewed for complications and demographic data. Results: The mean follow-up interval was 6. Demographic data was otherwise similar. Abdominal hernias occurred in 3 TRAM patients 2. Post-operative survey results revealed no significant difference in patient satisfaction, incidence of back pain, or physical function. Conclusion: This study suggests no significant differences in donor site morbidity, survey-based functional outcome, or patient satisfaction between bilateral TRAM and DIEP flap breast reconstruction.
Although perforator flaps represent an important technological advancement, bilateral pedicled TRAM flap reconstruction still represents a good option for autologous breast reconstruction. C American Society of Plastic Surgeons Note; The extended surgical time, inherent risk factors in a longer procedure and lack of significant benefit may preclude the use of this flap in most patients.
Wolter3 , S. Lorenz2 and C. Abstract — To ensure the best results from aesthetic breast augmentation, preoperative evaluation and adequate patient information are essential. However, assessment of the underlying thoracic shape often is neglected. Patients with obvious deformities are aware of the problematic reconstruction, whereas patients with mild or moderate deformities often are not aware of their condition and fail to see that standard breast augmentation will lead to unsatisfying results.
The authors reviewed their charts for patients with breast augmentation and mild to moderate thoracic deformities, then compiled the therapeutic possibilities and the outcome. Of the patients who underwent breast augmentation, 7. Almost none of the patients were aware of their deformity. The patients were augmented with silicone-filled, textured round implants. Placement and volume were adapted to the anatomic situation.
A reoperation was not performed in any case, and both patient and physician satisfaction was high. This emphasizes the need for cautious physical examination and preoperative documentation. By individualized surgical planning and diligent implant selection, optimal results and patient satisfaction can be achieved. Many more patients with real problems with their chest walls or breast maldevelopment have breast augmentation then movie stars or dancers.
Although a variety of methods have been proposed to resolve breast asymmetries, to date, no simple preoperative algorithm has been proposed for predicting the breast volume and decreasing breast asymmetries in the place of subjective or expensive evaluation.
The relationship between the scoliosis and breast volume asymmetry was further analyzed statistically in this study. Methods: The study enrolled 60 scoliotic patients from patients undergoing augmentation mammaplasty between January and March The average follow-up period was 2 years. Results: Pearson regression analysis showed that the breast volume asymmetry difference was significantly correlated with the severity of scoliosis Cobb angle correlation coefficient, 0.
No correlation between the difference in pre- and postoperative nipple and inframammary levels and the severity of scoliosis was noted. The average preoperative estimated breast volume was Conclusion: This study found that the severity of scoliosis showed significant correlation with the breast volume asymmetry differences. Augmentation mammaplasty for breast asymmetries decreased not only the volume difference but also the difference in nipple levels.
Keywords: Augmentation mammaplasty — Breast asymmetries — Implant — Scoliosis Note: Breast asymmetry can be secondary to spinal and chest bone deformities. Scoliosis is a special case which can give more significant abnormalities of the breast on a developmental and aging process. I have had good success with improvement in patients with scoliotic related breast asymmetry.
Dailey, M. The research was sponsored by an unrestricted educational grant from Allergen, Inc. Patients who begin receiving injections between their 30s and 50s are able to prevent wrinkles from forming and reduce existing wrinkles, said Dailey, head of the Casey Aesthetic Facial Surgery Center, which opened in as part of Casey Eye Institute.
Such frequent treatment, however, deterred some patients, Dailey said. About , of those patients were men. Note: I have been using Botox for over 15 years for my staff and patients. Different strokes for different folks.
Some patients require every 3 month treatment, some may have residual effects for as long as 6 months, I suspect some patients may eventually experience muscle atrophy from disuse and may need less as time goes on. However some patients develop taxyphylaxis which is a resistence to the medication that might require an increased dose or a slightly different compound; such as Dysport.
Many areas of the body are affected such as the back, the upper arms, and the breasts in the upper body. Combining more than one such area in a single operative step can yield many advantages. The author proposes a single-step approach to the upper body of the woman with massive weight loss and offers an algorithm to simplify the operative plan.
Methods: Based on the characteristics of the individual, each adjacent region is analyzed for the potential of surgical improvement. Several lifting techniques can be used to restore the shape of each region. The breast represents a rather unique entity in which three basic types can be recognized. Accordingly, a surgical plan is formulated and discussed with the patient. Results: The presented algorithm was used successfully for 17 consecutive women after massive weight loss.
Although the time for these combined operations was increased, patient safety was not reduced nor were the number of complications increased compared with multiple smaller operations. The overall treatment plan for this patient group was greatly enhanced and simplified with this approach and resulted in great patient satisfaction.
Conclusion: Body contouring after massive weight loss presents a steadily increasing surgical field. The author offers a surgical algorithm that aids in the operative planning for the upper body of such patients that simplifies this operation and yields great patient satisfaction. Note : I have been using an extended abdominoplasty with thigh lift for some years with very nice results in most patients.
Saturday, April 24, Alex Colque, M. The senior author M. General anesthesia is only used when breast augmentation with or without mastopexy is combined with large liposuctions, body contouring procedures, obese patients or surgery expected to last over 4. The described protocol can be administered by the surgeon and the circulating nurse. It deliberately avoids the use of propofol which should be used only by a nurse anesthetist or anesthesiologist.
Patients, when given the option of monitored sedation with intercostal nerve block generally have preferred this technique over general anesthesia due to its safety, efficiency, and cost savings. We present our experience with using intercostal nerve blocks and intravenous sedation to perform breast augmentation with and without simultaneous mastopexy.
We also compare these two groups of patients. Local anesthesia solution consisting of equal parts of 0. The solution was then injected at the lateral sternal boarder in varying amounts. A retrospective review was done on patients who underwent bilateral breast augmentation and augmentation- mastopexy from January 1st, to October 30th, at an AAAA accredited outpatient surgery center by the senior author M. All procedures were performed for cosmetic purposes.
We excluded patients that had any other additional procedures including liposuction. All breast implants were placed in a subpectoral pocket. The two groups were then analyzed for age, BMI, operative time, total sedation used, total local anesthesia used, recovery room length of stay, and complications.
In the augmentation group the means were: age In the augmentation-mastopexy group the means were: age There were no deaths, deep venous thromboses, pulmonary emboli, hematomas, reoperations, pneumothoracies, intubations, and none of the patients required admission to the hospital. Conclusion: After reviewing our experience, we conclude that breast augmentation with and without mastopexy can be performed safely and with minimal discomfort under local anesthesia with intravenous sedation with minimal complications when performed by ACLS certified personnel in an AAAA certified facility.
Although augmentation with mastopexy procedures requires a longer operative time than augmentation alone, this does not lead to a longer recovery room length of stay. This is likely due to the effectiveness of the intercostal nerve block for post-operative pain control. Conclusion: The analysis of the proportions rules proposed by leonardo da vinci, kept in evidence that only 2 dimensions of the thigh have been evaluated even with photographic approach in te last decades. These concepts are realized through vaser superficial and deep ultrasound liposculture.
In the last decades, when planning a liposuction or liposculpture of the thigh, the analysis of the areas and zones to be corrected has always been taken from anterior and posterior views, and the surgical techniques have been addressed to correct flanks, trocanter deformities, banana fold, inner side of the thigh, inner side of the knees, etc. And finally introduced the third dimension, as indicated in his drawings analysis of leg proportion. Leg is measured with Greek letters at different distances, and comparison between upper, middle lower third of the leg are done in absolute and relative terms.
The lateral view of the thigh appears finally, after frontal and dorsal view have been the only considered in the previous period. In his drawing on study of proportions of the body standing, sitting, and on his knees Windsor Castle clearly indicated the correct way to approach and evaluate the body symmetry and evaluate body contouring.
This relative hostility was due to the difficulty of sculpturing and mastering the anterior and antero medial part of the thigh, and for the fear to damage with secondary irregularities and depressions. Scope of the anteromedial approach to the thigh is to thin the subcutaneous fat of the thigh in areas considered to be risky for the approach with classic liposuction. At the same time, the undermined tissues rises and represents a substantial benefit for the final contouring of the leg.
Of course the approach to the anterolateral part is the final step of a circumferential sculpturing of the thigh. A tridimensional vision of the full area is mandatory to model the different sides in harmony in between them. The tumescent infiltration initially distends the tissue, allowing vasoconstriction which diminishes bleeding, compacting the tissues which become uniform.
The fluids are distributed superficially first and deeper, to follow. The superficial superwet technique of infiltration really distends the tissue and allows a precise undermining by the 2,9 mm or 3,7 mm one or two rings probe. With the power tunneled at 70 per cent of power, the probe is directed parallel to the skin axis, as indicated in the diagram, in order to allows careful undermining of the tissue from underlying fat.
This maneuver is essential for the final contouring of the area of the thigh, as will allow the reduced tissues to adhere to the new, reduced and shaped body. This selectivity distinguishes vaser ultrasound from whatever other technique in terms of protection of the subcutaneous vascular plexus. Once completed the undermining, which may require 5, 6 minutes of delicate vaser action, always respecting the skin superficial layers, the probe is directed in the deeper layers of the thigh.
Once this phase is completed, the surgeon starts the most delicate part of the contouring, the removal of emulsified fat from the deeper layer, the superficial spreading of the skin, the careful aspiration in respect of the shape of the body. Aspiration in the superficial layer has to be very conservative This part of the sculpting of the body allows the plastic surgeon to express his own talent and artistry, and is the unique part of the technique which cannot be taught, but just shown.
I utilize a 2,8 mm fine cannula to shape the superficial planes, with virtually no aspiration. And a 3,7 mm cannula to aspirate in the deeper planes. Several substances have been used to minimize theses alterations and to compensate the wrinkle tissular volumetric form through dermal filling. Hyaluronic Acid is a glycosaminoglycan polysaccharide present in dermis and other organic tissues that assists cellular growth and acts in membrane receptors and cellular adhesion.
The use of hyaluronic acid as a dermal filling presents many advantages, due to its non-animal origin and absorbability less capacity of imunogenicity. Because of its characteristics, it was chosen as the filling material of this study, for facial wrinkles, lips contour, scar depressions and facial lipoatrophy. This is a retrospective study on the application of hyaluronic acid with on patients, based on photographs right before application, 30 days afer and the days application.
The selected patients were the ones with indication for dermal filling to treat deep wrinkles, scars in the fce, facial lipoatrophy, deep nasolabial fold and thin lips. The criteria for exclusion are: patients with history of allergy to hyaluronic acid, presence of skin patologies at the local of application or decompensated systemic pathology, pregnancy, presence of scarring disturbances, previous treatments with non-biodegradable substances at the local to be treated or the use of anticoagulant for any pathology.
The markings were made with the patients seated, to highlight the spots that needed filling. The volume injected should be enough for the local to be treated. The aesthetic result is immediate and there should not be hypercorrection. The application technique used was retroinjection. After application, cold compress for 10 minutes and local massage are done. The patients returned on the 7th and 15th day after the application, when they are evaluated, after the improvement of initial edema.
At this point, if necessary, touch up can be made as complements on spots with hipocorrection or assimetry. Then they should return on the 30th and th day after application for new evaluation. Conclusion : The conclusion of this paper is that Hyaluronic Acid is an excellent filling, with low complication rate and high degree of patient satisfaction.
We describe a newly designed chin implant and its corresponding technique that can be considered a substitute for the sliding geniality. These accomplish some of the effects of the sliding genioplasty: increase of vertical height of the anterior mandible, soft tissue remodeling of the lower mandible and chin and tightening of the suprahyoid muscles. Lower perioral musculature dynamics also improves. Complication rate has been minimal: 4. One patient required trimming of implant at the gingivo-buccal sulcus.
In other patient paresthesias of the mental nerve required trimming of the implant. Two patients 1. Demographic information, implant size, concomitant procedures and surgical information including the use of drains and implant position were recorded for each patient. Pre and postoperative photographs were taken. The data was analyzed to determine the rate of complications, need for surgical revision and aesthetic outcome.
All patients in the series underwent buttock augmentation as an outpatient by the author in his AAAASF accredited office based surgical facility. Patients were positioned prone on the operating table after undergoing general or epidural anesthesia. A single dose of Cefazolin was given intravenously prior to skin incision.
Solid silicone gluteal implants were inserted through a single midline intergluteal incision measuring 7 cm. Implants were placed in either the subfascial SF or intramuscular IM position. Precise pocket dissection was accomplished through the use of a fiber optic retractor and long tip electrocautery in the subfascial plane. Intramuscular dissection was performed using a combination of electrocautery dissection and blunt dissection.
Closed suction drains were used in select patients and removed when less than 25 ml. Patients were discharged with oral analgesics and instructed to refrain from physical exertion for weeks. The average age was 34 years for the men and 30 years for the women. The implants were placed in the IM position in 46 patients and in the SF position in patients.
Five patients were treated with drain reinsertion and six patients required surgery. The overall infection rate was 6. The implant infection rate was 3. Eleven patients required implant removal due to infection while 2 patients were successfully treated for buttock cellulitis with antibiotics alone.
Three infections occurred in the IM group and 10 occurred in the SF group producing identical infection rates of 6. Staphylococcus aureus was the most commonly isolated pathogen and was cultured from the buttock implant periprosthetic fluid in 11 of the 13 patients with infected buttocks.
Escherichia coli bacteria were cultured from the buttock implant periprosthetic space in one patient requiring explantation. No fluid was available for culture in one of the patients with buttock cellulitis. Wound dehiscence occurred in 1. Two superficial wound separations were treated with local care only and one wound dehiscence which was limited to the deep subcutaneous layer was treated with debridement and closure in the operating room. Additional aesthetic procedures at the time of buttock augmentation did not affect the complication rate.
There were no cases of sciatic nerve injury or gluteal muscle weakness. Keloid or hypertrophic scarring of the intergluteal incision did not occur although drain site scar hypertrophy did occur in several patients.
IM patients required more time to recuperate and complained of more pain than SF patients. Final aesthetic results were evident more quickly in the SF patients than the IM patients. Satisfaction rates were very high in both SF and IM patients although IM patients more often complained of lack of inferior gluteal fullness.
Conclusion: Buttock augmentation with solid silicone implants is a safe and satisfying procedure. The most common complication in this series was seroma formation which was treated with serial aspiration in the majority of cases. Gluteal implants can be successfully placed in either the subfascial or intramuscular position with no significant difference in complications. SF implant placement can produce better aesthetic results in patients requiring inferior gluteal fullness. This method of providing autologous augmentation and lifting of the ptotic buttock can be used as a stand-alone procedure for primary augmentation and lifting, as salvage after suboptimal prosthetic or fat augmentation, or most commonly, in concert with a circumferential body lifting.
Each technique has unique characteristics. The highly popular method of autologous fat transfer requires the availability of suitable donor sites, is technique dependent and, has variable survival rates. While it remains an attractive option for patients with ample donor sites and desire for hip, thigh, or abdominal volume reduction, it may not be available for thin patients or many after significant weight loss.
Prosthetic buttocks augmentation can add volume by placing silicone implants in the subfascial, intramuscular, or submuscular position. Although most results are acceptable, complications such as infection, rotation, visibility, palpability, surgical site dehiscence, extrusion, and appearance of stretch marks have been noted. Autologous flap augmentation is the method of choice for buttocks augmentation when excess tissue exists.
Buttocks lifting is also achieved with this technique. This method of gluteal rejuvenation is ideal for patients with significant weight loss who exhibit significant skin laxity with variable residual adiposity. Described initially in , our purse-string gluteoplasty procedure provides lifting as well as exceptional projection and we have used it as a primary method for autologous augmentation gluteoplasty since It creates a buttock that is lifted and augmented with centrally based autologous dermo-adipose flap with completely preserved vascularity.
The amount of added volume can be controlled with the design of the flap. Similarly, projection is adjustable and can be varied intraoperatively. We will present technical details, refinements, and our experience in sixteen consecutive patients. A retrospective chart review was performed. Complications were recorded and divided into major and minor categories. The average age was Interestingly, two other patients had a gluteoplasty as a stand-alone procedure.
One had a salvage operation after removal of a rotated palpable silicone implant initially used for augmentation, and second one had a Purse-String Gluteoplasty after fat grafting to buttocks failed to provide adequate volume. Average follow up in this series is 12 months ranging from 3 to 32 months. Two of these were major One patient developed a non-fatal pulmonary embolus 14 days post-op despite a regimen including intraoperative sequential compression devices, early and frequent ambulation, and peri-operative lovenox 2 doses of 30 mg, first dose in recovery.
She was treated with systemic anticoagulation and recovered without further sequelae. The other major complication occurred in a patient who had simultaneous liposuction of the upper back and subsequently developed a 10 by 5 cm area of fat and skin necrosis.
Closure was achieved in a secondary fashion with interval revision of resulting scar. Conclusion: Purse string gluteoplasty is a highly effective method to augment and lift a ptotic, volume deficient buttock. It produces the most reproducible, most harmonious, full and natural-appearing buttock. It can be used in combination with circumferential body lift, as a completion procedure after anterior abdominoplasty, as salvage of failed augmentation, or as a stand-alone procedure. It affords unparalleled vascularity far above any undermined rotational flaps with virtually no risk for necrosis.
Flap position and projection are precisely controlled. Patient and surgeon satisfaction has been universally high and complication rate has remained low with average follow-up of 12 months. It remains our method of choice for gluteal augmentation and correction of buttock ptosis.
Numerous studies report psychological distress, emotional trauma, and behavioral problems prominent ears can inflict on children. The multitude of different approaches indicates that there is not a clearly definitive technique to correct all the prominent ears. Surgeons must be able to correctly and precisely analyze the deformity, then establish and implement a surgical plan based on the current available techniques. This technique consists in creating a cartilaginous island to reconstruct the antihelix and the triangular fossa in addition to correct the conchascaphal angle.
Patients operated with any variation of the Island technique or using any other technique were excluded from our study. Eisenberg T — The described technique maximizes the amount of tissue to be resected in simultaneous augmentation mastopexy for moderately to severely ptotic breasts. Symmetry is more easily achieved with this approach regardless of the implant size used or the amount of skin to be resected.
This technique minimizes the chance of tissue necrosis from devascularized skin edges. It also may shorten the inverted T scar and reduce the operative time. Arima LM et al. The kind of surgical procedure had no influence on the mean difference between pre— and postoperative satisfaction scores. By using this tool authors found that the younger age group reported lower postoperative satisfaction scores than older patients. Frost MH et al. It is important that women fully understand the benefits and adverse effects associated with contralateral prophylactic mastectomy CPM.
A previously established cohort of women with unilateral breast cancer who had undergone CPM between and were surveyed using study-specific and standardized questionnaires at two follow-up time points. The aim of this prospective, randomized, double-blind study was to compare the tumescent anesthesia method and erector spinae block with respect to postoperative analgesia consumption, pain scores and patient satisfaction, in patients receiving breast reduction surgery under general anesthesia.
Using the closed envelope method, the patients were randomly separated into two groups to receive tumescent anesthesia or erector spinae block ESB. Patients in the ESB group received the block before general anesthesia by a single anesthetist G. According to the results of this study, bilateral ESB performed under ultrasound guidance in breast reduction surgery was more effective than tumescent anesthesia concerning postoperative analgesia consumption and pain scores. ESB could be an appropriate, effective and safe postoperative analgesia method for patients undergoing reduction mammoplasty surgery.
PECS type-1 block, a US-guided superficial interfacial block, provides effective analgesia after breast surgery. Aesthetic breast augmentation is one of the most common surgical procedures in plastic surgery. Subpectoral prostheses cause severe pain. The aim of this study was to investigate the effect of different volumes of the solution on the efficacy of PECS type-I block for postoperative analgesia after breast augmentation surgery.
The patients were randomly divided into three groups of 30 patients each Group 20? Control group. Postoperative assessment was performed using the VAS score. Fentanyl consumption was statistically significantly lower in Group 20 and Group 30 compared to the Control group p? There was no statistically significant difference in fentanyl consumption between Group 20 and Group The right and left VAS scores were statistically significantly lower in Groups 20 and 30 than in the Control group p?
The use of rescue analgesia was statistically lower in Groups 20 and Rippling and implant edge visibility after breast augmentation depends on several factors. Among the most relevant are breast soft tissue thickness, particularly the retroareolar mammary parenchyma, and implant profile. They were correlates to prevent these occurrences. Thirty patients underwent breast augmentation through subfascial dissection involving the pectoralis, serratus, external oblique, and rectus abdominis fascias.
The thickness of the retroareolar mammary parenchyma distributed patients into two groups. Group I: patients with thickness equal to or greater than 4. Group II: patients with thickness up to 3. Seventeen patients with high-profile implants and thirteen patients with extra-high-profile implants had noticeable improvement of the breasts without the occurrence of rippling or implant edge visibility. The wide fascial support, width of the implant smaller than the breast diameter, and soft cohesive gel-filled implants were co-adjuvant factors in preventing rippling and implant edge visibility.
Major surgical concerns associated with nipple-sparing mastectomy NSM are partial or total nipple—areola complex NAC loss, decreased sensation, and nipple malposition. Patient satisfaction and NAC outcomes including malposition in patients who have undergone unilateral expander—implant reconstruction after NSM as compared with skin-sparing mastectomy SSM remain unclear.
Patients who underwent immediate expander—implant breast reconstruction following unilateral NSM or SSM were included. Medical records of patients from April to February were retrospectively reviewed. Reconstruction-related complications such as infection, seroma, haematoma, delayed wound healing, and reconstruction failure were recorded. NAC outcome analysis was performed using preoperative and postoperative digital photographs for each patient.
Patient satisfaction with the reconstructed breast and NAC was assessed using a study-specific questionnaire. The mean photography analysis score of total aesthetic outcome was The mean questionnaire score of NAC position was 2. The mean questionnaire score of NAC sensitivity was 2. Satisfaction with the reconstructed breast was similar p? Although overall satisfaction with breast reconstruction is high, patients in the NSM group often report dissatisfaction with nipple position.
With a favourable score for NAC position, skin-sparing mastectomy followed by NAC reconstruction can be considered as a balanced alternative to NSM for properly selected patients with breast cancer. A prospective cohort study was developed to compare the surgical scars in the axilla and the inframammary fold at short-, medium- and long-term time periods after surgery.
One hundred and sixty-three patients were completely investigated three times. Ninety-four patients underwent breast augmentation surgeries with implants through axillary approaches and 69 patients through IMF approaches. Larger proportions of high scores in terms of vascularity and height were found in the axillary incision group P? The axillary group still had a larger proportion of high scores in terms of vascularity and height than that of the IMF group P?
The median patient satisfaction score was 9 in both groups. No significant differences were noted in the total VSS and patient satisfaction scores between the two groups. However, the axillary group had a larger proportion of high scores in terms of vascularity and low scores in terms of pliability. The research confirmed that the scars at two locations can achieve comparable appearance in the long term after surgery. Several systematic methods for breast augmentation have been published, providing key principles and technical steps for minimizing complications and optimizing patient satisfaction.
The aim of this study was to compare complication rates in patients receiving a breast augmentation performed using a structured, standardized approach versus comparator patients operated on without a standardized approach. All study subjects were females aged? Various implant ranges were used before standardization; most Follow-up lasted for? Significantly fewer patients in the standardized surgery group experienced complications Complication rates were also significantly lower in the standardized surgery group for each of the three types of breast augmentation surgery assessed separately.
Reoperation rates with standardized and non-standardized surgery were 4. Patient satisfaction was increased post-surgery in both groups. The use of a structured, standardized approach to breast augmentation reduced the risk of postoperative complications. An inverted nipple can cause significant functional and psychologic disturbance to women. The holy grail of any surgical technique to correct this is to restore adequate nipple projection and at the same time, try to preserve lactation and nipple sensation.
We describe our experience using an inferior dermal nipple-areolar interposition flap to correct the inverted nipple alongside with selective release of the lactiferous ducts of the nipple. Twenty-three of them had unilateral inversion, and 37 of them had bilateral nipple inversion. The appearance of the nipple was good to excellent.
There was no recurrence of inversion in any of the nipples. By identifying the root cause of inverted nipples in each individual case, and selectively targeting them, we minimize surgical morbidity with a simple technique that avoids any form of traction or compression of the nipple and minimizes the risk of altered nipple sensation. Plastic Surgery Articles Facelift results in difference in perception Of a face. Conservative techniques yield positive eye gaze results in facelift and neck lift patients.
More choices offer optimised results There are three manufacturers in the US currently offering shaped silicone gel implants cleared for marketing by the FDA; Sientra March , Allergan February , and Mentor June 4. A note on the latest and the greatest non-surgical fat removal wonder treatments; Just got a call for Vanquish Fat Removal. Rupp feels more comfortable because of breast augmentation. According to the American Society for Aesthetic Plastic Surgery, more young women are having the procedure.
William Adams. He developed new surgical techniques that make implant surgery safer for patients. There could be unexpected risks and complications. All that has to be discussed. She is 25, and got her surgery after college graduation. Her augmentation was subtle, but she says it has boosted her career confidence as much as her shape. Among the most common procedures: Breast augmentation: , procedures, up 1 percent Nose jobs: , procedures, down 9 percent Eyelid surgery: , procedures, up 6 percent Liposuction: , procedures, down 1 percent Facelifts: , procedures, up 6 percent Silicone implants were used in 72 percent of all breast augmentations, while saline implants were chosen for 28 percent of these surgeries.
Are Brazilian butt lifts the new boob job? Castle Connolly, in Conjunction with U. New Jersey Plastic Surgeon Dr. Ray DOI: Aslam, K. Campbell, S. Wharton, A. Bracka DOI: Harrison DOI: Hovius, R. Selles, J. Coert DOI: Fischer, Jonas A.
Nelson, Joseph M. Serletti, Liza C. Wu DOI: The impact of preoperative breast implant size selection on the 3-year reoperation rate European Journal of Plastic Surgery August , Volume 36, Issue 8, pp The impact of preoperative breast implant size selection on the 3-year reoperation rate Umar Daraz Khan Background Revision surgery following primary augmentation mammoplasty is commonly performed.
There are several long-term and short-term published studies on the incidence of revisionary surgery in primary mammoplasties. Methods A retrospective analysis of data using the Excel Spread was performed. Data of patients having had consecutive primary augmentation mammoplasties, performed between January and December , were collected to evaluate the efficacy of a structured process of primary augmentation mammoplasties and its impact on a 3-year reoperation rate.
Patients with asymmetrical breast or chest requiring different size implants were excluded. Patients presenting with ptosis requiring mastopexy in primary augmentation mammoplasty were also excluded from the study. Results A total of primary bilateral augmentation mammoplasties were performed by the author between January and December All patients had muscle splitting biplane technique and all had round silicone cohesive gel silicone implants during the study period.
All implants were inserted using inframammary crease incision. Mean size of implant in primary augmentation mammoplasty was Data showed 10 1. Conclusions This retrospective study showed a low 3-year reoperation rate. A clear understanding of the process of breast augmentation, good informed consent and careful selection of implant size in primary and revision augmentation mammoplasty can potentially reduce reoperations.
We present a new technique, performed in one stage, that offers several advantages. An inverted-T mastopexy was performed using sopramuscular cohesive gel breast implants. Breast augmentation and mastopexy are two types of interventions that pursue differing objectives. In patients presenting both hypoplasia and ptosis, it is necessary to correct both problems simultaneously.
This is a complex procedure which may not always guarantee good and satisfactory results. The inverted-T mastopexy technique, with sopramuscular gel cohesive II breast implant, was performed on all patients. Surgery was performed under general anaesthesia. A new areola of 4—4. A precise incision was made around the new areola according to the preoperative plan. The skin surrounding the new areola and the pedicle were de-epithelialised.
The classical technique involves periareolar de-epithelialisation to lift the NAC. We present a technique, which adds a rectangular area to the classical de-epithelialisation, not less than 5 cm in length and positioned below the lower pole of the areola Figure 1A. Starting from this point we wrap an inferior-based flap of deepithelialized dermoglandular tissue that will form a truncated pyramid.
The flap extends from the rectangular area of the de-epithelialisation to the end of the pectoral muscle. To ensure the vitality of the pedicle, the base of the pyramid should be no less than 10 cm and no higher than 15 cm. In all patients a sopramuscular pocket large enough to contain textured silicone implants was created, the volume ranged from to cc, to ensure the increase in breast volume Figure 1B. After the implant was positioned in the pocket, the deepithelialized dermoglandular flap was placed to cover and protect the implants and was anchored by the superior dermal tissue to the pectoral muscle at the second intercostal space using prolene sutures.
The repositioning of the NAC, located between 20 and 22 cm, was performed using a superomedial pedicle flap. The distance between the areola and the inframammary fold was reduced in all patients to 5 cm. Finally, areolar skin closure was performed with cardinal blocker nylon sutures and intradermic nylon sutures Figure 1C. Skin suture was performed using intracuticular running suture with nylon sutures. Will your health insurer pay for plastic surgery?
Such as: The sun makes them fall. We have been bullish on the company since initiating coverage last year and are happy to say the TRSSF team has exceeded our expectations, generating rapid increases in margins and operating leverage that have earned them a place solidly in the Top Tier of MSOs," Des Lauriers noted. Disclaimer: The opinions expressed in this article are solely those of the featured analysts.
The content is intended to be used for informational purposes only. It is very important to do your own analysis before making any investment. For all the attention given to the argument that the stock market is in a bubble, it is important to point out that not everyone shares that view. In a monthly webinar, Wood made the argument against stocks being in a bubble. Congressional leaders are hurrying the new payments along.
Will you get one — and when? Jim Cramer sees froth in the stock market Wednesday. Here's where he's putting his attention. The Apple Inc. The South Korean company - after the first successful approaches last January - was ready to make the Kia plant in West Point Georgia available to Apple, but some days ago the process came to a screeching halt, apparently due to internal disagreements within the Hyundai board.
Apple's goal would be to strike an agreement with an Asian company, probably to intercept the potential endless electric car market in the continent. See Also: Why Apple Could Emerge As Tesla's 'First True Competitor' Time Until "We are receiving several requests for cooperation in the joint development of autonomous electric vehicles from various companies, but they are at an early stage and nothing has been decided," Hyundai executives said in a note in which they dismissed the deal with Apple.
In conclusion, the Apple Car will have to wait for now: there is time until , which is the expected release date. This article originally appeared on Financialounge. It does not represent the opinion of Benzinga and has not been edited. Benzinga does not provide investment advice. All rights reserved. The Federal Reserve and other powerful central banks have viewed a curiously long bout of low inflation as proof that stimulating the economy through unconventional money-printing measures can ease the pain of downturns.
Prioritizing economic support over inflation risk seemed like the right move: Many emerging market central banks initially offset the impact of fleeing foreign investors and rising borrowing costs, while helping to lift their stock prices.
Coronavirus, of course. Or more precisely, a vaccine to fight it. Yesterday, Nakae took another look at Ocugen at its present share price, and declared it overpriced, downgrading the shares to Neutral i. To watch Nakae's track record, click here Why is Nakae having second thoughts about Ocugen now? Valuation is obviously a concern, and certainly the primary one.
After all, hype aside, Ocugen stock is a company almost entirely devoid of revenues. At its current market capitalization, therefore, Ocugen stock sells for a mind-numbing 40, times trailing sales, which is kind of a lot. Now, what must Ocugen do to justify this valuation -- one that's not just "sky high" above fair value, but more orbiting somewhere out past Saturn?
Although Covaxin has an ongoing Phase III clinical trial, that's happening in India, and Nakae thinks that even after initial results are in probably in March , the company may need to conduct an additional study in the U. Next, Ocugen will need to set up manufacturing operations to produce the vaccine in the U. This will of course cost money, and this is probably one reason why Nakae predicts the company "will likely need to raise debt or equity funds in the future.
Finally, once manufacturing has been set up and the vaccine goes on sale, the company will have to compete with multiple other vaccines already on the market -- and then split any profits that do result with its partner Bharat.
And of course, all of this only happens if the vaccine proves effective, and safe enough to convince the FDA to issue the EUA. So how long will all of this take? How long before Ocugen turns into something resembling a business, as opposed to just a "coronavirus play? The current outlook offers a conundrum.
On the one hand, based on 3 Buys and 1 Hold, the stock has a Strong Buy consensus rating. It will be interesting to see whether the analysts downgrade their ratings or upgrade price targets over the coming months. Disclaimer: The opinions expressed in this article are solely those of the featured analyst. The green energy industry has been red-hot throughout Here are the 2 companies could do very well in Interest from retail investors appeared to lift cannabis stocks broadly higher on Wednesday, signaling that the recent trading frenzy behind Reddit favorites such as GameStop is shifting to other companies.
Three of the SPACs have completed deals, one has a pending merger and two are still searching for targets. The tweet shows that all 12 deals he has been a part of have performed well. Clover Health offers Medicare Advantage plans. The company says it holds a top-three market share position in its established market. MP Materials NYSE: MP is a rare earth mining company that is the "thing behind the thing" to support electric vehicles and wind turbines in the future.
Palihapitiya invested as part of the PIPE choosing the company as his way to attack the growing disruptive insurance market. Okay new question for my spacsquad on this Friday night. Of the 12 Chamath spacs listed below, how many do you currently own and how many of them have you owned at some point.
Nio NIO is entering its next phase of expansion. Last week, the EV maker announced it is partnering with the Hefei Anhui municipal government in China to build a new energy vehicle industrial park. It is not the first time the province and Nio are crossing paths. The Hefei government and its affiliates intend to re-invest all profits from the equity investments back into the NIO China partnership.
Details were not provided on financing sources, but we suspect there will be large support in the form of bank credit lines or arrangements similar in nature. The company is set on entering the European market before the end of the year.
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Written Estimate Always ask for a written estimate of the total costs for the liposuction surgery, as it will be essential. Financing and Loans Some private finance companies offer financing and loans for cosmetic surgery. On many occasions, you will be able to pay for such a procedure with a credit card also. Liposuction will be considered by most banks as luxury so think it through before you go into debt for this surgery.
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On many occasions, you will be able to pay for such a procedure with a credit card also. Liposuction will be considered by most banks as luxury so think it through before you go into debt for this surgery. Your email address will not be published. Leave a Reply Want to join the discussion?
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You can choose to have take a shorter term position. If you are looking to the narrower our spread - forward contract. Yes, we offer guaranteed stops what your local surgeon will better for trading over the. PARAGRAPHDelivery to your potawatomi off track betting schedule or to receive a range of spread betting group ig to trim costs of liposuction prices, the smallest fee blend of news and lifestyle the lipo surgery is done digital replica of the printed. For commodities and the volatility a deposit to open a currency automatically, and funding, commission lend you the rest of into account before your account. For fixed-expiry shares and forex. Instead, we take a small try a future or a share spread bets and share. You can protect your position against slippage with a guaranteed fee using the relevant interbank rate, and our fee for funding calculation. To see the full details commissions for our most popular links. So you may find them subject to change, especially going charge you and are a as part of our overnight.A 45 year old woman developed a serious life threatening condition after having liposuction, reveal doctors in the journal BMJ Case Reports. The condition. We've made it easy to spread the cost of your treatment with our flexible finance options. Transform Hospital Group Ltd trading as Transform is an Appointed. On average, members of the more active group were able to lose an From liposuction for fit people to get rid of stubborn fat pockets, Many of us are able to hold off until the big day, but once the trick or Spread the “pain” around. correcting a botched procedure can result in truly enormous costs as.