VIEWS: 23 PAGES: 10 POSTED ON: 11/10/2011
AEsthetic Surgery 1. Cervicofacial lift with vertical suspension T. Bratu, D. Grujic, Z. Crainiceanu, G. Nwachukwu 2. Our protocol in face rejuvenation T. T. Mugea 3. The open rhinoplasty for bifid nose T. Stamate 4. Halfopen rhinoplasty in nasal lobul malformations T. Stamate 5. Some indications for open rhinoplasty Al. V. Georgescu, C. Moraru, Ileana Matei 6. A sequential graduated anatomic nose surgery from transcartilaginous to external (open) approaches" C. Stan, S.Popescu 7. Breast augmentation – our experience T. Bratu, D. Grujic, D. Olariu, D. Mihajlovic 8. The breast reduction using the superomedial technique and fixation of the dermal inferior pedicle T. Bratu, D. Grujic, D. Olariu, D. Mihajlovic 9. Mammopexy and breast augmentation with implants placed completely in the retromuculoaponevrotic pocket. T. Bratu, S. Olariu, P. Matusz, D. Grujic 10. Diminishing of the clinical appearance of capsular contraction in augmentation mammoplasty Al. V. Georgescu, C. Moraru, Ileana Matei 11. Breast augmentation combined with mastopexy N.Antohi, V.Stan, C.Stingu 12. Surgical management of gigantomastia N.Antohi, C.Stingu, V.Stan, G.Hodarnescu, S.Nae 13. Vertical scar mastopexy with dermoglandular flap transposition. N.Antohi, V.Stan, C.Stingu, Carmen Orban. 14. Cosmetic augmentation mammoplasty – anatomic mamar implants versus round implants Ileana.Boiangiu, D.Calota, L.Banacu, C.Brezeanu,T. Panazan 15. Rehabilitation after surgical breast . It is a need? Sandra Dan, L. Galosi, T. Bratu, P. Matusz, Gh. Noditi, Z. Crainiceanu, Daciana Grujic, Mihaela Mastacaneanu. 16. "Sparring" soft tissue mono RF rejuvenation in the brow-upper and lower eyelid region C.Stan, S.Popescu 17. Liposuction. Removal of fat with the tumescence technique (Maag's solution) C. Chertif, M. C. Chertif 18. Limitations, approach, adjuvants and expectations in body contour aesthetic surgery Noela Elena Ionescu, I.P. Florescu S. Marinescu, Carmen Giuglea 19. Aesthetic Surgery – publicity deontology and postoperative results management Toma T. Mugea 20. Surgical treatment of axillary hyperhydrosis D. Totir, M. Leventer 1. Cervicofacial lift with vertical suspension T. Bratu, D. Grujic, Z. Crainiceanu, G. Nwachukwu Brol Medical Center Timisoara, Romania In the past years we have been trying to find a face-lift technique that will bring about a good and stable result for a period of time and, on the other hand, to reduce the surgical risk of the patient as well as stress. Thus, after the elevation of the necessary skin from the SMAS , a plicaturation and vertical traction of the SMAS is done using a 2-0 Vicryl suture. The first suture is placed between the posterior edge of the platysma muscle and the pretragal ligament. Then, additional 3-4 sutures are placed on a horizontal line parallel to the zygomatic arch. The skin is closed in horizontal and posterior orientation, avoiding suture tension that may lead to vicious scars. 2. Our protocol in face rejuvenation T. T. Mugea The visible morphologic changes associated with the ageing process are: - reduction of bony structure - diminution of skin thickness and elasticity - lessening of subcutaneous fat tissue volume - gravitational fall of soft tissues - appearance of skin wrinkles in the adherence areas with deep structures and also in the areas of muscles insertion Therapeutical principles: As a matter of fact there are seven available elements in the process of face rejuvenation: - stimulation of muscular tonus and of lymphatic drainage through: • microdermabrasion combined with vaccumatic massage, phototherapy and electrostimulation - improvement of local metabolism and revitalization of skin structures through: • mesotherapy - correction of dynamic wrinkles through supervised and temporal paralysis of the involved muscles through: • injection of botulinic toxin - microscopic abrasion proceeding of the skin and improvement of the skin features through: • chemical peeling or • laserpeeling - repositioning of ptosed structures with mini invasional threads - removal of skin excess and repositioning deep structures through: • surgical lifting, and - restoration of needful volumes of the cheeks or lips through: • resorptive materials • non resorptive materials 3. The open rhinoplasty for bifid nose T. Stamate U.M. „Gr.T. Popa" Iasi Plastic Surgery and Reconstructive Microsurgery Clinic Clinical Emergency Hospital Iasi Contact e-mail: firstname.lastname@example.org The "bifid nose" is a rare congenital anomaly, part of the median clefts – deformities that goes from the simple enlargement of the vermillon up to major skeletic malformations, frequently associated with hypertelorism. Of the 14 cranio-facial clefts described by Tessier, the pairs 0-14, 1-16, 2-12, 3-11 and 4-10 include nose lobule malformations. For the bifid nose, pathognomonic is the central sulcus in the center of the lobule, which can be associated with a partial or complete separation of the osteo-cartilagineous skeleton in the axis of the nose, resulting either a bifid nose with a central depression with variable depth or even two completely separated half-nose. Miller (1999) deals efficiently with the bifid nose by skin excision, exploring de viso all possible ways to bring closer the distant structures, with skin suturing in the axis of the dorsum. The widest excision is in the lobule area, where the nose has its largest segment. The personal; technique proposed by the author and applied in two patients has the advantage of avoiding any scar in the midline of the lobule, using only a columellar incision as in the open rhinoplasty. 4. Halfopen rhinoplasty in nasal lobul malformations T. Stamate U.M. „Gr.T. Popa" Iasi Plastic Surgery and Reconstructive Microsurgery Clinic Contact e-mail: email@example.com Rinoplastia semideschis` în malformatiile lobulului nazal T. Stamate U.M. „Gr.T. Popa" Iasi, Disciplina de Chirurgie Plastica si Reconstructiva 5. Some indications for open rhinoplasty Al. V. Georgescu, C.Moraru, Ileana Matei Clinical Rehabilitation Hospital, Cluj-Napoca Contact e-mail: firstname.lastname@example.org Despite of the fear of the close approach rhinoplasty, there are some special categories of patients in which open rhinoplasty is mandatory. We will refer to the patients coming for congenital or posttraumatic nasal displasya, with deformations of the nasal pyramid and cartilaginous modifications especially on the septum level. In this situation, septorhinoplasty and open approach are followed by a better reshape, especially of the tip of the nose and, in the same time, by the excision of some components which eventually can be reused for obtaining the best aesthetic and functional result. Cateva indicatii ale rinoplastiei deschise Al. V. Georgescu, C.Moraru, Ileana Matei Spitalul clinic de recuperare, Cluj-Napoca 6. A sequential graduated anatomic nose surgery from transcartilaginous to external (open) approaches" C.Stan*, S.Popescu** *Medical Service Clinic, Bacau, Romania *, ** Clinical Emergency Hospital Bucharest To get a satisfactory surgical result in the eyes of both patient and surgeon, the last one needs a large technical knowledge in the surgery of the nose. In this communication, on a study made between January 1999 and December 2004, on 728 cases, the author tries to find the most characteristic difficult nose (primary and secondary) and to identify between closed and open approach the different surgical ways to get a good result. The surgeon must have a graduated, sequential incremental anatomic approach and the procedure selected is that dictated by the anatomy encountered where minimal deformities needs less invasive techniques and major deformities are approached more aggressively. In the surgery of the tip of the nose, one of the most difficult parts of aesthetic surgery, the definition and analysis of a deformity is the first step o a good final outcome. After a thorough case study and previous other authors and own experience the most common deformities are: 1. wide tip 2. tip with low definition 3. overprojected tip 4. under-projected tip 5. downward rotated tip 6. upward rotated tip 7. asymmetric tip 8. abnormal tip shapes (boxy, ball tip, parenthesis tip) Each factor gets a "value" between ideal, minor, moderate and major deformity. Deeply connected with preoperative analysis is the selection of the operative planning. According to the previous tip analysis, the surgical technique is a sequential selection approach. 1. minor deformities are treated by closed incision with or without sutures. 2. moderate deformities are treated by open approach and tip excision with sutures 3. major deformities are treated by open approach and tip excision with sutures and grafts for so called tip complex structures. The study was made in the last 6 consecutive years on 728 cases; 156 patients were treated through open approaches and 572 by closed tip surgery. Having clear ideas on deformities and appropriated surgical techniques, the accuracy and quality of the results was improved in one of the most difficult and most challenging part of aesthetic surgery. 7. Breast augmentation – our experience T. Bratu, D. Grujic, D. Olariu, D. Mihajlovic Brol Medical Center, Timisoara, Romania Augmentation mammaplasty remains one of the most common operation in the field of aesthetic surgery. Material and method This presentation is based on a 10 years study ( 1995-2005) and makes references to the evolution of tendencies in surgical techniques ( incision, placement of the implant ) , types of implants, patients follow-up and long-term satisfaction degree . Conclusions In the last three years we used only anatomic coesive gel implants , by inframammary approach. the abord was through the lateral edge of pectoralis muscle, Followed by the section of the inferior costal and sternal insertions. Also we try to persuade the patients that a smaller implant gives in time a better result, avoiding the thinning of the tissues and visualisation of the implant. We consider that a good and long term result depends on the surgeon experience, the quality of the implant and the postop follow-up. 8. The breast reduction using the superomedial technique and fixation of the dermal inferior pedicle T. Bratu, D. Grujic, D. Olariu, D. Mihajlovic Brol Medical Center, Timisoara, Romania Although it has been described more than 100 techniques and variations of breast reduction, based on the principal vascular pedicles, we prefer the superomedial pedicle technique because it is safer, doesn’t give us emotions concerning the vascularization of the mammary gland and nipple areola complex. We prefer to combine the superior pedicle technique with the superomedial pedicle technique based on anatomist’s studies that confirmed that the internal thoracic artery with his branches have a relativelly constant distribution ( 74%). For obtaining a long time stabile result we anchored the inferior dermal pedicle at the fourth intercostal space level, creating an anatomic glandular bra. This technique has proved to be safe and doesn’t put at risk the gland and areola vascularization, even in wide excisions ( over 2000 g ) in gigantomasties. 9. Mammopexy and breast augmentation with implants placed completely in the retromuculoaponevrotic pocket. T. Bratu, S. Olariu, P. Matusz, D. Grujic Brol Medical Center Timisoara With references to the combinations of both techniques for the achievements of a good and stable result , there is always been a controversy. Some surgeons prefer to perform at first mammopexy and after about 6-9 months augmentation, while others perform augmentation and after 3- 6 months mamopexy. The controversy related to the first approach is that there is a wide sacr because of the pressure exerted by the implants. In literature, we describe a technique for the correction of ptotic and hipoplastic breasts. This technique combines mamopexy with superomedial pedicle technique with mammary augmentation placing the implant completely in a musculoaponevrotic pocket. It is known that in cases with a small and moderate grade of ptosis, periareolar mamopexy has been used to lift the NAC, but in most cases after operation the areola remains in inferior orientation making it necessary for mastopexy or reintervention. In case of moderate and severe ptosis, we underline the necessity of correction at the same time of the voilume and the projection using the combination of the two techniques with a good aesthetic and dureble result. Thus, the implant is placed in a vasculoaponevrotic pocket created by the dilaceration of the pectoral muscle and after the introduction of the implant the muscle is sutured. The pressure exerted on the scars is smaller and the implant being sustained by the newly created bra. 10. Diminishing of the clinical appearance of capsular contraction in augmentation mammoplasty Al. V. Georgescu, C. Moraru, Ileana Matei Clinical Rehabilitation Hospital, Cluj-Napoca Contact e-mail: email@example.com One of the most frequent belated complications after the augmentation mammoplasty is capsular contraction. Unfortunately it isn’t still found any kind of prosthesis of which presence in human body can cause a minimal capsular retraction. We are convinced, as statistics show; that the capsular contraction appears in the majority of the cases, but it is clinically evident only in few. We will try to present one of the multiples modalities which can enhance the tolerability of the capsular contracture secondary changes and to reduce negative implications concerning aesthetic result. 11. Breast augmentation combined with mastopexy N.Antohi, V.Stan, C.Stingu U.M.Ph. "Carol Davila" Hospital for Plastic Surgery and Burns, Bucharest Contact e-mail: firstname.lastname@example.org In many clinical situations, breast augmentation is difficult because of initial severe breast ptosis. Correction of ptosis cannot be achieved by implants only. In this paper we present 32 patients with breast augmentation combined with mastopexy (round- block, vertical scar, inverted T, L). Indications, results, complications are overviewed. 12. Surgical management of gigantomastia N.Antohi, C.Stingu, V.Stan, G.Hodarnescu, S.Nae U.M.Ph. "Carol Davila" Hospital for Plastic Surgery and Burns, Bucharest Contact e-mail: email@example.com Surgical management of gigantomastia is always a challenge for plastic surgeons. Besides the aesthetic considerations, gigantomastia always affects the patient in many physical and psychological ways. There are some surgical techniques proffered which are outlined in this paper. In 10 patients results, complications and aesthetic outcomes are discussed. 13. Vertical scar mastopexy with dermoglandular flap transposition. N.Antohi, V.Stan, C.Stingu, Carmen Orban. U.M.Ph. "Carol Davila" Hospital for Plastic Surgery and Burns, Bucharest Contact e-mail: firstname.lastname@example.org Mastopexy should result in a short and less visible scar assuring a good shape and nice appearance of the breast. The purpose of this paper is to present our experience in short scar mastopexy with vertical infraareolar dermoglandular flap, analysing the results and establishing indications and possible contraindications. We have used this technique in 41 cases. In all cases nipple-areolar complex was transposed on the superior pedicle. The infraareolar dermoglandular flap was folded behind the nipple-areolar complex and anchored at the level of 3rd rib to the prepectoral fascia serving as a biological breast implant. The inferior pole of the breast was created by suturing of the lateral and medial pillars. The new iframammary fold was usually placed 2-3cm above the old one. It converted the lower pole breast skin to chest skin. Vertical scar never exceed the new inframammary fold. The results were appreciated as good in 37 cases and satisfactory in 4 cases. There were no unsatisfactory results. Complications included one haematoma and one local skin slough along the vertical scar. Revision of the vertical scar was performed in two cases. In conclusion, vertical scar mastopexy using infraareolar dermoglandular flap significantly improves the shape and projection of the breast not leaving a horizontal scar. It proved to be a safe and reliable method and good addition to the mastopexy methods. Better results were achieved in grade one and two of breast ptosis. In severe ptosis with skin laxity we prefer to convert the vertical scar in J-fashion to obtain a better shape of the breast. 14. Cosmetic augmentation mammoplasty – anatomic mamar implants versus round implants Ileana Boiangiu, D. Calota, L. Banacu, C. Brezeanu, T. Panazan Clinical Hospital for Plastic Surgery and Burns, Bucharest Contact e-mail: email@example.com This paper is presenting a comparative analysis (without statistic involvement) between anatomical and round mammary implants in cosmetically mammary augmentation. Comparing criteria are: augmented upper pole breast aspect, lower pole augmented breast projection, implant dynamic, harmonious and adequate balance adjusted to thorax dimension, correction/lessening preoperatory asymmetry, ptosis correction, implant shell borders palpability or visibility, patient satisfaction, neutral surgeon evaluation. The aim is not a pleading for one or other implant, but the underlining of initial and perspective criteria that has to be considered in choosing the mammary implant form. 15. Rehabilitation after surgical breast . It is a need? Sandra Dan, L. Galosi, T. Bratu, P. Matusz, Gh. Noditi, Z. Crainiceanu, Daciana Grujic, Mihaela Mastacaneanu. Breast cancer is the most common neoplasm ¨in this century’s women¨, yet very little information is available about the reabilitation needs of these patients. Mastectomy will remain a way of treatment for breast cancer, in spite of efforts to perform more breast-conserving treatment. Although mortality rates from breast cancer are declining, many breast cancer survivors will experience physical and psychological sequela that affect their every day life (significant diferences were observed in the scales ¨self acceptance of the body image¨). The place of the physical therapist is inquestionable in the interdisciplinary team. It is important both for the doctor and for the patient to know WHEN, WHAT, HOW, the physical therapist could help a patient to regain functional use of her upper limb on the affected side, and to adapt functionally, psychologically, and emotionally to the loss of her breast and to the diagnosis of cancer, in the shortest time possible. 16. "Sparring" soft tissue mono RF rejuvenation in the brow-upper and lower eyelid region C.Stan*, S.Popescu** *Medical Service Clinic, Bacau, Romania *, ** Clinical Emergency Hospital Bucharest Objective: To review and appreciate our results and the surgical technique benefits in aesthetic surgery of the upper eyelid-brow interface region, doing mobile tissue incision and dissection with 4.0 Mhz RF generator and a special surgical tool called Micro Mono Bleph RF Forceps. Methods: The of 4.0 Mhz radio wave surgical technology is discussed in a multimedia presentation with a review of histological studies and a comparison with the cold scalpel, 0.6 Mhz classical electro-surgical unit and other RF Low frequency devices ( 1.7Mhz). Based on our experience and clinical observation during the last 10 years, using the scalpel and the classical electrosurgery unit for surgery of upper and lower eyelid and our 7 years experience using high radiofrequency, we had noticed clear differences and advantages of radio surgery technique as less bleeding with simultaneous hemo stasis, pressure less incision in a special area with very lax skin, minimal safety precautions needed compared with lasers, les post surgical pain and faster healing. An important element of RF technology is the active electrode. A special innovative device designed as a modification of a small bipolar forceps is called Micro Mono Bleph RF forceps for cutting, dissecting and simultaneously prospective hemo stasis who gives more. 17. Liposuction. Removal of fat with the tumescence technique(Maag's solution) C. Chertif, M. C. Chertif COSMEDICA Plastic Surgery Center, Baia Mare Liposuction is one the most frequently performed operations in aesthetic surgery. In men liposuction is primarily requested for the abdominal area. In women it is for the lateral and medial thigh, buttocks and hips ("saddle area").The tumescence technique was first published at the beginning of the 1990 by Jeff Klein. Lidocaine was used as local anesthesia. In view of the toxicity, we carried out a large study that showed that the aesthetic plastic surgical tumescence technique with lower doses of Pritocaine solution (maag's solution) produces the same results with lower incidence of complications. 18. Limitations, approach, adjuvants and expectations in body contour aesthetic surgery Noela Elena Ionescu, I.P. Florescu S. Marinescu, Carmen Giuglea Plastic, Reconstructive and Aesthetic Surgery Department, Clinical Emergency Hospital “Bagdasar-Arseni” Bucharest Contact e-mail: inoela @yahoo.com Fat tissue deposits means an actual problem, induced by two factors: heredity and diet. In our experience we tried various methods of body contour improvement: liposuction, mini-abdominoplasty, abdominopalsty, redistribution of fat tissue, breast augmentation, breast reduction, mastopexy, penis enlargement. Doesn’t matter the method of choice, we performed our best to avoid risks and complications like skin irregularities, prolonged edema, hematoma, seroma, scars, pain, asymmetry, patient dissatisfaction etc. Our paper presents few cases, adjuvants methods for this type of surgery and our conclusions after an obvious improvement in body self-image in all the situations. 19. Aesthetic Surgery – publicity deontology and postoperative results management Toma T. Mugea 20. Surgical treatment of axillary hyperhydrosis D. Totir, M. Leventer Dermastyle Clinic Bucharest Treatment of axillary’s hyperhydrosis can be accomplished with the botulinic toxin or using surgical procedures. A simple liposuction in the axillary’s area does not provide satisfactory results and the recurrence risk and the degree of unsatisfaction of the patient is relative high, so attention must be paid to use special canullae and a specific technique. This study is made on a group of 34 patients operated in the clinic in the last two years and demonstrates the method efficiency. The procedure is not risks or incidents free which are also evident in this study.
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