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Background Many authors have researched ways to optimize fat grafting by looking for a technique that offers safe and long-term fat survival rate. To date, there is no standardized protocol. We designed a “hydraulic system technique” optimizing the relationship among the quantity of injected fat, operative time, and material cost to establish fat volume cutoffs for a single procedure. Methods Thirty-six patients underwent fat grafting surgery and were organized into three groups according to material used: standard, “1-track,” and “2-tracks” systems. The amount of harvested and grafted fat as well as material used for each procedure was collected. Operating times were recorded and statistical analysis was performed to establish the relationship with the amount of treated fat. Results In 15 cases the standard system was used (mean treated fat 72 [30–100] mL, mean cost 4.23 ± 0.27 euros), in 11 cases the “1-track” system (mean treated fat 183.3 [120–280] mL, mean cost 7.63 ± 0.6 euros), and in 10 cases the “2-tracks” one (mean treated fat 311[220–550] mL, mean cost 12.47 ± 1 euros). The mean time difference between the standard system and the “1-track” system is statistically significant starting from three fat syringes (90 mL) in 17.66 versus 6.87 minutes. The difference between the “1-track” system and “2-tracks” system becomes statistically significant from 240 mL of fat in 15 minutes (“1-track”) versus 9.3 minutes for the “2-tracks” system. Conclusion Data analysis would indicate the use of the standard system, “1-track,” and “2-tracks” to treat an amount of fat

Background Phimosis is the inability to retract the preputium downward over the glans penis. Despite the various techniques of preputial plasty described in literature, the most performed surgical treatment is still the conventional circumcision. Methods In this paper we retrospectively reviewed data of a homogeneous population of 36 consecutive adult patients who underwent phimosis correction by circumcsion with dissection of the Deep Fascia. Patients were followed up by one independent plastic surgeon that measured penis length and circumference in nonerected state preoperatively and at 6 month time postoperatively. Results The Wilcoxon Signed Rank Test showed a significant (p Conclusions In conclusion, the ancillary technique we described leads to an increase of penis size, is safe and easy to perform and does not increase significantly operative time nor complication rate to the conventional procedure.

Introduction. The concept of beauty has always been important for man, if we think that cosmetics existed in ancient times and the body care had a crucial role. Among various techniques to repair physical defects exist lipofilling, that is an explant of fat tissue from a part of body and the implant in other areas; however, autologous fat graft is not very simple and often it causes damages to the cells. The procedure used is Coleman’s technique and, in literature, we find many variations of this method to overcome its limitations such as reabsorption of the implanted cells, formation of oil cysts and fibrous tissue. Today, there are some works that study what kind of modifications we can find utilizing Coleman’s technique but no one of these analyses with SEM the alterations that may suffer the fat. Therefore, our work is to evaluate changes induced by this procedure and to validate SEM for analyses of the tissue explanted. Materials and Methods. From 10 clinical surgeries of lipofilling we used: a) fragments of adipose tissue taken with Coleman’s technique. These fragments were divided in: untreated specimen, sedimented specimen for 15 minutes and centrifuged specimen at 1500 rpm for 3 minutes. Purpose of sedimentation and centrifugation was to remove blood and tryglicerides released by adipocytes during explants; b) a biopsy specimen of adipose tissue taken from the site of graft, as a control. Each fat graft specimen was freshly washed in PBS, fixed in glutaraldehyde and osmium tetroxide and observed at SEM FEI Quanta 200 in low vacuum. Results. The technique of lipofilling we studied causes different types of damage on the adipocytes during liposuction. The modifications we observed compared to control are: presence of oily surface veil, above all detectable in sedimented specimens and in centrifuged specimens; a reduction of the numbers of adipose cells up to 50% and an augmentation of damages to cell membrane about in 20% of adipocytes of centrifuged fragments. There aren’t differences of diameter of the cells after sedimentation and centrifugation. In the three observed specimens about a 90% of adipose cells with a normal structure without changements of volume and a 10-20% of altered cells was found. Conclusions. We can say that adipose tissue during fat graft has some modifications mainly due to the technique utilized. It justifies the higher engraftment of sedimented specimens compared to those centrifuged. We can say also that SEM in low vacuum can be easily applied to study new methods of lipofilling to improve Coleman’s technique., Italian Journal of Anatomy and Embryology, Vol 116, No 1 (Supplement) 2011

Implant-based breast reconstruction represents the most popular procedure for the treatment of women undergoing skin-sparing mastectomy. In selected patients, it allows for obtaining an excellent appearance of the reconstructed breast with great satisfaction to the patient. However, aesthetic and functional results can be affected by complications requiring reoperation. Among them, rippling is an undesired occurrence associated with implant-based reconstruction. It consists of a cutaneous manifestation, visible and/or palpable, of the implant wrinkles and edge which appear mostly when the patient leans forward. To treat this contour deformity, several techniques have been described such as acellular dermal matrices and autologous tissues. In this study, we intend to add the serratus anterior fascial flap within the autologous options in the treatment of implant rippling, reporting our experience.

Congenital or acquired thrombophilia is observed in 10–15% of the general population; therefore, careful screening is carried out in patients at higher risk of venous thrombo-embolism (VTE). High risk of VTE is a contraindication in patients undergoing abdominoplasty. We evaluated rivaroxaban, an oral Xa inhibitor, with enoxaparin, a subcutaneously low molecular weight heparin (LMWH), in 48 female patients with documented thrombophilia, undergoing thrombo-prophylaxis after abdominoplasty. Patients were stratified into two groups according to thrombo-prophylaxis procedure: enoxaparin Group (n = 28) and rivaroxaban Group (n = 20). Hematologic outcomes were evaluated including VTE and hematoma. No episodes of VTE occurred in both groups; two patients during their course of enoxaparin presented severe hematoma for drainage and hemostasis revision. This study suggests that abdominoplasty, in patients with thrombophilia, in combination with thrombo-prophylaxis can be performed safely. Rivaroxaban was as effective as LMWH for preventing VTE, with only a moderate risk of clinically relevant bleeding. More research is needed to determine the optimal timing and duration of prophylaxis in patients undergoing plastic surgery.