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In mastopexy surgery, extra skin and a specific amount of breast tissue are resected. Resected breast tissue is not in a large amount as in reduction surgery. In this study, we have investigated the results of an auto-augmentation mastopexy technique involving use of a superior pedicled mastopexy with conic-shaped inferior butterfly flap for augmentation without implant or fat injection.A total of 80 patients, 40 patients in each group, were included in the study. In the first group, double-pedicled auto-augmentation mastopexy with conic-shaped modified inferior butterfly flap technique was used. In the second group, conventional superior pedicled wise-pattern mastopexy was utilized. The results were evaluated from photographic measurements performed from standardized preoperative and postoperative lateral photographs.No major complications were seen such as partial or total areola necrosis or breast volume loss. None of our patients has made a return with request for revision surgery. Minor complication seen in several patients was resolved with early intervention. The preoperative and postoperative photographic measurements of breast projection, upper pole projection, nipple position and lower pole level from preoperative and postoperative standardized lateral photographs revealed no significant difference between the groups.We obtained highly satisfactory results for our patients. Following the surgery, our patients protected the cup sizes of their bra. In spite of the fact that there was no real augmentation performed in this procedure, effective straightening and the compact breast structure patients that achieved were highly successful in creating an augmented breast image.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Anatomical deformities can greatly alter nasal function, which can be largely corrected during septoplasty and septorhinoplasty operations. In this study, we aimed to objectively measure the results of septoplasty surgeries of deviated noses with radiological analysis and compare the results with clinical evaluations.Forty patients who were undergoing septorhinoplasty were included in the study. Patients were evaluated with preoperative and postoperative paranasal computed tomography scan measurements and satisfaction surveys.Preoperative and postoperative mean ± SD septal deviation angle measurements were 11.9 ± 5.3 degrees and 6.5 ± 3.1 degrees, respectively. Preoperative and postoperative mean ± SD septal deviation distance measurements were 7.3 ± 4 and 3 ± 1.3 mm, respectively. Preoperative and postoperative mean ± SD oblique conchal measurement on the deviated side was 17.3 ± 3.2 and 13.4 ± 2.8, respectively. Preoperative and postoperative mean ± SD patient satisfaction survey scores were 17 ± 1.9 and 4.5 ± 1.9 points, respectively.To obtain a nose with a greatly improved functional gains, especially in heavy deviated noses, is an important goal in septorhinoplasty surgery. It is essential to apply the technique that will benefit the patient. The most important success criterion seems to be the regression of the clinical complaints of the patients, which can be proven objectively with computed tomography scan measurements.

Purpose Prominent ear is common in the White population at a rate of 5%. Many surgical incision and suture techniques have been described for its correction. The purpose of this article was to report the results of the prominent ear surgeries applied in our clinic for the last 5 years and to show the details of the surgical technique, to evaluate long-term results, complications, revisions and to compare them with previously published studies. Materials and methods A total of 27 patients were included in the study. The patient age ranged from 7 to 60 at the time of surgery (mean age: 18.7). Of the 27 patients, 13 were female (48.2%) and 14 were male (51.8%). The procedure was bilateral in 19 cases (70.4%) and unilateral in 8 cases (29.6%). The patients were treated with the same technique by three surgeons. Aesthetic results were evaluated by patient and surgeon surveys. Results The follow-up was between 1 and 5 years (mean: 3 years). The patients very satisfied with the overall appearance of the ears, and the symmetry of the ears was rated as excellent by all patients, parents, and surgeons. Conclusion Regardless of the technique used, patient satisfaction appears to be high. To reduce negative results and prevent recurrence, the authors recommend that the ear is preoperatively evaluated and the treatment algorithm is used accordingly.

In this study, we have evaluated the efficiency of fractional carbon dioxide laser in the treatment of vaginal laxity and urinary incontinence. Thirty patients with vaginal laxity, sexual dysfunction and urinary incontinence complaints were treated with fractional carbon dioxide laser. Results were evaluated with patient questionnaires relating to comfort during the procedure and general satisfaction following the procedure. In the survey regarding comfort during the procedure, 90% (

Random flaps are frequently used in the practice of reconstructive surgery. The aim of this experimental study was to investigate the effects of Allium cepa on random flap survival in rats. Fourtee...

One of the simplest form of surgical delay can be performed by placing an incision around the flap without undermining, prior to flap elevation. In this study, we have compared the efficiency of different patterns of skin incision to improve flap survival. Twenty-eight animals were used in four groups. Incisional delay was performed prior to flap elevation in the three experiment groups. Complete incision of the three flap edges was performed in the all experiment groups with the exception of an intact skin section on the middle 1/3rd of the bilateral edges in group 1 (bilateral skin edge preserved delay: BSEPD), of a unilateral edge in group 2 (unilateral skin edge preserved delay: USEPD) and of the superior edge in group 3 (superior skin edge preserved delay: SSEPD) without any undermining. Two weeks following the delay procedure, dorsal skin flaps were raised and reinserted back to their place. The results were evaluated with the measurement of necrotic flap area, microangiographic imaging and histological evaluation. The mean percentage of necrotic flap area to whole flap area was 16.94%, 7.54%, 23.34% and 50.6% in the BSEPD, USEPD, SSEPD and control groups, respectively. In selected microangiographic images, vessels were more prominent in the delay groups. The results of the study indicate that three sided incision with an intact skin on the superior edge is not effective in providing a sufficient delay and flap survival improvement when compared to incisions with intact skin on the unilateral and bilateral edges.

Aim: Reversing the effects of facial aging is achieved through a combination of the best techniques. Minimizing the appearance of fine wrinkles is an important part of treatment, which can include skin resurfacing, intradermal filling injections, or a combination of the two. The search for the ideal filling material continues, but intradermal fat injections can be a cheap and safe alternative to classic intradermal fillers. This study aims to evaluate the feasibility, validity, and reliability of micrograft, nanofat graft, sharp needle intradermal fat grafting (SNIF) technique.Material and Methods: In this retrospective study, the records of 13 consecutive patients treated over 3 years were reviewed to evaluate the results of the technique including panfacial rejuvenation, contouring, augmentation with fat injection, and its complications. Results: The results were evaluated by clinical examination and patient photographs. Aesthetically good healing was achieved using microfat graft, nanofat graft, sharp needle emulsified fat with intradermal injection techniques, the results lasted more than 1 year, which exceeded the expected time for absorbable dermal fillers (typically 3 to 6 months). No major complications were encountered; the most common minor complications were bruising and swelling.Conclusion: Microfat and nanofat grafts, SNIF, are a safe and effective alternative to conventional absorbable dermal fillers for patients who can accept minor discomfort from donor site fat harvesting. Fat harvesting and injection techniques should be done precisely to achieve proper results and prevent complications, Amaç: Yüz yaşlanmasının etkilerini tersine çevirmek en iyi tekniklerin bir kombinasyonu ile elde edilir. İnce kırışıklıkların görünümünü en aza indirmek, yüzey yenileme, intradermal dolgu enjeksiyonları veya ikisinin bir kombinasyonunu içerebilen tedavinin önemli bir parçasıdır. İdeal dolgu malzemesi arayışı devam etmektedir, ancak intradermal yağ enjeksiyonları klasik intradermal dolgulara ucuz ve güvenli bir alternatif olabilir. Bu çalışmanın amacı mikrogreft, nanogreft, keskin iğne intradermal yağ greftleme (SNIF) tekniğinin fizibilitesini, geçerliliğini ve güvenilirliğini değerlendirmektir.Gereç ve Yöntemler: Çalışmamızda, 3 yıllık bir süre içinde tedavi edilen 13 ardışık hastanın kayıtları panfasiyal gençleştirme, kontür verme, augmente etme amaçlı yağ alma ve verme tekniğini ve komplikasyonlar dahil sonuçlarını değerlendirmek için gözden geçirildi.Bulgular: Sonuçlar klinik muayene ve hasta fotoğrafları ile değerlendirildi. Mikroyağ grefti, nanoyağ grefti, keskin iğne ile emülsifiye edilmiş yağ ile intradermal enjeksiyon teknikleri kullanılarak estetik açıdan iyi iyileşme sağlandı, sonuçlar 1 yıldan fazla sürdü, bu da emilebilir dermal dolgu maddeleri (tipik olarak 3 ila 6 ay) için beklenen süreyi aştı. Hiçbir önemli komplikasyon oluşmadı; en sık görülen küçük komplikasyonlar morarma ve şişlikti. Sonuç: Mikroyağ ve nanoyağ grefti, SNIF, donör bölgesinden yağ alımındaki küçük rahatsızlığı kabul edebilen hastalar için, klasik emilebilir dermal dolgu maddelerine güvenli ve etkili bir alternatiftir. Yağ alma ve enjeksiyon teknikleri uygun sonuçlar elde etmek ve komplikasyonları önlemek için hassas bir şekilde yapılmalıdır.

In female genital rejuvenation and beautification, interest and demand for combined surgical and non-surgical methods are increasing. This study presents the results of our labia minora reduction technique and a vulvovaginal rejuvenation and beautification concept, where a combination of fat injection into the mons pubis and labia majora, if necessary, combined with fractional carbon dioxide (CO2) laser is used. Genital rejuvenation and beautification were performed on 37 patients between January 2014 and January 2019. Postoperative follow-up for 1 year to obtain data on the satisfaction of surgical and non-surgical procedures was performed. Of the 37 female patients included in the study, 33 (94.5%) were satisfied or very satisfied with their postoperative appearance. Thirty (80%) patients were satisfied or very satisfied with functional results. The described genital beautification and rejuvenation technique combines different aesthetic female genital surgery techniques and non-surgical noninvasive procedures. These procedures, like other plastic surgeries and procedures, are designed for the subjective improvement of the patients' appearance and feelings. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Objective: The aim of this study was to compare the outcomes of primary nerve repair using either ethyl-cyanoacrylate orconventional microsuture technique in a rat peripheral nerve injury model.Methods: In this study, a total of 30 Wistar Albino rats weighing between 220 and 275 g were used. The rats were randomlydivided into three groups (10 in each), including one control (group 1) and two experimental groups (group 2, conventionalmicrosuture repair; group 3, cyanoacrylate repair). In each group, the sciatic nerve was identified and transected. No furtherintervention was performed in group 1. The nerve was repaired using the epineural technique with a 10/0 atraumaticnylon in group 2 and synthetic cyanoacrylate adhesive in group 3. At the fifth postoperative week, needle electromyography(EMG) was performed to measure distal latency, combined muscle action potential (CMAP), and motor nerve conductionvelocity (MNCV). Following the EMG recordings, animals were euthanized. Nerve samples were collected to evaluate vacuolardegeneration, fibrosis, and foreign body reaction histopathologically.Results: In the EMG analysis, mean distal latency was significantly shorter in group 1 (0.85±0.09 ms) than in groups 2(1.17±0.25 ms) (p=0.0052) and 3 (1.14±0.14 ms) (p=0.0026) while no significant differences existed between groups 2 and3 (p>0.9999). The mean CMAP was greater in group 1 (10.5±0.35 mV) than in groups 2 (2.86±1.28 mV) (p=0.011) and 3(2.16±1.34 mV) (p=0.0002), but there was no significant difference between groups 2 and 3 (p>0.9999). The mean MNCVwas 53.5±5.95, 39.62±7.31, and 39.84±4.73 mm/sec in groups 1, 2, and 3, respectively. There was a significant differencebetween groups 1 and 2 (p=0.0052) and between 1 and 3 (p=0.0026), but not between 2 and 3 (p>0.9999). In the histopathologicalevaluation, the mean vacuolar degeneration score was 0, 2.12, and 1.88 in groups 1, 2, and 3, respectively. No obviousdifference was observed between groups 2 and 3 (p=0.743). The mean fibrosis score was 0, 1.62, and 1.77 in groups 1, 2,and 3, respectively. There was no significant difference between groups 2 and 3 (p=0.888). The mean foreign body reactionscore was 0, 2.5, and 2.44 in groups 1, 2, and 3, respectively. No difference was present between groups 2 and 3 (p=0.743).Conclusion: Primary nerve repair using the cyanoacrylate adhesive may provide similar electrophysiological and histopathologicalresults as compared to the conventional microsuture repair. WOS:000539165200017 2-s2.0-85086686074

Vatansever, Alper/0000-0002-3632-1020 WOS: 000434304300097 PubMed: 29438203 Introduction:This study investigated the effect of periosteal graft + platelet-rich plasma (PRP) combination on facial bone defect healing. Methods: Five-millimeter critical sized defects in zygomatic arches of 12 adult New Zealand rabbits were created. Rabbits were randomly divided into 3 groups: First group (control group): bone defects of left zygomatic arches of 6 rabbits were wrapped with a silicone tube. Second group (periosteal graft group): bone defects of left zygomatic arches of 6 rabbits were wrapped with periosteal graft. Third group (experimental group): bone defects of right zygomatic arches of 12 rabbits were wrapped with periosteal graft-PRP combination. New bone formation was evaluated at 8th and 16th weeks. One rabbit was sacrificed at 8th week. Remaining 11 rabbits were imaged with 3-dimensional computed tomography (CT) at 16th week; then, zygomatic arches were removed for micro-CT and histologic examinations. Results: Three-dimensional CT analysis at 16th week revealed no significant difference between groups regarding new bone formation (P = 0.232). Micro-CT analysis of new regenerated bone at 16th week displayed significant differences between groups 1 and 3 regarding mean bone volume (BV, mm(3)) (P = 0.028) and mean bone mineral density (BMD, mm(2)) (P = 0.001). There was no difference between groups 2 and 3 or between groups 1 and 2, regarding BV or BMD. Histological Bone Regeneration Scorings at 16th week displayed significant difference between groups (P = 0.015). Negative correlation between 3-dimensional CT and histologic results (r = 0.120); positive correlations between BV/BMD values in micro-CT and histologic results (r = 0.524 and r = 0.456) were found. Conclusions: By enhancing bone formation capacity of periosteal grafts, periosteal graft-PRP combination provided bone formation having more volume and density comparing with silicone tube application. Duzce University Scientific Research Foundation [2013.04.02.179] The authors acknowledge the support of Duzce University Scientific Research Foundation (Project No: 2013.04.02.179).

Random flaps are frequently used in the practice of reconstructive surgery. The aim of this experimental study was to investigate the effects of

Ankarali, Handan Camdeviren/0000-0002-3613-0523 WOS: 000358416900019 PubMed: 24374394 Background Trigeminocardiac reflex (TCR) consists of bradycardia or asystole along with hypotension and apnea coinciding with stimulation of the trigeminal nerve. During rhinoplasty procedures, we noticed that local anesthetic solution (LAS) application to the columellar area results in bradycardia. We planned to conduct a randomized prospective study on 47 patients undergoing rhinoplasty to demonstrate the characteristics of TCR arising from the columella. Method Local anesthetic solution containing 2% prilocaine with 1:80,000 adrenaline was applied under standard general anesthesia protocol. In group 1 (study group, n = 24), 2 mL of LAS was applied to the columella. In group 2 (control group, n = 23), 2 mL of LAS was applied to the nasal dorsum. In group 3 (control group, n = 20), after LAS was applied to nasal dorsum in group 2, we waited for 10 minutes. Then, 2 mL of LAS was applied to the columella. Here, recordings were taken for the columella. Heart rate (HR) and blood pressure (BP) were recorded just before needle insertion (baseline level), at the time of needle insertion (NIT) to the columella or dorsum, and after the 1st, 5th, 10th, 30th, and 60th seconds. Results Transient bradycardia (>= 20% drop in HR) was observed in 33% of the patients in group 1. Decrease in HR compared to the baseline level in group 1 was significantly greater than that of groups 2 and 3 at all times (P

Glomus tumours are benign soft tissue neoplasms. In this paper, we present a case with subungual glomus tumour. Transungual resection was performed to remove tumour. The patient was doing well 6 months after the surgery with no sign of recurrence or nail deformity.

Introduction Facial bone defects are frequently encountered problems in clinical practice. Bone grafts, flaps, and alloplastic materials are often used in their treatment. This leads to donor site morbidity and prolongation of the operation. The authors have planned this study to examine whether adipose tissue derived stromal vascular fraction (SVF) has an osteogenic effect in the critical sized membranous bone defect of the zygomatic bone. Materials and methods Twenty male Wistar Albino rats were used. Bilateral zygomatic arches were opened with lateral incisions. A standard 3-mm bone defect was created bilaterally on the zygomatic arches of the rats. In the experiment side, the stem cell-rich SVF that was obtained by applying centrifugal process to the adipose tissue derived from the inguinal fat pad was injected into the site of the right zygomatic arch bone defect. In the control side, left zygomatic arch was left for secondary bone healing without any treatment after a 3-mm critical bone defect was created. In the postoperative 10th (n:5) and 20th weeks (n:13), the healing areas of bone defects were assessed by a 3-dimensional tomography, and then, the rats were sacrificed and bone healing was examined histologically. Results There were no statistically significant differences on the 10th week results. At the 20th week new bone formation amount calculated from the 3-dimensional computed tomography results was significantly higher in the experiment side (P = 0.033). In the histological examination at the 20th week, there was significantly more callus formation in the experiment side (P = 0.0112). Discussion Stem cells can increase the rate of bone healing by differentiating into certain tissues. It is predicted that adipose tissue-derived SVF rich with mesenchymal stem cells can increase bone healing in facial bone defects and this application could replace the use of bone grafts and flaps in clinical practice. As a result, it is concluded that adipose tissue-derived stem cells can potentiate osteogenesis and reduce the possibility of developing necrosis on the bone ends.

WOS: 000292134600012 PubMed: 21935805 BACKGROUND Proximal phalanx fractures are common. In this study, our preferred methods regarding the treatment of proximal phalanx fractures and their long-term objective results are presented. METHODS Between October 2001 and March 2010, in the Plastic Reconstructive and Aesthetic Surgery Department of Duzce Medical Faculty, we treated 23 patients with 32 proximal phalanx fractures. Stable fractures (n=5) were treated with splints, while unstable fractures (n=27) were stabilized with 1.0 mm percutaneous intramedullary Kirschner wires following open reduction. RESULTS At follow-ups, ranging from 3 months to 9 years, patients were evaluated with radiologic efficiency, range of motion (ROM), total active movements (TAM), and grip power of the digit. TAM scores of 20 fingers were perfect (>= 220 degrees for D2-5, >= 150 degrees for D1), for 7 fingers were good (180-220 degrees for D2-5, 120-150 degrees for D1), and for 5 fingers were either moderate or poor. No difference was observed between grip strength of broken fingers and that of healthy fingers. As a major complication, non-union occurred in one finger. CONCLUSION We concluded that Kirschner wire fixation is a reliable and simple method of treating unstable proximal phalangeal fractures, and excellent long-term results can be obtained in suitable cases. In stable proximal phalanx fractures, splints provide sufficient treatment.

WOS: 000296231200013 PubMed: 22016280 Proliferating trichilemmal (pilar) cysts, also known as pilar tumors, are most commonly found on the scalp of elderly women. Proliferating trichilemmal cysts are rare, slowly growing, lobular masses inherited autosomal dominantly and localized on scalps, and believed to arise due to a complication of a trauma and inflammation, and 5-10% of people are reported to be effected. Herein, we present the case of a 70-year-old woman with a 23-year history of multiple enlarging scalp masses. Clinically, squamous cell carcinoma was considered in the differential diagnosis, and the lesion was totally excised. Our case emphasizes the necessity for detailed clinical and pathological correlation for differential diagnosis.

Total ear amputation is common, and management can necessitate different procedures, especially microsurgical anastomosis. Partial ear amputations supplied by narrow pedicles, however, have been reported rarely. In a subtotally amputated auricle, the chance of survival depends on the vascularization within the pedicle. In our case, the right ear of a 36-year-old male patient was subtotally amputated following a traffic accident, leaving only a 6-mm skin pedicle on the cranial side. The subtotally amputated segment was bleeding from the wound margins. The ear was reattached with primary suture without using microsurgical techniques after optimal debridement. Postoperatively, we administrated dextran 40 for 5 days to improve the microcirculation and increase blood volume and antibiotic to control the infection. No signs of edema, venous congestion or arterial insufficiency were observed immediately after the operation or subsequently. The replanted auricle healed completely with 100% survival, resulting in an essentially normal contour and appearance. This successful result without microvascular anastomoses also points out the anatomical features of the auricular vascular networks.

WOS: 000264457400020 PubMed: 18953594 A 48-year-old female patient presented with gigantomastia. The sternal notch-nipple distance was 55 cm for the right breast and 50 cm for the left. Vertical mammaplasty based on the superior pedicle was performed. The resected tissue weighed 3400 g for the right breast and 2800 g for the left breast. The outcome was excellent with respect to symmetry, shape, size, residual scars, and sensitivity of the nipple-areola complex. Longer pedicles or larger resections were not found in the literature on vertical mammaplasty applications. In our opinion, by using the vertical mammaplasty technique in gigantomastia it is possible to achieve a well-projecting shape and preserve NAC sensitivity.