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10. Tangential Excision of Rhinophyma with the Disposable Razor Blade: Simple and Cost Efficient with Aesthetically Good Results

Author

Kiehlmann, Marcus Vishal, Morandi, Evi M., Kühn, Shafreena, Spennato, Stefano, Schloßhauer, Torsten, Djedovic, Gabriel, and Rieger, Ulrich M.

Subjects
mesh:Rhinophyma is a benign disease that afflicts mostly males in their 50th–70th decade. Surgical therapy in rhinophyma includes various techniques and devices. We would like to report on our experience with the tangential excision with a disposable razor blade. Nine patients were treated within 3 years. The use of a disposable razor blade in the surgical treatment of rhinophyma is inexpensive, easy, and yields excellent aesthetic results, rhinophyma, tangential excision, Original Article, Razor blade
Abstract

Medical therapies for rhinophyma have been described but these only delay progression. Therefore, surgery is the method of choice. Plenty of modalities have been described including cold-knife surgery, electrosurgery, hydrosurgery, laser-assisted treatments, and dermabrasion. Settings and Design: In this two-center study, patients’ charts and photodocumentation were analyzed retrospectively. Materials and Methods: Surgery was performed under general anesthesia with an additional local anesthesia of the affected areas of the nose. We removed the hypertrophic tissue in thin layers with a sterile disposable razor blade under constant visual control of the underlying cartilage and adnexal structures. A dressing with Mepithel and gauzes was applied. Patients presented weekly to monitor the wounds. Follow-up was 1 year. Results: From 2016 to 2019, nine male patients with rhinophyma underwent surgical therapy at AGAPLESION Markus Hospital, Frankfurt am Main, Germany and at the Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Austria. The mean age of the patients was 66 years. Mean time to complete re-epithelization equaled 31.5 days. No recurrences were noted within the follow-up period of 1 year. Patients’ satisfaction was very high. Only one patient had hypertrophic scars at the wing of the nose and another one developed a superficial fistula without connection to the nasal cavity. Conclusion: To the best of our knowledge, this is the first case series describing the use of a disposable razor blade for rhinophyma treatment supporting its efficiency described in previous anecdotal publications. We can highly recommend the technique, as it is cost-efficient and simple and provides excellent aesthetic results.

Published
2021

15. Otoplasty through ventral skin incision and shaping of the antihelix by abrasion - a retrospective study

Author

Kühn, Shafreena, Wöhler, Nadine, Wehle, Andrej, Küenzlen, Lara, Rothenberger, Jens Martin, Sader, Robert Alexander, Lemperle, Gottfried, Rieger, Ulrich, Kühn, Shafreena, Wöhler, Nadine, Wehle, Andrej, Küenzlen, Lara, Rothenberger, Jens Martin, Sader, Robert Alexander, Lemperle, Gottfried, and Rieger, Ulrich

Abstract

(1) Background: Protruding ears are the most common auricular malformation affecting approximately 5% of the population. One common factor leading to auricular protrusion is a deficiency or total absence of the antihelix. A technique first described by Gottfried Lemperle in 2003 attempts cartilage thinning, folding, and fixation by non-absorbable mattress sutures after ventral skin incision along the ventral helical rim. (2) Methods: Retrospective analysis of patient records was performed for otoplasties according to this technique, performed between 1985 and 2014 at Agaplesion Markus Hospital in Frankfurt, Germany. All recorded complications were examined. (3) Results: A total of 912 single otoplasties were performed according to this technique from 1985 to 2014. Overall complications included 26% minor complications not requiring further surgery and 11% major complications leading to revision surgery. Within those requiring revision surgery, the most common reason was recurrence of auricular protrusion (5%), followed by suture granulomas (5%) and hematomas (2%). (4) Conclusions: Lemperle’s otoplasty technique addresses the open thinning and shaping of the antihelix through a ventral incision along the helix to prevent irregularities and possible ridges. Results show a low complication rate comparable to data found in published studies. This technique is easy to perform, safe, and avoids often seen contour irregularities of the antihelix compared to techniques with a posterior approach.

Published
2021

20. Analyse von mehr als 600 konsekutiven Abdominoplastiken - Demographie, Komplikationen, Ergebnisse

Author

Kiehlmann, Marcus, Schloßhauer, Torsten, Jung, Diana, Kühn, Shafreena, and Rieger, Ulrich M.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Die Abdominoplastik ist an unserer Klinik eine der häufigsten postbariatrischen Operationen, sie wird aber auch aus ästhetischen Gründen oder als Zweiteingriff im Rahmen des Verschlusses des Hebedefekts bei autologer Brustrekonstruktion durch DIEP-Lappenplastik durgeführt. Wir möchten[zum vollständigen Text gelangen Sie über die oben angegebene URL], 50. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 24. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2019
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21. Mastectomy in female-to-male transgender patients: A single-center 24-year retrospective analysis

Author

Kühn, Shafreena, Keval, Seirah, Sader, Robert Alexander, Küenzlen, Lara, Kiehlmann, Marcus, Djedovic, Gabriel, Bozkurt, Ahmet, Rieger, Ulrich, Kühn, Shafreena, Keval, Seirah, Sader, Robert Alexander, Küenzlen, Lara, Kiehlmann, Marcus, Djedovic, Gabriel, Bozkurt, Ahmet, and Rieger, Ulrich

Abstract

Background: Mastectomy in male transgender patients is an important (and often the first) step toward physical manhood. At our department, mastectomies in transgender patients have been performed for several decades. Methods: Recorded data were collected and analyzed for all male transgender patients undergoing mastectomy over a period of 24 years at our department. Results: In total, 268 gender-reassigning mastectomies were performed. Several different mastectomy techniques (areolar incision, n=172; sub-mammary incision, n=96) were used according to patients’ habitus and breast features. Corresponding to algorithms presented in the current literature, certain breast qualities were matched with a particular mastectomy technique. Overall, small breasts with marginal ptosis and good skin elasticity allowed small areolar incisions as a method of access for glandular removal. In contrast, large breasts and those with heavy ptosis or poor skin elasticity often required larger incisions for breast amputation. The secondary correction rate (38%) was high for gender reassignment mastectomy, as is also reflected by data in the current literature. Secondary correction frequently involved revision of chest wall recontouring, suggesting inadequate removal of the mammary tissue, as well as scar revision, which may reflect intense traction during wound healing (36%). Secondary corrections were performed more often after using small areolar incision techniques (48%) than after using large sub-mammary incisions (21%). Conclusions: Choosing the suitable mastectomy technique for each patient requires careful individual evaluation of breast features such as size, degree of ptosis, and skin elasticity in order to maximize patient satisfaction and minimize secondary revisions.

Published
2019

22. Implant Replacement or Removal: What Happens after Capsular Contracture? A German Study Examining Breast Implant Revision Surgery and Patient Choices in 946 Cases.

Author

Kühn, Shafreena, Georgijewitsch, Mara Anna, Wehle, Andrej, Billner, Moritz, Küenzlen, Lara, Rothenberger, Jens, and Rieger, Ulrich Michael

Subjects
CONTRACTURE (Pathology), FOREIGN body reaction, SURGICAL complications, MAMMAPLASTY, RETROSPECTIVE studies, BREAST implants, REOPERATION, DESCRIPTIVE statistics, DATA analysis software, WOMEN'S health
Abstract

Introduction: Capsular contracture most often leads to implant revision surgery for aesthetic or reconstructive purposes. However, little is known about which operation is chosen when revision surgery has to be performed. We performed analysis of revision indications and performed revision surgery considering implant removal or replacement and additional surgical procedures. To our knowledge, this study presents the largest German single-center analysis regarding implant revision surgery after the onset of complications. Methods: Retrospective 10-year data analysis of a single-center population undergoing breast implant revision surgery. Results: Capsular contracture was the most frequent finding before reoperation, both removal and replacement (p < 0.05). It was linked to longer duration of in situ implant placement (p < 0.05) and more frequently in reconstructive patients (p < 0.05). Implant replacement was performed more often before definite implant removal for reconstructive patients (p < 0.05). Mean duration of in situ implant placement before definite removal was lower for reconstructive patients (p = 0.005). Overall reconstructive patients were older than aesthetic patients (p < 0.05). After implant removal, 61.7% of aesthetic patients chose to undergo mastopexy, 54.7% of reconstructive patients opted for autologous breast reconstruction, and 25.4% did not choose an additional surgical procedure after implant removal. Conclusion: Significant differences are observed for reconstructive and aesthetic patients regarding indication leading to revision surgery, time of revision surgery, and the type of performed revision surgery itself. After implant removal, more than 60% of aesthetic patients undergo mastopexy, more than half of reconstructive patients choose autologous breast reconstruction, and over a quarter of patients choose no additional surgical procedures. [ABSTRACT FROM AUTHOR]

Published
2021
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23. Behandlung einer ossären Sprunggelenks-Tuberkulose - Von der Diagnose zur interdisziplinären Therapie inklusive mikrochirurgischer Rekonstruktion

Author

Schloßhauer, Torsten, Priepke, Eckhard, Rehart, Stefan, Kühn, Shafreena, Jahn-Mühl, Bernhard, and Rieger, Ulrich

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einleitung: Die Knochen-TB stellt als extrem selten auftretende Form der Tuberkulose eine besondere Herausforderung hinsichtlich der Sanierung und Defektdeckung dar. Die Therapie besteht in einem radikalen Débridement bzw. der Resektion aller betroffenen ossären und Weichteilstrukturen. Die[zum vollständigen Text gelangen Sie über die oben angegebene URL], 49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2018
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24. Multimodale Untersuchung zur Nervenregeneration bei Transsexuellen (Frau zu Mann) mit freier, mikrovaskulärer Arteria radialis-Lappenplastik zur Phalloplastik

Author

Rieger, Ulrich, Kasper, Lara, Kühn, Shafreena, Nasim, Sahra, van Neerven, Sabien, Wirthmann, Anna, and Bozkurt, Ahmet

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Zu den geschlechtsangleichenden Operationen im Rahmen einer Transsexualität feminin zu maskulin gehört die Konstruktion eines Neophallus mit taktiler und erogener Sensibilität. Unser "Goldstandard" hierfür ist ein freier, neurovaskulärer Arteria-radialis-Lappen mit[zum vollständigen Text gelangen Sie über die oben angegebene URL], 49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2018

25. Explantationen und Mehrfachwechsel von Brustimplantaten am Agaplesion Markus Krankenhaus Frankfurt zwischen 2006 und 2016 - Eine retrospektive Analyse

Author

Kasper, Lara, Kühn, Shafreena, Georgijewitsch, Mara, Schloßhauer, Torsten, Djedovic, Gabriel, and Rieger, Ulrich M.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Wir untersuchten alle Mehrfachwechsel und definitiven Entfernungen von Brustimplantaten die zwischen 2006 und 2016 am AGAPLESION Markuskrankenhaus Frankfurt am Main durchgeführt wurden. Eingeschlossen wurden alle Patientinnen mit ein- oder beidseitig einliegenden Brustimplantaten ästhetischer[zum vollständigen Text gelangen Sie über die oben angegebene URL], 49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2018
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27. Outcomeanalyse nach Mastektomie bei Gynäkomastie mittels modifiziertem Breast Q: Form schlägt Narbe

Author

Wirthmann, Anna, Sattler, Amelie, Kühn, Shafreena, Wellenbrock, Sascha, Hüttinger, Susanne, and Rieger, Ulrich M.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Die operative Therapie der Gynäkomastie besteht häufig in einer subcutanen Mastektomie über verschiedene operative Zugangswege. Ziel dieser Studie war es herauszufinden, wie zufrieden Patienten mit dem postoperativen Erscheinungsbild nach einer Gynäkomastie Operation,[zum vollständigen Text gelangen Sie über die oben angegebene URL], 48. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 55. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie, 22. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2017
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28. Oberschenkelstraffung nach massivem Gewichtsverlust - eine retrospektive Analyse hinsichtlich Indikation, Operationstechniken und Komplikationen

Author

Kühn, Shafreena, Klettenheimer, Alana, Hüttinger, Susanne, and Rieger, Ulrich M.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einführung: Mit zunehmender Bedeutung post-bariatrischer Operationen, stehen neben Straffungsoperationen im Rumpfbereich speziell Straffungseingriffe der Extremitäten im Vordergrund, hierbei insbesondere die Oberschenkelstraffungen (OS).Am AGAPLESION Markus Krankenhaus Frankfurt werden horizontale[zum vollständigen Text gelangen Sie über die oben angegebene URL], 48. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 55. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie, 22. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2017

29. Mikrochirurgische Phallusrekonstruktion bei Intersexualität und nach Peniskarzinom - Indikationsstellung und operative Technik

Author

Schloßhauer, Torsten, Kühn, Shafreena, Hüttinger, Susanne, and Rieger, Ulrich M.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einleitung: Ziele der Phallus-Rekonstruktion sind die Fähigkeit des Urinierens im Stehen, die Kohabitationsfähigkeit sowie normales Erscheinungsbild im Nacktzustand. Hier sollen zwei seltenere Indikationen, die Phalloplastik bei Intersexualität sowie nach Penisamputation, dargestellt [zum vollständigen Text gelangen Sie über die oben angegebene URL], 48. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 55. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie, 22. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2017
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30. Patientenzufriedenheit nach Mastektomie bei transsexuellen Patienten (Frau-zu-Mann) - Eine Analyse mittels modifiziertem BREAST Q Fragebogen

Author

Kühn, Shafreena, Dashti, Morssal, Wirthmann, Anna, Hüttinger, Susanne, and Rieger, Ulrich M.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einführung: Die Mastektomie (ME) stellt oft den Auftakt einer Reihe von Operationen dar, die im Rahmen von Geschlechtsanpassungen bei transsexuellen Patienten Frau-zu-Mann (FzM) durchgeführt werden. Vorhandene Studien weisen auf eine hohe postoperative Patientenzufriedenheit hin [ref:1],[zum vollständigen Text gelangen Sie über die oben angegebene URL], 48. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 55. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie, 22. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Published
2017

32. [Patient satisfaction following gender reassignment mastectomy in female-to-male transsexual patients: a questionnaire-based analysis using a modified version of the BREAST-Q].

Author

Kühn S, Wehle A, Kiehlmann M, and Rieger UM

Subjects
Female, Humans, Male, Mastectomy, Patient Satisfaction, Quality of Life, Surveys and Questionnaires, Breast Neoplasms surgery, Mammaplasty, Sex Reassignment Surgery
Abstract

Background: Mastectomy is an essential part of gender reassignment surgery for female-to-male transgender patients. Available studies indicate high patient satisfaction within this patient group; however, a standardised evaluation procedure is yet to be established., Method: Based on the BREAST-Q questionnaire, we developed a modified version targeting issues concerning FM patients; hence, all questions focussing on the physiology of biologically female patients were removed or tailored to address more specific transgender issues. Post-mastectomy transgender male patients from 1991 until 2017 were contacted and evaluated based on the questionnaire. This questionnaire comprises a total of 57 questions regarding general satisfaction with the ches area, as well as specific questions regarding satisfaction with the nipple-areola complex (NAC) and topics regarding expectations, regrets, self-confidence and sex life after mastectomy., Results: Overall, we found a high level of patient satisfaction after mastectomy. The level of regret was low and all patients would repeat mastectomy if needed., Conclusion: For most transgender males, mastectomy plays an essential role in gender reassignment surgery, overall leading to an improved quality of life for this patient population., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Published
2021
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34. Outcome, Complications, and Body Mass Index Correlation of Horizontal and Combined Horizontal and Vertical Thigh Lift: A 16-year Single-center Experience.

Author

Kühn S, Klettenheimer A, Küenzlen L, Kiehlmann M, Schlosshauer T, Djedovic G, and Rieger UM

Abstract

Background: Thigh lift is a procedure used within the aesthetic as well as the post-bariatric field of surgery as it focuses on reducing excess lipodermal tissue within the medial thigh area. Depending on the specific area of excess tissue, common thigh lifting procedures include horizontal (H) and combined horizontal and vertical (HV) tissue reduction., Aims and Objectives: The aim of this study was the analysis of outcome of H and HV thigh lift procedures, including evaluation of comorbidities and complications., Subjects and Methods: Over a 16-year period, all thigh lift procedures performed at our department were assessed for comorbidities and outcome through our hospital documentation system., Results: A total of 151 thigh lifts have been performed over 16 years. Of which, 124 were performed using the HV technique and 27 thigh lifts were performed using H tissue excision only. Of all the patients, 9 of 10 were female, the overall average age was 43 years. Approximately 48% of the HV group of patients had previously undergone bariatric surgery, the mean body mass index (BMI) was 29.3 kg/m 2 for this group. Around 19% of the H patient population had previously undergone bariatric surgery. This group had a mean BMI of 25.1kg/m 2 . Wound-associated problems occurred in 48%, for these patients, surgical revision was necessary for 12%. Remaining excess tissue was an issue for 20% of all patients, for this reason, 14% needed revision surgery. Age was found to be a significant cofactor for wound-associated complications ( P = 0.02) and nicotine abuse for scar-related problems ( P = 0.032)., Conclusion: The rate of overall complication for thigh lifts is high, although surgical revision rate is low. Remaining excess tissue and wound-associated problems are most common, possibly reflecting a too restrictive and radical surgical approach, respectively. Increasing BMI increases the risk for development of complications., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Journal of Cutaneous and Aesthetic Surgery.)

Published
2019
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