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Anthropometric measurements of the breasts and their relevant position taken from fixed skeletal points provide a useful tool in the accurate evaluation of patients preoperatively and the assessment of surgical results. This paper presents the clinical correlation obtained by statistical analysis of the results of measurements of 973 women.

Expansion of a mesh skin graft depends on factors pertaining to the graft itself as well as on parameters of the meshing device. With regard to the graft, we examine the efficiency of graft handling and thickness of the skin graft. With regard to the parameters of the meshing apparatus, which determine the expansion ratio: (1) d equals the distance between the cutting blades, which will become the width of the mesh ribbons and is an underestimated parameter for expansion; and (2) L equals the length of cut, which determines proportionally the expansion ratio. This length defines the maximal distance of the raw square of the expanded mesh and therefore the healing time by epithelialization. The authors present a mathematical formula of expansion ratio that allows for an objective comparison of skin meshing apparatuses. It is concluded that optimal mesh skin grafting is based on mathematical principles rather than on inventive instrumentation. Furthermore, an analysis of the mechanical parameters as given by the manufacturers is important in anticipating healing time per expansion ratio.

Merkel-cell trabecular carcinoma of the skin has a prognosis poorer than expected for a small skin lesion. Surgery is central to actual treatment. A wide excision is indicated for localized disease. For selected cases we believe that an extensive resection of the draining lymphatics in continuity with the tumor should be performed. We have called this procedure "lymphangiectomy" in comparison to lymphadenectomy when the lymph nodes are removed. An early diagnosis and prompt treatment can contribute to improve the survival for this aggressive skin tumor.

A technic of combined split-thickness and full-thickness skin grafts and local flap closure for extensive deep cicatricial neck contractures is presented. The head and neck are mobilized by excision of limiting tissues. The lateral neck skin is mobilized to be rotated anteriorly as flaps, and a full-thickness skin graft is applied to the central neck. Split-thickness skin grafts are placed below the full-thickness graft and flaps, and also above the full-thickness graft over the horizontal part of the neck. The success of this technic relies upon the limited contracture of full-thickness skin grafts, mobilization of lateral neck tissue, and consideration of regional units of the neck. This relatively simple operation results in a dramatic and lasting improvement of the neckline, good range of motion of the head and neck, elimination of multiple operative procedures, and early rehabilitation of the patient.

The frequency of hair transplantation for treatment of male alopecia is increasing, and much time is consumed in free scalp plug removal and implantation. The amount of time depends upon the number of grafts required. Plugs ranging in diameter from 2 to 4 mm are recommended since larger sizes have increased fibrosis and decreased hair growth. Composite grafts show greater survival when cooled; therefore, a method of local hypothermia and 5.5 mm scalp plugs were used in this study. The lowered temperature of the recipient site during the early postoperative days permitted the use of the larger grafts without fibrosis, hematoma, or infection and with improved hair growth. This technic allows better quality of hair growth, requires fewer hair plugs, and decreases operating time.

Free transplants of hair-bearing scalp as "plugs" or "strips" are an adequate treatment for male alopecia. Cooling the grafts eliminates hematoma and infection and allows successful take and growth of larger plugs. However the result of grafting wide hairstrips is unreliable.