Comparison of objective and subjective evaluation of breast symmetrization results in patients with Poland syndrome.

INTRODUCTION: There are many methods of analyzing the appearance of the breasts, but most of them are based on the patient's subjective assessment or on the opinion of a specialist panel. Anthropometric measurements enable objective breast evaluation. The aim of the study was to compare the objective and subjective evaluation of aesthetic results of breast symmetrization in patients with Poland syndrome. MATERIAL AND METHODS: The analysis of the results of the treatment was performed in 7 patients treated surgically due to unilateral breast underdevelopment in Poland syndrome. In the postoperative assessment, the following features were considered: 1 - breast volume, symmetry of: 2 - nipple areola-complexes (NAC), 3 - inframammary folds (IMF), 4 - upper poles (UP). The subjective assessment performed by the patient included each of the listed features and the overall satisfaction with the results of symmetrization on the 10-point Likert scale. Then, objective metric breast analysis was performed. RESULTS: Overall assessment of postoperative breast asymmetry (mean 8.1) indicates a high level of patients' satisfaction with breasts symmetrization. An objective analysis showed that the average breasts' difference in volume was about 36 cc and the difference in NAC location was about 1.2 cm. CONCLUSION: 3D imaging is helpful in planning breast symmetrization procedures, especially in breast prostheses' selection. Combination of this method with clinical experience results in good postoperative effects.

[Total upper and lower eyelid reconstruction using an expanded forehead flap supplied by the frontal branch of superficial temporal artery]. / Rekonstrukcja tkanek miekkich obu powiek za pomoca plata z czola opartego na galezi czolowej tetnicy skroniowej powierzchownej.

Eyelids form the protective eye apparatus. Loss of upper or lower eyelid can lead to infection, vision impairment or even blindness. Although there are many techniques for upper or lower eyelid reconstruction, there are only few articles to report simultaneous reconstruction of both eyelids. The aim of this study is to present a two-stage eyelid reconstruction method using the forehead flap. A 60-year-old woman was admitted to our Department with animal bite wounds in the left periorbital area. During the first operation, the eyelid defect was covered with forehead flap and in the second stage, horizontal incision was created in the flap above the eyeball to form a palpebral fissure. During this two-step surgical treatment, both eyelids of the left eye were reconstructed. The length and width of palpebral fissure were 30 mm and 14 mm, respectively. The patient was satisfied with the surgery outcomes. Reconstruction of both eyelids with forehead flap supplied by the frontal branch of the superficial temporal artery provides the elementary protection to the eyeball, enables vision preservation and offers good aesthetic result.

[Surgical treatment of malignant eyelid tumors]. / Chirurgiczne leczenie zlosliwych nowotworów powiek.

UNLABELLED: Eyelid tumors constitute 5 to 10% of all skin malignancies. They mostly affect the elderly, chronically exposed to sunlight. The primary treatment is radical surgical excision of the tumor. The aim of this study was the clinical and microscopical analysis of malignant eyelid tumors in treated patients, the presentation of selected reconstructive methods and the evaluation of long-term results of surgical treatment of eyelid tumors. MATERIAL AND METHODS: The study involved 92 patients treated in 2000-2007 for malignant tumors of the eyelids. All patients underwent surgical excision of the tumor with concurrent eyelid reconstruction. The choice of reconstructive method depended on the size and location of the tumor. Histopathological evaluation was carried out specifying the type of cancer and radical surgery. The long-term results were rated on the basis of medical records and patients' examinations. RESULTS: Tumors were located mostly within the lower eyelid 67 (70.5%) and the medial canthus 17 (17.9%). Basal cell carcinoma was found in 83 (87.3%) cases, while in 12 (12.7%) diagnosed with other, less common cancers. Histopathological verification of tumor margins revealed incomplete excision in 14 specimens (14.7%). Reoperations due to recurrent tumor was performed in 11 (15.6%) cases. Good long-term results of functionally-aesthetic reconstruction of the eyelids was observed in 84 (91.3%) patients. CONCLUSIONS: 1. Basal cell carcinoma is the most common malignant tumor of the oculopalpebral region and originate mainly in the lower eyelid. 2. Significantly higher risk of recurrence exists in a more aggressive form of BCC (infiltrative basal-cell carcinoma) and tumors located in medial canthus. 3. The knowledge of multiple reconstruction methods allows the surgeon to choose the most appropriate one, depending on the size and location of the defect formed after excision of the tumor.

Giant epidermal cyst of the occipital area.

Epidermal cyst is the most commonly observed cutaneous tumor. It usually involves the scalp, neck, face, back, and trunk. A commonly seen epidermal cyst is usually a slow-growing tumor of a diameter of 1-2 cm. Cysts with a diameter of more than 5 cm have rarely been reported in the literature. Herein we report a case of a giant epidermal cyst localized in the scalp of the occipital area, diagnostic problems and therapeutic proceedings.

[Long-term aesthetic results of rhinoplasty in congenital nose deformities--comparison of surgeon's and patient's evaluation]. / Odlegle wyniki estetyczne chirurgicznego leczenia wrodzonych znieksztalcen nosa--porównanie oceny pacjenta i chirurga.

INTRODUCTION: Nose as the most projected face structure focuses the biggest people's attention. Nasal localization causes that even its small deformities are visible and subjected to different opinions. Rhinoplasty is one of the most common procedures in plastic surgery and at the same time one of the most difficult operation in facial surgery. The aim of this research is to analyze the long-term aesthetic results of rhinoplasty in congenital nose deformities in evaluation performed by surgeon and patient. MATERIAL AND METHOD: The study was carried out in the group of 50 patients operated on in the Department of Plastic, Reconstructive and Aesthetic Surgery due to congenital nose deformity. The group consisted of 38 women and 12 men, aged from 27 to 56 years. Long-term aesthetic results' evaluation was performed on the basis of clinical examination done by doctor and questionnaire filled in by patients and surgeon. RESULTS: Evaluation of long-term results after aesthetic rhinoplasty in patients' opinion qualified the effects as very good in 70%. In surgeon's opinion such a result was obtained in 62% of patients. Satisfactory result of performed operation was marked by 92% of patients while surgeon qualified results as a satisfactory in the group of 88%. Reoperation was considered by 12% of patients and doctor such a necessity reflected in 10%. CONCLUSIONS: Satisfactory results of rhinoplasty in congenital nose deformities are possible to obtain while taking the degree and type of deformity into consideration and choosing proper surgical method. Surgical procedures in congenital nose deformities give good aesthetic results in patients' and as well as surgeon's opinions. Doctor evaluates surgical results in more critical way.

Should we say NO to body piercing in children? Complications after ear piercing in children.

BACKGROUND: The popularity of body piercing procedures is increasing around the world. The trend for body ornamentation is not free from risks. The percentage of various complications following such procedures is growing. The aim of this paper is to present a rare complication after earlobe piercing, which happened to a child. MATERIALS AND METHODS: A 7-year-old girl was admitted to the Department of Plastic, Reconstructive and Aesthetic Surgery complaining of inflammatory lesions, caused by the presence of foreign bodies in both of her earlobes, which developed after the body piercing procedure. Her earlobes had been pierced in a beauty parlor six weeks earlier. RESULTS: With regard to the child's age, the embedded parts of the earrings were removed in the operating theatre. In our description, the hind parts of the earrings started to embed five weeks after the piercing procedure. Too strong and constant pressure caused by fixing clips led to skin ischemia, followed by inflammation and decubitus ulcer, and consequently to the penetration of clips into the earlobes. CONCLUSIONS: Complications after body piercing are observed in adults, as well as in children, in whom the decision of piercing performance should be carefully considered and rather postponed until self care is achievable.