External ear carcinoma: evaluation of surgical and reconstructive management with postauricular island flap.

Introduction: Cancers of the auricle and the external auditory canal (EAC) remain a relevant oncological problem. Aim: Presentation of the results after resections of conchal bowl and EAC carcinoma (with or without radical mastoid surgery) and after reconstructions (postauricular island flap - PIF). Material and methods: We analysed results of 37 patients with cancers of the auricular conchal bowl and EAC after tumour resection and reconstruction (2000-2017). Results: The cancers were completely excised in all patients, with no recurrences within at least 5 years after surgery. We noted venous congestion in 22 (59.4%) cases, pinning of the operated ear in 18 (48.6%), prominent earlobe in 14 (37.8%), and EAC constriction in 6 (16.2%) cases treated without radical mastoid surgery. Conclusions: Retroauricular approach in cancer of the auricular concha and EAC allowed for accurate evaluation of the tumour extent and proper surgical access, which facilitated complete removal of the tumour. Use of radical mastoid operation with conchal bowl resection and PIF reconstruction in patients with aquamous cell carcinoma or infiltrating basal cell carcinoma of auricular concha and osseous EAC resulted in cancer extirpation and good aesthetic outcomes, despite minor functional consequences. In these cancers mastoidectomy offered a wider access to determine the radicality of oncological resection.

Immunoexpression of Bmi-1, CK15, Bcl-2 in different types of basal cell carcinomas.

Introduction: Basal cell carcinoma (BCC) occurs in aggressive and non-aggressive forms. The expression of immunohistochemical markers varies in different types of BCC. Aim: Immunohistochemical analysis of selected proteins in BCCs. Material and methods: The immunohistochemical method was used to examine the immunoexpression of Bmi-1, CK15 and Bcl-2 in 56 cases of BCC divided into four groups. Results: Positive Bmi-1 staining 3-4+ level (nodular type) was seen in 91.3% of samples, 4+ (infiltrative) in 92.3%, 4+ (nodular/infiltrative) - 69.2%, 3+ - 30.8%, in BSC 3+ - 42.8%, and 28.6% each for 2+ and 4+. Low grade positivity (0-1+) in CK15 staining was present in 52.1% of nodular BCC, 46.2% - nodular/infiltrative, 92.3% - infiltrative, and 100% - BSC, but levels 2-3+ in nodular BCC in 47.8%, nodular/infiltrative BCC - 53.8%, infiltrative - 7.7%. Bcl-2 positivity (3-4+) was revealed in nodular BCC in 95.6%, (1-2+) in 100% of BSC, infiltrative and infiltrative/nodular BCC, but the lowest (0-1+) in 76.9% of nodular/infiltrative BCC, 71.4% of BSC, and in 38.4% of infiltrative BCC. Conclusions: Positive Bmi-1 staining was the highest in the aggressive infiltrative subtype of BCCs, whereas the lowest in basosquamous cell carcinomas (BSC). Infiltrative BCC was characterized by a lower level of CK15 expression than nodular BCC and nodular/infiltrative BCC. Differentiation of Bcl-2 expression depended on the type of tumour; the highest level was found in nodular BCC, low grade in nodular/infiltrative and infiltrative BCCs, and BSC.

Clinicopathological analysis of recurrent basal cell carcinoma of the eyelid.

INTRODUCTION: Basal cell carcinoma (BCC) is the most common malignant neoplasm of the eyelids and surrounding structures, usually developing in the area of the lower lid and medial canthus. Invasive forms of BCC are connected with a high risk of recurrence, often due to incomplete excision of these lesions. AIM: Clinical and pathological analysis of recurrent BCCs of the eyelids and surrounding structures. MATERIAL AND METHODS: We present clinical and pathological analysis including immunohistochemical reaction to Ki-67 antigen of 19 patients (11 women, 8 men) operated for recurrent BCCs of the eyelids in 2000-2012. RESULTS: In most cases, recurrences were present on the lower lid and in the medial canthus. In 15 patients the histopathological type did not change and in 4 cases it transformed into more invasive forms. The values of Ki-67 index for primary BCCs ranged between 1% and 20%, and for relapsing lesions between 11% and 48%. CONCLUSIONS: Proper clinical and pathological evaluation to determine the risk of relapse in BCCs of the eyelids and surrounding structures should include the analysis of prognostic factors, in particular location and size, histopathological type and radicalness of surgical treatment of primary BCCs. Clinical and pathological analysis of patients with recurrent BCC of the eyelids and surrounding structures should be combined with the evaluation of proliferation index Ki-67, which is essential for prognosis and choice of the appropriate therapeutic method.

Surgical treatment of skin lesions in lupus erythematosus.

Lipodystrophies are a wide group of diseases with various etiology, mainly genetic, metabolic or autoimmune. The treatment of these diseases is chronic and not always effective. Major concerns for patients with lipodystrophies are also esthetic defects, especially deformities in the face, neck and upper limbs. There are many surgical methods that can be used to improve patient's appearance like fillers, autologous fat transfer and skin flaps. The aim of this paper is to present and discuss surgical techniques used for correction of lipoatrophy and other skin lesions present in lupus erythematosus. In the first presented patient, lipodermal grafts were performed in two stages (first - to both zygomatic areas, the second - to both nasolabial folds). Moreover, the patient was qualified for arm scar plasty. Deepithelialized skin in the affected area was covered with advanced local skin flaps. In the second patient, an extensive scarring lesion on the scalp was excised and the defect was closed with an expanded scalp flap. Patients with lipodystrophies may require aesthetic surgical procedures to improve their appearance. In patients with lupus erythematosus, autologous fat graft in the face area seems to be a safe and effective method of refilling the volume of atrophic tissues. On the basis of our experience, it is worth emphasizing that the process of fat graft resorption is typical. In patients with scalp scars, an effective method of their removal and hairline restoring is usage of the tissue expander.

Mental Health, and Eating Disorders in Patients After Roux-en-Y Gastric Bypass Surgery (RYGB).

<b>Introduction:</b> Obesity, as one of the main health problems worldwide, is associated with an increased risk of developing mental and eating disorders and negative eating habits. Bariatric surgery allows for rapid weight loss and alleviates the symptoms of concomitant diseases in obese patients.<b>Aim:</b> Pre- and postoperative estimation of mental disorders and eating behaviors in patients after Roux-en-Y Gastric Bypass (RYGB).<b>Material and methods:</b> Analysis of data from up to 5 years of follow-up including clinical examination and questionnaires.<b>Results:</b> Following parameters decreased after RYGB: anxiety and hyperactivity from 32.81% to 21.88%, mood disorders - 31.25% to 20.31%, substance abuse - 40.63% to 28.13%, emotional eating - 76.56% to 29.69%, binge eating - 50% to 6.25%, night eating - 87.5% to 20.31%. Postoperative rates of: negative eating habits, daily intake of calories and sweetened beverages, flatulence, constipation, and abdominal pain decreased, while the rate of food intolerance and emesis increased.<b>Conclusions:</b> In our patients, the occurrence of: mental and eating disorders, negative eating habits, daily calories, sweetened beverages, coffee intake decreased after weight loss (as a result of RYGB), but water, vegetables and fruit consumption increased. Lower rate of flatulence, constipation, and abdominal pain, but higher of food intolerance and emesis were also confirmed after RYGB.

Analysis of epigenetic clocks links yoga, sleep, education, reduced meat intake, coffee, and a SOCS2 gene variant to slower epigenetic aging.

DNA methylation (DNAm) clocks hold promise for measuring biological age, useful for guiding clinical interventions and forensic identification. This study compared the commonly used DNAm clocks, using DNA methylation and SNP data generated from nearly 1000 human blood or buccal swab samples. We evaluated different preprocessing methods for age estimation, investigated the association of epigenetic age acceleration (EAA) with various lifestyle and sociodemographic factors, and undertook a series of novel genome-wide association analyses for different EAA measures to find associated genetic variants. Our results highlighted the Skin&Blood clock with ssNoob normalization as the most accurate predictor of chronological age. We provided novel evidence for an association between the practice of yoga and a reduction in the pace of aging (DunedinPACE). Increased sleep and physical activity were associated with lower mortality risk score (MRS) in our dataset. University degree, vegetable consumption, and coffee intake were associated with reduced levels of epigenetic aging, whereas smoking, higher BMI, meat consumption, and manual occupation correlated well with faster epigenetic aging, with FitAge, GrimAge, and DunedinPACE clocks showing the most robust associations. In addition, we found a novel association signal for SOCS2 rs73218878 (p = 2.87 × 10-8) and accelerated GrimAge. Our study emphasizes the importance of an optimized DNAm analysis workflow for accurate estimation of epigenetic age, which may influence downstream analyses. The results support the influence of genetic background on EAA. The associated SOCS2 is a member of the suppressor of cytokine signaling family known for its role in human longevity. The reported association between various risk factors and EAA has practical implications for the development of health programs to improve quality of life and reduce premature mortality associated with age-related diseases.

[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.

Selected factors affecting the rate of reduction of body weight components during the first six months after bariatric surgery: A cohort study.

<b><br>Aim:</b> To determine whether the rate of slimming following bariatric surgery depends on the sex, type of bariatric surgery, time elapsed since surgery or body weight components.</br> <b><br>Materials and methods:</b> The material is comprised of the results of three series of anthropometric measurements in 91 obese patients (before bariatric surgery, about 3 months after bariatric surgery and about 6 months afterwards). The inclusion criteria were patients of Polish origin admitted to the hospital from July 1, 2017 to January 31, 2019 for surgical treatment of obesity and written consent for the surgery and participation in the study. The measurements included body weight components assessed by bioelectrical impedance analysis.</br> <b><br>Results:</b> The reduction of all features was greater after SG than GB (p<0.0001), greater in the first quartile than in the second quartile after surgery (p<0.0001), and higher for fat mass than for other body weight components (p<0.0001). The sex of the patients, type of bariatric surgery, time elapsed since the operation, and type of body weight component constituted interactive modifiers of the rate of reduction.</br> <b><br>Conclusion:</b> After bariatric surgery, the reduction of fat mass was quicker in men than in women. SG and RYGB lead to a greater reduction of fat mass than GB. Among all three analyzed procedures, only for SG did the rate of body weight component reduction not decrease in the second quartile after surgery. This finding should be taken into account when creating an algorithm for treating a patient after bariatric surgery</br>.

Evaluation of outcomes of lower eyelid entropion and ectropion surgical repair.

<b><br>Introduction:</b> The imbalance of external and internal forces acting on the lower eyelid can result in entropion and ectropion, both of which cause ocular irritation and loss of proper eye protection. Potential complications of untreated cases include recurrent inflammation of the conjunctiva and cornea, conjunctival neovascularization, corneal abrasion or perforation, and ultimately even loss of vision. Although various surgical techniques are used to address this problem, their long-term outcome and effectiveness are still under discussion. </br> <b><br>Aim:</b> To evaluate outcomes of surgery for entropion and ectropion, including a modified Wheeler's method for entropion correction.</br> <b><br>Methods:</b> A non-comparative study (prospective and retrospective groups) included 100 patients operated on in two university hospitals' plastic surgery departments for lower eyelid entropion or ectropion, following formal ethics approval. The prospective group included 50 patients assessed preoperatively and at 3 and 12 months postoperatively. The retrospective group was comprised of 50 patients (2012-2018), whose preoperative documentation and clinical examinations were analyzed. The main outcome measures were change between pre- and postoperative patient-reported symptoms (VAS scale), ectropion/entropion grading scale (EGS/EnGS), quality of life (WHOQOL-BREF), and occurrence of complications.</br> <b><br>Results:</b> The differences in the severity of all symptoms before and after surgery evaluated with the VAS scale were statistically significant in both groups (p <0.05). We observed 6 recurrences (12%) in the prospective group and 9 (18%) in the retrospective group, with minor complications. Very good functional and esthetic postoperative results were confirmed in 70% (79) of the whole group and in 13 patients (81.3%) treated with the modified Wheeler's method. In the prospective group, the Mann- Whitney U test for dependent variables revealed significant improvement in the somatic, psychological, and environmental domains, with no significant change in the social relationships domain.</br> <b><br>Conclusions:</b> The results following entropion/ectropion surgery prove the effectiveness of the methods used. Complementing them with the modified Wheeler's method brought an increase in the number of very good outcomes. Surgery of lower eyelid malposition contributed to reduced symptoms and improved quality of life. The rates of postoperative sequelae were low.</br>.

The 2D:4D index is associated with the development of excess body weight in adults, but not with the rate of weight loss following bariatric surgery.

2D:4D finger length ratio is a proxy of prenatal sex hormone exposure. Prenatal testosterone decreases and prenatal estrogens increase this index. In the current study we investigated whether the 2D:4D index, as a marker of the prenatal hormonal environment, is associated with the development of overweight and obesity in adults, and whether is it correlated with the rate of weight loss in patients after bariatric surgery. We tested 125 adults with obesity (BMI ≥ 30.0 kg/m2), 125 adults with overweight (BMI 25.0-29.9 kg/m2) and 153 persons with normal body weight (BMI < 25 kg/m2) of both sexes. We have found that the development of excessive body weight in men and women, and fat accumulation in the upper arms, thighs and lower legs in women with obesity (but not men) are associated with increased prenatal estrogen exposure. This relationship indicates a new area of activity in the field of obesity prevention. Moreover, it seems that the 2D:4D index (especially of the right hand) may be a useful factor in early prediction of the risk of developing excessive body weight in humans. The rate of weight loss after bariatric surgery is independent of prenatal exposure to sex hormones.

[New modification of Reynwald macroglossia reduction]. / Modyfikacja wlasna metody Reynwalda operacji redukcyjnych przerosnietego jezyka.

INTRODUCTION: Macroglossia usually occurs as isolated malformation, however it can coexist with some of the hereditary defect. Enlargement of the tongue can cause cosmetic and functional difficulties. AIM: The aim of this paper was to analyzed patients with macroglossia operated with own modified Reynwald method. It was based on analysis of surgical treatment and rehabilitation of patients with: Down syndrome, oral-facial-digital syndrome and cerebral palsy, treated at the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz. MATERIAL AND METHODS: 63 patients (32 females and 31 males) with Down syndrome (60), oral-facial-digital syndrome (2) and cerebral palsy (1) were operated at the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz, because of hypertrophy of the tongue. 42 patients were operated with partial resection of macroglossia, 2 of them with additional correction of the tongue border and 21 patients with own modified Reynwald method. RESULTS: Postoperative treatment was non-complicated in all the patients. Early and long-lasting postoperative results were regard as satisfactory, and lead to improvement of basic physiological functions. CONCLUSIONS: 1. 3­6 years are the optimal age to partial macroglossia reduction. 2. Analyze of surgical macroglossia treatment showed effectiveness of methods based on partial resection of tongue. Surgical treatment with own modified Reynwald method lead to increase of number of satisfied postoperative results. 3. Partial resection of macroglossia influence on patients look, integration and environment acceptance; in children with deep retardation it simplify nursing.

Thyroid diseases and second to fourth digit ratio in Polish adults.

The association between second to fourth finger ratio and thyroid diseases is unexplained. There is a possible interaction between prenatal exposition to sex hormone and thyroid functions in the adulthood. The study included 175 adults investigated in Lódz in the central Poland. It consisted of two main parts: a survey including questions about occurrence of thyroid gland dysfunction and anthropometric measurements (body mass and height and length of the second and fourth finger, waist and hip circumferences). The women who had thyroid disease had higher 2D:4D digit ratio (left hand) (mean = 1.004; SD = 0.036) than healthy ones (mean = 0.989; SD = 0.030) (t = - 2105; p = 0.038; d = 0.707). The association between thyroid diseases occurrence and prenatal steroid hormone exposition is noticed. Only females who had thyroid diseases tend to have higher 2D:4D digit ratio, for left hand.

External auditory meatus and/or conchal bowl reconstruction with postauricular island flap in patients with Basal Cell Carcinoma or Squamous Cell Carcinoma.

AIMS: Presenting our clinical experience with the postauricular island flap (pif) and estimation of the results following partial external auditory canal (eac) and/or auricular conchal bowl reconstructions with the pif in patients after carcinoma resections. METHODS: We have analyzed postoperative results of 19 patients after auricular conchal bowl (11), or auricular conchal bowl and eac (8) reconstructions with pif, following malignant tumor resections, between 2000-2015. The patients were followed-up and evaluated in respect of early and long-term results after surgical treatment considering plastic surgeon's and patient's opinion. RESULTS: The cancers were completely excised in all patients, and there were no recurrences within at least 2 years of follow-up. The observed complications after reconstructions comprised venous congestion in five cases (26.3 %), pinning of the operated ear in four patients (21 %), prominent earlobe in three (15.8 %), and eac constriction in three cases (15.8 %). Postoperative result was very good in all cases (both in the opinion of plastic surgeon and patients), except patients with pinning of the operated ear, prominent earlobe (moderately satisfied). Conclusions 1. Combined operations involving postauricular island flap reconstructions after partial (external auditory meatus and/or auricular conchal bowl) resections allowed for complete removal of malignant tumors with no evidence of recurrence, and also preservation of proper conchal shape in the reconstructed ear. 2. Retroauricular approach in cases with cancer involvement of the external auditory meatus allowed for proper visualization and estimation of lesions extent, as well as adequate surgical access.

One stage onlay hernia repair with abdominoplasty in patients following gastric bypass surgery

PURPOSE: 1. Evaluation of results after one-time incisional hernia repair (IHR) modo on-lay and abdominoplasty (Ab-pl) in patients after loss of weight following previous Roux-en-Y Gastric Bypass ­ RYGB. 2. Analysis of differences in quality of life (QL) changes in bariatric patients before RYGB, as well as before and after abdominal contouring operation.tion. MATERIAL AND METHODS: Clinical analysis involved 20 patients with abdominal disfigurement (following RYGB, and massive weight loss) who underwent one-time IHR using on-lay method together with abdominoplasty. We estimated postoperative results, as well as changes in QL, before RYGB and before and after abdominal contouring procedure (based on DAS 24 and SF-36 scales) in comparison with stage before surgeries. RESULTS: Complications - abnormal wound healing (infection, local necrosis) and pneumonia were found in two persons, seroma in two cases, whereas dysesthesia in four patients. We confirmed QL improvement in all aspects after each stage of treatment. CONCLUSIONS: 1. One-stage on-lay hernia repair and abdominoplasty is a safe method improving the functioning of patients. 2. All stages of bariatric treatment resulted in gradual improvement of the quality of life. 3. High BMI in patients before onlay incisional hernia repair with abdominoplasty increases the risk of complications, which is connected with longer hospital stay.

Structural abnormalities in the levator palpebrae superioris muscle in patients with congenital blepharoptosis.

BACKGROUND AND OBJECTIVE: To evaluate structural and ultrastructural abnormalities of the levator palpebrae superioris (LPS) complex in patients with congenital blepharoptosis. PATIENTS AND METHODS: Samples of the LPS complex were obtained from patients operated on for congenital blepharoptosis between 2000 and 2001 and studied under light microscopy (15 cases) and electron microscopy (9 cases). RESULTS: Findings of light microscopy evaluation of the LPS complex correlated closely with the clinical grading of congenital blepharoptosis-hypoplasia, decreased number and varying diameter of muscle fibers, and fibrous tissue hyperplasia in the endomysium and perimysium. The Müller's muscle preserved a normal appearance. Mild blepharoptosis revealed proliferation of collagen fibers on electron microscopy. Moderate blepharoptosis showed abnormal distribution of myofibrils and distortion of the tubular system and mitochondria in addition to the changes observed in mild blepharoptosis. Severe blepharoptosis showed mitochondria loss, cytoplasm thinning, and homogenous fiber areas in addition to the changes observed in mild and moderate blepharoptosis. CONCLUSIONS: The clinical degree of severity of congenital blepharoptosis correlates positively with the degree of histopathologic changes in the levator palpebrae superioris muscle.

Personality Traits and Decision on Breast Reconstruction in Women after Mastectomy.

UNLABELLED: The aim of the study was evaluation of the correlation between selected personality traits in women after mastectomy and their decision on breast reconstruction. MATERIAL AND METHODS: The study was conducted between 2013­2015, in the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz, and Department of Oncological and Breast Surgery, CZMP. Comparative analysis comprised 40 patients, in whom mastectomy and breast reconstruction was done, and 40 women after breast amputation, who did not undergo reconstructive surgery. Basing on self-constructed questionnaire, five features of personality were evaluated in these women: pursue of success in life, ability to motivate others, openness to other people, impact of belonging to a social group on sense of security and the importance of opinion of others about the respondent. Apart from the questionnaire, in both groups of women a psychologic tool was used (SUPIN S30 and C30 tests) to determine the intensity of positive and negative emotions. RESULTS: Women who did not choose the reconstructive option were statistically significantly older at mastectomy than women who underwent breast reconstruction. There were statistically significant differences between both groups in response to question on being open to other people and value of other people's opinion. The differences in responses to question on the impact of belonging to a social group on personal sense of safety were hardly statistically significant. In psychometric studies there were significant differences in responses to SUPIN C30 test for negative emotions and S-30 for positive emotions. The level of negative emotions - feature of group A was in 47.5% in the range of high scores and in 47.5% within low and low-average scores. Among women from group B 57.5% had high scores, while 37.5% low and average scores. There were significant differences in the results of positive emotions evaluation in S-30. Women who did not undergo breast reconstruction usually had high scores, while those who decided on reconstructive surgery usually had low scores and low-high scores. CONCLUSIONS: 1. The decision on breast reconstruction after mastectomy is connected with personality features of patients. Introvert women, who base their self-opinion on opinion of others and their sense of security on belonging to a social group, rarely choose to undergo breast reconstruction. 2. Younger patients after mastectomy more frequently choose the breast reconstructive option. 3. A special algorithm of medical and psychological care in patients after mastectomy should be created to improve their further quality of life.

Results of auricular helical rim reconstruction with post-auricular tube flap.

UNLABELLED: The aim of the study was to present our experience with post-auricular tube flap (ptf) and clinical evaluation of the results following auricular helical rim reconstruction with this technique in patients after trauma. MATERIAL AND METHODS: We analyzed the results in 12 patients who underwent three-staged auricular helical rim reconstruction with ptf following trauma in the Department of Plastic, Reconstructive and Aesthetic Surgery between 2005-2014. The patients were followed-up for at least 1 year. We evaluated early and long-term results after surgery including plastic surgeon's and patient's opinion. RESULTS: Postoperative results were satisfactory (very good) in 10 cases, both in the opinion of the plastic surgeon and patients. Transient venous congestion of the helix occurred in two cases (16.6%). This complication did not have any influence on estimation of the results after surgery. Delayed wound healing in the poles of the reconstructed helical edge, as well as non-aesthetic helical scars with imperfections of helical rim, were seen in another two patients (16.6%). CONCLUSIONS: 1. Post-auricular tube flap reconstructions after helical rim trauma allowed for complete restoration of contour, size and orientation of the helix and the whole operated ear, which confirms the efficiency of the applied technique. 2. Reconstructive surgery with post-auricular tube flap in patients with auricular helical rim defects contributed to postoperative satisfaction in both patients and doctors' estimations.

Evaluation of the complex treatment for congenital blepharoptosis.

OBJECTIVE: To evaluate the results of treatment of congenital blepharoptosis (CBP) using selected surgical methods; and to evaluate concomitant visual system disorders. METHODS: Between 2001 and 2010, 52 children with CBP underwent surgical correction of CBP using the modified method of Mustarde, the original Mustarde method or frontal suspension at the Department of Plastic Surgery, Medical University of Lodz (Poland). Based on the results of ophthalmic and orthoptic examination, and standard measurements, postoperative differences in the position and symmetry of the upper eyelids, complications, and visual system abnormalities were analyzed. RESULTS: Very good results were obtained in all patients with mild unilateral CBP. The results in patients with moderate and severe unilateral CBP, and in bilateral anomaly after correction using Mustarde's method or the modified Mustarde's method, were also very good. Complications included lagophthalmos (15.4%) and undercorrection (3.8%). Visual system disorders, mainly amblyopia, resulting from strabismus, astigmatism, anisometropia and CBP, were observed in 88.5% of patients. CONCLUSIONS: Complex ophthalmic examination and measurements in individuals with CBP enable correct diagnosis, selection of appropriate treatment method and timing of surgical intervention. Postoperative results in patients with CBP supported the efficacy of the methods that shortened the levator palpebrae superioris. Supplementing with Mustarde's modified method contributed to an increase in the number of favourable postoperative results.

OBJECTIF: Évaluer les résultats du traitement de la blépharoptose congénitale (BPC) à l'aide de certaines méthodes chirurgicales et évaluer les troubles du système visuel s'y associant. MÉTHODOLOGIE: Entre 2001 et 2010, 52 enfants ayant une BPC ont subi une correction chirurgicale au moyen de la méthode modifiée de Mustarde, de la méthode originale de Mustarde ou de la suspension aux muscles frontaux au département de chirurgie plastique de l'université médicale de Lodz, en Pologne. D'après les résultats de l'examen ophtalmique et orthoptique et les mesures standards, les chercheurs ont analysé les différences postopératoires dans la position et la symétrie des paupières supérieures, les complications et les anomalies du système visuel. RÉSULTATS: Tous les patients ayant une BPC unilatérale bénigne ont obtenu de très bons résultats. Ceux dont la BPC unilatérale était modérée ou grave ou dont l'anomalie était bilatérale ont également obtenu de très bons résultats après correction par la méthode de Mustarde classique ou modifiée. La lagophtalmie (15,4 %) et la sous-correction (3,8 %) faisaient partie des complications. Les chercheurs ont observé des troubles du système visuel chez 88,5 % des patients, notamment l'amblyopie, causés par un strabisme, un astigmatisme, une anisométropie ou une BPC. CONCLUSIONS: Chez les enfants ayant une BPC, un examen ophtalmique approfondi et des mesures favorisaient un bon diagnostic, le choix de la méthode thérapeutique appropriée et la sélection du bon moment pour effectuer l'intervention chirurgicale. Les résultats postopératoires chez les patients ayant une BPC corroboraient l'efficacité des méthodes visant à raccourcir le muscle releveur de la paupière supérieure. L'ajout de la méthode modifiée de Mustarde contribuait à accroître le nombre de résultats postopératoires favorables.

Satisfaction with Life and Social Factors in Decision-Making Proces on Breast Reconstruction in Women after Mastectomy.

The aim of the study was to analyse the correlation between satisfaction with life in women after mastectomy and motivation to undergo breast reconstruction, compared to women who after breast amputation did not decide to undergo reconstructive treatment. MATERIAL AND METHODS: Comparative analysis comprised patients after mastectomy, who decided on breast reconstruction (40) and those who did not undergo reconstructive surgery (40). The study was conducted in the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz and Department of Oncological surgery and Breast Diseases ICZMP, Lódz, between 2013-2015. In the study the question whether higher satisfaction with life prompts decision on breast reconstruction was investigated. The Satisfaction with Life Scale (SWLS) was used, as well as an original questionnaire. The correlations between statistical parameters were evaluated using the chi-square test. RESULTS: We have demonstrated differences between the level of satisfaction with life in patients who decided to undergo breast reconstruction and those who did not choose reconstructive surgery. The discrepancies may reflect differences in the system of values and level of satisfaction with life before reconstructive treatment and also point to potential effect of these factors on the decision to undergo surgery. CONCLUSIONS: 1. Differences in cognitive structures between 'Amazons' determine the decision on reconstructive treatment. 2. Transfer of information between the therapeutic team and women after mastectomy is not satisfactory. 3. Higher level of satisfaction with life has a positive effect on the decision of breast reconstruction.

Long-Term Results of Incisional Hernia Repair with Concomitant Abdominoplasty in Postbariatric Patients.

UNLABELLED: The aim of the study was evaluation of long-term results after simultaneous incisional hernia repair and abdominoplasty in patients following RYGB (Roux-en-Y Gastric By-pass) and estimation of quality of life before and after this complex operation. MATERIAL AND METHODS: We analyzed long-term results in 18 patients who underwent complex anterior abdominal wall surgery after massive weight loss, following previous RYGB. The patients were followed-up for at least 8 years. We compared the quality of life before and after hernia repair combined with abdominoplasty. RESULTS: Observed wide postoperative scar in 4 persons, permanent dysesthesia in one, and flaccidity of the anterior abdominal wall in three cases. Estimation of the quality of life revealed significant improvement in functional, aesthetic and psychological aspects after complex surgery. CONCLUSIONS: 1. Simultaneous incisional hernia repair and abdominoplasty resulted in satisfactory long-term postoperative results, which confirms the efficiency of complex anterior abdominal wall surgery in patients following RYGB after massive weight loss. 2. Surgery in patients afflicted with disfigurements of the anterior abdominal wall contributed to significant improvement in their life quality in functional, aesthetic and psychological aspects, as compared with preoperative estimations. 3. All persons confirmed positive influence of abdominal wall surgery on their possibility to take challenges in life, and fulfill plans. 4. Surgery of the anterior abdominal wall deformities, if needed after massive weight loss, should become an integral part of complex multidisciplinary treatment in postbariatric individuals.