The effect of reduction mammaplasty on the vertebral column: a radiologic study.

Some studies emphasized that anatomic mechanisms of vertebral aberrations could be associated with large breasts. The effect of mammaplasty operation on the vertebral column and body posture seems to be beneficial; in this trial, it was planned to investigate the objective radiologic effect of reduction mammaplasty on the posture of the vertebral column in a group of patients operated due to the large breasts. Thirty-four white women with large breasts were enrolled in this study. The patients were divided into three groups according to their breast cup sizes. Anteroposterior and lateral radiographs of the lumbosacral and thoracic spine were taken at baseline preoperatively, and the same radiographic images were taken in an average of 12 months later than the reduction mammaplasty operation. All were evaluated and compared for thoracic kyphosis angle and lumbar lordosis angle both preoperatively and postoperatively. The mean thoracic kyphosis angle was 40,53 preoperatively and 39,38 postoperatively. However, there was no statistically significant difference between the preoperative and postoperative measurements in all groups (P > 0,05). The mean lumbar lordosis angle was 54,71 preoperatively and 53,18 postoperatively. Regarding the preoperative and postoperative measurements of lumbar lordosis angles, no statistically significant difference was found between the groups (P > 0,05). Although breast size may be an important factor that affects body posture, reduction mammaplasty operations have little or no radiologic effect on the vertebral column.

Splitted posterior auricular muscle flap combined with traditional otoplasty.

OBJECTIVE: This article presents a modified technique to split and reposition the posterior auricular muscle flap as an adjunct to traditional otoplasty. BACKGROUND: Although numerous techniques have been described for the correction of prominent ear deformity, there is still a continuing debate on which operative method achieves the best results. Recurrence of the deformity or the need for secondary revisions is still among the common problems. We aimed to focus on a technical modification of the use of the postauricular muscle flap to strengthen the effect of otoplasty and to obtain more prominent results. METHODS: Twelve patients with prominent ears (total, 24 ears) were operated on and followed up at least 6 months. To determine the efficacy of the technique on the different parts of the ears, 2 distances of each ear to the scalp for both the superior and middle third of the ears were measured and compared before the surgery, early after the surgery, and late after the surgery. RESULTS: The mean distances for both the upper and middle third of the ears were significantly lower (P < 0.05) at the end of the first month after the surgery. Although a millimetric slight rise was observed, there was no statistically significant difference between the mean postoperative results of the first and sixth months (P > 0.05). CONCLUSIONS: The splitted posterior auricular muscle flap repositioning to the upper and middle third of the ear may be successfully performed adjunct to the conventional corrective otoplasty. According to the late postoperative results, it seems to be that a stronger and more permanent otoplasty may be obtained with the addition of a splitted and reinserted postauricular muscle flap to the traditional otoplasty.

Monitorization of asymmetric dimethylarginine (ADMA) levels in an experimental ischemia-reperfusion flap model: a preliminary report.

One of the most important endothelium-derived vasoactive mediators is nitric oxide (NO). Endothelial dysfunction by the loss of NO is a critical event during ischemia. Asymmetric dimethylarginine (ADMA) is a competitive inhibitor of NO synthase (NOS) that inhibits vascular endothelial NO production in concentrations found in pathophysiological conditions. The goal of this study was to monitorize overexpression of ADMA in an experimental ischemia-reperfusion flap model. This study was performed using 20 rats. The baseline ADMA levels were measured preoperatively. In Group I (n = 10, control) abdominal flaps were harvested and replaced in situ without creating ischemia. The plasma ADMA levels were measured at 1, 12, and 24 hours postoperatively. In Group II (n = 10, study) abdominal flaps were harvested, and clamping the vascular pedicle created a subsequent 8-hour period of warm ischemia. Clamps were removed and provided tissue reperfusion. The ADMA levels were taken after 1 hour of reperfusion, and at 12th and 24th hours. The mean preoperative ADMA levels in group I and group II were calculated to be 0.37 ± 0.06 (µmol/L) and 0.40 ± 0.06 (µmol/L), respectively. The differences between the preoperative ADMA levels were not statistically significant (p > 0.05). The mean postoperative ADMA levels in group I (control) were calculated to be 0.39 ± 0.09 (µmol/L) at the first hour, 0.42 ± 0.07 (µmol/L) at the 12th hour, and 0.40 ± 0.08 (µmol/L) at the 24th hour. Respectively, the mean postoperative ADMA levels in group II were calculated to be 0.68 ± 0.14 (µmol/L) after 1 hour of reperfusion, 0.62 ± 0.09 (µmol/L) at the 12th hour, and 0.60 ± 0.12 (µmol/L) at the 24th hour. All postoperative ADMA levels were significantly higher in Group II (p < 0.05). These experimental results suggest that systemic production of ADMA is greater in animals having ischemia reperfusion injury of the skin flaps. The strategy of decreasing levels of ADMA may be beneficial to prevent ischemia-reperfusion injury of flaps or composite transplants; thus, ADMA might be an important candidate of therapeutic target in flap or transplantation surgeries.