Submuscular Gluteal Augmentation and Lipoplasty for Buttock Beautification.

The number of gluteal augmentation procedures with implants has increased in the last years. However, due to high complication rates related to the placement of the implants, surgeons have started to avoid using implants. The objective of the present study was to describe the details of the submuscular gluteal augmentation technique together with lipoplasty techniques and to increase the prevalence of its use. METHODS: All methods are complementary to each other rather than being superior to each other. That is why the author has used submuscular gluteal augmentation with implant technique and lipoplasty together during the surgeries. The complication rates are lower with this easy-to-learn technique described in this article. Eighty-six patients aged 20-46 underwent surgery. The follow-up period was 6-24 months. The implants used consisted of round cohesive silicone, with the most commonly used size being 330 cm3. The average volume of infiltrated fat was 514 cm3. RESULTS: The sciatic nerve is well protected by the surrounding anatomical structures, indicating that submuscular technique can be used safely. Partial wound dehiscence was noted in 1 patient, implant malposition in 5 patients, and seroma in 2 patients. All patients reported that they are highly satisfied with the results of the procedure. CONCLUSIONS: The author advocates that the combination of lipoplasty with the submuscular technique described is safe, easy to perform, has a short operative time and low complication rates. It can be preferred in buttock beautification as a simple and safe technique.

Reconstruction of full-thickness cheek defects with using free osseocutaneous radial forearm flap.

PURPOSE: The aim of the present clinical study was to evaluate the feasibility of free osseocutaneous radial forearm flap in the reconstruction of full-thickness cheek defect after ablative cancer surgery. METHODS: A retrospective review of data was obtained from consecutive patients requiring free osseocutaneous radial forearm flap to recover both the cutaneous and bone deficit in major full-thickness cheek defect after oncologic resection. RESULTS: Two patients had advanced cheek squamous cell carcinoma. All patients had combined bone and extensive soft-tissue defects. The free osseocutaneous radial forearm flap measuring 10 × 8 cm to 14 × 10 cm was used to reconstruct the major through-and-through cheek defects. No major complications occurred in any patient. The patients were followed up for 6 to 20 months; 1 patient was living with no evidence of disease, and 1 had died of local recurrence. CONCLUSIONS: The free osseocutaneous radial forearm flap to reconstruct major through-and-through cheek soft tissue and bone defects is reliable and an excellent alternative to other options for patients who have full-thickness defect of cheek.

Reconstruction of sphincteric function after dysfunctional total lower lip reconstruction using free muscle graft technique.

Many techniques can be used in primary reconstruction of total lower lip defects and most of them are functional. If a total lower lip defect is reconstructed with a static, dysfunctional technique, then the patient is prone to some problems such as drooling and gingival show. In order to restore sphincteric function in a previously reconstructed lower lip, we used the free muscle graft technique, which has been firstly used by Thompson for the treatment of facial paralysis. We obtained a satisfactory result, such that symptoms of drooling and gingival show have disappeared, and a minimal purse-stringing movement has been restored. To our knowledge, this is the first time of a free muscle graft application in this type of an indication. According to our result, the use of free muscle graft technique can be a good alternative method in patients, who suffer from drooling and gingival show following dysfunctional total lower lip reconstruction.

Titanium mesh fracture in mandibular reconstruction.

Mandibular reconstruction is important for providing good functional and cosmetic results after the resection of a mandibulary segment. Reconstruction plates and titanium meshes are usually used to reconstruct the bony defects in mandible. Although their complications are well known there is not a report on the fractures of a titanium mesh after mandible reconstruction in the literature. We reported a case of a broken titanium mesh after mandible reconstruction.

Using the sac membrane to close the flap donor site in large meningomyeloceles.

If a large transposition flap with or without muscle is used for closure of a large meningomyelocele defect, then, a part of the donor site of the flap can be closed by split thickness skin graft, which produces an additional donor wound for the patient. We used the sac membrane instead of split thickness skin graft for closure of donor sites of fasciocutaneous flaps and latissimus dorsi musculocutaneous flaps employed to cover large meningomyelocele defects. This technique was used in three thoracolumbar and in two lumbosacral meningomyelocele patients. The sac membrane was prepared like a full thickness skin graft. Follow-up in five patients has ranged from 1 to 18 months, with a mean of 10.6 months. The donor sites that were closed by the sac membrane exhibited complete healing in all patients. We conclude that the sac membrane supplies a reserve of epithelialised tissue that can be used for repair of the meningomyelocele defects.