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BACKGROUND: Fat grafting has been successfully used for reconstructive and esthetic surgery of the breast, face, and other body parts. In this article, we present our protocol for hand fat grafting and over a decade of clinical experience. METHODS: Fat tissue is obtained from the flanks, peri-umbilical region, or internal side of the thigh or knee. No centrifuge machine is used to prevent fat damage. After decantation, fat is injected into the dorsum of the hand using a cannula from the wrist and not from the fingers. Fat is distributed gently above the dorsal deep fascia to avoid perforation of the vessels. RESULTS: The proposed technique was applied to 65 patients. The amount of fat injected ranged from 10 to 30 cm3. No allergic reactions were noticed. Each patient's progress was followed-up for a minimum of 12 months. Over this period, contour changes and the effects of the procedure(s) on the skin were analyzed. Fifty-six patients (84%) were satisfied with the results during the observation period, 7 patients (12%) were somewhat satisfied and needed one more fat grafting procedure to achieve complete satisfaction, and 2 patients (4%) were dissatisfied with the results. Three cases of temporary swelling of the hands resolved naturally. No long-term complications were seen. CONCLUSIONS: This study covers over a decade of practical experience in applying fat grafts to hands. The procedure is effective in reshaping and rejuvenating the hand as it shows long-lasting results after 1-year follow-up.
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In the framework of historical buildings, wall thickness as well as wall constituents are not often known a priori, and active IR thermography can be exploited as a nonintrusive method for detecting what kind of material lies beneath the external plaster layer. In the present work, the wall of a historical building is subjected to a heating stimulus, and the surface temperature temporal trend is recorded by an IR camera. A hybrid numerical model is developed in order to simulate the transient thermal response of a wall made of different known materials underneath the plaster layer. When the numerical thermal contrast and the appearance time match with the experimental thermal images, the material underneath the plaster can be qualitatively identified.
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BACKGROUND: Brachioplasty often involves removing excess skin. Many traditional approaches to this form of surgery are prone to complications and imperfect healing of the incisions. Traditional techniques usually take little or no account of the force vectors that are subsequently applied to the incision after the operation. This contributes towards scarring and other complications. METHOD: The proposed technique involves the explicit application of three balanced force vectors that greatly reduce scar-related complications. Although the scar is longer, it is on the medial side of the arm and usually fades away completely over time, with greatly improved aesthetic results. A closely related aspect of this technique is the application of anthropometric techniques in order to plan the operation for best results. RESULTS: The proposed technique has been applied in practice to 23 patients. There were no long-term complications. Temporary paresthesia was observed in 5 patients and temporary swelling of hands in 2 patients. One case of seroma was also detected. Two patient required surgical scar revision. One patient was unsastified with the final scar quality. CONCLUSIONS: Due to the superficial resection in this technique, no damage to the subcutaneous tissue and lymphatic network occurs, resulting in a more predictable outcome with greatly reduced risk of complications. This technique is particularly good at reducing the scar retraction issues most common when using other single-vector approaches. Level of Evidence: Level IV, therapeutic study.
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The study of anthropometry defines the beauty of the torso from a geometric perspective. Anthropometry therefore aids the plastic surgeon in planning the reshaping of the torso and also makes positioning of areolae and the umbilicus easier. When performing surgery on the breast, it is necessary to relate the breast to the torso as a whole, being anthropometry perfect for this process. When the anthropometric proportions are respected, the result is aesthetically optimal, and the perceived beauty of the body is enhanced. The study of anthropometry is widespread in the artistic field, and I have chosen the work of sculptor, Carlo Rochet, as the basis for my own use of anthropometry during plastic surgery. Level of Evidence: Level V, diagnostic study.