Anatomical and aesthetical reconstruction of complex hair-bearing areas: a three-step procedure including implant of dermal regeneration templates, skin grafting, and hair micrografting.

Reconstructive surgery of complex hair-bearing skin defects often represents a challenge for the plastic surgeon; indeed, a multistage procedure is to be planned, including a first reconstructive step including local flaps, even if pre-expanded, or for larger defects, microsurgical flaps. To date, the implant of dermal regeneration templates has been proven an effective alternative. The authors relate their results of a complex hair-bearing reconstruction of a scalp and brow defect after a friction road burn with those reported in literature, concluding that a 3-staged reconstruction (dermal template implantation, skin grafting, and finally hair micrografting) can achieve good results in this complex kind of reconstruction. Histological specimens taken 2 years later confirmed a full anatomical reconstruction of the hair-bearing areas. Finally, this paper reports the first case of brow reconstruction performed with these techniques.

Triplane augmentation mammaplasty.

BACKGROUND: Sub-muscular positioning of breast implants requires interrupting as well as disinserting both the abdominal and sterno-chondral fibers of the pectoral muscle; this can produce a muscular strength reduction which reveal bothering and is often detected in some daily motions, such as cutting bread into slices. MATERIAL AND METHODS: The revision of anatomy and literature induced the authors to search for a conservative approach for breast augmentation. They describe a new technique defined "Tri-plane" where the muscular fibers are not cut but simply split to create the pocket for breast implants. RESULTS: Our experience evidenced that this technique gave good aesthetic results together with a more significant projection of the NAC without any strength diminution either in adduction or abduction of the arms. CONCLUSIONS: This technique is a valid alternative to other techniques of breast augmentation as it conjugates the advantages of sub-glandular and sub-muscular implants without muscular deficit.