Our experience in the application of lipofilling.

Autologous fat grafting, referred to as lipofilling was described first by Neuber in 1893. It has been gaining great popularity recently due in particular to the intensive development of liposuction and the anatomical availability of various subcutaneous adipose tissue depots in the human body. In the present study we present our experience in autulogous fat grafting for the reconstruction of soft tissue defects as well as for face rejuvenation and body contouring. Between May 2003 and May 2005 we performed lipofilling surgery in 13 patients at the Department of Plastic and Craniofacial Surgery in St. George University Hospital, Plovdiv. The grafts were harvested by lipoaspiration and, after subsequent treatment, re-injected. Our results are still preliminary because of the short terms of patients' follow-up. The most common complications at the recipient site were partial resorption of the graft and cyst formation, and at the donor site--hematoma.

Craniofacial fibrous dysplasia. conservative surgical management. Review of literature and report of a case.

The present study presents a case of craniofacial fibrous dysplasia attenuating the orbit and the nasal airway, which was treated by conservative surgical approaches. Nasal and orbital decompression, and facial recontouring were performed simultaneously. This was done via a transconjunctival and transcaruncular approaches with a lateral canthotomy, which provided access to the four walls of the orbit, midface and the lateral nasal wall. The reduction of the turbinates was done through a standard turbinectomy approach and the nasal decompression was done via intercartilaginous access and a full transfixion incision and nasal degloving. The bulk of the lesion was removed with chisels, gauges, and rotary instruments. The orbital debulking extended to the orbital apex, which was not involved by the fibrous dysplasia. Approximately 200 mg of dysplastic bone was removed. The functional and aesthetic results were good. The symptoms of chronic conjunctivitis and nasal obstruction have been alleviated and there is no deterioration of his condition. The symptoms of anosmia have also disappeared. Conservative surgical treatment of craniofacial dysplasia in adults with stable disease is recommended.

Nasal reconstruction with vascularized forehead flap (preliminary communication).

AIM: The authors have studied the anatomical characteristics of the vascularization of the forehead flap used for nasal reconstruction. MATERIAL AND METHODS: For the period 1990--2000 ten cadaver dissections were performed and three patients underwent reconstructions using the forehead flap. The results obtained reveal that the blood supply of the flap is provided by the suprathrochlear, supraorbital and frontal branch of the superficial temporal vessels, which form a network of anastomoses between the frontal muscle and the skin. Three cases of successful nasal reconstruction are presented. Two of the patients had traumatic injury of the nose and one was with postoperative defect in the naso-labial area, nose and maxilla obtained after ablation surgery for neoplasm (spinocellular carcinoma). The reconstruction was done with vascularized oblique forehead flap. DISCUSSION: The results were evaluated as good. There were no complications. CONCLUSION: The results of the anatomical study of the blood supply of the forehead flap and the clinical results of nasal reconstruction are discussed in relation with the literature data.

Unilateral superiorly-based nasolabial island flap for the reconstruction of the philtrum.

We present a case of reconstruction of the philtrum with a unilateral superiorly-based nasolabial island flap following a secondary Millard's bilateral cheiloplasty in a 23-year-old man with cleft lip and palate. His philtrum consisted of a full-thickness skin graft transplanted at one of his previous operations.