Ultrasound-guided Fat Graft of the Obliques-Serratus Complex.

Background: The idea of the anterolateral thoracic musculature in men during the contour procedure is very limited, particularly in terms of surgical techniques that improve its appearance and aesthetics. Therefore, this study aimed to describe a technique of deep definition liposuction with intramuscular grafting of the serratus external oblique muscle complex. Methods: A retrospective case series of a total of 11 cases of male patients aged between 29 and 60 years in the year 2022 is presented. These patients underwent body contouring surgery and subsequently underwent ultrasound-guided intramuscular fat grafting in the serratus external oblique complex. As part of the study, measurements were taken before and immediately after surgery. The data were stored in a database and analyzed with the statistical software SPSS, v23.0. Results: The patients were aged between 29 and 60 years, with a mean age of 38.3 years (±8.5). All cases had a body mass index of 30. Results were matched preinfiltration and postinfiltration; These results were subjected to statistical validation using the Student t test for related samples, and statistically significant differences were obtained in all the measures tested. Conclusions: The technique of fat grafting in the oblique-serratus complex allows for increasing muscle thickness. The measurements were made only immediately after the infiltration; it is important in the future to show the long-term follow-up. No adverse events occurred during the study.

A New Surgical Approach to Body Contouring.

BACKGROUND: The success of body contouring surgery will largely depend on the correct choice and performance of the technique, and utilization of the necessary scientific measures. Thus, this study sought to highlight the combination and evolution of the abdominoplasty-assisted liposuction technique, while individualizing each case for the patient's benefit. METHOD: We present a series of 188 cases from the past 3 years (2017-2019), using our modification to the surgical technique: performing 360-degree liposuction first, and then abdominoplasty in the same surgical time. We show our aesthetic results, surgical time, and complications, so as to compare them with the literature. RESULTS: Of the 188 cases, 184 were women (97.9%) and 4 were men (2.1%). In 11 cases (5.8%), we recorded 4 hours as a minimum surgical time and 8 hours in 16 cases (8.5%) as a maximum time. Regarding complications, hematomas were recorded in 1 case (0.5%) as the least frequent complication and seromas in 18 cases (9.6%) as the most frequent complication. The aesthetic results, although not objectively measurable, are flattering for both the patient and the surgeon, as shown by documented evidence (photographs) before and after surgery. CONCLUSIONS: Our study supports favorable results. Modification of this technique has resulted in outstanding body contouring surgery. We hope this procedure can be reproduced because of its few complications and the pleasant results it yields.

The Perception of the Ideal Body Contouring in Mexico.

Over the centuries, our appreciation of beauty has changed, as has the social environment that influences our perspective. Currently we are trying to use measurable instruments to achieve a better aesthetic result in each patient, using as a reference the "golden ratio," which is found in harmonies of all kinds-in art, nature, architecture, and today, in medicine-to aspire to the ideal proportion. METHODS: We conducted a survey in which we showed participants 4 digitally modified images of a model with different body proportions, 1 with the golden ratio and 3 with other variable proportions. In total, 900 people were surveyed, of which 131 had attended cosmetic surgery consultation, and 769 respondents were recruited on our social networks. RESULTS: Of the 900 respondents, 607 were women and 293 were men. Fifty-nine percent of the surveyed women chose image C (shown in Fig. 3) and similarly, so did 59.4% of surveyed men, which was not statistically significant; however, when considering age, we found the groups of 21-30, 31-40, and 41-50 chose image C at 46%, 65%, and 67%, respectively, whereas 44% of those over 51 years preferred image B, which is statistically significant. CONCLUSIONS: The image whose waist-hip harmony meets the golden ratio (1.61) is most often chosen as "the most beautiful," by both men and women. It is also the preferred image for all age groups under 50.

[Inappropriate use of antibiotics in acute appendicitis. A survey of Mexican surgeons]. / Uso inapropiado de antibióticos en apendicitis aguda. Resultado de una encuesta a cirujanos mexicanos.

BACKGROUND: Appendectomy is the most common non-elective surgery. The postoperative use of antibiotics depends on the stage of the appendix at the time of surgery. Several classifications establish that state. We determine if these classifications are known and used by Mexican surgeons. METHODS: A descriptive and observational study was performed. A questionnaire was completed by surgeons asking the following questions: Do you use a classification for acute appendicitis? 2) Which classification do you prefer? 3) Do you use antibiotics postoperatively? 4) For what period of time do you administer antibiotics postoperatively? We evaluated if the postoperative treatment is influenced by the use of a classification, using the chi(2) test. RESULTS: One hundred and forty two surgeons were interviewed, 99% used a classification, and 48% indicated postoperative antibiotics, despite the stage of the disease, monotherapy (69%), and for three doses (60%). Fifty two percent used antibiotic only in advanced stages, with two different types (61%), and from 7 to 10 days (66%). We did not find any statistical difference in management, regardless of whether or not an appendicitis classification was used. CONCLUSIONS: Although most surgeons use one classification for acute appendicitis, this does not influence postoperative treatment. This incongruity results in the unjustified use of antibiotics.

[Intestinal trichobezoar as a cause of small bowel obstruction. Case report and review of the literature]. / Tricobezoar como causa de oclusión intestinal alta. Informe de un caso y revisión de la literatura.

BACKGROUND: The trichobezoars are conglomerates of hair ingested by a person. They are located in the stomach, although they can extend also to the small bowel. They are common in children and adolescents, and 90% of the patients are women. An occasional complication is mechanical obstruction, usually at the gastric level or in the small bowel. It is extremely rare to find trichobezoars in the small bowel without a gastric component. CASE REPORT: A 18 year-old female patient was admitted for small bowel obstruction. Three weeks before she had underwent appendectomy. Laparotomy was performed identifying three trichobezoars occluding the jejune, without evidence of gastric bezoars. The bezoars were extracted by enterotomy. No post-operatory complications were presented. CONCLUSIONS: Trichobezoars are a rare entity that may be complicated by bowel obstruction. The discovery of trichobezoars in the bowel may be due to primary formation, which is improbable, or to fragmentation in the stomach followed by migration of the fragments, which in the case presented could be favored by the patient's previous operation.

Tricobezoar como causa de oclusión intestinal alta. Informe de un caso y revisión de la literatura / Intestinal tricobezoar as a cause of small bowel consumption

Antecedentes: Los tricobezoares son conglomerados de cabello ingerido por una persona. Se localizan en el estómago aunque se pueden extender hasta el intestino delgado. Son comunes en niños y adolescentes y 90% de los casos son mujeres. La obstrucción mecánica es una complicación ocasional, regularmente a nivel gástrico o en intestino delgado cuando el bezoar se extiende hasta ahí. El hallazgo de tricobezoares en intestino delgado sin componente gástrico es sumamente raro. Se reporta el primer caso de este tipo en nuestro país. Presentación del caso: Paciente femenino de 18 años ingresa por oclusión intestinal alta. Tres semanas antes se le había realizado apendicectomía. Se realiza cirugía identificando tres tricobezoares ocluyendo el yeyuno, sin evidencia de bezoares gástricos. Se extraen los mismos mediante enterotomía. La paciente evolucionó sin complicaciones. Conclusión: Los tricobezoares son entidades raras, que pueden complicarse causando oclusión intestinal. El hallazgo de tricobezoares múltiples en el intestino y no en el estómago se puede deber a formación primaria en el mismo, lo cual es poco probable, o a la fragmentación de uno gástrico y la posterior migración de los fragmentos, lo que pudo ser favorecido por la operación previa de la paciente.

Background: The trichobezoars are conglomerates of hair ingested by a person. They are located in the stomach, although they can extend also to the small bowel. They are common in children and adolescents, and 90% of the patients are women. An occasional complication is mechanical obstruction, usually at the gastric level or in the small bowel. It is extremely rare to find trichobezoars in the small bowel without a gastric component. Case Report: A 18 years old female patient was admitted for small bowel obstruction. Three weeks before she had underwent appendectomy. Laparotomy was performed identifying three trichobezoars occluding the jejune, without evidence of gastric bezoars. The bezoars were extracted by enterotomy. No post operatory complications were presented. Conclusions: Trichobezoars are a rare entity that may be complicated by bowel obstruction. The discovery of trichobezoars in the bowel may be due to primary formation, which is improbable, or to fragmentation in the stomach followed by migration of the fragments, which in the case presented could be favored by the patient's previous operation.