Microtia ear reconstruction

This ear reconstruction video shows a surgery to correct microtia by Toronto Plastic surgeon, Leila Kasrai MD. Microtia means small ear, and it is a congenital abnormality which causes problems with the formation of the ear tissue. In some children, a small portion of tissue is seen where the ear would normally be found. In others, the ear lobe or hollow of the ear, may be partially formed with the rest of the ear tissue missing. The most severe form of this condition leaves almost no ear tissue visible.

Keloids Pictures and Therapy

A Keloid is a type of scar with mainly type I and some type III collagen which results in an overgrowth of tissue at the site of a healed skin injury. Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can vary from pink to flesh-colored or red to dark brown in color. A keloid scar is benign, non-contagious, and usually accompanied by severe itchiness, sharp pains, and changes in texture. In severe cases, it can affect movement of skin.

You should not be confused with hypertrophic scars,Hypertrophic scars remain limited to the traumatized area and regress spontaneously within 12-24 months, although regression may not necessarily be complete.

Prevention:
It is the first line in keloid therapy. Avoid performing nonessential cosmetic surgery in patients known to form keloids; however, the risk is lower among patients who have only earlobe lesions. Close all surgical wounds with minimal tension. Incisions should not cross joint spaces. Avoid making midchest incisions, and ensure that incisions follow skin creases whenever possible.


Treatments:
*Occlusive dressings include silicone gel sheets and dressings, nonsilicone occlusive sheets, and Cordran tape. These measures have been used with varied success. Antikeloidal effects appear to result from a combination of occlusion and hydration, rather than from an effect of the silicone.

*Compression therapy involves pressure, which has long been known to have thinning effects on skin. Reduction in the cohesiveness of collagen fibers in pressure-treated hypertrophic scars has been demonstrated by electron microscopy.

- Compression treatments include button compression, pressure earrings, ACE bandages, elastic adhesive bandages, compression wraps, spandex or elastane (Lycra) bandages, and support bandages. In one study, button compression (2 buttons sandwiching the earlobe applied after keloid excision) prevented recurrence during 8 months to 4 years of follow-up observation.

*Corticosteroids, specifically intralesional corticosteroid injections, have been the mainstay of treatment. Corticosteroids reduce excessive scarring by reducing collagen synthesis, altering glucosaminoglycan synthesis, and reducing production of inflammatory mediators and fibroblast proliferation during wound healing. The most commonly used corticosteroid is triamcinolone acetonide (TAC) in concentrations of 10-40 mg/mL administered intralesionally with a 25- to 27-gauge needle at 4- to 6-week intervals.

Recent innovations:
New treatments for keloids and hypertrophic scars include intralesional IFN; 5-FU; doxorubicin; bleomycin; verapamil; retinoic acid; imiquimod 5% cream; tacrolimus; tamoxifen; botulinum toxin; TGF-beta3; rhIL-10; VEGF inhibitors; etanercept; manose-6-phosphate inhibitors; etanercept; onion extract; the combination of hydrocortisone, silicon, and vitamin E; PDT; intense pulsed light (IPL); UVA-1; and narrowband UVB.

Face Scar Revision Surgery

Principles of Soft Tissue Coverage for Tumor Reconstruction (Hand)

Reconstruction of defects produced after tumor extrication differs significantly from that which is normally encountered in the treatment of traumatic defects. Immediate reconstruction should be anticipated and planned in most instances. The use of two surgical teams is advantageous. This avoids the tendency of the surgeon to compromise the resection or remove less tissue out of concern for maintaining reconstruction options.

Operating room personnel must adhere to strict precautions to prevent cross contamination of operative fields. This includes the use of separate draping, instruments, operative clothing, and personnel. The planning for reconstruction should include the possibility that the margins of resection might be positive.
If a local or rotation flap is to be performed, the potential for spread of the tumor to the donor site must be considered. Groin flaps should be avoided. The use of distant or free tissue transfer increases reconstruction complexity but reduces the risk of donor field contamination and is more frequently used after tumor reconstruction.

Vascularized bone transfer or soft tissue coverage may be particularly beneficial and may improve healing in those patients who need postoperative chemotherapy or radiation.

 Wide excision soft tissue sarcoma from the dorsum of the hand (A,B) with radial forearm flap for soft tissue coverage (C).

Post Labioplasty Massage

Otto Placik MD. a board certified Chicago Illinois based plastic surgeon presents instructional video on post genital surgery (labia minora reduction aka labiaplasty or labioplasty or clitoral hood reduction) massage exercises for treatment of labum minora psot surgical fibrosis or hypersensitivity. Photos pictures and video of anatomic models are reviewed . Great for patients thinking about or planning labiaplasty or vaginal cosmetic surgery.

How to identify Hematoma in Mammography ??

In this article We will show WELL-CIRCUMSCRIBED and ILL-DEFINED HEMATOMA as seen in Mammogaphy...

WELL-CIRCUMSCRIBED HEMATOMA:
Most commonly caused by blunt or surgical trauma, although hematomas may develop in patients who are anticoagulated or have clotting abnormalities. The combination of hemorrhage and edema more commonly results in an ill-defined mass or a diffuse area of increased density. Although the mammographic findings simulate carcinoma, a history of trauma suggests a conservative approach. Follow-up examinations show gradual decrease in size or even disappearance of the lesion. An organized hematoma may occasionally persist as a more sharply defined mass.

Imaging Findings:

Medium to high-density mass, often having slightly irregular margins. Overlying skin edema is usually present in the acute stage if the hematoma is secondary to trauma.

Hematoma. (A) Mammogram of a firm, palpable mass that arose at a recent biopsy site shows a dense lesion associated with skin thickening (arrows). (B) Three months later, there has been almost complete resolution of the hematoma with only minimal residual architectural distortion (arrows).

ILL-DEFINED HEMATOMA

Overlying skin thickening from edema and bruising may simulate carcinoma. Hematomas tend to resolve within 3 to 4 weeks.

Imaging Findings:

May appear as an ill-defined lesion (more commonly a relatively well-defined mass or a diffuse increase in density).

Hematoma. Ill-defined area of increased density (arrows) in the area of a lumpectomy performed 2 weeks previously.

Carpal Tunnel Choices

This 3D medical animation depicts carpal tunnel syndrome and carpal tunnel release. Carpal tunnel syndrome is a nerve disorder of the hand caused by compression of the median nerve.2 different types of carpal tunnel release are animated, an open carpal tunnel procedure and the endoscopic approach.

Principle of Rhinoplasty

Tummy Tuck Abdominoplasty

This shows a full Abdominoplasty surgery performed by Dr. Art Foley in Olympia Washington. Abdominoplasty is also commonly referred to as a "Tummy Tuck." Tummy tuck is a surgical procedure also known as abdominoplasty to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar.

Mole Removal Performed by a Dermatologist

Video of Muscle-Splitting Breast Augmentation

Breast augmentation usually is performed in subglandular, subfascial, or partial submuscular pockets, including the dual plane. A new pocket has been described and used by the author. Methods: From October 2005 to April 2008, 600 patients underwent bilateral breast augmentation using the new technique.
Soft cohesive gel micro-textured round implants (range 200- 500cc) were used. The initial pocket is made in the subglandular plane up to the lower level of the nipple areolar complex. The submuscular plane is reached by splitting the pectoralis major muscle at the level of middle and lower third of sternum.

The muscle is split along the direction of its fibers up and laterally to the anterior axillary fold. No pectoralis major is released from costal margin. The implant lies in this plane simultaneously behind and in front of the pectoralis major. Procedure is performed as a day case under general anesthetic with no drains.

Results: Postoperative analgesia requirements is reduced because of dissection in natural planes resulting in quick recovery. No muscle contraction associated deformities is seen. All patients had aesthetically natural cleavage, with the nipple at the most projected part of the breast with three-dimensional enhancement.
Conclusion: An adequate muscle cover of the prosthesis is achieved by muscle splitting breast augmentation technique and the procedure is used in all breast augmentations procedures

Plastic Surgery Secrets Plus-April 2010 edition

Plastic Surgery Secrets-the first Secrets Series® title in the PLUS format-offers an easy-to-read, information-at-your-fingertips approach to plastic and reconstructive surgery and hand surgery. Jeffrey Weinzweig has joined forces with world-renowned plastic surgeons Joseph McCarthy, Julia Terzis, Joseph Upton, Fernando Ortiz-Monasterio, and Luis Vasconez, and others to bring you the expert perspective you need to grasp the nuances of this specialty. This new edition features an additional color that highlights tables, legends, key terms, section and chapter titles, and web references. All this, along with the popular question-and answer approach and list of the “Top 100 Plastic Surgery Secrets,” make it a perfect concise board review tool and a handy clinical reference.

* Maintains the popular and trusted Secrets Series® format, using questions and short answers for effective and enjoyable learning.

* Provides the most current overview and authoritative coverage of all topics thanks to contributions from an impressive list of over 300 experts in the field of plastic surgery and multiple related specialties.

* Introduces the new PLUS format, with an expanded size and layout and full color for easier review, more information, and more visual elements for an overall enhanced experience.

* Presents enhanced tables, legends, key terms, and section and chapter titles through the use of an additional color that makes finding information quick and easy.

* Contains new full color images and illustrations to provide more detail and offer a clearer picture of what is seen in practice

CLICK HERE

Rhinoplasty or nose job using open technique

HD Video presented by TheVideoPlasticSurgeon.com, Dr Michael J Brown MD, about nose job plastic surgery. This graphic video presents an overview of what to expect from an open rhinoplasty plastic surgery, or nose job.

Nasal reconstruction using median forehead flap