Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear
|
|
- Adele Williams
- 5 years ago
- Views:
Transcription
1 The British Association of Plastic Surgeons (2004) 57, Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear Yong Oock Kim*, Beyoung Yun Park, Won Jae Lee Institute of Human Tissue Restoration, Department of Plastic Surgery, College of Medicine, Yonsei University, 134 Shinchon-dong, Seodaemoon-ku, C.P.O. Box 8044, Seoul, South Korea Received 8 May 2003; accepted 9 December 2003 KEYWORDS Composite graft; Folding; Nasal tip Summary Defects of the nasal tip, the alar, and the columella were treated with composite grafts from the postauricular area. The graft was folded into a threedimensional shape, which provided a three-layered reconstruction of skin, cartilage and nasal lining. This procedure preserved the shape of the reconstruction for a longer time and yielded a good aesthetic result. Moreover, although this method was simple and was carried out in one stage, it left minimal morbidity of the donor site, and produced satisfying results. Q 2004 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. Defects of the nasal tip, the alar, or the columella represent significant aesthetic deformity. The reconstruction of these defects needs the addition of tissue, but should produce minimal donor morbidity. If the defect is located on the tip area involving the columellar and the alar and is larger than 10 mm in size, it frequently affects the nasal air passage. Primary closure is not adequate for two-layered defects of the nasal tip, because it destroys the natural contour of the tip. For a larger defect, the reconstruction can be accomplished by local flap or distant flap, although these methods have donor site morbidity and may need several stages. For a moderate defect, however, it is more difficult to choose an appropriate treatment method. The composite graft of auricular skin and cartilage has been used for a long time. Without *Corresponding author. Tel.: þ ; fax: þ address: sgm625@yumc.yonsei.ac.kr careful aesthetic consideration, however, the reconstructed nose will show unnatural bulkiness or flatness on the nasal tip area. The risk of a partial or total loss of a graft is also a reason for reluctance in using composite grafts. We used composite grafts in patients who had defects involving the tip, the alar, and the columella areas. We successfully reconstructed the tip projection and the contour of the alar and columella by folding one piece of the composite graft. Material and method Patients One patient had a human bite to her nasal tip. The soft triangle, the tip, and the columella were lost. The tip was abruptly cut, and the deficiency of the tip was clearly apparent in the lateral view (Fig. 1). S /$ - see front matter Q 2004 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. doi: /j.bjps
2 Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear 239 Figure 1 Case 1. (Above) Preoperative views of the patient. (Below) Two years postoperative. This defect was reconstructed by a composite graft of mm 2 in size. Another patient had an infectious disease on her nose from childhood. After controlling the infection, she lost her nasal tip contour. The defects were located on the tip, the soft triangle, and both alars. Both nostrils showed sharp triangular shapes (Fig. 2). After the release of the contracted scar, the defect was reconstructed by a composite graft of mm 2. Operative procedures In order to estimate the tissue requirement for the reconstruction, the following procedures were conducted. A piece of construction paper was folded in the shape of the nose to measure the size of the defected area. Then, we marked the size of the defect on the piece of paper. After marking the size of the defect, we unfolded the paper and cut it guided by the marked line. The size of the piece of paper showed the size of the defect (Fig. 3). We then marked the approximate size of the defect on the postauricular area using the piece of paper. Then, we harvested the composite graft in one piece from the postauricular area. Following this procedure, we removed a part of the cartilage in the line of a Y-shape, because the cartilage is not soft enough for it to be folded like a piece of paper. This removal took place before the actual construction or the folding of the composite graft (Fig. 4, above, right). Then, we folded the composite graft into the three-dimensional shape of the nose as we did with the paper, and grafted it on the defected area. The final shape of folded graft was a pyramid shape with four legs. The graft was sutured with fine silk on the recipient site after debridement of the wound (Fig. 4, below). A dressing was applied with no pressure. All stitches were removed on the seventh day after operation.
3 240 Y.O. Kim et al. Figure 2 Case 2. (Above) Preoperative views of the patient. (Below) Four months postoperative.
4 Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear 241 Figure 3 Diagram (A and B) shows pre-operative status and expected status after reconstruction (dotted line). (C) Three quarter and frontal views of folded paper after fitting the raw surface are demonstrated. (D) Raw surface after release of scar tissue on the nasal tip is shown. (E) Diagram shows the reconstructed nose using the folded composite ear graft. Dotted lines show layers of cartilage.
5 242 Y.O. Kim et al. Figure 4 (Above, left) Harvested composite graft. (Above, right) After removal of the cartilage strip in a Y-shape for three-dimensional folding. (Below) Antero-posterior and worm s eye views after insetting of the folded graft.
6 Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear 243 Result The composite grafts survived without losing the initial reconstructed shape. The nasal tip projections and the framework of the columellar and the alar were reconstructed successfully, and they were maintained well during the follow-up period (Figs. 1 and 2, below). There was a partial loss of the superficial skin of the graft on the columellar area in one patient. The area was healed without any additional procedures. By adding the tissue, the nostrils were wide enough and the soft triangle, the alar, and the columella were aesthetically acceptable. The scars along the boundaries of the composite graft became less obvious. Discussion The nose is a prominent structure in the face. When a plastic surgeon reconstructs the nose, the restoration of its subtle contours and highlights is as important as wound closure. The coverage of skin and nasal lining and the contour of the shape created by the cartilage graft are essential for superior aesthetic results. In the past, there have been many reports of the use of composite ear grafts for the repair of nasal defects, 1 4 ever since Dupertuis first reported a nasal tip reconstruction that used earlobe composite grafts in Composite grafts from the ear have been effectively used in reconstructions of smaller sized defects of the columella and alar. 6 When the defect involved the tip, the soft triangle, the alar, and the columella, local flaps may be preferred, because they can provide an adequate amount of tissue. However, the local flap, such as the forehead flap, needs subsequent operations to detach and to revise in order to sculpt and debulk for a more satisfactory result. Generally speaking, for the survival of the composite graft, 5 mm maximum distance from the point of vascular contact is preferred, even if the maximal size of a graft were arbitrarily determined Many composite grafts follow this guideline regardless of graft shape: wedge, elliptical, or rectangular shape. The three-dimensional tip projection, however, is difficult to reconstruct adequately with a two-dimensional composite graft. The tip projection following the procedure involving the two-dimensional composite graft can often be cosmetically unpleasant, due to its flatness. This outcome may occur because even if the thickness of the composite graft were added to the amount of tissue at the tip, the thickness of the composite tissue can be insufficient in creating adequate tip projection. 11,12 The patients in this report had unique deformities in the subunit areas of the nasal tip and the soft triangle. The deformities involved having a tissue deficiency in the nasal lining, the cartilage, and the skin cover. Using the composite ear graft in these patients would have obliged us to overcome two obstacles: the survivability of the composite graft and the aesthetically acceptable shape of the reconstructed tip and soft triangle. To overcome these obstacles, we devised a new design, the folding method, for the composite graft. This folding method produces the composite graft in a shape that is near to that of a three-dimensional pyramid. When we fold the composite graft in a threedimensional pyramid shape, we can ensure the survivability of the composite graft because the distance from the vascular margin is not more than 5 mm, although the original width of the graft before folding was 15 mm. This occurrence is due to the fact that when we fold an object once, the distance from its outer margin to the folding line is normally half of the original distance, but in a three-dimensional pyramid shape, the distance from the vascular margin to the center is decreased more than half. Moreover, folding effectively pushes the soft tissue to the apex of the pyramid from all directions, resulting in having sufficient amount of soft tissue to shape the tip and in having three buttresses of cartilage in the graft tissue to maintain the shape. Although this folding method ensures the survivability of the composite graft and the aesthetically acceptable form of the nose, there are some disadvantages, which is why this method must be used carefully. One patient showed superficial skin epidermal necrosis. However, all the skin was not affected, and it healed without a noticeable scar. We think the removal of the strip of cartilage in the Y-shape was what could have possible caused this necrosis. Because a strip of cartilage is removed, the blood circulation in the columellar area is a bit damaged, and this removal of cartilage may have caused the superficial skin epidermal necrosis. Thus in removing the cartilage and using the folding method, one must be careful and must be aware of the circumstances this method may yield. In conclusion, the tip projections of the patients after the operations proved to be aesthetically more acceptable than the resultant projections that used simple coverage of flaps or one-layer composite grafting. The results of these cases clearly present some of the beneficial features and outcomes of using the technique of three-dimensional
7 244 Y.O. Kim et al. folding of composite grafts as a treatment of choice in defects requiring reconstructive surgery. Acknowledgements The authors thank Hyun Jin Kim for her help in revising the English. This work was supported by grant No. R from the Basic Research Program of the Korea Science and Engineering Foundation. References 1. Converse JM. Reconstruction of the nasolabial area by composite graft from the concha. Plast Reconstr Surg 1950;5: Meade RJ. Composite ear grafts for reconstruction of the columella. Plast Reconstr Surg 1959;23: Symonds FC, Crikelair GF. Auricular composite grafts in nasal reconstruction: a report of 36 cases. Plast Reconstr Surg 1966;37: Breach NM. Repair of a full-thickness nasal defect with an ear lobe sandwich graft. Br J Plast Surg 1979;32: Dupertuis SM. Free earlobe grafts of skin and fat. Plast Reconstr Surg 1946;1: Lehman Jr JA, Garrett Jr WS. Earlobe composite grafts for the correction of nasal defects. Plast Reconstr Surg 1971;47: Barton Jr FE, Byrd HS. In: McCarthy JG, editor. Acquired deformities of the nose. Plastic Surgery, vol. 3. Philadelphia: WB Saunders; p Chapter Nagel F. Reconstruction of a partial auricular loss. Plast Reconstr Surg 1972;49: Rees TD. The transfer of free composite grafts of skin and fat: a clinical study. Plast Reconstr Surg 1960;25: Davenport G, Bernard FD. Improving the take of composite grafts. Plast Reconstr Surg 1959;24: Burget GC, Menick FJ. Nasal reconstruction: seeking a fourth dimension. Plast Reconstr Surg 1986;78: Barton FE. Aesthetic aspects of partial nasal reconstruction. Clin Plast Surg 1981;8:177.
Columella Lengthening with a Full-Thickness Skin Graft for Secondary Bilateral Cleft Lip and Nose Repair
Original Article Columella Lengthening with a Full-Thickness Skin Graft for Secondary Bilateral Cleft Lip and Nose Repair Yoon Seok Lee 1, Dong Hyeok Shin 1, Hyun Gon Choi 1, Jee Nam Kim 1, Myung Chul
More informationThe bi-pedicle post-auricular tube flap for reconstruction of partial ear defects
The British Association of Plastic Surgeons (2003) 56, 593 598 The bi-pedicle post-auricular tube flap for reconstruction of partial ear defects Mohammed G. Ellabban*, Maamoun I. Maamoun, Moustafa Elsharkawi
More informationTHE pedicled flap, commonly used by the plastic surgeon in the reconstruction
THE PEDICLE!) SKIN FLAP ROBIN ANDERSON, M.D. Department of Plastic Surgery THE pedicled flap, commonly used by the plastic surgeon in the reconstruction of skin and soft tissue defects, differs from the
More informationFour Limb Shaped Auricular Chondrocutaneous Composite Graft for the Alar and the Columellar Defects
ORIGINAL ARTICLE https://doi.org/10.14730/aaps.2017.23.3.149 Arch Aesthetic Plast Surg 2017;23(3):149-154 pissn: 2234-0831 eissn: 2288-9337 aaps Aesthetic Plastic Surgery Four Limb Shaped Auricular Chondrocutaneous
More informationRECONSTRUCTION OF SUBTOTAL DEFECTS OF THE NOSE BY ABDOMINAL TUBE FLAP. By MICHAL KRAUSS. Plastic Surgery Hospital, Polanica-Zdroj, Poland
RECONSTRUCTION OF SUBTOTAL DEFECTS OF THE NOSE BY ABDOMINAL TUBE FLAP By MICHAL KRAUSS Plastic Surgery Hospital, Polanica-Zdroj, Poland RECONSTRUCTION of the nose is one of the composite procedures in
More informationSurgical treatment of non-melanoma skin cancer of the head and neck: expanding reconstructive options van der Eerden, P.A.
UvA-DARE (Digital Academic Repository) Surgical treatment of non-melanoma skin cancer of the head and neck: expanding reconstructive options van der Eerden, P.A. Link to publication Citation for published
More informationThis article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and
This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution
More informationPrinciples of flap reconstruction in ORL-HN defects. O.M. Oluwatosin Department of Surgery
Principles of flap reconstruction in ORL-HN defects O.M. Oluwatosin Department of Surgery Nasal defects and deformities Cleft palate and Velopharyngeal incompetence Pharyngeal and oesophageal defects Pinnal
More informationPrinciples of Facial Reconstruction After Mohs Surgery
Objectives Principles of Facial Reconstruction After Mohs Surgery Identify important functional anatomy and aesthetic units of the face. Describe techniques used in facial reconstruction. Discuss postoperative
More informationCombined tongue flap and V Y advancement flap for lower lip defects
British Journal of Plastic Surgery (2005) 58, 258 262 CASE REPORTS Combined tongue flap and V Y advancement flap for lower lip defects Kenji Yano*, Ko Hosokawa, Tateki Kubo Department of Plastic and Reconstructive
More informationAn alternative approach for correction of constricted ears of moderate severity
British Journal of Plastic Surgery (2005) 58, 389 393 An alternative approach for correction of constricted ears of moderate severity M.M. Al-Qattan* Division of Plastic Surgery, King Saud University,
More informationORIGINAL ARTICLE. Reconstruction of the Nasal Columella. David A. Sherris, MD; Jon Fuerstenberg, MD; Daniel Danahey, MD, PhD; Peter A.
ORIGINAL ARTICLE Reconstruction of the Nasal Columella David A. Sherris, MD; Jon Fuerstenberg, MD; Daniel Danahey, MD, PhD; Peter A. Hilger, MD Objective: To report techniques successful for nasal columella
More informationScientific Forum. Nostrilplasty: Raising, Lowering, Widening, and Symmetry Correction of the Alar Rim
Nostrilplasty: Raising, Lowering, Widening, and Symmetry Correction of the lar Rim Richard Ellenbogen, MD; and Greg azell, MD ackground: lthough the alar rim has frequently been neglected in correction
More informationProboscis lateralis: report of two cases
The British Association of Plastic Surgeons (2003) 56, 704 708 CASE REPORT Proboscis lateralis: report of two cases Lütfi Eroğlu a, *, Osman Ata Uysal b a Faculty of Medicine, Department of Plastic and
More informationA new classification system of nasal contractures
Original Article J Cosmet Med 2017;1(2):106-111 https://doi.org/10.25056/jcm.2017.1.2.106 pissn 2508-8831, eissn 2586-0585 A new classification system of nasal contractures Geunuck Chang 1, Donghak Jung
More information1 The nasal bones are deeper and are therefore MATERIAL AND METHODS. At the Department of Plastic and Reconstructive
Technical Experiences Reconstruction of the Nasal Tip Valerio Cervelli, MD, DJ Bottini, PhD, Pietro Gentile, MD Rome, Italy Defects of the nasal tip present complex problems in terms of reconstruction,
More informationOther ways to use tissue expanded flaps
The British Association of Plastic Surgeons (2004) 57, 336 341 CASE REPORTS Other ways to use tissue expanded flaps Donald A. Hudson* Department of Plastic and Reconstructive Surgery, University of Cape
More informationUniversity Journal of Surgery and Surgical Specialties
University Journal of Surgery and Surgical Specialties ISSN 2455-2860 Volume 2 Issue 1 2016 Ear lobe reconstruction Techniques revisited ANANTHARAJAN NATARAJAN Department of Plastic Reconstructive Surgery,
More informationEvaluation of the donor site after the median forehead flap
Evaluation of the donor site after the median forehead flap June Seok Choi 1, Yong Chan Bae 1,2, Soo Bong Nam 1, Seong Hwan Bae 1, Geon Woo Kim 1 1 Department of Plastic and Reconstructive Surgery, Pusan
More informationBackground: Methods: Results: Conclusions: 887
RECONSTRUCTIVE Defects of the Nose, Lip, and Cheek: Rebuilding the Composite Defect Frederick J. Menick, M.D. Tucson, Ariz. Background: The face can be divided into regions (units) with characteristic
More informationUpper Triangular Flap Method for Primary Repairs of Incomplete Unilateral Cleft Lip Patients. Minor to Two-Thirds Way Defects
HEAD AND NECK SURGERY Upper Triangular Flap Method for Primary Repairs of Incomplete Unilateral Cleft Lip Patients Minor to Two-Thirds Way Defects Kyung S. Koh, MD, PhD,* Tae Suk Oh, MD,* and Jin Woo Song,
More informationPARTIAL RECONSTRUCTION OF THE AURICLE
Hirosaki Med.J. 66:99 104,2016 REVIEW PARTIAL RECONSTRUCTION OF THE AURICLE Satoshi Urushidate,Katsunori Yokoi,Yosuke Watanabe, Makoto Mikami and Yuko Higuma Abstract Auricular reconstruction is often
More informationClin Plastic Surg 31 (2004) Ear reconstruction. E. Fred Aguilar III, MD, FACS a,b,c, *
Clin Plastic Surg 31 (2004) 87 91 Ear reconstruction E. Fred Aguilar III, MD, FACS a,b,c, * a Division of Plastic and Reconstructive Surgery and the Department of Otolaryngology/Head and Neck Surgery,
More informationNose Reshaping (Rhinoplasty)
Nose Reshaping (Rhinoplasty) Are you interested in improving the appearance of your nose? If so, you re not alone. Nose reshaping, or rhinoplasty, is one of the most common plastic surgery procedures performed
More informationISPUB.COM. Cutting Burr Otoplasty. D Wynne, N Balaji INTRODUCTION ANATOMY CUTTING BURR TECHNIQUE
ISPUB.COM The Internet Journal of Otorhinolaryngology Volume 7 Number 1 D Wynne, N Balaji Citation D Wynne, N Balaji.. The Internet Journal of Otorhinolaryngology. 2006 Volume 7 Number 1. Abstract Prominent
More informationManagement of Complex Avulsion Injuries of the Dorsum of the Foot and Ankle in Pediatric Patients by Using Local Delayed Flaps and Skin Grafts
Management of Complex Avulsion Injuries of the Dorsum of the Foot and Ankle in Pediatric Patients by Using Local Delayed Flaps and Skin Grafts Ahmed Elshahat, MD Plastic Surgery Department, Ain Shams University,
More informationOF CONCHA-HELIX DEFECTS. BY JAMES K. MASSON, M.D. Mayo Clinic and Mayo Foundation, Rochester, Minnesota
British Journal qf Plastic Surgery (x97z), 7,5, 399-403 A SIMPLE ISLAND FLAP FOR RECONSTRUCTION OF CONCHA-HELIX DEFECTS BY JAMES K. MASSON, M.D. Mayo Clinic and Mayo Foundation, Rochester, Minnesota AFTER
More informationPearls for Keeping it Simple in Cutaneous Reconstruction
Pearls for Keeping it Simple in Cutaneous Reconstruction Jerry D. Brewer, MD, MS, FAAD brewer.jerry@mayo.edu Professor of Dermatology Division of Dermatologic Surgery Department of Dermatology Mayo Clinic
More informationPerichondrial Cutaneous Grafts in Facial Reconstruction
IJHNS Jamie G Bizzell, Jennings R Boyette ORIGINAL ARTICLE 10.5005/jp-journals-10001-1285 1 Jamie G Bizzell, 2 Jennings R Boyette ABSTRACT Aim: The purpose of this study is to review the indications, techniques,
More informationHospital das Clinicas, Brazil
THE IMPORTANCE OF THE CARTILAGINOUS FRAMEWORK IN PLASTIC SURGERY OF THE NOSE By ROBERTO FARINA, M.D., OSVALDO DE CASTRO, and RICARDO BAROUDI, M.D. Hospital das Clinicas, Brazil As far as plastic surgery
More informationUsing the sac membrane to close the flap donor site in large meningomyeloceles
The British Association of Plastic Surgeons (2004) 57, 273 277 Using the sac membrane to close the flap donor site in large meningomyeloceles Cengiz Bozkurt a, Selçuk Akın a, *,Şeref Doğan b, Erkut Özdamar
More informationThe gluteal perforator-based flap in repair of pressure sores
The British Association of Plastic Surgeons (2004) 57, 342 347 CASE REPORTS The gluteal perforator-based flap in repair of pressure sores Çilingir Meltem*, Çelik Esra, Fındık Hasan, Duman Ali Department
More informationRHINOPLASTY (NOSE RE-SHAPING)
PROCEDURE FACT SHEET PLASTIC SURGERY RHINOPLASTY (NOSE RE-SHAPING) This is a guide for people who are considering having a nose re-shaping (Rhinoplasty) operation. We advise that you talk to a plastic
More informationTRANSPOSITIONAL ADIPOFASCIAL FLAPS FOR COMPLICATED ACUTE FINGER INJURIES
K.B. Poon, S.H. Chien, G.T. Lin, et al TRANSPSITINAL ADIPFASCIAL FLAPS FR CMPLICATED ACUTE FINGER INJURIES Kein Boon Poon, Song-Hsiung Chien, 1 Gau-Tyan Lin, 1 and Yin-Chih Fu 1 Department of rthopaedic
More informationThe Versatile Naso-Labial Flaps in Facial Reconstruction
Journal of the Egyptian Nat. Cancer Inst., Vol. 17, No. 4, December: 245-250, 2005 The Versatile Naso-Labial Flaps in Facial Reconstruction HAMDY H. EL-MARAKBY, M.D., F.R.C.S. The Departments of National
More informationUse of internal callus distraction in the treatment of congenital brachymetatarsia
British Journal of Plastic Surgery (2005) 58, 1014 1019 CASE REPORT Use of internal callus distraction in the treatment of congenital brachymetatarsia Naoto Yamada*, Yoshihiro Yasuda, Nobuko Hashimoto,
More informationJPRAS Open 3 (2015) 1e5. Contents lists available at ScienceDirect. JPRAS Open. journal homepage:
JPRAS Open 3 (2015) 1e5 Contents lists available at ScienceDirect JPRAS Open journal homepage: http://www.journals.elsevier.com/ jpras-open Case report The pedicled transverse partial latissimus dorsi
More informationThe gastrocnemius with soleus bi-muscle flap
The British Association of Plastic Surgeons (2004) 57, 77 82 The gastrocnemius with soleus bi-muscle flap Ikuo Hyodo a, *, Bin Nakayama b, Mitsuru Takahashi c, Kazuhiro Toriyama d, Yuzuru Kamei d, Shuhei
More informationAugmentation Rhinoplasty with Autologous Grafts
Aesth Plast Surg (2008) 32:136 142 DOI 10.1007/s00266-007-9052-3 REVIEW Augmentation Rhinoplasty with Autologous Grafts D. J. Bottini Æ P. Gentile Æ A. Donfrancesco Æ L. Fiumara Æ V. Cervelli Published
More informationOur algorithm for nasal reconstruction *
Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 239 247 Our algorithm for nasal reconstruction * T. Yoon*, J. Benito-Ruiz, E. García-Díez, J.M. Serra-Renom Department of Plastic, Reconstructive
More informationThere are numerous suture techniques described for nasal. Septocolumellar Suture in Closed Rhinoplasty ORIGINAL ARTICLE
ORIGINAL ARTICLE Erdem Tezel, MD, and Ayhan Numanoğlu, MD Abstract: Several surgeons advise a variety of tip sutures and describe their own techniques in open approach. Septocolumellar suture is one of
More informationReconstruction of axillary scar contractures retrospective study of 124 cases over 25 years
British Journal of Plastic Surgery (2003), 56, 100 105 q 2003 The British Association of Plastic Surgeons. Published by Elsevier Science Ltd. All rights reserved. doi:10.1016/s0007-1226(03)00035-3 Reconstruction
More informationA NEW METHOD FOR TOTAL RECONSTRUCTION OF THE NOSE : THE EARS AS DONOR AREAS
A NEW METHOD FOR TOTAL RECONSTRUCTION OF THE NOSE : THE EARS AS DONOR AREAS By MIGUEL ORTICOCHEA, M.D. 1 Professor of Plastic Surgery, Medical School, Javeriana University, Bogotd, Colombia THE early history
More informationDisclosures. The Expanding Role of Microvascular Reconstruction. Overview. Things they are a Changing. Surgical Advisory Board, Genentech Corp
Disclosures Surgical Advisory Board, Genentech Corp The Expanding Role of Microvascular Reconstruction P. Daniel Knott, MD FACS Associate Professor Director, Facial Plastic and Reconstructive Surgery UCSF
More informationRECONSTRUCTION of large surgical
Triple-Flap Technique for Reconstruction of Large Nasal Defects Timothy W. Wild, MD, DDS; C. Patrick Hybarger, MD ORIGINAL ARTICLE Objective: To determine the usefulness of a triple-flap technique for
More informationConstruction of the congenitally missing columella in midline clefts
Construction of the congenitally missing columella in midline clefts Kurt-Wilhelm BÜTOW Department of Maxillo-Facial and Oral Surgery (Head: Prof. Kurt-W. Bütow, MChD(OMFSurg), DMD, PhD, DSc(Odont), FCMFOS),
More informationTriple Plane Dissection in Open Primary Rhinoplasty in Middle Eastern Noses
Triple Plane Dissection in Open Primary Rhinoplasty in Middle Eastern Noses Ahmed Elshahat, MD Plastic Surgery Department, Faculty of Medicine, Ain Shams University; and Eldemerdash Hospital, Cairo, Egypt
More informationLarge full-thickness nasal tip defects after Mohs
RECONSTRUCTIVE CONUNDRUM Repair of a Large, Exposed-Cartilage Nasal Tip Defect Using Nasalis-Based Subcutaneous Pedicle Flaps and Full-Thickness Skin Grafting DIEGO E. MARRA, MD, EDGAR F. FINCHER, MD,
More informationCompared with other ethnicities, Asians have
Original Article Correction of Asian Short Nose with Lower Lateral Cartilage Repositioning and Ear Cartilage Grafting Jin Suk Byun, MD, PhD* Kenneth K. Kim, MD, FACS, Background: Asians with short nose
More informationPlastic Surgeon, Middlesbrough General Hospital, Stockton Children's Hospital, Newcastle Regional Hospital Board
THE NASAL TIP IN BILATERAL HARE LIP By J. POTTER, F.R.C.S.Ed. Plastic Surgeon, Middlesbrough General Hospital, Stockton Children's Hospital, Newcastle Regional Hospital Board IN the problem of the bilateral
More informationCleft lip is the most common craniofacial
Ideas and Innovations Fat Grafting in Primary Cleft Lip Repair Elizabeth Gordon Zellner, M.D. Miles J. Pfaff, M.D. Derek M. Steinbacher, M.D., D.M.D. New Haven, Conn. Summary: The goal of primary cleft
More informationNaso-Orbital Complex Reconstruction with Titanium Mesh and Canthopexy
Case Report imedpub Journals http://www.imedpub.com DOI: 10.4172/2472-1905.100011 Naso-Orbital Complex Reconstruction with Titanium Mesh and Canthopexy Abstract Context: We are introducing the reconstruction
More informationRECONSTRUCTION OF SCALP DEFECTS: AN INSTITUTIONAL EXPERIENCE Sathyanarayana B. C 1, Somashekar Srinivas 2
RECONSTRUCTION OF SCALP DEFECTS: AN INSTITUTIONAL EXPERIENCE Sathyanarayana B. C 1, Somashekar Srinivas 2 HOW TO CITE THIS ARTICLE: Sathyanarayana B. C, Somashekar Srinivas. Reconstruction of Scalp Defects:
More informationFibular Bone Graft for Nasal Septal Reconstruction: A Case Report
220 Nasal septal reconstruction Case Report Fibular Bone Graft for Nasal Septal Reconstruction: A Case Report Yakup Cil1* Diyarbakır Military Hospital, Department of Plastic Surgery 21000 Diyarbakır, Turkey
More informationTrigeminal Trophic Syndrome: Report of 2 Cases
Trigeminal Trophic Syndrome: Report of 2 Cases Yoko Osaki, MD, Tateki Kubo, MD, PhD, Kyosuke Minami, MD, and Daisuke Maeda, MD Department of Plastic Surgery, Osaka Rosai Hospital, Sakai, Japan Correspondence:
More informationThe upper buccal sulcus approach, an alternative for post-trauma rhinoplasty
British Journal of Plastic Surgery (2003), 56, 218 223 q 2003 The British Association of Plastic Surgeons. Published by Elsevier Science Ltd. All rights reserved. doi:10.1016/s0007-1226(03)00117-6 The
More informationGastrocnemius Myocutaneous Flap: A Versatile Option to Cover the Defect of Upper and Middle Third Leg
Downloaded from wjps.ir at 22:25 +0330 on Sunday November 18th 28 314 Gastrocnemius flap for coverage of leg defects Original Article Gastrocnemius Myocutaneous Flap: A Versatile Option to Cover the Defect
More informationRepair of scalp defect using a superficial temporal fascia pedicle VY advancement scalp flap *
British Journal of Plastic Surgery (2005) 58, 676 680 Repair of scalp defect using a superficial temporal fascia pedicle VY advancement scalp flap * Kiyoshi Onishi a, *, Yu Maruyama b, Akiteru Hayashi
More informationOriginal Article Case analysis of triangular bracket from autogenous nasal septal and auricular cartilage for the correction of short nose
Int J Clin Exp Med 2018;11(2):1337-1342 www.ijcem.com /ISSN:1940-5901/IJCEM0070763 Original Article Case analysis of triangular bracket from autogenous nasal septal and auricular cartilage for the correction
More informationFOLLOWING INTRODUCTION OF
ORIGINAL ARTICLE Alternative 1-Step Nasal Reconstruction Technique Kazuo Kishi, MD, PhD; Nobuaki Imanishi, MD, PhD; Yusuke Shimizu, MD; Ruka Shimizu, MD, PhD; Keisuke Okabe, MD; Hideo Nakajima, MD, PhD
More informationUCL Repair: Emphasis on Muscle Dissection and Reconstruction
UCL Repair: Emphasis on Muscle Dissection and Reconstruction Unilateral cleft lip repair is performed using rotation-advancement technique. Markings are made on columella base, redlines, Cupid s bow on
More informationCME. Nasal Reconstruction
CME Nasal Reconstruction Frederick J. Menick, M.D. Tucson, Ariz. Learning Objectives: After studying this article, the participant should be able to: 1. Understand nasal wound healing and develop an organized
More informationCorrection of the Retracted Alar Base
218 William D. Losquadro, M.D. 1 Anthony Bared, M.D. 2 Dean M. Toriumi, M.D. 2 1 Mount Kisco Medical Group, Katonah, New York 2 Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology
More informationDepartment of Plastic Surgery. Forehead Flap Reconstruction
Department of Plastic Surgery This leaflet explains more about a forehead flap reconstruction procedure and what to expect. We may use this type of flap following skin surgery to your nose, to repair the
More informationReconstruction of seventeen full-thickness defects of the eyelids with twenty-two Hübner tarsomarginal grafts *
British Journal of Plastic Surgery (2005) 58, 361 365 Reconstruction of seventeen full-thickness defects of the eyelids with twenty-two Hübner tarsomarginal grafts * G. Dagregorio a, *, V. Huguier b, V.
More informationAll surgery carries some uncertainty and risk
Dr Mi chel s on@mi chel s onmd. com All surgery carries some uncertainty and risk While scar revision is normally safe, there is always the possibility of complications. These may include infection, bleeding,
More informationMcGregor Flap Reconstruction of Extensive Lower Lip Defects Following Excision of Squamous Cell Carcinoma
Kasr El Aini Journal of Surgery VOL., 12, NO 2 May 2011 27 McGregor Flap Reconstruction of Extensive Lower Lip Defects Following Excision of Squamous Cell Carcinoma Mohamed A. Albadawy, MD and Bassem M.
More informationUse of tent-pole graft for setting columella-lip angle in rhinoplasty
Agrawal et al. Plast Aesthet Res 2018;5:13 DOI: 10.20517/2347-9264.2018.17 Plastic and Aesthetic Research Letter to Editor Open Access Use of tent-pole graft for setting columella-lip angle in rhinoplasty
More informationInteresting Case Series. Reconstruction of Dorsal Wrist Defects
Interesting Case Series Reconstruction of Dorsal Wrist Defects Maelee Yang, BS, and Joseph Meyerson, MD The Ohio State University Wexner Medical Center, Columbus Correspondence: maelee.yang@osumc.edu Keywords:
More informationUNCORRECTED PROOF. The conchal cartilage graft in nasal reconstruction * ARTICLE IN PRESS. Armando Boccieri*, Alessandro Marano 1
Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) -, -e- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47
More informationThomas T. Jeneby, M.D Wurzbach Suite 801 San Antonio, TX /
Nose reshaping, or rhinoplasty, is one of the most common plastic surgery procedures performed today. Often, the structure or size of the nose is not proportionate with the other features on the face.
More informationcally, a distinct superior crease of the forehead marks this spot. The hairline and
4 Forehead The anatomical boundaries of the forehead unit are the natural hairline (in patients without alopecia), the zygomatic arch, the lower border of the eyebrows, and the nasal root (Fig. 4.1). The
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,800 116,000 120M Open access books available International authors and editors Downloads Our
More informationMOHS MICROGRAPHIC SURGERY: AN OVERVIEW
MOHS MICROGRAPHIC SURGERY: AN OVERVIEW SKIN CANCER: Skin cancer is far and away the most common malignant tumor found in humans. The most frequent types of skin cancer are basal cell carcinoma, squamous
More informationVancouver, B.C., Canada
THE "ALAR SHIFT" REVISITED By THEODORE F. WILKIE, B.A., M.D., F.R.C.S.(C), F.A.C.S. Vancouver, B.C., Canada IN the hands of many plastic surgeons certain procedures have an evanescent history. Usually
More informationSequellae of Chemical Burn.. Scar management in burn patient
Sequellae of Chemical Burn.. Scar management in burn patient ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก กก ก ก ก ก ก (hypertrophic scar) ก ก ก ก ก ก ก ก ก immature 12 18 ก ก กก ก ก ก ก ก ก ก ก ก ก ก immature (2-9 )
More informationThe earlobe occupies a unique position among facial
Rev Bras Otorrinolaringol 2006;72(4):447-51. ORIGINAL ARTICLE Earlobe cleft reconstructive surgery Lucas Gomes Patrocínio 1, Rodrigo Márcio Morais 2, José Edmundo Pereira 3, José Antônio Patrocínio 4 Keywords:
More informationRECONSTRUCTION OF MICROtia
ORIGINAL ARTICLE A 2-Stage Ear Reconstruction for Microtia Haiyue Jiang, MD; Bo Pan, MD; Yanyong Zhao, MD; Lin Lin, MD; Lei Liu, MD; Hongxing Zhuang, MD Objective: To introduce our 2-stage reconstruction
More informationExtended Bilaminar Forehead Flap With Cantilevered Bone Grafts for Reconstruction of Full-Thickness Nasal Defects
J Oral Maxillofac Surg 63:566 570, 2005 Extended Bilaminar Forehead Flap With Cantilevered Bone Grafts for Reconstruction of Full-Thickness Nasal Defects Jason K. Potter, DDS, MD,* Yadranko Ducic, MD,
More informationSingle-Stage Full-Thickness Scalp Reconstruction Using Acellular Dermal Matrix and Skin Graft
Single-Stage Full-Thickness Scalp Reconstruction Using Acellular Dermal Matrix and Skin Graft Yoon S. Chun, MD, a and Kapil Verma, BA b a Division of Plastic and Reconstructive Surgery, Department of Surgery,
More informationijcrr Vol 04 issue 12 Category: Case Report Received on:22/04/12 Revised on:07/05/12 Accepted on:22/05/12
SURGICAL RECONSTRUCTION OF INTERDENTAL PAPILLA USING AN INTERPOSED SUBEPITHELIAL CONNECTIVE TISSUE GRAFT: A CASE REPORT ijcrr Vol 04 issue 12 Category: Case Report Received on:22/04/12 Revised on:07/05/12
More informationBody contouring by combined abdominoplasty and medial vertical thigh reduction: experience of 14 cases
The British Association of Plastic Surgeons (2004) 57, 222 227 Body contouring by combined abdominoplasty and medial vertical thigh reduction: experience of 14 cases M.G. Ellabban*, N.B. Hart Plastic Surgery
More informationSpreader Graft in Closed Rhinoplasty: The Rail Spreader
Original Article 515 Spreader Graft in Closed Rhinoplasty: The Rail Spreader Alberto Scattolin, MD 1 Niana Orlando, MD 1 Luca D Ascanio, MD 2 1 Department of Otolaryngology, Villa Donatello Clinic, Piazzale
More informationINTRODUCTION. Typical secondary bilateral cleft lip nasal deformities present a short columella, a laterally-spreading dome of the alar cartilages
The Correction of a Secondary ilateral Cleft Lip Nasal Deformity Using Refined Open Rhinoplasty with Reverse-U Incision, V-Y Plasty, and Selective Combination with Composite Grafting: Long-term Results
More informationNasal Soft-Tissue Triangle Deformities
339 Hossam M.T. Foda, MD 1 1 Division of Facial Plastic Surgery, Otolaryngology Department, Alexandria Medical School, Alexandria, Egypt Facial Plast Surg 2016;32:339 344. Address for correspondence Hossam
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,000 116,000 120M Open access books available International authors and editors Downloads Our
More informationKevin T. Kavanagh, MD
Kevin T. Kavanagh, MD Axial Based upon a named artery. Survival length depends upon the artery not the width of the flap. Random Has random unnamed vessels supplying it. Survival length is directly proportional
More informationOPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY
OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY PARAMEDIAN FOREHEAD FLAP NASAL RECONSTRUCTION SURGICAL TECHNIQUE Brian Cervenka, Travis Tollefson, Patrik Pipkorn The paramedian forehead
More informationInteresting Case Series. Scalp Reconstruction With Free Latissimus Dorsi Muscle
Interesting Case Series Scalp Reconstruction With Free Latissimus Dorsi Muscle Danielle H. Rochlin, BA, Justin M. Broyles, MD, and Justin M. Sacks, MD Department of Plastic and Reconstructive Surgery,
More informationThe Importance of a Conchal Bowl Element in the Fabrication of a Three-Dimensional Framework in Total Auricular Reconstruction
The Importance of a Conchal owl Element in the Fabrication of a Three-Dimensional Framework in Total uricular Reconstruction Young Soo Kim ona Microtia and esthetic Ear Surgery Clinic, Seoul, Korea Original
More informationAesthetic surgery techniques after excision of dermatofibrosarcoma protuberans: a case report
British Journal of Plastic Surgery (2005) 58, 556 560 CASE REPORT Aesthetic surgery techniques after excision of dermatofibrosarcoma protuberans: a case report G. Dagregorio a, *, V. Darsonval b a Department
More informationAn island flap based on the anterior branch of the superficial temporal artery for perioral defects
Free full text on www.ijps.org Original Article An island flap based on the anterior branch of the superficial temporal artery for perioral defects V. Bhattacharya, Ganji Raveendra Reddy, Sheikh Adil Bashir,
More informationA PROSPECTIVE STUDY ON AURICULAR BURNS
Int. J. Pharm. Med. & Bio. Sc. 2013 Ramesha K T et al., 2013 Research Paper ISSN 2278 5221 www.ijpmbs.com Vol. 2, No. 4, October 2013 2013 IJPMBS. All Rights Reserved A PROSPECTIVE STUDY ON AURICULAR BURNS
More informationCairo Dental Journal (24) Number (I), 77:84 January, Haitham Sayed Attia 3, Mohamed Saied Hamed 1 and Monteser El Koutobey 2
Cairo Dental Journal (24) Number (I), 77:84 January, 2008 Anthropometric Analysis of cases of Unilateral Cleft Lip Versus cases of Complete Unilateral Cleft Lip and Palate Haitham Sayed Attia 3, Mohamed
More informationFundamental to the evolution of rhinoplasty COSMETIC. Classifying Deformities of the Columella Base in Rhinoplasty.
COSMETIC Classifying Deformities of the Columella Base in Rhinoplasty Michael R. Lee, M.D. Georges Tabbal, M.D. T. Jonathan Kurkjian, M.D. Jason Roostaeian, M.D. Rod J. Rohrich, M.D. Dallas, Texas Background:
More informationReconstructive and Cosmetic Services
Reconstructive and Cosmetic Services Policy Number: 10.01.09 Last Review: 4/2018 Origination: 2/2006 Next Review: 4/2019 Policy Determination of whether a proposed therapy would be considered reconstructive
More informationVertical mammaplasty has been developed
BREAST Y-Scar Vertical Mammaplasty David A. Hidalgo, M.D. New York, N.Y. Background: Vertical mammaplasty is an effective alternative to inverted-t methods. Among other benefits, it results in a significantly
More informationExpanded Transposition Flap Technique for Total and Subtotal Resurfacing of the Face and Neck
Expanded Transposition Flap Technique for Total and Subtotal Resurfacing of the Face and Neck Robert J. Spence, MD, FACS Johns Hopkins School of Medicine, Baltimore, MD Correspondence: rspence@jhmi.edu
More information