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IMCAS Asia 2019
Program

FOCUS ON S081, S082

Open stage talks: surgery

Room: Courtyard
Date: Saturday 6 July 2019 at 09:00 to 10:30
Format: OPEN STAGE TALK > oral presentations taking place on a dedicated stage within the exhibition area and which are video-recorded by our professional AV team

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
09:00	Dr Muhammad Zeeshan AHMED	Single stage body contouring: is it safe?	View	88030
09:15	Dr Muhammad Zeeshan AHMED	Day stay breast reduction superomedial pedicle using diluted LA infiltration and lateral pillar suture tightening technique: 200 consecutive reductions	View	87975
09:30	Dr Marisa MANZANO SURROCA	Update on postbariatric plastic surgery patient safety	View	84179
09:45	Dr Marisa MANZANO SURROCA	Strategies in breast asymmetry surgery	View	83267
10:00	Dr Mingjie YANG	Correction of columellar-labial angle (CLA) in Asian female patients with autologous grafts	View	94598

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Body contouring (surgical)

Complications

Breast reduction

Breast malformations

Nose (rhinoplasty - surgical)

Dr Muhammad Zeeshan AHMED

Plastic Surgeon

New Zealand

Other author(s) : Winston McEwan. Plastic, reconstructive and aesthetic surgeon

Single stage body contouring: is it safe?

Objectives: Body contouring is a challenging single stage procedure. Teamwork, planning and effective execution of each step of the procedure leads to minimal complications perioperatively.

Introduction: Body contouring after weight loss is gradually growing in the field of plastic surgery. Bariatric procedures aimed at reducing weight result in significant skin relaxation and invariably these patients need surgery to correct the residual issues and improve overall appearance. Single stage body contouring can be challenging as its major hemodynamic challenge. As with other aesthetic procedures, it’s important to have proper patient selection, risk identification and safe and effective execution of surgery to achieve optimal results.

Materials / method: The aim of the study was to review all single stage body contouring surgeries carried out between July 17 to December 18.
All cases were performed under GA combined with tumescent LA infiltration (18-20 mg/kg lidocaine) with adrenaline.
Single stage surgery included: Extended abdominoplasty, reduction/mastopexy/augmentation, brachioplasty, medial vertical thigh lift in all patients i.e., all patients had five procedures as a single stage. All these areas were also combined with liposuction.
All patients had pressure garments for 6 weeks.

Results: 15 cases were performed between July 17 to December 18. The mean age was 40 years, and 13 were females and 2 males. All cases were performed under GA with range of 4-6 lit of tumescent LA infiltration. All patients had five procedures as a single stage.
The mean surgery time was 4 hours and range form 3-4.5 hrs. The follow up period ranged from 6-20 months. The mean hospital stay was 1.5 days.
No major complication was noted. 12 cases required small revision surgery; Liposuction 6 cases, dog ear excisions 7 cases, other scar revisions 3 cases.

Conclusion: Body contouring is a challenging one stage procedure. Teamwork, planning and effective execution of each step of the procedure leads to minimal complications perioperatively. We think if these procedures are performed as well organized team work in short period of time under effective use of tumescent anesthetic fluid, it results in shorter anesthetic time and also reduces the bleeding. All these contribute in reducing perioperative problems and result in quicker recovery.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Muhammad Zeeshan AHMED

Plastic Surgeon

New Zealand

Other author(s) : Winston McEwan. Plastic, reconstructive and aesthetic surgeon

Day stay breast reduction superomedial pedicle using diluted LA infiltration and lateral pillar suture tightening technique: 200 consecutive reductions

Objectives: We use superomedial pedicle technique at our centre and propose deep lateral pillar suture to narrow the breast and achieve good projection and not to leave extra skin inferiorly to avoid bottoming out.
Also using diluted LA infiltration reduce the bleeding and thus reduces operative time and overall complication rates.

Introduction: Symptomatic enlarged breasts are both a physical and mental debilitating condition for the young female. Common physical symptoms associated with this condition are bra strap marks, skin rash and neck/shoulder/back pain. Breast reduction surgery offer relief to these symptoms and also significantly improve the self-esteem and reduces the emotional stress.
Several breast reduction techniques have been described, commonly used ones are inferior pedicle and superomedial pedicle technique.

Materials / method: The aim of the study was to review all breast reductions carried out between March 18-december 18. All cases are performed under GA combined with diluted LA infiltration at the incision line and in the breast parenchyma. We use superomedial pedicle technique at our centre and propose deep lateral pillar suture to narrow the breast and achieve good projection and not to leave extra skin inferiorly to avoid bottoming out.

Results: 100 cases (200 breast reductions) were performed at the ASC as a day case procedure from March 2018 to Dec 2018. The mean age was 42 years.
99 cases had superomedial pedicle with wise pattern reduction and only one patient needed breast amputation with free nipple areola graft. The mean weight of reduction was 520 gm per breast and largest reduction was 4kg for both breasts.
The surgery time ranged from 25-60 min. The follow up period ranged from 6-18 months.All patients were satisfied with the outcome. No major complication was noted, 15 cases had some minor suture line breakdown.

Conclusion: Breast reduction is a safe day case procedure with minimal complications and aesthetically pleasing outcome. Using diluted LA infiltration reduce the bleeding and thus reduces operative time and overall complication rates.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Marisa MANZANO SURROCA

Plastic Surgeon

Spain

Other author(s) :

Update on postbariatric plastic surgery patient safety

Objectives: Give an update on patient safety related to plastic surgery on postbariatric patients

Introduction: The obesity epidemic has spread further in the past 5 years.
Bariatric surgery has proven to be the most effective treatment of the morbidly obese patients. Body contouring is the final phase.

Materials / method: We have done a systematic review on Pubmed, Cochrane Plus, Scopus, Web of Science and Europe PMC. The following search terms were used: postbariatric surgery and patient safety or postbariatric surgery and complications or massive weight loss patients and complications or body contouring and surgery and complications. The search results were filtered in Pubmed for human species and MeSH terms.

Results: As high as 70% have at least one complication, the most common is wound dehiscence. 10% have major complications.

Conclusion: Due to these numbers we propose 6 topics to be focusing on before, during and after to minimize and optimize patient safety based on the conclusion of the literature review.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Marisa MANZANO SURROCA

Plastic Surgeon

Spain

Other author(s) :

Strategies in breast asymmetry surgery

Objectives: The aim of the presentation is to analyze a 5-10 years outcomes after breast asymmetry surgery due to constitutional cause.

Introduction: Severe breast asymmetry is one of the most challenging surgeries. Not only breast volume or shape are involved.

Materials / method: This is a retrospective study including patients presenting constitutional breast asymmetry treated by a a single surgeon during a perior of 10 years.

Results: The statistical analysis included 35 patients divided in two groups: with or without implant reconstruction. The results show that the best outcomes are in those cases without implant. In those cases were fat grafting had been used in addition to breast implants the results are better than implant alone.

Conclusion: The best results are obtained in those patients were the same technique has been proposed. The worse results are seen in those patients with unilateral implants, weight changes, ageing and tuberous breasts.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Mingjie YANG

Facial Plastic Surgeon

China

Other author(s) :

Correction of columellar-labial angle (CLA) in Asian female patients with autologous grafts

Objectives: To correct columellar-labial angle (CLA) using autologous grafts, and improve tip labial relationship and aesthetic appearance for Asian patients with retracted ANS which will often company with protruding mouth.

Materials / method: Between Jan．2016 and Jan．2018，182 Asian female patients have undergone Rhinoplasty with autologous costal cartilage.
A large columellar strut graft was carved V shape notch at its base. And it was fixed to ANS directly in order to bring CLA and SN forward. These patients usually have several characteristics, such as severe protruding mouth, retro position of SN point, an acute CLA, and a retracted ANS.
A pair of long wide caudal extension grafts was placed and fixed along the caudal septum with 5-0 PDS. The inferior edges are usually 2mm lower than the caudal border of septum. Each extended ca

Results: The period of observation was 6 to 30 months. All 182 patients exhibited balanced tip labial relationship without protruding mouth. CLA measured in female patients was about 95°. The SN segment- the part of CLA, presented a gradual curve, no longer a sharp acute point. Postoperatively the SN point can be brought forward by 2mm on average.

Conclusion: Columellar-labial angle (CLA) is of great accuracy and surgical relevance. It is more easily seen intraoperation than the nasal labial angle. CLA can be corrected easily with 2 different types of autologous grafts when performing Rhinoplasty. And the correlated variables can be corrected and improved aesthetically. The correction of CLA also helps achieve new aesthetic balance.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

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IMCAS Asia 2019 Program

FOCUS ON S081, S082

Open stage talks: surgery

Lectures of the session

Recommended sessions

IMCAS Asia 2019
Program