Tommaso AGOSTINI's publications (110)

Early implant placement in bilateral sinus floor augmentation using iliac bone block grafts in severe maxillary atrophy: a clinical, histological, and radiographic case report.

2009

Effectively restoring a grossly atrophic maxilla can be difficult for the implant surgeon. The placement of dental implants in patients who are edentulous in the posterior maxilla can present difficulties because of deficient posterior alveolar ridge and increased pneumatization of the maxillary sinus, resulting in a minimal hard tissue bed. Implant placement requires adequate quality and quantity of bone, especially in the posterior maxilla. Insufficient bone height and width in this area of the maxilla, because of expansion of the maxillary sinus and atrophic reduction of the alveolar ridge, represents a contraindication for conventional insertion of dental implants. The reconstruction of edentulous patients with adequate bone volume and density by the use of bone graft and, subsequently, the placement of dental implants has become a viable treatment option with high predictability. It is commonly shared that autologous bone graft is the gold standard grafting method in the augmentation of Higmoro antrum and in any kinds of guided bone regeneration. In this article, the authors report a case of severe maxillary atrophy that is augmented by block bone graft harvested from iliac crest. An early placement of implants is possible due to the quick healing of the site, as proven by histologic examinations. read more

The Journal of oral implantology

Treatment of human immunodeficiency virus-associated facial lipoatrophy with lipofilling and submalar silicone implants.

2006

In the absence of a current therapy to prevent facial lipoatrophy in HIV+ patients treated with HAART, surgical correction of the defect still remains the best option. We evaluate two different surgical techniques for facial contour enhancing and suggest the right choice related to the lipodystrophy severity. Twelve HIV+ patients underwent surgical submalar correction: eight were treated with lipofilling following Coleman's technique and four had bilateral malar silicone implants inserted after determining their positioning with the aid of a new software. Both techniques gave long lasting results in facial contour reshaping ranging from good to very good. No complication was observed. In the mean follow-up period of 2 years no patient felt uncomfortable with his/her image. Both techniques, lipofilling and silicone implant positioning, for managing facial lipoatrophy in HIV+ patients treated with HAART had good results, but the right choice has to be related to the severity of the lipodystrophy in the patient. read more

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

A Novel Approach to Keloid Reconstruction with Bilaminar Dermal Substitute and Epidermal Skin Grafting.

01, 2017

read more

Plastic and reconstructive surgery Load more  

Reply: Full Facial Feminization Surgery: Patient Satisfaction Assessment Based on 180 Procedures Involving 33 Consecutive Patients.

Oct, 2016

read more

Plastic and reconstructive surgery

Analysis of Lipoasiprated Following Centrifugation: Wet Versus Dry Harvesting Technique.

Sep, 2016

The success of lipotransfer strongly depends on the harvesting, processing, and placement of the lipoaspirated samples. This study was designed to assess the histomorphometric characteristics and viability of fat harvested using different techniques (wet and dry) following centrifugation, as described by Coleman. read more

The Journal of craniofacial surgery

Management of Mandibular Angle Fractures by Two Conventional 2.0-mm Miniplates: A Retrospective Study of 389 Patients.

Sep, 2016

Fractures of the mandibular angle account for 23 to 42% of all facial fractures with a high complication rate (0-32%). Although the ideal treatment remains debatable, two main procedures are commonly used to manage the majority of mandibular angle fractures that are open reduction and internal fixation by a noncompression miniplate placed on the external oblique ridge with or without a second miniplate on the outer cortex. The purpose of this study was to describe our management of mandibular angle fractures by two noncompression miniplates placed on the outer cortex via a transbuccal approach. Medical records and radiographic examination of 389 patients (258 males [66.3%] and 131 females [33.7%]) operated from January 2000 to December 2012 were retrospectively reviewed. Postoperative complications including malocclusion, infection, wound dehiscence, nonunion, and reoperative surgery were recorded and analyzed. Fifty-three patients developed postoperative complications (overall complication rate: 13.6%). No significant difference was found in the complication rate by age and gender variables and regarding the interval between the trauma and the operation and the presence of the teeth in the line of fracture. A higher rate of complications was found among patients with alcohol/drug addiction and in patients with multiple-site involvement. The findings of this study suggest that the use of two transbuccal miniplates placed on the outer cortex for the internal fixation of mandibular angle fracture provided a low rate of complications. The global incidence of screw loosening, wound dehiscence, plate exposure, infection, reoperation, and plate removal were similar with the data reported in the literature with improved health outcomes, lower postoperative morbidity, and a faster return to normal life. read more

Craniomaxillofacial trauma & reconstruction

Full Facial Feminization Surgery: Patient Satisfaction Assessment Based on 180 Procedures Involving 33 Consecutive Patients.

Feb, 2016

Gender dysphoria refers to the discomfort and distress that arise from a discrepancy between a person's gender identity and sex assigned at birth. The treatment plan for gender dysphoria varies and can include psychotherapy, hormone treatment, and gender reassignment surgery, which is, in part, an irreversible change of sexual identity. Procedures for transformation to the female sex include facial feminization surgery, vaginoplasty, clitoroplasty, and breast augmentation. Facial feminization surgery can include forehead remodeling, rhinoplasty, mentoplasty, thyroid chondroplasty, and voice alteration procedures. Described here is an assessment of patient satisfaction after facial feminization surgery, including outcome measurements after forehead slippage and chin remodeling. read more

Plastic and reconstructive surgery

Complex craniofacial advancement in paediatric patients: Piezoelectric and traditional technique evaluation.

Oct, 2015

The piezoelectric device allows bone cutting without damaging the surrounding soft tissues. The purpose of this study was to assess the role of this surgical instrument in paediatric craniofacial surgery in terms of safety and surgical outcomes. read more

Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery

Lipomodeling: An Innovative Approach to Global Volumetric Rejuvenation of the Hand.

Aug, 2015

Rejuvenation of the hand, particularly the dorsum, has garnered increased attention because of its unique aesthetic importance. Various methods have been advocated for achieving optimal aesthetic results. read more

Aesthetic surgery journal

Three-dimensional airways reconstruction in syndromic pedriatric patients following mandibular distraction osteogenesis.

May, 2015

Airway obstruction, associated with mandibular hypoplasia, is a frequent complication in syndromic pediatric patients. The clinical signs of airway obstruction change from mild positional obstruction to severe respiratory distress with cyanosis. The young age of the patients makes medical management extremely complex. read more

The Journal of craniofacial surgery

Closed reduction of the isolated anterior frontal sinus fracture via percutaneous screw placement.

Jan, 2015

Fractures of the frontal sinus are a common maxillofacial trauma and constitute 5-15% of all maxillofacial fractures. Conventional surgical approaches include the coronal flap, direct cutaneous incision, and endoscopic techniques. Minimally invasive techniques have recently been described for the reduction of the isolated anterior frontal sinus fracture via a closed approach. The medical records and radiological findings of all patients who underwent surgical treatment for anterior frontal sinus fractures from January 2009 to December 2013 at the study hospital in Florence, Italy, were reviewed. The final study sample consisted of 15 patients (13 males and two females) with isolated anterior frontal sinus fractures who were treated with closed reduction using percutaneous screws. The mean age was 32.1 years. The skin incisions healed without any visible scarring, and no depressions of the frontal sinuses were evident in the postoperative period. Computed tomography scans performed at 6 months postoperatively showed adequate reduction of the displaced fragments. This closed technique is a good option for displaced isolated fractures of the anterior frontal sinus. However, the technique is not adequate for complex fractures of the frontal sinus. read more

International journal of oral and maxillofacial surgery

Six factors justify the pathologic analysis of subcutaneous mastectomy specimens in patients with gynaecomastia.

Dec, 2014

read more

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

Perforator flaps in late-stage pressure sore treatment: outcome analysis of 11-year-long experience with 143 patients.

Dec, 2014

In the last decade, perforator flaps have been introduced for the treatment of pressure ulcers as alternative to the more popular myocutaneous local flaps. We reviewed our single-team 11-year experience in order to define whether real advantages could be achieved. read more

Annals of plastic surgery

Fat transfer in 2014: what we do not know.

Dec, 2014

read more

Plastic and reconstructive surgery

Retroseptal lipotransfer to correct enophthalmos in the postraumatic amaurotic eye.

Dec, 2014

read more

Plastic and reconstructive surgery

Comparison of piezosurgery and traditional saw in bimaxillary orthognathic surgery.

Oct, 2014

Investigators have hypothesised that piezoelectric surgical device could permanently replace traditional saws in conventional orthognathic surgery. read more

Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery

The effectiveness of mandibular distraction in improving airway obstruction: the florentine center experience.

Sep, 2014

read more

Plastic and reconstructive surgery

A case of a survivor to a through-and-through head gunshot wound following Russian roulette.

Jun, 2014

read more

Plastic and reconstructive surgery

Microsurgical reconstruction after bisphosphonate-related osteonecrosis of the jaw: our experience with fibula free flap.

May, 2014

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is the most serious complication of bisphosphonates therapy. Despite that several treatment modalities have been described, aggressive surgical treatment approach with wide bone resection and vascularized microsurgical reconstruction are controversial. The aim of this study was to evaluate the clinical outcome of 8 new cases of BRONJ treated with radical resection and mandibular reconstruction with fibula free flap, to enforce the evidence about the reliability of this treatment option. read more

The Journal of craniofacial surgery

Primary intraosseous squamous cell carcinoma of the mandible. Is adjuvant therapy still necessary to improve a 5-year survival rate?

May, 2014

read more

The Journal of craniofacial surgery

Esthetic restoration in progressive hemifacial atrophy (Romberg disease): structural fat grafting versus local/free flaps.

May, 2014

Progressive hemifacial atrophy, also called Parry-Romberg disease, is a craniofacial disorder that typically involves the subcutaneous layer of 1 side of the face. Autologous reconstruction is achieved through various techniques, including autologous grafting of fatty tissue, the use of pedicled flaps, and free tissue transfer based on microvascular anastomoses. Thus far, a systematic literature review devoted to compare different surgical techniques has not been published. read more

The Journal of craniofacial surgery

Anterolateral thigh flap thinning: techniques and complications.

Feb, 2014

A thinned anterolateral thigh flap is often necessary to achieve optimal skin resurfacing. In this article, we describe the techniques available for immediate flap thinning and the vascular complications that can follow trimming. read more

Annals of plastic surgery

Infraorbital nerve block for isolated orbital floor fractures repair: review of 135 consecutive cases.

Jan, 2014

Orbital blowout fractures can be managed by several surgical specialties including plastic and maxillofacial surgery, otolaryngology, and ophthalmology. Recommendations for surgical fracture repair depend on a combination of clinical and imaging studies to evaluate muscle/nerve entrapment and periorbital tissue herniation. read more

Plastic and reconstructive surgery. Global open

Successful combined approach to a severe Fournier's gangrene.

Jan, 2014

We present a case of a successful reconstruction of a severe Fournier's gangrene (FG) involving the scrotum, the perineum, the right ischial area and extended to the lower abdomen. There are many different surgical techniques to repair and reconstruct the defect following debridement in FG. The authors treated this complex wound using negative pressure wound therapy (NPWT), dermal regeneration template and a split-thickness skin graft. Complete recovery was achieved and no major complications were observed. The patient showed a satisfying functional and aesthetic result. read more

Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India

Histomorphometry of dystrophic fat in a patient suffering Madelung's disease.

Jan, 2014

read more

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

Through-and-through Nasal Reconstruction with the Bi-Pedicled Forehead Flap.

Nov, 2013

Nasal reconstruction is one of the most difficult challenges for the head and neck surgeon, especially in the case of complex full thickness defects following malignant skin tumor resection. Full-thickness defects require demanding multi-step reconstruction. read more

Archives of plastic surgery

A novel combined surgical approach to head and neck dermatofibrosarcoma protuberans.

Oct, 2013

The surgical management of dermatofibrosarcoma protuberans has historically been a challenge, particularly in the head and neck and other aesthetic areas. The current priority is to achieve local oncologic control and a good reconstructive outcome. Here, we present our experience using a novel combined approach with a dermal regenerative template, sub-atmospheric pressure and skin graft. read more

Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery

Lipolysis using a new 1540-nm diode laser: a retrospective analysis of 230 consecutive procedures.

Aug, 2013

Although traditional liposuction still remains the most required body sculpting procedure, laser lipolysis systems are becoming increasingly popular. The feasibility and efficacy of a new 1540-nm diode laser for suction-assisted laser lipolysis were evaluated. read more

Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology

Surgical correction of rhinophyma: comparison of two methods in a 15-year-long experience.

Jul, 2013

Rhinophyma is characterized by slowly progressive tumour-like enlargement of the nasal skin that will not resolve spontaneously. Though its treatment consists of surgical removal of the hyperplastic alterations, in the literature there is not general agreement about the best method. We presented our experience with two different treatment modalities such as decortication by scalpel and CO2 laser treatment. read more

Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery

Atypical Spitz tumour with positive sentinel lymph node.

Jun, 2013

A 16-year-old young man presented with an atypical Spitz tumour of the left buttock with involvement of the left inguinal sentinel node. After inguinal lymphadenectomy, none among the further 21 left inguinal lymph nodes excised was positive. The patient has been free of disease for 39 months. Reviewing published reports, 68 of 147 patients with atypical Spitz tumours having sentinel node mapping had positive nodes. Complete nodal dissection was performed in 66 of these 68 patients. All these patients with a positive sentinel node including this patient were alive and disease-free, with a mean follow-up of 35.8 months. Doubts about the exact nature of atypical Spitz tumours still persist. Although it does not seem to behave like conventional melanomas since prognosis is highly favourable despite a high incidence of sentinel node deposits, interpretations of these nodal involvements are still debated. A longer follow-up period of surveillance should be useful to definitively disclose this question. A literature review to provide an analysis of current knowledge regarding diagnosis, management, and treatment options was undertaken. Furthermore, current misconcepts leading to under-treatment as well as over-treatment, new trends in diagnosis, and surgical approach are discussed. The real biologic potential of the disease could not often be evaluated by sentinel lymph node status. Although this procedure may have a role, possibly being therapeutic for those patients who have malignant lesions, it produces morbidity and outcomes that are sometimes difficult to interpret in this type of pigmented lesions. Thus, it should be reserved to selected patients. read more

Journal of plastic surgery and hand surgery

Thoracoacromial artery perforator flap: anatomical basis and clinical applications.

May, 2013

Concerns and criticism have been reported on the feasibility and vascular reliability of the thoracoacromial artery perforator flap because of the inconsistent size of the pectoral branch of the thoracoacromial artery and its cutaneous perforators. The authors have investigated its vascular basis through a cadaver dissection and described their clinical experience in the surgical strategy, range of application, and indications for the thoracoacromial artery perforator flap. read more

Plastic and reconstructive surgery

A novel design of the multilobed latissimus dorsi myocutaneous flap to achieve primary donor-site closure in the reconstruction of large defects.

May, 2013

The main drawback of the latissimus dorsi myocutaneous flap for large defect repairs is the relatively small skin paddle size that can be raised to allow primary closure of the donor site. In this article, the authors describe a novel design of the flap using multiple separate skin paddles, with each paddle nourished by independent perforators, to repair very large defects while maintaining primary donor-site closure. read more

Plastic and reconstructive surgery

Prefabricated neck expanded skin flap with the superficial temporal vessels for facial resurfacing.

May, 2013

The achievement of a normal-appearing face after surgical resurfacing remains an elusive goal. This is due in part to insufficient color matching, restoration of contours, and the persistence of visible scars. Flap prefabrication is a staged procedure that provides an independent axial blood supply to local expanded tissues. We describe a new reconstructive alternative with superior reconstructive surgical options for facial resurfacing that better matches damaged or discarded facial tissues. read more

Journal of reconstructive microsurgery

Reverse bipaddle posterior interosseous artery perforator flap.

Apr, 2013

The reverse posterior interosseous artery perforator flap is useful for covering defects over the distal forearm, wrist, and hand, but some of its major limitations include short vascular pedicle, inadequate distal reach, difficult pedicle dissection, and risk of venous congestion. Some of these drawbacks have been overcome with refinements over the years, but the problems of donor-site morbidity and inability to reconstruct multiple subunits of the hand in a single stage remain. The authors developed a variant of the original distally based flap to extend its applications and minimize donor-site morbidity. read more

Plastic and reconstructive surgery

Adipofascial anterolateral thigh flap safety: applications and complications.

Mar, 2013

A thinned anterolateral thigh (ALT) flap is often harvested to achieve optimal skin resurfacing. Several techniques have been described to thin an ALT flap including an adipocutaneous flap, an adipofascial flap and delayed debulking. read more

Archives of plastic surgery

Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections.

Feb, 2013

read more

American journal of ophthalmology

Optimizing cosmesis with conservative surgical excision in a giant rhinophyma.

Feb, 2013

Rhinophyma is considered the end stage in the development of rosacea, with a clinical aspect characterized by sebaceous hyperplasia, fibrosis, follicular plugging, and telangiectasia. Although the treatment of rhinophyma typically has an aesthetic purpose, in some cases it also can help with nasal obstruction and eating difficulties caused by rhinophyma beyond the abnormal physical appearance that can cause social seclusion. Very few giant rhinophymas have been reported in the literature. In most cases full-thickness excision of the rhinophymatous tissue down to perichondrium and periosteum of the nasal osteocartilaginous framework followed by coverage of the residual defect with a full-thickness skin graft or local flap has been described in patients affected by giant rhinophyma. The poor results of this approach encouraged us to manage conservatively a very severe form of rhinophyma. We describe the case of a 62-year-old man who presented with a 12-year history of a progressively growing mass on the nose and with a history of nasal obstruction and eating difficulties. We advocate a careful tangential excision of the rhinophymatous tissue which allows the residual deep pilosebaceous appendages to reepithelialize as a safe method and provides a good cosmetic result with minimal scarring. To our knowledge this is the first case of a giant rhinophyma treated with conservative excision followed by secondary healing. read more

Aesthetic plastic surgery

Indications, outcomes, and complications of pedicled propeller perforator flaps for upper body defects: a systematic review.

Jan, 2013

The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. read more

Archives of plastic surgery

Contrast-enhanced ultrasound combined with three-dimensional reconstruction in preoperative perforator flap planning.

Jan, 2013

Along with technical advancements in perforator flap surgery, great interest has been recently focused on the accuracy of preoperative perforator location through the assessment of the donor-site vascular network. The goal of the present study was to investigate the usefulness of contrast-enhanced ultrasound combined with three-dimensional reconstruction in the planning of perforator flaps. read more

Plastic and reconstructive surgery

Thoracoacromial artery perforators.

Jan, 2013

read more

Microsurgery

Anterolateral thigh flap: systematic literature review of specific donor-site complications and their management.

Jan, 2013

The anterolateral thigh flap (ALT) is one of the most common flaps used in reconstructive microsurgery, due to its demonstrated lower donor-site morbidity when compared to other sites. Despite this, there are case reports of specific donor-site complications following the raising of an ALT flap. To date, there has been no systematic review of ALT-flap-related complications and overall ALT donor-site morbidity. read more

Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery

Delayed thinning of the anterolateral thigh flap.

Nov, 2012

read more

The Journal of craniofacial surgery

Capsular contracture as a further presenting symptom of implant-related anaplastic large cell lymphoma.

Nov, 2012

read more

The American journal of surgical pathology

Leonardo da Vinci and Michelangelo: the eternal challenge.

Sep, 2012

read more

Plastic and reconstructive surgery

The cost utility of reduction mammaplasty.

Sep, 2012

read more

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

Ethics and the limits of science.

Aug, 2012

read more

Plastic and reconstructive surgery

Wet and dry techniques for structural fat graft harvesting: histomorphometric and cell viability assessments of lipoaspirated samples.

Aug, 2012

Autologous fat transplantation is among the surgical procedures performed most commonly by plastic surgeons for cosmetic and/or reconstructive purposes. In the procedure, autologous fat is harvested and infiltrated during the same operation, and the success of this procedure relies on harvesting and transferring viable adipocytes. This study was designed to assess the histomorphometric characteristics and viability of the lipoaspirated cells that were harvested through different techniques. read more

Plastic and reconstructive surgery

The contribution of Aulus Cornelius Celsus (25 B.C.-50 A.D.) to eyelid surgery.

Jun, 2012

An accurate study of ancient medicine reveals that our forebears developed a large number of surgical ideas and techniques considered to be quite modern. Although the contribution of Aulus Cornelius Celsus to the development of several branches of surgery has already been celebrated, scant attention has been focused on his description of eyelid surgery in the seventh book of his encyclopedia, De Medicina octo libri. Although the practice was quite advanced by that time, the first century A.D., Celsus was the first among the Greco-Roman authors to deal systematically with ophthalmology and oculoplastic surgery. He was a compiler, and many of his "innovations" were in fact done in principle by others. Yet it is almost certain that the surgical procedures presented were introduced more than 15 centuries before the time of Celsus by Egyptians, Indian surgeons, and Greek and Alexandrian doctors. The burning of the Ancient Library of Alexandria as well as the perishing of many writings of pioneer physicians resulted in a tragic loss of ancient knowledge for posterity. Celsus, whose work has been preserved in our time, helped to publicize this ancient knowledge, and perhaps because of the loss of so much early medical literature, became one of the most influential experts on ancient medicine. An analysis of how previous authors have influenced Celsus' description of eyelid surgery and reflections on how modern his ideas (or those of his time) were are presented in the paper. read more

Orbit (Amsterdam, Netherlands)

Vacuum-assisted closure, dermal regeneration template and degloved cryopreserved skin as useful tools in subtotal degloving of the lower limb.

Jun, 2012

The standard management of degloving injuries involves either immediate grafting with the avulsed skin or full- or split-thickness grafts at a later date. Alternative methods include pedicle and free flaps and revascularisation. The authors present an innovative technique of treating degloving injuries with cryopreserved split-thickness skin grafts harvested from degloved flap, artificial dermal replacement and vacuum-assisted closure (VAC therapy). To the authors' knowledge, this is the first reported case of such bilaminar reconstruction of a degloving injury. read more

Injury

Delayed free flap salvage after venous thrombosis.

May, 2012

The incidence of free flap failure is reported at 4% to 5%,but pedicle thrombosis occurs in a higher percentage, with the difference resulting from successful salvage of failing flaps. Often, these failures are attributed to postoperative venous thrombosis with salvage reported at 42%. The venous engorgement of the flap and the resulting microvascular changes lead to a more rapid and less reversible no-reflow phenomenon established within 6 hours. However, this report shows successful free flap salvage with thrombolytic drugs after 6 hours, highlighting that the mechanisms of free flap failure are still poorly understood. read more

The Journal of craniofacial surgery

Blindness following cosmetic injections of the face.

Apr, 2012

Complications following facial cosmetic injections have recently heightened awareness of the possibility of iatrogenic blindness. The authors conducted a systematic review of the available literature to provide the best evidence for the prevention and treatment of this serious eye injury. read more

Plastic and reconstructive surgery

Rhinophyma and non-melanoma skin cancer: an update.

Apr, 2012

read more

Annales de chirurgie plastique et esthetique

Malignancies within rhinophyma: report of three new cases and review of the literature.

Apr, 2012

Rhinophyma, which represents the end stage of rosacea, is characterized by sebaceous hyperplasia, fibrosis follicular plugging, and telangiectasia. Although it is commonly labeled as an aesthetic problem, it may also determine airway obstruction and because of its nature to hide the growth of tumors. Due to the increasing number of reports of nonmelanoma skin types of cancer within rhinophyma, further concern about a higher incidence of malignancies in rhinophyma than in the skin of normal noses is reasonable. read more

Aesthetic plastic surgery

Surgical techniques to achieve direct anterolateral thigh flap donor-site closure.

Mar, 2012

read more

Plastic and reconstructive surgery

Head and neck polypoid melanoma.

Jan, 2012

Polypoid melanoma represents a rare clinical variant of nodular melanoma skin cancer in which the tumor is connected to the skin by a pedicle, characterized by exophytic growth, ulceration, and young age at onset (20-39 years) with a special predilection for the back and with a survival rate at 5 years ranging from 32% to 42% as compared with 57% 5-year survival for nodular subtype and 77% for the superficial subtype. We present a case of a deeply pigmented polypoid melanoma arising on the face of a 77-year-old man. We performed a literature review to clarify its surgical management and prognosis. read more

The Journal of craniofacial surgery

What about the informed consent for breast implantation?

Dec, 2011

read more

Plastic and reconstructive surgery

More on periorbital infections following therapy with biological agents.

Dec, 2011

read more

Cutaneous and ocular toxicology

Expanding the indications for latissimus dorsi musculocutaneous flap in totally autologous breast reconstruction: the extended variant.

Dec, 2011

read more

Annals of surgical oncology

Should indications for skin-reducing mastectomy be expanded?

Dec, 2011

read more

Annals of surgical oncology

Solitary plasmacytoma of the jaw.

Nov, 2011

There is a lack of consensus on the appropriate management of solitary plasmacytoma (SP) of the jaw. The aim of the present investigation was to provide scientific evidence for the optimal management of this disease through a systematic literature review. read more

The Journal of craniofacial surgery

ALK-1-negative anaplastic large cell lymphoma associated with breast implants: a new clinical entity.

Oct, 2011

Concerns have been raised recently regarding the increasing number of reports of non-Hodgkin lymphoma (NHL) that developed in close proximity to silicone or saline breast implants. In particular, an increased risk of anaplastic large cell lymphoma (ALCL) in patients with breast prostheses has been proposed. We reviewed clinical and pathologic findings in 40 women who received a diagnosis of breast NHL arising in association with breast implants and of 27 patients who had a diagnosis of ALCL with breast involvement reported in the published literature. Among the 40 reported cases of prosthesis-associated breast lymphomas, 28 were anaplastic lymphoma kinase-1-negative (ALK-1(-)) ALCLs, whereas of 27 ALCLs in patients without implants found in the literature, only 10 were ALK-1(-). The finding of 28 cases of breast ALK-1(-) ALCL occurring in patients with implants compared with 10 cases in women without implants is in favor of an association between silicone breast prostheses and ALK-1(-) ALCL. Although the incidence of this type of lymphoma remains remarkably low given that breast prostheses have been widely used for decades, clinical and pathologic evidence for a causative role is becoming dramatically strong. The histologic, phenomenologic, and clinical similarities of the majority of implant-related ALK-1(-) ALCLs suggest a common mechanism, especially when compared with the counterpart of patients without implants in which very few and highly dishomogeneous cases of the same malignancy were detected. There is convincing evidence that primary implant-related ALK-1(-) ALCL represents a distinct clinicopathologic entity that has been inappropriately fitted into the category of systemic ALK-1(-) ALCL. Thus it should be recognized as a separate category and classified on its own. read more

Clinical breast cancer

Maximizing the use of precapsular space and the choice of implant type in breast augmentation mammaplasty revisions: review of 49 consecutive procedures and patient satisfaction assessment.

Oct, 2011

Capsular contracture, implant malposition and displacement, breast asymmetry, improper contour, and symmastia may compromise the aesthetic outcome of breast augmentation and usually require surgical correction. Correction of these deformities may be achieved by accommodating a new implant in a novel pocket created in the precapsular space in either the subpectoral or subglandular plane. This article describes a modality to correct adverse results of augmentation mammaplasty and evaluates patient satisfaction. read more

Aesthetic plastic surgery

Further information on anaplastic large cell lymphoma and breast implants.

Sep, 2011

read more

Plastic and reconstructive surgery

Unsuspected breast carcinoma in reduction mammaplasty specimens and the role of pathologic examination.

Sep, 2011

read more

Plastic and reconstructive surgery

Staphylococcus aureus necrotizing fasciitis involving eyelids and periorbita.

Aug, 2011

read more

Orbit (Amsterdam, Netherlands)

Management of contour irregularities following superficial liposuction.

Aug, 2011

read more

Plastic and reconstructive surgery

Refinements in postoperative free flap monitoring.

Jun, 2011

read more

Plastic and reconstructive surgery

Null-type anaplastic lymphoma kinase-negative anaplastic large cell lymphoma arising in a silicone breast implant capsule.

Jun, 2011

read more

Plastic and reconstructive surgery

Peri-implant squamous odontogenic tumor.

May, 2011

Squamous odontogenic tumor (SOT) is a benign, locally infiltrative intraosseous tumor composed of well-differentiated squamous epithelium in a fibrous stroma. It seems to derive from the epithelial rests of Malassez in the periodontal ligament space. It presents an odontogenic origin, involving both the upper and lower maxillary bone, mainly areas without teeth or connective tissue of the odontogenic cysts. Clinically, SOT could be asymptomatic (3 cases), notwithstanding it is mainly characterized by pain, swelling, and tooth/teeth mobility. The most typical presentation of SOT is a slowly growing endobony lesion arising within a single periodontal location. Frequent misdiagnosis concerns either ameloblastoma and squamous cell carcinoma and fibroma. Since its first description in 1975, less than 50 cases have been identified. In light of the few reported cases, there are no consistently recorded clinical and radiographic features of SOT, and there is no predictable sex or site predilection. Diagnosis is predicated on recognition of the histopathologic features of SOT to obviate possible misdiagnosis of malignancy or ameloblastoma.We report the first case of SOT that arose in the vicinity of an implant. Through a meticulous review of literature, we discuss current etiology, pathogenesis, and treatment. read more

The Journal of craniofacial surgery

Comparison between fasciocutaneous and jejunum flaps in pharyngolaryngoesophageal reconstruction.

May, 2011

read more

Plastic and reconstructive surgery

The versatility of the distally based peroneus brevis muscle flap.

Apr, 2011

read more

Plastic and reconstructive surgery

Ischemic optic neuropathy as a rare but potentially devastating complication of liposuction.

Apr, 2011

read more

Plastic and reconstructive surgery

Ischemic optic neuropathy and implications for plastic surgeons: report of a new case and review of the literature.

Apr, 2011

Postoperative visual loss is a rare and devastating complication after nonocular as well as ocular surgery. A case of such a complication arising as a consequence of nonocular surgery prompted a review of the literature, and an appraisal of current theories on etiology, risk factors, and potential treatment options, as well as implications for informed consent. It is clear from our review that all patients undergoing both reconstructive and cosmetic surgery are at risk. read more

Annals of plastic surgery

Current roles of adipofascial anterolateral thigh flap in head and neck reconstructions.

Apr, 2011

read more

Head & neck

Modified superficial musculoaponeurotic system face-lift: a review of 327 consecutive procedures and a patient satisfaction assessment.

Apr, 2011

A conventional superficial musculoaponeurotic system (SMAS) face-lift is well established because it allows the skin envelope to be rotated in a bit more lateral direction than the cephalad redirection of the SMAS flap. This ensures an individualization of the treatment plan according to the needs of the patient and avoids a postoperative stretched look. However, this technique has some limitations with respect to its long-term effects on the sagging tissue, inadequate lifting of the malar fat pad, and flattening of the nasolabial fold. read more

Aesthetic plastic surgery

The favorable psychological approach of single-stage curative and prophylactic skin-reducing mastectomy in patients with macromastia.

Mar, 2011

read more

Plastic and reconstructive surgery

Measuring the meter: on the constancy of lightness scales seen against different backgrounds.

Mar, 2011

The constancy of a 16-step achromatic Munsell scale was tested with regards to background variations in two experiments. In experiment 1 three groups of observers were asked to find lightness matches for targets in simultaneous lightness displays by using a 16-step achromatic Munsell scale placed on a white, black, or white-black checkered background. In experiment 2, a yellow-blue checkered background and a green-red checkered background replaced Munsell scales on the black and on the white backgrounds. Significant effects of scale background on matches were found only in experiment 1, suggesting that background luminance is a crucial factor in the overall appearance of the scale. The lack of significant differences in experiment 2, however, may stand for an overall robustness of the scale with respect to background luminance changes occurring within certain luminance ranges. read more

Behavior research methods

High- and low-evolutive-potential premalignant skin lesions: what about the role of photodynamic therapy?

Feb, 2011

read more

Plastic and reconstructive surgery

Skin-reducing mastectomy: new refinements.

Dec, 2010

Skin-reducing mastectomy is a single-stage technique that helps us to overcome the cosmetic inadequacy of a Type IV Wise pattern skin-sparing mastectomy (final T-inverted scar) in heavy and pendulous breasts by filling the lower-medial quadrant with adequate volume. It also conceals scars as an aesthetic operation and at the same time provides satisfactory and safe coverage of the implant. We report our experience with 22 skin-reducing mastectomies done for 18 women. We modified part of the original description of raising the dermal flap to refine the anatomical results. This flap was mobilised better by detachment of the lateral part of its insertion along the inframammary fold, and this allowed us to close the dermomuscular pouch inferiorly and laterally without raising the serratus anterior or limiting its rise. The total or partial preservation of the serratus muscle together with the creation of a force directed medially, as indicated by the dermal flap, reduced the risks of lateral dislocation of the implant and improved the lateral breast contour to give a more natural shape. Skin-reducing mastectomy is an oncologically safe skin-sparing mastectomy that solves all cosmetic problems and reduces complications of the original Type IV Wise pattern in medium to large breasts. Doing the mastectomy and reconstruction in a single stage aids the favourable psychological approach of the patient. We emphasise the use of our small modification to refine the contour of the breast and improve the aesthetic outcomes by giving a natural curvilinear profile. read more

Journal of plastic surgery and hand surgery

In search of suitable indications for homografts and allografts in nasal augmentation.

Dec, 2010

read more

Plastic and reconstructive surgery

Immunocompromise as major risk factor for necrotising infections of orbital and ocular adnexa caused by Pseudomonas aeruginosa.

Dec, 2010

read more

Orbit (Amsterdam, Netherlands)

Malignant melanoma of the nasal septum.

Nov, 2010

Primary malignant melanoma involving the nasal and paranasal sinus mucosa is a rare neoplasm, accounting for less than 1% of all melanomas. Being more aggressive than its cutaneous counterpart, it carries a poor prognosis. We report a case arising from the nasal septum mucosae in a 78-year-old man. We describe clinical features, diagnosis, and treatment of this rare disease along with a review of the pertinent literature. Endoscopic resection of the neoplasm was performed, enabling diagnosis of sinonasal mucosal melanoma involving the frontal sinus floor. Because the patient was too compromised to achieve radical surgical approach (craniofacial resection), he underwent radiation therapy. Through this article, we wish to emphasize that early diagnosis with a high index of suspicion is critical because this type of tumor is extremely aggressive. Its location and relatively nonspecific features frequently delay diagnosis, and its rarity avoids an optimal treatment guideline setting. read more

The Journal of craniofacial surgery

Anterolateral thigh flap as the ideal flap to full-thickness cheek reconstruction.

Nov, 2010

Reconstruction of the cheek presents a number of challenges when seeking to recreate form and function. The use of the anterolateral thigh flap in various and novel configurations is argued as being the ideal reconstruction, illustrated by case reports. read more

The Journal of craniofacial surgery

Tendon transfer in radial palsy: a historical reappraisal.

Nov, 2010

read more

Plastic and reconstructive surgery

Homografts and the rejection phenomenon: from burn care to organ transplantation.

Nov, 2010

read more

Plastic and reconstructive surgery

Abdominal wall reconstruction: some historical notes.

Nov, 2010

read more

Plastic and reconstructive surgery

Onlay bone autografts in nasal augmentation: ilium versus calvaria.

Nov, 2010

read more

Plastic and reconstructive surgery

Total burn surface area (TBSA): propose of a new objective approach based on the body mass index (BMI).

Nov, 2010

read more

Burns : journal of the International Society for Burn Injuries

A dermomuscular pocket provides superior coverage of the implant in skin-reducing mastectomies.

Oct, 2010

read more

Aesthetic plastic surgery

Eyelid and periorbital necrotizing fasciitis as an early devastating complication of blepharoplasty.

Sep, 2010

read more

Plastic and reconstructive surgery

The versatility of the adipofascial anterolateral flap.

Sep, 2010

read more

Plastic and reconstructive surgery

Spindle cell liposarcoma of the face: case report and literature review.

Sep, 2010

Liposarcoma is a common soft tissue sarcoma accounting for approximately 20% of all mesenchymal tumours across all ages. Recently, collaborative research in the specialties of pathology and genetics has led to the delineation of several tumour variants with different behaviours and prognoses, one of which includes the very rare spindle cell liposarcoma (SCL) subtype. We present the first case of an SCL arising in the subcutaneous tissue of the forehead of a 78-year-old man. In light of the rarity of this tumour, we describe the tumour and its clinical and pathological characteristics and undertake a literature review to clarify the surgical management and prognosis of SCL, and increase awareness to avoid misdiagnosis of a benign soft tissue neoplasm. read more

The British journal of dermatology

On the multiple-procedure approach to body contouring in the massive weight loss patient.

Aug, 2010

read more

Plastic and reconstructive surgery

The key roles of the deep fascia of the anterolateral thigh flap.

Feb, 2010

read more

Plastic and reconstructive surgery

Contribution to histologic analysis of mastectomy scars following breast reconstruction.

Dec, 2009

read more

Plastic and reconstructive surgery

Adipofascial versus fasciocutaneous anterolateral thigh flap in oral cavity reconstruction. Focus on the vascular supply.

Dec, 2009

read more

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

Advantages of the pectoralis major myocutaneous flap that includes the third intercostal branch of the internal thoracic artery.

Oct, 2009

read more

Plastic and reconstructive surgery

Minimizing donor-site morbidity after osteocutaneous radial forearm flap harvest: how, when, and why.

Jun, 2009

read more

Plastic and reconstructive surgery

Cephalic vein transposition in head and neck microsurgery: advantages of a modified step-wise (closed) technique.

May, 2009

read more

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

Adipofascial anterolateral thigh free flap for hemifacial atrophy.

Apr, 2009

Restoration of a harmonious and pleasant appearance is a crucial aspect of surgical treatment for many congenital and acquired deformities of the face. A 38-year-old female patient with residual scarring on the right hemiface following evacuation of a odontogenic phlegmon underwent microsurgical reconstruction with a free adipofascial anterolateral thigh free flap. A stable result was achieved 7 years later. Thanks to adipofascial anterolateral thigh free flap fixation onto the periosteum a very good long-lasting aesthetic and dynamic result was obtained; this approach can be used in patients both with severe and mild abnormalities. Whereas many methods of facial contour restoration are described in the literature, in Authors' opinion, microsurgical techniques are the gold standard unless contraindications; fasciocutaneous flaps, in particular, have shown the best aesthetic results since they can be sculptured to match the defect and stable anchoring is possible thanks to the thick fascia of the anterolateral thigh free flap. read more

Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale

Preventing septorhinoplasty complications: evaluating the personal experience.

Apr, 2009

read more

Plastic and reconstructive surgery

Anterolateral thigh flap morbidity: considerations and reflections on donor-site closure.

Mar, 2009

read more

Plastic and reconstructive surgery

The Sabattini-Abbé flap: a historical note.

Feb, 2009

read more

Plastic and reconstructive surgery

Simultaneous implant placement in sinus floor augmentation using iliac bone block grafts in severe maxillary atrophies: case report.

Dec, 2008

The placement of implants requires adequate basic conditions. Insufficient bone height and width in the area of the maxilla, because of expansion of the maxillary sinus and atrophic resorption of the alveolar ridge, represent a common anatomical complication, which can be solved by augmentation of the floor of the maxillary sinus. It is commonly shared that autologous bone graft is the gold standard method in the augmentation of the Higmoro antrum. The reconstruction of atrophies with adequate bone volume and density has become a viable treatment option with high predictability and success rates. The purpose of this study was to present the results obtained with a surgical procedure aimed at reconstructing (rehabilitating) advanced maxillary atrophies. This method includes the use of intramembranous, corticocancellous bone grafts harvested from the iliac crest. These are then fixed to the residual bone by endosseous implants. read more

Implant dentistry

Further experience with adipofascial ALT flap for oral cavity reconstruction.

Oct, 2008

The restoration of the buccal mucosa is the main challenge for the plastic surgeon. In the past 15 years the free radial forearm flap has been widely used, due to its thickness and pliability. More recently, the anterolateral thigh free flap has become the customary flap in oral cavity reconstruction. read more

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

Cutaneous carcinosarcoma: report of a case with myofibroblastic sarcomatous component.

Mar, 2008

read more

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Acute thyroiditis of odontogenic origin.

Sep, 2007

If an abscess is not able to establish drainage through the skin surface or into the oral cavity, it may spread diffusely through fascial planes of the neck's soft tissue. Once the infection descends into the submandibular space, it may extend to the lateral pharyngeal space, and then to the retro-pharyngeal space. From here, it may reach the thyroid gland. The authors here describe a case of submandibular phlegmon derived from a periapical abscess of inferior premolar, which has reached the thyroid gland. The damage caused to the gland resulted in the release of a conspicuous quantity of thyroid hormones, thus causing a thyrotoxic pattern: temperature, cutaneous pallor, excessive perspiration, tremor, tiredness, weight loss, increased appetite, and tachycardia. Additionally, the gland's edema caused dysphagia and dysphonia commonly seen with thyroid gland enlargement. After dental drainage and appropriate anti-inflammatory and antibiotic therapy, administration of oral beta-blockers and corticosteroid therapy were performed to counteract thyrotoxicosis in order to prevent recurrences. Finally, a root canal was performed once the thyrotoxicosis had been resolved. read more

Minerva stomatologica

Adipofascial anterolateral thigh free flap for tongue repair.

Sep, 2003

With the advent of microsurgery fasciocutaneous free flaps have become a well known and accepted option for the repair of tongue defects. Many authors have tried to recover tongue function by modifying this approach. An innovative method for the repair of tongue defects using an adipofascial anterolateral thigh free flap is presented in this paper. The results are compared with those of tongue reconstructions implementing traditional fasciocutaneous free flaps performed at our institution. The histological features of the flaps were investigated postoperatively. Although this preliminary report has to be confirmed by further experience, it seems to solve many tongue-reconstruction related problems. read more

British journal of plastic surgery