Objectives: The objective of this presentation is demonstrating how changing the deep structures of the neck contributes to a better surgical outcome in neck rejuvenation

Introduction: Necklift is a surgery that leads to many opinions regarding whats the best technique.

Some state, that all it takes to get a good result, is a simple lateral plication of the platysma

Our opinion is that if the deep structures of the neck, submaxilary gland, subplatismal fat, hyoid fáscia, and digastric muscles, are not dealt with, than a subptimal result will appear shortly

Materials / method: The author presents several cases of High Smas face and necklifts with gland reduction, digastric plication and subplatisma fat removal.

All documented with standardized 3D Photo equipment.

Intra operatory details are shown in vídeos and photos, in order to teach how the surgery is performed, in a safe way

Protocols for surgery safety are shown

Pre and pos 3D vídeos and photos are presented showing the results and evolution

Results: Different types of necks are presented, with short and long term results

Clear demonstration of neck volume changes and skin tension relapse can be evaluated, throughout the post op period

Unsatisfactory results are also presented and discussed

Conclusion: When the deep structures are ignored, and simply pushed upwards with plastysma suspension, in our hands, doesnt lead to a good result, and instead has premature relapse.
Neck rejuventation is limited with non surgical procedures, so evolving in neck surgery, is for sure, mandatory, because in the near future, this anatomical área, will have a big pursue in demand.
I Intend to promote discussion on this topic, allowing surgeons to understand the need to deal with deep neck anatomy in a consistente and safe way.

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Objectives: This retrospective study describes the simple reproducible complication free approach to restoring the neck after massive weight loss. With a stable weight of the patient it allows for accurate preoperative planning and a straightforward procedure. It results in a visible but pleasing scar as a trade off for improved neck contour of the MWL patients. With consideration of the type of neck deformity and following the suggested treatment algorithm according to our grading scale this procedure is a great amendment to weight loss surgery.

Introduction: The number of patients with history of obesity and massive weigh loss (MWL) is continuously rising. Patients are left with damaged ptotoc skin, contour deformities, causing intertriginous disorders. Once major areas of excess skin have been removed the patient is often left with stigmatizing skin redundancies at the neck an apparent area with little options to cover up. Currently no classification for neck deformities after MWL exists and the operation planning is individual. We therefore propose a classification and treatment algorithm for MWL triggered deformities of the neck.

Materials / method: The authors introduce options of isolated neck lift procedures in MWL patients. According to the grade of deformity a treatment algorithm is proposed. A retrospective study was carried out on 17 patients. All patients were operated on, by the senior surgeon in a 6 year period from Jan 2012 to Dec 2017. In 14 cases a direct submental incision was applied for skin excision while in 3 cases neck tightening was achieved by a star-excision or zigzag zorro-scar in the midline. Resulting scarring and complications are compared to a patient group receiving neck procedures for aesthetic reasons.

Results: In the study group 17 patients after massive weight loss (BMI drop averages at 19.6) underwent a neck lift. All patients received concomitant surgery without raising complication risks. No complications were noted in the treatment group. Scar quality was rated acceptable to good in all patients.

Conclusion: The direct excision neck lift showes to be a reliable technique with rare complication rates throughout the group of MWL patients and aesthetic patients. Once a stable weight has been achieved the submental ptotic tissue is a mere skin redundancy in MWL patients, liposuction has not been necessary. The submental neck lift can safely be performed together with other postbariatric procedures and improves appearance.

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Objectives: Pectus excavatum(PE) is a congenital deformity of the anterior thoracic rib cage, also known as sunken or funnel chest.We describe how to perform BA safely and easily in patients with Pectus excavatum

Introduction: Women with P.E have very commonly hypoplastic and asymmetric breasts however they don’t wish any surgical treatment for the pectus excavatum but just a breast augmentation.

Materials / method: 25 patients with PE and hypo plastic breasts were treated from 2010 to 2017. The mean age was 25 years old (53-21 years old). They all had breast asymmetry All our patient were healthy without any other problems. All patients expressed the following three wishes: To correct the asymmetry, augment the breasts and improve the Pectus Excavatum We propose 8 surgical steps in order to perform the operation easily and safely.
All patients were requested to fill up a questionnaire at 1 year following the procedure in order to evaluate their results

Results: No complication related to the procedure were observed. All patients offered high scores to all three questions of the questionnaire. The medial surgical time was 55 minutes (90 min-45 minutes)

Conclusion: Breast Augmentation with certain steps is a procedure that can give good results in patient who have P.E. and wishes to augment their breasts. The steps we describe are easy to be learn and can be done easily by all plastic surgeons.

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Objectives: A study of factors influencing the stability of the results of breast augmentation, has become the purpose of our work. The stability of the aesthetic result of this operation depends on many factors: the state of the surface tissue of the patient, weight, shape and design of the implant, the interaction of the implant capsule to the surrounding tissues, Features a private surgical technique, management of the postoperative period.

Introduction: Breast augmentation is one of the most popular aesthetic operations in the world

Materials / method: We examined 704 patients who applied for the increase of the mammary glands replacement and removal of silicone implants The largest number consisted of patients with postlactational involution with a variety of congenital deformities and underdevelopment of the mammary glands patients who have applied for replacement of implants Methods: clinical method of acoustic scanning of the soft tissues of the mammary glands ultrasound methods mammography computed tomography pathological macro and microscopy, experimental laboratory

Results: The round implant with the same width of the base and the projection have a large weight compared to the anatomical which increases the risk of secondary ptosis of the breast Had perfected a own surgical technique of correction of 1-2 degrees of mammary ptosis with highprofile anatomical implants without the additional use of technology T or vertical mastopexy with minimal risk of rotation and capsular contracture 1% The peculiarities of surgical tactics during the replacement of the breast implants with capsularcontracture and secondary ptosis

Conclusion: Our experience in combination with experimental and clinical studies allowed us to obtain optimal stable aesthetic results when correcting the shape and volume of the mammary glands with silicone implants and to minimize the risk of possible complications, the observation period was 15 years.

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Objectives: 1. Present a new surgical option for immediate breast reconstruction after mastectomy.
2. Demonstrate the surgical technique and indications.
3. Show the possible results.
4. Show the main mistakes during our learning curve experience.

Introduction: Immediate breast reconstruction after a conservative mastectomy is an attractive option made easier by prosthetic devices. Titanized polypropylene meshes are used as a hammock to cover the lower lateral implant pole. We examine the use of TCPM as an alternative to ADM and share our experience and complication of our initial period for comparison.

Materials / method: We performed immediate implant breast reconstructions after conservative mastectomies and nipple sparing mastectomies, as well as cases needing a breast lift at the same time. using TiLoop® Bra, with the standard retropectoral approach. We chose patients with early stage breast cancer to minimase the possibility of post-op radiation treatment need. The use of TCPM permited us to include patients with bilateral nipple sparing mastectomy with very ptotic breast that also needed a breast lift at the same time. We analysed short-term outcomes and present you noteworthy results.

Results: A total of 20 mastectomies were performed including, bilateral procedures, nipple sparing procedures, patients with severe ptosis, patients with gigantomastia. We present our surgical technique, our favourable results and also our mistakes during our first experience with TiLoop.

Conclusion: Titanium-coated polypropylene meshes, as a tool for immediate definitive implant breast reconstruction, resulted as safe and effective in a short-term analysis, both for a retropectoral and a totally subcutaneous implant placement. Long-term results are forthcoming. A strict selection is mandatory to achieve optimal results.

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