Seminars in Plastic Surgery

Publications in this journal

• Article: Azita madjidi, m.d., m.s.

  Larry H Hollier
  Seminars in Plastic Surgery 11/2011; 25(4):245-6.
• Article: Otoplasty for the protruded ear.

  Ronen Nazarian, Adrien A Eshraghi
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  ABSTRACT: The prominent ear can produce significant social and psychological effects on an individual. Through the last century, many procedures have been described to correct this deformity. In this review, the authors navigate through the history of otoplasty for the protruded ear, and describe some of the breakthroughs in the procedure. Furthermore, they discuss key measurements that must be kept in mind in preoperative and intraoperative settings. They also describe in more detail some of the more common methods for correcting the protruded ear, as well as postoperative management and common complications faced after surgery.
  Seminars in Plastic Surgery 11/2011; 25(4):288-94.
• Article: Otologic and audiology aspects of microtia repair.

  Michael J Lipan, Adrien A Eshraghi
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  ABSTRACT: Congenital abnormalities of the outer ear pose a reconstructive challenge for plastic surgeons and otologists. Many patients with microtia of the auricle have concurrent atresia of the external auditory canal. The hearing loss associated with canal atresia can have long-lasting effects if not treated promptly and appropriately. The diagnosis and workup for canal atresia requires an otologic evaluation. Audiologic and radiologic evaluations direct treatment, which varies depending on unilateral or bilateral presence of atresia. Rehabilitation of hearing loss can be performed via hearing aids, bone-anchored conductive devices or canalplasty. Due to the complexity of treatments, communication between the reconstructive plastic surgeon and the otologist is necessary to detect hearing loss and determine the best method of restoring hearing in conjunction with microtia repair.
  Seminars in Plastic Surgery 11/2011; 25(4):273-8.
• Article: Prosthetic reconstruction of the auricle: indications, techniques, and results.

  Jean-Philippe Giot, Daniel Labbé, Eric Soubeyrand, Régine Pacini, Marie-Reine Guillou-Jamard, Jean-François Compère, Hervé Bénateau
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  ABSTRACT: Extensive defects of the ear require satisfactory cosmetic reconstruction to enable the patient to achieve full social integration. Although surgical procedures are the gold standard for reconstruction of the ear, in some cases they cannot be performed because of extended scars, threatening tumor, or congenital tissue abnormalities. Prosthetic reconstruction of the auricle is an established and reliable alternative technique to autologous surgical reconstructions. Since studies performed by Brånemark, osseointegrated implants have been widely used to provide a reliable and stable anchorage for a prosthesis (prosthesis anchored to bone). To allow good osseointegration of the titanium screw implants, two stages are necessary. After careful preparation for the surgical procedure (local and general examination, computed tomography scan, skin preparation), screws are implanted into bone, which are then covered by a skin flap. During the second stage, the skin is incised, and penetrating fixtures are attached to the screw implants, which allow fixation of the prosthesis. This procedure is reliable and reproducible, with good to excellent results and stability over time.
  Seminars in Plastic Surgery 11/2011; 25(4):265-72.
• Article: Partial auricular reconstruction.

  Bob B Armin, Robert O Ruder, Babak Azizadeh
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  ABSTRACT: The authors summarize current methods for reconstructing partial auricular defects resulting from trauma, neoplasm, or congenital defects. They also review the anatomy and embryology of the ear as this is critical for proper reconstruction. Defects of the auricle are divided into upper-third, middle-third, and lower-third defects. Methods of total auricular reconstruction are also briefly discussed as these methods can provide more superior reconstruction than partial techniques in select cases.
  Seminars in Plastic Surgery 11/2011; 25(4):249-56.
• Article: Historic aspects of ear reconstruction.

  Azita Madjidi
  Seminars in Plastic Surgery 11/2011; 25(4):247-8.
• Article: A novel algorithm for autologous ear reconstruction.

  Françoise Firmin, Alexandre Marchac
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  ABSTRACT: Sculpting a tridimensional autologous rib cartilage framework is essential to restore a natural ear shape and becomes routine with preoperative training, but management of the skin is the key to minimizing complications. Here the authors provide a classification scheme to manage auricular skin: Type 1 is a Z-plasty with transposition of the lobule; type 2 is a transfixion incision of the microtic ear; type 3 exposes the cartilage remnants through a cutaneous incision. They also explain how to choose between the three types, depending upon the auricular skin potential. With training and method, results in ear reconstruction using autologous rib cartilage are excellent and reproducible.
  Seminars in Plastic Surgery 11/2011; 25(4):257-64.
• Article: Pathology of the ear.

  Ida Orengo, Kerri Robbins, Amanda Marsch
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  ABSTRACT: The external ear is exposed to weathering and trauma; it also has sparse vascularity, making it prone to infection and disease. The external location of the cutaneous ear makes it easily visible for diagnosis and accessible for treatment. In this article, the authors focus on diseases of the ear that are most commonly encountered and may be subject to surgical and medical evaluation and/or treatment. Epidemiology, pathogenesis, clinical course, and treatment for each disease entity are discussed.
  Seminars in Plastic Surgery 11/2011; 25(4):279-87.
• Article: Aesthetic and functional genital and perineal surgery: male.

  Christopher J Salgado, Stan J Monstrey
  Seminars in Plastic Surgery 08/2011; 25(3):177-8.
• Article: Hypospadias repair: an overview of the actual techniques.

  Ramnath Subramaniam, Anne Francoise Spinoit, Piet Hoebeke
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  ABSTRACT: Hypospadias is one of the most common congenital genital anomalies for which surgery early in life is indicated. The surgical treatment is changing progressively, often by repeating treatment strategies that have been used decades ago. Indeed, historically two-stage procedures were replaced by one-stage procedures and nowadays two-stage procedures gain new interest. The same for reconstructions using the urethral plate, which decades ago were based on the Thiersch Duplay principle. In the 1980s, preputial onlay flaps were most often used and today we see a new interest in the use of the urethral plate. The actual surgical approach to hypospadias is described and technical details are given.
  Seminars in Plastic Surgery 08/2011; 25(3):206-12.
• Article: Scrotal and perineal reconstruction.

  Nho V Tran
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  ABSTRACT: The scrotal and perineal area serves a special function. It is the pelvic outlet for the gastrointestinal tract, urinary system, and sexual function. In the male, the scrotum allows testicular mobility to reduce trauma and allow optimal thermal regulation for spermatogenesis. Trauma, infection, and cancer resection create defects that require reconstruction. The reconstructive goal here is to obtain durable coverage, function, and lastly aesthetic outcome. Pedicled local and regional flaps are the mainstay for this area. Due to the special function and appearance of the scrotum, reconstructive options for total scrotal defect always fall far short of the native scrotum. On the other hand, perineal reconstruction is overall satisfactory.
  Seminars in Plastic Surgery 08/2011; 25(3):213-20.
• Article: Normal penile, scrotal, and perineal anatomy with reconstructive considerations.

  Moira E Dwyer, Christopher J Salgado, Deborah J Lightner
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  ABSTRACT: A broad overview is provided of the normal anatomy of the male genitalia to offer the best surgical outcomes in cases related to congenital abnormalities, trauma, cancer-related extirpation, and aesthetics. Neural and vascular anatomy is discussed in depth due to its critical role in maintaining function and in assuring tissue viability.
  Seminars in Plastic Surgery 08/2011; 25(3):179-88.
• Article: Sex Reassignment Surgery in the Female-to-Male Transsexual.

  Stan J Monstrey, Peter Ceulemans, Piet Hoebeke
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  ABSTRACT: In female-to-male transsexuals, the operative procedures are usually performed in different stages: first the subcutaneous mastectomy which is often combined with a hysterectomy-ovarectomy (endoscopically assisted). The next operative procedure consists of the genital transformation and includes a vaginectomy, a reconstruction of the horizontal part of the urethra, a scrotoplasty and a penile reconstruction usually with a radial forearm flap (or an alternative). After about one year, penile (erection) prosthesis and testicular prostheses can be implanted when sensation has returned to the tip of the penis. The authors provide a state-of-the-art overview of the different gender reassignment surgery procedures that can be performed in a female-to-male transsexual.
  Seminars in Plastic Surgery 08/2011; 25(3):229-44.
• Article: Aesthetic surgery of the male genitalia.

  Gary J Alter, Christopher J Salgado, Harvey Chim
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  ABSTRACT: Appearance of the male genitalia is linked with self-esteem and sexual identity. Aesthetic surgery of the male genitalia serves to correct perceived deficiencies as well as physical deformities, which may cause psychological distress. Attention to patient motivation for surgery and to surgical technique is key to achieving optimal results. In this review, the authors describe aesthetic surgical techniques for treatment of penile and scrotal deficiencies. They also discuss techniques for revision in patients with previous surgery.
  Seminars in Plastic Surgery 08/2011; 25(3):189-95.
• Article: Penile reconstruction.

  Christopher J Salgado, Harvey Chim, Jennifer C Tang, Stan J Monstrey, Samir Mardini
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  ABSTRACT: A variety of surgical options exists for penile reconstruction. The key to success of therapy is holistic management of the patient, with attention to the psychological aspects of treatment. In this article, we review reconstructive modalities for various types of penile defects inclusive of partial and total defects as well as the buried penis, and also describe recent basic science advances, which may promise new options for penile reconstruction.
  Seminars in Plastic Surgery 08/2011; 25(3):221-8.
• Article: Christopher j. Salgado, m.d. And stan j. Monstrey, m.d., ph.d.

  Larry H Hollier
  Seminars in Plastic Surgery 08/2011; 25(3):175-6.
• Article: Phalloplasty in complete aphallia and ambiguous genitalia.

  Rachel Bluebond-Langner, Richard J Redett
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  ABSTRACT: The most common indications for phalloplasty in children include aphallia, micropenis/severe penile inadequacy, ambiguous genitalia, phallic inadequacy associated with epispadias/bladder exstrophy and female to male gender reassignment in adolescents. There are many surgical options for phalloplasty; both local pedicled tissue as well as free tissue transfer. The advantages of local tissue include a more concealed donor site, less complex operation and potentially faster recovery. However, pedicled options are generally less sensate, making placement of a penile prosthesis more risky and many children with bladder exstrophy have been previously operated upon making the blood supply for local pedicled flaps less reliable. This Here the authors discuss free tissue transfer, including the radial forearm, the anterolateral thigh, the scapula and latissimus, and the fibula free flaps, as well as local rotational flaps from the abdomen, groin, and thigh. The goal of reconstruction should be an aesthetic and functional (ability to penetrate) phallus, which provides tactile and erogenous sensation, and the ability to urinate standing. Ideally, the operation should be completed in one to two operations with minimal donor site morbidity. There are advantages and disadvantages of each of flap and thus the choice of donor site should be a combination of the patient's preference and surgeon's ability to produce a consistent result.
  Seminars in Plastic Surgery 08/2011; 25(3):196-205.
• Article: Normal vulvovaginal, perineal, and pelvic anatomy with reconstructive considerations.

  Sujata Yavagal, Thais F de Farias, Carlos A Medina, Peter Takacs
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  ABSTRACT: A thorough insight into the female genital anatomy is crucial for understanding and performing pelvic reconstructive procedures. The intimate relationship between the genitalia and the muscles, ligaments, and fascia that provide support is complex, but critical to restore during surgery for correction of prolapse or aesthetic reasons. The external female genitalia include the mons pubis, labia majora and minora, clitoris, vestibule with glands, perineal body, and the muscles and fascia surrounding these structures. Through the perineal membrane and the perineal body, these superficial vulvar structures are structurally related to the deep pelvic muscle levator ani with its fascia. The levator ani forms the pelvic floor with the coccygeus muscle and provides vital support to all the pelvic organs and stability to the perineum. The internal female genital organs include the vagina, cervix, uterus, tubes, and ovaries with their visceral fascia. The visceral fascia also called the endopelvic fascia, surrounds the pelvic organs and connects them to the pelvic walls. It is continuous with the paraurethral and paravaginal fascia, which is attached to the perineal membrane. Thus, the internal and external genitalia are closely related to the muscles and fascia, and work as one functioning unit.
  Seminars in Plastic Surgery 05/2011; 25(2):121-9.
• Article: Aesthetic and functional genital and perineal surgery: female.

  Christopher J Salgado, Stan J Monstrey
  Seminars in Plastic Surgery 05/2011; 25(2):119-20.