[Show abstract][Hide abstract] ABSTRACT: Although cartilage grafts are frequently used for structural integrity and volume restoration, one of the main concerns dealing with cartilage grafting is gradual volume loss and unpredictable viability rates of cartilage grafts. Platelet-rich plasma (PRP) is a well known platelet concentrate reported to enhance cartilage repair and stimulates chondrocyte proliferation and matrix biosynthesis. The purpose of the current study was to investigate the effect of subcutaneous PRP injection on improving the viability of cartilage grafts.
Six circular cartilage grafts were obtained from auricular cartilages of 6 New Zealand white rabbits. Cartilage grafts were prepared in 3 forms: block, crushed, and crushed/wrapped with Surgicel (Surgical, Ethicon, Somerville, NJ). Grafts were placed to 6 dorsal subcutaneous pockets and pockets were closed. Autologous PRP was prepared and injected subcutaneously into the pockets of experiment groups. At the end of 8 weeks, cartilage grafts were removed. Cartilage mass reduction rates were measured. Resorption rates of cartilage grafts and formation of fibroelastic and bone tissue were microscopically evaluated.
All of the cartilage grafts lost significant weight. Viability scores of block cartilages were higher than crushed cartilages. Although less weight loss rates and higher histopathologic scores were obtained in subcutaneously PRP injected cartilage graft groups, these results were not statistically significant.
Although our study gives a new insight about increasing the viability of cartilage grafts, the subcutaneous PRP injection did not result in improving the viability of cartilage grafts in this experimental design.
The Journal of craniofacial surgery 06/2015; 26(5). DOI:10.1097/SCS.0000000000001819 · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although aesthetic procedures are known to have a higher impact on women, men are becoming more inclined toward such procedures since the last decade. To determine the reason behind the increase in demand for male aesthetic procedures and to learn about the expectations and inquietude related to body contouring surgery, a prospective questionnaire study was conducted on 200 Turkish males from January 1, 2011–May 31, 2012. Demographic information, previous aesthetic procedures and thoughts on body contouring procedures with given reasons were questioned. The results of the study showed that 53 % of all participants considered undergoing body contouring surgery with the given reason that they believed their current body structure required it. For those who did not consider contouring operations, 92.5 % said they felt that they did not need such a procedure. The results of the statistical analysis showed that BMI was a significant factor in the decision making process for wanting to undergo body contouring procedures. The results of the study showed that mens’ consideration for aesthetic operations depends mainly on necessity and that the most considered region was the abdominal zone in regard to contouring. We can conclude that men are becoming more interested in body contouring operations and therefore different surgical procedures should be refined and re-defined according to the expectations of this new patient group.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www. springer. com/ 00266.
Aesthetic Plastic Surgery 12/2014; 39(1). DOI:10.1007/s00266-014-0440-1 · 0.96 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Goals/Purpose:
Although aesthetic procedures are known to have a higher impact on women, men are becoming more open to such procedures since the last decade. Of patients presenting to the hospital in order to have aesthetic operations, approximately 25-30% are male. This ratio was 20% four years ago, and 10-15% ten years ago. A questionnaire study was designed to determine the reason behind the increase in demand for male aesthetic procedures.
A prospective questionnaire study was conducted between January 2011 – May 2012 to determine how male outpatients consider body contouring operations. Demographic information, previous aesthetic procedures, thoughts on body contouring applications with given reasons were questioned.
The average age of participants was 39 years. Thirty-one percent of respondents had undergone previous aesthetic surgery. When asked if they had information regarding body contouring surgery, 55% replied “yes”. The internet was the most commonly used tool for gathering information concerning body contouring. Fifty-three percent replied that they would consider undergoing body contouring surgery with the given reason that they believed they needed it. For those who didn’t consider contouring operations, 92.5% said that they did not need such a procedure. The results of a statistical analysis showed that there is no significant difference between the demographical status between those who consider body contouring surgery and those who don’t consider it. (p>0.05). Participants were catagorized into two groups according to body mass index. Participants with a BMI over 30 kg/m2 (Group 1) agreed to undergo body contouring surgery more than those who had a BMI less than 30 kg/m2 (Group 2). The results of the statistical analysis showed that there was a significant difference between the two groups. (p<0.05).
When asked which operation they would want to undergo primarily, 31% replied “abdominoplasty”. This was followed by liposuction at 20% , and gynecomastia operations. with 14%. When asked how they would prefer to contour their body, 51.9% replied they would first increase physical activity such as jogging, spinning, swimming while 11.8% replied that they would consider contoring operations as the first alternative. The difference between the preference of body contouring alternatives were also statistically significant (p<0.05).
The results of the study show that mens’ consideration for aesthetic operations depend mainly on necessity and they mostly consider the abdominal zone. Word of mouth communication is the most commonly used source of information regarding woman but for men it is the internet. Body mass index is an independent predictor for considering body countouring operations. We can conclude that men are becoming more interested in aesthetic operations.
The Aesthetic Meeting 2014 The American Society for Aesthetic Plastic Surgery; 04/2014
[Show abstract][Hide abstract] ABSTRACT: Botulinum toxin type A (BTX-A) is currently used in temporal brow lifting. Reducing the activity of the superolateral portion of orbicularis oculi muscle causes lateral brow elevation. The objective of this study was to determine the quantitative brow elevation after paralysis of the superolateral portion of orbicularis oculi muscle.
This study includes 10 female patients. Six units of BTX-A were injected into the superolateral portion of the orbicularis oculi in a serial manner into 3 points, below the lateral half of the brow at each side. Bilateral measurements were obtained by using calipers, immediately before and 2 weeks after the treatment. The medial canthus to the medial brow margin (AB), the lateral brow margin to the lateral canthus (CD), the medial brow margin to the lateral brow margin (BC), the brow apex to upper lid margin at the level of the lateral limbus (EF), the brow apex to the medial brow margin (EB), the brow apex to the lateral brow margin (EC), and upper eyelid margin to lower eyelid margin at the level of the pupil (GH), were measured.
There were no statistically significant differences found between pretreatment and posttreatment left and right measurements. There were statistically significant increases in CD, EF, and GH measurements, which are point out brow elevation. There were no statistically significant differences found in other measurements.
Same doses of BTX-A application did not disrupt symmetry. Applications of 6U BTX-A to the superolateral portion of orbicularis oculi provide brow elevation and increased interpalbebral distance and upper eyelid distance. Our study has confirmed that BTX-A treatment of superolateral portion of the orbicularis oculi muscle produces quantitative temporal brow elevation.
The Journal of craniofacial surgery 07/2013; 24(4):1285-1287. DOI:10.1097/SCS.0b013e318292c80c · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Temporalis muscle metastasis of a tumor is a rare condition. Basaloid squamous cell carcinoma is an uncommon variant of squamous cell carcinoma, which often occurs in the aerodigestive tract. To the best of our knowledge, there have been no previous reports dealing with temporalis muscle metastasis from esophageal carcinoma in the literature.
The Journal of craniofacial surgery 03/2011; 22(2):736-7. DOI:10.1097/SCS.0b013e318208bae9 · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Arsenic is a carcinogenic agent for human beings. Arsenic
can be exposed mostly through arsenic-contaminated
water.1,2 Arsenicosis can be defined as “a chronic health condition
arising from prolonged ingestion (more than 6 months)
of arsenic above a safe dose (>10μg/L).” Usually manifested
by characteristic skin lesions, with or without visceral organ
involvement. Furthermore arsenicosis provoke some types
of non-melanoma skin cancer and systemic diseases such as
nervous, respiratory, cardiovascular, and gastrointestinal system.
In this case report a 47-year-old male patient admitted
to our clinic with characteristic skin lesions and atypically
located multiple skin cancers (5 basal cell carcinomas, 1 basosquamous
carcinoma, 3 carcinomas-in situ) due to arsenicosis.
Otherwise, the importance of additional investigation
should apply to this patients who were admitted with atypical
skin lesions. If any suspicion about arsenic exposure we have
to inform public health units for similar cases. We chose and
applied wide surgical excisions for treatment. Patient is in the
follow-up period for recurrent and new lesions.
[Show abstract][Hide abstract] ABSTRACT: Herpes zoster may develop after surgery, but the mechanism is unclear. It has been previously reported after esthetic surgical
procedures, such as liposuction, breast augmentation, and face lifting. A post abdominoplasty patient who developed herpes
zoster 6months after surgery is presented. This case may demonstrate an association between abdominoplasty and the reactivation
of the Varicella zoster virus.
European Journal of Plastic Surgery 01/2008; 30(6):301-302. DOI:10.1007/s00238-007-0196-9
[Show abstract][Hide abstract] ABSTRACT: Various materials such as autogenous bone, cartilage and alloplastic implants have been used to reconstruct orbital floor fractures. A new material is needed because of disadvantages of nonresorbable alloplastic materials and difficulties in harvesting autogenous tissues. In this study safety and value of the use of resorbable mesh plate in the treatment of orbital floor fractures are discussed. Between 2002 and 2004 a total of 17 maxillofacial trauma patients complicated with orbital floor fractures were treated with resorbable mesh plate through subciliary or transconjunctival incisions. Pure blow-out fractures were determined in 6 patients and 11 patients had accompanying maxillofacial fractures. Resorbable plate was easily shaped to fit to the orbital floor by cutting with scissors. Patients were evaluated clinically and with computed tomography scans preoperatively and at 3-, 6- and 12-month intervals postoperatively. Twelve patients had preoperative enophthalmos. Two patients had diplopia that was corrected postoperatively. In all 17 cases there was no evidence of infection, diplopia and gaze restriction postoperatively. Scleral show appeared in three patients by the second postoperative week but resolved totally within 3 to 6 weeks except one patient. In this patient anterior displacement of mesh was evident which caused ectropion and enophthalmos and required re-operation. No any other mesh related problems were seen at 15 months mean follow-up time. The advantage of the resorbable mesh system in orbital floor fracture is the maintenance of orbital contents against herniation forces during the initial phase of healing and then complete resorption through natural processes after its support is no longer needed. Our experience represents that resorbable mesh is a safe and effective material for reconstruction of the selected, non-extensive orbital floor fractures.
Journal of Craniofacial Surgery 06/2007; 18(3):598-605. DOI:10.1097/01.scs.0000246735.92095.ef · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The major goals in contour restoration procedures are to re-establish the desired contour with the use of resilient and durable materials that can be easily found and harvested. Cartilage grafts are commonly used for these purposes though they often possess a problem of donor site morbidity and shortage of quantity. The neo-cartilage formation capacities of both perichondrium and periosteum are well-known. We aimed to optimize both the amount and quality of the newly forming tissue from perichondrial and periosteal grafts. For this purpose the grafts were wrapped on themselves. Placement of oxidized regenerated cellulose (ORC) within graft layers was performed in two groups with the aim of giving support to the regenerating tissue, and increasing the connective tissue formation within the graft layers. Three-month-old New Zealand white rabbits were used. Group 1 ear perichondrial, and Group 2 calvarium periosteal grafts of 1.4 x 2.4 cm were harvested, folded on themselves, and sutured at the edges to create closed pockets. 0.8 x 0.8 cm sized ORC sheets were placed inside the pockets before wrapping in Group 3 perichondrial and Group 4 periosteal grafts. 0.2-mL autogenous blood was injected in each pocket. All grafts were transplanted under the abdominal muscle fascia, and harvested after 6 weeks. Volumes and weights of wrapped perichondrial grafts were higher than their periosteal counterparts either with or without the inclusion of ORC. Grafts with ORC (Groups 3 and 4) were heavier than the grafts lacking ORC (Groups 1 and 2), in a statistically significant manner (P </= 0.01). Histologically, the inclusion of ORC in both perichondrial and periosteal grafts resulted in an increased amount of fibrosis, yet did not preclude neo-cartilage formation.
Journal of Craniofacial Surgery 11/2006; 17(6):1137-43. DOI:10.1097/01.scs.0000236439.82473.fe · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Reconstruction of defects around the ankle region has always been challenging for plastic surgeons. Distally based lateral and medial leg adipofascial flaps are among the flaps of choice for coverage of this difficult region. Presented here is the authors' clinical experience with these flaps, particularly emphasizing the complicated attempts in diabetic patients.
Seven skin defects around the ankle were reconstructed with lateral and medial leg adipofascial flaps. The lowermost perforators of the peroneal or posterior tibial artery were identified preoperatively, and a straight incision through skin only was made proximal to this perforator. With the skin flaps reflected, the adipofascial flap was than raised in the subfascial plane. The perforators to be retained in the base were located and the flap was then turned over to cover the defect, followed by application of a split-thickness skin graft over the flap. The donor site was closed primarily.
The ages of the patients ranged from 25 to 80 years, and the size of the flaps ranged from 3 x 5 cm to 7 x 10 cm. Four defects were reconstructed with lateral leg adipofascial flaps, and medial leg adipofascial flaps were used in three. Two flaps healed uneventfully. Partial or total graft loss and partial flap necrosis were observed in five patients, four of whom were diabetic.
Leg adipofascial flaps offer a valuable option for repair of defects around the ankle in many cases. However, adipofascial flaps should be used with caution in old, diabetic patients and, when performed, the probability of a second or third procedure should be considered.
Plastic and Reconstructive Surgery 02/2006; 117(1):272-6. DOI:10.1097/01.prs.0000187139.50211.00 · 2.99 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Diabetic ulcers located in the plantar surface of the great toe resist conservative treatment modalities including skin grafts and usually require flap coverage for a stable reconstruction. Free tissue transfer is not feasible in these patients, because these defects are closely associated with peripheral vascular disease and local flap alternatives are extremely limited in this region. Reported here is the use of homodigital reverse flow island flap for reconstruction of neuropathic great toe ulcers in diabetic patients with encouraging results.
British Journal of Plastic Surgery 08/2005; 58(5):717-9. DOI:10.1016/j.bjps.2005.01.002 · 1.29 Impact Factor