P M Vogt

Hannover Medical School, Hanover, Lower Saxony, Germany

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Publications (320)293.95 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Die chirurgische Intervention bei der persistierenden ideopathischen Gynäkomastie hat einen hohen Stellenwert im Behandlungsschema eingenommen. Die Wahl der jeweiligen chirurgischen Therapie stützt sich dabei auf den Ausgangsbefund und die Diagnose. Vor der Indikationsstellung zur operativen Therapie ist die Differenzialdiagnostik interdisziplinär hinsichtlich der Pathogenese vollständig aufzuarbeiten. Die Liposuktion wird zunehmend bei der chirurgischen Behandlung der Gynäkomastie verwandt. Sie kann gut mit den traditionellen Techniken wie der subkutanen Mastektomie und der periareolären Straffung kombiniert werden und zeigt ihre Rechtfertigung insbesondere bei der Gynäkomastie GradIIa/b als narbensparende und komplikationsarme Methode mit sehr guten ästhetischen Reduktionsergebnissen. In unserem Zentrum wurden in den Jahren 2000 bis 2010 162Patienten mit Gynäkomastie GradI–III nach Simon operiert und retrospektiv ausgewertet. Es zeigte sich ein Rückgang der T-Schnitt-Reduktion und der subkutanen Mastektomie kombiniert mit periareolärer Straffung gegenüber einer Zunahme der subkutanen Mastektomie in Kombination mit der Liposuktion. Zum Ausschluss eines Malignoms sollte immer eine Exzision der Drüse mit histologischer Untersuchung erfolgen. Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I–III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present. SchlüsselwörterGynäkomastie–Pathogenese–Liposuktion–Subkutane Mastektomie–Periareoläre Straffung KeywordsGynecomastia–Pathogenesis–Liposuction–Subcutaneous mastectomy–Periareolar mastopexy
    Der Chirurg 09/2011; 82(9):789-796. DOI:10.1007/s00104-011-2109-5 · 0.52 Impact Factor
  • K Knobloch, H Sorg, P M Vogt
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    ABSTRACT: In Germany, Austria and Switzerland the "Habilitation" (postgraduate qualification) is currently the highest ranked university degree which qualifies candidates to perform high ranking autonomous research and teach the specific subject at university level. Although it is legally not an academic degree, the habilitation is a mandatory qualification for the later appointment and employment as a professor. The habilitation process is a complex assessment of diverse prerequisites which differ highly in terms of uniformity among the medical faculties in Germany. In order to re-evaluate these prerequisites and to find out if there might be more conformity for candidates all habilitation requirements were analyzed for 12 primary outcome measures according to Nagelschmidt and rated with a specific scoring system (Nagelschmidt score). The overall scoring for habilitation requirements increased from 15.2±5.1 points in 1998 to 21.9±4.0 points in 2010 (95% confidence interval 20.6-23.3, p<0.001, mainly due to increased requirements in terms of publications, teaching and mandatory board certification. No correlation was found between the number of habilitation degrees per faculty and the overall Nagelschmidt score (y=-0.0545x+26.021, r(2)=0,00028). The requirements for habilitation have substantially increased by 44% from 1998 to 2010 in Germany. This is mainly based on higher requirements in terms of publications, teaching and board certification.
    Der Chirurg 07/2011; 83(5):452-62. · 0.52 Impact Factor
  • Journal of Plastic Reconstructive & Aesthetic Surgery 06/2011; 64(9):1226-7. DOI:10.1016/j.bjps.2011.06.010 · 1.47 Impact Factor
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    ABSTRACT: Salvage rates of free flaps have been reported to be inversely related to the time interval between the onset of ischaemia and its clinical recognition. Consecutively, monitoring of free flaps remains of major importance. The aim of this study was to analyse the correlation of postoperative free flap microcirculation and free flap skin temperature as a potential tool of postoperative flap monitoring. Free flap skin temperature correlates to free flap capillary microcirculation. Fifty-four free flaps were prospectively monitored during the study. Postoperative flap monitoring was performed using a regular digital infrared surface thermometer (Medisana FTD, Germany) simultaneously to microcirculatory assessment using combined Laser-Doppler and photospectrometry (Oxygen-to-see, Lea Medizintechnik, Germany). Mean microcirculatory blood flow was 105±35 arbitrary units (AU). Mean temperature was 34.9±2.2 °C. We found a significant correlation between free flap temperature and free flap capillary blood flow (Pearson correlation r=0.48; p<0.001) and postcapillary venous filling pressure (r=-0.32; p=0.021) in 54 free flaps. A 1 °C less free flap temperature was associated with a decrease of the mean microcirculatory capillary blood flow by 37 relative units. Our study demonstrates free flap skin temperature related to capillary microcirculation. Our primary hypothesis was confirmed. We postulate an acute temperature drop of 3 °C at the centre of the skin island as indicative of arterial thrombosis, whereas a 1-2 °C uniform temperature drop of the flap is indicative of venous compromise. Consecutively, free flap skin temperature assessment might be a reliable and inexpensive adjunct monitoring method in plastic reconstructive surgery to improve patients' safety.
    Journal of Plastic Reconstructive & Aesthetic Surgery 06/2011; 64(10):1353-8. DOI:10.1016/j.bjps.2011.04.030 · 1.47 Impact Factor
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    ABSTRACT: BACKGROUND: Full-thickness skin defects over functional structures (tendons, vessels) or deperiosted bones of the extremities usually require extensive soft tissue reconstruction to cover the defect. A new option for coverage of the defect is the application of MATRIDERM®, a bovine matrix consisting of collagen and elastin, as a neodermis underneath skin transplants. Can this combined one-stage surgical intervention successfully cover deperiosted bone or tendon? PATIENTS AND METHODS: We performed this one-stage procedure in ten patients instead of soft tissue reconstruction. The success of wound coverage with the one-stage method and in combination with skin transplantation for defects generally associated with considerable loss of transplants (deperiosted bones and tendons without paratenons) was determined. RESULTS: In nine of ten patients, complete defect coverage could be achieved. A one-stage wound closure in extensive defects with exposed tendons in four of five locations could be achieved. In deperiosted bone defects the one-stage coverage was only successful in two of six patients. However, complete wound closure could be achieved with a second skin transplantation in a patient with exposed tendon and bone in three of the four locations. CONCLUSION: As a one- or two-stage procedure, MATRIDERM® application with skin transplantation resulted in an effective defect closure without the need for a complex plastic reconstructive procedure. With regard to its functionality it cannot be considered as a substitute for skin flaps. In selected cases MATRIDERM® is an interesting and successful method in plastic reconstructive surgery.
    Der Unfallchirurg 05/2011; · 0.61 Impact Factor
  • B. Weyand, K. Reimers, P. M. Vogt
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    ABSTRACT: Collagen and ceramic matrices are extracellular scaffolds frequently used for bone tissue engineering. Human mesenchymal stem Collagen and ceramic matrices are extracellular scaffolds frequently used for bone tissue engineering. Human mesenchymal stem cells from adipose tissue with their unique properties for multipotent differentiation were cultured on a microporous collagen cells from adipose tissue with their unique properties for multipotent differentiation were cultured on a microporous collagen scaffold (Matriderm) and a macroporous ceramic scaffold (Sponceram) under static culture and in a dynamic flow environment scaffold (Matriderm) and a macroporous ceramic scaffold (Sponceram) under static culture and in a dynamic flow environment in a laminar flow bioreactor. Both matrices differed in respect to cellular distribution after seeding which depended on pore in a laminar flow bioreactor. Both matrices differed in respect to cellular distribution after seeding which depended on pore size of the matrix. Cultivation under dynamic flow conditions influenced cellular morphology, collagen fiber alignment and size of the matrix. Cultivation under dynamic flow conditions influenced cellular morphology, collagen fiber alignment and extracellular matrix deposition compared to static culture. The flow rate had an effect on the amount of extracellular matrix extracellular matrix deposition compared to static culture. The flow rate had an effect on the amount of extracellular matrix formed by mesenchymal stem cells on the ceramic matrix. Further studies are necessary to reveal the ideal matrix and environmental formed by mesenchymal stem cells on the ceramic matrix. Further studies are necessary to reveal the ideal matrix and environmental culture conditions for bone tissue engineering. culture conditions for bone tissue engineering. Keywordslaminar flow–bioreactor–fluid shear stress–stem cell–bone tissue engineering Keywordslaminar flow–bioreactor–fluid shear stress–stem cell–bone tissue engineering
    03/2011: pages 47-50;
  • Klinische Neurophysiologie 03/2011; 42(01). DOI:10.1055/s-0031-1272706 · 0.33 Impact Factor
  • Zentralblatt für Chirurgie 02/2011; 138(2). DOI:10.1055/s-0030-1247476 · 1.19 Impact Factor
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    ABSTRACT: After numerous experiments with free-fat transfer since 1893 , many promising methods and results of large-volume fat grafts have been published recently . A common disadvantage was the time of the procedure and a lack of proof of efficiency. In 2007 we developed the BEAULI™ method (Berlin autologous lipotransplantation), a new and reliable procedure to collect larger amounts of transplantable fatty tissue. It was evaluated in a prospective clinical study with 85 patients in 2 centres in Germany, the overall number of transplantations amounting to 216 treated breasts. Indications were general lack of breast volume, either genuine or acquired in the course of surgical procedures. The fat was harvested with the BEAULI™ method, which consists in general of the harvest of very small fat particles by means of water-assisted liposuction (Bodyjet®, Humanmed Ag, Germany) and reinjection of the fat after separation from superfluous water by means of the Lipocollector®. All procedures were performed in a standardised pattern, measurements were taken preoperatively, at day 1 postop, after 1 week, 4 weeks, 3 months, 6 months and then to be continued yearly. An MRI of the breasts was taken preop and 6 months postoperatively, the longest follow-up is 30 months. Average operation time was 1.5 h. In every case a definite increase of volume of the fatty layer in the treated areas was observed. We saw no macroscopic oily cysts, in two cases there were 3 months after the operation some palpable subcutaneous nodules which proved to be granulomas. The volume control of 35 aesthetic patients by means of BrainLab™ Software and MRI could verify a permanent take rate of 76±11% of the grafted fat. In aesthetic patients generally 2 (80%) fat-grafting procedures with an average gain in volume of ½ bra cup size or 100-150 ml) per procedure were required. After implant removal, satisfaction was usually reached after only a single procedure, for complete reconstruction after cancer surgery 4-5 grafting sessions were necessary. An extension of the skin envelope as well as improvement of existing scars were observed.
    Handchirurgie · Mikrochirurgie · Plastische Chirurgie 02/2011; 43(1):65. DOI:10.1055/s-0031-1271814 · 0.54 Impact Factor
  • PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 02/2011; 61(02). DOI:10.1055/s-0031-1272392 · 1.02 Impact Factor
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    ABSTRACT: Extravasations of chemotherapeutic drugs may lead to tissue necrosis and subsequent tissue defects, sometimes resulting in loss of function. In the absence of therapy, approximately one-third of vesicant extravasations will result in ulcerations, some of which necessitate plastic microsurgery to cover the soft tissue defects. The aim of this study was to describe the surgical technique itself and to present clinical results of the procedure in a clinical series of chemotherapeutic extravasation injuries that benefitted from a subcutaneous wash-out procedure (SWOP) by minimisation of serious complications. Over a time period of 3 years, we treated 13 female patients following chemotherapeutic extravasation injury. Nine of the cases involved a high vesicant chemotherapy agent, and four patients involved chemotherapy with low vesicant potential. The therapeutic approach was performed using SWOP exclusively without the application of specific antidotes. The mean time interval between the extravasation injury and the SWOP was 345min (140-795min). In none of the cases was there a tissue breakdown, but there was a steady decrease in the inflammatory reaction of the cutaneous and subcutaneous soft tissues without additional complications over a 3-month follow-up period. The results of the study suggest that SWOP is a minimally invasive, safe and effective emergency treatment for chemotherapeutic extravasation injury. Based on the absence of comparative studies with regard to the efficacy of conservative therapy, SWOP should be offered as a therapeutic option for chemotherapeutic extravasations, especially in cases of medical malpractice and also as a defence in case of a legal conflict.
    Journal of Plastic Reconstructive & Aesthetic Surgery 02/2011; 64(2):240-7. DOI:10.1016/j.bjps.2010.04.040 · 1.47 Impact Factor
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    ABSTRACT: A case of autologous fat transplantation for labia majora augmentation after ablative surgery is presented. The patient reported pain and deformity of the left labium majus after resection for Bowen's disease. The symptoms had not been solved by classic plastic surgical reconstructions including a pudendal thigh fasciocutaneous flap. Use of autologous fat transplantation facilitated an improved aesthetic result while preserving residual sensation to the external genitalia and improving symptoms of mucosal exposure and dryness.
    Aesthetic Plastic Surgery 02/2011; 35(5):913-5. DOI:10.1007/s00266-011-9664-5 · 1.19 Impact Factor
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    ABSTRACT: Autologous fat transplantation to the female breast is becoming generally accepted as a standard procedure in plastic surgery. Periglandular planes and also intrapectoral planes are used, based on the idea of having a highly vascularised matrix. To assess this surgical technique a reproducible and exact tool for volume analysis is necessary. The volume of pectoral muscles and breast tissue including periglandular fat was analysed by MRI volumetry before and 6 months after autologous fat transplantation in 10 patients. The volume of the glandular tissue itself was also analysed to evaluate the effect of volume up-, and down-turns between the 6 months. A comparison of the volumes calculated with MRI volumetry preoperatively and postoperatively revealed a mean volume persistence of 64% (± 13%) within the pectoral muscle and of 81% (± 8%) within the periglandular fat. Glandular volume had a mean alternation of 7% (± 4%). In relation to the region of interest for breast volumetry the glandular tissue represented 15% (± 5%) preoperatively und 13% (± 4%) postoperatively. In autologous fat transplantation to the breast the periglandular plane is superior to the intramuscular plane in terms of volume persistence. As bolus injections of fat tissue must be strictly avoided, the pectoral muscles offer an additional receptor tissue for fat transplantation, and might be especially needed in smaller breasts to achieve the desired volume augmentation. The alternation of glandular tissue within the 2 points of time was low and in relation to the whole region of interest for breast volumetry rather inconsequential. Nevertheless consideration and subtraction of the glandular volume in mamma volumetry optimises the exactness of the volumetry.
    Handchirurgie · Mikrochirurgie · Plastische Chirurgie 02/2011; 43(2):119-24. DOI:10.1055/s-0030-1269931 · 0.54 Impact Factor
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    ABSTRACT: Die Hand in ihrer Funktion als taktiles Greiforgan ist fortwährend der Kontamination durch pathogene Keime ausgesetzt. Infektionen an der Hand sind meist bakteriell bedingt. Neben großen Weichteiltraumen sind häufig kleinere Verletzungen mit oder ohne Fremdkörperverhalt ursächlich für schwere Infektionsverläufe. Besonders problematisch sind Bisswunden durch Mensch und Tier, da sie zu einer tiefen Inokulation hochvirulenter Keime im Handbereich mit Fortleitung der Entzündung entlang der anatomischen Kompartimente führen können. Entscheidend für den weiteren Verlauf ist die Erstdiagnose einer beginnenden Handinfektion. Die Therapie von Infektionen der Hand ist in erster Linie chirurgisch und erfordert ein umfassendes und radikales Débridement. Eine verzögerte Diagnose durch initiale Bagatellisierung der Verletzung kann zu einer fulminanten Entzündung mit erheblichen funktionellen Defiziten und im Endstadium zur Sepsis mit Multiorganversagen führen.
    Trauma und Berufskrankheit 02/2011; 14(1). DOI:10.1007/s10039-011-1788-y
  • C. Radtke, J.D. Kocsis, P.M. Vogt
    Plastic &amp Reconstructive Surgery 01/2011; 128(2):626. DOI:10.1097/01.prs.0000400386.71166.48 · 3.33 Impact Factor
  • J Redeker, P M Vogt
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    ABSTRACT: Carpal instability can be understood as a disturbed anatomical alignment between bones articulating in the carpus. This disturbed balance occurs either only dynamically (with movement) under the effect of physiological force or even statically at rest. The most common cause of carpal instability is wrist trauma with rupture of the stabilizing ligaments and adaptive misalignment following fractures of the radius or carpus. Carpal collapse plays a special role in this mechanism due to non-healed fracture of the scaphoid bone. In addition degenerative inflammatory alterations, such as chondrocalcinosis or gout, more rarely aseptic bone necrosis of the lunate or scaphoid bones or misalignment due to deposition (Madelung deformity) can lead to wrist instability. Under increased pressure the misaligned joint surfaces lead to bone arrosion with secondary arthritis of the wrist. In order to arrest or slow down this irreversible process, diagnosis must occur as early as possible. Many surgical methods have been thought out to regain stability ranging from direct reconstruction of the damaged ligaments, through ligament replacement to partial stiffening of the wrist joint.
    Der Chirurg 01/2011; 82(1):85-93; quiz 94. · 0.52 Impact Factor
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    ABSTRACT: Zusammenfassung Hintergrund Diese Arbeit soll den aktuellen Stand der Kooperation zwischen Plastischen Chirurgen und Gynäkologen in zertifizierten Brustzentren darstellen. Die Rate der Brustrekonstruktionen nach nichtbrusterhaltender Therapie ist mit 8–13% sehr niedrig. Der Plastische Chirurg ist auch bei zertifizierten Brustzentren häufig nicht Teil des Teams. Methoden Über das Westdeutsche Brustzentrum (WBC) wurden 220 im Jahr 2007 an das WBC angeschlossene Kliniken angeschrieben. 80 Kliniken schickten einen Fragebogen zurück. Die Untersuchung basiert auf den Daten von ca. 24.000 Patientinnen. Ergebnisse Von den 80 Kliniken waren zum Zeitpunkt der Untersuchung 60 Kliniken (75%) als Brustzentrum zertifiziert. Die Zertifizierung erfolgte nach unterschiedlichen Vorgaben: Land Nordrhein-Westfalen, DKG/DGS (Deutsche Krebsgesellschaft/Deutsche Gesellschaft für Senologie), EUSOMA, andere. In 8 Kliniken (10%) wurde ein Plastischer Chirurg als operativ tätiger Facharzt und Teil des Brustzentrums benannt. Die meisten Brustzentren (44 von 80 Kliniken) arbeiten mit 3 bis 4 operativ tätigen Fachärzten. Diskussion Die Zusammenarbeit innerhalb eines Brustzentrums zwischen Gynäkologen und Plastischen Chirurgen kann ausgebaut werden. Nicht jede Frau braucht nach einer Mastektomie einen (mikrochirurgischen) Brustaufbau, aber jede betroffene Frau hat das Recht auf eine Aufklärung über alle zur Verfügung stehenden Rekonstruktionsverfahren inklusive der mikrochirurgischen Verfahren.
    Der Chirurg 01/2011; 82(6):526-530. DOI:10.1007/s00104-010-1993-4 · 0.52 Impact Factor
  • J. Redeker, P.M. Vogt
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    ABSTRACT: Die karpale Instabilität kann als gestörte anatomische Ausrichtung der im Karpus artikulierenden Knochen untereinander verstanden werden. Diese gestörte Balance unter physiologischer Krafteinwirkung tritt entweder nur dynamisch (unter Bewegung) oder bereits statisch in Ruhe auf. Die häufigsten Ursachen für karpale Instabilitäten sind das Handgelenkstrauma mit Ruptur der stabilisierenden Bänder und die adaptive Fehlstellung nach Frakturen des Radius oder Karpus. Dabei nimmt der karpale Kollaps durch eine nicht verheilte Fraktur des Skaphoids eine besondere Rolle ein. Daneben können degenerativ entzündliche Veränderungen wie die Chondrokalzinose oder die Gicht, seltener aseptische Knochennekrosen des Lunatums oder Skaphoids oder anlagebedingte Fehlstellungen (Madelung-Deformität) zu einer Handwurzelinstabilität führen. Die fehlgestellten Gelenkflächen führen unter erhöhtem Druck zur Knochenarrosion mit sekundärer Arthrose des Handgelenkes. Um diesen unwiderruflichen Prozess aufzuhalten oder zu verlangsamen, ist die möglichst frühe Diagnostik notwendig. Zahlreiche Operationsmethoden sind erdacht worden, um eine erneute Stabilität herzustellen. Die Operationsmethoden reichen von der direkten Rekonstruktion verletzter Bänder über Bandersatzoperationen, bis hin zu Teilversteifungen der Handwurzelgelenke. Carpal instability can be understood as a disturbed anatomical alignment between bones articulating in the carpus. This disturbed balance occurs either only dynamically (with movement) under the effect of physiological force or even statically at rest. The most common cause of carpal instability is wrist trauma with rupture of the stabilizing ligaments and adaptive misalignment following fractures of the radius or carpus. Carpal collapse plays a special role in this mechanism due to non-healed fracture of the scaphoid bone. In addition degenerative inflammatory alterations, such as chondrocalcinosis or gout, more rarely aseptic bone necrosis of the lunate or scaphoid bones or misalignment due to deposition (Madelung deformity) can lead to wrist instability. Under increased pressure the misaligned joint surfaces lead to bone arrosion with secondary arthritis of the wrist. In order to arrest or slow down this irreversible process, diagnosis must occur as early as possible. Many surgical methods have been thought out to regain stability ranging from direct reconstruction of the damaged ligaments, through ligament replacement to partial stiffening of the wrist joint. SchlüsselwörterBiomechanik–Karpale Knochen–Gelenkinstabilität–Handgelenk–Karpale Ligamente KeywordsBiomechanics–Carpal bones–Joint instability–Wrist–Carpal ligaments
    Der Chirurg 01/2011; 82(1):85-94. DOI:10.1007/s00104-009-1867-9 · 0.52 Impact Factor

Publication Stats

1k Citations
293.95 Total Impact Points

Institutions

  • 2001–2015
    • Hannover Medical School
      • Department of Plastic, Hand and Reconstructive Surgery
      Hanover, Lower Saxony, Germany
  • 2011
    • Klinikum Duisburg
      Duisburg-Hamborn, North Rhine-Westphalia, Germany
  • 2009
    • University of Colorado Hospital
      Denver, Colorado, United States
  • 2008
    • Leibniz Universität Hannover
      • Institute of Technical Chemistry
      Hanover, Lower Saxony, Germany
  • 2007
    • Hochschule Hannover
      Hanover, Lower Saxony, Germany
  • 2002–2007
    • Johns Hopkins University
      • Department of Plastic and Reconstructive Surgery
      Baltimore, MD, United States
  • 2006
    • University Hospital RWTH Aachen
      Aachen, North Rhine-Westphalia, Germany
    • University Medical Center Hamburg - Eppendorf
      Hamburg, Hamburg, Germany
  • 2000–2006
    • Ruhr-Universität Bochum
      • Klinik für Plastische Chirurgie und Schwerbrandverletzte
      Bochum, North Rhine-Westphalia, Germany
  • 1996
    • Weizmann Institute of Science
      Israel
  • 1995
    • Harvard University
      Cambridge, Massachusetts, United States
  • 1992–1994
    • Brigham and Women's Hospital
      • Division of Plastic Surgery
      Boston, MA, United States
    • Harvard Medical School
      • Department of Surgery
      Boston, Massachusetts, United States
  • 1993
    • University of California, Los Angeles
      Los Angeles, California, United States