Science topic

Plastic And Reconstructive Surgery - Science topic

Plastic surgery is a medical speciality concerned with the correction or restoration of form and function.
Questions related to Plastic And Reconstructive Surgery
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Hello all, has anyone experience with autologous fat injection following breast implant revision due to capsular contracture?
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It is getting more and more popular
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Somebody have experience using comorbidities index such as Elixhauser index or Charlson index in burns patients.
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I have used Burns Depth Index but not exactly comorbidity index.
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What is the best conservative approach for management of xanthelasma palpebrum?
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 thanks my dear 
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Why do teenagers want to change there appearance at such a young age?
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If you say:"Plastic surgery", my answer  is "yes".For exemple i operate on approximatly 2000 children for cleft lip and palate and about the last 450 ones i operate during the 15 days after birth with better results than with late surgery :  local résult and more safety anesthesia : buccal and naso-pharynx more clean than after several monts...
But if you say :"Esthetic surgery, never perform it for teen aggers!
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What is the best treatment option for facial moles?
Cosmetics, Plastic surgery, Dermatology, Aesthetics
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If they are superficial clearly benign (freckles etc) and in younger patients, I shave them in an intradermal plane.- and let the wound epithelialize from the hair follicles. There is a 20 % chnce of recurrence, however, but young people bear the same chance of a hypertrophic or hyperpigmented scar !
Ellman-radio-shaving will do the same.  but if you use magnifying glasses, you can see in surgery possible melanin-nests and go deeper.
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Best treatment options for this challenging case and choice of implants and exposure
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Nice case. Looked difficult... The procedure used is probably the best and the more secure. Hard to say if there was an option for TER?
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Plastic surgery, Plastic and Reconstructive Surgery,  Breast surgery 
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Capsule formation Baker III and IV has nothing to do with the surface of the implants- it is merely due to slow infection with Biofilm producing bacteria, mostly St. epidermidis of the patient ! Read the recent literature on Breast Implants and  Biofilm (abstracts at www.pubmed.gov)  and use the more natural feeling of silicone gel filled implants with natural feeling - and a vial of antibiotics (any cephalotin) into the implant pocket at the end of the operation . 
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Prune belly's babies survived with abdominal wall muscular weakness and disfigurement, and which age we can reconstruct their abdomen? and is it feasible to use mesh for strengthening of their muscles? and which type of mesh is suitable?  
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I would not be in a hurry to operate. Attention to bladder function is the first priority. I have one Prune Belly that never required surgery beyond my cinching up the trigone where it had been so weak and flexible that it would flip up and block the bladder neck. This boy is now in his fifties and with family and all.
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I'm going from CT data to 3D printing of pediatric skull models. We need to increase the thickness of thin tissues to keep the printer happy. Does anyone know of a morphological operation/algorithm or MatLab script which will dilate thin parts of the object while ignoring other areas? I imagine this is best done before converting the object to a mesh, but am open to solutions either working with the original CT data or post-processing after converting to an STL.
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Just a quick idea: you could perhaps (haven't tried it) use a 3D erosion followed by a dilation to remove the thin structures; then calculate the difference to the original and apply a dilation to this difference; finally "add" the result to the original mask.
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An elderly woman who complained of progressive ulcero-nodular lesion eroding the lower palpebra and the palpebral conjunctiva.. Duration 5 years. No lymph nodes were palpable, hearing was good, no vertigo, no diabetes, mild hypertension was told.
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For a biopsy-proven basal cell carcinoma like this, Mohs excision would also be an option.  It can have the advantage that all of the margin can be evaluated, whereas a standard frozen section, or "wax" histology, will only bread slice the specimen and therefore its results will only be based upon a sample of the margin. 
The other advisable thing to do, of course would be a pre-operative CT scan to rule out intra-orbital involvement, which might require orbital exenteration.
  For reconstruction, personally, I would use a temporal skin flap for the outer lamella.  For the inner lamella and uspport, a mucoperiosteal graft from hard palate is also excellent.
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Has somebody tried to assess the total fat volume after using tumescent liposuction with lipoaspirate far greater than 500ml?
Although the success of liposuction is not determined by absolute weight loss, patients are often told the volume of the lipoaspirate which is the supernatant fluid after several minutes without movement.
Yet, the fatty tissue should be socken with the tumescent solution and so overrating the actual amount of fat harvested.
While evaluating liters of lipoaspirate is not comfortable, perhaps taking a 10ml syringe sample to centrifugation may give a good estimate in relation?
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A good question and a sensible suggestion (re. centrifuging a sample to give an estimate - although that has to be after many hours to allow the different layers to settle in the initial collection-pot).
You are absolutely correct that the amount of fat aspirated is most likely overstated, given that there shall be tumescent fluid mixed in with it.
Furthermore, the tumescent fluid gets absorbed by the system during the procedure, particularly during prolonged procedures, and therefore it is not a case of subtraction, either.
Lastly, depending on the type of liposuction involved, some of the cavitated/ broken-down fat shall be removed by the lymphatics, et.c..
I do not think that a suitably accurate answer exists, and therefore it is better to give the patient an approximate value for the maximum amount of fat aspirated.