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Biomedical subjects

A Matarasso

Publications and source records attributed to A Matarasso.

At least 19 recordsLinked to original sources

Alar rim excision: a method of thinning bulky nostrils.

A thick nostril is a disturbing deformity and one for which surgeons and patients may be reluctant to employ the traditional "piece of pie" skin excisions commonly described. As an alternative in selected circumstances, a method of internally thinning the nostril rim using an alar base groove incision known as alar rim excision is presented. An alar base resection can accompany this, or the incision can be used solely for access when reducing a bulky nostril, while avoiding additional scarring or the risk of alar rim elevation.

Adolescent

Minimal-access variations in abdominoplasty.

The use of liposuction began a trend toward less invasive abdominal contour surgery and resulted in a variety of techniques based on individual anatomy. An analysis of 170 patients was undertaken to determine which patients benefited from even less invasive techniques that evolved from these concepts. The selection criteria used were based on the physical examination of the skin, fat and muscle layers, and patients' goals, willingness to accept incisions, and tolerance for the recovery period. The options used for this new category of treatment were subtypes of the abdominolipoplasty system (type 1, suction-assisted lipectomy; type 2, miniabdominoplasty; type 3, modified abdominoplasty; type 4, full abdominoplasty) and included extended liposuction (type 1a); "open" miniabdominoplasty (type 2a); and endoscopically assisted or muscle access abdominoplasty (type 3a). Also included in this series were patients whose procedures were downstaged to a less extensive alternative and cases during which the abdominoplasty incision was used for access for another operation. All procedures resulted in smaller or fewer incisions. Results suggested that the current period (1991-present) is marked by less invasive treatment options, characterized by a preponderance of "closed" techniques (60% vs. 40%: 1986-1991). With the availability of technology to treat muscle and adipose tissue through inconspicuous incisions, judgment regarding the capability of the skin to recontour becomes the overriding physical factor in the decision-making process. The outcomes support the conclusion that minimal-access variations in abdominoplasty are appropriate alternatives, reflecting a philosophical alteration in the approach to patients.

Abdominal Muscles

Superficial suction lipectomy: something old, something new, something borrowed....

Superficial suction lipectomy has been proposed for the treatment of flaccid skin and for irregular-appearing, peau d'orange skin. For the purposes of diagnosis and treatment, this represents two entities for which superficial suction lipectomy is applicable: type A and type B conditions. A series of 20 patients who had contour problems amenable to liposuction and either of these two skin conditions were evaluated concurrently. Results suggested that superficial suction lipectomy is a feasible extension of traditional liposuction using smaller cannulas as the subdermal fat layer is approached. It is likely that it represents an additional tool for specific situations seen in a spectrum of disorders that multiply and overlap with age rather than a replacement for dermolipectomies or a definite treatment for skin textural disorders.

Bandages

Calcitonin gene-related peptide increases microcirculation after mechanically induced ischemia in an experimental island flap.

Vasoconstriction, as a result of mechanical manipulation of blood vessels during microsurgery, may produce a decrease in blood supply and endanger flap viability. A study was undertaken to determine the effects of the topical vasodilator calcitonin gene-related peptide on the microcirculation of flaps after mechanically induced ischemia. A neurovascular island flap based on the superficial epigastric vessels was raised in 42 rats. Blood cell flux in the flap was recorded continuously with a laser Doppler flux meter. The feeding artery was pinched to induce vasospasm, and different concentrations of calcitonin gene-related peptide (10(-7), 10(-8), 10(-9), 10(-10) mol) or a control of sodium chloride 0.9% was applied topically to relieve the ischemia. Results showed that calcitonin gene-related peptide at a concentration of 10(-7) mol significantly shortened the time to reach 50% of the original blood cell flux values (270 +/- 123 seconds) and significantly increased the number of flaps in which the blood cell flux values were restored to prestress levels within 30 minutes. The data support the conclusion that, in this model, topical calcitonin gene-related peptide at the concentration of 10(-7) mol was effective in promoting recovery of the microcirculation after mechanically induced ischemia, without the adverse effects associated with other commonly used vasodilators.

Animals

Endoscopic surgical correction of glabellar creases.

BACKGROUND: A number of alternatives exist for the temporary correction of glabellar creases and frown lines. The traditional "open" operative procedure has often involved a large incision to gain access to the depressor muscles that are responsible for the deformity. While useful for patients with multiple or more significant deformities, patients with isolated glabellar creases and frown lines have been reluctant to consider an extensive surgical procedure, with its attendant morbidity, for an isolated problem. OBJECTIVE: The purpose of this report is to describe a new technique of endoscopic corrugator muscle resection, without the need for the traditional lengthy scalp incision. METHODS: Traditional criteria for patient selection was employed. A series of 10 consecutive patients with vertical mid-forehead glabellar-eyebrow frown lines were treated by endoscopic corrugator muscle resection and evaluated. RESULTS: The procedure was efficacious in reducing the frown-muscle complex prominence and rhytids in the mid-forehead area. Circumstances of heavy folds, hyperactive muscle function, or premature furrows in patients with good skin tone appear to be most suitable for this technique. CONCLUSION: With the introduction of a more acceptable, less problematic surgical solution, deformities in the forehead-eyebrow area can be readily addressed surgically. The procedure is a cost-effective alternative to temporary techniques improving aesthetic problems in the forehead-eyebrow area.

Adult

Liposuction as an adjunct to a full abdominoplasty.

The safety and locations for liposuction over the aesthetic unit of the abdomen in situations where a full (type IV) abdominoplasty was combined with liposuction were studied. The locations were determined based on the axial- and random-pattern blood supplies of the anterior abdominal wall. By using these areas and technical guidelines to enhance success, the combined procedures were undertaken in a consecutive series of patients. The efficacy of the procedures was assessed by patient acceptance and by the difference in the incidence of complications from an abdominoplasty alone group. The complication rates of the two groups were found to be similar, although it was ascertained that medically higher-risk situations, smoke exposure, and disregard for interacting vascular territories were detrimental to combined surgery. In addition, four suction areas (SA 1-4) were delineated, and the results suggested that certain areas are more reliable than others, that each suction area interacts with and affects neighboring areas, and that these are germane in preoperative planning. A risk-profile classification was established, and this proved beneficial for initial patient screening.

Abdomen

Forehead-brow rhytidoplasty: reassessing the goals.

Forehead-eyebrow rhytidoplasty traditionally has been advocated for senile brow ptosis. As the procedure became more widely accepted, it became a routine consideration in facial rejuvenation surgery. Indeed, over time, forehead-eyebrow rhytidoplasty also has withstood the initial criticism that was lodged against it of limited longevity, and it is realized that as with all other lifting procedures, it will gradually succumb to time, gravity, and the aging process. Moreover, refinements in techniques have added versatility to the procedure so that a variety of problems encountered in the upper face in addition to brow ptosis can be addressed. Consequently, an eclectic population with a range of deformities benefits from the procedure. Recently, though, it has seemed that the pendulum is swinging back, and that some surgeons are hesitating to incorporate forehead surgery because patients are voicing dissatisfaction with it. In order to assess the goals and indications for surgery, we reviewed a series of 350 patients who had a variety of aesthetic complaints in the upper face. Traditionally, patients' "other" indications for surgery, exclusive of brow ptosis, have been referred to as secondary (minor) indications. Now, with closer scrutiny, it appears that such problems, including forehead rhytids, frown muscle imbalance, upper eyelid aesthetics, lateral temporal laxity, and an abnormal expression, as a newly defined group, may actually be more frequent reasons than brow ptosis alone for performing a forehead-brow rhytidoplasty. As evaluated by the authors and supported by independent reviewers, low brow position alone should now account for less than half the forehead-brow surgery candidates. Furthermore, it is recognized that in considering the benefits achieved for patients with brow ptosis, often the results were due to "ancillary" surgical maneuvers routinely employed for the secondary indications. On balance, surgeons are advised to avoid adhering to traditional formulas for skin excision/brow elevation when operating on the brow; these can ultimately be the source of unsatisfactory outcomes. We believe that this philosophy will ultimately account for improved outcomes in forehead surgery. In addition, objective guidelines for the upper face have been reviewed and visual criteria defined which can be used in supplementing established brow spatial relationships for determining the ideal normal criteria for the upper third of the face.

Adult

The anatomic data sheet in plastic surgery: graphic and accurate documentation for standardized evaluation of results.

A graphic and written anatomic data sheet (ADS) for facial aesthetic surgery and body contour surgery is presented as a tool for: (1) analyzing surgical maneuvers and their effect on final outcome; (2) recording individual anatomic variations; (3) communicating data between office personnel and colleagues; (4) aiding in the treatment of the postsurgical patient; (5) use as a worksheet for the surgeon; and (6) standardizing, evaluating, and comparing surgical techniques. The ADS takes account of the common aesthetic facial and body contour procedures performed in plastic surgery. A supplemental rubber stamp for use on the office chart, with graphics identical to those of the ADS, identifies areas of treatment concern before and after surgery.

Anatomy, Artistic

Abdominolipoplasty: a system of classification and treatment for combined abdominoplasty and suction-assisted lipectomy.

Criteria for diagnosing abdominal contouring candidates and a new classification system for procedures are presented. The surgical techniques for each of four patient categories of abdominolipoplasty are reviewed: type I--suction-assisted lipectomy alone, type II--mini-abdominoplasty, type III--modified abdominoplasty, and type IV--abdominoplasty with suction-assisted lipectomy. With the combination of suction-assisted lipectomy and abdominoplasty, the majority of patients can actually be treated with a limited abdominoplasty procedure or suction lipectomy. Complications noted in a series of 75 consecutive patients operated on by one surgeon are presented. The blood supply that is relevant to a combination of suction lipectomy with abdominoplasty is outlined. Specific guidelines for these combined procedures are recommended in order to safely combine full abdominoplasties with suction-assisted lipectomies.

Abdomen

Buccal fat pad excision: aesthetic improvement of the midface.

Visual criteria for a harmonious midface depends on (1) a distinction between the anterior border of the parotid gland and cheek hollow, (2) a visible posterior border of the nasolabial fold (this signifying the most variable criterion), (3) an intervening cheek soft-tissue convexity that does not exceed the plane of a perpendicular from the midzygoma to the mandible (subtle submalar depression), (4) prominent zygomatic eminences, and (5) a well-defined mandible, particularly the angle. The space within the zygomatic arch and the mandible that defines the ideal midfacial "cheek hollow" has been established. This can be achieved through a combination of: aesthetic contouring of the facial skeleton, facial liposculpture, and cervicofacialplasty. A series of 25 consecutive patients undergoing submuscular fat removal by buccal fat pad excision to improve aesthetic midface were treated and are presented. To preserve the subcutaneous fat commonly lost with aging and to avoid late secondary deformities, only submuscular buccal fat excision is recommended in a carefully selected group of patients. The anatomy, indications, and technique for buccal lipectomy in midface contouring are discussed.

Adipose Tissue

Suction mammaplasty: the use of suction lipectomy to reduce large breasts.

The use of suction lipectomy to reduce breast volume is described. The technique applies only to a very limited group of patients whose nipple-areola complexes are normally located and whose enlargement is primarily fibrofatty in nature. Suction mammaplasty can be used as a sole technique in congenital asymmetry or in post-reduction enlargement or asymmetry.

Breast