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Biomedical subjects

D R Laub

Publications and source records attributed to D R Laub.

At least 19 recordsLinked to original sources
PubMed1996

Obagi's modified trichloroacetic acid (TCA)-controlled variable-depth peel: a study of clinical signs correlating with histological findings.

Currently, no documentation correlates histological changes with clinical signs of depth of the trichloroacetic acid peel. Obagi identified clinical signs of depth of injury following topical trichloroacetic acid application, employing prepeel conditioning and a method for slowing trichloroacetic acid action. A three-part study of 20 patients was undertaken to determine whether Obagi's visual and palpatory signs of depth correlated histologically with depth of peel. Also analyzed were physiological mechanisms associated with these signs. Patients were pretreated and biopsy specimens were harvested before and after modified trichloroacetic acid peeling. The results largely confirmed the validity of Obagi's observations regarding the method of trichloroacetic acid peel described. These clinical signs are verified by histology and correlated with some findings by electron microscopy. Differentiation of papillary from upper reticular dermal penetration is particularly useful. Physiological explanations for the phenomena observed are proposed. The specificity and safety of peels may be improved with these criteria.

Acne Vulgaris↗
PubMed1995

A finite-element facial model for simulating plastic surgery.

CAPS (Computer-Aided Plastic Surgery) is a prototype computer program that uses a three-dimensional graphic model of a human face and incorporates a finite-element mathematical model of the physical properties of the soft tissue. This program can estimate the biomechanic consequences of ablation and rearrangement of tissue. The results of two hypothetical surgeries on the face are presented: A surgeon could use this program as a sketch pad to predict and compare the outcome of facial plastic procedures on a patient-specific model. The relation of this program to previous work is discussed, and directions for research and possible applications are addressed.

Computer Simulation↗
PubMed1990

Fat embolism syndrome after liposuction: a case report and review of the literature.

There have been three previous case reports of fat embolism syndrome (FES) after lipectomy. We present a case of FES diagnosed by pulmonary angiography. It seems likely that there is an incidence of subclinical fat embolization after liposuction, but conservative patient selection and aggressive postoperative management can lessen the morbidity and mortality of FES.

Embolism, Fat↗
PubMed1988

A new approach to evaluation and surgery of the malar complex.

Prominent malar eminences are considered aesthetic and have been equated with a more youthful appearance. The precise area for accentuation and the surgical method for altering contour have not been universally agreed upon. A new technique for evaluation is suggested, and a surgical osteotomy for malar contouring is described. Twenty-one patients have undergone treatment; 16 procedures were bilateral and 5 were unilateral. The longest postoperative follow-up is 20 months and the shortest, 6 months. Results have shown symmetry, natural contour, good patient acceptance, and no significant complications. These two new techniques, when combined with existing knowledge and experience, should enhance the ability to analyze and alter the malar complex.

Adolescent↗
PubMed1988

Vaginoplasty for gender confirmation.

Male-to-female surgery for properly diagnosed gender dysphoria, conducted as an interdisciplinary rehabilitation program, may be a valid endeavor in many cases. Successful surgical results have been obtained by those skilled in this type of surgery.

Disorders of Sex Development↗
PubMed1982

Customized silicone implants of the breast and chest.

Custom-fabricated silicone implants were used in 17 patients to reconstruct thoracic deformities associated with pectus excavatum, hypoplasia of the thorax, and radical mastectomy. The implants have been in place an average of 2 1/2 years. Custom implants have been permanently removed in only two of these patients. These implants can provide accurate, complex contour restoration without creating donor defects. However, problems of extrusion, capsule formation, slippage, and infection requiring implant removal are characteristic of nonautogenous materials. Because these are foreign bodies, well-vascularized soft-tissue coverage is especially essential to retain these implants.

Adolescent↗
PubMed1981

Tensor fascia lata myocutaneous flap in lower abdominal wall reconstruction.

The tensor fascia lata myocutaneous flap provides a reliable autogenous building block for anatomical lower abdominal wall reconstruction. Preservation of innervation allows maintenance of voluntary motor control and protective sensation. The excellent blood supply of this flap is particularly helpful in reconstructing previously irradiated areas. A one-stage repair is possible, leaving minimal secondary defect. We describe 4 patients illustrating the uses and versatilty of this flap. Anatomy, operative procedures, and indications for delay are also discussed.

Abdominal Muscles↗
PubMed1981

Breast reconstruction following mastectomy: a comparison of submuscular and subcutaneous techniques.

An analysis of the benefits of submuscular versus subcutaneous implantation was made on mastectomy patients. Ninety-one breast were reconstructed following mastectomy. In 30 breasts, the implants were placed subcutaneously; in 19, subpectorally, and in 42, beneath both the pectoralis and the serratus. The follow-up averaged 2 to 3 years, and recent cases included postoperative tonometry measurements to quantitate the degree of capsular contraction. In addition, 12 cadaver dissections were done to delineate muscle insertion and origins. Results indicate that (1) submuscular implants are clearly superior to subcutaneous ones; (2) subpectoral implantation requires complete detachment of the muscular origin from the ribs; (3) subserratus implantation provides extra muscular coverage, but dissection is more difficult owing to its firm rib attachment; and (4) the subserratus technique provided the lowest incidence of capsular contracture, although the breast was slightly flatter initially, but improved with time.

Breast↗
PubMed1981

Breast reconstruction for premalignant and malignant disease--an update.

New concepts in the control of breast cancer and improvements in plastic surgery techniques have facilitated subsequent breast reconstruction. In a six-year period 72 breast reconstructions were carried out in 57 women after surgical treatment for premalignant or malignant breast disease and, in some cases, radiation therapy. The average age of the patients was 48 years and the average interval between the primary cancer operation and breast reconstruction was 42 months. Our experience in these cases has been free of serious complications.

Adult↗
PubMed1981

Submuscular breast reconstruction--indications and techniques.

We review the care and treatment of 93 patients who underwent submuscular breast reconstruction in our service between 1975 and 1980. The indications and clinical situations in which submuscular reconstruction has been useful include: following simple mastectomy; following modified radical mastectomy; following subcutaneous mastectomy (immediate or delayed reconstruction); in standard augmentation mammaplasty in selected patients; and with unusual, unsatisfactory, or dangerous preexisting breast conditions. Unusual indications include unsatisfactory subcutaneous placement with capsule formation after subcutaneous mastectomy; use of unsatisfactory or dangerous implants such as Ivalon and Etheron; and replacement of the old-fashioned Cronin gel implants with fixation patches. Submuscular placement has also been used to advantage in patients with excessively scarred, tenuous skin. Technical modifications in the submuscular implantation technique are detailed. We have used subserratus-subpectoral placement in most instances. Technical tips to keep the implant in a low position by division of the serratus attachments and limitations of upward dissection are detailed. Clinical studies on the upward migration of implants and pressures developed under the serratus and pectoralis muscles as measured by manometer are also detailed.

Breast↗