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Biomedical subjects

G C Burget

Publications and source records attributed to G C Burget.

12 recordsLinked to original sources
PubMed1995

Aesthetic reconstruction of the tip of the nose.

The nasal tip is a thin structure, often just 3 or 4 mm thick. There is little need to inform an audience of Mohs histographic surgeons that as a defect becomes progressively deeper it goes in the space of a few short millimeters from superficial to full-thickness perforation. Tissue defects of little significance to the structure and aesthetics of the nose (and requiring a simple solution) can at first glance look the same as defects of great significance. Attainment of the aesthetic result, rather than a merely reparative one, requires that the wound be analyzed anatomically and three-dimensionally, tissues be replaced in like kind, the wound be braced with a lamina of cartilage (or bone), the internal hard tissue framework be given a refined aesthetic shape (at Stage II), and the mantle of carefully selected donor skin and subcutaneous fat be a work of sartorial excellence.

Adult↗
PubMed1990

Nasal valve malfunction resulting from resection of cancer.

Following cancer resection of the nasal unit, nasal valve malfunction is manifested by the symptoms of nasal stuffiness or difficulty getting air into the nostril. These symptoms occur in cases in which the resection is in the alar crease at the junction with the lateral sidewall of the nose. Wound scar contracture elevates the alar margin and causes the alar and lateral cartilages to move inward forming a visible and palpable shelf on the lateral wall of the nasal vestibule. This displacement of the alar and lateral cartilages and the rigid scar formed between these cartilages render the nasal valve immobile. Since it is easier to prevent nasal valve malfunction than to repair it later, wounds that bridge the alar crease or are located in either the alae or lateral sidewall and come within 1 mm of the alar crease with a total diameter of 1.0 cm should be repaired to prevent nasal valve malfunction. In the process of repairing deep defects, the overlapping region of the lateral crus of the alar cartilage and the lateral cartilage may be stabilized by a conchal cartilage graft. This cartilage graft may be used in combination with reconstruction of the nasal skin with a forehead flap and repair of the nasal lining. In the event that the nasal lining is intact, the cartilage graft may be used with a full-thickness skin graft.

Humans↗
PubMed1989

Nasal support and lining: the marriage of beauty and blood supply.

Assured of a robust blood supply by its narrow pedicle centered on the septal branch of the superior labial artery, the pivoting septal flap provides nasal support from the radix to the most distal nasal tip and from the tip to the columella base--plus a large bonus of lining tissues for the nasal vault and vestibules. Lining flaps from such intranasal tissues are thin, vascular, and flexible. They allow the use of primary cartilage grafts and the establishment of a subsurface architecture in the shape of a nose. When visualized through a conforming forehead flap, the normal landmarks and highlights are restored. In cases of total nasal amputation, a pivoting septal flap permits the fabrication of dorsal nasal support weeks before lining and cover flaps are assembled.

Cartilage↗
PubMed1986

Nasal reconstruction: seeking a fourth dimension.

A method of nasal reconstruction emphasizing the use of thin but highly vascular local lining and cover flaps to allow successful primary placement of delicate cartilage grafts is presented. The cartilage fabrication provides projection in space, airway patency, and, when visible through conforming skin cover, the delicate contour of the normal nose. Because tissue is replaced in kind and quantity, the need for multiple revisions to sculpt and debulk is decreased. Techniques and four case reports describe its applications to tip, heminose, subtotal, and total nasal defects.

Adult↗
PubMed1986

Aesthetic restoration of one-half the upper lip.

Aesthetic units of the face have been previously described. The lip itself may be divided into smaller topographic subunits. The lateral subunit is bordered by philtrum column, nostril sill, alar base, and nasolabial crease, while the medial topographic subunit is one-half the philtrum. When a large part of a subunit has been lost, replacing the entire subunit rather than simply patching the defect often gives a superior result. The only tissue suitable for the aesthetic restoration of moderate-sized defects of the upper lip is lower lip. An exact pattern is outlined and an Abbé flap is taken from the midline of the lower lip and transferred in two stages. Like tissue is replaced in kind, border scars are positioned aesthetically, and the orbicularis sphincter is reconstituted with an intact symmetrical commissure, muscular modiolus, and upper and lower lip symmetry. Spontaneous reinnervation by appropriate segmental facial branches occurs within 1 year. Four patients are presented.

Adult↗
PubMed1985

The subunit principle in nasal reconstruction.

The nasal surface is made up of several concave and convex surfaces separated from one another by ridges and valleys. Gonzalez-Ulloa has designated the nose an aesthetic unit of the face. These smaller parts (tip, dorsum, sidewalls, alar lobules, and soft triangles) may be called topographic subunits. When a large part of a subunit has been lost, replacing the entire subunit rather than simply patching the defect often gives a superior result. This subunit approach to nasal reconstruction causes unsatisfactory border scars of flaps to mimic the normal shadowed valleys and lighted ridges of the nasal surface. Furthermore, as trapdoor contraction occurs, the entire reconstructed subunit bulges in a way that simulates the normal contour of a nasal tip, dorsal hump, or alar lobule. Photographs show five patients in whom this principle was followed and one in whom it was not.

Adult↗
PubMed1985

Aesthetic restoration of the nose.

By using intranasal tissues for lining, employing cartilage battens to brace against contraction or collapse, designing axial skin flaps from exact three-dimensional patterns, using the topographic subunits of the nose as templates, and refining the result by subcutaneous sculpturing, a new nasal part that is nearly normal in appearance can be created in a few stages. It should be remembered that the restored part is not a nose, but merely a collage of forehead skin, cheek skin, mucosa, vestibular lining, nasal septum, and ear cartilage fragments all stuck together with collagen, as with glue. It is taken for a nose only because its contour, color, and texture are exact. The principles of aesthetic reconstruction are valid, and the results are consistent.

Basal Cell Carcinoma↗