Biomedical subjects
Publications and source records attributed to J M Avelar.
A new approach is described for a type of lower blepharoplasty to correct excess skin and subcutaneous adiposity localized on the malar eminences. This surgery removes skin and subcutaneous tissue leaving only a fine and invisible scar on the lower malar rim.
The authors present six cases of nose reconstruction and four ear repairs using large composite grafts. The post-auricular area is the best donor site. Very large composite grafts can be taken and in one patient a composite graft of 30 sq cm was successfully transferred. The surgical technique should be as atraumatic as possible in order to preserve intact the transplanted vascular tissue in the graft and in the recipient bed. An important feature of this surgical manoeuvre is the modified post-operative dressing technique that is described in detail.
The author describes surgical details and improvements on his personal technique. He establishes a relationship between the method and the natural phenomenon that occurs on the umbilical region of the newborn child. The author suggests reimplanting the umbilicus 1 cm below its natural projection on the abdominal flap. He presents two new instruments, one to facilitate the incisions and the other to help the marking of the umbilical area. He describes 8 years' follow-up of 130 patients.
A galea fascial flap is described based on the superficial temporal and posterior auricular vessels. This has been used by the author in 14 cases of craniofacial abnormalities including 3 cases of Treacher Collins Syndrome. The galea flap can be used for soft tissue augmentation of the face and also for protection of bone grafts. The technique of raising the galea flap is described in detail and its use in cases of craniofacial defects are illustrated.
A one-stage method of total reconstruction of the external ear in microtic patients is described. The auricular framework is fashioned from autogenous rib cartilage. Cover is provided by a vascular pedicle of the conchal area and by the aponeurotic layer which protects the posterior surface supplemented by a full-thickness skin graft. The surgical technique is described and the indications for the operation are indicated.
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