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Biomedical subjects

J M Psillakis

Publications and source records attributed to J M Psillakis.

At least 19 recordsLinked to original sources
PubMed1988

Subperiosteal approach as an improved concept for correction of the aging face.

A harmonious facial appearance is determined by a balanced relationship among all tissues of the face. With advancing age, balance is lost among the bone, muscle, fat, and skin as progressive changes occur in their volume, shape, position, and consistency. Study of clinical cases and fresh cadaver dissections has led to better understanding of the superficial musculoaponeurotic system (SMAS) and its relationship with the facial muscles and their bony insertions. From these anatomic studies we have developed an improved concept of rhytidectomy with the subperiosteal detachment of all soft tissues from the orbit, upper maxilla, malar bone, and nose. Following this detachment, the soft tissues of the cheek, forehead, jowls, nasolabial folds, lateral canthus, and eyebrows can be lifted to reestablish their youthful relationship with the underlying skeleton. Our 4-year experience includes 105 patients. Sixty percent of these patients were admitted to the hospital and had their procedure under general anesthesia; forty percent, however, had their procedure in an outpatient setting requiring only local anesthesia (lidocaine hydrochloride 1% plus epinephrine) and intravenous sedation (midazolam, ketamine). Complications have been minimal except for temporary paralysis of the frontal nerve in seven patients; guidelines for prevention have subsequently been developed. The subperiosteal rhytidectomy is excellent and appears more natural for rejuvenation of the upper and central face, eyebrows, periorbita, external canthus, cheeks, and nasolabial fold.

Aged↗
PubMed1988

Abdominoplasty: a new concept and classification for treatment.

From a study of the deformities of each layer of the abdominal wall, we have categorized five types of abdominoplasties. For each type, we used a different surgical technique, aiming to sculpture the abdomen and treat each layer according to the deformity present in each patient. Two hundred thirty-eight patients were treated with this method, and the results were judged good to excellent by the surgeons and patients because of the more natural appearance of the final results.

Abdominal Muscles↗
PubMed1986

Craniofacial reconstruction after tumor resections using vascularized outer table calvarial bone flaps.

The outer table of calvarium is a useful donor site for facial reconstruction after resection of tumors. Large defects, especially when associated with multiple operations and radiotherapy, are poor recipient beds for nonvascularized bone grafts. A technique for the transfer of vascularized outer table has been developed and used in 11 patients for reconstruction of tumor defects. Satisfactory correction of both functional and esthetic problems has been achieved with satisfactory long-term stability and low morbidity.

Adolescent↗
PubMed1986

Anatomic basis for vascularized outer-table calvarial bone flaps.

The vascularization of the scalp and calvarium was studied in cadavers to better define the design of vascularized split- or full-thickness calvarial bone flaps. Selective dye injections of the superficial temporal and internal maxillary arteries established a horizontal and vertical network of vessels within and between each layer of the scalp. The periosteum of the frontoparietal region continues over the temporal aponeurosis as a separate, distinct layer, the innominate fascia, which is irrigated by numerous proximal branches of the superficial and deep temporal arteries. The periosteum can sustain the outer table of the calvarium by means of multiple small, vertical perforators. Between the periosteum and the outer table is a thin areolar layer of subperiosteum which continues beneath the temporal muscle. We feel that vascularized outer-table calvarial flaps can safely be pedicled using only the temporal aponeurosis, innominate fascia, and periosteum without including the galea or temporal muscle.

Blood Vessels↗
PubMed1986

Vascularized outer-table calvarial bone flaps.

Based on an anatomic study of the vascularization of the calvarium in cadavers, a technique for the transfer of vascularized outer-table calvarial bone has been developed. The outer table of the calvarium receives numerous small perforators from its overlying periosteum. The periosteum is continuous with a distinct fascial layer overlying the temporal aponeurosis which we have termed the innominate fascia. Because of a network of anastomosing vessels from proximal branches of the superficial temporal artery and perforating branches of the deep temporal artery, the outer table of the calvarium can be carried on a pedicle which contains the temporal aponeurosis, innominate fascia, and periosteum. Thirty-seven vascularized outer-table calvarial bone flaps have been performed for a variety of craniofacial reconstructive deformities. Remarkable stability and lack of resorption have led the authors to favor this method of reconstruction particularly in poorly vascularized or previously infected recipient beds.

Adolescent↗
PubMed1985

Craniofacial fibrous dysplasia.

This article describes a 20-year-old man with widespread polyostotic fibrous dysplasia that resulted in massive craniofacial deformity with unilateral exorbitism and oronasal obstruction. The patient illustrates the rare occurrence of fibrous dysplasia with major malformation of the face and skull, requiring multiple stages of surgical "sculpture" to improve function and appearance. The disease entity, differential diagnosis, and treatment are discussed.

Adolescent↗
PubMed1985

Burned breast: treatment with a transverse rectus abdominis island musculocutaneous flap.

A contralateral transverse rectus abdominis island musculocutaneous flap was employed in the treatment of a unilateral burned breast. The vascularization of the flap was based on the superior epigastric pedicle. The advantages of this method are that a transverse island musculocutaneous flap of the rectus muscle can be used with good results in the reconstruction of the burned breast; and that in patients with hypertrophic contralateral breasts, the inferior pole of the opposite breast can be added to obtain a larger area of the flap. The cutaneous color and the texture offered by this method assure a more symmetrical appearance in the area.

Breast↗
PubMed1984

Use of large composite grafts in the reconstruction of deformities of the nose and ear.

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.

Basal Cell Carcinoma↗
PubMed1984

Plastic surgery of the abdomen with improvement in the body contour. Physiopathology and treatment of the aponeurotic musculature.

The author presents the evolution of his technique of undermining the major oblique musculature to reduce the diameter of the waist and also reduce the diameter of the superior abdomen by resecting cartilage from the seventh and eighth ribs when the anterior projection is exaggerated. Treatment of the aponeurotic muscle wall plays an important role in obtaining good aesthetic results because this wall will serve as a base for the cutaneous tegument upon healing.

Abdomen↗
PubMed1983

A study of regeneration of donor areas of bone grafts.

Roentgenograms of 26 bone grafts from 21 patients ranging in age from 8 to 64 were reviewed to study the osseous regeneration of the donor area. They were followed from six to seventy-two months--most about twenty-four months. Complete regeneration occurred only in patients under 30 and did not occur in those over 30 within the time period studied. It took place more rapidly in young people starting from the bone stumps and in no case did it start from the periosteum, which seems to behave mainly as a conductor in the deposition of bone. Donor areas of bone grafts may be reused in young patients and with complete assurance in those under 20.

Adolescent↗
PubMed1983

Rectus abdominis deepithelialized musculocutaneous island flap as a silicone substitute in breast reconstruction.

The authors present a method for replacing silicone implants in breast reconstruction. The method is suitable in selected patients and consists of the rotation of a deepithelialized rectus abdominis musculocutaneous island flap to form the mammary mound. Two patients who had already had breast reconstruction but with insufficient volume underwent this surgery.

Abdominal Muscles↗