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Biomedical subjects

M Scheflan

Publications and source records attributed to M Scheflan.

At least 19 recordsLinked to original sources
PubMed2001

Combined erbium:YAG laser resurfacing and face lifting.

Facial aging occurs secondary to gravity-induced tissue ptosis and photoaging. Combined face lifting and carbon dioxide laser resurfacing provides a comprehensive one-stage approach to facial rejuvenation but is condemned by many plastic surgeons due to the nonspecific thermal effects of the laser and risk of skin necrosis. Newer high-energy erbium:YAG lasers allow precise tissue ablation with minimal thermal effect. In this study, various facial rejuvenation techniques were combined with simultaneous erbium:YAG laser resurfacing to assess results and complications. A total of 257 patients from Florida, Melbourne, Australia, and Tel Aviv, Israel, underwent combined erbium:YAG laser resurfacing and surgical facial rejuvenation. Various face-lift methods were used, including endoscopic, deep plane, and subcutaneous. Simultaneous, full-facial laser resurfacing was performed using a variety of erbium:YAG lasers. It was found that combined laser resurfacing and face lifting was successful in greater than 95 percent of patients with minimal morbidity. Two patients (1 percent) (both heavy smokers) developed small areas of skin necrosis that healed with minor pigment changes. Five patients (2 percent) developed synechia that was treated with no residual effect. Two additional patients (1 percent) developed temporary ectropion. There were no other cases of scarring, infection, or cosmetically obvious hypopigmentation. Although larger studies are necessary, it seems that the lack of thermal injury from the erbium:YAG laser makes it possible to safely perform laser resurfacing with surgical facial rejuvenation in nonsmokers. However, the authors caution that familiarity with the nuances of erbium:YAG laser resurfacing be obtained before performing combined laser resurfacing and face lifting.

Adult↗
PubMed2000

Simultaneously combined ER:YAG and carbon dioxide laser (derma K) for skin resurfacing.

The simultaneously combined Er:YAG and carbon dioxide laser is ideally suited for treating deeper wrinkles with greater accuracy than either laser alone. By combining the precise ablative properties of the Er:YAG laser with the coagulative properties of the carbon dioxide laser, it is possible to control the depth of skin resurfacing to minimize complications and improve difficult and substantial wrinkles.

Aged↗
PubMed1997

Ultrasonically assisted lipectomy in aesthetic breast surgery.

A case report of a young patient with marked asymmetry treated successfully with ultrasonically assisted lipectomy with a good functional cosmetic result, undetectable scars, and mammographic control and showing no ill-effect on the breast parenchyma is presented. Further studies and follow-up are needed to confirm the value and advisability of using ultrasonic energy in the female breast.

Adolescent↗
PubMed1996

Subperiosteal facelifting: complications and the dissatisfied patient.

As endoscopic subperiosteal lifting of the upper face is explored, it may significantly limit the indications for the open approach. However, this report is based on our combined large experience and long follow-up in open bicoronal subperiosteal lifting. The combined experience of four surgeons in four countries with an open subperiosteal approach to lifting of the upper face in 545 patients is described. The complications of the procedure, both common and rare, and techniques to avoid untoward effects are discussed. Reasons for patient dissatisfaction are addressed. Based on their evaluation of results and complications of the surgery over a 6-year period (1986-1992), we conclude that subperiosteal lifting is an effective, reliable, reproducible, and safe operation.

Face↗
PubMed1993

The subperiosteal lift.

The subperiosteal lift developed by Tessier is a technique for rejuvenating the face and emphasizing beauty. It is performed using two approaches: intraoral and bicoronal or precapillary. It entails a total subperiosteal undermining of the face beginning 2 cm over the orbits and continuing on the orbital rims, the zygomatic arches, and the malar bones. This allows total lifting of the soft tissues of the face (DMAS, deep musculo aponeurotic system). The lateral and vertical traction allows elevation of the superior two thirds of the face, eyebrows, and cheeks. Lifting pulls up from the forehead to the mandibular line. The fixation of the superficial layer of the temporal aponeurosis in traction to the upper part also has an effect on tissue elevation. The best candidates for this procedure are women in their late 30s or early 40s but can be used on those from 30 to 50 and more. It is highly specialized operation which requires substantial surgical experience both in selecting the patient and in execution.

Adult↗
PubMed1991

The subperiosteal bicoronal approach to total facelifting: the DMAS--deep musculoaponeurotic system.

Craniofacial surgery, developed by Paul Tessier, has shown that subperiosteal undermining and lifting of the soft tissues of the upper two-thirds of the face results in an excellent and long-lasting rejuvenated look to the entire face. The result is significantly more durable and longer lasting than the classic subcutaneous facelift reinforced with SMAS plication, transposition, and shortening. The authors--three surgeons working independently--are convinced that we have entered a new era in facelift procedures. We decided to combine our experiences which total 250 patients with followups of 6 months to 6 years.

Facial Muscles↗
PubMed1984

Bilateral cleft lip repair: "putting it all together".

The surgical repair of the bilateral cleft lip should take into consideration restoration of normal anatomy throughout the lip. If it is well done, it contributes to both form and function. A composite technique is presented here, with additions taking advantage of all tissues and based on this principle. Preoperative orthodontic preparation is used to achieve more satisfactory spatial relationships when appropriate and to permit a one-stage repair without lip adhesions. The technical aspects are clearly outlined and supported by case presentations. The technique saves all tissue; avoids tightness; provides good muscular function; constructs a labial sulcus providing for proper movement of the lip; provides good nasal sills and floors; is adaptable to complete or incomplete clefts; can be easily revised or used for secondary revisions in other cases, and so on.

Cleft Lip↗
PubMed1984

Meningomyelocele closure with distally based latissimus dorsi flap.

Our experience with the distally based latissimus dorsi flap in 12 patients (7 primary closures and 5 secondary procedures) indicates that it is an extremely reliable and useful flap in this setting. It provides coverage of the dural repair with viable soft tissues under a minimum of tension. The suture lines are distant from the dural closure, the donor defect closes primarily, and in the event of a complete failure, the contralateral latissimus dorsi remains available. In those cases of meningomyelocele where direct primary closure is not possible, we view this as the procedure of choice.

Back↗
PubMed1984

Building a breast without a prosthesis. The transverse abdominal island flap.

Use of the transverse abdominal island flap for breast reconstruction enables the plastic surgeon to redistribute the body's excess fat and skin into more fashionable and aesthetic proportions. The operation remains a complex and detailed procedure. Patient selection, suitability, and preparation for the operation are critical to its success.

Abdominal Muscles↗
PubMed1984

Complications of breast reconstruction.

The authors discuss general complications of breast reconstruction, complications associated with reconstruction with subcutaneous or submuscular prostheses, complications of latissimus dorsi musculocutaneous flaps, and complications of transverse abdominal island flaps. Although no surgeon can expect to perform a series of complex yet delicate operations such as breast reconstructions and escape the complications described, it is hoped that by utilizing sound judgment in patient and procedure selection and having detailed knowledge of the procedure to be performed, such complications can be kept to a minimum and managed to a satisfactory resolution if and when they do occur.

Abdominal Muscles↗
PubMed1983

The transverse abdominal island flap: part I. Indications, contraindications, results, and complications.

The transverse abdominal island flap is not just another myocutaneous flap. Although it derives its blood supply from myocutaneous perforators, the portion of the skin and fat that overlies muscle comprises only about 20% of its surface. The surface area of the flap by far exceeds the surface area of the entire muscle that carries it. Its hemodynamics are more complicated than usual and consist of delicate communications between the superior and inferior deep epigastric systems and the deep and superficial epigastric systems across the midline. Its use in breast reconstruction has been as exciting as it is complex. We describe our experience with 60 consecutive patients and 65 transverse abdominal island flaps.

Abdominal Muscles↗