Biomedical subjects
Publications and source records attributed to S A Botta.
This article demonstrates how the surgeon performs a major surgical procedure on himself using self-hypnosis as the means of anesthesia and pain control. The hypnotic techniques used by the author for self hypnosis are reviewed. These include glove anesthesia and transference; the switch technique; dissociation; positive imagery; as well as the specific post-hypnotic suggestions used by the surgeon during the operative procedure.
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A review of the Skoog technique for reduction mammaplasty is presented. A laterally based single pedicle is used for transposition of the nipple-areola flap, deriving its blood supply from a cutaneous vasculature. From our experience using this procedure in a majority of patients, we have developed specific refinements starting with the preoperative planning and including various modifications in the operative technique. The advantages of these refinements are discussed as well as their contribution to the final aesthetic result.
Numerous otoplasty procedures for correcting the protruding ear are described in the literature. What makes one technique superior to another lies in its reproducibility of natural-appearing results. One must avoid the "operated-on" postoperative look of sharp cartilaginous margins and the straight-line antihelical appearance.
Rhytidectomy in the male is always more complicated than in the female. We present important modifications of the usual female-type face lift procedure that solve problems peculiar to the male patient. We describe a combined procedure of male rhytidectomy in continuity with the lower blepharoplasty incision. This technique increases the aesthetic results significantly. It provides an increased mechanical advantage in rotation and elevation of the cheek flap which is necessary to correct adequately the frequent redundancy and marked sagging in the lower face and neck often witnessed in the aging male patient. The preauricular non-hair-bearing portion of skin is left undisturbed with no change in the appearance of the sideburn. There is no elevation of the temporal hairline. The operative technique is fully described with emphasis on the complications we observed and how to avoid them. The results presented justify the slightly visible scarring that may occur in the temporal area which heals extremely well and is very acceptable aesthetically.
Cardiac arrhythmias are a potential complication in phenol face peeling. A comprehensive review of the literature is presented here demonstrating its reported incidence, as well as the actions of phenol both locally and systemically. In addition to the conventional measures that are presently followed in chemical face peeling, we present further recommendations for the prevention of cardiac arrhythmias. These include maintaining the patient with a sufficient fluid load, forcing diuresis with furosemide, and using lidocaine hydrochloride as a prophylactic antiarrhythmic agent. These guidelines will help avoid serious and even lethal complications.
Two surgical techniques available for the correction of severe gynecomastia in the male patient are described in detail. Severe gynecomastia complicates the plan for correction by presenting the same obstacles which are found in mastopexy or breast reduction for the female patient. These include: tissue resection, skin excision, and nipple-areolar complex elevation. The amount of each of these will determine which specific procedure should be used.