PubMed · 14049792
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I PITANGUY, C REBELLO. 1963. [FACIAL SCARS].. https://pubmed.ncbi.nlm.nih.gov/14049792/
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Rhinoplasty is performed to improve the appearance of the nose. However, conventional procedures may result in impairment of nasal breathing. The purpose of this article is to describe a "functional and esthetic" rhinoplasty technique designed to avoid adverse effects on ventilation by preserving the structure of the nasal vault. The main indication for this technique is treatment of cyphotic or tension nose. Since this procedure does not correct nasal obstruction due to septo-turbinal abnormalities and narrow nasal fossa, turbinoplasty must be performed concurrently if necessary. Our series of >1000 cases over a 15-year period demonstrates that this conservative rhinoplasty technique prevents most functional complications associated with conventional procedures and often improves ventilation. Immediate and long-term cosmetic outcome is excellent with a natural-looking appearance and fewer tip revisions.
The authors have reconstructed neck scar contractures with "super-thin flaps" (subdermal vascular network [SVN] flaps) since 1994 and have used the circumflex scapular artery and veins (CSAV) and dorsal intercostal perforators (DICPs) to augment the blood flow in the distal portion of the flaps. These free microvascular augmentations enlarge the flap survival area. In this report, the authors describe a severe neck scar contracture reconstructed with a ninth DICP augmented "super-thin flap." The patient was a 51-year-old woman with severe flame burns on 44% of her total body surface area, resulting from a cooking accident. After emergency skin grafting, the patient had a severe scar contracture and intractable ulcer of the anterior neck. CSAV and a ninth DICP augmented occipito-cervico-dorsal (OCD) "super-thin flap" transfer were used to reconstruct the anterior neck. The flap size was 28 x 15 cm, and it survived completely. The cervico-mental angle was clear and esthetically pleasing, and not only the aesthetic results but also the functional results were excellent.
A 56-year-old man presented with symptoms of monocular diplopia and reduced vision in his left eye. Visual acuities were R6/6, L6/12. At his previous visit left visual acuity was 6/6. An irregular area of anterior corneal stromal scarring was evident, encroaching on the visual axis of the left eye. Rigid lens fitting improved left visual acuity to 6/6, however, lens wear caused a corneal abrasion over the lesion after one to two hours of wear. Several other contact lens and surgical strategies were employed to successfully address the visual requirements of the patient.