[Plastic surgery in Europe. A plastic surgery service in Yugoslavia].
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Plastic surgery has acquired an important place in primary breast cancer treatment (conservative or radical) and in the treatment of sequelae. The authors have tried to define, based on their experience, the contraindications for breast reconstruction. They are rare from a technical point of view. The carcinologic contraindications are relative: highly aggressive cancers, locally advanced cancers, cancers with metastases or recurrences. Radionecrosis and radio-induced sarcomas, treatment sequelae are also contraindications for breast reconstruction. General contraindications are relative (major obesity, smoking, diabetes, general weakness). Psychological contraindications must be taken into consideration. The authors conclude that contraindications for breast reconstruction are mainly carcinologic and the decision for reconstruction is usually taken by the patient after complete medical information.
Progress in microvascular surgery has made possible important advances in reimplantation and transplantation. The author briefly reviews the success of early pioneers of these procedures and discusses the surgical equipment required and the techniques that he uses for microvascular anastomoses. A discussion of the clinical applications of free skin flap transfers, free transfer of omentum and muscle, toe-to-hand transplantation, and vascularized bone grafts, with brief case reports from the author's experience, is included.
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Alloplastic materials have become an essential part of reconstructing the craniofacial skeleton. This article reviews several of the more commonly used implant materials and summarizes their mechanical properties and use in reconstructive surgery.
Plastic surgery residency program directors are frequently interested in predictors of future career direction in their applicants. Many programs strive to train leaders in academic plastic surgery. To determine what factors may predict the ultimate fate of graduating plastic surgery residents, the authors reviewed the application files of 33 former residents from a single, major plastic surgery training program. The data from 29 residents were available for analysis. Nearly half of the residents graduating from the plastic surgery training program went into private practice. Two factors, the number of years taken off for research before entering the plastic surgery residency and the presence of children, were found to be indicative of a candidate's future career path. Of particular note, there was no difference between academic graduates and nonacademic graduates with regard to their intentions in their letters of recommendation and personal statements. This information is useful to both academic program directors and resident applicants.
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