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At least 829 records · Page 46Linked to original sources
PubMed2006

Breast reconstruction with alloplastic implants.

This article reviews immediate and delayed breast reconstruction with prosthetic implants, and the effect of irradiation therapy. Despite widespread use of breast conserving surgery for early breast cancer, many breast cancer patients still undergo mastectomy. Some of these patients choose breast reconstruction. Over the last 30 years, techniques for breast reconstruction have evolved significantly with new alternative techniques and improved surgical devises. Immediate or delayed breast reconstruction with silicone prosthesis can be an excellent option. Implant reconstruction may be single or two stage procedures. Traditionally, small breasts with minimal ptosis are suited for single-stage reconstruction. Large breasts or inadequate skin require expanders followed by implants. Minimal excision mastectomy and biological spacers are allowing larger breast single stage reconstruction and improved aesthetics for two stage procedures. With recent studies suggesting survival advantage of post-mastectomy irradiation, many candidates for breast reconstruction are receiving radiotherapy, which complicates healing after breast reconstruction.

Breast Implants↗
PubMed1991

A special tissue expander in combination with extensive scalp-lifting.

Although posterior closure of male pattern baldness is usually accomplished in two procedures when using extensive scalp-lifting, there is the occasional patient who will require three operations because of very poor scalp laxity. A newly developed horseshoe-shaped tissue expander was designed for these patients so that a third procedure could be eliminated. This differential expander is actually placed during the first extensive scalp-lifting operation. This differs from the conventional placement as a separate preliminary operation. The significant salient features of this expander and the technique of placement are discussed in detail.

Alopecia↗
PubMedDate not supplied

Mammareconstruction with skin-expander and silicone prostheses: 15 years' experience.

We report on 170 breasts that were reconstructed with Skin-Expander and silicone implants over a period of 15 years [1,2]. Reconstruction occurred primarily in only about one-third of the cases, since the information provided by the first doctor in charge regarding the possibilities of breast reconstruction was rather scanty. In cases treated with radiotherapy, reconstruction with Skin-Expander should not be excluded, but it is necessary to proceed with extreme caution and to give patients exact information. The complication rate is higher here than in cases which have not been exposed to radiotherapy. The final result depends directly on the primary surgery and the skin as well as the contralateral breast quality [3]. In most cases reconstruction with Skin-Expander and silicone implants meets the patients' desires: low-risk operation, fewer additional scars, and similar and improved breasts on both sides.

Adult↗
PubMed2004

Calf augmentation with supraperiostic solid prosthesis associated with fasciotomies.

This article describes, for the first time, the supraperiostic technique used for aesthetic purposes to remedy hemiatrophy, genu valgum, poliomyelitis sequela, and thin legs. For genu valgum and thin legs, a solid prosthesis was used, whereas for severe hemiatrophy a double light prosthesis was used as a tissue expansor, with excellent reports. The advantages of this technique are delineated further in this article.

Epiphyses↗
PubMed1995

A universal incision for tissue expander insertion.

A new type of V- or W-shaped intralesional incision for tissue expander insertion is presented. The experience with 50 of these incisions in 36 consecutive patients in the period 1990-93 without any complication has proved the safety of this approach and the advantages of V- or W-shaped incisions over tangential or radial incisions.

Adult↗
PubMed1991

Tissue expanders in children.

Tissue expanders are particularly applicable in the pediatric population. They are extremely well tolerated by children and can withstand the everyday play and trauma unique to children. Over the past 2 years, we have used 26 tissue expanders in 17 pediatric patients. Fifteen of the 17 patients successfully underwent reconstructive surgery with the aid of expanders. The expander became exposed in two patients, necessitating removal. In each of these patients, a more complicated and less satisfactory method of reconstruction was performed.

Adolescent↗
PubMed1993

Treatment of giant omphalocele by enlargement of the abdominal cavity with a tissue expander.

Even in the absence of major associated anomalies, treatment of giant omphaloceles is difficult primarily because of the disproportion between the large volume of the omphalocele and the small volume of the intraabdominal cavity. The case of a child is presented in whom conservative treatment had to be abandoned. Reduction of the omphalocele contents and closure of the defect was successfully accomplished after a 19-day period of enlargement of the abdominal cavity by means of an intra-abdominally placed tissue expander.

Abdomen↗
PubMed2006

Evaluation of an integrated orbital tissue expander in an anophthalmic feline model.

PURPOSE: To evaluate the anatomical effects and tissue biocompatibility in a feline model of an integrated orbital tissue expander (OTE) designed to stimulate bone growth in an anophthalmic socket. DESIGN: An animal study was performed in cats to assess orbital bone growth with and without an OTE. METHODS: The OTE is an inflatable (0.5 to >6.0 cm(3)) polymeric globe sliding on a titanium T plate secured to the lateral orbital rim with screws. Eight cats had left eye enucleation at age two weeks, with five orbits receiving an OTE and the remaining three serving as nonimplanted controls. Serial transconjunctival implant inflation was performed by injecting normal saline solution into the OTE to a final volume of 3.5 ml. Serial computed tomographic scans were obtained to assess socket growth. All eight cats were euthanized at 18 weeks and dry skulls prepared. The effective orbital volume was measured by inflating an OTE in the orbit of a dry skull until it filled the cavity completely. RESULTS: Three cats periodically scratched open the tarsorrhaphy and conjunctiva to rupture the OTE, which resulted in implant exchanges. At 18 weeks, the OTE expanded orbital volume was approximately 18% smaller than the normal contralateral side. In the control animals, the anophthalmic orbital volume was approximately 66% smaller than the contralateral orbit. Histopathology of orbital tissues showed no evidence of foreign body reaction. CONCLUSIONS: This proof-of-concept pilot study demonstrated implant efficacy in cats, and no implant-related adverse effects were observed. OTE has the potential to stimulate bone growth in human anophthalmic orbits.

Animals↗
PubMed2003

Expanded occipito-cervico-pectoral flap for reconstruction of burned cervical contracture.

Postburn neck contracture and hypertrophic scarring can cause functional limitation and aesthetic disfigurement. Reconstruction of severe deformities and scar of neck following healing from burns confronts the surgeon with some of the most challenging problems in reconstructive surgery. Through knowledge of available reconstructive technique accurate diagnosis of tissue deficiency and secondary distortion, imaginative planning and definitive, careful execution of ones surgical plan are the bare minimum items for achieving improvement in a burned deformed neck. The aim of this article is to assess the role of expanded occipito-cervico-pectoral (o-c-p) flap for reconstruction in a series of four patients with severe burn scar of neck and involvement of shoulder back but intact anterior aspect of chest. This is an alternative method of reconstruction burn scar of neck area.

Adolescent↗
PubMed2006

Superior oblique tendon expanders with inferior rectus recessions for chin-up null point nystagmus.

Three patients with chin-up head postures caused by a nystagmus null point in downgaze were treated using bilateral superior oblique tendon expanders and inferior rectus muscle recessions. Preoperative chin-up head postures measured from 25 to 45 degrees. Postoperatively, 2 patients had complete resolution of their abnormal vertical head postures, and the third showed improvement.

Adolescent↗
PubMed2006

Management of giant omphalocele with rapid creation of abdominal domain.

BACKGROUND: The management of giant omphaloceles (GO) can be quite difficult when there is absence of abdominal domain. Coverage with delayed closure has been described. We present a technique to create an adequate peritoneal domain. METHODS: This is a retrospective review of our experience using an intraperitoneal tissue expander (IPTE) to create adequate abdominal domain in 2 patients with GO. RESULTS: In 2 children with unrepaired GO, an IPTE was placed into the pelvis and was inflated to the target volume over 3 to 4 weeks. At the definitive operation for the closure of the abdominal defect, the IPTE was removed, allowing reduction of all the viscera into the peritoneal cavity and achieving complete abdominal wall closure. The patients are now 1 year postoperative, each having a normal abdomen and enjoying normal growth and development. CONCLUSION: Intraperitoneal tissue expander placement can create the needed domain over several weeks in GO. Its use in 2 cases was associated with satisfactory complete abdominal wall closure in short order. This technique should be considered as a treatment option.

Child, Preschool↗
PubMed1996

Breast reconstruction with anatomical expanders and implants: our early experience.

Dissatisfied with the upper pole fullness produced by the Becker expander/mammary prosthesis, we started using 'anatomically' shaped expanders and implants, as described by Maxwell, for breast reconstruction. We reviewed the results of our first 24 breast reconstructions in 19 patients, who were deemed suitable for reconstruction with this technique between August 1994 and April 1995 (9 months). The most commonly used expander was 500 cc (range 400-700 cc) and an average of 2.73 inflations was required before replacing the expander with a definitive implant. The minimum follow-up was 6 months. Few complications were recorded and all patients were very happy with the final result. We found that the anatomically shaped expanders and implants produced better aesthetic reconstructions compared to dome shaped prostheses. Importantly, the procedure was technically simple and the results readily reproducible.

Adult↗
PubMed2003

Large-segment superior oblique tendon expanders in the management of severe congenital Brown syndrome.

PURPOSE: To report the effectiveness of large-segment superior oblique tendon expanders for severe congenital Brown syndrome. METHODS: Medical records of 12 consecutive patients with severe congenital Brown syndrome were evaluated retrospectively. All patients had a hypotropia > 20 prism diopters in primary position. A superior oblique tendon lengthening procedure, using a 10- to 12-mm-long silicone band, was performed on each patient. Preoperative and postoperative extraocular motility patterns were analyzed, and the final results were graded as "excellent," "good," "fair," "poor, undercorrected" and "poor, overcorrected." RESULTS: As of the last recorded follow-up examination (mean, 32 months), three patients had an excellent result, six had a good result, three had a fair result, and none had a poor result. All patients experienced an improvement in their severe Brown syndrome, with 100% showing a postoperative primary-position hypotropia < 8 prism diopters. Postoperative limitation of elevation in adduction was either -1 or -2 for all patients. No patient required further surgery, and no extrusions of the implants were noted. CONCLUSION: The superior oblique tendon expander procedure appears to be an effective tool in the surgical treatment of severe Brown syndrome. The use of a large-segment (10- to 12-mm) band seems to be an appropriate choice when dealing with patients having primary-position hypotropia > 20 prism diopters.

Adolescent↗
PubMed1993

Clinical applications of acute intraoperative arterial elongation.

This study reports four clinical cases in which acute intraoperative, extraluminal, arterial elongation was utilized. This technique was developed to facilitate end-to-end anastomoses across vascular defects traditionally bridged with vein grafts. In the reported cases, arterial defects, ranging from 17 to 25 mm, were closed primarily following the application of this technique. Follow-up, ranging from 3 to 34 months, has demonstrated patency in all cases. The authors believe this technique can be used clinically as a reliable alternative to vein grafting for the reconstruction of certain arterial defects.

Adolescent↗