Preoperative infiltration with lidocaine and epinephrine for breast reduction.
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Anesthetics, Local↗
Biomedical subjects
A D Mandrekas
Publications and source records attributed to A D Mandrekas.
Cyst formation after fat injection.
Autologous fat injection has been widely used during the past 20 years to correct contour anomalies. We have been using suction-assisted lipectomy for the past 13 years, and we have used the aspirated fat to correct contour irregularities on several occasions. We present the case of a 44-year-old woman who, after autologous fat transplantation to correct a contour anomaly (depression secondary to a previous operation) at her left groin, developed a large cyst containing pearl-like fat lobules. The cyst was first noticed 3 months postoperatively and was removed under local anesthesia 5 months postoperatively. Histology confirmed that the lobules were mature fat cells.
Adipose Tissue↗
Reduction mammaplasty with the inferior pedicle technique: early and late complications in 371 patients.
A review of reduction mammaplasties with the inferior pedicle technique in 371 patients over 10 years is presented and the complications associated with this particular technique are discussed. The mean age was 33.1 years (range 15-67), the average preoperative sternal notch to nipple distance was 30.4 cm (range 21-43), the mean breast tissue resected was 870 g per breast (range 250-1960) and the mean operating time was 3.1 hours (range 2.5-4). The overall complication rate was 11.4%. The incidence of specific complications in our series was: haematoma 0.3%, nipple and/or pedicle necrosis 0.8%, wound dehiscence 4.6%, fat necrosis 0.8%, carcinoma 0.5%, loss of sensitivity of the nipple 1.3%, hypertrophic scars 3.3%, dermoid cysts 0.3% and marked lower fullness 0.3%. 72% of the patients that became pregnant were able to lactate.
Adolescent↗
Immediate and delayed breast reconstruction with permanent tissue expanders.
Breast reconstruction has greatly advanced during the past decade, offering the surgeon and the patient a choice between autologous tissue transfer and silicone implants, as well as between immediate and delayed reconstruction. In this retrospective study we reviewed the results of immediate versus delayed reconstruction with a permanent tissue expander, a method which is simple, fast and gives good aesthetic results. 19 patients had immediate reconstruction and 25 patients had delayed reconstruction. Capsular contracture (Baker II, III, IV) was more common with delayed (7/25) than immediate (3/19) reconstruction; however, the difference was not statistically significant (p = 0.47). The overall complication rates and the final aesthetic results were similar in the two groups.
Adult↗
Fat necrosis following breast reduction.
Between 1984 and 1992, 300 patients underwent breast reduction in our unit. Three patients during the follow-up period were found to have a palpable mass in their breast. Excision biopsy revealed fat necrosis of the breast. The clinical, radiological and pathological features of fat necrosis of the breast are described.
Adolescent↗
Reverse-flow radial forearm flap for reconstruction of the hand.
Soft-tissue injuries of the hand often require flap coverage to achieve primary wound closure and a good functional result. The use of the reverse radial forearm fasciocutaneous flap in the reconstruction of the hand is discussed. This flap offers thin, pliable, hairless skin and has proved very reliable because of its excellent vascular supply. The anatomy and vascular basis of this flap are presented along with its application in three patients.
Adult↗
Upper lip reconstruction with a radial forearm free flap.
Although there are several methods available for lip reconstruction, the challenge for plastic surgeons is young children, in whom there is no laxity of skin. Free-tissue transfer is the method of choice in young children to avoid large unsightly scars and severe distortion of facial appearance. The radial forearm free flap is an ideal flap for lip reconstruction because it is thin and can be folded to restore both the skin and the inner lining. We present reconstruction of half the upper lip in a young girl, in whom the radial forearm free flap was folded to replace the full-thickness defect.
Animals↗
The management of decubitus ulcers by musculocutaneous flaps: a five-year experience.
Large decubitus ulcers can be treated by using many methods, including musculocutaneous flaps. Musculocutaneous flaps provide reliable, well-vascularized cover and often can be revised in patients with secondary recurrence. We have treated 30 patients with large decubitus ulcers during a 5-year period by using musculocutaneous advancement flaps of the gluteus maximus, the hamstring muscle, and the tensor fasciae latae. There were two complications treated by debridement with flap advancement in 1 patient and the use of another flap in the second patient. Four patients developed a recurrent ulcer, which was treated by reelevation and advancement of the original flap in all patients. The general management and overall results are presented.
Buttocks↗
Fasciocutaneous flaps for lower extremity wounds.
The use of fasciocutaneous flaps to cover soft tissue defects of the lower leg following trauma, is discussed in this article. Our experience with 15 cases is presented. There have been no complications. We feel that fasciocutaneous flaps are a safe and reliable method for the management of difficult wounds of the lower leg.
Adult↗