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Biomedical subjects

A Matarasso

Publications and source records attributed to A Matarasso.

At least 37 records · Page 2Linked to original sources
PubMed1998

Reevaluating the need for routine drainage in reduction mammaplasty.

The incidence of complications after reduction mammaplasty without drains was reviewed by analysis of 50 bilateral reduction mammaplasty procedures. Patients ranged in age from 14 to 65 years; the average combined volume removed was 953 g. Eighty-four percent of the patients underwent a Pitanguy technique, and the remaining patients underwent an inferior pedicle or amputative technique with free nipple grafts. Three patients had six complications; one of these patients had three of the complications. Complications included two cases of fat necrosis and one case of wound disruption. One patient had a hematoma with wound disruption and partial nipple loss. There were no cases of infection. The purpose of this study was to determine the rate of complications in reduction mammaplasty performed without drains. Incidentally, statistical analysis using the chi-squared test revealed that this series without drains compared favorably with previously published data for reduction mammaplasty using drains. It is concluded that routine closed suction drainage after reduction mammaplasty is unnecessary and should be reconsidered.

Adolescent↗
PubMed1997

Facialplasty.

Facelift surgery is a highly satisfactory solution to many problems that are manifested in the aging face. With one operation, relatively inconspicuous incisions, and brief convalescence, correction of the mid-face and neck can be achieved, providing a uniform degree of facial rejuvenation. As long as our perception of youth and beauty continue to be admired, so will the demand for aesthetic surgery.

Adult↗
PubMed1997

Concurrent functional endoscopic sinus surgery and rhinoplasty.

Traditionally surgeons have avoided performing rhinoplasty in conjunction with sinus surgery for rhinosinusitis. With advances in rhinoplasty and endoscopic sinonasal surgery and its added benefits of precision, minimal trauma, and hemorrhage, the combined procedure is now feasible. The indications, management, and results are discussed in 40 patients who underwent the combined procedure. Patients were divided into three categories based on the location and severity of the sinus disease: mild, moderate, or severe. The majority of patients had mild or moderate sinus disease. The most common presenting symptoms were nasal obstruction and postnasal drip. All patients had a history of sinusitis recalcitrant to conservative medical management. Results demonstrate the combined treatment modality to be safe and effective in patients with mild to moderate sinus disease and in selected patients with severe sinus disease.

Adolescent↗
PubMed1997

Cell adhesion and short-term patency in human endothelium preseeded 1.5-mm polytetrafluoroethylene vascular grafts: an experimental study.

It has been shown that endothelialization improves short-term patency of 1.5-mm expanded polytetrafluoroethylene vascular grafts. A model for endothelialization of 1.5-mm expanded polytetrafluoroethylene vascular grafts with human endothelial cells is described. In this model, the adherence of endothelial cells was increased significantly in grafts coated with serum proteins and collagen. By means of this protocol, graft patency was tested after implantation in two animal models: the rat aorta and the rabbit common carotid artery. Anastomosis was performed with a 3M Precise Microvascular Anastomotic System. In both animal models, no significant loss of endothelial cells in the precoated grafts (rat, n = 8) were noted 1 hour after blood flow restoration. All uncoated grafts showed significant endothelial cell loss. In the rabbit model, all nonendothelialized grafts (n = 8) clotted 5 to 25 minutes after flow restoration. Seven (n = 8) endothelialized grafts showed no clotting during 1 hour's observation: one clotted immediately for a patency rate of 87.5 percent. These results indicate that endothelialization of 1.5-mm grafts is practical. Furthermore, adhesion of endothelial cells to the graft walls is not affected by short-term, pulsatile, high-pressure blood flow.

Animals↗
PubMed1997

Standardization in photography for body contour surgery and suction-assisted lipectomy.

Despite the existence of basic clinical standards in plastic surgery, specific guidelines for body contour photography have not been detailed previously. In this report we propose standard and supplemental views for positioning of the subject for suction-assisted lipectomy and body contour surgery. Also demonstrated are specialty views for the face, where liposuction has become an integral component of the procedures. Finally, recommendations for photographic documentation of skin "textural" changes and "cellulite" improvement with liposuction, as well as regions requiring lipectomy, are discussed. A professional photographic studio and a model were utilized. Proper lighting, equipment, and backgrounds are described to achieve such standards. General principles for clinical photography are reviewed. We present standard and supplemental views for suction-assisted lipectomy and body contour surgery, with an emphasis on methods to address advanced liposuction techniques (i.e., superficial suction lipectomy) that may affect texture and contour of the skin. These techniques provide consistency for all practitioners, allowing comparison of results and techniques.

Female↗
PubMed1997

Pseudoherniation of the buccal fat pad: a new clinical syndrome.

The differential diagnosis of cheek masses can include any component that arises from the region or that metastasizes to it. Given the array of potential anomalies that can present in this area and their clinical implications, an early diagnosis is essential. This report describes a condition observed in a series of patients with abnormal positioning of the buccal fat pad as the cause of their cheek masses. In the appropriate setting, a soft, nontender, walnut-sized mass that reduces into the buccal space is pathognomonic for the syndrome referred to as pseudoherniation of the buccal fat pad. Magnetic resonance imaging can also be used to evaluate the region. Treatment is accomplished by excision or repair of the fascial defect.

Adipose Tissue↗
PubMed1997

When does your liposuction patient require an abdominoplasty?

BACKGROUND: Abdominal surgery has evolved from one operation applied to all patients requesting contouring, to a group of procedures based on individual variations in anatomy. Currently, the authors favor four (Types I-IV) different procedures. Liposuction alone (Type I) is performed in the majority of patients. In the remainder (procedures Type II-IV) liposuction combined with modifications of open, traditional abdominoplasty are utilized. These additional methods are appropriate in patients that necessitate rectus muscle reinforcement or skin reduction procedures in order to adequately contour the abdomen. OBJECTIVE: This report describes the indications for abdominal contour surgery, beyond just liposuction. METHODS: A consecutive series of over 300 abdominal contour patients were reviewed and analyzed, with recommendations based on individual variations in their soft tissue anatomy. RESULTS: We demonstrate that the majority of patients benefit from a "closed" procedure (liposuction or ultrasonic assisted liposuction) but that patients with muscle flaccidity or laxity in their skin may require an open procedure. CONCLUSION: Abdominal contour surgery should be considered a group of operations (abdominolipoplasty system of classification and treatment) based on individual varieties in anatomy.

Abdominal Muscles↗
PubMed1996

Alar rim excision: a method of thinning bulky nostrils.

A thick nostril is a disturbing deformity and one for which surgeons and patients may be reluctant to employ the traditional "piece of pie" skin excisions commonly described. As an alternative in selected circumstances, a method of internally thinning the nostril rim using an alar base groove incision known as alar rim excision is presented. An alar base resection can accompany this, or the incision can be used solely for access when reducing a bulky nostril, while avoiding additional scarring or the risk of alar rim elevation.

Adolescent↗
PubMed1996

Labial incompetence: a marker for progressive bone resorption in silastic chin augmentation.

Bone erosion below silicone rubber implants is a wellknown sequela, occurring in a majority of patients undergoing augmentation genioplasty. It is generally considered to be self-limiting and with minimal adverse consequences. However, if bone erosion progresses to the extent to which teeth are jeopardized or alterations in sensibility of the mental nerve occur, removal of the implant is indicated. Osteoplastic genioplasty may be required to restore aesthetic contour to the chin and to avoid functional anomalies that may occur from explantation. A number of factors have been identified that contribute to this phenomenon; however, speculation regarding its etiology has not acknowledged the functional aberration of a tensed mentalis muscle. A study of six patients with aesthetically positioned and appropriately sized Silastic implants revealed a correlation between preoperative baseline labial incompetence and mentalis muscle hyperactivity and progressive bony erosion. One patient had grade II erosion and four patients had grade III erosion, one with the exposure of dental roots. The sixth patient with mentalis muscle strain, subsequent to attempts to contain her lower denture, also had severe resorption. Such findings suggest that attention should be paid to an alternative approach in microgenic patients presenting with lip strain, since labial incompetence appears to be a reliable marker for ongoing mandibular resorption following Silastic augmentation. Furthermore, since most patients are asymptomatic until significant erosion occurs or are satisfied and do not return, in those individuals with labial incompetence who have already had Silastic chin implants, consideration should be given to routine follow-up examination and radiographs.

Adult↗
PubMed1995

Minimal-access variations in abdominoplasty.

The use of liposuction began a trend toward less invasive abdominal contour surgery and resulted in a variety of techniques based on individual anatomy. An analysis of 170 patients was undertaken to determine which patients benefited from even less invasive techniques that evolved from these concepts. The selection criteria used were based on the physical examination of the skin, fat and muscle layers, and patients' goals, willingness to accept incisions, and tolerance for the recovery period. The options used for this new category of treatment were subtypes of the abdominolipoplasty system (type 1, suction-assisted lipectomy; type 2, miniabdominoplasty; type 3, modified abdominoplasty; type 4, full abdominoplasty) and included extended liposuction (type 1a); "open" miniabdominoplasty (type 2a); and endoscopically assisted or muscle access abdominoplasty (type 3a). Also included in this series were patients whose procedures were downstaged to a less extensive alternative and cases during which the abdominoplasty incision was used for access for another operation. All procedures resulted in smaller or fewer incisions. Results suggested that the current period (1991-present) is marked by less invasive treatment options, characterized by a preponderance of "closed" techniques (60% vs. 40%: 1986-1991). With the availability of technology to treat muscle and adipose tissue through inconspicuous incisions, judgment regarding the capability of the skin to recontour becomes the overriding physical factor in the decision-making process. The outcomes support the conclusion that minimal-access variations in abdominoplasty are appropriate alternatives, reflecting a philosophical alteration in the approach to patients.

Abdominal Muscles↗
PubMed1995

Superficial suction lipectomy: something old, something new, something borrowed....

Superficial suction lipectomy has been proposed for the treatment of flaccid skin and for irregular-appearing, peau d'orange skin. For the purposes of diagnosis and treatment, this represents two entities for which superficial suction lipectomy is applicable: type A and type B conditions. A series of 20 patients who had contour problems amenable to liposuction and either of these two skin conditions were evaluated concurrently. Results suggested that superficial suction lipectomy is a feasible extension of traditional liposuction using smaller cannulas as the subdermal fat layer is approached. It is likely that it represents an additional tool for specific situations seen in a spectrum of disorders that multiply and overlap with age rather than a replacement for dermolipectomies or a definite treatment for skin textural disorders.

Bandages↗
PubMed1995

Calcitonin gene-related peptide increases microcirculation after mechanically induced ischemia in an experimental island flap.

Vasoconstriction, as a result of mechanical manipulation of blood vessels during microsurgery, may produce a decrease in blood supply and endanger flap viability. A study was undertaken to determine the effects of the topical vasodilator calcitonin gene-related peptide on the microcirculation of flaps after mechanically induced ischemia. A neurovascular island flap based on the superficial epigastric vessels was raised in 42 rats. Blood cell flux in the flap was recorded continuously with a laser Doppler flux meter. The feeding artery was pinched to induce vasospasm, and different concentrations of calcitonin gene-related peptide (10(-7), 10(-8), 10(-9), 10(-10) mol) or a control of sodium chloride 0.9% was applied topically to relieve the ischemia. Results showed that calcitonin gene-related peptide at a concentration of 10(-7) mol significantly shortened the time to reach 50% of the original blood cell flux values (270 +/- 123 seconds) and significantly increased the number of flaps in which the blood cell flux values were restored to prestress levels within 30 minutes. The data support the conclusion that, in this model, topical calcitonin gene-related peptide at the concentration of 10(-7) mol was effective in promoting recovery of the microcirculation after mechanically induced ischemia, without the adverse effects associated with other commonly used vasodilators.

Animals↗
PubMed1995

Endoscopic surgical correction of glabellar creases.

BACKGROUND: A number of alternatives exist for the temporary correction of glabellar creases and frown lines. The traditional "open" operative procedure has often involved a large incision to gain access to the depressor muscles that are responsible for the deformity. While useful for patients with multiple or more significant deformities, patients with isolated glabellar creases and frown lines have been reluctant to consider an extensive surgical procedure, with its attendant morbidity, for an isolated problem. OBJECTIVE: The purpose of this report is to describe a new technique of endoscopic corrugator muscle resection, without the need for the traditional lengthy scalp incision. METHODS: Traditional criteria for patient selection was employed. A series of 10 consecutive patients with vertical mid-forehead glabellar-eyebrow frown lines were treated by endoscopic corrugator muscle resection and evaluated. RESULTS: The procedure was efficacious in reducing the frown-muscle complex prominence and rhytids in the mid-forehead area. Circumstances of heavy folds, hyperactive muscle function, or premature furrows in patients with good skin tone appear to be most suitable for this technique. CONCLUSION: With the introduction of a more acceptable, less problematic surgical solution, deformities in the forehead-eyebrow area can be readily addressed surgically. The procedure is a cost-effective alternative to temporary techniques improving aesthetic problems in the forehead-eyebrow area.

Adult↗
PubMed1995

Liposuction as an adjunct to a full abdominoplasty.

The safety and locations for liposuction over the aesthetic unit of the abdomen in situations where a full (type IV) abdominoplasty was combined with liposuction were studied. The locations were determined based on the axial- and random-pattern blood supplies of the anterior abdominal wall. By using these areas and technical guidelines to enhance success, the combined procedures were undertaken in a consecutive series of patients. The efficacy of the procedures was assessed by patient acceptance and by the difference in the incidence of complications from an abdominoplasty alone group. The complication rates of the two groups were found to be similar, although it was ascertained that medically higher-risk situations, smoke exposure, and disregard for interacting vascular territories were detrimental to combined surgery. In addition, four suction areas (SA 1-4) were delineated, and the results suggested that certain areas are more reliable than others, that each suction area interacts with and affects neighboring areas, and that these are germane in preoperative planning. A risk-profile classification was established, and this proved beneficial for initial patient screening.

Abdomen↗
PubMed1994

Forehead-brow rhytidoplasty: reassessing the goals.

Forehead-eyebrow rhytidoplasty traditionally has been advocated for senile brow ptosis. As the procedure became more widely accepted, it became a routine consideration in facial rejuvenation surgery. Indeed, over time, forehead-eyebrow rhytidoplasty also has withstood the initial criticism that was lodged against it of limited longevity, and it is realized that as with all other lifting procedures, it will gradually succumb to time, gravity, and the aging process. Moreover, refinements in techniques have added versatility to the procedure so that a variety of problems encountered in the upper face in addition to brow ptosis can be addressed. Consequently, an eclectic population with a range of deformities benefits from the procedure. Recently, though, it has seemed that the pendulum is swinging back, and that some surgeons are hesitating to incorporate forehead surgery because patients are voicing dissatisfaction with it. In order to assess the goals and indications for surgery, we reviewed a series of 350 patients who had a variety of aesthetic complaints in the upper face. Traditionally, patients' "other" indications for surgery, exclusive of brow ptosis, have been referred to as secondary (minor) indications. Now, with closer scrutiny, it appears that such problems, including forehead rhytids, frown muscle imbalance, upper eyelid aesthetics, lateral temporal laxity, and an abnormal expression, as a newly defined group, may actually be more frequent reasons than brow ptosis alone for performing a forehead-brow rhytidoplasty. As evaluated by the authors and supported by independent reviewers, low brow position alone should now account for less than half the forehead-brow surgery candidates. Furthermore, it is recognized that in considering the benefits achieved for patients with brow ptosis, often the results were due to "ancillary" surgical maneuvers routinely employed for the secondary indications. On balance, surgeons are advised to avoid adhering to traditional formulas for skin excision/brow elevation when operating on the brow; these can ultimately be the source of unsatisfactory outcomes. We believe that this philosophy will ultimately account for improved outcomes in forehead surgery. In addition, objective guidelines for the upper face have been reviewed and visual criteria defined which can be used in supplementing established brow spatial relationships for determining the ideal normal criteria for the upper third of the face.

Adult↗