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Biomedical subjects

D A Brandy

Publications and source records attributed to D A Brandy.

31 records · Page 2Linked to original sources
PubMed1992

A new infiltration needle for rapid local anesthesia in retromammary breast augmentation.

In the past, local field block anesthesia for retromammary breast augmentation has usually been performed with spinal needles. In this article, I present an alternative, a cannula-like needle that delivers large amounts of very dilute local anesthetic in an extremely quick fashion for retromammary breast augmentation. Besides being a time-saver, this needle also offers the patient better anesthesia and improved safety. Another advantage is that the retromammary pocket is partially hydrodissected by the large amount of dilute anesthesia delivered, thereby further decreasing intraoperative time. A description of the instrument, its usage, and its pros and cons are given.

Anesthesia, Local↗
PubMed1992

A three step punchgrafting approach.

The author presents a variation of a previously described 3 step hair transplantation approach. Besides reducing a step from the more widely used 4 step approach, this methodology entails developing the hairline with a gradation of 1 and 2 haired micrografts, minigrafts and conventional punch grafts.

Alopecia↗
PubMed1992

Extensive scalp lifting as a reconstructive tool for a large scalp defect.

Extensive scalp lifting is a relatively new technique for the treatment of alopecia. Because this technique involves the undermining of the entire occipitoparietal scalp down to the hairline of the nape, a significant anterior and medial advancement is accomplished with one operation. This case report describes a patient with a large surgically induced scalp defect that was reconstructed with the use of extensive scalp lifting in combination with coronal brow lifting--thus, the intermediate cosmetic deformity of the more commonly used tissue expansion technique was completely circumvented. Why this technique can be substituted for tissue expansion or multiple rotation-transposition flaps in certain cases in elaborated.

Alopecia↗
PubMed1992

A new instrument for the expedient production of minigrafts.

In the past, minigrafts have been made by either quartering 4.5-mm punchgrafts, halving 4.0-mm grafts, or a variety of other similar methods. These techniques notoriously require a prodigious amount of time for harvesting and preparation of the minigrafts. This article presents an instrument and technique that significantly cuts down on both harvesting and preparation time. Besides these important factors, the author has found the shape of these minigrafts to be more similar to the shape of an incisional slit. There has also been noted better healing at the donor site, less wasting of viable hair follicles, and improved control over the number of hairs per minigraft.

Adipose Tissue↗
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↗
PubMed1991

The effectiveness of occipital artery ligations as a priming procedure for extensive scalp-lifting.

Extensive scalp-lifting is a relatively new cosmetic scalp procedure that involves cutting both occipital arteries, which then allows undermining of the entire donor dominant scalp down to the hairline of the nape. Because of this more extensive undermining, dramatic improvements are accomplished even with one operation. Conversely, one can develop necrosis at the nuchal ridge because of a sudden curtailment of circulation in the occipital region. In an attempt to eliminate this complication, the author experimented with "horizontal incision ligations" of the occipital arteries 4 to 8 weeks prior to the surgery which resulted in a significant reduction in the average size of necrosis (from 3.1 cm2 to 1.6 cm2; P = .036) but no significant difference in the incidence (P = .49). When these patients did develop necrosis, it always occurred below the horizontal incisions--therefore, the procedure was changed to vertical incisions, which to date have yielded a significant protective effect when compared with the previous method of "horizontal incision ligations" (P = .014), and even greater significance when compared with the original method of no previous ligations (P = .012). Vertical-incision ligation performed 4 to 8 weeks prior to surgery is an optimal method for preventing the complication of necrosis after extensive scalp-lifting surgery.

Adult↗
PubMed1987

Conventional grafting combined with minigrafting: a new approach.

Using a combination of 4.0-mm conventional Orentreich punch grafts and minigrafts, the author describes a methodology to achieve a very uniform, untufted look which is usually the end result of conventional grafting alone. Advantages and disadvantages are detailed.

Alopecia↗
PubMed1986

The bilateral occipito-parietal flap.

The "bilateral occipito-parietal flap" is a technique whereby the entire occipito-parietal, donor dominant scalp is undermined past the galeal attachment and advanced forward into the balding areas. Use of this method for the treatment of bitemporal recessions and type 6 male pattern baldness is discussed in detail.

Alopecia↗