Coronal incision extending postauricularly.
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Biomedical subjects
Publications and source records attributed to R Yavuzer.
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Various measurements are still considered to be important for making decisions regarding the approach in reduction mammaplasty, even though the vast majority of techniques used are based on an inferior pedicle. This study was performed to analyze the variability of the suprasternal notch-to-nipple and nipple-to-inframammary fold distance measurements when using the inferior pedicle technique. In 92 patients, 184 breasts having various volumes were measured preoperatively, and the variability of the measurements of the suprasternal notch-to-nipple and nipple-to-inframammary fold distance was analyzed. The values of the distance from the suprasternal notch to nipple were dispersed over a wide range with a trimodal distribution, with peaks at the intervals of 23 to 27 cm, 28 to 33 cm, and 34 to 45 cm. In contrast, the values of the nipple-to-inframammary fold distance showed a normal distribution pattern, with the peak at 14 cm. The distance from the suprasternal notch to nipple has a fair relationship to the inframammary fold-to-nipple distance, the latter being concentrated in a smaller range (r = 0.51). The former is often used to decide whether a free-nipple graft should be performed. However, the relative consistency of the latter measurement has led to the conclusion that the free-nipple graft technique need never be considered.
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Hypospadias surgery is one of the most challenging surgical interventions that still need further refinements for increased success rates. During the last 5 years, we operated on 26 mid-penile or proximal hypospadias cases by using vascularized double-sided preputial island flap and W flap glanuloplasty to achieve superior functional and aesthetic results. Follow-up period of the patients revealed a 92.3 percent success rate with a single operation. Two cases developed fistula, which was located at the proximal anastomosis site. However, they were repaired in a second sitting without any additional problem. The basic aim in hypospadias surgery is the correction of chordee, reconstruction of urethra, and sufficient ventral penile skin coverage in one stage with minimal complication. The use of vascularized tissue for urethral reconstruction and ventral coverage is believed to have a superior healing capacity with better functional and cosmetic outcome. On the other hand, adding W flap glanuloplasty to this technique avoids the risk of meatal stenosis. We conclude that by combining the two above-mentioned techniques, it is possible to cope better with this devastating congenital deformity.
Reconstruction of the exenterated orbit is a difficult problem with several advantages and disadvantages. Satisfactory reconstructive results for both the physician and the patient may need multistage operations that are time consuming and disfiguring. A simple and effective one-stage technique that combines two regional flaps is described for reconstruction of deformities of orbital exenteration. A temporalis muscle flap is transposed for orbital filling, and a prefabricated frontal island flap based on superficial temporal vessels is used for eye socket and eyelid reconstruction. For patients who oppose living with exenteration deformity and request quicker reconstruction, this new and simple technique may be used successfully.
The combination of chemical peeling and dermabrasion for the improvement of facial wrinkles, acne, posttraumatic scars, and abnormal pigmentation was first described by Dupont in 1972 and Horton in 1984. We have been using the combined technique since 1972, and we have obtained more satisfying results than by using these techniques independently. The purpose of this paper is to summarize the results obtained using the combined technique of chemical peeling and dermabrasion and to emphasize a simple method of postoperative care that can be applied after any physical or chemical rejuvenation technique. Whereas the combined technique takes advantage of depth-controlled surgery, less bleeding, less postoperative pain, less risk of local and systemic complications, and longer lasting results, the covering of the wound with one layer of fine mesh gauze is another advantage that provides easy postoperative care.
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A polydactyly anomaly of the thumb with three nails, two metacarpals, and seven phalanges is presented. This anomaly is named triplicated thumb, and its place in Wassel's classification is discussed. The patient was treated according to the principles of surgery of polydactyly anomalies. Good motor function with acceptable aesthetic appearance was obtained.
Although, one out of every eight women has a risk of developing breast cancer, the reported incidence of breast carcinoma detection in reduction mammaplasty materials is rather low. To our knowledge, specimen radiography, which is used for breast biopsies has not been used for the assessment of breast reduction materials. We investigated the applicability of specimen radiography and its potential benefits in detection of the breast pathologies, especially malignancies in reduction mammaplasty materials. Forty patients scheduled for reduction mammaplasty operation were included. In all cases an inferior pedicle reduction technique was preferred and the radiographs of the resected breast tissues were taken immediately. The radiographs were evaluated for any possible pathologic appearance and all abnormal findings were marked. For the histopathologic evaluation, in addition to the random sampling of the pathologist, any marked areas were also microscopically examined. In two cases fibrocystic changes were found in radiographs and the same results were obtained in the histological examination. No false negative mammogram was seen. Specimen radiography, which is applicable for breast reduction materials is an easy and cheap method and does not cause any patient discomfort. It seems that the radiographs of reduction mammaplasty materials are useful to provide guidance to the pathologist during tissue sampling for microscopic examination especially when large amounts of breast tissue is excised.
Dermatofibrosarcoma protuberans is a rare soft tissue cancer of the skin with the potential for intermediate malignity, characterized by local invasion and recurrence. Presenting with local atrophic and sometimes erythematous plaques, these lesions are best treated with surgery in which large excisions are necessary to reduce the risk of recurrence and to prevent rarely seen metastases. We report on a 26-year-old female patient with dermatofibrosarcoma protuberans on her breast, an very unusual site. As a novel surgical approach to treat the patient's tumor, a keyhole pattern was used, allowing wide safety margins during resection, while preserving the cosmetic appearance of the breast.