Re: The use of expanded polytetrafluoroethylene as a permanent filler and enhancer: an early report of experience.
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Biomedical subjects
Publications and source records attributed to T R Vecchione.
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The direct excision of glabellar frown lines is a method that is not new, but neither has it been well evaluated. This paper describes the method, discusses the reason for the problem, and suggests why this method should have long-lasting results. Several examples of the scars are demonstrated. In selected patients, this may be a reasonable alternative to the myriad surgical possibilities in our quest for a solution to this problem.
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A method of tattoo removal using a precise partial thickness tangential excision of foreign body and dermis followed by dermal overgrafting with thin, split-thickness skin grafts is presented.
It has been proposed that scleroderma in particular or connective-tissue diseases in general may be caused by exposure to silicone-containing materials used for breast augmentation. We performed a historical cohort study to estimate the point prevalence of this potential complication sometimes referred to as "human adjuvant disease." Three-hundred and seventy-eight patients who underwent augmentation mammaplasty with silicone-containing envelope-type prostheses from 1970 through 1981 were surveyed. Regional musculoskeletal syndromes, fibrositis, or osteoarthritis occurred in a third (38 of 125) of our responders. No patient developed an inflammatory systemic rheumatic disease during the period of observation (mean 6.8 years for the 125 subjects). Using calculations based on risk for development of rheumatic disease, it does not appear likely that augmentation mammaplasty is a significant or major inducer of inflammatory connective-tissue diseases in general. However, the number of patients surveyed was small, and our results must be considered preliminary. We could not exclude a specific risk for the development of scleroderma.
This article describes the treatment of the late effects of oral commissure scarring, especially after electrical cord injuries. The combination of mucosal advancement flaps plus split vermilion grafts and full-thickness preauricular skin grafts are used and illustrated in two patients. These methods have yielded satisfactory results in six patients.
A simple method of creating nipple projection in flattened nipple-areola complexes is presented. The results required, on average, 14 months of follow-up, with very good projection and general appearance in all patients. This technique eliminates the unnecessary surgical gymnastics of other methods when obtaining nipple projection.
An operation is described for the correction of the unilateral cleft lip nose when there is a deficiency of alar tissue with superior displacement of the alar maxillary junction. This method uses a full-thickness graft from the contralateral alar crease.
Five patients who developed calcification of the capsule following augmentation mammaplasty are described. This long-term complication may be encountered with increasing frequency and should be considered in evaluating women with solid, firm, constructed capsules.
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A method of approaching the separated, granular temporal scalp wound in a rhytidectomy patient is presented. The time-honored principles of wound healing are discussed with reference to the first skin graft described.
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Palatal mucosal grafts are used to provide bulk and improve the contour of lip defects. Since the palatal grafts are markedly different in color, they must be placed behind the wet-dry mucosal line so that they cannot be easily seen at conversational distances. The contrast with the red vermilion is too great for this graft to be used as a cosmetic lip substitute, but when the graft is used as a living tissue expander in the posterior position, it improves subtle lip contours.
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