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Biomedical subjects

U T Hinderer

Publications and source records attributed to U T Hinderer.

At least 19 recordsLinked to original sources
PubMed1992

Erich Lexer's mammaplasty.

A summary of Hans May's biography of Erich Lexer is reproduced, followed by a translation of Lexer's first publication, in Spain in 1921, on the correction of pendular breasts. Lexer's fundamental contributions to mammaplasty are analyzed. This author was the first in the history of mammaplasty to perform breast reduction with an "open" nipple-areola complex transposition, with preservation of the continuity of the skin to the remaining gland. This feature was far ahead of its time, as the techniques based on this concept did not become popular until after 1955. Lexer also was the first to propose subcutaneous mastectomy for treatment of fibrocystic disease, to perform breast augmentation in the ptotic hypoplastic breast with fat flaps, and to use free fat grafts taken from the abdomen or hips for augmentation mammaplasty.

Female↗
PubMed1991

Nasal base, maxillary, and infraorbital implants--alloplastic.

The aesthetic surgery of the facial skeletal contour requires either the performance of ostectomies of excessively prominent segments or the augmentation of retruded segments with organic or synthetic material, in order to achieve balanced tridimensional relations of each segment with regard to the total facial unit. Craniomaxillofacial surgeries are necessary in major malformations or in those combined with malocclusion. In the nasal dorsum or tip, the author prefers the use of cartilage, because synthetic materials need adequate soft-tissue bulk for cover to be inserted without tension and absence of passive mobility of the reception site. For malar augmentation, first proposed by the author and independently by Spadafora in 1971, for chin augmentation up to 8 mm, and for augmentation of the mandibular angle, the author prefers silicone implants because they do not change in shape or volume, may be premanufactured or custom-made, have a similar consistency to that of bone, and do not support bacterial growth. On the other hand, autologous bone grafts adapt less to curved bony surfaces, have an erratic rate of resorption, and need an additional surgical step for removal with the corresponding morbidity and scar. Subperiosteal insertion is preferred because it confers greater stability and the cavity is easier to dissect without soft-tissue damage. Although bone erosion may occur, with over 1200 implants clinically no major change in the soft-tissue contour has been observed, nor has the author been consulted for late complication. In the malar region this may be due to the large surface of the implant and absence of muscular pressure. In the chin, an insertion over the site of the dental roots is avoided. For midface augmentation the following implants are used: (1) The premaxillary lower nasal base implant, proposed in 1971, is indicated to correct a concave midfacial profile, frequent in Asian, black, and Mestizo patients from Latin America and in Caucasian patients with maxillonasal dysplasia or Binder's syndrome, after trauma, with excessive septum and nasal spine resections, and in nasal-maxillary sequels in cleft patients. In case of dental malocclusion, orthognathic surgery is the technique of choice. A prototype implant is available in two sizes, to be inserted through a lateral incision at the base of the columella. In 108 patients two implants have been partially removed. After the first month the patient is usually well adapted to the foreign body.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1990

Dermal and subdermal tissue filling with fetal connective tissue and cartilage, collagen, and silicone: experimental study in the pig compared with clinical results. A new technique of dermis mini-autograft injections.

The early reaction to the injection of silicone, collagen, and lyophilized heterologous fetal connective and cartilage tissues into the limiting zone deep dermis-superficial subcutaneous tissue was histologically examined in the pig and compared with clinical results. The inflammatory reaction to lyophilized heterologous fetal tissue is considerably more intense than that to collagen and silicone and lasts for several weeks. Therefore, it is not recommended for soft tissue filling in the face. Admitting an inferior antigenicity of fetal tissues, the authors suggest that enzymatically denaturalized collagen should be manufactured from heterologous fetal connective tissue, to be then further tested. The reaction of tissue to silicone and collagen is minimal. Silicone is preferred for dermal injections since in clinical experience it remains in the site of injection much longer. For subdermal injections, however, collagen is preferred. Based on experience with over 600 patients since 1958, the first author continues using liquid silicone. The lack of complications is probably a result of the fact that only small amounts (milliliters) of silicone were used in wrinkles or small depressions in the dermal layer and that from the beginning injection into the subcutaneous tissue was avoided. Since 1988 a new technique for the treatment of wrinkles and skin depressions with injections of dermal miniautografts has been used with satisfactory results.

Animals↗
PubMed1989

Reconstruction of the external genitalia in the adrenogenital syndrome by means of a personal one-stage procedure.

The techniques for correction of the external genitalia in the adrenogenital syndrome, as far as known by the author, are reviewed. The goals of repair and timing of surgery are discussed. The author's one-stage technique, first published in 1974, is described with intraoperative illustrations, and the results obtained in nine patients are discussed. The advantages of the technique are preservation of a clitoral glans with erogenous sensation based exclusively on the deep dorsal neurovascular bundle. The glans of the megaloclitoris is obliquely reduced in size at its base toward the ventral surface and by resection of up to two-thirds of the ventral segment. It is relocated at its anatomic female position. The labia minora and the introitus vaginae are reconstructed at the same stage with the skin of the megaloclitoris displaced in posterior direction after a cutback incision. Dispareunia is prevented by total excision of the corpora cavernosa, including the crura.

Adrenal Hyperplasia, Congenital↗
PubMed1987

Otoplasty for prominent ears.

A technique for correction of prominent ears is described. It combines the advantages of simplicity and accuracy and provides satisfactory results. Essential points of the technique are perichondrial cartilage scratching at the superior crus and antihelical fold according to Stenström, mattress sutures applied to the perichondrium and soft tissues at the medial surface, and to these we add the trimming of the tail of the helix, thinning of the antitragus, and a double-spindle skin excision at the medial auricular surface. In patients with insufficient curling of the helical rim ("shell-ear" deformity) the base of the helical arch is scratched at its medial surface.

Child↗
PubMed1987

Otoplasty for lop ears.

The classification of malformations of the auricle is reviewed. Hinderer's technique is described. It is based on long oblique skin and cartilage flaps of the upper pole of the ear, taken in opposite directions for expansion of the helical arch, thus preventing a later visible notching at the helical rim. The remaining scapha is straightened and the superior crus and antihelical fold are formed by scratching and sandpaper abrasion of the lateral surface. A deep concha is treated by a cartilage strip expansion from the posterior conchal wall.

Cartilage↗
PubMed1987

Macrotia.

Techniques for treatment of severe and moderate macrotia and for hypertrophy of the earlobe are described. For macrotia, the excision of cartilage at the scapha, helical arch, and skin are performed at different levels to prevent a notching, mainly at the helix. For hypertrophies of the earlobe, through-and-through excisions of two triangular pieces are used with reinsertion of the remaining earlobe at the base.

Cartilage↗
PubMed1987

The blepharo-periorbitoplasty: anatomical basis.

A new combined subperiosteal-subcutaneous musculo-aponeurotic system and suborbicularis technique is described: the "blepharo-periorbitoplasty." This technique achieves complete mobilization of the forehead and brow, the lower eyelid, the raphe and lateral canthal area, the upper palpebral region, and of the suprazygomatic and infrazygomatic soft tissues, including the cheeks. These soft tissues are displaced upward and moderately backward. If a major lateral upward slant of the palpebral fissure is desired, Hinderer's lateral canthoplasty must be added. The blepharo-periorbitoplasty technique can be combined with a facial-cervical rhytidectomy. The technique is also useful for senile preectropion and postoperative "round eye" conditions with scleral show. The safety has been proven both clinically and in anatomical dissections.

Adult↗
PubMed1986

[Neural risk zones in rhytidectomy].

During the last decades the treatment of the ageing face has evolved from a mere action at the skin level, towards an additional correction of the ptosis of the underlying soft tissues, and procedures involving the bony-cartilaginous framework. Any new rhytidectomy technique with deep undermining should be examined with regard to high risk areas. The areas of risk relate to the branches of the facial nerve and to sensory innervation. These are described on the basis of the current literature, clinical observations and cadaver dissections. The expected improvement in results by the use of techniques with deep dissection compensate for the longer surgery and the increased stress to the patient whenever the risk areas are respected.

Face↗
PubMed1985

An unusual case of gigantomasty.

The authors report an unusual case of gigantomasty, of such proportions that it is believed to be the most striking published case, when the ratio of breast weight/body weight is taken into account (24%). The outstanding breast volume and the aggressive and pronounced growth potential of the breast tissue presented unusual problems which required special solutions. The case is presented from its beginning, when the patient was 12 years old up to the completion of treatment with the patient at adult age.

Breast Diseases↗
PubMed1985

A simple method for enhancing X-ray details.

The authors describe a simple and low-cost process to achieve a bas-relief effect with normal X-rays, allowing observation of fine detail. No additional apparatus is needed and patient exposure is not increased.

Hand↗
PubMed1984

Relationship between the protrusion of the nasal tip and the dorsum in rhinoplasty.

The author discusses the relationship of the nasal tip and its protrusion to the physical contours of the dorsum. This relationship can be positive or negative. He emphasizes the necessity of correcting the tip before any correction of the dorsum, believing that correction of the alar cartilages is the key that determines the amount of hump resection or of lowering of the nasal dorsum, demonstrating his concepts with appropriate case illustrations. The author's technique (1974) of forward projection of the lower nasal base with a transverse silicone implant for patients with a negative tip-dorsum relationship is described.

Female↗
PubMed1984

[Indications and significance of esthetic plastic surgery].

The motivations of aesthetic operations for achievement of a more harmonious appearance or for treatment of the external signs of aging are, besides purely aesthetic reasons, the desire to increase professional opportunities, to better adapt to the social environment or to improve affective relations. Aesthetic surgery has therefore a mainly psychic indication: the aim is to improve the self-esteem, which, on the other hand facilitates the social integration. A responsible execution of aesthetic surgery requires, besides a basic knowledge of psychology and sensitivity for aesthetics, a complete training in general surgery and in reconstructive plastic surgery as well as a continuing education in the aesthetic field. It is therefore not advisable to divide the specialty of plastic surgery. The advancements in both fields have a mutual positive influence and both have to consider function as well as appearance, although with different emphasis. The adequate treatment of eventual complications also requires a basic knowledge in both fields. The intensive advertising made by commercial, so-called "cosmetic clinics" is in contrast to the plastic surgeon's possibilities of public relations, restricted for ethical considerations. Undoubtedly it is not sufficient, at least on a medium-term basis, to achieve better results--in benefit of the patient--unless this is also made known to the public. The necessary information of the public should therefore be taken over or be directed by the National Societies of Plastic Surgery, on an anonymous basis.

Adaptation, Psychological↗
PubMed1983

Treatment of the postoperative inverted nipple with or without asymmetry of the areola.

Postoperative inversion of the nipple is a possible complication in reduction mammoplasty, especially when a tendency toward inversion exists prior to surgery. A technique for correction is presented, leaving no more scars than the peri-areolar scar corresponding to the nipple transposition. Dermal flaps are used to prevent recurrence. Any asymmetry in the location of the areolas or excessively high position can be corrected simultaneously.

Breast↗
PubMed1976

The dermal brassiere mammaplasty.

With most methods, it is possible to obtain a good breast shape as an immediate postoperative result. The question is whether the satisfactory shape is permanent. The 7-year evaluation of the method described here has confirmed the safety of the procedure as well as the satisfactory conic breast shape it achieves. The result has proven to be lasting. The drooping of the gland is prevented by means of the dermopexy with firm fixation of the infra-areolar dermal pillar to the pectoral muscle. The method is indicated even for large hypertrophies as well as in cases of ptotic breasts of normal size and when combined with augmentation by silicone prosthesis for ptotic hypoplastic breasts. The careful pre-operative planning allows control of scar size with satisfactory quality since it is not exposed to undue tension. If these techniques are followed, only minor complications such as the occasional extrusion of a subcutaneous dermal stitch or, seldomly, cyst formation (as in all dermopexy methods), may occur.

Arteries↗
PubMed1975

Malar implants for improvement of the facial appearance.

Esthetic correction of flat malar eminences may contribute to the harmony of facial proportions by making the face more oval and by giving a more youthful appearance. Zygomatic augmentation may also be indicated for the treatment of congenital hypoplasias, asymmetries, or traumatic depressions of the malar region. We have used the procedure in 52 cases since 1964. For augmentation we use a perforated soft, silicone rubber implant. The technique and results are described. The results have been satisfactory, for both the patients and the surgeon.

Bone Transplantation↗