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[Surgical treatment of sequelae after facial paralysis].

This review describes some of the principal surgical possibilities in the treatment of established facial palsy of long duration in which the opportunity for nerve reconstruction is lost and no remission can be expected. In such cases, ipsilateral or cross-facial nerve grafting, followed by microneurovascular muscle transfer are the methods of choice for providing controlled and emotional movement of the paralyzed side. Regional muscle transfer is also applicable. For patients who are not candidates for these extensive surgical procedures, symmetry to the face can be restored by one of several static procedures. Lastly, the eye-related problems and their surgical solutions are also addressed. Modern plastic surgery has much to offer this group of patients, who should not be left to live with their ailment, but should be referred to a few national centres for specialised treatment.

Eye Diseases↗

Overview of facial cosmetic surgery.

Dentists routinely refer patients to oral and maxillofacial surgeons for dentoalveolar surgery, however few of these dentists are fully informed as to the full scope of surgical practice. Appropriately trained oral and maxillofacial surgeons may also offer cosmetic facial surgery to their patients under certain circumstances. This paper will provide an overview of cosmetic facial surgery.

Esthetics↗

[Fifty years of plastic surgery in the Netherlands. IX. Reconstructive surgery illustrated by breast reconstruction].

The earliest reports on reconstructive surgery are more than two thousand years old. However, the most significant developments took place in the past four decades. At the beginning of the 21st century we are able to perform reconstructions with a moderate functional and good cosmetic result and limited donor site morbidity. The reconstructive options regarding the mammary region include application of mammary implantation only, and techniques in which autologous tissues are applied, with or without implantations. Autologous tissue is used in transposition of the M. latissimus dorsi, in application of the myocutaneous flap of the M. rectus abdominis ('transverse rectus abdominis myocutaneous flap' (TRAM flap)), which is refined in the 'deep inferior epigastric artery perforator' (DIEP) flap procedure.

Female↗

The deep plane facelift.

The goal of any cosmetic facial plastic surgery procedure is to obtain a natural-appearing result that is not overdone or obviously operated upon. This is the case whether the background of the operating surgeon is in facial plastic and reconstructive surgery, general plastic surgery, dermatology, or oculoplastic surgery. To satisfy this goal, the surgeon must apply those techniques that consistently achieve effective but understated results rather than experimenting with every new innovation or fad. More and more surgeons are moving away from some of the so-called advances of the last decade, including the use of lasers for skin resurfacing and the application of endoscopic approaches to the face, in the search for the best results possible. Sometimes this means utilizing older techniques that have proven the test of time, such as the coronal browlift and chemical peels, whereas other times this means embracing those newer techniques that clearly represent major advances in our specialty, such as the transconjunctival approach to lower lid blepharoplasty. The deep plane facelift is one such advance. In contrast to traditional, skin or short-SMAS flap techniques, the deep plane facelift allows the surgeon to consistently obtain a natural-appearing result that not only addresses the key areas of concern in the aging face but also proves to be longer lasting as well. The deep plane technique also results in fewer complications, an improved ability to address the melolabial region and jowls, and increased anatomic appeal for the operating surgeon.

Facial Muscles↗

Posterior capsulolabral reconstruction in posterior shoulder instability: deltoid saving.

To determine the efficacy of an open posterior capsulolabral reconstruction (PCLR) with a posterior deltoid-saving approach, 30 PCLRs in 29 patients with unidirectional posterior instability were reviewed retrospectively. The mean follow-up period was 30 months (range, 25-59 months). Posterior capsular redundancy was observed in all cases, but a posteroinferior labral tear was found in only 5. Posterior capsular thinning developed in 6 patients. According to the Rowe scale, 24 shoulders were rated as excellent, 1 as good, 2 as fair, and 3 as poor. The modified American Shoulder and Elbow Surgeons score at last follow-up was 91. During follow-up, recurrence of instability was observed in 4 cases, including 3 cases of voluntary instability. The overall recurrence rate was 13.3%, but the success rate was 92.6% when cases of voluntary instability were excluded. Whereas the midterm clinical results of PCLRs were satisfactory, the risk of recurrence was very high in patients with voluntary posterior instability, even though some subjective improvement could be obtained through a PCLR.

Adolescent↗

[The role of plastic surgery in the treatment of cancer and its progress].

Advances in the treatment of cancer have resulted in the long survival of patients afflicted with various types of cancers. Many patients, however, still suffer post-treatment sequelae which frequently prevent patients from returning to a normal life style. Plastic surgery procedures facilitate the immediate coverage of large and complex tissue defects after either radical ablation of cancer or heavy irradiation, the recovery of lost functions and the reconstruction of body contours. The modern techniques of plastic surgery and advance such as musculocutaneous flaps and microsurgical free tissue transfers are introduced.

Breast Neoplasms↗