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At least 19 recordsLinked to original sources
PubMed2002

Cervicoplasty and facial laser resurfacing: a paired technique for facial rejuvenation.

OBJECTIVE: A specific group of patients interested in facial rejuvenation was identified in a plastic surgery practice. These patients were primarily concerned with improving their neck contour and correcting their facial rhytides. To address those problems a one-stage paired technique was designed - cervicoplasty with full-face laser resurfacing. MATERIALS AND METHODS: Thirteen patients were treated with this procedure during a 1 year period. RESULTS: The patients experienced no significant complications and were extremely satisfied with their results. A retrospective study of 206 patients over the same year period revealed that the group undergoing the combination procedure: 1) was identifiable by the ranking of their specific aesthetic concerns; 2) was averse to undergoing a full facelift; and 3) comprised a significant percentage (22%) of surgical patients in the study period. CONCLUSIONS: Combining cervicoplasty with full-face laser resurfacing is a safe, effective procedure that provides another option in the realm of facial rejuvenation.

Aged↗
PubMed2002

Use of free thin anterolateral thigh flaps combined with cervicoplasty for reconstruction of postburn anterior cervical contractures.

Free thin anterolateral thigh flaps combined with cervicoplasty were used in a series of seven patients undergoing reconstruction for previous burn injury from September of 2000 to May of 2001 at Chang Gung Memorial Hospital. This method uses a suprafascial dissection technique to provide a thin flap to improve cervical contour. Neck contractures had resulted from flame burns in six patients and from a chemical burn in one patient. The mean age was 32.7 years (range, 22 to 45 years). The size of excised scar ranged from 10 x 2 cm to 26 x 5 cm (mean, 19.7 x 3.3 cm). The size of flaps ranged from 11 x 5 cm to 26 x 8 cm (mean, 21.3 x 6.5 cm). Average operative time was 6 hours. Average hospital stay was 10 days. All flaps survived, with one flap sustaining partial marginal loss. The donor site was closed primarily in five cases and by using a split-thickness skin graft in two cases. At a mean follow-up time of 5 months, the functional improvement was measured as follows: a mean increase in extension of 30 degrees (preoperatively, 95 degrees; postoperatively, 125 degrees), a mean increase in rotation of 18 degrees (preoperatively, 59 degrees; postoperatively, 77 degrees), and a mean increase in lateral flexion of 12.5 degrees (preoperatively, 26.5 degrees; postoperatively, 39 degrees). The average cervicomandibular angle was improved by 25 degrees (preoperatively, 145 degrees; postoperatively, 120 degrees). This series demonstrates that the use of free thin anterolateral thigh flaps combined with cervicoplasty provides a one-stage reconstruction with a thin, pliable flap that achieves good cervical contour with low donor-site morbidity.

Adult↗
PubMed1997

Preliminary results of muscle cuff cervicoplasty in the ewe for the treatment of urinary incontinence.

OBJECTIVE: Muscle cuff cervicoplasty consists of dissecting a strip of the superior slip of the levator ani muscle, by sectioning it flush with the symphysis pubis, and applying it like a cuff around the urethra below the bladder neck. METHODS: We conducted a preliminary study in 12 ewes, including preoperative urodynamic assessment, intravenous urography with retrograde cystography on day 15, and another urodynamic assessment 1 and 3 months after the operation. Two animals died, but the other 10 animals were able to be evaluated. An increase in the urethral functional length with an infracervical plateau was revealed on all postoperative urethral profiles. Only transrectal electrostimulation, performed on the last 5 ewes, demonstrated an elevation of the closure pressure by 5-10 cm H2O. At sacrifice of the animals at 4 months, in situ stimulation of the muscle strip induced muscle contraction in 7 of 10 cases. Histological examination demonstrated persistence of muscle fibers in the cuff, despite the presence of marked fibrosis. RESULTS: The preliminary results are encouraging: urinary continence was improved with a minimal risk of retention, and cervicoplasty appears to retain its contractile activity, suggesting the possibility of a long-term sphincteric and proprioceptive action. CONCLUSION: This technique could be proposed in women suffering from urinary stress incontinence with sphincter hypoactivity.

Animals↗
PubMed2002

Combined method of free lateral leg perforator flap with cervicoplasty for reconstruction of anterior cervical scar contractures: a new flap.

Anterior cervical scar contracture remains a challenging problem for the plastic surgeon. Recent advances in flap techniques have made it possible to transfer various kinds of autogenous tissue. A free lateral leg perforator flap (LLPF) was first introduced and developed to reconstruct this burn deformity, according to the special nature of perforator anatomy. The authors used this flap to resurface post-burn anterior cervical contracture in a 31-year-old female patient with second-to-third-degree flame burns. The size of the excised scar was 25 x 5.5 cm; the size of the flap was 22 x 8 cm, with total flap survival. The hospital stay was 9 days, and the donor site was covered with a split-thickness skin graft. After a 5-month follow-up, functional improvement was evaluated by an increase in extension of 33 degrees (preoperative 92 to postoperative 125 degrees); an increase in rotation of 15 degrees (preoperative 70 to postoperative 85 degrees); and an increase in lateral flexion of 10 degrees (preoperative 35 to postoperative 45 degrees). The cervicomandibular angle was improved by 20 degrees (preoperative 110 degrees to postoperative 90 degrees). Both functional and aesthetic results, including contour restoration, can be achieved, using this kind of perforator flap combined with cervicoplasty.

Adult↗
PubMed2000

Anterior cervicoplasty in the male patient.

Most men develop visible redundant tissue in the anterior neck with aging. Some seek surgical improvement. If the patient does not wish to have a conventional face/neck lift, anterior cervicoplasty is a good option. The procedure accomplishes tightening in the horizontal direction by excising a midline vertical ellipse of skin and subcutaneous fat. The surgeon tightens and lengthens the platysma muscles by suturing the anterior borders of the muscle to each other and by performing one or more Z-plasties in the muscle. A Z-plasty in the skin and subcutaneous tissue predictably creates a mental/cervical crease or angle with precise planning of the location of the horizontal limb. It also provides added length to the vertical skill closure. Every patient has thought that the improved contour of his neck more than offset the presence of a visible scar. In fact, no patient has indicated that his scar has been noticed by others, nor has any patient requested scar revision.

Aged↗
PubMed1996

[Experimental cervicoplasty: correction of the cervicomental angle by postero-superior suspension of the hyoid bone. A study of 20 anatomical dissections].

The elegance of the cervical region is due to a certain balance between concave and convex surfaces, and is based on the presence of a well-defined cervicomental angle, generally between 90 degrees to 110 degrees. An excessively wide-open cervicomental angle makes the cervical profile inelegant. Numerous surgical techniques can improve this angle. There is however a certain limit to this correction: an excessively caudal and anterior hyoid bone. In this case the last proposal is a modification of the hyoid bone position in order to replace it in a backward and upper location. To achieve this goal we studied postero-superior suspension of the hyoid bone by plication of the tendon of the digastric muscle in 20 anatomic dissection. Each an dissection was controlled by x-ray of the profile of the cervical region before and after application of this technique. Cephalometric measures were performed and statistically analysed using the "Paired t-test" on Statview II. Analysis of the results after the plication of the tendon of the digastric muscle, demonstrated an average closing of the cervicomental angle of 25.6 degrees with an average ascent of the hyoid bone of 13.27 millimeters and an average posterior transposition of 3.75 millimeters. This experimental cervicoplasty appears to be feasible. A precise surgical technique has been developed with an easy approach to the digastric tendon during standart faced lift procedures. The effect of the compression generated on the pharyngo-oesophageal complex by posterior transposition of the hyoid bone is unknown. This problem is now under investigation.

Cephalometry↗
PubMed2001

Anterior cervicoplasty.

Explore the source record for details and available documents.

Dermatologic Surgical Procedures↗
PubMed1997

Cervicoplasty: nonexcisional anterior approach.

The purpose of this paper is to demonstrate a technique of cevicoplasty by means of a submental incision exclusively, without removal of skin. This technique is indicated in patients with good-quality skin that has adequate capacity for contraction and redraping. The neck is approached by means of a 3- to 4-cm incision posterior to the submental crease. A thick subcutaneous flap is developed. Initial "open" dissection is continued with dissection using the endoscope. All the fat over the platysma muscle is dissected off. The dissection follows a triangle outlined by the sternocleidomastoid muscles. An insulated suction coagulator is used for hemostasis. Conservative defatting of the subcutaneous layer is done, and no suction lipectomy is used routinely. However, all the fat pad between the platysma borders and the fat pad between the mylohyoid and the digastric muscles are removed. The digastric muscles are either "shaved off" or plicated in the midline with 3-0 nylon sutures. This provides a smooth and flat contour to the submental area. Subplatysmal dissection beyond the submaxillary salivary gland is done with the aid of the endoscope. After a trial of advancement, the medial borders of the platysma are resected, and plication in the midline is performed from the level of the thyroid cartilage to the symphysis of the mandible. In most cases, a backcut on the platysma from the thyroid cartilage level in an oblique direction for about 3 to 4 cm is done to avoid secondary lateral platysma bands. If no good definition on the submental angle is obtained, an interlocked suture suspension with anchoring to the mastoid fascia is performed. The relative value of this maneuver will be discussed. The skin is allowed to redrape. Usually, after medial advancement of the platysma, an additional platysma-skin separation is needed in some segments to allow smooth contour on the surface of the skin. The suture suspension may leave minimal rippling laterally. This usually disappears in a few days. The technique described has been used for several years as an isolated procedure or as a part of a full endoscopic face lift without skin excisions. If used in the right patient, the result is comparable with that of the open excisional approach and has a high rate of satisfaction. The long-term durability remains to be seen.

Adult↗
PubMed2001

Comprehensive approach to rejuvenation of the neck.

A comprehensive rejuvenation of the neck depends on accurate analysis of the lower face and neck with attention to the contours and deep-lying structures. Although many surgeons address the well-recognized changes in skin and soft tissue that occur with aging, we believe bone resorption is also an important component. Loss of bone volume leads to loss of support for the soft tissues of the face. The result is soft tissue ptosis and loss of angularity between the various planes of the face. Initially, there is loss of the submental shadow and loss of height of the mandibular ramus. The gonial angle loses its prominence, and the chin becomes ptotic. The line of the body of the mandible is further obscured by the appearance of jowls. As the mandible shrinks, the submandibular gland as well as the muscles that make up the floor of the mouth are pushed inferiorly. For loss of bone support, implants tailored to the areas of deficit and to the aesthetic goals are used. These implants used for the mandible are tridimensional structures made from beaded polyethylene material. This restores the bone volume and provides good support for the soft tissues. We routinely perform a deep-layer cervicoplasty. This involves removing fat from the subplatysmal layer and between the anterior bellies of the digastric muscles. The digastric muscles are plicated toward the midline. The platysma muscle is separated from the underlying submandibular gland. Ptosis of the submandibular gland is treated by suspension of the fascia with sutures or imbrication of the overlying muscle. A short corset platysmaplasty brings the platysma muscles to the midline. Above the level of the hyoid bone, the digastric muscles are included in the sutures. If the patient has an obtuse cervicomental angle, but good-quality skin, there may be no need to perform skin resection. In these patients who are candidates for nonexcisional cervicoplasty, we routinely place a neck suspension suture. Patients with poor skin quality or excessive skin on the neck and jawline will require an excisional cervicoplasty or cervicofacial rhytidectomy. We have obtained consistently good results using this comprehensive approach.

Chin↗
PubMed1997

Female epispadias.

PURPOSE: We assessed the incidence, anatomical features and treatment of female epispadias. MATERIALS AND METHODS: We studied 10 patients followed from 1 to 18 years. Four were operated on in 2 stages: first, cervicoplasty with original technique, and second, reconstruction of genitalia and distal urethra. Two had only a cervicoplasty. The last 4 patients were operated on in 1 stage according to Hendren's technique but with a simplified cervicoplasty. RESULTS: Eight of 10 patients are totally continent, 1 has some small nocturnal leakage, and 1 is incontinent but the interval of dryness is increasing and is longer than 1 hour. Concerning external genitalia, the result is good but not perfect. CONCLUSIONS: Female epispadias is most often complete with total incontinence. The aim of treatment is to reconstruct the anatomy in 1 stage. Treatment is easier and the results are better than in cases of female exstrophy or male incontinent epispadias.

Adolescent↗
PubMedDate not supplied

Optimising results from minimal access cranial suspension lifting (MACS-lift).

Between November 1999 and February 2005, 450 minimal access cranial suspension (MACS) lifts were performed. Starting with the idea of suspension for sagging soft tissues using permanent purse-string sutures, a new comprehensive approach to facial rejuvenation was developed in which the vertical vector appeared to be essential. The neck is corrected by extended submental liposuction and strong vertical traction on the lateral part of the platysma by means of a first vertical purse-string suture. The volume of the jowls and the cheeks is repositioned in a cranial direction with a second, slightly oblique purse-string suture. The descent of the midface is corrected by suspending the malar fat pad in a nearly vertical direction. In 23 cases (5.1%), the result in the neck was unsatisfactory, and additional work had to be done secondarily, or in later cases, primarily. The problem that appeared was unsatisfactory correction of platysmal bands (resolved with an additional anterior cervicoplasty) or vertical skin folds that appeared in the infralobular region (corrected with an additional posterior cervicoplasty). This article describes two ancillary procedures that, although not frequently necessary, can optimise the result of MACS lifting.

Adipose Tissue↗
PubMed2003

Vesicouterine fistula and blind vagina.

A case of vesicouterine fistula with blind vagina following cesarean section for obstructed labor is presented. It was surgically treated by fistulectomy, cervicoplasty and maintenance of bladder and cervical patency by catheterization. Intrauterine synechiae formation was prevented by copper T insertion and oral contraceptive pills. The patient is making uneventful asymptomatic progress planning to conceive.

Adult↗
PubMedDate not supplied

Subperiosteal minimally invasive laser endoscopic rhytidectomy: the SMILE facelift.

Current concepts of total facial rejuvenation involve a comprehensive integrated approach to achieve a balanced youthful appearance. Recently introduced endoscopic-assisted techniques allow us to rejuvenate the face through small, remote incisions. Previously, we have considered only young patients with good skin turgor as candidates for minimally invasive procedures, but the advent of the resurfacing laser has allowed us to expand our indications for single stage minimal access rejuvenation. Full facial immediate laser resurfacing at the time of standard rhytidectomy has been avoided due to risk of flap necrosis. Subperiosteal minimally invasive endoscopic assisted techniques do not substantially interfere with facial blood supply. We can now perform endoscopic-assisted full facelifts combined with immediate laser resurfacing to reposition the tissues in a more youthful position and then tighten the skin envelope. Extended endoscopic-assisted subperiosteal forehead lift is performed through three to five scalp incisions; subperiosteal midface lift is performed through a crow's foot or intraoral incision. Cervicoplasty, if needed, is performed through a small submental incision. Full face laser resurfacing is done using a Coherent Ultrapulse laser. To date we have performed eleven subperiosteal minimally invasive laser endoscopic (SMILE) rhytidectomies. There has been no evidence of flap necrosis with this technique. Postoperative recovery has been no different from patients treated only by full face resurfacing, except perhaps for the slight increase in early facial edema. We believe the SMILE facelift is a viable alternative to standard techniques. The limitations of this procedure still need to be elucidated.

Adult↗
PubMed2005

Abdominal surgical approach to a case of complete cervical and partial vaginal agenesis.

OBJECTIVE: To construct a uterovaginal canal in a patient with a complete cervical agenesis and partial vaginal agenesis. DESIGN: Case report. SETTING: Zeynep Kamil Women's and Children Hospital. PATIENT(S): A 15-year-old woman presented with lower abdominal pain. On examination, partial vaginal agenesis with a 4-cm vagina was noted. A pelvic ultrasonography revealed hematometra and the absence of a cervix. INTERVENTION(S): Surgical therapy included creation of an ostium by making 1.5-cm midline vertical hysterotomy incision, trimming away the fibrous tissue at the distal portion of uterus, and attaching the proximal end of the vagina to the uterus by the abdominal route. A stent was left in place for 2 weeks. MAIN OUTCOME MEASURE(S): Pelvic ultrasonography and clinical follow-up evaluation. RESULT(S): Regular menstrual periods were observed for 6 months beginning at the first month. The follow-up pelvic ultrasonography was normal. CONCLUSION(S): Cervicoplasty attaching the mucosal lining of the endometrium to that of the vagina permits the creation of a patent cervical canal with short stenting time.

Abdomen↗
PubMed2005

Amniotic membrane for cervical reconstruction.

OBJECTIVE: To evaluate the use of amniotic membrane grafts in cases of vaginal and cervical agenesis. METHODS: Five girls with complete cervical and vaginal agenesis underwent cervicoplasty and vaginoplasty using amniotic membrane grafts. RESULT: Excellent epithelization and patency of cervix and vagina was achieved in all cases. CONCLUSION: Amniotic membrane may be used as an allograft in cervical reconstruction. It is inexpensive, readily available, of low antigenicity and does not necessitate repeated cervical dilatation. The performance of the reconstructed cervix during labor is yet to be observed. To the author's knowledge, this is the first series reported in the literature in which amniotic membrane was used for cervical reconstruction.

Adolescent↗