Core Procedures in Plastic Surgery

Extensor tendon injuries

Synopsis ▪ A thorough understanding of the complex anatomy is crucial for successful treatment of extensor tendon injuries. ▪ Injuries are classified into nine anatomic zones. Treatment strategies vary considerably according to the location of the lesion, ranging from splinting…

Tendon transfers in the upper extremity

Synopsis ■ Tendon transfers in the upper limb are indicated to restore function to paralyzed muscle and tendon following nerve injury, direct muscle, or tendon injury, and to restore balance to hands affected by neurological disease. ■ In selecting donor…

Nerve transfers

Synopsis ■ Nerve injuries are often devastating, with associated pain and impaired function. ■ Motor nerve injuries must be managed expeditiously, because regenerating axons must reach target muscle prior to degeneration and fibrosis – “time is muscle”. ■ Nerve transfers…

Flexor tendon injury and reconstruction

Synopsis ■ Tendons transmit forces generated by muscles to move joints or to create action power. Flexor tendon injuries are common, but recovery of satisfactory function, particularly after injuries within the digital sheath, is sometimes difficult. Lacerated flexor tendons should…

Examination of the upper extremity

Synopsis ▪ Physical examination of the upper extremity starts with a detailed and accurate patient history. ▪ Physical examination of the upper extremity consists of inspection; palpation; measurement of length, girth, and ranges of motion; assessment of stability; and detailed…

Essential anatomy of the upper extremity

Synopsis ▪ The hand is an incredibly designed structure with complex anatomy and precise biomechanics. The hand must be able to produce adequate force to allow performance of activities of daily living. Furthermore, it must ensure coordination of the fingers…

Autologous breast reconstruction using abdominal flaps

Synopsis Pedicled TRAM ▪ The pedicled transverse rectus abdominis (TRAM) flap is still the most popular way of transferring abdominal tissue to the breast. ▪ This technique, introduced by Dr. Carl Hartrampf, is consistently successful if it is performed properly.…

Implant-based breast reconstruction

Synopsis Implant-based reconstruction ▪ Alloplastic breast reconstruction is the most common approach used today for postmastectomy breast reconstruction. ▪ Traditional breast implant reconstruction is performed as a planned two-stage procedure with the use of a tissue expander followed by exchange…

Reduction mammaplasty and gynecomastia

Synopsis ▪ Macromastia, or mammary hypertrophy, is a disease process which can result in physical and psychological symptoms. ▪ Macromastia symptoms rarely improve without surgical intervention, which typically results in significant improvement in the patient's quality of life. ▪ Reduction…

Mastopexy and augmentation mastopexy

Synopsis ■ Mastopexy ■ Breast ptosis presents in many forms and can be congenital in nature or acquired due to causes such as aging, weight changes, and pregnancy. ■ Patients with ptosis generally desire the same result – youthful and…