Core Procedures in Plastic Surgery

Breast augmentation

Synopsis ■ Breast augmentation is one of the most commonly performed aesthetic procedures in the United States and abroad. ■ Preoperative assessment should determine the appropriate approach, including choice of implant, breast pocket (submuscular, subfascial, subglandular, subpectoral with dual plane),…

Abdominal wall reconstruction

Synopsis ■ Defects due to failed laparotomy closures, tumor ablation, congenital anomalies, and trauma are the most common indications for abdominal wall reconstruction (AWR). ■ Ventral hernias can be the result of a genetic predisposition in impaired collagen formation or…

Back reconstruction

Synopsis ■ Reconstruction of the soft tissues of the back at first may seem to be a daunting task compounded by large wounds, unfamiliar and segmental anatomy, radiation, hardware, and difficulties with postoperative positioning. ■ Many of the conditions treated…

Chest reconstruction

Synopsis ▪ Rigid chest wall support may be achieved with mesh, acellular dermal matrix, or autogenous material such as tensor fascia lata (TFL). Of these, alloplastic mesh is most prone to infection. ▪ Soft tissue coverage can be achieved with…

Lower extremity reconstruction

Synopsis ■ The reconstructive surgery for the lower extremity has evolved from a staged approach to proving best solutions for functional and cosmetic outcome. ■ This chapter covers the classical approach with a gradual change of principle that advocates a…

Cleft palate

Synopsis ▪ Normal speech is the primary goal of cleft palate repair; minimizing effects of maxillary growth is also important but ultimately secondary. ▪ Cleft palate repair prior to 1 year of age (ideally 9–10 months) results in better speech…

Cleft lip repair

Synopsis Unilateral lip repair Principles of unilateral cleft lip repair ▪ Presurgical nasoalveolar molding. ▪ Modification of surgical techniques. ▪ Mohler rotation incision. ▪ Mucosal flaps for nasal floor reconstruction, correction of mucosal deficiency in piriform area. ▪ Eliminate the…

Local flaps for facial coverage

Synopsis ▪ Always consider the defect when planning a flap. ▪ Assess availability and laxity of local tissue. ▪ Rob Peter to pay Paul but only if Peter can afford it. ▪ Match the flap to the defect, not the…

Facial injuries

Synopsis ▪ The teachings of John Converse, Nicholas Georgiade, and Reed Dingman provided the benchmark for an entire generation of surgeons in facial injury repair. ▪ The treatment concepts discussed in this chapter were developed at the University of Maryland…

Liposuction and fat grafting

Synopsis ■ Incorporation of a diet and exercise program in conjunction with liposuction will allow patients to achieve their optimal shape and contour. Patients who do not adhere to diet and exercise are least happy with their results. ■ A…