Plastic Surgery: Principles and Practice

Radiation Therapy and Soft Tissue Response

Radiation Principles Radiotherapy is the medical use of ionizing radiation, generally as part of cancer treatment to control or kill malignant cells. Ionizing radiation is composed of particles that individually carry enough kinetic energy to liberate an electron from an…

Vascularized Composite Allotransplantation

“Losses must be replaced in kind.” Sir Harold Gillies Historical Background Advances in regenerative medicine have opened a new era and enabled reconstruction of devastating soft and bony tissue defects due to trauma, congenital deformities, and neoplastic conditions. Among the…

Atypical Skin Lesions

Introduction The atypical skin lesions are a diverse group of tumors that are uncommon but clinically important. They include a spectrum from benign lesions through to those that demonstrate local invasion and/or distant metastatic potential. Since these lesions are only…

Nonmelanoma Skin Cancer

Introduction Nonmelanoma skin cancer (NMSC) is the most common malignancy amongst Caucasians and occurs sporadically in all other populations. NMSCs are comprised predominantly of basal cell (BCC) and squamous cell (SCC) carcinoma, among other rarer types of cutaneous malignancy. UV…

Melanoma

Epidemiology Over the past four decades, melanoma has shown a consistent increase in incidence in white populations, becoming one of the most frequent cancers in light skin populations. The incidence rate of this disease varies widely in relation to race,…

Tissue Engineering

Introduction The reconstructive options for today’s plastic surgeons are unprecedented in history. Despite this reality, the ideal reconstruction for many patients and defect types does not yet exist. The traditional paradigm of plastic surgery has centered around re-purposing existing tissues…

Tissue Expansion

Background The process of tissue expansion in reconstructive surgery was first reported by Charles Neumann, who described its application for auricular soft tissue reconstruction in 1957. Neumann simply applied concepts found in both normal physiological as well as pathological processes…

Lasers

General Principles LASER stands for Light Amplification by the Stimulated Emission of Radiation. Einstein first proposed the concept of stimulated emission in 1927. The first laser was developed in 1959 (ruby), and was first used on human skin in 1963.…

Local Anesthetics

Introduction Local anesthetic agents cause reversible blockade of the neuronal sodium (Na + ) channel, thereby blocking transmission of nerve impulses from nociceptive afferents. Mechanism of Action of Local Anesthetics In the un-ionized state, local anesthetics are varyingly lipid-soluble, thereby…

Biomaterials and Structural Fat Grafting

General Principles Living cells respond to physical and biochemical cues, e.g., hormones, cell–cell signaling molecules, and with the physical environment through the extracellular matrix (ECM), enabling them to adapt to changes in the physiological environment. Regulation of cell function (growth,…