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…
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…
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.…
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…
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,…
Introduction Flap surgery is the commonest procedure in plastic surgery and is the essence of the discipline. Critical to its success is a sound understanding of soft tissue’s blood supply, its compliance, and its mobility. As all flaps “rob Peter…
Skin Structure and Function The integument comprises the skin together with its appendages ( Figs. 1.1 and 1.2 ). These include hair and hair follicles, sebaceous and sweat glands, and nails. The skin covers the entire body and is the…
Introduction Breast Conservation Increased compliance with breast cancer screening guidelines, as well as advancements in imaging technology, have led to earlier detection of breast cancer. Currently, the majority of breast cancers are diagnosed at earlier clinical stages. This should eliminate…
Introduction The surgical treatment of breast cancer has undergone a paradigm shift and evolved from the Halsted radical mastectomy to the simple mastectomy and now includes breast conservation therapy (BCT). BCT is defined as local excision of the primary tumor…
In this chapter, we will lay out the rationale for screening mammograms to start at age 40 and continued annually until age 70, at which time biannual imaging should be performed until life expectancy is less than 5 years, or…