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Correction of Poland Syndrome Breast Deformity

Introduction Poland syndrome is a complex malformation syndrome and was first described by Alfred Poland in 1841 and in French literature by Lallemand in 1826. The diagnosis is clinical and the malformations are not life-threatening. The impact is mostly psycho-social and the malformations become more visible at puberty when the growing process is accelerated. The functional impact is minimal, even in hypoplasia or agenesis of several…

Nipple-Sparing Mastectomy

Introduction Nipple-sparing mastectomy (NSM) is the most recent advancement in the surgical management of breast cancer, allowing for complete preservation of the nipple–areola complex along with the breast skin envelope. Initially, NSM was largely limited to utilization in prophylactic cases. As experience with this technique has grown, oncologic safety has been demonstrated as comparable to skin-sparing and total mastectomy. As such, indications for NSM have expanded…

Nipple–Areola Complex Reconstruction

Introduction Nipple–areola complex (NAC) reconstruction can be an important part of breast reconstruction and will definitely add an aesthetic component of breast reconstruction. Without NAC reconstruction, it usually gives the impression that the breast reconstruction has not been completed. Therefore, NAC reconstruction can be an important component of breast reconstruction and should be considered an important part of any type of breast reconstruction. Although a number…

Fat Grafting as an Adjunct Procedure in Breast Reconstruction

Introduction Autologous fat grafting to the breast is a widely used and accepted adjunct in breast reconstruction today. The technique involves harvest of fat from patient-specific donor sites, fat processing, and subsequent transfer in order to improve depressions and step-offs, which may exist at the junction of the reconstructed breast and chest wall, or following lumpectomy. First introduced in 1895 by Czerny, fat grafting was utilized…

Fat Grafting for Total Breast Reconstruction

Introduction To reconstruct total mastectomy defects, implants and flaps were traditionally the only available options. Fat grafting, for total breast reconstruction, is now an evolving third alternative. Over the past 15 years we have refined this procedure and we are now able to, in most cases, restore aesthetically pleasing breasts that feel and look like the original, with the added benefit of normal sensation. Total breast…

Symmetry Procedures in Breast Reconstruction

Introduction Achieving optimal symmetry is the primary goal of unilateral and bilateral breast reconstruction. In cases of unilateral breast reconstruction, which is the focus of this chapter, this often requires a secondary procedure on the ipsilateral breast and/or contralateral breast. It is estimated that up to 70% of women will undergo one or two procedures in an attempt to obtain symmetry. The primary operations utilized include…

Partial Breast Reconstruction With Oncoplastic Techniques

Introduction Partial breast reconstruction using large volume displacement oncoplastic techniques has become an important part of reconstructive practice. As an option for women with breast cancer who undergo breast conservation therapy (BCT), this approach has many proven benefits. In some well-selected patients it improves upon standard lumpectomy alone and in others it has advantages over skin-sparing mastectomy and reconstruction. The term oncoplastic combines cancer surgery and…

Partial Breast Reconstruction With Local Tissue Rearrangements

Introduction Breast conservation surgery (BCS) has become an alternative technique to mastectomies as a consequence of its lower morbidity, sensitivity preservation and equivalent overall survival rate. BCS reconstruction consists of a concept that combines BCS with techniques of breast reshaping in order to improve the final aesthetic outcome and to expand the indications for breast conservation without decreasing oncological safety. Recently, increasing attention has been focused…

Implant refinement of postorthognathic surgery facial contour

Le Fort I maxillary and sagittal split mandibular osteotomies are performed to correct dental malocclusion and improve facial harmony. Skeletal movements of large magnitude, particularly those for correction of preexisting facial asymmetries, may create new contour irregularities and disharmony. Both the midface and lower face can manifest characteristic postorthognathic contour irregularities that are amenable to alloplastic implant improvement. Midface Contour Irregularity Because the Le Fort I…

Designer faces: CAD/CAM facial implants

Indications for and Advantages of Cad/Cam Computer-aided design and manufacturing (CAD/CAM) provides added sophistication to facial implant surgery. It provides three-dimensional millimeter accuracy in implant design and manufacturing specific to the facial skeleton being addressed. This precision potentially minimizes or eliminates limitations intrinsic to the use of “off-the-shelf” implants and asymmetry of the facial skeleton. CAD/CAM implants are custom made for the individual patient. CAD/CAM implants…

Facial Gender Differences in Nonsurgical Treatments and Treatment of the Tear Trough Deformity

What did Steve Jobs do for Apple? He did something different. He brought to a technology company the concept that design, and how a product is presented, are important. Before him, any computer you bought was just the same boring design; what the technology companies centered on was what was inside that computer, but Steve Jobs proved with Apple that design and presentation make a difference.…

Fat Grafting to the Penis

Why Did You Decide to Do This Technique? Penis enlargement is becoming more popular every day and thousands of male individuals are seeking some help to satisfy their desire. Our community, however, is generally skeptical of performing penile enlargements because of the uncertain results and bad reputation, mostly produced by non-board-certified plastic surgeon physicians or unprepared medical professionals and commercial agencies, who reproduce and imitate the…

Penile Enlargement: Suspensory Ligament, Fat Grafting, Scrotal Webbing

Just as female genital surgery has been increasing exponentially in the past years, male genital surgery is now becoming more available and with better outcomes, and I am sure that will start increasing also. Today, more and more men are asking for body definition surgeries and male genital aesthetics serve well to provide a better harmonious figure overall. Because function is so important, often men were…

Scrotal Lift

Many might say, why is there a need to lift the scrotal area? Well, just like women lift their breasts, men can also lift their scrotal area. Because we live on planet Earth and planet Earth has gravity, our bodies are constantly exposed to this downward force that makes everything fall, and and testes are no exception. Testes are supported in a cutaneous sac for a…

Tightening Inside the Vagina

Today women are not only more aware of their genitalia, but also participate actively in their sexual wellbeing. The concept that the main purpose of sex is for procreation is in the past. Along with the joy of childbirth and kids, woman experience changes in their vagina making it less tight, changes that impact sexual gratification, but woman were silent about it, talking about their sexuality…

Hoodplasty

Only a few years ago nobody mentioned the term hoodplasty; it did not exist. But thank goodness, today we just cannot conceive of a labiaplasty without also having the option of a hoodplasty. But before we talk more about this procedure, I would like to mention the importance of treating the entire region. Not liking our genitalia and having an aesthetic genital procedure is no longer…

A Regenerative Approach to Treat Vulvar and Vaginal Scarring

Why Did You Decide to Do These Techniques? Vulvar and vaginal surgery cause an inevitable scarring process and when major complications occur, an uncontrolled scar process undermines tissue reconstruction. There are inevitable scars and others are true vulvovaginal (VV) complications leading to uncontrolled scars. Here, I explain the differences between these two processes. Inevitable scar Vulvar Surgery The inevitable subdermal and deep scar as a result…

Mastopexy After Taking Out or Substituting Breast Implants

When all breast procedures are accounted for, they form a major piece of the pie of all aesthetic plastic procedures performed worldwide. Why? Because breasts are what differentiate males from females. Throughout art history, we see how important it is for artists to represent the female breast and because plastic surgery is unique among other specialties, regarding the artistic view, this is why for the practice…

Liposuction and J-Plasma

After liposuction was first described, different techniques and technologies have been invented to assist us during this procedure. First, the use of tumescent solution was described, which considerably decreased bleeding and the need for transfusions, but still the aim was to decrease fat deposits. Then an Italian ultrasound device was produced with the intention of liquefying the fat so that it would be easier to extract,…