Pneumodissection: Enhancement of the Receptor Area before Fat Grafting

Introduction: Fat grafts have become a frequent procedure among plastic surgeons due to their versatility for different pathologies. Different techniques have been described about graft enhancement to increase survival; in this chapter, with CO2 pneumodissection, a technique for improving the biological conditions of the receptor area is exposed. Already known effects of carboxitherapy, such as vasodilation, enhanced Bohr effect and neoangiogenesis, are applied to increase the chance of graft survival. Tissue pneumodissection reduces the fat infiltration pain, thus reducing the sedation requirements

Five Fluorouracil, Hyaluronidase, and Triamcinolone in the Nasal Region

Introduction: The use of five fluorouracil (5 FU) as antifibrotic started in the 1960s, in the hands of ophthalmologists, to prevent adherence after glaucoma and pterigion surgery. In 1999, Fitzpatrick presented his experience in keloids and hypertrophic scars, making a great contribution to their treatment. Fibroblasts’ main function is collagen synthesis; in vicious scar the amount of collagen is normal, but what is altered is the ratio between collagen subtypes. The use of triamcinolone, the previous standard treatment, produced different degrees of atrophy and telangiectasias

Auxiliary Procedures in the Nasal Skin

Dermabrasion: This is a procedure that removes epidermis and superficial dermis in order to stimulate neo formation of collagen, elastic fibers, and vessels. Radiofrequency: The equipment can be regulated in ablative or nonablative (heat in dermis results in collagen fibers contraction) mode. The main effect is contraction and remodeling of collagen fibers. Chemical peels: Most used products are: retinoic acid, alpha hydroxy acids, trichloroacetic acid, phenol, and resorcinol. Superficial and mid peels are indicated in pigmented lesions and fine wrinkles. Deep wrinkles need a deep peel. External nasal lifting: As we age, flaccidity and solar damage in nasal skin turns the tip downward, and its classical correction (rhinoplasty) deepens the nasal dorsum wrinkles. Incisions and skin resection is planned in the nasoglabellar area. Subnasal lifting: An open nasolabial angle creates disequilibrium between the lip and nose in the central face. A buffalo horn like resection in the implantation of the nasal ala in the lip solves this angle, restoring the loss balance. Treatment of vascular lesion with luminic energy: Here we present our experience with nasal vascular lesions in the last 15 years. Treatment of nasal vascular lesions through thermocoagulation with radiofrequency: This technique is indicated in vascular lesions smaller than 3 mm of diameter, and punctiform lesions as rubi nevus and telangiectasias. Hair removal with LASER or IPL: The hairs anagen period of the nasal tip and vestibule gets longer as people age, turning hair to be unaesthetic

Botulinum Toxin in the Nasal Area

Introduction: Botulinum toxin type A for aesthetic purposes has been used since 1987, proving to be one of the most popular procedures in aesthetics due to its effectiveness in softening dynamic wrinkles

New Concepts on Safer Abdominoplasty

Abdominoplasty was one of the first techniques described in literatura, and in some of his writings, Hippocrates mentioned the resection of skin and the apron-like abdominal flaps. The first standardization of this procedure was carried out by H.A. Kelly, who was a gynecologist, in 1890, but the procedure gained some popularity when Pitanguy published his report in 1967. With the advent of liposuction, they tried to replace abdominoplasty; however, in many cases, they yielded unreliable results. It was in the year 2000, with the advent of the pull down abdominal flap technique proposed by Avelar and then spread by Saldanha, surgeons significantly increased the indications for abdominoplasty. This was reflected in international statistics since abdominoplasty climbed from the 15th place in the 1990s to the 4th place in 2012. According to some publications, traditional abdominoplasty generally includes extensive dissection of upper abdominal flap all the way to the costal margin with a consequent decrease of blood flow of 50–70%. We present a technique with no flap undermining, including in-bloc resection of premarked área from the umbillicus scar to the suprapubic area, dissecting the tissue with an instrument called Iconoclast, thus preserving blood flow, after hydrodissection with tumescent solution, which varies if the patient is under general anesthesia or sedation. It has been shown that simultaneous liposuction of flap and flanks in the conventional abdominoplasty technique increases the risk of necrosis and seromas, so in many cases it is contraindicated. Therefore, our technique allows us to perform the liposuction of the upper abdominal flanks and waistline without running any risks. In this technique umbilicus scar its recreated with the use of skin graft. Unlike conventional abdominoplasty techniques, the presence of previous abdominal wall scars is not a limitation. In the case of smokers patients, risks are reduced by keeping the blood flow of the upper flap constant. We do not recommend this technique for very thin patients, with multiple pregnancies and regularly an important rectus muscles diastasis where we indicate the abdominal wall.vertical plicature

Application of the liposuction techniques and principles in specific body areas and pathologies

The buttocks have been a symbol of attraction, sexuality and eroticism since ancient times and therefore, they have an important role in defining the posterior body contour. More and more people are talking about and understand the meaning and the role that buttocks play in modeling and physical beauty. The three dimensional gluteoplasty (3-DGP) is an innovative technique that allows us to change volume, shape and firmness, not only in the buttocks but also in the adjacent regions such as the thighs and trochanters, becoming an ideal tool to answer the frequent reasons of consultation of our patients about this particular area of the body: ..