Lipoabdominoplasty: Revisiting the Superior Pull-Down Abdominal Flap and New Approaches

Abdominoplasty is a very common procedure, especially for patients with abdominal laxness, striaes, and muscle rectus diastases. With the advent of liposuction 28 years ago, we can improve body contouring by treating lipodystrophies in the epigastric, flank, trochanteric, and buttocks areas. The procedure combining abdominoplasty and liposuction is called lipoabdominoplasty. Many new techniques have been proposed since these procedures were introduced; we now revisit the superior pull-down abdominal flap technique with several new modifications and improvements

Cutaneous approach in toxic epidermal necrolysis

INTRODUCTION: Toxic epidermal necrolysis is a severe acute mucocutaneous condition usually induced by drugs associated with a high rate of morbidity and mortality. The care of the mucous lesions and skin and a multidisciplinary approach are very important for the prognosis and future sequelae. OBJECTIVES: To discuss the main aspects of this syndrome through a literature review illustrated by a clinical case. Methods: Review of the literature using the PubMed and SciELO online databases was performed. Articles in English, Portuguese, French, and Spanish were included and illustrated with a pediatric clinical case. The keywords used were as follows: "toxic epidermal necrolysis," "Stevens-Johnson overlap," "necrólise epidérmica tóxica," and "síndrome Stevens-Johnson." RESULTS: We presented data to guide the management of patients with toxic epidermal necrolysis for plastic surgeons, pediatricians, intensivists, dermatologists, and emergency physicians. The case treated had a favorable disease course without sequelae. CONCLUSION: A high level of suspicion is necessary for an adequate diagnosis and risk stratification, and early support measures and treatment should be performed by a multidisciplinary team trained to minimize damage and mortality

Hair Restoration with the Erbium YAG Laser

We introduced in 1995 the erbium YAG laser to hair restoration surgery. With this device, produced by ESC Co. (Vorkham, Israel), we obtained a 90% yield from the implanted grafts, achieving a density that was 20% higher than that obtained using the cold steel method. Causing 10 times less thermal damage than the CO2 laser, the erbium YAG laser brought new technology to both skin resurfacing and baldness surgery. At the end of 1997 we introduced an upgrade with a new 3.0 J device. With more power, we can now make the same orifices in a single shot. This was a considerable improvement and made the procedure faster, with the same degree of thermal damage. In this article we present our experience, highlighting how we handle the erbium laser, results, and complications. Laser hair surgery is still an open chapter, where investigation and continuous research should be important goals for those dedicated to the constant improvement of baldness surgery

The Punctiform Technique in Hair Transplantation

I first presented micrografts for hair restoration surgery in 1982, combining to hide the anterior hairline of the temporo-parieto-occipital (TPO) flaps. Later, in 1986 and 1991 respectively, I introduced megasessions with micrografts and minigrafts. At that point, I created my own surgical routine, introducing a “stick-and-place” method, named the punctiform technique, which was published in several magazines, Congressional annals, and books. Hair-micrografting is a simple, yet refined, technique that requires three assistants and lasts 2 to 3 hours; the result is a natural-looking transplant with small incidence of risk or postoperative complications