Approccio chirurgico e indicazioni ai trattamenti estetici nel dismorfismo da eccesso

Introduction. Patients with body dysmorphic disorder often go to the plastic surgeon to correct what they consider a physical deformity or defect, although their appearance falls within normal aesthetic standards. The aim of our study was to evaluate the real need for aesthetic treatments in such patients. Patients and methods. We included patients who practised an intense sport activity and believed they had body deformities ascribable to their sport activity. We evaluated whether the deformities described by the patients were real or exaggerated. The patients who did have a deformity underwent surgery to correct it; their level of satisfaction was evaluated at a 6-month follow-up examination. The patients with subjective deformities underwent a psychiatric examination. Results. We enrolled 51 patients who practised an intense sport activity and reported body deformities. Forty-one of these patients were found to have a body deformity upon examination and underwent surgery. Surgery was considered to be unnecessary in the remaining 10 patients. Thirty-two of the 41 patients who did undergo were highly satisfied with the outcome. Discussion. The plastic surgeon often sees patients with minor body deformities that do not require treatment but are a major cause of psychological disorders. A thorough psychiatric examination is necessary in such patients to rule out psychiatric diseases. The plastic surgeon should make every effort to identify patients with subjective body dysmorphic disorder to avoid the negative consequences due to the patient’s insatisfaction for the outcome of surgery

Hemostasis in skin surgery

[No abstract available

Hand-meshed skin graft

[No abstract available

Umbilical Endometriosis, Our Experience

Background: Endometriosis is the presence of functioning endometrial tissue outside the uterine cavity. Umbilical endometriosis has been reported in more than one hundred cases and the umbilicus represents the location of 0.5-1% of ectopical endometrioses. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. Patients and Methods: We report our experience in preoperative differential diagnosis and treatment of four cases of umbilical endometriosis. An accurate anamnesis and clinical examination together with the use of 13 MHz probe ultrasonography with echocolor duplex scan led us to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. Results and Conclusion: In all treated cases, a hemi-circumferential incision in the inner aspect of the umbilical opening was performed allowing adequate access to the lesion and umbilical repositioning. At the follow-up visit (from 6 to 24 months after surgery), no symptoms or signs of recurrence were evidenced. A natural-looking umbilicus was observed in all cases with minimal visible scars

Breastfeeding After Reduction Mammaplasty Using Different Techniques

Background This study reviewed mammary glandular function and breastfeeding after reduction mammaplasty performed via four different surgical techniques. Patients who underwent this procedure were asked to answer questions concerning the birth of a child, natural breastfeeding, and the reasons why natural breastfeeding was not performed or was interrupted. Methods Between 1992 and 2001, 368 reduction mammaplasties were performed in the Department of Plastic Surgery at the "La Sapienza" University of Rome. After reduction mammaplasty, 105 patients had a child and were enrolled in the study. Breastfeeding data were compared with data from hospital records at the time of surgery in terms of patient age, reduction mammaplasty technique, sensitivity of the nipple-areola complex after the operation, and proportion of the gland removed. Results Maternal breastfeeding was considered to have occurred if it lasted more than 3 weeks and was not accompanied by any nutritional supplements. Babies were breastfed by 60.7% of the patients who underwent a superior pedicle reduction mammaplasty, by 43.5% of those who underwent an inferior pedicle reduction mammaplasty, by 48% of those who underwent a medial pedicle reduction mammaplasty, and by 55.1% of those who underwent a lateral pedicle reduction mammaplasty. Conclusions The findings demonstrate that conservative reduction mammaplasty techniques supported by medical and paramedical staff permit subsequent breastfeeding. In particular, the best outcomes resulted from superior pedicle reduction mammaplasty. Skilled execution of the surgical technique is mandatory to guarantee adequate vascularization and sensitivity of the nipple-areola complex and to spare as many of the glandular ducts and lobules as possible