Submental artery island flap for reconstruction of the lower and mid face.

Ideal reconstruction of facial defects should be accomplished by like tissue, The submental artery island flap has the same characteristics as facial tissue, consisting of thin, pliable tissue with a perfect color match. The flap can be manipulated in different configurations employing skin, the platysma, the rim of the mandible, and the anterior belly of the digastric muscle to be utilized in the reconstruction of complex defects, The pedicle of the flap is quite reliable and enables a wide range of applicability. We have used this versatile flap successfully for various defects in 14 patients and our results are presented. Ten of the 14 flaps consisted of the skin and platysma, two flaps also included the anterior belly of the digastric muscle, one flap was elevated with the rim of the mandible, and one flap consisted of skin, the platysma, bone, and muscle

Inverted, T-shaped silicone implant for the treatment of temporomandibular joint ankylosis

Reconstruction of the ankylosed temporomandibular joint is a challenging task. Speech impairment, difficulties with mastication, poor oral hygiene, facial asymmetry, and mandibular micrognathia results in physical and psychologic disabilities. Various surgical techniques with varying success rates have been reported. Many autogenous and alloplastic materials have been proposed. The authors used an inverted, T-shaped silicone implant for the reconstruction of the temporomandibular joint after the release of the ankylosis in 10 patients without any complications in the postoperative period. The authors assert that the reconstruction of the ankylosed temporomandibular joint with an inverted, T-shaped silicone implant is a reliable and effective alternative. This technique can be used according to the special requirements of each patient and obviating the need for the fixation of the implant and is a safer and better way of using silicone for the treatment of temporomandibular joint ankylosis

Matrix metalloproteinase-2 and-9 activities in human keloids, hypertrophic and atrophic scars: a pilot study

Proteolytic degradation of extracellular matrix is one of the principal features of cutaneous wound healing but little is known about the activities of gelatinases; matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) on abnormal scar formation. The aim of this study is to determine collagen levels and the gelatinase activities in tissue from hypertrophic scars, atrophic scars, keloids and donor skin in 36 patients and 14 donors. Gelatinase levels (proenzyme + active enzyme) were determined by ELISA and their activities by gelatin zymography. MMP-9 activity was undetectable in gelatin zymography analysis. Pro-MMP-2 levels (median) were highest in nor Inial skin group 53.58 (36.40-75.11) OD mu g(-1) protein, while active MMP-2 levels were highest in keloid group 52.53 (42.47-61.51) OD mu g(-1) protein. The active/pro ratio was the highest in keloid group 0.97 followed by hypertrophic scar, normal skin and atrophic scar groups 0.69 > 0.54 > 0.48, respectively. According to results of our study, the two-phase theory of the duration of hypertrophic scar and keloid formation can be supported by the data of tissue collagen and gelatinase analysis. This study is the first to relate scar formation relationship in regard to gelatinase activation ratio in a keloid, hypertrophic and atrophic scar patient group which is chosen appropriate in age and sex. Copyright (C) 2009 John Wiley & Sons, Ltd

Evaluation of results from reduction mammaplasty: Relief of symptoms and patient satisfaction

Reduction mammoplasty is one of the most common operations performed in plastic surgery clinics. Although patients present with functional symptoms, the aim of treatment usually is obtaining aesthetic satisfaction. This retrospective study evaluated charts and operation notes of patients and a self-assessment questionnaire. A detailed questionnaire form was sent to 121 patients who had undergone reduction mammaplasty at the Dokuz Eylul University Medical Faculty Plastic, Reconstructive, and Aesthetic Surgery Clinic between 1991 and 2001. The questionnaire asked the subjects about pre- and postoperative, physical, and psychosocial symptoms, as well as operative satisfaction. The results were evaluated with respect to different techniques. The findings showed that reduction mammaplasty remains a very satisfying procedure for most of the patients undergoing this operation, as indicated by the high rate of patient satisfaction. The limited number of studies in this area and the lack of groups conducting such work in our society indicates the importance of similar study