Surgical Therapy of Migraine and Tension-Type Headache

During the last few years, multiple studies have demonstrated the efficacy of migraine and tension-type headache trigger site deactivation surgery, hence expanding the therapeutic potentiality of plastic surgery. These procedures are performed based on headache onset and location: four trigger points that may cause the compression of the trigeminal branches have been described. In the present chapter, we describe indications, contraindications, procedures, and results of this therapy, focusing on our approach that relies on one 1-cm incision, and it is performed under local anesthesia

Minimally Invasive Surgical Treatment of Migraine

Migraine headache (MH) is a very common disorder affecting 10–12% of the world’s adult population. The first line therapy for migraine is usually a combination of conservative treatments but some patients seem to be refractory. For this group of patients, the minimally invasive surgical treatment of migraine might offer a solution. Migraine is usually caused by extracranial sensitive nerve compression due vascular, fascial or muscular structures nearby. The aim of migraine surgery is to relieve such compression at specific trigger points located in the occipital, temporal and frontal regions. From June 2011 until July 2019, we performed MH decompression surgeries in over 269 patients with either frontal, occipital, or temporal migraine trigger sites. In the occipital and temporal areas, nerve decompression was achieved by occipital and superficial temporal artery ligation, respectively. In patients suffering from frontal headache we performed both endoscopic nerve decompression and transpalpebral decompression. Among patient suffering from occipital migraine, 95% of them showed improvement of their condition, with 86% reporting complete relief. As concern temporal migraine, positive outcome was achieved in 83% of the patients (50% complete elimination and 33% partial improvement). In patient suffering from frontal migraine, positive results were observed in 94% of the patients (32% complete elimination, 62% partial improvement). Migraine is a common and debilitating condition that can be treated successfully with minimally invasive surgical procedure especially for those patients non-responding to medical therapies

Breast reconstruction with anatomical implants: A review of indications and techniques based on current literature

One important modality of breast cancer therapy is surgical treatment, which has become increasingly less mutilating over the last century. Breast reconstruction has become an integrated part of breast cancer treatment due to long-term psychosexual health factors and its importance for breast cancer survivors. Both autogenous tissue-based and implant-based reconstruction provides satisfactory reconstructive options due to better surgeon awareness of \u201cthe ideal breast size\u201d, although each has its own advantages and disadvantages. An overview of the current options in breast reconstruction is presented in this article

Facial transplantation. An update of results and perspectives from tissue engineering

Facial transplantation is a revolutionary procedure developed recently, which is indicated if autologous transfers fail to restore human appearance. More than 30 patients have undergone facial transplantation in different centers worldwide. Here, we provide an update on its main anatomical, surgical, immunological, ethical, and follow- up aspects. We also provide innovative perspectives of regenerative medicine and tissue engineering that could hold promise for this emerging surgical field

Facial transplantation. An update of results and perspectives from tissue engineering

Facial transplantation is a revolutionary procedure developed recently, which is indicated if autologous transfers fail to restore human appearance. More than 30 patients have undergone facial transplantation in different centers worldwide. Here, we provide an update on its main anatomical, surgical, immunological, ethical, and follow- up aspects. We also provide innovative perspectives of regenerative medicine and tissue engineering that could hold promise for this emerging surgical field

Adipose-derived stem cells: Comparison between two methods of isolation for clinical applications

Background: Adipose-derived stem cells are recognized as being an effective mesenchymal stem cell population with enormous potential in different fields of regenerative medicine and stem cell therapy. Although there is unanimous agreement on the harvesting procedure for adipose tissue, there are various protocols for adipose-derived stem cell isolation. The aim of this study was compare two methods of adipose-derived stem cells (ASCs) isolation, one based on a mechanical + enzymatic (ME) procedure and the other one exclusively mechanical (MC), in order to determine which one was superior to the other in accordance with current European and US legislation. Methods: We reported step by step the two different methods ASCs isolation by comparing them. The ME procedure included the use of a centrifuge, an incubator and collagenase digestion solution (Collagenase NB 6 GMP Grade 17458; Serva GmbH, Heidelberg, Germany). The MC procedure was performed by vibrating shaker and centrifuge, both placed in a laminar airflow bench. Results: With the ME procedure, a mean of 9.06 × 105 ASCs (range, 8.4 to 9.72 × 105; SD ± 6.6 × 105) was collected, corresponding to 25.9% of the total number of harvested cells. With the MC procedure, a mean of 5 × 105 ASCs (range: 4.0 to 6.0 × 105; SD, ±1 × 105) was collected, corresponding to 5% of the total number of harvested cells. Conclusion: Based on data collected, from the same amount of lipoaspirate the ME procedure allowed to isolate a greater number of ASCs (25,9%) compared to the MC one (5%)

Analysis of Complications in Postbariatric Abdominoplasty: Our Experience

Abdominoplasty is one of the most popular body-contouring procedures. It is associated with a significant number of complications: the most common ones are seroma, hematoma, infection, wound-healing problems, and skin flap necrosis. From January 2012 to December 2014, 25 patients (18 women and 7 men) (mean age: 51 years) underwent abdominoplastic surgery at the Plastic Surgery Section, Department of Surgical Sciences, University of Parma, Italy. All patients reported a weight loss between 15 kg and 47 kg. All of the of 25 patients were included in the study; minor and major complications were seen in 17 (68%) and 8 (32%) patients, respectively. The percentage of complications in our patients was as follows: 9 patients with seroma (36%); 4 patients with wound dehiscence with delayed wound healing (16%); 3 cases with hematoma (12%); 2 patients with postoperative bleeding (8%); 1 patient (4%) with an umbilical necrosis; 1 patient (4%) with a deep vein thrombosis; 3 patients with infected seroma (12%); and 2 patients with wound infection (8%). There were no cases of postoperative mortality. The aim of this study is to analyze our complications in postbariatric abdominoplasty

The art and science beyond body contouring a solution for massive weight loss patients

The massive weight loss often resulted in an excess of loose skin mainly in the abdomen, upper arms, thighs, chest, back, and laterally on the back. Consequently, most patients sought for a solution, provided by the plastic surgery through the body-contouring surgery. Abdominoplasty, arm lift, tight lift, breast lift, and liposuction are all body contouring procedures that aim to reshape the patients' body. Furthermore, body-contouring surgery can improve the patients' physical discomfort in daily life, also helping in the maintenance of normal BMI (body mass index) in formerly obese patients, thus having a positive aesthetic and psychosocial outcome. A key component of body contouring after massive weight loss is managing patient expectations. Understanding the risks of body contouring's procedures is important for patient counseling and the informed consent process. The goal of this study was to perform a literature review concerning the indication, surgical technique, outcomes and complications of body-contouring surgery

Stem cells derived from adipose tissue: Possible uses and clinical applications

none4In the past adipose tissue was considered only as the energy storage of our body, today we can talk about adipose organ, an active and dynamic tissue from which multipotent stem cells can be obtained. The aim of our study was to focus on the properties and possible uses of stem cells derived from adipose tissue (ASCs) in regenerative medicine based on the major scientific studies reported in international literature. Referring to current scientific literature, we have described the main properties of ASCs by focus on the sources from which they can obtained, isolation procedures, clinical applications and the current legislation on their use. ASCs are multipotent stem cells with paracrine, immunomodulatory, chemotactic and differentiating activity that promote their use in various fields of regenerative medicine and tissue engineering. Currently there is no universally recognized protocol regarding the isolation procedure. Under current European legislation, ASCs can only be used if autologous, non-cultivated, mechanically isolated and transferred at the level of a homologous tissue. To date, clinical protocols that do not comply with these guidelines are considered off-lable. Today, there is a growing need for a protocol shared by the international scientific community on the stem cells isolation procedure from adipose tissue and on their clinical applications in compliance with current legislation.noneSImonacci, Francesco; Bertozzi, Nicolò; Grieco, Michele P.; Raposio, EdoardoSimonacci, Francesco; Bertozzi, Nicolò; Grieco, Michele P.; Raposio, Edoard

From liposuction to adipose-derived stem cells: indications and technique

Adipose tissue is an organ of energy storage, an endocrine organ, a soft tissue filler and a cosmetically unnecessary tissue discarded by liposuction. Liposuction was designed to correct unaesthetic deposits of subcutaneous fat; it produces satisfactory silhouette contouring when performed by appropriately trained operators using properly selected technologies. However, from lipoaspirate it is possible to obtain autologous fat graft and adipose-derived stem cells (ASCs) for reconstructive surgery and regenerative medicine. Autologous fat transplantation uses include the correction of body contour, malformations and post-surgical outcomes. The regenerative properties of ASCs allow treating damaged tissues such as wounds, burns, scars and radiodermatitis. The aim of this study was to perform a literature review highlighting the crucial role of adipose tissue in plastic and reconstructive surgery, from liposuction to lipofilling and ASCs, exposing the indications, procedures and complications of these surgical techniques