Lipoinjection and Multiple Internal Cuts for Congenital Constriction Bands: A New Treatment Approach

Background Traditional treatment for a congenital constriction band of the limb involves multiple Z-plasties and W-plasties. We propose an alternative surgical procedure for the treatment of congenital constriction bands that obviates the need for Z-plasties and eliminates the constriction band. Methods We present the case of a 36-year-old woman with a congenital constriction band of the leg. Using a minimally invasive approach, the skin segment that included the band was dissected from the deep tissues. Afterwards, multiple slices were performed on the internal surface of the fibrous ring. This and lipoinjection were used to reverse the depression that characterizes the ‘‘hourglass sign’’ and homogenize the skin surface. Results Results have remained stable in a follow-up period of 18 months. Conclusions This surgical alternative can be considered as an option for the treatment of congenital constriction bands. It is a safe, reproducible procedure that does not cause additional scars and has good functional and aesthetic results.Doyma M´exico S.A. Thisis an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Level of evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Doble abordaje para el tratamiento del rinofima: reporte de un caso

El rinofima, palabra derivada del griego rino-nariz y fi ma-crecimiento, es una enfermedad deformante y progresiva caracterizada por engrosamiento de la piel en la nariz, además de hiperplasia de las glándulas sebáceas, oclusión de los conductos con formación de quistes y cierto grado de fibrosis. Aunque históricamente se han propuesto diversos factores para su desarrollo, como defi ciencias vitamínicas, estrés, alcohol, componentes hormonales o infecciones, su única causa confirmada es la asociación con el acné rosáceo, del cual es la forma más severa. La enfermedad aparece principalmente en hombres caucásicos, más comúnmente en el oeste de Escocia, y es rara en japonese así como en afroamericanos. La edad de presentación oscila entre los 50 y 70 años. Se han propuesto diversas formas para tratarlo, incluidos antibióticos, retinoides, crioterapia, radioterapia, escisión tangencial y escisión de espesor completo con cierre directo, con o sin injertos de piel. Recientemente se ha reportado el uso de láser CO2 en el tratamiento del rinofima severo, con buenos resultados y una morbilidad y riesgo operatorio mínimos. Se reporta un caso tratado por medio de un doble abordaje terapéutico, que consiste en una escisión de espesor total de piel con cierre directo, más escisión tangencial con navaja de rasurar y colocación de malla fina sobre la nariz

Management of firearm facial fractures at the ‘‘Dr. José Eleuterio González’’: University Hospital Case Report

Gunshot wounds in the facial region produce important functional disabilities if they are not properly treated. They may also cause an important effect in the social and psychological development of the patient because of the aesthetic problems that they produce. This article presents a case of a 20 years-old female patient who was referred to our institution because of facial trauma secondary to a gunshot wound, whose treatment consisted of multiple reconstructive surgeries in order to obtain an adequate, functional and esthetic result. Also, we did a review of the bibliography in order to establish the proper management of the wounds found in these type of cases

Decreased pain in split-thickness skin graft donor sites with the use of a non-adherent polyurethane dressing

Donor sites of split-thickness skin grafts (STSGs) are painful and limit patient rehabilitation. We conducted this study to assess the efficacy of a non-adherent polyurethane dressing in reducing pain and its effect on the epithelialization rate of donor sites of STSGs. Methods: Fifteen patients requiring an STSG were included. In 10 patients the donor sites were randomly divided into two halves and covered with either a non-adherent polyurethane dressing or a standard non-adherent gauze. In five patients with bilateral donor sites, one side was covered with the non-adherent polyurethane dressing and the other with non-adherent gauze. The pain was assessed with a visual analog scale and epithelialization was also assessed, calculating non-epithelialized areas with image software by a blinded surgeon. Epithelialization of the wounds covered with the non-adherent polyurethane dressing was assessed at day 8 and 10 and those with non-adherent gauze at day 10. Results: Postoperative pain significantly decreased with the non-adherent polyurethane dressing during the length of the study (6.07 ± 1.46 vs. 1.72 ± 1.6) and at each time point (p < 0.001). Epithelialization was not affected with the polyurethane dressing, compared to the standard method

Cell-Assisted Lipotransfer for the Treatment of Parry-Romberg Syndrome

Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome

Análisis biomecánico de osificación en distracción osteogénica mandibular utilizando terapia génica ex - vivo. Un modelo canino.

El proceso de distracción craneofacial se concibe como la generación de tejido óseo por medio de dos segmentos vascularizados creados por una osteotomía, los cuales son separados gradual y progresivamente hasta alcanzar la elongación deseada. Este recurso ha sido aceptado ampliamente en el campo de la cirugía ortopédica y más recientemente, en el área de la cirugía craneofacial. Aunque la distracción ósea ha demostrado su eficacia, continúa siendo un procedimiento que requiere mucho tiempo para conseguir su objetivo, en particular el periodo de consolidación, por esa razón se han buscado métodos para acelerar este proces

Volumetric lipoinjection of the fronto-orbital and temporal complex with adipose stem cells for the aesthetic restoration of sequelae of craniosynostosis

Background Non-syndromic craniosynostosis causes craniofacial asymmetry and may persist after cranioplasty. These postoperative asymmetries are primarily depressions. In some cases, patients may be subjected to pranks and harassment by their peers, affecting their psychosocial development. We propose lipoinjection enriched with adipose stem cells (ASCs) to treat the sequelae of craniosynostosis in the fronto-orbital and temporal complex in cranioplasty patients, with the goal of improving the appearance of the upper third of the face. Methods Twelve children (four boys and eight girls) between 4 and 8 years of age (mean age, 6 years) in the postoperative period after treatment for plagiocephaly, brachycephaly, and trigonocephaly were included, with a follow-up period of 1 to 18 months. Fat tissue was obtained from the lower abdomen, and ASCs were isolated using the Yoshimura technique. Lipoinjection was performed using several mini-approaches to ensure adequate distribution. Results Two different scales were used to evaluate the aesthetic outcomes. At 6 months, three plastic surgeons independent of the study classified the results using a Likert scale. The patients’ parents categorized the results using a visual analog scale at 6, 9, and 18 months. R esults were favorable on both scales, as the patients’ facial appearance improved and they reported increased happiness and self-esteem due to their remodeled facial appearance. Conclusions We suggest that lipoinjection enriched with ASCs is a good alternative for correcting asymmetry of the fronto-orbital and temporal contour in patients with sequelae of craniosynostosis. This treatment will help boost patients’ self-esteem starting at an early age

The Versatility of Autologous Fat Transplantation in Abnormalities of the Craniofacial-Complex and Facial Esthetics

In the historical pursuit of soft tissue augmentation, fat has seemed a natural choice for plastic surgeons. The use of fat transfer to replace volume or camouflage soft tissues is an increasingly popular method in craniofacial surgery and facial esthetics. Craniofacial malformations undoubtedly have a certain psychosocial effect. Children of early age are particularly vulnerable to comments, teasing, and harassment related to their appearance; therefore, improving the facial image is of great importance. We believe that volumetric lipoinjection represents an excellent alternative to obtain greater facial esthetic harmony, which directly increases patient self-esteem in children and adults

Cell-Assisted Lipotransfer for the Treatment of Parry-Romberg Syndrome

Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive andself-limited deformation of the subcutaneous tissue volume on one side of the face thatcreates craniofacial asymmetry. We present the case of a patient with a five-year historyof progressive right facial hemiatrophy, who underwent facial volumetric restoration usingcell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched withadipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacityto differentiate into adipocytes. They also promote angiogenesis, release angiogenic growthfactors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissueatrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome.Currently, CAL has showed promising results in the long term by decreasing the rate of fatreabsorption. The permanence and stability of the graft in all the injected areas has showedthat autologous fat grafts enriched with stem cells could be a promising technique for thecorrection of defects caused by this syndrome

LIPOINJECTION WITH ADIPOSE STEM CELLS FOR NASAL MODELING. RHINO-CELL, A HIGHLY VERSATILE ALTERNATIVE.

It is undeniable that a significant number of patients who want to improve their facial appearance is increasingly interested in non-surgical procedures. Without a doubt, the use of autologous fat could not be left out as a magnificent alternative for nasal modeling simply because of four influential factors: ease of collection, compatibility, the temporality of the results, and safety. This work describes an innovative alternative technique for nasal modeling using micrografts enriched with ASCs. With this technique, fat was collected and divided into 2 samples, nanofat and microfat. Nanofat was used to isolate the ASCs; microfat was enriched with ASCc and used for nasal modeling. Lipoinjection was performed in a supraperiosteal plane on the nasal dorsum. Through a retrolabial access, the nasal tip and base of the columella were lipoinjected. We consider that non-surgical nasal modeling using micrografts enriched with ASCs can be an attractive and innovative alternative. This technique will never be a substitute for surgical rhinoplasty. It can be performed in a minor procedure area with rapid recovery and return to the patient's daily activities the next day. If necessary, the procedure can be repeated