1.Managing Complications in Abdominoplasty: A Literature Review.
Pedro VIDAL ; Juan Enrique BERNER ; Patrick A WILL
Archives of Plastic Surgery 2017;44(5):457-468
BACKGROUND: Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. METHODS: A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. RESULTS: According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. CONCLUSIONS: The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.
Abdominoplasty*
;
Cicatrix, Hypertrophic
;
Cosmetic Techniques
;
Humans
;
Lipectomy
;
Medical Subject Headings
;
Necrosis
;
Observer Variation
;
Postoperative Complications
;
Pulmonary Embolism
;
Reconstructive Surgical Procedures
;
Seroma
;
Skin
;
Surgery, Plastic
;
Sutures
;
Venous Thrombosis
2.Managing Complications in Abdominoplasty: A Literature Review.
Pedro VIDAL ; Juan Enrique BERNER ; Patrick A WILL
Archives of Plastic Surgery 2017;44(5):457-468
BACKGROUND: Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. METHODS: A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. RESULTS: According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. CONCLUSIONS: The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.
Abdominoplasty*
;
Cicatrix, Hypertrophic
;
Cosmetic Techniques
;
Humans
;
Lipectomy
;
Medical Subject Headings
;
Necrosis
;
Observer Variation
;
Postoperative Complications
;
Pulmonary Embolism
;
Reconstructive Surgical Procedures
;
Seroma
;
Skin
;
Surgery, Plastic
;
Sutures
;
Venous Thrombosis
3.Bilateral Atypical Ductal Hyperplasia with Microcalcifications in a Patient with Gynecomastia.
Pedro VIDAL ; Juan Enrique BERNER ; Alejandra KLENNER ; Oscar TAPIA
Archives of Plastic Surgery 2016;43(3):299-301
No abstract available.
Gynecomastia*
;
Humans
;
Hyperplasia*
;
Male
4.Successful salvage of failed post-sarcoma excision reconstruction and exposed alloplastic mesh with an anterolateral thigh flap
Juan Enrique BERNER ; Luigi TROISI ; Paul WILSON
Archives of Plastic Surgery 2019;46(4):390-391
No abstract available.
Thigh
5.Descended Mouth Corner: An Ignored but Needed Feature of Facial Rejuvenation.
Pedro VIDAL ; Juan Enrique BERNER ; Pablo CASTILLO ; Gunther ROCHEFORT ; Rodrigo LOUBIES
Archives of Plastic Surgery 2013;40(6):783-786
For years, the gold standard in facial rejuvenation has been the face lift. However, exploring new, less complex procedures for achieving the same goal is currently drawing interest. Rejuvenation of the perioral area is a difficult task for plastic surgeons because of the minimal effect that face lift procedures have over this region and the lack of published material on the subject. In this article, the descended mouth corner anguloplasty technique is presented. It is a 20-minutes lift technique that can correct this typical feature of the ageing mouth. The authors have treated 71 patients using the technique with consistently good results, with just one requiring revision. They conclude that this procedure by itself and in combination with other small operations or even a full face lift can rejuvenate the ageing face.
Humans
;
Lifting
;
Lip
;
Mouth*
;
Rejuvenation*
;
Rhytidoplasty
;
Surgery, Plastic
6.Lymphovenous anastomoses with three-dimensional digital hybrid visualization: improving ergonomics for supermicrosurgery in lymphedema
Patrick A. WILL ; Christoph HIRCHE ; Juan Enrique BERNER ; Ulrich KNESER ; Emre GAZYAKAN
Archives of Plastic Surgery 2021;48(4):427-432
The conventional approach of looking down a microscope to perform microsurgical procedures is associated with occupational injuries, anti-ergonomic postures, and increased tremor and fatigue, all of which predispose microsurgeons to early retirement. Recently, three-dimensional (3D) visualization of real-time microscope magnification has been developed as an alternative. Despite its commercial availability, no supermicrosurgical procedures have been reported using this technology to date. Lymphovenous anastomoses (LVAs) often require suturing vessels with diameters of 0.2–0.8 mm, thus representing the ultimate microsurgical challenge. After performing the first documented LVA procedure using 3D-augmented visualization in our unit and gaining experience with this technique, we conducted an anonymized in-house survey among microsurgeons who had used this approach. The participants considered that 3D visualization for supermicrosurgery was equivalent in terms of handling, optical detail, depth resolution, and safety to conventional binocular magnification. This survey revealed that team communication, resident education, and ergonomics were superior using 3D digital hybrid visualization. Postoperative muscle fatigue, tremor, and pain were also reduced. The major drawbacks of the 3D visualization microscopic systems are the associated costs, required space, and difficulty of visualizing the lymphatic contrast used.
8.Lymphovenous anastomoses with three-dimensional digital hybrid visualization: improving ergonomics for supermicrosurgery in lymphedema
Patrick A. WILL ; Christoph HIRCHE ; Juan Enrique BERNER ; Ulrich KNESER ; Emre GAZYAKAN
Archives of Plastic Surgery 2021;48(4):427-432
The conventional approach of looking down a microscope to perform microsurgical procedures is associated with occupational injuries, anti-ergonomic postures, and increased tremor and fatigue, all of which predispose microsurgeons to early retirement. Recently, three-dimensional (3D) visualization of real-time microscope magnification has been developed as an alternative. Despite its commercial availability, no supermicrosurgical procedures have been reported using this technology to date. Lymphovenous anastomoses (LVAs) often require suturing vessels with diameters of 0.2–0.8 mm, thus representing the ultimate microsurgical challenge. After performing the first documented LVA procedure using 3D-augmented visualization in our unit and gaining experience with this technique, we conducted an anonymized in-house survey among microsurgeons who had used this approach. The participants considered that 3D visualization for supermicrosurgery was equivalent in terms of handling, optical detail, depth resolution, and safety to conventional binocular magnification. This survey revealed that team communication, resident education, and ergonomics were superior using 3D digital hybrid visualization. Postoperative muscle fatigue, tremor, and pain were also reduced. The major drawbacks of the 3D visualization microscopic systems are the associated costs, required space, and difficulty of visualizing the lymphatic contrast used.