Background: The use of acellular dermal matrix (ADM) in breast reconstruction can inhibit capsular contracture, increasing the success rate of surgery. Adipose-derived stem cells (ADSCs) can effectively suppress foreign body reaction, which is a major cause of capsular contracture. This study aimed to elucidate the synergistic effects of combining ADSCs with ADM on capsule formation, utilizing a rat model. Methods: The study utilized 12 rats, equally divided into two experimental groups. Group A received silicone implants covered with ADM, while Group B was implanted with silicone prostheses wrapped in ADM, pre-seeded with ADSCs. Capsule formation was assessed through visual examination, histological analysis, and reverse transcription-polymerase chain reaction (RT-PCR) at 4 and 8 weeks post-implantation. Results: At 4 weeks, the mean capsular thickness was 177.16 μm in Group A and 170.76 μm in Group B; at 8 weeks, it was 196.69 μm in Group A and 176.10 μm in Group B. Statistical analysis showed no significant difference in capsule thickness between the groups (P>0.05). Histological findings indicated that Group A had more inflammatory cells and collagen fibers and reduced angiogenesis. RT-PCR showed that angiogenesis-promoting gene expression in Group B was 14% higher at 4 weeks and 156% higher at 8 weeks compared to Group A. Conclusion Although no statistically significant reduction in capsule thickness was observed, ADSC-seeded implants showed histological features associated with reduced inflammation and enhanced angiogenesis, suggesting potential benefits in capsule formation management.

Background: Immediate breast reconstruction after mastectomy can be challenging in some patients for medical or oncological reasons. Delayed two-stage tissue expander/implant breast reconstruction is a reliable option for these patients. However, data regarding surgical techniques, outcomes, and complication rates are limited. This study reports our experience using the two-stage tissue expander/implant procedure for delayed breast reconstruction. Methods: This retrospective study included 32 patients (34 breasts) who underwent delayed two-stage tissue expander/implant breast reconstruction at our institution from January 2018 to July 2022. We summarized the techniques used in the procedure and evaluated the 1-year postoperative outcomes and complication rates. Results: The mean time from mastectomy to expander insertion was 210±25 days, and 8.2±2.3 additional expansions were required prior to the implant insertion. The mean time of tissue expansion was 187±15 days, and the mean volume of expansion was 495±31 mL. No major complications occurred that required reoperation, and the patients were highly satisfied with the surgical results. Conclusions Although delayed two-stage tissue expander/implant breast reconstruction resulted in satisfactory outcomes, consensus regarding the operative technique is still needed. Two-stage tissue expander/implant breast reconstruction is a safe and effective option for delayed breast reconstruction.

Background: The use of acellular dermal matrix in implant-based breast reconstruction immediately after mastectomy has attracted attention in recent years because it yields good outcomes. Herein, we analyzed the usefulness of meshed SurgiMend in direct-to-implant (DTI) breast reconstruction. Methods: In this retrospective single-center analysis, 44 one-stage breast reconstructions using SurgiMend were performed in 42 patients from May 2016 to December 2017. The implant was inserted into the subpectoral plane and SurgiMend was applied to the inferolateral part that lacked tissues to wrap the silicone implant. In 19 patients (20 breasts), fenestration was performed with SurgiMend, while in the remaining 23 patients (24 breasts), SurgiMend that was meshed at a ratio of 1:1.5 was used. We analyzed the frequency of complications. Patient satisfaction was compared and analyzed using a five-item questionnaire (shape, texture, symmetry, pain, and overall outcome). Results: The average age of the patients was 43.2 years, and their mean body mass index was 21.1 kg/m2. The average follow-up period was 24.0 months. In the control (fenestrated SurgiMend) and experimental (meshed SurgiMend) groups, major seroma occurred in five of the 20 breasts (25.0%) and two of the 24 breasts (8.3%), respectively. Minor complications were resolved with conservative treatment. The patient satisfaction score for shape, texture, symmetry, pain, and overall satisfaction was 4.3, 4.1, 4.7, 4.5, and 4.4, respectively. Conclusions Applying meshed SurgiMend in DTI breast reconstruction is a useful surgical technique.

Background: The use of acellular dermal matrix in implant-based breast reconstruction immediately after mastectomy has attracted attention in recent years because it yields good outcomes. Herein, we analyzed the usefulness of meshed SurgiMend in direct-to-implant (DTI) breast reconstruction. Methods: In this retrospective single-center analysis, 44 one-stage breast reconstructions using SurgiMend were performed in 42 patients from May 2016 to December 2017. The implant was inserted into the subpectoral plane and SurgiMend was applied to the inferolateral part that lacked tissues to wrap the silicone implant. In 19 patients (20 breasts), fenestration was performed with SurgiMend, while in the remaining 23 patients (24 breasts), SurgiMend that was meshed at a ratio of 1:1.5 was used. We analyzed the frequency of complications. Patient satisfaction was compared and analyzed using a five-item questionnaire (shape, texture, symmetry, pain, and overall outcome). Results: The average age of the patients was 43.2 years, and their mean body mass index was 21.1 kg/m2. The average follow-up period was 24.0 months. In the control (fenestrated SurgiMend) and experimental (meshed SurgiMend) groups, major seroma occurred in five of the 20 breasts (25.0%) and two of the 24 breasts (8.3%), respectively. Minor complications were resolved with conservative treatment. The patient satisfaction score for shape, texture, symmetry, pain, and overall satisfaction was 4.3, 4.1, 4.7, 4.5, and 4.4, respectively. Conclusions Applying meshed SurgiMend in DTI breast reconstruction is a useful surgical technique.

Background: Microtia with constricted features is characterized by a short helical length of variable severity, upper antihelical or scaphal deficiency, and a downfolded upper ear. No consensus has been reached regarding the most appropriate surgical method for this condition. In this study, we aimed to introduce a simple and safe surgical method for the correction or reconstruction of upper helix ear deformities. Methods: Between February 2011 and June 2014, eight patients with microtia with constricted upper helix ear deformity underwent reconstruction of the ear deformity. The upper ear helical framework was constructed by carving and curving the eighth rib cartilage harvested from the ipsilateral chest wall, covering this cartilage with a superficial temporal fascial flap, and adjusting the skin graft to align with the ear contour. To evaluate their satisfaction, patients were asked to complete a questionnaire regarding ear shape, symmetry, position, color, and overall outcome scored on a 5-point scale at 12 months postoperatively. Results: None of the patients experienced severe complications in the reconstructed ear. The preoperative and postoperative vertical ear length ratios were 0.88 and 1.02, respectively. And the mean patient satisfaction scores for shape, symmetry, position, color, and overall outcome were 4.2, 4.5, 4.7, 4.4, and 4.6 out of 5 points, respectively. All patients expressed a high level of satisfaction at 12 months postoperatively. Conclusions Our technique provides a good alternative method for the reconstruction of moderate constricted upper helix ear deformities in patients who meet the surgical indications with satisfactory outcomes and few complications.

In recent years, there has been a notable increase in the rate of refractory donor site seroma, defined as seroma that persists for at least 3 months postoperatively, as the number of breast reconstructions using a latissimus dorsi (LD) musculocutaneous flap has increased. Various factors have been proposed to be related, including smoking, obesity, flap mass, and body weight, and several studies have been conducted to explore treatment methods. Typically, surgical treatment, such as capsulectomy, has been considered for refractory seroma, but in this case report, we describe positive outcomes achieved by using Abnobaviscum to treat three female patients who developed a donor site seroma at least 3 months after breast reconstruction using an LD flap.
Body Weight ; Breast ; Female ; Humans ; Mammaplasty ; Myocutaneous Flap ; Obesity ; Seroma ; Smoke ; Smoking ; Superficial Back Muscles ; Tissue Donors

Trichoblastic carcinoma usually occurs as a malignant transformation of the trichoblastoma, but is very rare. A 25-year-old man was admitted with trichoblastoma in the nuchal area with frequent recurrences since birth. The preoperative neck magnetic resonance image revealed lobulated soft tissue lesions involving superficial fascia and infiltrating into both proximal trapezius muscles. In our department, wide excision and reconstruction with a free anterolateral thigh flap were performed. Histological examination revealed skin adnexal carcinoma, originating from the hair follicles, consistent with trichoblastic carcinoma. There was no palpable mass 5 years postoperatively, and there was no recurrence on follow-up positron emission tomography-computed tomography. Trichoblastic carcinomas are rare and difficult to diagnose, but histopathological findings include atypical basaloid keratinocytes with crowded, hyperchromatic nuclei, and increased mitotic activity. The presence of hypercellular stroma is a criterion for distinguishing trichoblastic carcinoma from basal cell carcinoma. A rare giant trichoblastic carcinoma was reported, which was the biggest one in the literature.
Adult ; Carcinoma, Basal Cell ; Electrons ; Follow-Up Studies ; Hair Follicle ; Humans ; Keratinocytes ; Neck ; Parturition ; Recurrence ; Skin ; Subcutaneous Tissue ; Superficial Back Muscles ; Thigh

BACKGROUND: Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship. METHODS: We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate. RESULTS: A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits. CONCLUSIONS: Our condylar repositioning method using a centric relation splint and mini-plate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.
Centric Relation ; Congenital Abnormalities ; Head ; Head Movements ; Humans ; Jaw ; Methods ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Le Fort ; Osteotomy, Sagittal Split Ramus ; Physical Examination ; Radiography ; Recurrence* ; Splints ; Temporomandibular Joint

BACKGROUND: In contrast to fillers made from artificial substances, platelet-rich fibrin matrix (PRFM) filler does not cause hypersensitivity reactions or foreign body reactions. PRFM is also highly accessible in terms of cost. Hence, in this study, the efficacy of PRFM for soft tissue augmentation and volume maintenance was evaluated in an animal experiment. METHODS: Twenty nude mice were injected with hyaluronic acid filler, fibrin glue, PRFM filler, and normal saline (control). The remaining volume was measured 4 times over the course of 8 weeks using the volumetric taping bowl method and magnetic resonance imaging. RESULTS: All nude mice survived and showed no signs of infection, such as erythema or edematous changes, during the study period. Migration of the injected substance was not detected at 2, 4, or 8 weeks after the procedure. The remaining volumes of normal saline at 2, 4, and 8 weeks were 10.50%, 2.00%, and 0.00%; fibrin glue, 20.50%, 9.00%, and 2.50%; hyaluronic acid filler, 82.00%, 35.00%, and 17.33%; and PRFM filler, 70.31%, 26.75%, and 14.37%, respectively. CONCLUSIONS: PRFM filler had a high soft-tissue filling capacity compared with the control. It also showed a similar effect to hyaluronic acid filler. Thus, PRFM filler could be a good alternative for correcting soft-tissue deficits.
Animal Experimentation ; Animals ; Cosmetic Techniques ; Erythema ; Fibrin Tissue Adhesive ; Fibrin* ; Foreign Bodies ; Hyaluronic Acid ; Hypersensitivity ; Magnetic Resonance Imaging ; Methods ; Mice ; Mice, Nude* ; Platelet-Rich Plasma

No abstract available.
Breast* ; Hyperplasia*