Phamrodgers2362

our deformities and to assess reimbursement of body contouring surgery.With recent advances in microsurgical instruments and technique, microvascular anastomosis has become a universal surgical technique; however, thrombosis still presents in a number of cases. Tension, twisting, and compression to the anastomotic site are the main causes of thrombus; however, disorder of the coagulation-fibrinolysis system also need to be considered. To date, only few reports exist regarding thrombosis caused by disorder of coagulant system in microvascular anastomosis. Here we report our 3 cases in which multiple thrombus formation occurred intraoperatively caused by decrease of antithrombin (AT) activity. AT activity was measured twice a day after vascular anastomosis after surgery and up to 3 days after surgery. Thrombosis was not observed in any of the 3 patients intraoperatively after the transfusion, or thrombosis was not observed in any of 3 patients intraoperatively after the transfusion or postoperatively, and no other complications were observed. In these 3 cases, the thrombus was not caused by technical error or other previously described factors. The observed intraoperative decrease in AT activity was thought to be caused by thrombus formation. BAL-0028 chemical structure It is important that microsurgeons are reminded that disorders of the coagulation-fibrinolysis system could cause thrombosis.

Problems with poor circulation often occur when a large defect or a distant region, such as the apex of the nose, is covered with a paramedian forehead flap. Delay technique increases the safety of reconstruction procedures, but it has been used less frequently because a 2-stage surgery is necessary, and various other flaps and techniques have been developed.

We performed the delay technique of paramedian forehead flap at the same time as tumor resection. For the flap, a narrow pedicle of about 1-cm was prepared on the supratrochlear artery and vein, and the incision was extended toward the lateral side conforming to the defect morphology, and a paramedian forehead flap with a design consistent with the esthetic unit containing the defect was prepared. The region below the flap was dissected to create the flap bipedicle, and surgery was completed.

This procedure was used in 4 patients with malignant tumor of the external nose, and the flap survived perfectly in all patients. The postoperative esthetic oimited to forehead flap alone) should be considered an effective technique for the current treatment of malignant tumors.

Nasal deformities accompanying unilateral incomplete cleft lip have minor skeletal and soft tissue deficiencies compared with deformities associated with unilateral complete cleft lip. Extended dissection and surgical incisions (often required for nasal deformities in complete cleft lip) are not recommended to address deformities accompanying incomplete cleft lip. The purpose of this study is to describe an innovative method involving a rotational composite flap for nasal repair in patients with unilateral cleft lip.

Since 2016, 49 consecutive patients with unilateral incomplete cleft lip have undergone primary anatomical repair of accompanying nasal deformities. The technique involves a skin incision along the marginal and intercartilaginous borders to create a V-shaped composite flap consisting of vestibular skin and alar cartilage. Rotational mobilization of the composite flap creates a triangular raw surface laterally, which is closed by advancement of the vestibular skin.

This innovative method, which is based on the use of a rotational composite vestibular flap, achieves proper symmetry of the repaired nose.

The herein described composite flap rhinoplasty is a good surgical option, which provides a good overall nasal symmetry in patients with nasal deformities accompanying unilateral incomplete cleft lip.

The herein described composite flap rhinoplasty is a good surgical option, which provides a good overall nasal symmetry in patients with nasal deformities accompanying unilateral incomplete cleft lip.

Polycaprolactone (PCL) implants show isovolemic degradation during phase-1 degradation; they maintain their volume as their molecular weight decreases. Phase-2 begins with PLC volume being reduced by bulk degradation with autocatalysis. Isovolemic degradation of PCL particles during phase 1 and their longevity should be established in humans. PCL particle size can be mathematically calculated through cross-sectioned PCL particles in biopsy slides.

Biopsy specimens were obtained from humans after giving them a subdermal injection for 4 years to measure cross-section diameters of PCL particles. In all (160) biopsy slides, all cross-sections of PCL particles were measured in size in microscopic photographs, and the real size of PCL particles was calculated through



) and

(



). Diameters of Ellansé particles were measured with particle size analyzer.

On average, the calculated PCL particle size using



was 42.83 (immediately), then 43.18(1), 42.62(2), 40.90(3), and 34.46 µm(4 years), respectivedation. PCL particles were smooth and circular for 3 years, and from the fourth year, the surface became very rough. The Ellansé-M longevity was longer than 4 years.Autologous fat grafting is a common, relatively safe procedure for breast augmentation and reconstruction. The most commonly reported complications tend to be fat necrosis and oil cysts. The incidence of rare events, such as breast implant rupture, is likely underreported. Here we present the case of a patient who underwent fat grafting and sustained implant rupture with injection of fat within the silicone implant. She complained of her implant changing shape and magnetic resonance imaging (MRI) showed classic signs of implant rupture (linguini sign). At the time of surgery however, fat was surprisingly found to be within the implant itself. To our knowledge this finding has yet to be reported. Here we review the radiologic and surgical findings of implant rupture following fat grafting and present some suggestions to prevent this occurrence and ensure safe, aesthetically pleasing outcomes.