Salvage (tertiary) breast reconstruction after implant failure
Summary Background Salvage breast reconstruction is defined as a complete revision of a previous reconstruction in case of unsatisfactory results or failure of primary or secondary breast reconstruction. We have termed this ‘tertiary breast reconstruction'. This article presents our experience with tertiary reconstructions, including the indications, method of reconstruction and outcomes. Methods A retrospective note review was performed for all patients who underwent breast reconstruction with autologous tissue under one surgeon between 2002 and 2009 at the University Hospital, Ghent. Out of these 688 patients, 54 patients (7.8%) required tertiary surgery with autologous tissue after failu…
Reconstruction of the face with skin-grafted muscle flaps: Optimizing the aesthetic outcome
BACKGROUND: Reconstruction of large defects in the temporal region can be performed with skin grafts or pedicled or free flaps. Results are often not optimal because of the patch of a skin graft, lack of availability of local flaps, and distant skin from free flaps. A technique for reconstruction of these defects with local tissue is presented in this article that uses superficial musculoaponeurotic system (SMAS) plication to allow wide advancement of a cervicofacial flap. METHODS: Once the defect is outlined, a face-lift-like skin incision is used to raise the flap. The SMAS is plicated with two purse-string sutures that relieve tension on the flap and allow maximal advancement. Thirteen f…
Therapeutic use of hyaluronic acid fillers in the treatment of corticosteroid-induced skin and subcutaneous atrophy
Corticosteroid injection–related tissue atrophy might cause permanent skin and soft tissue deformities1 due to several factors, most importantly fibroblast inhibition and decreased Type I collagen synthesis. Correction of these deformities is challenging and is mostly based on volume replacement with lipofilling or other methods. Clinical observations and research have shown that injection of stabilized hyaluronic acid (HA) induces collagen synthesis, partially restoring dermal matrix components, and eventually producing a permanent effect.2–5 Based on these data, we hypothesize that HA injections might successfully treat atrophic tissue changes caused by corticosteroid injection. We descri…