Plastic surgery is a general term for operative manual and instrumental treatment which is performed for functional or aesthetic reasons. The word "plastic" derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with modern plastics.

The principal areas of plastic surgery include two broad fields.

• Reconstructive surgery, including microsurgery, focuses on undoing or masking the destructive effects of trauma, surgery or disease. Reconstructive surgery may include closing defects using skin grafts or with local, regional or distant flaps—that is, by moving tissue from other parts of the body.
• Cosmetic (or aesthetic) surgery is most often performed in order to change features the patient finds unflattering. In many cases, however, there are medical reasons (for example, breast reduction when orthopedic problems are present).

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Permanent Plastic Surgery Jobs

Fantastic Plastic Surgery Opportunity With Group of Three Surgeons :: Pennsylvania :: CompHealth Inc
Job 658071 Busy Plastic Surgery group is recruiting an experienced Plastic Surgeon to join them Top Salary and benefits for the right candidate Call 1:4 No competition in local region Located in a wonderful
Facial Plastic Surgeon Needed for Excellent Practice Opportunity :: Pennsylvania :: CompHealth Inc
Job 6512599 Require Board Certified / Board Eligible Plastic Surgeon with Fellowship training in craniofacial surgery Employed position Join a surgical team at a 400 bed modern facility Enjoy an established
Plastic Surgeon Needed for Breast Reconstruction :: Pennsylvania :: CompHealth Inc
Job 6512851 Breast Surgery program is expanding Requires an additional Fellowship in Breast Reconstruction beyond Plastic Surgery Residency Relocation and CME Medical Education Debt Repayment Assistance

Archives of Facial Plastic Surgery current issue

About This Journal [About This Journal]

Highlights of Archives of Facial Plastic Surgery [Highlights of Archives of Facial Plastic Surgery]

The Evolution of the Archives of Facial Plastic Surgery [Editorial]
Larrabee, W. F.
The Technical and Anatomical Aspects of the World's First Near-Total Human Face and Maxilla Transplant [Original Article]
Alam, D. S., Papay, F., Djohan, R., Bernard, S., Lohman, R., Gordon, C. R., Hendrickson, M., Siemionow, M. Objective  To discuss the technical and anatomical analysis and design of an osteocutaneous allograft transplant incorporating the donor maxilla and the execution of the operative protocol during the transplant. Methods  The Cleveland Clinic reported the world's first successful combined face and maxilla transplant in December 2008. Unlike the 3 prior face transplants, this surgical procedure was done as a salvage operation in a patient who had undergone 23 major reconstructive procedures. The additional complexity due to significant postoperative scarring and recipient vessel depletion presented a unique challenge in this case. The extensive 3-dimensional losses of facial structures in multiple tissue planes required a Le Fort III osteomyocutaneous allotransplant incorporating the donor maxilla. Results  We report the first successful transfer of a complete bony framework and soft-tissue envelope. The allograft has shown excellent integration and no long-term rejection. The traditional conception based on anatomical studies suggested that this transfer would require independent dissection of the internal maxillary vascular system. This was not required in our patient whose allograft was based solely on the facial arterial system and its arcades. Conclusions  Successful near-total face and maxilla allograft transplant can be accomplished based on the facial arterial system and its arcades. This presents a novel method for reconstructing massive facial injuries with significant involvement of the facial skeleton.
Long-term Use and Follow-up of Irradiated Homologous Costal Cartilage Grafts in the Nose [Original Article]
Kridel, R. W. H., Ashoori, F., Liu, E. S., Hart, C. G. Objective  In 1993, Kridel and Konior published a preliminary report (in the Archives of Otolaryngology–Head and Neck Surgery) on the use of irradiated homologous costal cartilage (IHCC) or homograft cartilage in the nose. This is a follow-up study to share our experience in answering fundamental questions: (1) What are the major long-term complications of IHCC, and are they any greater than with the use of the patient's own cartilage? (2) Is IHCC a reliable and safe implant? (3) Does IHCC resorb over time? (4) What measures are implemented in our practice to minimize the sequelae? Design  We performed a retrospective review of patient medical charts in a university-affiliated private practice setting. A total of 357 patients underwent primary or revision rhinoplasty using IHCC grafts with postoperative follow-up duration ranging from 4 days to 24 years (mean [SD], 13.45 [2.83] years). A total of 1025 IHCC grafts and 373 other grafts (including 218 autogenous cartilage [AC] grafts) were used. A total of 201 grafts were dorsal onlay grafts, and 74 of them have been further followed up since the previous report. The grafts were evaluated for warping, infection, infective resorption, noninfective resorption, mobility, and extrusion. Patient satisfaction evaluation was performed in 42 patients. Results  The total complication rate related to IHCC grafts was 3.25%, which included 10 warped grafts of 941 palpable or superficial IHCC grafts (1.06%), 9 infections of 1025 IHCC grafts (0.87%), 5 cases of infective resorption of 1025 IHCC grafts (0.48%), 5 noninfective resorptions of 943 palpable IHCC grafts (0.53%), and 3 cases of graft mobility of 941 palpable grafts (0.31%). Nine cases of local infection were treated and could have arisen from any of the 1025 IHCC grafts as well as from the 373 other grafts. Among the 9 cases of infection, in 2 patients IHCC grafts were used alone, and in 7 patients IHCC grafts were used in combination with other types of graft materials; therefore, the actual infection rate related to the pure use of IHCC was 2 of 1025 or 0.2%. Of the 218 AC grafts used at the same operative intervention along with IHCC grafts, 3 grafts (1.37%) underwent minimal resorption. The overall comparative resorption rates were 1.01% (IHCC) vs 1.37% (AC). The complication rate in conjunction with the use of 162 IHCC s in 53 cases of septal perforation repair was 2.46% (4 cases), including only 1 case of infection, 1 case of mobility of the graft, 1 case of warping, and 1 case of infective resorption (0.61% for all). Of the 25 AC grafts used in septal perforation cases, there were 2 cases of noninfective resorption (8%). The overall comparative complication rates in septal perforation cases were 2.46% for IHCC vs 8% for AC, which indicated a 3.25-times higher complication with the AC than with IHCC. No allergic reaction or systemic disease was reported by patients as a result of use of the IHCC. Irradiated homograft cartilage also proved to be a reliable graft in 2 patients with progressive autoimmune diseases over 2.08 years and 10 years of follow-up. The average rates of patient satisfaction increased during a mean follow-up of 7.87 years, from 91.31% to 94.18%, in 4 categories, including nasal appearance, nasal breathing, nasal symptoms, and quality of life. Conclusions  Based on careful and extensive review of the data, we have concluded that IHCC is well tolerated as a grafting material in rhinoplasty and yields superb functional, structural, and cosmetic results in the most complex and challenging operative cases necessitated by previous unsuccessful nasal surgery, septal perforations, and even in autoimmune diseases that led to nasal deformity. Not only did very few complications occur following the use of 1025 IHCC grafts in 357 patients after 386 rhinoplasties over 24 years (rate, 3.25%), but the rate of complications was no greater than rhinoplasty complication rates when AC grafts are used. The results indicate safety and reliability and justify the convenient use of IHCC grafts for primary and revision rhinoplasty without creating donor site morbidity. Irradiated homograft cartilage grafts are quite stable in the nose and maintain structural contour and support in most cases. Irradiated homograft cartilage grafts should be considered as an alternative or even a primary grafting material when the patient does not have adequate quantities of septal or auricular cartilage remaining to provide the correction or when the shape or quality of such an AC does not adequately provide the structure required. Autogenous rib cartilage is also an alternative material but also increases operative and anesthesia time and adds potential morbidity. The use of IHCC is both cost- and time-effective.
Measurements of Orbital Volume Change Using Computed Tomography in Isolated Orbital Blowout Fractures [Original Article]
Kwon, J., Barrera, J. E., Jung, T.-Y., Most, S. P. Objectives  To measure the orbital volume of unilateral pure blowout fractures with computed tomography before and after surgery and to compare 3-dimensional (3-D) imaging systems. Methods  Twenty-four patients were evaluated with facial computed tomographic scans before and after surgery. Both the orbital volume and the displaced soft tissue volume were measured by 2 operators using 2 different 3-D software programs (Vitrea; Vital Images Inc, Minnetonka, Minnesota; and Dextroscope; Bracco AMT Inc, Princeton, NJ). Results  The mean (SD) normal orbital volumes calculated by Vitrea and Dextroscope were 25.5 (2.4) mL and 24.8 (3.0) mL, respectively. The average preoperative orbital volumes were 28.3 (2.3) mL and 27.6 (3.1) mL, while the postoperative volumes were 25.8 (2.5) mL and 24.9 (3.0) mL. Vitrea showed that the average volume of displaced orbital soft tissue was 2.8 (1.9) mL before surgery and that it was reduced to 0.3 (1.3) mL after surgery, while Dextroscope showed that the average displaced orbital soft tissue was 2.9 (1.4) mL before surgery and that it was reduced to 0.1 (1.2) mL after surgery. There was no statistical difference between the 3-D analysis programs. Conclusions  Consistent volume measurements can be obtained using different 3-D image analysis programs. Measuring preoperative and postoperative volume changes and postoperative reduction can ensure a good surgical result and thereby decrease the incidence of enophthalmos.

Aesthetic Plastic Surgery

A New Technique for Gluteal Lifting Using Deepithelialized Dermal Flaps
Sat, 05 Dec 2009 08:58:09 -0000
A New Technique for Gluteal Lifting Using Deepithelialized Dermal Flaps Content Type Journal ArticleCategory DiscussionDOI 10.1007/s00266-009-9448-3Authors Sadri Ozan Sozer, Texas Tech University Health Sciences Center Department of General Surgey 4800 Alberta Avenue El Paso TX 79905 USAFrancisco J. Agullo, Texas Tech University Health Sciences Center Department of General Surgey 4800 Alberta Avenue El Paso TX 79905 USA Journal Aesthetic Plastic SurgeryOnline ISSN 1432-5241Print ISSN 0364-216X
Is Breast Augmentation Using Hyaluronic Acid Safe?
Sat, 05 Dec 2009 08:58:06 -0000
Is Breast Augmentation Using Hyaluronic Acid Safe? Content Type Journal ArticleCategory DiscussionDOI 10.1007/s00266-009-9451-8Authors Sebastián Mir-Mir Caragol, Paseo del Perello 12, San Andres del Llavaneras Barcelona 08392 Spain Journal Aesthetic Plastic SurgeryOnline ISSN 1432-5241Print ISSN 0364-216X
Changes in Occlusal Force After Intraoral One-Stage Curved Osteotomy of the Prominent Mandibular Angle
Sat, 05 Dec 2009 08:58:06 -0000
Abstract Background  Curved osteotomy of a prominent mandibular angle is widely used in narrowing the width of the lower face, but its influence on occlusal force has not been evaluated. Methods  The maximum occlusal forces of five different teeth areas in 20 consecution patients with an average age of 26.5 years were studied. The examinations were performed both before the operation and 6 months afterward. Results  The values of maximum occlusal force had reached the preoperative levels or slightly above for the incisor teeth, bilateral premolar teeth, and bilateral molar teeth 6 months after operation. There were no significant differences between the levels before the operation and 6 months afterward (P > 0.05). Conclusion  According to the study findings, curved osteotomy of the prominent mandibular angle had no long-term harmful effects on occlusal force. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00266-009-9439-4Authors Wuyuan Tan, Peking Union Medical College, Chinese Academy of Medical Sciences Craniomaxillofacial Surgical Center, Plastic Surgery Hospital Ba Da Chu Road No. 33, Shi Jing Shan District Beijing 100044 ChinaLai Gui, Peking Union Medical College, Chinese Academy of Medical Sciences Craniomaxillofacial Surgical Center, Plastic Surgery Hospital Ba Da Chu Road No. 33, Shi Jing Shan District Beijing 100044 ChinaMeng Wang, Peking Union Medical College, Chinese Academy of Medical Sciences Plastic Surgery Hospital Beijing ChinaShuang Qiu, Peking Union Medical College, Chinese Academy of Medical Sciences Plastic Surgery Hospital Beijing ChinaYing Chen, Peking Union Medical College, Chinese Academy of Medical Sciences Plastic Surgery Hospital Beijing ChinaFeng Niu, Peking Union Medical College, Chinese Academy of Medical Sciences Plastic Surgery Hospital Beijing ChinaBing Yu, Peking Union Medical College, Chinese Academy of Medical Sciences Plastic Surgery Hospital Beijing ChinaJianfeng Liu, Peking Union Medical College, Chinese Academy of Medical Sciences Plastic Surgery Hospital Beijing China Journal Aesthetic Plastic SurgeryOnline ISSN 1432-5241Print ISSN 0364-216X
Is Breast Augmentation Using Hyaluronic Acid Safe?
Sat, 05 Dec 2009 08:58:06 -0000
Abstract  Macrolane™, a compound composed of hyaluronic acid, is the newest product to be marketed for breast augmentation. Like many previous breast augmentation products, Macrolane has been authorised for use with very little published scientific data on its safety and efficacy in breast augmentation. This article reviews the evidence available on the safety of using hyaluronic acid and raises concerns with regard to its use as a product for breast augmentation, the technique recommended for its use, and the authorisation process for new implantable medical devices. It is strongly recommended that clinicians review the lack of data on Macrolane before offering it as a treatment option to patients. Content Type Journal ArticleCategory ReviewDOI 10.1007/s00266-009-9450-9Authors Micheal J. McCleave, The Royal Adelaide Hospital Department of Plastic & Reconstructive Surgery North Terrace Adelaide SA 5000 Australia Journal Aesthetic Plastic SurgeryOnline ISSN 1432-5241Print ISSN 0364-216X
Comparison of Surgisis®, AlloDerm®, and Vicryl Woven Mesh® Grafts for Abdominal Wall Defect Repair in an Animal Model
Sat, 05 Dec 2009 08:58:05 -0000
Abstract Background  Surgisis® and AlloDerm®, two biosynthetic materials, have been previously used with success in abdominal wall repairs in the setting of contaminated fields. Historically, Vicryl Woven Mesh®, a synthetic material, has also been used in such settings as a temporary bridge for abdominal wall reconstruction. This study compares Surgisis and AlloDerm with Vicryl Woven Mesh with respect to tensile strength, collagen remodeling, and neovascularization using a rat hernia model. Methods  A prospective randomized trial of 54 Sprague-Dawley rats were assigned to the Surgisis, AlloDerm, or Vicryl Woven Mesh group with baseline, 30-day, and 60-day end points. A 1.5-cm × 5.0-cm defect was created in the right abdominis rectus muscle and repaired with an underlay bridge graft using the different treatment materials. Tensile strength was measured using an Instron tensiometer. Histologic specimens were evaluated for neovascularization, collagen deposition, and collagen organization at the 30- and 60-day time points. Results  Surgisis had significantly greater tensile strength compared to Vicryl Woven Mesh at the baseline time point (0.142 vs. 0.091 MPa, p < 0.05). There were no differences between groups tensile strength at 30 or 60 days postoperatively. The Vicryl Woven Mesh and AlloDerm groups showed increases in tensile strength at 30 days postoperatively versus baseline (p < 0.05). Vicryl Woven Mesh, Surgisis, and AlloDerm all showed increases in tensile strength at 60 days postoperatively compared to 30 days postoperatively and at baseline (p < 0.05). Surgisis and AlloDerm had significantly greater (p < 0.05) amounts of collagen deposition and organization at 30 and 60 days compared to Vicryl Woven Mesh. There was no significant difference between AlloDerm and Surgisis with respect to collagen deposition and organization. Surgisis and AlloDerm showed a significantly greater amount (p < 0.05) of neovascularization than Vicryl Woven Mesh at both time points. In addition, Surgisis had a significantly greater amount (p < 0.05) of neovascularization than AlloDerm at both 30 and 60 days. Conclusion  Surgisis has increased baseline tensile strength compared to Vicryl Woven Mesh. Tensile strength in Vicryl Woven Mesh is equal to biosynthetic grafts after tissue incorporation. Biosynthetic grafts showed superior collagen deposition and organization. Surgisis mesh showed increased neovascularization over both AlloDerm and Vicryl Woven Mesh. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00266-009-9449-2Authors Robert D. Rice, Dwight D. Eisenhower Army Medical Center Department of General Surgery Fort Gordon GA 30905 USAFarhan S. Ayubi, Dwight D. Eisenhower Army Medical Center Department of General Surgery Fort Gordon GA 30905 USAZachary J. Shaub, Dwight D. Eisenhower Army Medical Center Department of General Surgery Fort Gordon GA 30905 USADavid M. Parker, 121 Combat Support Hospital Department of General Surgery Yongsan KoreaPeter J. Armstrong, Dwight D. Eisenhower Army Medical Center Department of General Surgery Fort Gordon GA 30905 USAJohn W. Tsai, Dwight D. Eisenhower Army Medical Center Department of General Surgery Fort Gordon GA 30905 USA Journal Aesthetic Plastic SurgeryOnline ISSN 1432-5241Print ISSN 0364-216X
Can the Pectoral Fascia Integrity Be Preserved During Subfascial Breast Augmentation Through the Axillary Approach?
Tue, 01 Dec 2009 08:29:12 -0000
Abstract Background  Although many authors recently have reported good results with subfascial breast augmentation, it still is controversial whether the integrity of the pectoral fascia can be preserved. Some authors think the pectoral fascia will be broken during the operation because it is thin and weak. Therefore, this study aimed to investigate whether the integrity of the pectoral fascia can be preserved during subfascial breast augmentation through an axillary incision without endoscopic assistance. Methods  For this study, 10 patients underwent subfascial augmentation mammaplasty through the axillary approach. The technique was used for patients with small or moderate breasts. The pockets were made with the fingers. The area beyond the reach of the fingers was dissected using a breast dissector. Then the pocket and major pectoral fascias were examined with an endoscope. The endoscope was used only to inspect the fascia and major pectoral muscle after the subfascial dissection was completed. The fascia and surgical effects were evaluated. Results  The integrity of 11 (55%) of 20 pectoral fascias in 10 patients was preserved during the surgery. Four fascias (20%) were broken at about the fourth intercostal space or at the fifth costa. In five breasts (25%), the superficial layer of the pectoral muscle was split, but the integrity of the fascia was maintained. All the patients except one with asymmetric breasts achieved satisfactory results. There was no active bleeding, hematoma, infection, or fibrous capsule contracture during the follow-up period. Conclusion  The integrity of most pectoral fascias (11 + 5 fascias) could be preserved through the axillary approach during subfascial breast augmentation without endoscopic assistance. Even if the lower portion of the pectoral fascia was broken, this did not interfere with the aesthetic outcome or the normal postoperative recovery. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00266-009-9443-8Authors Lin Jinde, Nanjing Medical University International Plastic and Aesthetic Center Nanjing Jiangsu ChinaChen Xiaoping, Nanjing Medical University International Plastic and Aesthetic Center Nanjing Jiangsu ChinaZhang Wanquan, Nanjing Medical University International Plastic and Aesthetic Center Nanjing Jiangsu ChinaGao Xia, Nanjing Medical University International Plastic and Aesthetic Center Nanjing Jiangsu ChinaXu Ligang, Nanjing Medical University International Plastic and Aesthetic Center Nanjing Jiangsu China Journal Aesthetic Plastic SurgeryOnline ISSN 1432-5241Print ISSN 0364-216X

pubmed: 1529-4242


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