The Dimpleplasty: A New Streamlined Approach to Surgical Creation of Dynamic Facial Dimples, Our Experience, and Results

2018 ◽  
Vol 36 (3) ◽  
pp. 138-142
Author(s):  
Achih Chen ◽  
Daniel Gerry ◽  
Zachary Zimmerman
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Complications ◽  
Postoperative Infection ◽  
Adverse Outcomes ◽  
Consecutive Series ◽  
Surgical Time ◽  
Primary Endpoints ◽  
Aesthetic Results ◽  
Static Versus Dynamic ◽  
Low Rate

The purpose of the study is to provide a review of published techniques for creating facial dimples as context for describing a new streamlined approach, and to describe our experience and results in a series of 20 patients. A consecutive series of 20 patients was selected. All patients underwent bilateral open, trans-oral dimpleplasty procedures consisting of the use of an 8-mm punch to excise a core of tissue extending from mucosa to subcutaneous fascia, followed by placement of intradermal polydioxanone (PDS) sutures placed from the intra-oral mucosa, including the dermis, and all intervening layers. Patients were followed for a period of 6 months, with postoperative complications, persistence of static versus dynamic dimple formation, and overall patient satisfaction recorded as primary endpoints. Out of 20 patients, 2 adverse outcomes were reported: one reversal of dimpling was associated with accidental removal of PDS sutures by the patient’s dentist, and one, unilateral, postoperative infection was associated with postoperative antibiotic noncompliance. All other patients reported persistent bilateral dynamic dimple formation and excellent overall satisfaction with aesthetic results. Our experience with a new streamlined approach to surgical dimple creation produced consistent, reliable, and durable results with a low rate of complications, minimal investment of surgical time, and excellent patient satisfaction with their aesthetic results.

Evaluation of the Surgical Treatment for Congenital Blepharoptosis Using Mustarde’s Modified Method

2016 ◽  
Vol 88 (3) ◽  
Author(s):  
Aleksandra Iljin ◽  
Andrzej Zieliński ◽  
Edward Lewandowicz ◽  
Bogusław Antoszewski ◽  
Tomasz Zieliński
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Surgical Technique ◽  
Surgical Correction ◽  
Small Range ◽  
Modified Method ◽  
Aesthetic Results ◽  
Low Rate

AbstractThe aim of the study was evaluation of the results of surgical treatment of congenital blepharoptosis (CBP) using Mustarde’s modified method.Material and methods. Between 2005-2014 forty eight children with CBP underwent surgical correction of CBP by Mustarde’s modified method. Basing on the results of ophthalmic and orthoptic examination, and standard measurements, we estimated postoperative difference in the position and symmetry of the upper eyelids, and postoperative complications in our patients.Results. Very good results were obtained in all cases with mild, in 89.5% with moderate, and in 85.7% with severe unilateral CBP after correction by Mustarde’s modified method. Lagophthalmos was seen in 6.25%, and undercorrection in 12.5% of cases.Conclusions. 1. Mustarde’s modified method allows for obtaining very good functional and aesthetic results in CBP patients. 2. Mustarde’s modified method is a valuable supplemental surgical technique in CBP, and contributes to a low rate and small range of lagophthalmos.

Activity Tracking After Surgery: Does It Correlate With Postoperative Complications?

2021 ◽  
pp. 000313482098881
Author(s):  
Yehonatan Nevo ◽  
Tali Shaltiel ◽  
Naama Constantini ◽  
Danny Rosin ◽  
Mordechai Gutman ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
Inverse Correlation ◽  
Complication Rates ◽  
Activity Tracking ◽  
Primary Endpoints ◽  
Specific Complication ◽  
Secondary Endpoints ◽  
Enhanced Recovery Programs

Background Postoperative ambulation is an important tenet in enhanced recovery programs. We quantitatively assessed the correlation of decreased postoperative ambulation with postoperative complications and delays in gastrointestinal function. Methods Patients undergoing major abdominal surgery were fitted with digital ankle pedometers yielding continuous measurements of their ambulation. Primary endpoints were the overall and system-specific complication rates, with secondary endpoints being the time to first passage of flatus and stool, the length of hospital stay, and the rate of readmission. Results 100 patients were enrolled. We found a significant, independent inverse correlation between the number of steps on the first and second postoperative days (POD1/2) and the incidence of complications as well as the recovery of GI function and the likelihood of readmission ( P < .05). POD2 step count was an independent risk factor for severe complications ( P = .026). Discussion Digitally quantified ambulation data may be a prognostic biomarker for the likelihood of severe postoperative complications.

Perioperative management after elective cardiac surgery: the predictive value of procalcitonin for infective and noninfective complications

2021 ◽  
Author(s):  
Alice Laudisio ◽  
Antonio Nenna ◽  
Marta Musarò ◽  
Silvia Angeletti ◽  
Francesco Nappi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Predictive Value ◽  
Odds Ratio ◽  
Rate Ratio ◽  
Perioperative Management ◽  
Incidence Rate Ratio ◽  
Adverse Outcomes ◽  
Elective Cardiac Surgery ◽  
The Third

Objective: Procalcitonin (PCT) has been associated with adverse outcomes after cardiac surgery. Nevertheless, there is no consensus on thresholds and timing of PCT measurement to predict adverse outcomes. Materials & methods: A total of 960 patients undergoing elective cardiac surgery were retrospectively evaluated. PCT levels were measured from the first to the seventh postoperative day (POD). The onset of complications was recorded. Results: Complications occurred in 421 (44%) patients. PCT on the third POD was associated with the occurrence of any kind of complications (odds ratio: 1.06; p: 0.037), and noninfectious complications (odds ratio: 1.05; p: 0.035), after adjusting. PCT above the median value at the third POD (>0.33 μg/l) predicted postoperative complications (incidence rate ratio: 1.13; p = 0.035). Conclusion: PCT seems to predict postoperative complications in cardiac surgery. The determination at the third POD yields the greatest sensitivity and specificity.

Presepsin and Procalcitonin Levels as Markers of Adverse Postoperative Complications and Mortality in Cardiac Surgery Patients

2018 ◽  
Vol 47 (1-3) ◽  
pp. 140-148 ◽  
Author(s):  
Anna Clementi ◽  
Grazia Maria Virzì ◽  
María-Jimena Muciño-Bermejo ◽  
Federico Nalesso ◽  
Davide Giavarina ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Predictive Value ◽  
Renal Outcome ◽  
Positive Trend ◽  
Receiver Operating Characteristic Curves ◽  
Primary Endpoints ◽  
Significant Difference ◽  
Respiratory Outcome ◽  
Complications And Mortality

Backgound: This study was aimed at evaluating the presepsin and procalcitonin levels to predict adverse postoperative complications and mortality in cardiac surgery patients. Methods: A total of 122 cardiac surgery patients were enrolled for the study. Presepsin and procalcitonin levels were measured 48 h after the procedure. The primary endpoints were adverse renal, respiratory, and cardiovascular outcomes and mortality. Results: Presepsin and procalcitonin levels were significantly higher in patients with adverse renal and respiratory outcome (p < 0.001 and 0.0081). The presepsin levels were significantly higher in patients with adverse cardiovascular outcome (p = 0.023) and the procalcitonin values in patients with sepsis (p = 0.0013). Presepsin levels were significantly higher in patients who died during hospitalization (382 pg/mL, interquartile range [IQR] 243–717.5 vs. 1,848 pg/mL, IQR 998–5,451.5, p = 0.049). In addition, the predictive value for in-hospital, 30-days, and 6-months mortality was higher for presepsin, with a significant difference between the 2 biomarkers (p = 0.025, p = 0.035, p = 0.003; respectively). Presepsin and procalcitonin seem to have comparable predictive value for adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Although a positive trend was notable for presepsin and adverse renal outcome (area under the ROC [receiver operating characteristic] curves [AUC] of 0.760, 95% CI 0.673–0.833 versus procalcitonin: AUC 0.692; 95% CI 0.601–0.773): no statistically significant difference was evident between the AUC of the 2 biomarkers (p = 0.25). Conclusions: Presepsin and ­procalcitonin seem to have comparable predictive value for ­adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Also, presepsin possesses a better predictive value for in-hospital, 30-days, and 6-months mortality.

scholarly journals Complications in Treatment of 31-A Fractures with Trochanteric Gamma Nail (TGN) Versus Gamma3 Nail (G3N) - A Review of 217 Cases

2016 ◽  
Vol 10 (1) ◽  
pp. 389-395 ◽  
Author(s):  
R. Schupfner ◽  
L.T. Käsmann ◽  
W. Wagner ◽  
A.P. Schulz
Keyword(s):  
Complication Rate ◽  
Statistical Significance ◽  
Gamma Nail ◽  
Consecutive Series ◽  
Related Complication ◽  
Surgical Time ◽  
Adequate Treatment ◽  
Femur Fractures ◽  
Two Generations

Introduction:The aim of this study was to clinically evaluate two generations of intramedullary gamma-nail used in the treatment of 31-A femur fractures.Materials and Methods:In two consecutive series, 117 trochanteric gamma nails (TGN) and 100 Gamma3 nails (G3N) were implanted for the treatment of inter- and subtrochanteric fractures between 2009 and 2011. Clinical and radiological follow-up examinations were assessed. An analysis of surgical time, hemoglobin drop and complications were performed.Results:Average surgical time, fluoroscopy time, haemoglobin drop and length-of-stay (LOS) were similar in both groups. No significant differences were found in surgery-related complications like wound hematomas (p=0,59), abscesses (p=0,38), wound infections (p=0,69) and Cut-outs (p=0,69) between the two groups. The cumulative surgery-related complication rate was higher in the TGN group compared to the G3N group (13,68%vs.8%) but this did not reach statistical significance (p=0,2).Conclusion:Our findings suggest that both TGN and G3N allow adequate treatment of trochanteric fractures with an acceptable complication rate.

scholarly journals Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of Gynecomastia

2018 ◽  
Vol 14 (1) ◽  
pp. 18-23
Author(s):  
Kurdo Akram Qradaghi
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Operative Time ◽  
Surgical Techniques ◽  
Satisfaction Rate ◽  
Areola Complex ◽  
Different Types ◽  
Aesthetic Results ◽  
The Mean ◽  
Patient Satisfaction Rate

Background: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia. Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in different type Gynecomastia Type of the study: This is a retrospective study Methods: The study  includes the use of a modification of combine vibrated power-assisted liposuction with periareolar gland excision applied for managing different types of gynecomastia. In 23 consecutive patients (46 breasts) treated between February of 2011 and March of 2016. Results: 23 patients (46 breasts) were successfully treated using this technique. Volume aspirated in both breast was 792 ml (range, 450 to 1600 ml). Using the periareolar excision technique, the mean operative time was 55 minutes (range, 45 to 90 minute). Complications were minimal (1.5 % per breasts), and no revisions were required. Conclusions: The modified Combined vibrated power assisted liposuction and the periareolartechnique have demonstrated to be a less time consuming versatileapproach, for the treatment of gynecomastia and consistently produces a smoothcontoured male breast, it is promising method to achieve good aesthetic results in gynecomastia surgerywhile resulting in an inconspicuous scar.

scholarly journals Efficacy of ultrasound-guided forearm nerve block versus forearm intravenous regional anaesthesia in patients undergoing carpal tunnel release: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246863
Author(s):  
Hassanin Jalil ◽  
Florence Polfliet ◽  
Kristof Nijs ◽  
Liesbeth Bruckers ◽  
Gerrit De Wachter ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Intensity ◽  
Nerve Block ◽  
Carpal Tunnel ◽  
Regional Anaesthesia ◽  
Carpal Tunnel Release ◽  
Ultrasound Guided ◽  
Surgical Time ◽  
Randomized Controlled ◽  
Intravenous Regional Anaesthesia

Background and objectives Distal upper extremity surgery is commonly performed under regional anaesthesia, including intravenous regional anaesthesia (IVRA) and ultrasound-guided forearm nerve block. This study aimed to investigate if ultrasound-guided forearm nerve block is superior to forearm IVRA in producing a surgical block in patients undergoing carpal tunnel release. Methods In this observer-blinded, randomized controlled superiority trial, 100 patients undergoing carpal tunnel release were randomized to receive ultrasound-guided forearm nerve block (n = 50) or forearm IVRA (n = 50). The primary outcome was anaesthetic efficacy evaluated by classifying the blocks as complete vs incomplete. Complete anaesthesia was defined as total sensory block, incomplete anaesthesia as mild pain requiring more analgesics or need of general anaesthesia. Pain intensity on a numeric rating scale (0–10) was recorded. Surgeon satisfaction with hemostasis, surgical time, and OR stay time were recorded. Patient satisfaction with the quality of the block was assessed at POD 1. Results In total, 43 (86%) of the forearm nerve blocks were evaluated as complete, compared to 33 (66%) of the forearm IVRA (p = 0.019). After the forearm nerve block, pain intensity was lower at discharge (-1.76 points lower, 95% CI (-2.92, -0.59), p = 0.0006) compared to patients treated with forearm IVRA. No differences in pain experienced at the start of the surgery, during surgery, and at POD1, nor in surgical time or total OR stay were observed between groups. Surgeon (p = 0.0016) and patient satisfaction (p = 0.0023) were slightly higher after forearm nerve block. Conclusion An ultrasound-guided forearm nerve block is superior compared to forearm IVRA in providing a surgical block in patients undergoing carpal tunnel release. Trial registration This trial was registered as NCT03411551.

scholarly journals Analysis of the clinical and aesthetic results of facial dimple creation surgery

2020 ◽  
Vol 47 (5) ◽  
pp. 467-472
Author(s):  
Jae Min Chung ◽  
Joo Hyuk Park ◽  
Jeong Su Shim
Keyword(s):  
Foreign Body ◽  
Postoperative Complications ◽  
Medical Records ◽  
Foreign Body Reaction ◽  
Clinical Experiences ◽  
Tumor Removal ◽  
Presurgical Evaluation ◽  
Accurate Knowledge ◽  
Aesthetic Results ◽  
Age And Sex

Background Dimples on the cheeks can make the smile look more cheerful and attractive. Therefore, some people who do not have dimples may choose to undergo dimple creation surgery. Although dimple surgery is quite common, those desiring this procedure often lack information about it. Therefore, we conducted the present study to share our surgical tips and clinical experiences regarding safe dimple creation surgery.Methods This study included 2,048 patients who underwent dimple creation surgery at our plastic surgery clinic between April 2010 and June 2014. These patients were selected from those who displayed no scarring from injury or tumor removal in the central face during the presurgical evaluation. Medical records were used to identify the age and sex of each patient, the location of dimple creation, any postoperative complications, reoperation, and the reason for reoperation.Results Of the 2,048 patients, 159 (7.7%) underwent reoperation. The reason for reoperation was undercorrection in 78 cases (49.0%), disappearance of the dimple in 62 cases (38.9%), and overcorrection in nine cases (5.6%). Five patients (3.1%) had their stitches removed to eliminate the created dimple because they changed their minds, and five patients (3.1%) had their stitches removed because of infection. No patients reported complications after reoperation, and no other complications, such as hyperpigmentation or foreign body reaction, were observed.Conclusions Safe surgery with minimal complications and satisfying cosmetic results can be achieved via accurate knowledge of the relevant anatomy and its relationship with dimples, as well as appropriate surgical methodology.

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