The Versatility of Autologous Fat Grafting in Facial Volumetric Restoration

Deformities in the craniofacial region are of great social and functional importance. Several surgical techniques have been used to treat such pathologies often with high morbidity and lacking the ability to address smaller contour defects. The minimally invasive technique of fat transplantation has evolved rapidly within the last few decades. The objective of this paper is to present the versatility and applicability of fat transplantation in a wide range of contour deformities in the craniofacial region. We share our experiences in treating 24 patients with autoimmune disorders, congenital malformations, and acquired defects.

Ultrasonic C-scan techniques for the evaluation of impact damage in CFRP

In the present work, different ultrasonic C-scan approaches were used to evaluate Carbon Fiber Reinforced Polymers (CFRP) submitted to impacts of low energy, in order to evaluate their effectiveness for the detection and characterization of small defects. In particular, as to the question how useful could be the air-coupled C-scan approach, using low frequencies, for in-service application. For that goal, several samples with different stacking sequences and thicknesses were impacted with 1.5 and 3 J. Then, ultrasonic C-scan images were produced by immersion pulse-echo (in amplitude and time-of-flight (TOF)) and immersion through-transmission, and also by air-coupling through-transmission. The immersion C-scan images were produced using 5, 10 and 20 MHz probes and the air-coupled C-scan was made using two 400 kHz probes. The obtained images for the considered samples show that all used methods are able to detect the defects and give acceptable information about their size and shape. However, if the way of delamination evolving over thickness is of interest, the images by TOF should be used. As expected, good image resolution with sharp contour defects require high frequencies. Nevertheless, the air-coupled C-scan demonstrated similar capabilities to detect defects, with the advantage that the coupling medium is air, thus widening the range of applications, such as real-time damage monitoring of composite structures. As a disadvantage, the air C-scan system requires high power emission signals, and also great amplification of the received signals, to face the considerable attenuation in the air.

Securing cartilage grafts in closed rhinoplasty

Contour defects of the nose, in secondary cases or if encountered during primary rhinoplasty, are corrected by cartilage grafts in the majority of cases. Securing these grafts is tricky and time consuming, especially in closed rhinoplasty. There is still wide debate regarding the need for open or closed rhinoplasty which is very surgeon specific. Open rhinoplasty proponents use the difficulties in securing cartilage grafts as an example of one of the disadvantages to the closed approach. We describe a simple and quick suture method of securing cartilage grafts externally, to correct a range of defects in closed rhinoplasty, for which we have seen no disadvantage. This work was presented at The 39th Annual Meeting of The Israel Society of Plastic & Aesthetic. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Principles of Wound Management and Soft Tissue Repair II

Wound management and soft-tissue repair can vary depending on the location. The head and neck, chest and back, arm and forearm, hand, abdomen, gluteal area and perineum, thigh, knee, lower leg, and foot all have different local options and preferred free flaps to use for reconstruction. Secondary reconstruction requires a detailed analysis of all aspects of the wound including any scars, soft tissue and/or skin deficits, functional defects, contour defects, complex or composite defects, and/or unstable previous wound coverage. Careful monitoring of both the patient and reconstruction is necessary in the postoperative period to ensure long-term success. This review contains 2 figures and 17 references. Key Words: free tissue transfer, pedicle flaps, soft-tissue coverage, wound closure, wound healing, wound management, wound reconstruction, tissue flaps

Principles of Wound Management and Soft Tissue Repair II

Wound management and soft-tissue repair can vary depending on the location. The head and neck, chest and back, arm and forearm, hand, abdomen, gluteal area and perineum, thigh, knee, lower leg, and foot all have different local options and preferred free flaps to use for reconstruction. Secondary reconstruction requires a detailed analysis of all aspects of the wound including any scars, soft tissue and/or skin deficits, functional defects, contour defects, complex or composite defects, and/or unstable previous wound coverage. Careful monitoring of both the patient and reconstruction is necessary in the postoperative period to ensure long-term success. This review contains 2 figures and 17 references. Key Words: free tissue transfer, pedicle flaps, soft-tissue coverage, wound closure, wound healing, wound management, wound reconstruction, tissue flaps

Volumetric estimation of autologous fat for augmentation of contour defects of face

<p>Autologous fat transfer for correcting contour defects of face has gained wide popularity in aesthetic surgery. However, quantification of fat requirement and its survival is still a fertile area for research to improve the predictability of volume retention of injected fat. There have been no detailed studies of the calculation for the amount of fat to be injected and percentage of fat retained. The objective of this study was to quantify the amount of fat required for correcting a facial deformity and amount retained postoperatively over a period of 6 months. Thirty patients were recruited in a prospective study where in, the fat requirement for augmenting the soft tissue defect was assessed using USG preoperatively and followed up at 1, 3 and 6 months by the same technique. It was found that USG is a simple, objective, reliable, cost-effective method of assessing the fat requirement and retention in autologous fat transfer.</p>