Power-Assisted Liposuction Mammaplasty (PALM): A Short Scar Mammaplasty in Gigantomastia

Breast reduction has been widely studied throughout the years, with different types of resection and breast reshaping techniques being described based on one or two pedicles. This chapter introduces the combination of parenchymal resection and liposuction to treat Gigantomastia, leaving a short scar. Liposuction improves breast remodeling, whereas breast glandular resection and repositioning enhances the upper pole fullness. The Power-Assisted Liposuction Mammaplasty (P.A.L.M.) technique is a safe and reliable procedure, insuring an optimal vascularization to the breast through the preservation of the central, superior and lateral pedicle, thus reducing the complication rate. In this chapiter we emphasize the importance of the preoperative markings, considered as essential for optimal results.

Short-Scar Latissimus Dorsi (SSLD) With a Lateral Approach: A Game Changer in Breast Reconstruction?

Background In delayed breast reconstruction, the thoraco-mammary cutaneous tissue often shows residual damage from radiotherapy. The fragility of this tissue is associated with a risk of skin necroses of about 8% when dissection is performed by reopening of the mastectomy scar. Objectives The objective of our study was to adapt the technique of short-scar latissimus dorsi flap surgery with an abdominal advancement flap using a lateral approach only avoiding re-incision of the mastectomy scar. Methods In this retrospective study, we performed 150 reconstructions in 146 patients to assess the safety and effectiveness of the SSLD technique with lateral approach. The primary outcome was the occurrence of postoperative skin necrosis of the thoraco-mammary area. Results Of the 150 delayed breast reconstruction procedures performed, none showed skin necrosis of the thoraco-mammary area, and a positive effect on skin trophicity of this area was observed. The resulting patient and surgical team satisfaction were very favorable. Conclusions In our practice, this technique changed our paradigm because of good skin safety and effectiveness. It allows reconstruction without a patch-effect in patients with very poor skin quality in whom the thoraco-mammary skin would have been replaced in the past by a skin paddle. Reconstruction would have even be contraindicated. It could also be an alternative to many other more complex and longer techniques of autologous reconstruction.

Extending the “Reach” of the Short-Scar Facelift with Energy Devices—An Early Report

Facial rejuvenation has become more popular. A wider breadth of the patient population is seeking procedures to preserve their youthful facial attributes and to remedy age-related deleterious changes. Along with this increasing interest in facial rejuvenation is also the expressed desire for any interventions to be relatively low risk, with limited recovery, and with achievable positive results. Many new technologies have become available in an attempt to improve age-related facial changes. The radiofrequency (RF)-based technologies are largely directed toward skin tightening and toward reducing and remodeling subcutaneous fat. It can be contemplated that the combination of RF-based technology with limited surgical procedures may extend the patient selection for less invasive procedures while improving potential results. This is a report of the combination of radiofrequency technologies—percutaneous and transcutaneous—with short scar face techniques in facial rejuvenation.

Patient Satisfaction Following Inverted-T and Short-Scar Mammaplasty as Measured by the Breast Evaluation Questionnaire 55

Background Mastopexy combined with silicone implant placement is one of the most frequently performed plastic surgeries. Various techniques have been developed to increase the degree of patient satisfaction after surgery. The goal is to give the breasts a harmonious shape, generating the smallest scars possible. The Breast Evaluation Questionnaire 55 (BEQ 55) was developed in 2006 as a tool for assessing the satisfaction and comfort of patients with the general appearance of their breasts. Objectives The objective of this study was to compare the degree of satisfaction of patients undergoing mastopexy by the inverted-T technique vs the short-scar technique by the BEQ 55. Methods The BEQ 55 was administered pre- and postoperatively to 200 patients who underwent mastopexy performed by the first author between October 2013 and September 2017. One hundred patients underwent the short-scar technique, and 100 patients underwent the inverted-T technique. Results The first analysis used descriptive statistics. Relative frequencies were used to track the responses corresponding to each technique. There was an increase in the level of patient comfort and satisfaction with breast appearance after surgery in both groups. The short-scar technique was shown to be superior, with statistical significance (P < 0.05) found for the questions evaluating comfort with overall appearance naked, comfort with breast appearance naked, and satisfaction with breast appearance. Conclusions Both techniques improved the patients’ satisfaction and comfort with their breasts. When the short-scar technique was used, patients were more comfortable with their breast appearance and with their overall appearance naked. Level of Evidence: 4

Short or Minimum Incision Deep Plane/Extended Deep Plane Facelift/Rhytidectomy

The mini facelift, often referred to as short scar or minimum incision facelift or rhytidectomy, is a facial rejuvenation procedure with limited incisions. It aims to lift and tighten the superficial musculo-aponeurotic system to restore the lower midface and the mandibular contour, thus eliminating undesirable jowls. By performing the deep plane or extended deep plane facelift with short incisions, the midface and upper neck can also be improved without the full face and neck incisions as in the typical rhytidectomy. With its decreased operative time and expense, rapid recovery, less complications, as well as more limited incisions with resultant less evidence of scars, mini facelift techniques have boomed over a decade for younger patients who seek facial rejuvenation. We describe our concept of the short or minimum incision deep plane/extended deep plane facelift or rhytidectomy and address what results can be expected.