Abstract:
BACKGROUND:Most nasal reconstructions previously repaired with regional flaps require a revision to improve appearance and function. Many local flaps also create significant landmark and contour distortions, such as alar crease obliteration or nostril margin malposition. METHODS:Over 400 nasal reconstructions with regional tissues, primarily forehead flaps, and 100 local flap repairs were evaluated to identify the causes of failure of the primary repair, to classify late deformities, and to develop an approach to the late revision of a nasal reconstruction. Surgical timing, staging, incisional approaches, and operative technique were defined with the goal of restoring normal dimension, volume, position, projection, symmetry, skin quality, border outline, and contour. RESULTS:Deformities can be classified as "minor," when overall dimension, volume, and position are satisfactory but nasal landmarks are imperfect, nostril margins are asymmetric, or the nostrils are small; or "major," when there is a significant failure to restore the basic fundamental character of the nose. It is bulky, shapeless, malpositioned and without landmarks. These characteristics determine incision sites, the extent of required flap reelevation, soft tissue excision and cartilage grafting, the number of stages, the use of secondary local flaps, surgical delay, and the need for reoperation with a second regional flap. CONCLUSIONS:Revision is accomplished through new direct incisions and old peripheral border scars. Soft tissue excision and secondary cartilage grafts can effectively reestablish contour. Lining deficiencies are addressed by transferring discardable local excess skin from the nostril margin, columella, cheek, or upper lip to open the airway. If local tissues are inadequate, a second regional flap must be transferred to resurface or line the nose.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Menick FJdoi
10.1097/PRS.0b013e3182362226subject
Has Abstractpub_date
2012-01-01 00:00:00pages
92e-103eissue
1eissn
0032-1052issn
1529-4242pii
00006534-201201000-00027journal_volume
129pub_type
杂志文章abstract::This article presents our experience with microsurgical lymphaticovenous implantation in the treatment of chronic lymphedema. Our attempt is to create a lymphaticovenous shunt with an implantation of the collecting lymphatics, including some lymphatic vessels and lymphatic capillaries, within external connective adven...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199801000-00026
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The free fibular flap has become the workhorse flap for composite mandibular defect reconstruction. As advancements in microsurgery have improved flap survival, greater interest has shifted toward flap refinements to avert donor-site morbidities. METHODS:A total of 27 free fibular flaps used for mandible re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318218fc70
更新日期:2011-07-01 00:00:00
abstract::The purpose of this study was to investigate the significance of fiber type and the effects of the duration of ischemia on metabolic and contractile function of skeletal muscle. Under anesthesia, the distal tendons of the fast twitch extensor digitorum longus (EDL) and slow twitch soleus (SOL) muscles of the right hin...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199701000-00025
更新日期:1997-01-01 00:00:00
abstract::Three methods of obtaining digital photographs in a clinical setting were compared using direct anthropometry as a reference standard. The methods included a digital camera, scanning negatives from a 35-mm single-lens reflex camera, and scanning Polaroid photographs taken with a Polaroid camera designed for medical do...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199906000-00002
更新日期:1999-06-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198511000-00024
更新日期:1985-11-01 00:00:00
abstract:BACKGROUND:Vascular malformations frequently enlarge during adolescence, suggesting that hormones may be involved. The purpose of this study was to determine whether pubertal hormone receptors are present in vascular malformations and whether they differ from normal tissue. METHODS:Tissue specimens (arteriovenous malf...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31824ec3fb
更新日期:2012-06-01 00:00:00
abstract::Congenital double-lip deformity is an infrequent developmental abnormality affecting the lips, more commonly the upper lip. We report seven cases of double lip, all in males, of which six were in the upper lip and one in the lower lip. It was quite interesting to observe that in the upper lip, the buccal portion of th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198909000-00006
更新日期:1989-09-01 00:00:00
abstract::Xeroradiography, because of its unique phenomenon of "edge enhancement," has some advantages for assessing facial fractures. In 17 of the 19 patients in our pilot study group, this technique was as valuable as, or more so than, plain films. The xerogram done prior to laminagraphy is a useful "map" for the radiologist ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197808000-00008
更新日期:1978-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000438060.46290.7a
更新日期:2014-03-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198501000-00016
更新日期:1985-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181a65ac3
更新日期:2009-06-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199804040-00014
更新日期:1998-04-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198003000-00008
更新日期:1980-03-01 00:00:00
abstract::Human liposuction aspirates contain pluripotent adipose-derived mesodermal stem cells that have previously been shown to differentiate into various mesodermal cell types, including osteoblasts and chondrocytes. To develop an autologous research model of bone and cartilage tissue engineering, the authors sought to dete...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200203000-00037
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journal_title:Plastic and reconstructive surgery
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更新日期:2010-05-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318195668e
更新日期:2009-02-01 00:00:00
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pub_type: 杂志文章,meta分析
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:1998-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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更新日期:2009-04-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2015-10-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2010-11-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
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