Acne Scars

Ann Plast Surg. 2009 Jul 13; Cárdenas-Camarena LThe techniques of reduction mammoplasty are multiple and varied. Each one has advantages and disadvantages. With any of them, full preservation of vascularity and sensitizing of the nipple-areola complex (NAC) should be sought, as well as functionality of the breast. We present our 15 years' experience using the superolateral dermoglandular pedicle, a technique that fully preserves the integrity of the breast. During that 15-year period, we operated on 702 breasts in 356 patients, using the superolateral dermoglandular pedicle, with the NAC requiring a migration of 5 to 16 cm (mean: 9.2 cm), having resected breast tissue between 300 and 1380 g, (average: 660 g). The technique was used in women between 16 and 63 years of age (average 37), who wanted breast reduction and who required a migration of the NAC greater than 5 cm.We had minor complications consisting of wound dehiscence (5.9%), scar hyperpigmentation (3.9%), fat necrosis (3.8%), hypertrophic scarring (3.1%), alterations in sensitivity (2.27%), and keloid scarring (0.5%). We had 9 cases of necrosis of the NAC (1.28%), of which 7 were partial (0.99%) and 2 were total (0.28%). Satisfaction with the results was 94%.The technique of reduction mammoplasty with a superolateral dermoglandular pedicle has been used in mammary hypertrophy and gigantomasty with excellent results. Its design is simple, its performance easy, and its aesthetic results are highly reproducible. The position of the pedicle allows full preservation of the vascularity, sensitivity, and functionality of the breast, and is therefore a highly recommendable technique.

Pain Med. 2009 Jul 6; Tamimi MA, McCeney MH, Krutsch JABSTRACT Introduction. Pulsed radiofrequency (PRF) current applied to nerve tissue to treat intractable pain has recently been proposed as a less neurodestructive alternative to continuous radiofrequency lesioning. Clinical reports using PRF have shown promise in the treatment of a variety of focal, neuropathic conditions. To date, scant data exist on the use of PRF to treat myofascial and neuromatous pain. Methods. All cases in which PRF was used to treat myofascial (trigger point) and neuromatous pain within our practice were evaluated retrospectively for technique, efficacy, and complications. Trigger points were defined as localized, extremely tender areas in skeletal muscle that contained palpable, taut bands of muscle. Results. Nine patients were treated over an 18-month period. All patients had longstanding myofascial or neuromatous pain that was refractory to previous medical management, physical therapy, and trigger point injections. Eight out of nine patients experienced 75-100% reduction in their pain following PRF treatment at initial evaluation 4 weeks following treatment. Six out of nine (67%) patients experienced 6 months to greater than 1 year of pain relief. One patient experienced no better relief in terms of degree of pain reduction or duration of benefit when compared with previous trigger point injections. No complications were noted. Discussion. Our review suggests that PRF could be a minimally invasive, less neurodestructive treatment modality for these painful conditions and that further systematic evaluation of this treatment approach is warranted.

Aesthet Surg J. 2009 May-Jun; 29(3): 180-8van der Lei B, Cromheecke M, Hofer SOBACKGROUND: Over the last two decades, short scar facelifts, often referred to as "mini" facelifts, have gained popularity. We use a purse-string reinforced (PRS) superficial musculoaponeurotic system rhytidectomy (SMASectomy) shortscar facelift that combines a SMASectomy in the vertical direction and suspension sutures in order to improve structural facial support. In the case of visible platysma bands and/or local fat deposition, liposuction (frequently followed by an anterior plastysmaplasty procedure) was added to correct features that are not consistently correctable using only a short scar facelift. OBJECTIVE: This study retrospectively analyzes our experience with a new type of short scar facelift technique that combines both a superficial musculoaponeurotic system rhytidectomy (SMAS-ectomy) and suspension sutures with a thorough approach to the anterior surface of the neck. METHODS: Over a period of three years, the PRS short scar facelift was performed in 137 patients with a mean age of 55 years (range 23-79 years). In almost half of the patients, the PRS short scar facelift was preceded by a separate treatment of the anterior neck contour by liposuction (67/137 patients; 49%). In two-thirds of these patients (42/67 patients), this liposuction was followed by an anterior plastymaplasty. RESULTS: Most patients (129/137; 94%) were satisfied or very satisfied with their results at the end of the follow-up period. Eight patients were not satisfied: five because of higher expectations, two because of insufficient improvement of the plastysma bands (which had not been treated by a plastysmaplasty procedure), and one because of the improper recognition of midface sagging (which had not been treated and was not properly discussed preoperatively). In the case of plastysma bands, platysmaplasty (n = 42) did improve the presence of these bands. There were no major complications in this series: 1 case had temporary neuropraxia of a buccal branch, which resolved after two months; two cases had hematoma, requiring evacuation on the outpatient clinic after one week; two cases with traction dimpling in the neck over the sternocleidomastoid region required late surgical revision; and one case had hypertrophic scarring in the preauricular area. CONCLUSIONS: The PRS technique is a short scar facelift technique that is both simple and safe. Complications are uncommon and usually minor. However, in the presence of platysma bands and/or local fat deposition, an anterior neck procedure-liposuction and/or anterior platysmaplasty-should be incorporated in order to optimize the results.