Background: Silicone implants have been used to improve volume and body contour in buttocks for almost 45 years. Although the intramuscular plane continues to be the standard, surgeons still diverge on the best incision technique: using a vertical incision, and thus without the preservation of the intergluteal groove, or preserving this area through a triangular dissection. The goal of this research study was to evaluate and compare these techniques of intramuscular augmentation gluteoplasty. Methods: Two randomized groups were formed with 53 patients in each group. One of the groups underwent intramuscular gluteoplasty with a vertical incision in the intergluteal groove, and therefore without the preservation of said intergluteal groove (group A). In the other group, intramuscular gluteoplasty was performed using a triangular dissection, thus preserving the intergluteal groove (group B). The groups were compared in relation to the incidence of complications (ie, dehiscence, hematoma, seroma, and infection). Results: A total of 7.5% of patients in group A presented dehiscence and 1.9% presented seroma. In group B, however, 28.3% of patients presented dehiscence and 7.5% presented seroma and dehiscence during the first 21 days after surgery. No patient had hematoma or infection in either group. Conclusion: In the comparison between the groups of patients, the technique with a vertical incision in the intergluteal groove showed a lower number of surgical wounds, dehiscences, and seromas when compared with the technique that preserves the intergluteal groove. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
Background Paralytic lagophthalmos can have devastating consequences for vision if left untreated. Several surgical techniques have been described, including the use of alloplastic and autologous materials. Objectives To evaluate the effectiveness of the surgical treatment of paralytic lagophthalmos with combined techniques using autologous material and involving the upper and lower eyelids. Methods Patients with paralytic lagophthalmos underwent stretching of the levator aponeurosis with interposition of conchal cartilage in the upper eyelid associated with sectioning of the orbitomalar ligament and lateral canthoplasty in the lower eyelid. The effectiveness of the technique was evaluated using subjective (symptomatology) and objective parameters (ophthalmologic evaluation and measurements of lagophthalmos and marginal reflex distances 1 and 2 [MRD1 and MRD2]). Results Eight patients with paralytic lagophthalmos were subjected to the proposed technique. In the postoperative period, 85.7% reported complete improvement of symptoms and 62.5% presented a normal eye examination. The mean lagophthalmos measurement was reduced by 5.93 mm, the mean MRD2 was reduced by 2.61 mm, and the mean MRD1 was reduced by 0.69 mm. Conclusions The technique presented herein, using autologous material associated with sectioning of the orbitomalar ligament and lateral canthoplasty, was effective in the treatment of paralytic lagophthalmos and did not present significant complications, such as extrusion.
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