Buccal fat pad removal is an effective technique for refining the facial silhouette that should be reserved only for patients with increased buccal fat pad volume. Removal of only the excessive portion of the fat pad is important because this structure provides significant volume in the midface that can be difficult to restore once aging takes its toll on the surrounding soft and bony tissue.

Variable absorption rate is one of the biggest problems of fat grafting and one of the most important causes of fat graft volume loss is apoptosis. Minocycline is a tetracycline derivative and besides its antibacterial capacity, it has been widely using for anti-apoptotic effects. This study was designed to investigate the effect of minocycline on fat graft survival and adipocyte apoptosis. A total of two main and eight subgroups were designed and a total of 48 experimental animals, 6 in each group, were used. Fat grafts are obtained from Wistar albino rats and implanted to dorsal area of rats. Local and systemic minocycline was applied in the study groups. On the 9th day, apoptotic cells were detected by the terminal deoxynucleotidyl transferase dUTP nick end labeling method and on the 90th day morphologic characteristics and viability of adipocytes were evaluated using histologic and immunohistochemical methods and statistically compared. This study revealed that the fat grafts were bigger, and they kept their structures better and they were more vascular in the minocycline groups and apoptosis was significantly lower in the minocycline groups. The authors demonstrated that minocycline increases fat graft survival and statistical improvement in apoptosis inhibition via using minocycline therapy has been shown.

IntroductionReconstruction of the eyelids is a challenging task for plastic and reconstructive surgeons and is mostly performed due to trauma, tumor resection, or, less commonly, congenital abnormalities (e.g., coloboma, Tessier no. 3-6 clefts) (1,2). The decision as to the most appropriate reconstructive option depends on assessment of the eyelid defect in terms of its size, extent, orientation, and, most importantly, location. A method of classifying periocular defects according to location was developed by Spinelli and Jelks (3), in which the eyelid was divided into 5 zones: zone I, the upper eyelid; zone II, the lower eyelid; zone III, the medial canthal region; and zone IV, the lateral canthal region. Furthermore, any area outside zones I-IV but contiguous with the eyelids was described as zone V in this classification system (Figure 1).Full-thickness defects up to 25% of the width of the lower eyelid can be repaired via direct closure. Lateral canthotomy and cantholysis can provide 25% additional horizontal length, leading to tissue advancement and rotation to aid in closure of larger defects (1,3,4). When primary closure is not feasible, various flap alternatives developed with the aims of functional restoration and aesthetic improvement of the lower eyelid zones can be employed, such as the semicircle (Tenzel) flap ( 5), superiorly based tarsoconjunctival advancement (Hughes) flap (6), upper eyelid myocutaneous (Tripier) flap (7), transposed cheek (McGregor) flap (8), cheek rotation and advancement (Mustardé) flap (9), and supraorbital (Fricke) flap (10).Nasolabial flap is rarely employed for the reconstruction of the lower eyelid. It is a random-pattern cutaneous flap with redundant blood supply from the perforating branches of the facial and angular arteries and can be used as an inferiorly or superiorly based flap (11,12). It has a wide spectrum of use for nasal and midfacial defects (13,14) and can be used as an island (15) or transposition flap (16-18) for the reconstruction of the lower eyelid.In this study, we aimed to present the clinical results of using the superiorly based nasolabial island flap for repair Background/aim: Various flap procedures have been described and used for the lower eyelids; however, the nasolabial flap is rarely employed. We herein aimed to present the clinical results of using the superiorly based nasolabial island flap for repair of surgical defects extending to the lateral lower eyelid. Materials and methods:Nine patients with a mean age of 62 ± 6 years underwent surgery for reconstruction of the lower eyelid. Results:The diagnosis of lesions was nodular basal-cell carcinoma (n = 5), superficial basal-cell carcinoma (n = 1), well-differentiated squamous-cell carcinoma (n = 1), and basosquamous-cell carcinoma (n = 2). According to the classification reported by Spinelli and Jelks, 6 surgical defects were located at zones II and IV, while 3 were at zones II and V. Five patients required posterior lamellar reconstruction. Lagopthalmos (n = 1), ectropion (n = 1), and trans...

Rectovaginal fistulas, which are abnormal epithelial-lined connections between the rectum and vagina, are challenging to treat. Treatment of recto-neovaginal fistulas is more complicated due to the altered perineal anatomy in individuals undergoing gender reassignment surgery. We present a recto-neovaginal fistula that occurred after reassignment surgery male-to-female transgender case of a was successfully treated with restorative perineal graciloplasty.

Tension of the wound edges should be overcome with precise surgical planning, which is recognized as one of the major contributors to local complications by compromising circulation of the wound edges. In this article, it was aimed to present the clinical results of a surgical technique, in which the plastic straps and Kirschner wires are used for delayed primary closure of traumatic tension wounds. Depending on the assessment of the wound localization, wound dimension, and mobility of adjacent soft tissue, the technique was performed in 9 patients with a male to female ratio of 8:1. Gunshot injury was the leading cause (n ¼ 5), and in most cases, the wounds were located at the lower extremities (n ¼ 6). The mean time between performing the technique and closing the wound primarily and the mean hospitalization time were 4.8 + 1.1 and 13.5 + 3.9 days, respectively. In each case, wound closure and healing were achieved successfully without any serious complications. The presented technique provides advantages of using a low cost as well as a very simple equipment, improved and reliable stability during tightening process due to self-locking feature of the plastic straps, no donor site morbidity, short operating time with low rate of post-operative complications, and short hospitalization time. We recommend using this invaluable technique reliably for the treatment of traumatic tension wounds. However, further studies are needed for better evaluation of cosmetic and functional outcomes of the presented technique. Résumé Il faut une planification chirurgicale précise pouréviter la tension au pourtour des plaies, qui est reconnue comme l'un des principauxéléments responsables des complications locales. En effet, la tension compromet la circulation au pourtour des plaies. Dans le présent article, les auteurs ont cherché à présenter les résultats cliniques d'une technique chirurgicale qui fait appel à des bandes de plastique et à des broches de Kirschner pour retarder la fermeture primaire des plaies de tension traumatiques.

Background Although columellar strut grafts (CSGs) are considered among the fundamental steps for providing nasal tip support, a downward rotation of the nasal tip in patients with strut grafts can still be encountered. Patient-related factors such as nasal skin thickness can allow the plastic surgeon to anticipate certain drawbacks that can be encountered in the healing phase, but patient-based differences of nasal cartilage and the resulting impact have yet to be investigated. The purpose of this study was to evaluate the effect of the biomechanical properties of CSGs on late postoperative nasal tip position and support. Methods The study was undertaken with the participation of 20 patients undergoing closed-technique primary rhinoplasty with CSGs. Each cartilage specimen was biomechanically analyzed to calculate the modulus of elasticity. Preoperative and postoperative images were obtained to determine nasal tip position and rotation with quantitative measurements. Postoperative 3- and 12-month measurements were evaluated according to their relationship with the elasticity modulus of the utilized cartilages. Results The evaluation demonstrated that the elasticity modulus can impact the long-term support of the nasolabial angle in which an increase in the coefficient of elasticity can result in a decrease in long-term nasal tip support. Conclusion The results of the study reveal a new objective variable that can impact nasal tip dynamics and patient-related differences following rhinoplasty. This study not only brings forth a different perspective in the evaluation of nasal tip dynamics but can also provide data for determining ideal values for cartilage prefabrication.

It has been established that many chemotherapeutic agents are associated with a variety of ocular side effects. As an antineoplastic agent, 5-fluorouracil (5-FU) is the chemotherapeutic agent that is frequently linked with cicatricial ectropion. Capecitabine is a prodrug of 5-FU and has a more favorable side effect profile than 5-FU. Frequent side effects of capecitabine include gastrointestinal events and hand–foot–mouth syndrome; cicatricial ectropion is rather uncommon. Enzyme deficiencies affecting the capecitabine metabolism have been reported to be associated with exaggerated generalized systemic and cutaneous side effects; however, there are no cases in the literature reporting capecitabine-induced isolated bilateral-progressive ectropion. Although cessation of the agent is frequently sufficient for the treatment of ectropion, close follow-up is indicated in such patients as permanent damage may occur if the problem is left untreated. We report a case of capecitabine-induced bilateral cicatricial ectropion refractory to treatment cessation, ultimately requiring surgical treatment.

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