No abstract

No abstract

No abstract

Macromastia causes back and neck pain, scaphodynia, intertrigo of the inframammary crease up to dysaesthesia. Typical complaints of patients with macromastia are physical burden, psychological irritation and aesthetic deformity, often resulting in social isolation. Despite the demonstrable success of reduction mammaplasty to eliminate not only the symptoms of macromastia but the cause of the ailment, conservative therapy is still favoured by insurance companies and bearing of costs for surgical therapy therefore is rejected. Expenses of conservative treatment as well as costs related to appeal and lawsuits against insurance decisions exceed the case-based lump sum of reduction mammaplasty manifold. Conservative treatments do not eliminate the causes of the illness. Therefore the rejection of a medically indicated reduction mammaplasty has to be regarded as unfavourable and economically inefficient.

Patients sustaining high-voltage electrical injury may experience neurological sequelae. The exact mechanism of nervous cell destruction is an ongoing subject of research, frequently a combination of both thermal and nonthermal causes. In this report, brain damage of the entire right hemisphere according to the current flow with isolated affection of pre- and postcentral gyrus of left hemisphere is described. Clinical findings, including neurological symptoms, radiographic images, and autopsy results, are presented. Possible mechanisms of brain destruction solely caused by current flow are discussed.

Rhinophyma is considered the end stage in the development of rosacea, accompanied by hypertrophy of the sebaceous glands, which causes an enlargement of the nose. It is an uncommon condition that often results in both functional and cosmetic impairment. A large variety of surgical and nonsurgical treatments have been published to treat it. Closure is usually obtained by wound granulating in by secondary intention, skin grafting or local flaps. Rarely these lesions can attain a giant size and pose a challenge in surgical treatment. We present a 63-year-old male with the necessity for tracheostomy at the ICU due to total nasal obstruction and recurrent episodes of pneumonia caused by a huge giant rhinophyma, which had undergone extreme growth in the last five years. The tumor was removed under general anesthesia by decortication with an electrosurgical wire loop to recreate the aesthetic units of the nose preserving the alar cartilage as well as the pilosebaceous appendages. The wounds healed in by secondary intention with a very pleasant cosmetic and improved functional result. The relevant literature is discussed. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Ribeiro technique is a well established, versatile standard technique for reduction mammaplasty, which helps to create high-quality reproducible results with longterm formstable shape. In gigantomastia, this procedure is also very effective to achieve volume reduction and aesthetically pleasing results with a low complication rate.

Liposuction is one of the most common aesthetic procedure used in plastic surgery. Reports are available on the results, the probable complications, and the feedback of patients. However, systematic studies dealing with these aspects using reliable large-enough data are still needed. The data comprised 116 procedures during a 6-year period up to 2005. The data were processed and categories of results were formed. Furthermore, a follow-up examination and a survey on the feedback of patients were carried out. Significant differences were identified in indications, results, and complications. The follow-up examinations and the survey showed satisfying results. In the majority of cases, surgeons were satisfied with the operations. In conclusion, if conducted by qualified surgeons in appropriate surgical conditions and postoperative care possibilities, liposuction may be considered as a reliable surgical procedure. The success of this procedure depends, however, on suitable infrastructure and operative competence.