(1) The current operation corresponded to the expectations of the patients with few complications and favorable body contouring result. (2) Quality of life, quantified by means of adaptation and social adjustment scores, was adequate in most circumstances. (3) Outstanding responses for social/cultural performance were registered with encouraging findings for affectivity/personal relations, productivity, and organic/somatic health as well.

. Surgical treatment of lymphedema of the penis and scrotum. Clinics. 2006;61(4):289-94. PURPOSE:Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. MATERIALS AND METHODS:Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. RESULTS: Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. CONCLUSIONS: The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.

The major disadvantage of the circumferential abdominoplasty is the resulting scar. However, this procedure should be taken into consideration as an option to achieve a more harmonious body contour. Complications are not enough to contraindicate the surgery, because the patients preferred better social and professional integration, as well as behavioral improvement due to enhancement in their self-confidence.

1) Surgical treatment was effective. 2) Functional rehabilitation was achieved. 3) No recurrence was observed within the follow-up period.

In a prospective study, indices of glucose homeostasis, lipid profile, and systemic inflammation were monitored after an aesthetic abdominoplasty, aiming to scrutinize the possible metabolic benefits for abdominal fat removal. Premenopausal females with substantial weight loss (N=40) undergoing circumferential abdominoplasty (index group, n=20) or augmentation mammoplasty with mastopexy (controls, n=20) were recruited. All of them originally underwent Roux-en-Y gastric bypass. Variables included BMI, white blood cell count, C-reactive protein, hemoglobin, total cholesterol and fractions, triglycerides, glucose, and HbA1c. Follow-up reached 20.3 ± 13.6 months for index cases and 29.5 ± 17.4 months for controls. The metabolic and inflammatory indices improved after the bariatric surgery. Subsequent monitoring indicated a stable body weight and biochemical profile in both groups. The exceptions were HDL cholesterol and C-reactive protein, which respectively increased and diminished after the abdominoplasty, consistent with an inflammatory and metabolic advantage for this operation. This is the first long-term study in a weight-stable population to point out such a pattern after abdominoplasty.

When compared to the current mammaplasty techniques performed in formerly obese patients, this is a good surgical option because it uses tissues adjacent to the breast itself and does not require silicone prosthesis for breast augmentation. The patients reported increased self-esteem and improvement in their quality of life.

The most common complication of silicone breast implants is capsular contracture (massive scar formation around the implant). We postulate that capsular contracture is always a sequel to inflammatory processes, with both innate and adaptive immune mechanisms participating. In general, fibroblasts and macrophages have been used as cell types to evaluate in vitro the biocompatibility of breast implant surfaces. Moreover, also T cells have been found at the implant site at the initial stage of fibrous capsule formation. However, only few studies have addressed the influence of surfaces with different textures on T-cell responses. The aim of the present study was to investigate the immune response of human peripheral blood mononuclear cells (PBMC) to commercially available silicone breast implants in vitro. PBMC from healthy female blood donors were cultured on each silicone surface for 4 days. Proliferation and phenotype of cultured cells were assessed by flow cytometry. Cytokine levels were determined by multiplex and real-time assay. We found that silicone surfaces do not induce T-cell proliferation, nor do they extensively alter the proportion of T cell subsets (CD4, CD8, naïve, effector memory). Interestingly, cytokine profiling identified matrix specific differences, especially for IL-6 and TNF-α on certain surface topographies that could lead to increased fibrosis.

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