In the article literature data concerning indications to placement of silicone breast implants in plastic surgery are presented. Peculiarities of preoperative preparation of patients aimed at prevention of postoperative complications are considered. The technique of surgical intervention, advantages and disadvantages of different methods are described. Difference in choice of surgical approach and positioning of implant relative to mammary gland are considered. Recommendations are given on selection of the type of implant, on determination of the volume of supposed silicone breast-implant prostheses, and also on the choice of optimal access for their insertion. The early and long-term complications and measures proposed by the authors for their elimination are studied. According to different studies, the commonest complication of the augmentation mammoplasty is contracture of the fibrous capsule surrounding the implant that requires surgical correction. One of main complications of all kinds of augmentation mammoplasty is secondary ptosis of mammary gland. A common complication of the augmentation mammoplasty is incorrect position of implants such as their asymmetry and location on different levels. In case of tubular breast a double inframammary fold may result unless tubularity of areola is corrected. Authors think that a significant number of unsolved problems concerning augmentation mammoplasty, optimal surgical approach, existence of the immediate and long-term complications are reasons for further study of augmentation mammoplasty. Increased dissatisfaction of patients with long-term results of augmentation mammoplasty, necessity to prevent such complication as fibrous contracture, create an urgent need for search of new methods. Thus, application of silicone implants in augmentation mammoplasty requires further study with the aim of optimization of the final aesthetic and clinical result.
We performed detection, examination and surgical treatment of trauma injuries of the main trunk or branches of the facial nerve among 16 patients. The main complaints of patients were related to aesthetic defects of tissues and organs within certain areas of the face or the whole half on the side of the injury and their functional disorders. The most frequent cause of injury was yatrogenic nerve damage. In the case of yatrogenic causes of injury, there are following groups of surgical interventions: surgery of the peritoneal salivary gland; aesthetic operations of the face in case of pathological processes or traumatic injuries of the temporal-lower joint and lower zone of the face. The following surgical treatments were used to repair damage to facial nerve structures: nerve suture; transposition of facial nerve branches; neuroplasticity; miofastsialny plasticity; neuroplasty in combination with the transplant of the revascularized neuromuscular transplant of the gentle soapy. In the distant postoperative period, complete recovery of facial nerve branch function and effectors, respectively, occurred among 10 patients. Partial recovery of their function - among 3 patients and recovery were absent among 3 clinical cases.
To show the clinical significance of dividing distal complete nerve damages of the upper extremity into topographic zones for the optimal reconstruction of the nerve at distal branching segment.
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