Abstract

Tummy tuck procedures continue to be one of the most popular aesthetic procedures for many patients after pregnancy or significant weight loss.  The standard abdominoplasty or lipoabdominoplasty procedures as are often performed tend to flatten the abdomen and alter the natural three-dimensional contour of the abdominal soft tissue by disturbing the discrete abdominal regions or forms.  Method: Since 2006, the author has been performing a modified abdominoplasty technique that he termed “High-Definition Tummy Tuck” since.  The underlying premise of this technique is a modified dissection approach that preserves the discrete abdominal forms inorder to retain definitions and manipulation of Scarpe’s fascia to enhance the three-dimensional contour of the abdomen, according to aesthetic principles.  Results: Since 2006, the author has performed over 1000 High-Definition tummy tuck procedures safely and consistently in non-bariatric and post-bariatric patients.  This presentation describes the principles, technique, results and fundamentals of this natural yet athletic abdominoplasty technique.  Conclusion:  High-Definition Tummy Tuck is a safe abdominoplasty technique that preserves definitions and contour of the abdomen to achieve an aesthetically pleasing three-dimensional abdominal contour without employing liposculpture or fat grafting.

Abstract

The Muscular Sculpture (MS) represents a revolutionary approach to body contouring developed over 20 years of clinical experience. This comprehensive technique achieves tight skin that optimally reveals muscular bulk, creating a masculine athletic physique with minimal observable scarring across all anatomical regions. Unlike traditional liposuction which is focused solely on fat removal, MS emphasizes muscular definition through strategic three-dimensional sculpting of the entire body silhouette.

Over two decades, we have refined a standardized six-step MS protocol applicable to all body regions: abdomen, chest, arms, lower extremities, and gluteal area. The technique includes: 1) progressive defatting; 2) muscular sculpture with emphasis on anatomical borders; 3) internal scar removal; 4) irregularity elimination; 5) dermal grasping for skin retraction; 6) final fat residue removal. Using customized cannulas (80 different types, 3-10mm  in diameter, varying lengths and tip configurations) with high-vacuum, high-flow liposuction systems, we create convex and concave zones that enhance natural muscular anatomy. The technique is applicable to normal weight, overweight, and post-bariatric patients seeking athletic definition.

Analysis of 20 years of MS procedures demonstrates exceptional outcomes with a 98% patient satisfaction rate maintained from short-term (1 week) to long-term follow-up (18+ years). Complications remain minimal with no major adverse events reported. Results show stable muscular definition with natural-appearing athletic contours across all treated anatomical areas. The comprehensive approach addresses the entire body as an integrated aesthetic unit, avoiding the disharmonious results often seen with isolated regional treatments.

Two decades of MS experience confirm this technique as the gold standard for body contouring, offering superior aesthetic outcomes compared with traditional methods. The ability to sculpt the entire body with consistent, long-lasting results addresses the growing demand for comprehensive body enhancement. Further research and technique refinement continue to expand the applications of this innovative approach to male and female aesthetic surgery.

Abstract

Surgical decompression of Carpal Tunnel Syndrome (CTS) by the standard open carpal tunnel release (OCTR) technique is associated with postoperative pain and tenderness. To address these limitations, endoscopic carpal tunnel release (ECTR) was introduced, offering a minimally invasive alternative aimed at reducing complications through a shorter incision, thereby decreasing scar pain and enabling faster recovery. This study aims to compare the outcomes of OCTR and ECTR based on randomized controlled trial (RCT) evidence. A systematic literature search was conducted across PubMed, Web of Science, EBSCO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Meta-analysis was performed using Comprehensive Meta-Analysis (CMA) software. Standard mean difference and 95% confidence intervals were used for continuous outcomes, while odds ratios with 95% confidence intervals were employed for dichotomous outcomes. A total of 34 studies were included in the analysis. The findings demonstrated that ECTR significantly reduces scar pain and shortens recovery time compared to OCTR. However, no significant differences were observed between the two techniques regarding complication rates, incidence of local pain, mean pain scores, subjective complete or near-complete symptom relief, subjective satisfaction rates, mean satisfaction scores, symptom severity scores, functional status scores, or mean operative time. In conclusion, both ECTR and OCTR are safe and effective for managing CTS, but ECTR provides advantages in terms of reduced scar pain and faster postoperative recovery.

Abstract

Cleft rhinoplasty presents unique challenges due to the complex interplay of structural, soft tissue, and functional deformities associated with cleft lip and palate. Patients typically exhibit significant nasal

asymmetry, soft tissue discrepancies, septal deformities, and deficient nasal tip support, all compounded by scarring from previous surgeries and unpredictable wound healing. Functional concerns, such as nasal airway obstruction, further complicate management, necessitating a careful balance between aesthetic and functional outcomes. Primary rhinoplasty, performed during initial cleft lip repair, aims to restore nasal contour, symmetry, and projection by repositioning the lower lateral cartilages and correcting septal alignment, while considering the nose’s and lip’s interrelationship. Secondary rhinoplasty is reserved after facial growth

completion, utilizing an open approach for optimal visualization and anatomical reconstruction. Techniques include cartilage grafting for structural support, osteotomies for dorsal realignment, and various grafts to enhance tip definition and correct alar malposition. Preoperative interventions, such as alveolar bone grafting and maxillary osteotomies, are crucial for establishing skeletal support. Despite advances in surgical

technique, achieving ideal symmetry and patient satisfaction remains challenging due to intrinsic anatomical limitations and high patient expectations. Ultimately, successful cleft rhinoplasty requires individualized planning, meticulous surgical execution, and realistic goal-setting to optimize form and function in this

complex patient population