Abstract

 Background: Squamous cell carcinoma (SCC) of the lower lip is a common malignancy requiring complex reconstruction to restore function and aesthetics. Advanced cases often necessitate neck dissection, adding to the challenges of treatment.

Objective: To present the clinical outcomes of the Bilobed Platysma Myocutaneous Flap (BPMF) technique for single-stage full-thickness lower lip reconstruction, applied with or without neck dissection based on tumor staging.

Methods: A total of 40 patients underwent reconstruction with the BPMF technique. From January to May 2012, 17 patients were treated for lower lip defects without neck dissection. Between 2014 and 2018, 23 patients underwent simultaneous lower lip reconstruction and neck dissection. Preoperative mapping of the submandibular artery was performed using computerized tomographic angiography and Doppler. The flap consisted of two lobes: one for defect coverage and the other for donor site closure. Neck dissections included bilateral supraomohyoid in 14 patients and a combination of modified radical and supraomohyoid in 9 patients.

Results: All flaps survived without complications. In the 17 patients without neck dissection, oral continence was achieved at a 16-month follow-up, and electromyography confirmed platysma functionality. Among the 23 patients with neck dissections, no recurrence was observed during a 5-year follow-up period, and high levels of patient satisfaction were reported. Across both groups, the flap provided excellent functional and aesthetic outcomes.

Conclusion: The BPMF technique is a versatile and reliable option for lower lip SCC reconstruction, providing effective functional and aesthetic restoration. Its combination with neck dissection addresses oncologic and reconstructive needs in advanced cases, ensuring long-term success.

Abstract

Rhinoplasty with or without septoplasty is a frequent esthetic and functional operation. The number of rhinoplasties varies widely depending on country, sex, age, and other factors. Different surgical techniques are described for each of particular rhinoplasty demands and needs. Surgical complications, outcomes, revision operations, and surgical planning are briefly mentioned. Reference data on each of the mentioned topics are emphasized.

Osteotomies, especially medial and lateral, are one of the most important steps in obtaining proper functional and esthetic success in rhinoplasty. Lateral osteotomy is performed as endonasal continuous osteotomy or as external perforating osteotomy. The technique of external perforating osteotomy is precisely described, and compared to reference data on other possibilities and techniques of osteotomies. The advantages of such approach, limitations, and results in obtaining the proper position and size of nasal structures are discussed extensively.

Extensive thirty years personal experience with primary and revision rhinoplasties is here documented. Each step of rhinoplasty with or without septoplasty is presented. Some particular difficult and rare problems in rhinoplasties are described, such as primary failure, augmentarion rhinoplasty, rhinoplasty on facial malformation, and others. Surgical results are discussed from surgical and patient perspective.

Abstract

According to the Scientific Association of Probiotics and Prebiotics, “probiotics are live
microorganisms which provide health benefits when they are consumed in an adequate manner.
Probiotics are acknowledged for their beneficial effects on the human body and could be utilized in
the management of various diseases. They also possess the capacity to accelerate wound healing,
due to their remarkable anti-pathogenic, antibiofilm, and immunomodulatory effects. Oral and
topical probiotic formulations have shown promising openings in the field of dermatology, and
there are various in vitro and in vivo models focusing on their healing mechanisms. Many clinical
trials, in vitro and in vivo experiments conducted on various animal models, demonstrated the
ability of probiotic formulations to improve tissue repair and to modulate the host immune system.
The concept that probiotics promote wound healing has been studied for a number of years.
Researchers have elucidated some anti-pathogenic mechanisms of probiotics, which are useful for
improving the healing process, i.e., inhibition of pathogen attachment, competition for adherence
sites, nutrients, and other vital resources, production of anti-pathogenic molecules, antagonistic
activity, as well as stimulation of epithelial barrier function and modulation of the immune
response. Wound dressings embedded with prebiotics and probiotics are now prime candidates for
designing wound healing therapeutic approaches to combat infections and to promote the healing
process. Therefore, it is essential to consider that probiotic strains exhibit specific effects through
particular mechanisms. Dressings containing probiotic and prebiotic components offer multiple
advances in healing and on-site infection control. The design of such materials currently represent a
priority research focus and we expect an increasing amount of studies and clinical trials aiming their
evaluation in the next few years.

Abstract

Capsular contracture (CC) is one of the most common complications of implant-based breast reconstruction or augmentation surgery. Common risk factors of CC include biofilm, surgical site infections, history of prior CC or fibrosis, history of radiation therapy, and implant characteristics. Though bacterial contamination of breast protheses is associated with adverse sequelae, there are not universally accepted guidelines and limited best practice recommendations for antimicrobial breast pocket irrigation. Despite advanced molecular biology, the exact mechanism of this complication is not fully understood. Interventions that decrease the rate of CC include antibiotic prophylaxis or irrigation, acellular dermal matrix, leukotriene inhibitors, surgical techniques, and others. However, there is inconsistent evidence supporting these risk factors, and the current data was based on broad heterogeneous studies. The objective of this review was to provide a summary of the current data of contributing risk factors as  well as preventative and treatment measures for CC.