Key Issues in Plastic and Cosmetic Surgery Vol. 16

Transcription

1 Key Issues in Plastic and Cosmetic Surgery Vol. 16

2 Key Issues in Plastic and Cosmetic Surgery Vol. 16 (by the editorial board of the series previously known as Advances in Plastic and Reconstructive Surgery ) Editor-in-Chief Mutaz B. Habal, Tampa, Fla. Editorial Board Harvey N. Himel, New York, N.Y. William C. Lineaweaver, Jackson, Miss. Gustavo A. Colon, New Orleans, La. Robert W. Parsons, Chicago, Ill. John E. Woods, Rochester, Minn. 116 figures and 3 tables, 1999 Basel Freiburg Paris London New York New Delhi Bangkok Singapore Tokyo Sydney

3 Mutaz B. Habal, MD FRCSC Research Professor/USF Tampa Bay Craniofacial Center, Inc. 801 West Dr. Martin Luther King Jr. Blvd. Tampa, Fla , USA William C. Lineaweaver, MD Professor of Plastic Surgery The University of Mississippi Medical Center, Jackson, Miss., USA Harvey N. Himel, MD Hyperbaric Medicine Service Associate Professor of Plastic Surgery New York Hospital Burn Center New York Hospital Cornell University Medical Center New York, N.Y., USA Gustavo A. Colon, MD Private Practicer Metairie Professor of Plastic Surgery New Orleans, La., USA Robert W. Parsons, MD Professor Emeritus of Plastic Surgery University of Chicago Chicago, Ill., USA John E. Woods, MD Professor Emeritus of Plastic Surgery Mayo Clinic and Foundation Rochester, Minn., USA Drug dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 1999 by S. Karger AG, P.O. Box, CH 4009 Basel (Switzerland) Printed in Switzerland on acid-free paper by Reinhardt Druck, Basel ISBN X

4 Contents VIII Introduction to the New Image Key Issues Habal, M.B. (Tampa, Fla.) 1 History of Aesthetic Plastic Surgery of the Face Colon, G.A. (New Orleans, La.) 12 Calf Implantation, New and Old Principles Aiache, A.E. (Beverly Hills, Calif.) 12 History 14 History of the Implants 15 Development of the Instruments for Implantation 17 Positioning of the Patient 17 Anesthesia 18 Anatomy of the Nerves in the Lower Extremity 19 The Muscles and Fascia of the Leg, The Group of Muscles Are Anterior, Posterior and Lateral, The Anterior Group 20 The Posterior Crural Muscles, Two Groups, Superficial and Deep 20 The Deep Group, The Popliteus, Flexor Hallucis, Flexor Digitorum Longus, The Tibialis Posterior 20 The Lateral Group 21 Calf Implants Indications 22 Reconstructive Indications 22 Surgical Technique 26 Remarks 26 Postoperative Care 29 Implant-Related Complications

5 30 Complications due to Surgery 30 Hematoma, Seroma 31 Early Infection 31 Myonecrosis Secondary to Implantation 32 Specific Complications Related to the Soft Silicone Bag Implants 33 Calf Underdevelopment Treated by Expanders Followed by Regular Implants 35 Editorial Comment on Calf Augmentation by A.E. Aiache Colon, G.A. (New Orleans, La.) 36 Editorial Comment on Calf Implantation by A.E. Aiache Parsons, R.W. (Chicago, Ill.) 38 Key Issues on the Status of Silicone Breast Implants Habal, M.B. (Tampa, Fla.) 43 The Problems with Breast Implants 46 Implant Rupture 51 The Capsule 55 The Grand Settlement 59 Prospectus 62 New Advances to Improve Outcome in Cosmetic Surgery Wilkinson, T.S. (San Antonio, Tex.) 63 Muscle-Sparing Procedures in Saline Silicone Breast Augmentation 72 The French Line or Victoria s Secret Abdominoplasty 76 External Ultrasound 91 Angiosomes and Extension of Skin Flaps Anatomic Study and Clinical Implications Tan, K.C.; Tan, B.K. (Singapore) 91 Introduction 91 Materials and Methods 93 Results 96 Clinical Applications 98 Discussion 100 Avoidance of Disaster in Liposuction Perry, A.W. (New Brunswick, N.J.) 100 History 101 Subcutaneous Infiltration Solutions 103 Epinephrine 103 Hyaluronidase 104 Lidocaine 107 Fluid Replacement 108 Blood Loss Contents VI

6 109 Large Volume Liposuction 110 Complications 112 Deep Venous Thrombosis 113 Pulmonary Edema 114 Blood Loss 114 Hypovolemia 114 Intra-Abdominal or Intrathoracic Penetration 115 Infection 115 Aesthetic Imperfections 116 Unknown Effects of Liposuction 118 Conclusions 122 Editorial Comment on Avoidance of Disaster in Liposuction by A.W. Perry Parsons, R.W. (Chicago, Ill.) 124 An Epidemic of Malpractice May Be Sweeping through Our Courtrooms Luria, L.W. (Tampa, Fla.) 124 Follow the Money Deep Throat 131 Direct Cost 140 Summary 141 Malpractice on the Witness Stand Huber, P.W. 144 Cranial Sutures: A Biomolecular Review Greenwald, J.A.; Mehrara, B.J.; Gittes, G.K.; Longaker, M.T. (New York, N.Y.) 144 Introduction 145 Animal Model 145 Importance of the Dura mater 147 Growth Factor Expression and Localization 150 Genetic Abnormalities 152 Conclusion 156 An Algorithm for Tenorrhaphy Evaluation Greenwald, D.P.; Wassermann, R.J.; Deluca, L. (Tampa, Fla.) 156 Introduction 160 Discussion 163 Editorial Comment on An Algorithm for Tenorrhaphy Evaluation by D.P. Greenwald et al. Lineaweaver, W. (Jackson, Miss.) 165 Author Index 166 Subject Index Contents VII

7 Habal MB, Himel HN, Lineaweaver WC, Colon GA, Parsons RW, Woods JE (eds): Key Issues Plast Cosmet Surg. Basel, Karger, 1999, vol 16, pp IX X Introduction to the New Image Key Issues After the almost 20 years that we have had the advances series, we have changed three publishers and now we are on the fourth. Most of the changes were business-oriented through mergers and acquisitions. The advances series started in the early 1980s to spearhead the expansion of Yearbook Medical Publishers in Chicago by doing the advances series as the fourth of the series. The editorial board was selected and we proceeded to get the periodical on target as a peer-reviewed annual. After a stormy start, we were able to sail well in high seas till we found that through mergers and acquisitions we had a new company to publish our series based on business and not on medical decisions. The second set of mergers moved us to St. Louis. The last merger took place recently and as the paceman is catching on as it is moving along in the dark, alliances such as these mergers and aquisitions will continue on a regular basis. Now, after careful consultation and deliberation we, the editorial board, had a new publisher: Karger Publishers in Switzerland. We as an editorial board welcome the opportunity to work closely with our new publisher and are seeking a mutual exchange of ideas and concepts plus an interactive exchange across the continents. With this last change, we the editorial board have changed the name therby giving our periodical a face-lift. We understood the need to include cosmetic surgery into the arena, so we added a member to the original editorial board who is known for his dedication to cosmetic surgery as well as adding the term cosmetic surgery to the title. Thus, Key Issues in Plastic and Cosmetic Surgery will be introduced in this issue. We will add the reference phrase to the title as we retain the other members who were formerly the editorial board members of Advances in Plastic and Reconstructive Surgery. This then will be volume 16 of the advances series with the changes that were noted previously in the title to demonstrate to our readers that we will be following the same path in our peer-reviewed periodical, since it is the original editorial board of the advanced series. Our mission will continue to be the same, which is complete dedication to our readers as we bring new advances. We will also

8 need to continue bringing current, hot and interesting topics as we see fit in the future issues. Your editorial board will continue to work hard to produce the issue on time for the ASPRS Meeting, and if not possible even a dummy copy for you to preview will be available. The topics will be advances in the fields as well as reiteration of old principals. Key issues that have an impact on the specialty of plastic surgery will be discussed. With the new millennium, key issues will enter a new phase in which we will focus more on controversial issues and bring them to the fore with point counterpoint. Finally, we would like our readers to continue to feel free to send us feedback and suggest topics that seem of interest to the practicing plastic surgeon. Even though the papers are primarily by invitation, we do also accept submitted manuscripts on their merit. The peer review process will be the same. All manuscripts are peer reviewed and we stress a multidisciplinary involvement in all aspects of our publications. Our mission is to provide a peer review forum of communication and interaction between plastic surgeons and their colleagues in other disciplines, and to matrix as well as cross barriers with those interested in the topics that are presented in the Key Issues series. Volume 16 is the beginning in many aspects including new innovations and advances for the new century. Goodbye to the advances of the last century and let the sun shine on Key Issues for the next century. I would like to express a note of thanks to our publisher Thomas Karger, his team of professionals and all who have worked very hard to get volume 16 of the series out on time. It is truly fascinating that a lot of our activities can be done by and I feel most of the time that I get the work done faster that way. Well, great for the Internet. After all it was found in Switzerland for scientific communication and is now benefitting the whole world, even changing the way we think! Till we net again. Mutaz B. Habal, MD, FRCSC Editor-in-Chief Tampa, Fla., USA Introduction X