Ivo Pitanguy

Indications for and treatment of frontal and glabellar wrinkles in an analysis of 3,404 consecutive cases of rhytidectomy.

In recent years, there has been an increase in the percentage of forehead lifts in patients undergoing face lift surgery on our service. Also we find that younger patients are having the surgery. We describe our present technique and choices of incisions. We avoid incisions anterior to the hairline whenever possible, since they may produce conspicuous scars. Our treatment of the aponeurotic expansion by vertical and horizontal incisions has produced very satisfying results (Figs. 11 through 15). No postoperative complications are reported in our series.

Hematoma Postrhytidectomy: How We Treat It

A simple method for treating postrhytidectomy hematomas is described. Its main advantage is that reoperation is avoided.

Histopathological aspects of mammary gland tissue in cases of plastic surgery of breast

Summary The histological aspects and surgical orientation in 181 cases of mammary tissue excised for plastic purposes have been studied. Practically no patient had any clinical symptom. Statistical data regarding age and pathological prognosis are presented. Seven per cent. of the cases presented tumour lesions. Malignant tumours were found in 1·5 per cent. The plastic surgery results of the treatment of benign lesions were very satisfactory. The management of these cases should be as conservative as possible. The advantage of systematic histopathological examination of these specimens was evident. A method of cutting the specimens is described in detail.

Repeated expansion in burn sequela.

This paper presents a retrospective study of the use of 346 expanders in 132 patients operated at the Ivo Pitanguy Clinic, between the period of 1985 and 2000. The expanders were used in the treatment of burn sequela. In the majority of cases, more than one expander was used at the same time. In 42 patients, repeated tissue expansion was done. The re-expanded flaps demonstrated good distension and viability. With the increase in area at each new expansion, larger volume expanders were employed, achieving an adequate advancement of the flaps to remove the injured tissue. The great advantage of using tissue re-expansion in the burned patient is the reconstruction of extensive areas with the same color and texture of neighboring tissues, without the addition of new scars.

Treatment of abdominal wall eventrations associated with abdominoplasty techniques

An experimental and clinical study using alloplastic materials (Marlex and Prolene mesh) for repairing large defects of the abdominal wall is reported. A defect was created in the experimental model to simulate an anatomical disarrangement of the musculo-aponeurotic-fascial complex of the abdominal wall and the surgical correction of this deformity. Macroscopic and microscopic observations of the operated area were done to demonstrate the good integration of the surrounding tissues with the mesh.In a clinical study, 16 patients, presenting large eventrations of the abdominal wall, were surgically treated using Marlex or Prolene mesh to reinforce the abdominal wall. Two techniques of abdominoplasty, vertical and horizontal, were performed on these patients, according to the location of previous scars. The advantages of using alloplastic materials to reinforce the abdominal wall and the cosmetic results of both abdominoplasty techniques are discussed.

Nerve injuries during rhytidectomy. Considerations after 3,203 cases.

The potential for injury to the nerves of the face is ever-present in rhytidectomy. Only a thorough knowledge of the anatomy, of the face, adequate surgical experience, and strict adherence to basic operating principles can avoid problems. The temporalis, paraorbitalis, genian, mandibular, and cervicoauricularis areas each offer hazards, which are detailed in this discussion, along with some technical details to avoid both temporary and permanent damage.

A chiro-cheilo-podalic syndrome

Summary Six patients with characteristic facial and associated hand and foot lesions are presented. These cases are compared with four described by Burian (1963). The constancy and familial character of the symptoms suggest the possibility of a previously undescribed syndrome. The possible ˦tiology of the complex of malformations and the treatment of some of the hand deformities is discussed.

Aesthetic plastic surgery of the upper and lower limbs.

A single surgical approach is proposed for correction of lipodystrophy of the upper and lower limbs, coexisting deformities, and other conditions affecting these areas. The procedure has great versatility, and results are satisfactory. The inevitability of noticeable scars, however, still constitutes a problem, mandating careful evaluation of the indications and a very realistic doctor-patient relationship.