Jorge de Moura Andrews

Capsular hematoma as a late complication in breast reconstruction with silicone gel prostheses

This paper presents a rare complication of breast reconstruction with silicone gel prostheses in which formation of intracapsular hematomas in the mammary region occurred 3 years after surgery. Treatment by bilateral capsular excision was successful. The rarity of this occurrence and the progress of the case are the major reasons for this publication.

Umbilicoplasty for the abdomen with a thin adipose layer

The authors present a new technique for umbilicoplasty performed on nine patients who were followed up for at least a year. The method is based on the formation of four dermal flaps which after deepithelialisation and fixation reconstitute the umbilical anatomy. The depth of the new umbilicus depends upon the construction of a cylinder. This method is easily performed in patients with a thin abdominal adipose layer and gives good results.

Abdominoplasty: modified plication

The authors present an addition to standard abdominoplasty techniques. Transverse plication of the aponeurotic layer in the epigastrium corrects the prominence in this area and helps the flap to reach the pubic region.

A severe case of Beare-Stevenson syndrome and associated congenital deformities.

A severe case of congenital anomalies is described, with several characteristics of Beare-Stevenson syndrome, such as cutis gyrata, acanthosis nigricans, craniofacial anomalies, ear defects, enlarged umbilical stump and anogenital anomalies. He does not have craniosynostosis or clover leaf skull, which has also been described in this syndrome. This patient also shows hands and feet anomalies, absence of skin adnexa in several locations and dental anomalies, which could suggest an associated ectodermal dysplasia.

Critical analysis of methods of reconstruction of exenterated orbits

Reconstructive procedures were used on 14 patients who had undergone orbital exenteration and radiotherapy for malignant tumours. All patients were tumour free after a follow-up of between 5 and 18 years. Reconstruction was carried out in 3 stages. In the first operation the orbit was filled, in the second the orbital rims and eyelids were shaped, and in the third a cavity for a static eye prosthesis was created. Critical assessment of results showed that the first stage alone produced a marked improvement in appearance and occluded existing fistulae. The subsequent procedures improved aesthetic results further. Difficulties were encountered from retraction of the tissues and insufficient tissue mobility.

Freeman-Sheldon syndrome: surgical correction of microstomia

In this report, we describe a case of microstomia associated with club feet and ulnar deviation of the hands (Freeman-Sheldon syndrome) and the surgical technique for correction of the oral deformity.

Total reconstruction of the alar cartilage en bloc using the ear cartilage: a study in cadavers.

To determine whether the lamina tragi, isthmus, and cavum conchae are a donor area for reconstruction of the alar cartilage with all its elements (medial crus, junction of the medial and lateral crura, and lateral crus), with the same dimension and en bloc, 40 alar cartilages and 40 lower parts of ear cartilages of 20 cadavers were dissected. Several measurements were taken in the alar cartilages, such as distance, thickness, and angle. Then they were compared with the measurements performed in the ear cartilages and segments removed from the lamina tragi, isthmus, and cavum conchae. This study, done with cadavers, shows that from the lamina tragi, isthmus, and cavum conchae, en bloc resection is possible with characteristics of form and dimension similar to those of the homolateral alar cartilage. The segment removed en bloc from the intermediate part of the lamina tragi, isthmus, and cavum conchae replaces, respectively, the medial crus, junction of the medial and lateral crura, and lateral crus.

Total en bloc reconstruction of the alar cartilage using autogenous ear cartilage

A new technique is described for increasing the nasal tip by using an en bloc autogenous ear cartilage graft in such a manner as to create, in essence, a replacement of the entire ipsilateral alar cartilage.

An assessment of carbon and fluorocarbon implants as soft tissue space fillers in rats

Abstract The physical properties of carbon and fluorocarbon implants and surrounding tissue were assessed and compared over 1 year in rats. The inflammatory and reparative phases were separated and physical properties were tested both before and after incorporation by surrounding tissue. Although both implant materials demonstrated a marked inflammatory response, less peripheral fibrosis was seen around the carbon implant than the fluorocarbon implant; the carbon implant was also more homogeneously penetrated by host tissues. The physical tests showed fluorocarbon to be a more rigid substance than carbon with carbon more closely resembling the characteristics of rat soft tissue.