Roberto Farina

Riding-trousers-like typpe of pelvicrural lipodystrophy (trochanteric lipomatosis)

Summary Two cases of riding-trousers-shaped type of pelvicrural lipomatosis treated by surgery are presented. The clinical aspect of lipodystrophy is mentioned, and it is believed that there is no relation whatsoever to other cases of endogenous adiposity.

Reduction mammaplasty with free grafting of the nipple and areola

Summary A simple technique of reduction mammaplasty involving free nipple transplantation is described. Fourteen cases have been operated on with satisfactory results.

The prominent nasal tip

The authors associate the projection of the nasal tip to hypertrophy of the alar cartilages and, more specifically, of their medial branches. The heavy, blobby, or bulbous nose is caused by an increase of the columellar-alar angle of the alar cartilages, and bears no relationship to the cephalometric nasal index. Moreover, the bulbous nose usually has excess fatty tissue present in the tip of the nose. The projecting tip may be corrected by excising a rectangular or quadrangular segment from the medial branches of the alar cartilages, or by resecting the cupula of the alar cartilages, including a small or large segment of its medial branch, in order to obtain the desired effect, namely, to lower the tip and decrease the columellar-alar angle. The nasal index remains unchanged. If in addition, the tip of the nose is bulbous, the fatty tissue should be removed at the same time.

Palpebral ptosis: Correction by transplant of fascia lata

Summary The authors consider palpebral ptosis an ˦sthetico-functional defect of serious consequence. They show the physiological mechanism of the method which, in spite of being indirect, may be applied to all types of blepharoptosis; they make a few comments as to the occasion of and precautions necessary during the intervention, and stress the slight inconveniences.

Plastic surgery for the management of palmoplantar keratodermia (palmoplantoneoplasty).

Keratodermia is an incurable genetic and regional disease located in the palmar and plantar regions. The author reports his experience with five cases of palmoplantar keratodermia that were treated by grafting onto the soles and the palms skin taken from the calves and the thighs.

Saddle and Boxer's nose

The deformities known, as saddle nose and boxers nose result from injuries or poorly planned nasal surgery. Boxers nose may eventually be corrected using Straiths method. It is possible to correct both deformities by simply using a bone graft. Neither the use of cartilage grafts nor organic or inorganic inclusions are recommended, the former because they tend to deform, and the latter because they are not well tolerated. There are many advantages to using bone grafts taken from the tibia, including good integration and successful results. This personal method has been used by us since 1948, and is based on the principle of the first-class lever.

S-shaped nasal wings: Rhinopteroplasty. Case reports

The authors discuss theS-shaped nasal wing that is responsible for pseudocryptocolumella. Simple excision of a spindle-shaped cutaneous wedge from the lower rim of the nasal wings corrects this imperfection. The cosmetic appearance is satisfactory and the resulting scar scarcely noticeable.

Plastic surgery of the breast

The authors divide the techniques of reduction mammoplasty into two groups. The first one is done by the so-called classical method in which the two important pedicles—th medial (internal mammary artery) and the lateral (lateral thoracic artery)—are preserved. The second one is made through the free transplant of the areolar, chiefly in those cases of large hypertrophic breasts. Both methods give good results in experienced and skillful hands, as well as good satisfaction to the majority of our patients. On the other hand, complications may arise, as in every field of plastic surgery.

Labial malocclusion: (Labium arcuatum)

Summary Two cases of labial malocclusion are presented. The probable cause of the malformation and the surgical correction are described. Good results were obtained.

Traumatic nasal deformities

Lateral deviations of the nose can be caused by various violent injuries or even by unsuccessful surgery (iatrogenic). Early treatment of fractures is not only bloodless but very much easier in contrast to older injuries which can only be corrected by surgery. Under these circumstances, a complete revision and repositioning of the upper and inferior lateral cartilages or alar cartilages is advisable. In both cases, the simultaneous correction of the affected septum is fundamental. The authors recommend packing of the nasal cavities for 5 days and immobilization with an aluminum splint for 7 days.