http://www.aaronstonemd.com/rhinophyma.shtm Rhinophyma is a severe form of acne rosacea that results in enlargement of the nose with overgrowth of skin forming ridges and pits that frequently become infected. It is more common in men than women
In the early stages accutane may help shrink the sebaceous glands but could adversely effect future surgical treatment of the disease. For more marked disease the treatment is full thickness excision with skin grafting or tangential (partial thickness) excision allowing the skin to heal without grafting. Some surgeons prefer laser excision citing less bleeding among other reasons. Having seen
Gynecomastia surgery is a battle between tissue removal, removal of excess skin and skin scar minimization. This patient had surgery elsewhere with inadequate breast tissue and skin removal. This left him with drooping stretched nipple complexes. The solution is gynecomastia revision surgery to remove the breast tissue and skin leaving a scar the patient can live with and that will not stretch itself or the surrounding skin.
#abdominoplasy #tummytuck is designed differently for men and women. The common components are removal of excess skin, liposuction and muscle tightening/diastasis repair. The difference is placement of the skin incisions to account for clothing preferences.
Surgery for hidradenitis suppuritiva under the breasts is complicated by
-the limited amount of adjacent skin to allow closure following excision while maintaining a normal breast shape
-the inability to address hidradenitis on the central chest between the breasts (as in this case) at the same time.
If there is breast drooping, as in this case, the hidradenitis affected skin can be removed with a breast lift. In the absence of drooping other modalities (such as a thoracodorsal artery perforator flap) can be employed to achieve closure while maintaining breast shape.
Most patients gladly trade the pus draining, painful, bad smelling hidradenitis affected skin for a few surgical scars and possible minor breast asymmetry.
Virtually all light skinned individuals living in temperate or tropical climates will have a cancerous or pre-cancerous skin lesion during the course of their lives. These are most common on the face, ears, arms and legs. In all cases early detection and treatment is needed to avoid disfigurement or aggressive complicated surgery. One needs to ensure complete cancer removal, then see what the remaining defect is and then repair that defect with like tissue without creating a deformed donor area.
There are 9 options for repairing a lower eyelid defect that employ like tissue from either eyelid, the side of the nose or the cheek. In this case basal cell cancer was removed leaving a skin only defect. A skin graft was harvested from the upper eyelid leaving her with a good functional result. Just suturing the hole was not an option as it would have deformed the lower eyelid. More severe cases require replacement of eyelid muscle and/or inner lining.
Wound closure after removal of #basalcellcarcinoma of the leg can be difficult because there is limited surrounding skin laxity. V-Y advancement flaps are good options for closure because they retain normal surface contour, have a good blood supply and are associated with less risk than other flaps or skin grafts.
http://www.aaronstonemd.com Pectus excavatum or funnel chest is usually noted after birth but in some people it is not visible until they are older as the deformity can be unpredictably progressive. The exact cause is not known but it is more common in males than females. It is believed to be due to overgrowth of the rib cartilage adjacent to the breastbone (sternum) which pushes the breastbone backwards. If there is no compromise of heart or lung function pectus excavatum implant surgery is a good option. I prefer to place the implant under the chest muscles so they are covered by more tissue and are less visible with a better aesthetic result.
Many say #medporCheekImplant and other Medpor facial implants are not a good idea because they are too hard to remove or replace. I made this video to show that a #MedporImplantRemoval can be performed within 10 to 15 minutes by careful dissection with little or no surrounding tissue damage.
#triggerFinger refers to locking of a finger on flexion into the palm and lag on its return to extension with a sudden pop on its release. The problem is due to the flexor tendon having difficulty passing through a thickened pulley in the palm just below the involved finger. The solution is release of the pulley which can easily be performed in the office under local anesthesia.
Asymmetric or uneven breasts are common. Although it is impossible to achieve complete symmetry by surgery your surgeon needs to assess these asymmetries before breast surgery and account for them so you do not end up more asymmetric or uneven after surgery. Women with A or AA cup sized breasts have tight lower halves of the breasts and placing too large an implant in these patients can create bad scars and stretchmarks that cannot be erased. Allowing the implants to slowly stretch the lower half is a much better option.
#basalCellCarcinoma of the scalp is common because of sparse use of hats and failure to apply sunscreen to the area. Its treatment is complicated by the underlying skull that impairs sufficient scalp laxity to allow closure after surgical excision.
#Lentigomaligna is a precancerous skin lesion that will eventually become deadly #melanoma if ignored. Due to the irregular borders of lentigo maligna the safest approach is a surrounding square biopsy to clear the margins followed by a later definitive excision within those margins including the fat layer. These excisions result in large defects that require plastic surgical closure using surrounding flaps of skin. This is a case of lentigo maligna on the back.
Created 1 year, 3 months ago.
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Cosmetic and Reconstructive Plastic Surgeon