Correction of the post-burn malpositioned nipple-areola complex by transposition of two subcutaneous pedicled flaps

Symmetrical anatomy of the chest wall is the aesthetic goal in any technique for nipple-areola complex positioning in post-burn patients. In 15 patients, a new surgical technique was applied by transposition of two subcutaneously pedicled flaps, one of which carries the malpositioned nipple-areola complex. The long-term results of this procedure were found to be satisfactory in all patients.

Imaging signs and radiologists' jargon of ruptured breast implants

Silicone gel leakage problems are central to the furor over the complications alleged to be caused by breast implants. Because clinical examination may not reveal confirmatory signs of gel bleed or rupture, radiologists are often requested by plastic surgeons to evaluate the integrity of the implant's envelope. The findings of the various imaging investigations are reported in terms such as "teardrop," "linguini," and "snowstorm." To interpret the radiologist's report correctly, the plastic surgeon should be familiar with these terms and the findings they represent. In this article, we present an explanation of the radiologists' vocabulary in these matters, as well as an indication as to the significance of the various signs.

[Plastic surgery as a last resort in lichen sclerosus]

Lichen sclerosus, formerly called lichen sclerosus et atrophicus, is a chronic skin disease manifesting itself mostly in the perineal region and often associated with itching. Characteristic elements are well-defined depigmentation and degeneration of the skin sometimes showing haemorrhagic bullae or teleangiectases. The skin grows thinner and shrinks. Malignant degeneration is rare. The prevalence is 1:300 to 1:1000. The condition occurs more often in females than in males and more often in adults than in children. Drug treatment (symptomatic) comprises local application of corticosteroids, anaesthetics and/or sex hormones. In case of insufficient response, cryotherapy is a good alternative. Chemical and surgical neurotomy are also sometimes applied, with fairly poor results. In refractory symptoms, excision of the affected skin, possibly with transplantation using a pedicled skin flap, may lead to mitigation.

The inframammary ligament: myth or reality?

After histological investigation, we concluded that a transversely oriented inframammary ligament extending from the sternum to the lateral margin of the pectoralis major muscle is invariably present in female transsexuals. The literature on this subject is reviewed.