Plastic Surgery - Principles and Practice

1st Edition - April 29, 2021
Editors: Rostam Farhadieh, Neil Bulstrode, Babak J. Mehrara, Sabrina Cugno
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 5 3 8 1 - 7

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With detailed, expert guidance on each essential topic, Plastic Surgery: Principles and Practice offers single-volume convenience without sacrificing complete coverage of this multi-faceted field. Written by global leading authorities, it provides concise, easy-to-follow instruction with the clinical details and supportive data needed to achieve optimal patient outcomes.

Instructions for online access
Cover image
Title page
Table of Contents
Copyright
Dedication
Foreword
Preface
List of Contributors
Part I. Basic Science and Principles
1. Skin Structure and Function, Wound Healing and Scarring
Skin Structure and Function
Type 1 – Classical Cutaneous Wound Healing
Type 2 – Neoclassical Cutaneous Wound Healing
2. Basic Skin Flaps and Blood Supply
Introduction
Evolution of Flap Surgery
Physiology and Anatomy of Skin Blood Supply
Indications for Skin Flaps
Design and Application of Flaps
3. Biomaterials and Structural Fat Grafting
General Principles
Autologous Grafts
Allografts and Xenografts
Alloplastic Materials
Conclusion
4. Local Anesthetics
Introduction
Physiochemical Properties of Local Anesthetics
Pharmacokinetics of Local Anesthetics
Local Anesthetics in Clinical Practice
Topical Local Anesthetics
Local Anesthetic Systemic Toxicity (LAST)
Methemaglobinemia
Sedation
Regional Techniques of Relevance to Plastic Surgery
5. Lasers
General Principles
Laser Therapy in Cutaneous Treatment
Laser Treatment by Lesion Type
Conclusion
6. Tissue Expansion
Background
Viscoelastic Properties of Skin
Tissue Changes during Expansion Techniques
Evolution of Tissue Expansion Devices
Surgical Technique: Basic Incision and Design Plan
External Volume Expansion with BRAVA
Advantages and Disadvantages of Tissue Expansion
Complications
Future of Tissue Expansion
Ten Golden Rules of Expanders
7. Tissue Engineering
Introduction
Experimental Tissue Engineering
Tissue Engineering in Plastic Surgery
Targeted Tissue Engineering Strategies
Bioreactors
Tissue Engineering in Practice: Tissue Engineered Breast Reconstruction
Regulation of Regenerative Medicine Therapies
Conclusion
Part II. Integument
8. Melanoma
Epidemiology
Risk Factors
Clinical Diagnosis
Biopsy
Histology
Staging
Wide Excision
Sentinel Lymph Node Biopsy
Lymphadenectomy
Adjuvant Therapy
Locoregional Treatment
Distant Metastases
Noncutaneous Melanomas
9. Nonmelanoma Skin Cancer
Introduction
Basal Cell Carcinoma
Squamous Cell Carcinoma
10. Atypical Skin Lesions
Introduction
Benign Lesions
Unusual Malignancies of Skin
Conclusion
11. Vascularized Composite Allotransplantation
Historical Background
Nomenclature
Basic Transplantation Immunology
Experimental Models of VCA Transplantation
Clinical Applications of VCA Transplantation
VCA Outcomes
Future VCA Perspectives
12. Radiation Therapy and Soft Tissue Response
Radiation Principles
Mode of Action in Malignancies
Modes of Delivery
Treatment Parameters
Radiation Effects
13. Burns: Acute Care and Reconstruction
Introduction
Burn Assessment
Pathophysiology of Burn
Types of Burns
Inhalation Injury
Fluid Resuscitation
Systemic Effects
Timing of Reconstruction
Acute Techniques to Limit Subsequent Reconstruction
Intermediate and Late Reconstruction
Surgical Techniques for Reconstruction
Nonsurgical Techniques
Anatomical Considerations
Part III. Pediatric Plastic Surgery and Congenital Disorders
14. Congenital Melanocytic Nevi
Incidence of Phenotypic Classification
Histological and Clinical Appearances of CMN
Neurological Associations of CMN
Other Associated Features of CMN
Melanoma and CMN
Genetics of CMN and Implications for Treatment of Melanoma
Surgical Management of CMN
Conclusion
15. Vascular Anomalies
Introduction
Vascular Tumors
Vascular Malformations
16. Cleft Lip
Embryology
Clinical Anatomy
Preoperative Assessment
Presurgical Orthopedics
Unilateral Cleft Lip Repair
Bilateral Cleft Lip Repair
Primary Nasal Correction
Postoperative Care
Complications and Revision Surgery
Outcomes
Conclusion
17. Cleft Palate and Velopharyngeal Dysfunction
Embryology
Anatomy
Submucous Cleft Palate
Associated Syndromes
Palatoplasty
Velopharyngeal Dysfunction
18. Congenital Ear Anomalies
Ear Development
Prominent Ears
Other Auricular Anomalies
Microtia
Oculo-auriculo-vertebral Spectrum
Complications
19. Rare Craniofacial Clefts
Etiology
Classification
Management
Skin
Eyelids
Nose
Cheek
Skeletal Reconstruction
Prevention
Conclusion
20. Craniosynostosis
History
Skeletal Development
Craniosynostosis
Parameters of Care for Craniosynostosis
Treatment of Nonsyndromic Craniosynostosis
Treatment of Syndromic Craniosynostosis
Conclusion
21. Orthognathic Surgery and Genioplasty
Orthognathic Surgery
Dentofacial Relationships and Terminology
Clinical Evaluation
Radiography and Cephalometrics
Orthodontics
Surgical Anatomy, Treatment Planning, and Operative Management
Case Examples
Special Considerations
Genioplasty
Surgical Anatomy
Indications for Genioplasty
Surgical Technique
Complications
22. Facial Reanimation
Introduction
Anatomy of the Facial Nerve
Anatomy of Potential Donor Nerves for Facial Reanimation
Vascular Supply of the Face
Etiology of Facial Paralysis
Clinical Examination
Diagnostic Studies
Management
The Future
Part IV. Head and Neck Reconstruction
23. Head and Neck Malignancies
Introduction
Evaluation of the Patient with Head and Neck Cancer
Staging
Neck Dissections
Postoperative Complications
Radiotherapy
24. Oral Tongue and Mandibular Reconstruction
Introduction
Normal Anatomy and Function of Oral Tongue and Mandible
Etiology and Classification System
Reconstruction Principles
Surgical Options
Defect-Directed Reconstruction
Osseointegration
Postoperative Complications and Management Approach
Computer-Assisted Surgery and Jaw-in-a-Day
Conclusion
25. Midface Reconstruction
Introduction
Reconstruction of the Palate and Alveolus
Reconstruction of the Orbital Walls
Orbitomaxillectomy (Maxillectomy with Orbital Exenteration)
Complications
Outcomes and Conclusions
26. Pharyngeal Reconstruction
Introduction
Pathology
Anatomy
Indications for Surgery and Reconstruction
Classification of Pharyngeal Defects
Historical Perspectives
Assessment and Planning
Reconstruction
Complications
Voice
Management Strategies for Major Flap Complications
Future Directions and Tissue Engineering
27. Reconstruction of the Skull Base
Introduction
Anatomy
Reconstructive Approach
Postoperative Care and Management of Complications Specific to Skull Base Reconstruction
28. Cheek Reconstruction
Introduction
Anatomy
Management
Complications
Contour Defects
Conclusion
29. Lip Reconstruction
Introduction
Anatomy
Etiology of Lip Defects
Reconstruction: General Principles
Algorithm for Reconstruction
Commissuroplasty
Conclusion
30. Nasal Reconstruction
Introduction
Surgical Anatomy
Principles of Reconstruction
Small and Superficial Defects
Large and/or Deep Defects
Structural Support
Composite and Extended Defects
Use of an Algorithm for Flap Selection for Nasal Reconstruction
31. Eyelid Reconstruction
Introduction
Periocular Physiology
Periocular Anatomy: Fundamentals of Eyelid Anatomy
General Principles of Reconstruction
Techniques
32. Ear Reconstruction
Introduction
Initial Assessment Concerning a Posttraumatic Amputation
Reconstruction in Partial Amputations
Total and Subtotal Amputation
Complications
Algorithm
33. Scalp and Calvarial Reconstruction
Introduction
Anatomy of the Scalp
Reconstructive Principles
Reconstruction Options
Conclusion
34. Facial Trauma
Introduction
Frontal Bone and Naso-orbital Fractures
Naso-orbito-ethmoid Fractures
Zygomatico-maxillary Fractures
Complications
Orbital Fractures
Mandible Fractures
Fractures and Fracture Dislocations of the Condyle
Part V. Breast
35. Breast Augmentation
Introduction
Implant Evolution
Indications
Assessment and Implant Selection
Operative Techniques
Complications and Treatment
Breast Implant-Associated Anaplastic Large Cell Lymphoma
Autologous Fat Grafting
36. Breast Reconstruction
Introduction
Reconstructive Goals
Mastectomy Incisions
Autologous Tissue Breast Reconstruction
Abdominally-Based Flaps
Thigh-Based Flaps
Implant Breast Reconstruction
Latissimus Dorsi Flap
Conclusions
37. Congenital Breast Anomalies
Embryology
Polythelia and Polymastia
Gynecomastia
Virginal Hypertrophy
Athelia and Amastia
Tuberous Breast
Poland Syndrome
Breast Hypoplasia
38. Mastopexy and Breast Reduction
Introduction
Macromastia
Operative Technique for Superomedial Vertical Breast Reduction
Operative Technique for Vertical Mastopexy
Operative Technique for Vertical Augmentation-Mastopexy
Complications
Part VI. Trunk and Lower Limb
39. Chest Wall Reconstruction
Overview of the Thoracic Cage
Congenital Defects
Pectus Deformities
Poland Syndrome
Sternal Cleft
Jeune Syndrome: Asphyxiating Thoracic Dystrophy
Acquired Defects
Sternal Wound Dehiscence
Neoplasms
Chest Wall Radiation
Chest Wall Trauma
Reconstruction of Chest Wall Defects
Congenital Chest Wall Defects in the Adult Patient
40. Abdominal Wall Reconstruction
Anatomy
Etiology and Classification of Abdominal Wall Hernia Defects
Assessment of the Abdominal Wound
Goals of Reconstruction
Management of Abdominal Wounds
Management of Fascial Defects
Soft Tissue Reconstruction in Abdominal Wall Reconstruction
Management of the Postoperative Bulge
Conclusion
41. Genitourinary and Perineal Reconstruction
Perineal Reconstruction
Introduction
Anatomy of the Blood Supply of the Perineum
Reconstruction of the Perineum
Reconstructing the Perineal Body
Regional Flaps
Discussion
Genital Reconstruction
Vaginal Reconstruction
Penile Reconstruction
Gender-Affirming Surgery
Conclusion
Hypospadias
Classification
Incidence and Etiology
Associated Anomalies
Management
Surgical Techniques
42. Pressure Injuries
Introduction
Epidemiology
Pathophysiology
Prevention
Assessment of the Patient with a Pressure Sore
Initial Management
Reconstruction
Postoperative Care
Conclusion
43. Lower Limb Reconstruction
Introduction
History
Initial Management
Injury Classification
Orthoplastic Approach
Compartment Syndrome
Vascular Injury
Antibiotics
Wound Debridement
Principles of Skeletal Fixation
Principles of Soft Tissue Reconstruction
Locoregional Flaps
Skeletal Reconstruction
Amputation
Key Points
44. Lymphedema: Anatomy, Pathophysiology, Evaluation, and Treatment
Introduction
Anatomy of the Lymphatic System
Etiology of Lymphedema
Risk Factors for Lymphedema
Pathophysiology of Secondary Lymphedema
Lymphedema Diagnosis
Lymphedema Classification
Lymphedema Treatment
Conclusions
Part VII. Upper Limb
45. Congenital Hand Differences
Embryology
Classification
Syndactyly
Clinodactyly
Camptodactyly
Duplication
Ulnar Polydactyly
Central Polydactyly
Macrodactyly
Thumb Hypoplasia
Radial Longitudinal Deficiency
Constriction Ring Syndrome
Arthrogryposis
Trigger Thumb
46. Fingertip Injuries
Introduction
Assessment
Healing by Secondary Intention
Surgical Options for Cover
Options for Skin Cover
The Nail
Psychological Aspects of Hand Injuries
Conclusions
47. Flexor Tendon Injuries
Introduction
Anatomical Features
Zones and Subzones of Flexor Tendons
Biomechanical Considerations
Clinical Diagnosis
Primary and Delayed Primary Repair
Outcomes
Tenolysis
Tendon Grafting, Pulley Reconstruction, and Staged Reconstruction
48. Extensor Tendon Injuries
Extensor Tendon Injuries
Anatomy
Wrist and Hand
Fingers
Thumb
Presentation and Management by Zone
Injuries to Extensor Tendons of the Thumb
Summary
49. Tendon Transfers
Introduction
Indications
Biomechanics
Principles
General Approach
Surgical Technique
Radial Nerve Palsy
Median Nerve Palsy
Ulnar Nerve Palsy
Combined Palsy
Tetraplegia
Recent Advances
Postoperative Care
Conclusion
50. Digital Replantation and Thumb Reconstruction
Introduction
Indications for Replantation
Functional Loss Assessment
Contraindications
Technique and Principles
Multiple Digital Replantation
Ring Avulsion Injury
Postoperative Care
Complications
Thumb Reconstruction
Metacarpal Hand
51. Compartment Syndrome in the Extremities
Introduction
Anatomy
Pathophysiology
Treatment
Late Sequelae
52. Nerve Injury, Repair, and Reconstruction
Introduction
Nerve Injury Classification
Evaluation of Nerve Injuries
Factors Affecting Nerve Recovery in Nerve Repair
Nerve Reconstruction
Postoperative Management and Long-Term Sequelae
Complex Regional Pain Syndrome
Summary
53. Brachial Plexus Injuries and Reanimation
Clinical History and Assessment
Etiology
Investigations
Patterns of Injury
Management Principles and Operative Approach
Postoperative Care
Complications
Outcomes
Summary
54. Nerve Compression
Pathophysiology
Investigations
Median Nerve Compression
Ulnar Nerve Compression
Radial Nerve Compression
55. Dupuytren Disease
Introduction
Surgical Anatomy of the Palmar Fascia and Changes Found in DD
Etiology
Pathophysiology and Histology
Clinical Assessment and Differential Diagnosis
Grading Systems
Management Principles, Operative and Nonoperative Options, and their Outcome
Long-Term Outcome
Rehabilitation
Conclusions/Personal View
56. Fractures and Dislocations in the Hand
Introduction
Pediatric Fractures of the Digits
Adult Fractures
Management of Other Soft Tissue Injuries
Management Principles and Operative Options and Tips
Complications
Outcomes
Final Comments
57. Osteoarthritis and Prosthetic Joints in the Hand
Introduction
Osteoarthritis of the Small Joints of the Hand
Osteoarthritis of the Thumb
58. Wrist Pathology
Physical Examination of the Wrist
Kienböck’s Disease
De Quervain’s Tenosynovitis
Scaphoid Fractures
Scapholunate Dissociation
Perilunate and Lunate Dislocations and Fracture Dislocations
Lunotriquetral (LT) Dissociation
Scapholunate Advanced Collapse (SLAC) and Scaphoid Nonunion Advanced Collapse (SNAC)
59. Rheumatoid Arthritis of the Hand and Wrist
Definition
Diagnostic Criteria
Pathophysiology
Management Principles and Operative Options
60. Lesions of the Hand
Introduction
History, Examination, and Diagnosis
Soft Tissue
Cartilage
Bone
Conclusion
Part VIII. Esthetic Surgery
61. Nonoperative Facial Rejuvenation
Introduction
Botulinum Toxin
Soft Tissue Fillers
Submental Fullness
Cutaneous Remodeling
Conclusion
62. Facial Aging and Anatomy of the Facial Nerve
Introduction
Five-Layered Anatomy, Facial Soft Tissue Spaces, and Retaining Ligaments of the Face
Aging Changes of the Face
Regional Changes Observed with the Aging Face
Summary
63. Forehead Lift
Introduction
Patient Options in Forehead Rejuvenation
Identifying the Patient in Need of a Forehead Lift
Eyebrow Esthetics and Planning Eyebrow Elevation
Foreheadplasty Techniques
Postoperative Care
Case Example (Fig. 63.50)∗
64. Upper Eyelid Rejuvenation
Introduction
Periorbital Aging
Anatomy
Patient Evaluation
Surgical Techniques
Postoperative Care
Complications
Conclusion
65. Lower Eyelid and Midcheek Rejuvenation
Introduction
Surgical Anatomy and Dissection Planes
Patient Selection
Nonsurgical Techniques
Surgical Correction of Midcheek Aging
Discussion
Summary
66. Facelift
Introduction
The Aging Face
Subcutaneous Facelift
SMAS Manipulation Techniques
Complications
Senior Author’s Limited Dissection Composite Facelift Technique
67. Neck Lift
Introduction
Strategies for Neck Lift
Surgical Planning in Neck Lift
Assessing the Anatomical Basis of Neck Problems
Preoperative Preparations and Care
Surgical Technique
Postoperative Care
Case Examples
68. Rhinoplasty
Introduction
Anatomy
Patient Assessment
Rhinoplasty Dynamics
Operative Approach
Postoperative Care
Complications
Secondary and Tertiary Rhinoplasty
69. Blepharoptosis
Definition
Anatomy
Etiological Factors
Preoperative Assessment
Treatment Principles
Complications
70. Liposuction and Liposculpture
Introduction
Harvest Site
Donor Site Preparation
Harvest Technique
Processing Technique
Injection Technique
Recipient Site
Complications and Emerging Safety Concerns
Conclusion
71. Abdominoplasty and Body Contouring
Anatomy
Esthetic Assessment
Patient Assessment
Operative Principles and Approach
Body Contouring after Massive Weight Loss
Summary
Part IX. Professional Examinations
72. Board and Fellowships Exams
Introduction
FRACS(Plast)/EBOPRAS Exams
FRACS(Plast): The IMG (International Medical Graduate) Perspective
FRCS(Plast) Exams
FRCSC Exams
Plastic Surgery Fellowships in the United States
Index

Rostam Farhadieh

Mr Ross Farhadieh is the Head of Department of Plastic Reconstructive & Hand surgery of The Canberra and Calvary Hospitals, in Canberra Australia. He completed his medical degree with honours (BSc) in Surgery. He was awarded the prestigious Surgeon Scientist Scholarship (2005) Royal Australasian College of surgeons and completed a three year Medical Doctorate (MD) research degree in molecular biology of head and neck cancers. He completed his plastic surgery training in Melbourne with microsurgical training under Professor Wayne Morrison in 2011 FRACS(Plast). He completed multiple subspecialty fellowships in London, in paediatric surgery at Great Ormond St, Aesthetic surgery at the Wellington and Microsurgery at the Royal Free and completing the FRCS(Plast) in 2012 and European Board of Plastic Reconstructive and Aesthetic Surgery fellowships in 2013 EBOPRASF. He is the director of Panthea Clinics in Sydney and Canberra. His practice encompasses complex trauma and oncological microsurgical reconstruction and aesthetic surgery of the face, breast and body.

Affiliations and expertise

Consultant Plastic and Reconstructive Surgeon Head of Department of Plastic Reconstructive and Hand Surgery, The Canberra and Calvary Hospitals, Canberra, ACT, Australia, Director, Panthea Clinics Senior Clinical Lecturer Sydney University Medical School Sydney,

Neil Bulstrode

Mr Neil Bulstrode is a Consultant Plastic Surgeon at Great Ormond Street Hospital where he is the Lead Clinician for the Department of Plastic and Reconstructive Surgery. He was educated at Sherborne School, UK, before commencing his medical studies at Charing Cross and Westminster Medical School, London. He completed his medical degree with honours degree (BSc) in Physiology. He completed his in Plastic Surgery training in some of London’s World premier units. He completed a post graduate Doctorate Medicine MD research at the RAFT Institute of Plastic Surgery at Mount Vernon Hospital. He spent organised a year exchange with the plastic surgery training program in Sydney, Australia 2003-4 and obtained his fellowship in Plastic Surgery - FRCS (Plast) - from the Royal College of Surgeons in 2005, entering into the GMC Specialist Register for Plastic Surgery in 2006. Neil has both an NHS reconstructive and an adult aesthetic/cosmetic practice. This involves the reconstruction of congenitally deformed children, ear reconstruction, craniofacial surgery, the treatment of giant congenital naevii and vascular anomalies. His cosmetic practice includes all aspects of cosmetic facial, breast and body contouring surgery.

Affiliations and expertise

Consultant Plastic Surgeon and Lead Clinician for the Department of Plastic Surgery at Great Ormond Street Hospital London. Honorary Associate Professor, UCL Great Ormond Street Institute of Child Health London, United Kingdom.

Babak J. Mehrara

Dr Babak Mehrara is the Chief of the Plastic and Reconstructive Surgery Service in the Department of Surgery at Memorial Sloan Kettering Cancer Center. Dr Mehrara obtained his medical degree from Columbia University College of Physicians and Surgeons and completed his residency in Plastic Surgery at New York University. He then completed a fellowship in microsurgery with William W. Shaw at UCLA Medical Center. Dr. Mehrara's clinical expertise includes microsurgical and alloplastic breast reconstruction, complex head and neck reconstruction, and lymphedema. Dr. Mehrara is also the director of the Lymphedema Research Center at Memorial Sloan Kettering and has a deep interest in developing novel treatments for this disease.

Affiliations and expertise

Plastic and Reconstructive Surgeon, Chief, Plastic and Reconstructive Surgical Service, Peter G. Cordeiro Endowed Chair in Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York

Sabrina Cugno

Dr Sabrina Cugno is a consultant plastic surgeon at the Montreal Children’s Hospital, the Shriners Hospital and CHU Sainte-Justine in Montreal. She completed her undergraduate degree at McGill University (Montreal, Canada) followed by a Masters’ degree at Oxford University (Oxford, United Kingdom). She completed her medical studies at McMaster University (Hamilton, Canada) and training in plastic and reconstructive surgery at Université de Montréal (Montreal, Canada). She completed a specialty training in pediatric plastic and reconstructive surgery at the world renowned Great Ormond Street Hospital for Children (London, United Kingdom). She is a fellow of both the Royal College of Surgeons of Canada and American College of Surgeons. Sabrina’s practice is dedicated to the care of children with either congenital and traumatic injuries, with a focus on cleft lip and palate/velopharyngeal insufficiency, ear reconstruction, treatment of giant congenital nevi and vascular anomalies.

Affiliations and expertise

Pediatric Plastic and Reconstructive Surgeon, Montreal Children’s Hospital and Shriners Hospital, Assistant Professor, McGill University, Montreal Children’s Hospital, McGill University Health Center, Montreal, QC, Canada

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Plastic Surgery - Principles and Practice

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Rostam Farhadieh

Neil Bulstrode

Babak J. Mehrara

Sabrina Cugno