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Number 1/July 2000 

Original Articles 

1 The Use of Pedicled Expanded Flaps for Aesthetic Konrad Hoekstra, MBBS 
Resurfacing of the Burned Face Donald A. Hudson, FRCS, MMed 

; . ; A. Wayne Smith, FCS(SA) 
A series of facial burn patients is presented in which 

hyperexpanded chest flaps were used to resurface aesthetic 
units of the face. Pedicles were divided two weeks later without 
flap loss. 

The Use of Pedicled Perforator Flaps for Reconstruction —_ Nathalie A. Roche, MD 
of Lumbosacral Defects Koenraad Van Landuyt, MD 
Phillip N. Blondeel, MD, PhD 

Four lumbosacral reconstructions were carried out using etal 

perforator-based flaps based on the superior gluteal artery, the 
lumbar artery, or an intercostal artery. The flaps proved to be 
large and highly reliable with wide arcs of rotation and the 

ability to close the donor defects primarily. 

Abdominal Recovery After Laparotomy and Omental Yoav Barnea, MD 

Transposition Into a Grossly Contaminated Median Meir Cohen, MD 

Sternotomy Wound Michael Giladi, MD 
et al 

A retrospective review of abdominal wound healing compared 
(1) 15 septic sternotomy wounds treated with omental flaps 
against (2) a control group of 15 elective splenectomies. No 
difference was seen in post-operative peritonitis or number of 
days to recovery of peristalsis, NG tube removal, oral feeding, or 
first bowel movement. 

Anterior Oblique Ligament Reconstruction of the Thumb __M. W. Elmaraghy, MD, FRCSC 
Using the Transverse Carpal Ligament: Description of a 
New Procedure 

A cadaver study demonstrated the feasibility of thumb anterior 
oblique ligament reconstruction using the transverse carpal 
ligament for stabilization. 

Fingertip Reconstruction Using Two Variations of Direct- Huseyin Borman, MD 

Flow Homodigital Neurovascular Island Flaps Tugrul Maral, MD 

Mehmet Tancer, MD 
Eleven fingertips and seven more proximal amputation stumps 

were resurfaced using two different methods of direct-flow 
homodigital neurovascular island flaps. No flap failures were 
seen, and good sensibility was achieved. 

Verrucous Malformations: Their Presentation and Mahesh H. Mankani, MD 
Management Craig R. Dufresne, MD, FACS 

Six patients with verrucous vascular malformations were 
excised in single or staged procedures. With only a single 
recurrence over seven years, excision is seen to be superior to 
laser ablation or cryosurgery. 

Contents of Volume 45, July-December 2000 


Prevention of Meatal Stenosis With W-Flap 
Glanuloplasty in Hypospadias Surgery: A Long-Term 

Three hundred fifty-six hypospadias cases repaired with 
incorporation of a W-flap glanuloplasty demonstrated a 0.8% 
meatal stenosis rate. The advantages included an anatomically 
located meatus, wider meatal diameter, avoidance of a circular 
anastomosis, a satisfactory urinary stream, and elimination of 
need for a stent. 

Effect of the Delay Phenomenon in the Rat Single- 
Perforator-Based Abdominal Skin Flap Model 

In a rat musculocutaneous, perforator-based, abdominal skin 
flap model, delay was effective if performed by incising the flap 
boundaries alone or by adding the ligation of all ipsilateral 
perforators except the pedicle artery. 

The Role of Periosteum and Different Dissection Types on 
Callus Formation: Quantitative Analyses With 
Scintigraphy in a Rabbit Mandible Model 

In a rabbit mandible model, callus formation progressed more 
rapidly the less periosteum had been stripped at the time of the 
initial osteotomy, confirming the beneficial effect of intact 
periosteum on fracture healing. 

Secondary Venous Ischemic Injury Associated With 
Neutrophil Infiltration and Lipid Peroxidation: 
Amelioration of Injury by Cyclosporin A in a Rat 
Inguinal Island Flap 

In a rat neurovascular island flap model, post-treatment of 
secondary venous ischemia with high-dose Cyclosporin A 
resulted in increased flap surviving area and lower MDA and 
MPO levels. The effect was probably a result of attenuation of 
neutrophil infiltration and reduction of lipid peroxidation. 

Case Reports 

Elongated Uvula With a Pleomorphic Adenoma: A Rare 
Cause of Obstructive Sleep Apnea Syndrome 

Pneumomediastinum After Injection Injury to the Hand 

A Modified Reversed Digital Island Flap Incorporating 
the Proper Digital Nerve 

Seyhan Cenetoglu, MD 
Reha Yavuzer, MD 
Osman Latifoglu, MD 
et al 

O. Koray CoSkunfirat, MD 
H. Seckin OkSar, MD 
H. Ege Ozgenta$, MD 

Ufuk Bilkay, MD 
Naci Celik, MD 
Ulkem Bilkay, MD 
et al 

Akin Yiicel, MD 
Cemal Senyuva, MD 
Giilnur Andican, MD 
et al 

Hisashi Motomura, MD 
Teruichi Harada, MD 
Mitinari Muraoka, MD 
Toshiko Taniguchi, MD 

C. L. F. Temple, MD 
R. S. Richards, MD, FRCSC 
W. B. Dawson, MD, FRCPC 

Ahmet Karacalar, MD 
Cenk Sen, MD 
Mesut Ozcan, MD 

Contents of Volume 45, July-December 2000 

Functional Lip Reconstruction With a Radial Forearm 
Free Flap Combined With a Masseter Muscle Transfer 
After Wide Total Excision of the Chin 

Malignant Fibrous Histiocytoma Arising in a 
Thoracotomy Scar 

Metastatic Basal Cell Carcinoma of the Axilla: Report of 
a Case and Reconstruction With an Island Lateral 
Pectoral Flap 

Review Article 

Advances in the Biology of Flexor Tendon Healing and 
Adhesion Formation 

Tips & Techniques 

A New Test for Superficialis Flexor Tendon Function 

Free Transfer of the Radial Forearm Flap With 
Preservation of the Radial Artery 

A Thousand Authors 


Distally Based Superficial Peroneal Neuroadipofascial 
Turnover Flap for Dorsal Foot Reconstruction 

Malignant Clear Cell Hidradenoma with Giant Metastasis 
to the Axilla 

Superior and Inferior Ulnar Collateral Arteries 
Originating As A Common Trunk In The Arm 

Hiroshi Shinohara, MD 
Motonao Iwasawa, MD 
Takeshi Kitazawa, MD 
Hideo Kushima, MD 

Sean Lille, MD 
Paul Schnur, MD 

Yii, FRCS(plast) 
Niranjan, MS, FRCS(plast) 

N. W. 

Moneer Jaibaji, FRCS 

Teoman Dogan, MD 
Ozhan Celebiler, MD 
Raffi Giriinlioglu, MD 
et al 

Tunc Safak, MD 
Mustafa Akyiirek, MD 

William D. Morain, MD 

Shi-Min Chang, MD, PhD 
Chun-Lin Hou, MD 

Serkan Yildrim, MD 
Tayfun Akéz, MD 
Iker Apaydin, MD 
et al 

H. |. Canter, MD 
A. Erdem, MD, PhD 
C. C. Denk, MD, PhD 

Contents of Volume 45, July-December 2000 

Number 2/August 2000 

Original Articles 

Repair of Large, Anterior Palatal Fistulas Using Thin 
Tongue Flaps: Long-Term Follow-up of 10 Patients With 
Invited Discussion By Jeffrey C. Posnick, DMD, MD, 
FRCS(C), FACS, and Ramon L. Ruiz, DMD, MD 

Ten thin anteriorly based tongue flaps were used for closure of 
large anterior palatal fistulas with 100% survival. One 
reoperation for bleeding occurred, and one recurrent fistula 
appeared during maxillary expansion. 

Immediate Coverage of Exposed, Denuded Cranial Bone 
With Split-Thickness Skin Grafts 

Five consecutive acutely denuded skull wounds were 
successfully closed by immediate burring of the outer table and 
skin grafting. Delaying until the formation of granulation tissue 
was unnecessary. 

Long-Term Results of Tendon Transfers for Radial Nerve 
Palsy in Patients With Limited Rehabilitation 

Long-term follow-up of 22 patients with tendon tranfers for 
isolated radial nerve palsy demonstrated improved function in 
all but one. Thirteen of 17 previously employed paiients 
returned to work following recovery. 

Correlation of Electrodiagnostic Findings With Subjective 
Symptoms in Carpal Tunnel Syndrome 

A retrospective record review of 138 patients (222 hands) 
evaluated for carpal tunnel syndrome with nerve conduction 
studies (NCS) and questionnaires demonstrated that NCS data 
correlated more closely with severity of symptoms than with 
functional status. 

The Distally Based Superficial Sural Flap: Our 
Experience in Reconstructing the Lower Leg and Foot 

Distally based superficial sural flaps were performed for 18 
distal third and foot defects with only a single superficial 
necrosis resulting. 

Rotation Ligamentoplasty for the Correction of 
Epicanthus Inversus 

Congenital epicanthus inversus was permanently corrected in 
seven of eight patients by rotation of the medial canthal 
ligament during transnasal wiring. 

M. Zeki Guzel, MD 
Fatis Altintas, MD 

J. M. Pitkanen, MD 
M. M. Al-Qattan, MD 
N. A. Russel, MD 

Paul J. Skoll, FRCS, FCS(SA)Plast 

Donald A. Hudson, FRCS, FCS(SA)Plast, 

Wikus de Jager, FCS(SA)Ortho, MMed 

Martin Singer, FRCS 

Eun Sang Dhong, MD 
Seung Kyu Han, MD 
Byung Ii Lee, MD 
Woo Kyung Kim, MD 

Marco Fraccalvieri, MD 
Giovanni Verna, MD 
Massimo Dolcet, MD 
et al 

Ercan Karacaoglu, MD 
Erdem Tezel, MD 
M. Miimtaz Giiler, MD 

The Limitation of Primary Excision of Cicatricial 
Alopecia: A Report of 63 Patients 

A review of 63 patients operated for cicatricial alopecia of the 
scalp disclosed the clear superiority of tissue expansion over 
direct excision. Direct excision was satisfactory only in scars 
less than 10 mm in width. 

Cartilage Shaping Using the Er:YAG Laser: Preliminary 

In a rabbit ear cartilage model, stripping with the Er:YAG laser 

resulted in controlled, progressive bending over a 10-day period, 

suggesting its clinical value in cartilage shaping. 

The Effect of Pedicle Artery Vasospasm on 
Microhemodynamics in Anatomically Perfused and 
Extended Skin Flap Tissue 

In a hamster island skin flap model, recovery from clamp- 
induced vasospasm was accompanied by reactive arteriolar 
vasodilatation in the well-perfused portion of the flap, but no 

vasodilatation in the extended portion of the flap. It is suggested 

that distal ischemic necrosis may be a result of prolonged 
uncompensated vasospasm in poorly perfused areas. 

Both Dermal Matrix and Epidermis Contribute to an 
Inhibition of Wound Contraction 

In a swine excisional wound model, both dermal matrix and 
epidermal coverage inhibited wound contraction. Prompt 
epithelial coverage impeded contraction by reducing 

Hyperbaric Oxygen Therapy in Adriamycin 
Extravasation: An Experimental Animal Study 

In a rat model, healing of an adriamycin-induced wound was 
accelerated by the use of hyperbaric oxygen administration. 

Case Reports 

Are Triglyceride Breast Implants Really Biocompatible? 
With Invited Discussion By V. Leroy Young, MD 

Reconstruction of Hip Abduction Using Free Muscle 
Transplantation: A Case Report and Description of the 

Contents of Volume 45, July-December 2000 

F. Duteille, MD 

B. Le Fourn, MD 

D. Hepner Lavergne, MD 
M. Pannier, MD 

Metin Gorgii, MD 
Meltem Ayhan, MD 
Giircan Aslan, MD 
et al 

Reto Wettstein, MD 
Robert Wessendorf, MD 
Axel Sckell, MD 

et al 

Jennifer L. Walden, MD 
Habacue Garcia, MS 
Hal Hawkins, MD et al 

Samil Aktas, MD 
Akin Savas Toklu, MD 
Vakur Olgac, PhD 

S. Papanastasiou, FRCSEd 
J. Odili, MRCS 

P. Newman, FRCPath 

J. Evans, FRCS(Plast) 

Koichiro Ihara, MD 
Tetsuro Kishimoto, MD 
Shinya Kawai, MD 
Kazuteru Doi, MD 

Contents of Volume 45, July-December 2000 


Total Tongue Reconstruction With Free Functional 
Gracilis Muscle Transplantation: A Technical Note and 
Review of the Literature 

New Multilobe “Accordion” Flaps for Three-Dimensional 
Reconstruction of Wide, Full-Thickness Defects in the 
Oral Floor 

The Compound Sternal Flap for Laryngeal 

When Is Surgical Treatment Not Appropriate for 

Reconstruction of a Tibial Defect With Microvascular 
Transfer of a Previously Fractured Fibula 

Review Aricle 

Clinical and Scientific Considerations in Leech Therapy 
for the Management of Acute Venous Congestion: An 
Updated Review 

Rhapsody in Greek 

Re: What’s the Alternative? 

Re: Transsacral Usage of an Island TRAM Flap for 
Sacral Defects 

Urethral Fistula as the Cause of Circumcision Phobia 

A New Tool to Eliminate Hyperpigmentation in 
Liposuction Scars 

Pediatric Plastic Surgery in a Day Hospital: Use of 
Propofol and a Laryngeal Mask 

Levent Yoleri, MD 
Hatice Mavioglu, MD 

Isao Koshima, MD 
Masaru Hosoda, DDS 
Takahiko Moriguchi, MD 
Shinsaku Kawada, MD 

Vladimir Shur, MD 
Ivor B. Kaplan, MD 

Nandan V. Kamath, MD 
Arif Usmani, MD 
Arthur Pellegrini, MD 

Sheel Sharma, MD 
Pankaj Tiwari, BS 
Armen K. Kasabian, MD 
Michael T. Longaker, MD 

Adam B. Weinfeld, MD 
Eser Yuksel, MD 
Sean Boutros, MD et al 

William D. Morain, MD 

James W. Fox, MD 

John P. Cederna, MD 

Azize Kilic, MD 
Murat Emsen, MD 
Emre Ozdengil, MD 

Carlo Gasperoni, MD 
Marzia Salgarello, MD 
Antonella Cimino, MD 
Paolo Gasperoni, MD 

Francesco D’Andrea, MD 
A. Corcione, MD 

G. Ferraro, MD 

Sergio Brongo, MD 

A Giant Recurrent Pyogenic Granuloma of the Thumb 

Re: Soft Tissue Reconstruction of Sole and Heel Defects 
with Free Tissue Transfers 

Microphthalmia With Linear Skin Deficiency Syndrome 
Accompanied by Cleft Lip and Palate 

Simultaneous Use of a Tissue Expander and Skin Graft 
in Scalp Reconstruction 

Pacinian Corpuscle Hyperplasia Coexisting With 
Dupuytren’s Contracture 

Palliative Amputation for a Peculiar Case of Malignant 
Melanoma of the Lower Limbs 

Idiopathic Calcinosis of the Scrotum 

The Effects of Oxidized, Regenerated Cellulose on Diced 
Cartilage Xenografts: An Experimental Study 

Re: Treatment of Painful Neuromas: A Case Report 


Contents of Volume 45, July-December 2000 

Akin Yiicel, MD 
Yagmur Aydin, MD 
Erol Benlier, MD 
et al 

Mansoor S. Khan, MBBS, MRCS, AFRCS 

Ufuk Bilkay, MD 
Naci Celik, MD 
Ciineyt Ozek, MD 
et al 

Masamitsu Kuwahara, MD 
Mitsuo Hatoko, MD, PhD 
Aya Tanaka, MD 

et al 

Nalan Akyiirek, MD 
Omiir Ataoglu MD 
Seyhan Cenetoglu, MD 
et al 

Francesco D’Andrea, MD 
Carlo Pellegrini, MD 
Sergio Brongo, MD 

Yavuz Demir, MD 
Osman Latifoglu, MD 
Sibel Yenidiinya, MD 
Cemalettin Celebi, MD 

Nilgiin Markal ErtaS, MD 
Sema Hiiciimenoglu, MD 
Omer BeSalti, PhD 

et al 

Marcel F. Meek, MD 
Peter H. Robinson, MD, PhD, FRCS 

Number 3/September 2000 

Special Article 

Cleft Lip in the Talmud With Invited Discussion by Fred 
Rosner, MD, FACP 

The author makes the case that cleft lip represents the “Sandal” 

deformity described in the Talmud. 

Melvyn Westreich, MD 
Samuel Segal, MD 

Contents of Volume 45, July-December 2000 

Original Articles 

Elevating the Island: The Simplest Method of Delaying 
the TRAM Flap 

Fifty-five pedicled TRAM flaps were delayed by pre-elevating the 
island 7-10 days prior to transfer, leaving the deep inferior 
epigastric pedicle intact. No total flap necrosis and only 3.6% 
partial necrosis resulted after subsequent transfer. 

Elective Plastic Surgery in a Jehovah’s Witness: A Case 
Series and Review of the Literature 

Three Jehovah’s Witnesses underwent complex surgical 
operations with the aid of supportive procedures, including 
monitoring, volume replacement, erythropoietin, and vitamin/ 
nutritional supplements. Legal and historical issues are 

A Prospective Blinded Evaluation of Nerve Conduction 
Velocity Versus Pressure-Specified Sensory Testing in 
Carpal Tunnel Syndrome 

A new apparatus, the Pressure-Specified Sensory Device, was 
found to be as sensitive and specific as nerve conduction 
velocity (NCV) testing in the diagnosis of carpel tunnel 
syndrome in 79 patients. It was significantly less painful for the 
patient than NCV. 

Two New Intramedullary Implant Designs for 
Phalanx Fixation in Digital Replantation: An 
Experimental Study 

Two new intramedullary implants, a two-sided asymmetric 
screw and a hook-trap device provided rapid and rigid 
fixation for digital replantation when tested in 40 cadaver 

Correction of Crooked Nail Deformity by Modified 
Osteoplastic Reconstruction 

Ten crooked nail deformities were treated by modified 
osteoplastic reconstruction, elevating a dorsally based volar skin 
flap and placing an iliac bone graft beneath. All nails were 
lengthened and straightened postoperatively. 

Endoscope-Assisted Parotidectomy for Benign Parotid 

Sixteen endoscope-assisted parotidectomies were performed 
through 7-cm incisions. The combination of magnification and 
enhanced illumination was valuable in avoiding facial nerve 

Edward Towpik, MD, PhD 
Slawomir Mazur, MD, PhD 
Tadeusz Witwicki, MD 

et al 

Robert F. Centeno, MD 
Charles D. Long, MD 
Mark S. Granick, MD 

Robert A. Weber, MD 
John A. Schuchmann, MD 
James H. Albers, MD 
Jaime Ortiz, CHT 

Aycan Kayikcioglu, MD 
Sebat Karamiirsel, MD 
Emin Mavili, MD 
Abdullah Kecik, MD 

Yoonho Lee, MD, PhD 
Sungtack Kwon, MD, PhD 
Kyoungho Ko, MD 

Sin-Daw Lin, MD 
Chih-Cheng Tsai, MD 
Chung-Sheng Lai, MD 
et al 

Contents of Volume 45, July-December 2000 

Free Flap Closure in Complex Congenital and Acquired 
Defects of the Palate 

Six patients with congenital and acquired palatal defects 
underwent free flap coverage using rectus abdominis flaps and 
radial forearm flaps with and without bone. One patient 
required revision and another underwent placement of 
Branemark osseointegrated implants into the transferred bone. 

Combined Microvascular Anastomosis: Experimental and 
Clinical Experience 

A combined microanastomotic technique is presented, 
incorporating a continuous suture with interrupted ties. Studies 
of the rat aorta and inferior vena cava demonstrated more rapid 
execution with this technique, and 150 clinical cases 
demonstrated no technique-related failures. 

Reverse Fasciosubcutaneous Flap Versus Distally 
Pedicled Sural Island Flap: Two Elective Methods for 
Distal-Third Leg Reconstruction 

Twenty-five soft tissue defects of the lower third of the leg and 
heel were resurfaced with the fasciosubcutaneous reverse and 
sural reverse flaps, resulting in six minor complications. The 
fasciosubcutaneous flap was more suitable for large defects. 

Sequential Segmental Neuromuscular Stimulation 
Reduces Fatigue and Improves Perfusion in Dynamic 

Using a canine dynamic graciloplasty model for urinary neo- 
sphincter, sequential segmental neuromuscular stimulation 
(SSNS) was compared to conventional, single-channel, 
continuous stimulation. SSNS proved superior in muscle 
endurance and blood perfusion. 

Effect of Surgical Denervation on the Viability of Inferior 
Epigastric Neurovenous Flaps in the Rat 

In a rat neurovenous inferior epigastric flap model, acute 
denervation produced a significant decrease in surviving flap 
area, whereas chronic denervation demonstrated no survival 
difference from control flaps. 

A Rat Musculocutaneous Flap Model: The Biceps 
Femoris Musculocutaneous Flap 

Based on the caudal femoral-popliteal vascular pedicle, the 
biceps femoris musculocutaneous flap is described in the rat. 
The flap has a consistent perforating vessel, supports a large 
skin island, and is at no risk for autocannibalization because of 
its dorsal position. 

Andrew E. Turk, MD 
James Chang, MD 

A. Ebbie Soroudi, MS 
et al 

Tsan-Shiun Lin, MD 
Yuan-Cheng Chiang, MD 

Antonio Bocchi, MD 
Stefano Merelli, MD 
Andrea Morellini, MD 
et al 

Erik D. H. Zonnevijlle, MD 
Naveen N. Somia, MD, PhD 
Gustavo Perez Abadia, MD 
et al 

Ahmet Karacalar, MD 
Hiilya Oztiirk, MD 
Mesut Ozcan, MD 

Mustafa Akyiirek, MD 
Tung Safak, MD 

ilker Manavbasi, MD 
Abdullah Kecik, MD 

Contents of Volume 45, July-December 2000 

Case Reports 

Congenital Volkmann-Lesser Ischemic Contracture of the 
Upper Limb 

Congenital Pressure Necrosis of the Forearm in a 
Newborn Infant With Invited Discussion by Joseph 
Upton, MD 

Tips & Techniques 

A Method for Minimizing Donor Site Complications of 
the Radial Forearm Flap 

Guest Editorial 

Whither Subatmospheric Pressure Dressing? 

Editorial Response 


Subcutaneous Emphysema of Hand and Forearm After 
High-Pressure Injection of Air During Scuba Diving 

Hypospadias Repair: Collaboration Between Urologist 
and Plastic Surgeon 

A New Concept for the Treatment of Postburn 
Contracture of the Elbow 
Foreign Body Infection of Methicillin-Resistant 

Staphylococcus aureus in a Sternal Wound 

Elastofibroma Dorsi 

Antihelical Folding for Pinnaplasty Using One Posterior 
Cartilage Score and Horizontal Mattress Sutures 

Dermoid Cyst at the Suprasternal Notch 

Ram Silfen, MD 
Abraham Amir, MD 
Lea Sirota, MD 

Daniel J. Hauben, MD 

Arun K. Gosain, MD 
Forrest O. Moore, MD 
Linda G. Rabinowitz, MD 

Adam R. Kolker, MD 
Christopher J. Coombs, FRACS 
John G. Meara, MD, DMD 

Steven E. Greer, MD 

Louis C. Argenta, MD 

Halil |. Canter, MD 
Ibrahim Vargel, MD 
Tacettin Giiger, MD 

Yvonne L. Karanas, MD 
James Chang, MD 
Richard Yagol, MD 

et al 

Vishwa Prakash 
S. P. Bajaj 

Tomoharu Kiyosawa, MD, PhD 
Toshio Demitsu, MD 

Naoto Yamamoto, MD 

et al 

Reha Yavuzer, MD 
Selahattin Gzmen, MD 
Tarik Cavusoglu, MD 
et al 

Peter Sylaidis, FRCS 
David Gault, FRCS 

Mustafa Yilmaz, MD 
Haluk Vayvada, MD 
Cenk Demirdéver, MD 

Contents of Volume 45, July-December 2000 

Cleft Lip and Dental Eruption 

Book Review 

Lasers in Aesthetic Surgery 


Giircan Aslan, MD 
Naci Karacgal, MD 
Bilent Erdogan, MD 

Martha S. Matthews, MD, FACS 

Number 4/October 2000 


Characteristics of Women With Cosmetic Breast 
Augmentation Surgery Compared With Breast Reduction 
Surgery Patients and Women in the General Population 
of Sweden With Invited Discussion by Tina S. Alster, MD 

A retrospective questionnaire study of 1,369 women with 
cosmetic breast implants, 2,211 with prior breast reduction, and 
49,262 with neither of these demonstrated that those with 
implants were more likely to smoke, to have a lower body mass 
index, to have undergone a miscarriage or induced abortion, 
and to have had fewer live births than the others. The data 
reflect that women who undergo cosmetic breast surgery tend to 
have distinct characteristics. 

Using the Pulsed Dye Laser to Influence Scar Formation 
After Breast Reduction Surgery: A Preliminary Report 

An examination of 11 patients undergoing breast reduction 
demonstrated that early scars showing tiny transverse vessels 
were destined to become hypertrophic and wide. Use of the 
Pulse Dye Laser disrupted this vessel pattern and inhibited 
further hypertrophic change. 

The Use of External Ultrasound Combined With 
Superficial Subdermal Liposuction 

Using the superwet technique, 30 patients underwent external 
ultrasound application, followed immediately by superficial 
liposuction and then deep liposuction. The superficial 
subdermal areas pretreated with external ultrasound produced 
an oilier and less bloody aspirate than in those areas without 

Hazards of Piercing and Facial Body Art: A Report of 
Three Patients and Literature Review 

Three complications of body piercing are presented, including 
perichondrial auricular abscess, nasal alar granulomatous 
perichondritis, and stud embedding of the lower lip. 

Jon P. Fryzek, PhD 
Elisabete Weiderpass, MD 
Lisa B. Signorello, ScD 
et al 

P. G. Shakespeare, PhD 
E. Tiernan, FRCS(Plast) 
A. E. Dewar, PhD 

J. Hambleton, MPhil 

Carlo Gasperoni, MD 
Marzia Salgarello, MD 

Benedikt J. Folz, MD 
Burkard M Lippert, MD 
Christoph Kuelkens, MD 
Jochen A. Werner, MD 

Contents of Volume 45, July-December 2000 


Endoscopic-Assisted Harvest of the Temporoparietal 
Fascial Flap 

Nine microtia patients underwent endoscope-assisted harvesting 
of the temporoparietal fascial flap through two 2-cm incisions. 
Two patients required wider intraoperative exposure to achieve 

Extraoral vs. Intraoral Distraction Osteogenesis in the 
Treatment of Hemifacial Microsomia 

Twelve hemifacial microsomia patients treated with an extraoral 
distraction device were compared to ten treated with an 
intraoral device. Although the intraoral method was more 
socially convenient, the extraoral device permitted greater 
elongation, better vector control, and more accurate gonial angle 

Reliability of Island Flaps Raised After Superficial and 
Deep Burn Injury 

Rat epigastric island flaps were raised and resutured 4 days 
after administration of a superficial or deep burn to the flap site. 
There were no significant differences in flap survival between 
burned and unburned flaps. 

The Free Musculocutaneous Tensor Fascia Lata Flap as a 
Backup Procedure in Tumor Surgery 

Nine free TFL flaps were successfully transferred for 
reconstruction after recurrent tumor resections of the chest and 
abdominal walls. The two-team procedures resulted in no 
functional deficits, and all donor sites were closed primarily or 
skin grafted. 

An Anatomic Examination of the Suprascapular 

A cadaver injection study demonstrated a highly variable 
branching pattern of the suprascapular artery, confirming that a 
“suprascapular flap” is not practicable. 

The Effect of Blood Supply in Muscle and an Elevated 
Muscle Flap on Endogenous Tissue-Engineered Bone by 
rhBMP-2 in the Rat 

Implantation of recombinant human bone morphogenetic 
protein-2 into rat latissimus dorsi muscle and muscle 

pouches resulted in heterotrophic osteoinduction. The difference 
in bony tissue between the two groups suggested that the blood 
supply is an important factor in promoting osteoinduction by 

Akihiko Takushima, MD 
Hirotaka Asato, MD 
Kiyonori Harii, MD 

Adi Rachmiel, DMD, PhD 
Dror Aizenbud, DMD 
Stavros Eleftheriou, DMD 
et al 

Huseyin Borman, MD 
Tugrul Maral, MD 

Beyhan Demirhan, MD 
Mehmet Haberal, MD, FACS 

C. Heitmann, MD 
M. Pelzer, MD 
H. Menke, PhD 
G. Germann, PhD 

Takeshi Kitazawa, MD 
Kiyoshi Matsuo, MD, PhD 
Tetsuji Moriizumi, MD, PhD 
Yoshinori Hataya, MD 

Kenji Kusumoto, MD 
Kazuhisa Bessho, DDS, DMSc 
Kazuma Fujimura, DDS, DMSc 
et al 

Contribution of Conventional Axial Computed 
Tomography (Nonhelical), in Conjunction With 
Panoramic Tomography (Zonography), in Evaluating 
Mandibular Fractures 

In a series of 66 mandibular fractures in 39 patients, axial 
computed tomography demonstrated two parasympheseal 
fractures and several instances of undiscovered comminution 
not seen on Panorex. The data added by axial computed 
tomography could have changed an operative plan based solely 
on Panorex in 44% of the cases. 

Case Reports 

A Unique Case of Secondary Microvascular Glansplasty: 
The Last Genitoreconstructive Frontier? 

Critical Leg Ischemia Resulting From Interruption of 
Collaterals by Harvest of the Rectus Abdominis Free 
Flap: Endovascular Salvage 

Pregnancy as a Tissue Expander in the Repair of a 
Massive Ventral Hernia 

The Sandwich Technique for Closure of a Palatal Fistula 

Docetaxel (Taxotere) Extravasation: A Report of Five 
Cases With Treatment Recommendations 

Giant Plexiform Neurofibroma of the Back 

Multiple-Digit Onychomycosis: A Simple Surgical Cure 

Unilateral Virginal Breast Hypertrophy 

Sclerosing Lobular Hyperplasia of the Breast After 
Reduction Mammaplasty 

Tips and Techniques 

Use of Triamcinolone Acetonide Injection in Ear 

Contents of Volume 45, July-December 2000 

lan F. Wilson, MD 
Adam Lokeh, MD 
Charles |. Benjamin, MD 
et al 

J. Joris Hage, MD, PhD 

Keith Hodge, MD 
James Yuen, MD 
Mohammed Moursi, MD 
John F. Eidt, MD 

Eric T. Elwood, MD 
Walter L. Ingram, MD 
Grant W. Carlson, MD 

Ismail Kuran, MD 
Bugra Sadikoglu, MD 
Tugrul Turan, MD 

et al 

Jeffrey A. Ascherman, MD 
Sean L. Knowles, BA 
Keith Attkiss, MD 

Maurice Y. Nahabedian, MD 
Shai M. Rozen, MD 

James D. Namnoum, MD 
Craig A. Vander Kolk, MD 

Maurice Y. Nahabedian, MD 

Galip Agaoglu, MD 
Figen Ozgiir, MD 
Yiicel Erk, MD 

W. Glenn Lyle, MD 
Kerrie R. Bossard, BA 
D. Scott Day, MD 

P. S. Bhandari, MCh 

Contents of Volume 45, July-December 2000 


The “Stegosaurus” Dressing: A Simple and Effective 
Method of Securing Skin Grafts in the Burn Patient 

Of Boobs and Bobos 


Endoscopic Harvest of Pectoralis Major Muscle Flap for 
Correction of a Neck Deformity 

Drains in Reduction Mammaplasty 

Rhomboid Flap for Surgery of the Scalp With or Without 
Expansion: An Experimental Study 


James K. Fullerton, MD 

Christopher E. Smith, MD 

Stephen M. Milner, MBBS, BDS, 

William D. Morain, MD 

Kazuya Matsumoto, MD 
Hideki Nakanishi, MD 
Takuya Seike, MD 

Alastair Brown, MB, BCh, BAO, FRCS 

Chris Hill, MB, BCh, BAO, FRCS 

Khalid Khan, MB, BCh, FRCS, 

F. Duteille, MD 
P. LaCroix, MD 
G. Duport, MD 

Number 5/November 2000 

Original Articles 

One-Stage Immediate Breast and Nipple—Areolar 
Reconstruction With Autologous Tissue I: A Preliminary 

Seven women with early breast cancer underwent skin-sparing 
mastectomy and immediate breast reconstruction using 
de-epithelized TRAM flaps. A full-thickness areola graft from 
the specimen was combined with a CV flap on Zone II of the 
TRAM flap to complete the single-stage reconstruction. 

Brachytherapy: Reconstructive Options and the Role of 
Plastic Surgery 

Nineteen patients received brachytherapy and reconstruction for 
cancer of the upper and lower extremities and trunk. Despite 
local catheter irradiation of 45-50 Gy (Ir192) beginning 5 days 
after flap closure, all flaps survived with only 10% 
complications. Local recurrences were seen in 42%. 

Donald A. Hudson, FRCS 
David M. Dent, ChM, FRCS 
Dirk Lazarus, FCS(SA) 

Haluk Duman, MD 
Gregory R. D. Evans, MD 
Gregory Reece, MD 

et al 

Contents of Volume 45, July-December 2000 

Total Reconstruction of the Alar Cartilages With a 
Partially Split Septal Cartilage Graft 

In 22 secondary rhinoplasties, deficient lower lateral cartilages 
were present. Tip support was supplied with a hockey 
stick-shaped septal graft partially split to create double domes. 
All gained greater tip projection, and three reported functional 

Philtral Construction by Composite Skin—-Muscle 
Rotation and Orbicularis Oris Muscle Advancement in 
Secondary Cleft Lip Deformity 

Ten secondary unilateral cleft lip repairs were performed using 
a hinged muscle flap from the medial side to augment the cleft 
philtral ridge. Final results demonstrated a more symmetric 
philtrum and cupid’s bow. 

Sentinel Node Biopsy in Melanoma Using Technetium- 
99m Rhenium Colloid: The London Experience 

Fifty-six consecutive patients with stage 1b or 2 melanoma 
underwent sentinel node biopsy assisted by preoperative 
lymphoscintigraphy using 99m-technetium rhenium colloid or 
filtered sulfur colloid. Scans identified sentinel nodes in 55 of 
56 patients (18 in unpredicted locations), and 12 were found to 
be positive. 

An Experimental Study of Skin Flap Associated With 
Muscle: Is Muscle Nourishment Possible Through the 
Musculocutaneous Perforators? With Invited Discussion 
by Thomas J. Krizek, MD 

A rat flap model with both muscle and skin based on the 
inferior superficial epigastric vessels demonstrated that muscle 
may survive by reverse flow through the musculocutaneous 
perforators when elevated with an axial skin flap. 

Crossover Innervation After Digital Nerve Injury: Myth 
or Reality? 

In a retrospective review of 74 sharp epineural digital nerve 
repairs in 54 patients, there was no significant difference in final 
2-point discrimination between unilateral and bilateral repairs. 
Crossover innervation did not appear to influence long-term 
outcome after digital neurorrhaphy. 

Overexpression of Transforming Growth Factor Beta-2 
and Its Receptor in Rhinophyma: An Alternative 
Mechanism of Pathobiology 

TGF-B2 and TGF-B II receptor immunoreactivity staining of 
rhinophyma tissue was stronger than that in normal skin, 
confirming overexpression of this fibrogenic protein and its 
receptor in rhinophyma tissue. The data support the hypothesis 
that fibrosis plays an important role in the pathobiology of 

Luiz Carlos Ishida, MD 
Jorge Ishida, MD 

Luis Henrique Ishida, MD 
et al 

Ushio Haramoto, MD 
Takashi Kamiji, MD 
Satoshi Takagi, MD 
et al 

C. L. F. Temple, MD 
C. G. Scilley, FRCSC 
C. J. Engel, FRCSC 
et al 

Sikri Yazar, MD 
Oguz Cetinkale, MD 
Osman Senel, MD 
et al 

Norman Weinzweig, MD, FACS 

Lee L. Q. Pu, MD, PhD 
Paul D. Smith, MD 
Wyatt G. Payne, MD 

et al 

Contents of Volume 45, July-December 2000 


Thrombogenic Effects of a Nonthrombin-Based Fibrin 
Sealant Compared With Thrombin-Based Fibrin Sealant 
on Microvenous Anastomoses in a Rat Model 

Although high concentrations of thrombin are known to be 
harmful at the site of a microvenous anastomosis, use of a 
nonthrombin-based fibrin sealant was no different from controls 
when applied to a microvenous anastomosis in a rat flap model. 

Patterns of Radial Dysmorphology With the VACTERL 
Association in the Adriamycin-Exposed Prenatal Rat 

The spectrum of upper limb deformities seen in adriamycin- 
exposed prenatal rats closely paralleled that seen in the human 
VACTERL association of multiple anomalies, suggesting a 
reliable embryological model for further study of the VACTERL 

Case Reports 

Occult Craniocerebral Injuries From Dog Bites in Young 

Using the Ilizarov External Fixation Device for Skin 

Bilateral Eyelid Edema: Cutis Laxa or Blepharochalasis? 

A Vascularized Osteocutaneous Fibular Free Flap for 
Reconstruction of a Complex Injury of the Foot 

The Full-Thickness Retroangular Flap 

Secondary Epispadias Repair With Rectus Abdominis 
Musculocutaneous Flap 

Review Article 

A Guide to Establishing the Risk for Breast Cancer in the 
Plastic Surgery Patient 

David B. Drake, MD 
Brent C. Faulkner, MD 
Lester R. Amiss Jr, RN 
et al 

Adam R. Kolker, MD 
Christopher J. Coombs, FRACS 
John G. Meara, MD, DMD 

et al 

A. Corde Mason, MD 
David D. Zabel, MD 
Ernest K. Manders, MD 

Alexander Lerner, MD 
Yehuda Ullmann, MD 
Haim Stein, MD 
Isaac J. Peled, MD 

A. Braakenburg, MD 
J.-P. A. Nicolai, MD, PhD 

Yoon-Kyu Chung, MD, PhD 
Joon Pio Hong, MD 
Sang-Yoon Kang, MD 

et al 

Naoshige lida, MD 
Noboru Ohsumi, MD 
Yoshiaki Tsutsumi, MD 
Mamoru Tonegawa, MD 

Mustafa Yilmaz, MD 
Haluk Vayvada, MD 
Adnan Menderes, MD 
Ali Barutcu, MD 

Karen A. Gronau, MD, MSc 
John L. Semple, MD, MSc, FRCSC, FACS 

Contents of Volume 45, July-December 2000 

Tips and Techniques 

Staged Closure of Complicated Bronchopleural Fistulas 

An Improved Design for Vacuum Tube Drains 

For Whom the Bell Tolls 


Re: Nonsurgical Delay of Cutaneous Flaps Using the 
Flash Lamp Pumped Pulsed Dye Laser 


Re: Aeromonas Species Isolated From Medicinal Leeches 

Re: Increased Axonal Regeneration Through a 
Biodegradable Amnionic Tube Nerve Conduit: Effect of 
Local Delivery and Incorporation of Nerve Growth 
Factor/Hyaluronic Acid Media 

Different Approaches in Extreme Nasal Septum Deviation 

Axillary Reduction Mammaplasty 

Book Review 

Manual of Sclerotherapy 


Andrew E. Turk, MD 
Yvonne L. Karanas, MD 
Walter Cannon, MD 
James Chang, MD 

Oren Lapid, MD 

Yuval Kreiger, MD 

Ronen Glesinger, MD 

Alexander Bogdanov-Berezovsky, MD, PhD 

William D. Morain, MD 

M. M. Al-Qattan, FRCSC 

G. Aslan, MD 
N. Karagal, MD 
M. Gorgii, MD 
B. Erdogan, MD 

Ethem Guneren, MD 
Murat Hokelek, MD, PhD 
Cafer Eroglu, MD 

O. Ata Uysal, MD 

Marcel F. Meek, MD 
J. Henk Coert, MD 
Peter H. Robinson, MD, PhD, FRCS 

Sergio Brongo, MD 
Giuseppe Ferraro, MD 
Francesco D’Andrea, MD 

Yhelda Felicio, MD 

Brian M. Kinney, MD, FACS 

Contents of Volume 45, July-December 2000 

Number 6/December 2000 

Original Articles 
Outcomes in Breast Reduction Surgery 

A prospective series of 69 women undergoing reduction 
mammaplasty was evaluated pre-operatively and post- 
operatively with quality-of-life and psychological testing. 
Whereas pre-operative physical health was rated poorer than 
control patients, significant improvement was noted in all areas 

nine months post-operatively with health status similar to 

Prefabrication of Combined Composite (Chimeric) Flaps 

in Rats With Invited Discussion by Geoffrey G. Hallock, 

A rat chimeric flap with four different tissues was successfully 
prefabricated by wrapping a fascial graft and local muscle flap 
around the saphenous and superficial inferior epigastric 
pedicles, adding an ear cartilage graft, and implanting the 
structure subcutaneously. Re-elevation demonstrated 86% and 
100% survival at six and twelve weeks, respectively. 

The Use of Serial Tissue Expansion in Pediatric Plastic 
Surgery With Invited Discussion by Bruce S. Bauer, MD 

Serial tissue expansion with 63 expanders was performed on 12 
children for reconstruction of giant nevi and burn deformities. 
Complication rates for the first to fourth expansions were 4%, 
20%, 18% and 0%, respectively. 

Management of Lawnmower Injuries to the Lower 
Extremity in Children and Adolescents 

Sixteen pediatric lower-extremity lawnmower injuries required 
early debridement and bony fixation in all cases, with half 
sustaining amputations. Three of five long bone fractures 

underwent external fixation, and five free flap transfers were 

New Eyebrow Lift Technique Using a Semiautomatic 

Suturing Device (Maniceps) for Patients With Facial 

Thirteen facial paralysis patients underwent fascia lata 
suspension browlift through two small post-hairline incisions 
with the aid of a semiautomatic suturing device. 

Tuberous Breast Deformity: Principles and Practice 

Sixteen patients with 23 tuberous breast deformities were 
surgically treated in accordance with an algorithm based on a 
three-tiered anatomic classification system. 

Ramin A. Behmand, MD 
De-Hong Tang, PA 
David J. Smith, Jr. MD 

Atay Atabey, MD 

Edward McCarthy, MD 
Paul Manson, MD 

Craig A. Vander Kolk, MD 

Donald A. Hudson, FRCS 
Dirk Lazarus, FCS(SA) 
Ram Silfen, MD 

Detlev Erdmann, MD 
Ben Lee, MD 

Craig D. Roberts 

L. S. Levin, MD 

Atsushi Niu, MD, DDS 
Kazuki Ueda, MD 

Mutsumi Okazaki, MD 
Akira Momosawa, MD 

John G. Meara, MD, DMD 
Adam Kolker, MD 

Glenn Bartlett, FRACS 

et al 

Contents of Volume 45, July-December 2000 

The Cross-Leg Soleus Muscle Flap 

Nine large lower-extremity defects were closed with cross-leg 
soleus flaps. The flap is advantageous when the recipient vessels 
are too damaged for a free flap, and its donor site is superior to 
that of the conventional cross-leg flap. 

Lateral—-Dorsal Neurovascular Island Flaps for Pulp 

Seventeen acute traumatic digital pulp losses were reconstructed 
with two types of homodigital lateral-dorsal neurovascular 
island flaps. Mean static two-point discrimination was 5.2 and 
9.3 mm in the two types, and 71% had no loss of 
interphalangeal motion. 

Reducing Postoperative Morbidity After the Insertion of 
Gold Weights to Treat Lagophthalmos 

A review of 76 facial paralysis patients with prior gold lid 
loading demonstrated a 12% revision rate for inadequate 
weighting and a 16% extrusion rate. All extrusions and most 

migrations of the implant occurred in the absence of suture 

The Effects of Hyperglycemia on Skin Graft Survival in 
the Burn Patient 

A study of 74 burn patients indicated that skin graft take was 
significantly decreased in the presence of hyperglycemia and/or 
gram-positive bacterial counts = 10° per gram of tissue. 

Application of Artificial Dermis Graft to Correct a 
Depression After Tissue Resection 

Seven patients with contour depression following tissue 
resection underwent implantation of 5-mm thick sheets of 
atelocollagen sponge. No allergic or infectious complications 
occurred, and significant residual thickness of the implants was 
noted on MRI at eight months after placement. 

Case Reports 

End-to-Side Neurorrhaphies of the Ulnar and Median 
Nerves at the Wrist: Report of Two Cases Without 
Sensory or Motor Improvement 

Phlegmasia Cerulea Dolens of the Upper Extremity 

Severe Extensor Tendon Attrition and Multiple Tendon 
Ruptures Resulting from Kienbéck’s Disease 

Chris Ladas, FCS (Plast) 
Roger Nicholson, FCS (Plast) 
Vernon Ching, FCS (Plast) 

Chien-Tzung Chen, MD 
Fu-Chan Wei, MD, FACS 

A. Misra, MRCS 

R. Grover, FRCS 

S. Withey, FRCS (Plast) 
et al 

Arian Molavi, MD 
Kris Andrews, MD 

Stephen Milner, MB, BS, BDS, FRCS (Ed) 
et al 

Mitsuo Hatoko, MD, PhD 
Masamitsu Kuwahara, MD 
Aya Tanaka, MD 

et al 

Aycan Kayikcioglu 
Sebat Karamirsel 
Galip Agaoglu 

et al 

D. Glynn Bolitho, MD, PhD 
Eric T. Elwood, MD 
Fred Roberts, PA-C 

S. Ramkumar, MBBS 
1. C. Josty, FRCS 
P. J. Sykes, FRCS 

Contents of Volume 45, July-December 2000 


Three Different Types of Congenital Lacrimal Sac 

A Rare Craniofacial Cleft: Bilateral Tessier No. 5 Cleft 
Accompanied by No. 1 and No. 6 Clefts 

Bilateral Congenital Pits of the Upper Lip 

Pilar Leiomyoma: A Case Report and Review of the 

Review Article 

The Evolution of Velopharyngeal Imaging 

Guest Editorial 
Was the Power Really Off? 


Re: Breast Reduction Outcome Study 


Re: Endoscopic Harvest of the Rectus Abdominis Muscle 

Perioperative Use of the Endoscope in Cleft Palate 
Surgery: A Preliminary Report 

Sight Lost After Lower Lid Blepharoplasty 

The Use of Hirudo medicinalis in Nipple-Areolar 

Human Skin Allograft for Difficult Extremity Wounds 

Chiaya Toda, MD 

Keisuke Imai, MD 
Kounosuke Tsujiguchi, MD 
et al 

Ufuk Bilkay, MD 
Hakan Gundogan, MD 
Cunyet Ozek, MD 

et al 

Figen Ozgiir, MD 
Goékhan Tuncbilek, MD 

J. D. Latoni, MD 
M. Neuburg, MD, PhD 
H. S. Matloub, MD, FACS 

Peter D. Will, MD 

Jeffrey L. Marsh, MD 

Elizabeth G. McFarland, MD 

John E. Riski, PhD, FASHA, CCC-SLP 

David J. Smith, MD 

Anne Klassen 
Tim Goodacre 

Cynthia L. Mizgala, MD, FRCS(C), FACS 
K. M. MacKenzie, MD 

Stephen Southern, FRCS (Plast) 
Venkat Ramakrishnan, FRACS 

Raurell, FRCS (Ed) 
J. Southern, FRCS (Plast) 
M. Fenton, FRCS (Eng) 


Mario A. Trelles, MD, PhD 

Ethem Giineren, MD 
Litfi Erolu, MD 
Hayati Akba, MD 

et al 

W. Bradford Rockwell, MD 
Stephen P. Daane, MS 
Jan L. Pierce, CTBS 

Tumor Necrosis factor-a and Lipopolysaccharides 
Induce Differentially Interleukin 8 and GRO-a 
Expression in Human Endothelial Cell Line EA.hy926 


Indexes to Volume 45 
Author Index 

Subject Index 

Contents of Volume 45, July-December 2000 

Yao-Hua Song, MD, PhD 
Michael M. Neumeister, MD 
Arian Mowlavi, MD 

Hans Suchy, MS