British journal of plastic surgery
-
A large number of techniques have been described for the correction of prominent ears to improve the cosmetic outcome and reduce the complication rates. The procedure favoured by the senior author brings together a number of refinements, notably, percutaneous anterior scoring using a modified green needle, control over the degree of fold created and a simple but effective dressing. 114 consecutive patients underwent the correction of 214 ears, with a mean follow up of 3 years and 11 months (9 months to 9 years and 6 months). The senior author performed 100 of these procedures and supervised a senior trainee for the remainder. ⋯ No prominent sutures, no anterior skin necrosis, no visible irregularity of the anterior surface of the cartilage and no haematoma occurred. We feel that the low complication rate is due to maximising the advantages and minimising the disadvantages of the different techniques and refinements. We recommend this technique for the routine correction of prominent ears due to a poorly formed antihelical fold or deep conchal bowl.
-
We present a retrospective study of 134 axillae treated in 124 cases of axillary scar contractures with the use of skin grafts and various flaps over the last 25 years in our department. Free skin grafts were performed in 25 axillae, and local flap transfers including skin elongation procedures such as z-plasty were performed in 76 regions. As regional flap transfers, i.e. pedicled axial local flap transfers, latissimus dorsi flaps, para-scapular flaps, superficial cervical artery flaps (SCA flap) and bilateral combined scapular flaps were used for the reconstruction of 23 severe axillary scar contractures. ⋯ In this report, we classify axillary contractures into five types and present our conclusions on the criteria for selecting appropriate surgical methods according to contracture type. Our results suggest there are four key scar features to be considered in the selection of surgical methods for axillary reconstruction: (1) size; (2) depth; (3) location and (4) shape. We also discuss and evaluate the various methods of reconstruction.