The Experts below are selected from a list of 306 Experts worldwide ranked by ideXlab platform
Seiichiro Mori - One of the best experts on this subject based on the ideXlab platform.
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eyelids and eye socket reconstruction using the expanded Forehead Flap and scapha composite grafting
Plastic and Reconstructive Surgery, 2001Co-Authors: Hiroko Yanaga, Seiichiro MoriAbstract:After trauma or excision of malignant tumor, it is difficult to achieve satisfactory results when reconstructing deformed eyclids and the socket for an ocular prosthesis. The authors demonstrate examples of successful reconstruction for a prosthetic eye that provided adequate and aesthetic soft-tissue support achieved by applying a three-step surgical procedure of reconstruction of the eye socket, the eyelids, and the tarsus and eyelid margin. Because it is highly vascularized and its distal end can be divided into two or three portions for easy three-dimensional reconstruction, the expanded Forehead Flap alone, with a galea Flap, or with a free rectus abdominis muscle perforator Flap was used. The expanded Forehead Flap also provides excellent thin upper lid contour and good colormatching with a recipient site. For the eye socket, sufficient volume of tissue was provided from the expanded Forehead Flap with or without a galea or a free rectus abdominis muscle perforator Flap, and a deep and convex fornix was formed. This resulted in a good lit and in stability of the ocular prosthesis. The surface and the inner lining of the eyelids were reconstructed using portions of the expanded Forehead Flap. For the tarsus and eyelid margin, conventional reconstruction techniques use cartilage of the concha, which has limitations of length and which does not lit the shape of the tarsal margin. The authors used the scapha composite graft, and a natural shape and good elasticity resulted.
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eyelids and eye socket reconstruction using the expanded Forehead Flap and scapha composite grafting
Plastic and Reconstructive Surgery, 2001Co-Authors: Hiroko Yanaga, Seiichiro MoriAbstract:After trauma or excision of malignant tumor, it is difficult to achieve satisfactory results when reconstructing deformed eyelids and the socket for an ocular prosthesis. The authors demonstrate examples of successful reconstruction for a prosthetic eye that provided adequate and aesthetic soft-tissue support achieved by applying a three-step surgical procedure of reconstruction of the eye socket, the eyelids, and the tarsus and eyelid margin. Because it is highly vascularized and its distal end can be divided into two or three portions for easy three-dimensional reconstruction, the expanded Forehead Flap alone, with a galea Flap, or with a free rectus abdominis muscle perforator Flap was used. The expanded Forehead Flap also provides excellent thin upper lid contour and good color-matching with a recipient site. For the eye socket, sufficient volume of tissue was provided from the expanded Forehead Flap with or without a galea or a free rectus abdominis muscle perforator Flap, and a deep and convex fornix was formed. This resulted in a good fit and in stability of the ocular prosthesis. The surface and the inner lining of the eyelids were reconstructed using portions of the expanded Forehead Flap. For the tarsus and eyelid margin, conventional reconstruction techniques use cartilage of the concha, which has limitations of length and which does not fit the shape of the tarsal margin. The authors used the scapha composite graft, and a natural shape and good elasticity resulted.
Hiroko Yanaga - One of the best experts on this subject based on the ideXlab platform.
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eyelids and eye socket reconstruction using the expanded Forehead Flap and scapha composite grafting
Plastic and Reconstructive Surgery, 2001Co-Authors: Hiroko Yanaga, Seiichiro MoriAbstract:After trauma or excision of malignant tumor, it is difficult to achieve satisfactory results when reconstructing deformed eyclids and the socket for an ocular prosthesis. The authors demonstrate examples of successful reconstruction for a prosthetic eye that provided adequate and aesthetic soft-tissue support achieved by applying a three-step surgical procedure of reconstruction of the eye socket, the eyelids, and the tarsus and eyelid margin. Because it is highly vascularized and its distal end can be divided into two or three portions for easy three-dimensional reconstruction, the expanded Forehead Flap alone, with a galea Flap, or with a free rectus abdominis muscle perforator Flap was used. The expanded Forehead Flap also provides excellent thin upper lid contour and good colormatching with a recipient site. For the eye socket, sufficient volume of tissue was provided from the expanded Forehead Flap with or without a galea or a free rectus abdominis muscle perforator Flap, and a deep and convex fornix was formed. This resulted in a good lit and in stability of the ocular prosthesis. The surface and the inner lining of the eyelids were reconstructed using portions of the expanded Forehead Flap. For the tarsus and eyelid margin, conventional reconstruction techniques use cartilage of the concha, which has limitations of length and which does not lit the shape of the tarsal margin. The authors used the scapha composite graft, and a natural shape and good elasticity resulted.
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eyelids and eye socket reconstruction using the expanded Forehead Flap and scapha composite grafting
Plastic and Reconstructive Surgery, 2001Co-Authors: Hiroko Yanaga, Seiichiro MoriAbstract:After trauma or excision of malignant tumor, it is difficult to achieve satisfactory results when reconstructing deformed eyelids and the socket for an ocular prosthesis. The authors demonstrate examples of successful reconstruction for a prosthetic eye that provided adequate and aesthetic soft-tissue support achieved by applying a three-step surgical procedure of reconstruction of the eye socket, the eyelids, and the tarsus and eyelid margin. Because it is highly vascularized and its distal end can be divided into two or three portions for easy three-dimensional reconstruction, the expanded Forehead Flap alone, with a galea Flap, or with a free rectus abdominis muscle perforator Flap was used. The expanded Forehead Flap also provides excellent thin upper lid contour and good color-matching with a recipient site. For the eye socket, sufficient volume of tissue was provided from the expanded Forehead Flap with or without a galea or a free rectus abdominis muscle perforator Flap, and a deep and convex fornix was formed. This resulted in a good fit and in stability of the ocular prosthesis. The surface and the inner lining of the eyelids were reconstructed using portions of the expanded Forehead Flap. For the tarsus and eyelid margin, conventional reconstruction techniques use cartilage of the concha, which has limitations of length and which does not fit the shape of the tarsal margin. The authors used the scapha composite graft, and a natural shape and good elasticity resulted.
Yenchang Hsiao - One of the best experts on this subject based on the ideXlab platform.
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Laser hair removal following Forehead Flap for nasal reconstruction
Lasers in Medical Science, 2020Co-Authors: Cheng-jen Chang, Chunshin Chang, Hung-chang Chen, Mei-hua Chien, Yenchang HsiaoAbstract:The Forehead Flap is a dependable option for nasal reconstruction owing to its reliability and anatomic likeness to nasal skin. For patients with low hairlines, the vertical design of the paramedian Forehead Flap can intrude into the scalp, thus incorporating hair into the nasal reconstruction. The inadequate length of the Forehead Flap or shift to an oblique design may result in eyebrow elevation and asymmetry. Therefore, laser hair removal (epilation) on the Forehead Flap has been proposed to improve esthetic results. An alexandrite laser (755 nm, 10 to 20 ms, 18-mm spot size) with a Dynamic Cooling Device^™ (DCD^™) cooling system was used for hair removal in 22 patients (16 male and 6 female patients) after nasal reconstructions using Forehead Flaps from December 2011 to September 2016. All patients received cryogen spray cooling laser treatment (CSC-LT). The mean follow-up period was 24 months, with a range between 18 and 50 months. The average duration of treatment was 1.8 months (range, 1–5 months). The energy density ranged from 14 to 18 J/cm^2 with an average of 17.2 J/cm^2. The number of treatments ranged from 2 to 4 (mean 2.8). Patients had satisfactory esthetic results over 11.1 months (range, 8–18 months). Residual white hairs were observed in 3 patients, and 4 patients had tiny black residual hairs without deteriorating cosmesis. Using an alexandrite laser to remove hair on the Forehead is safe and reliable in nasal reconstruction with superior recipient site cosmesis.
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aesthetic refinements in Forehead Flap reconstruction of the asian nose
Plast Surg (Oakv), 2017Co-Authors: Yenchang Hsiao, Chunshin Chang, Jonathan ZelkenAbstract:Background:Traditional paramedian Forehead Flap reconstruction exploits the aesthetic subunit principle. Refinements and outcomes of Forehead Flap nasal reconstruction largely reflect Western exper...
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nasolabial and Forehead Flap reconstruction of contiguous alar upper lip defects
Journal of Plastic Reconstructive and Aesthetic Surgery, 2017Co-Authors: Jonathan Zelken, Chunshin Chang, Sashank Reddy, Cheng-jen Chang, Hung-chang Chen, Shiow Shuh Chuang, Yenchang HsiaoAbstract:Summary Background Defects of the nasal ala and upper lip aesthetic subunits can be challenging to reconstruct when they occur in isolation. When defects incorporate both the subunits, the challenge is compounded as subunit boundaries also require reconstruction, and local soft tissue reservoirs alone may provide inadequate coverage. In such cases, we used nasolabial Flaps for upper lip reconstruction and a Forehead Flap for alar reconstruction. Methods Three men and three women aged 21–79 years (average, 55 years) were treated for defects of the nasal ala and upper lip that resulted from cancer (n = 4) and trauma (n = 2). Unaffected contralateral subunits dictated the Flap design. The upper lip subunit was excised and replaced with a nasolabial Flap. The Flap, depending on the contralateral reference, determined accurate alar base position. A Forehead Flap resurfaced or replaced the nasal ala. Autologous cartilage was used in every case to fortify the Forehead Flap reconstruction. Results Patients were followed for 25.6 months (range, 1–4 years). All the Flaps survived, and there were no complications. Satisfactory aesthetic results were achieved in every case. With the exception of a small vertical cheek scar and a vertical Forehead scar, all incisions were concealed within the subunit borders. Conclusion From preliminary experience, we advocate combining nasolabial Flap reconstruction of the upper lip with a Forehead Flap reconstruction of the ala to preserve normal facial appearance. This combination addresses an important void in the algorithmic approach to central facial reconstruction.
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donor site aesthetic enhancement with preoperative botulinum toxin in Forehead Flap nasal reconstruction
Annals of Plastic Surgery, 2016Co-Authors: Jonathan Zelken, Chunshin Chang, Cheng-jen Chang, Hung-chang Chen, Shiow Shuh Chuang, Shih Yi Yang, Jui Yung Yang, Yenchang HsiaoAbstract:Donor site scarring after Forehead Flap nasal reconstruction is acceptable. However, as aesthetic outcomes standards for cosmetic and reconstructive surgery merge, we aim to enhance results. We recently demonstrated the cosmetic benefit of botulinum toxin type A (BTX-A) for cleft lip cheiloplasty outcomes. We hypothesize that similar mechanism(s) benefit Forehead Flap donor scars.A single surgeon performed 26 Forehead Flap reconstructions. Indications were cancer (n = 17), trauma (n = 3), and congenital deformity (n = 6). In this split-scar study half the Forehead was pretreated with BTX-A and half with normal saline after random assignment. Photographs were evaluated at most recent follow-up. Scar evaluation was based on photographs by 3 plastic surgeons using a composite subjective visual analogue score (VAS).Photographic follow-up was 27 months (range, 10-60 months). Botulinum toxin type A was assigned to the upper Forehead in 16 cases and lower Forehead in 10 cases. Intrarater reliability among 4 evaluators of 104 VAS scores was 78.1%. Upper Forehead VAS (7.9 ± 1.2) was not different than lower Forehead VAS (7.9 ± 1.2) regardless of treatment (P = 0.62). The VAS score of BTX-A-treated scars (8.5 ± 1.0) was significantly higher than the control (7.3 ± 1.1; P < 0.0001). Among 104 individual comparisons (26 patients × 4 observers), there were 73 instances (70.2%) where the experimental VAS score was higher than the control.Preoperative BTX-A injection is feasible and enhances donor site scar appearance after Forehead Flap nasal reconstruction in an Asian population.
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Double Forehead Flap reconstruction of composite nasal defects.
Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2016Co-Authors: Jonathan Zelken, Chunshin Chang, Sashank Reddy, Yenchang HsiaoAbstract:Summary Background and aim Composite nasal defects require skin, framework, and lining reconstruction. The Forehead Flap is an ideal donor for skin coverage because of good color match and excellent donor-site healing. Intranasal Flaps and grafts are reserved for lining reconstruction of small defects. Locoregional and free Flaps are used for larger lining defects, but these may not be ideal or safe. The authors advocate the double Forehead Flap for large composite defects of the nose in a subset of patients. Methods Three men and three women aged 55–87 years (average 74.7 years) were treated for composite nasal defects that resulted from cancer ( n = 5) and trauma ( n = 1). Skin and lining defects were >2 cm in every dimension. Double Forehead Flaps were raised in stages ( n = 1) or simultaneously ( n = 5), and nasal reconstruction was performed in two ( n = 1) or three stages ( n = 5). Results Patients were followed for 19.3 months (range 13–24 months). Donor sites of Flaps raised in stages healed after 3 months. When Flaps were raised together, healing required 5–13 months (average 7.6 months). There were no partial or complete Flap losses. None of the patients had infection, hematoma, or nerve injury. Satisfactory aesthetic results were achieved in every case. Conclusion The authors advocate the double Forehead Flap for large composite nasal defects in patients who are not suitable candidates for nasolabial Flaps and those who may not tolerate free tissue transfer. The advantages of this method must be weighed against the drawbacks, which include prolonged donor-site healing and elimination of the contralateral Forehead Flap.
Chunshin Chang - One of the best experts on this subject based on the ideXlab platform.
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Laser hair removal following Forehead Flap for nasal reconstruction
Lasers in Medical Science, 2020Co-Authors: Cheng-jen Chang, Chunshin Chang, Hung-chang Chen, Mei-hua Chien, Yenchang HsiaoAbstract:The Forehead Flap is a dependable option for nasal reconstruction owing to its reliability and anatomic likeness to nasal skin. For patients with low hairlines, the vertical design of the paramedian Forehead Flap can intrude into the scalp, thus incorporating hair into the nasal reconstruction. The inadequate length of the Forehead Flap or shift to an oblique design may result in eyebrow elevation and asymmetry. Therefore, laser hair removal (epilation) on the Forehead Flap has been proposed to improve esthetic results. An alexandrite laser (755 nm, 10 to 20 ms, 18-mm spot size) with a Dynamic Cooling Device^™ (DCD^™) cooling system was used for hair removal in 22 patients (16 male and 6 female patients) after nasal reconstructions using Forehead Flaps from December 2011 to September 2016. All patients received cryogen spray cooling laser treatment (CSC-LT). The mean follow-up period was 24 months, with a range between 18 and 50 months. The average duration of treatment was 1.8 months (range, 1–5 months). The energy density ranged from 14 to 18 J/cm^2 with an average of 17.2 J/cm^2. The number of treatments ranged from 2 to 4 (mean 2.8). Patients had satisfactory esthetic results over 11.1 months (range, 8–18 months). Residual white hairs were observed in 3 patients, and 4 patients had tiny black residual hairs without deteriorating cosmesis. Using an alexandrite laser to remove hair on the Forehead is safe and reliable in nasal reconstruction with superior recipient site cosmesis.
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aesthetic refinements in Forehead Flap reconstruction of the asian nose
Plast Surg (Oakv), 2017Co-Authors: Yenchang Hsiao, Chunshin Chang, Jonathan ZelkenAbstract:Background:Traditional paramedian Forehead Flap reconstruction exploits the aesthetic subunit principle. Refinements and outcomes of Forehead Flap nasal reconstruction largely reflect Western exper...
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nasolabial and Forehead Flap reconstruction of contiguous alar upper lip defects
Journal of Plastic Reconstructive and Aesthetic Surgery, 2017Co-Authors: Jonathan Zelken, Chunshin Chang, Sashank Reddy, Cheng-jen Chang, Hung-chang Chen, Shiow Shuh Chuang, Yenchang HsiaoAbstract:Summary Background Defects of the nasal ala and upper lip aesthetic subunits can be challenging to reconstruct when they occur in isolation. When defects incorporate both the subunits, the challenge is compounded as subunit boundaries also require reconstruction, and local soft tissue reservoirs alone may provide inadequate coverage. In such cases, we used nasolabial Flaps for upper lip reconstruction and a Forehead Flap for alar reconstruction. Methods Three men and three women aged 21–79 years (average, 55 years) were treated for defects of the nasal ala and upper lip that resulted from cancer (n = 4) and trauma (n = 2). Unaffected contralateral subunits dictated the Flap design. The upper lip subunit was excised and replaced with a nasolabial Flap. The Flap, depending on the contralateral reference, determined accurate alar base position. A Forehead Flap resurfaced or replaced the nasal ala. Autologous cartilage was used in every case to fortify the Forehead Flap reconstruction. Results Patients were followed for 25.6 months (range, 1–4 years). All the Flaps survived, and there were no complications. Satisfactory aesthetic results were achieved in every case. With the exception of a small vertical cheek scar and a vertical Forehead scar, all incisions were concealed within the subunit borders. Conclusion From preliminary experience, we advocate combining nasolabial Flap reconstruction of the upper lip with a Forehead Flap reconstruction of the ala to preserve normal facial appearance. This combination addresses an important void in the algorithmic approach to central facial reconstruction.
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donor site aesthetic enhancement with preoperative botulinum toxin in Forehead Flap nasal reconstruction
Annals of Plastic Surgery, 2016Co-Authors: Jonathan Zelken, Chunshin Chang, Cheng-jen Chang, Hung-chang Chen, Shiow Shuh Chuang, Shih Yi Yang, Jui Yung Yang, Yenchang HsiaoAbstract:Donor site scarring after Forehead Flap nasal reconstruction is acceptable. However, as aesthetic outcomes standards for cosmetic and reconstructive surgery merge, we aim to enhance results. We recently demonstrated the cosmetic benefit of botulinum toxin type A (BTX-A) for cleft lip cheiloplasty outcomes. We hypothesize that similar mechanism(s) benefit Forehead Flap donor scars.A single surgeon performed 26 Forehead Flap reconstructions. Indications were cancer (n = 17), trauma (n = 3), and congenital deformity (n = 6). In this split-scar study half the Forehead was pretreated with BTX-A and half with normal saline after random assignment. Photographs were evaluated at most recent follow-up. Scar evaluation was based on photographs by 3 plastic surgeons using a composite subjective visual analogue score (VAS).Photographic follow-up was 27 months (range, 10-60 months). Botulinum toxin type A was assigned to the upper Forehead in 16 cases and lower Forehead in 10 cases. Intrarater reliability among 4 evaluators of 104 VAS scores was 78.1%. Upper Forehead VAS (7.9 ± 1.2) was not different than lower Forehead VAS (7.9 ± 1.2) regardless of treatment (P = 0.62). The VAS score of BTX-A-treated scars (8.5 ± 1.0) was significantly higher than the control (7.3 ± 1.1; P < 0.0001). Among 104 individual comparisons (26 patients × 4 observers), there were 73 instances (70.2%) where the experimental VAS score was higher than the control.Preoperative BTX-A injection is feasible and enhances donor site scar appearance after Forehead Flap nasal reconstruction in an Asian population.
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Double Forehead Flap reconstruction of composite nasal defects.
Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2016Co-Authors: Jonathan Zelken, Chunshin Chang, Sashank Reddy, Yenchang HsiaoAbstract:Summary Background and aim Composite nasal defects require skin, framework, and lining reconstruction. The Forehead Flap is an ideal donor for skin coverage because of good color match and excellent donor-site healing. Intranasal Flaps and grafts are reserved for lining reconstruction of small defects. Locoregional and free Flaps are used for larger lining defects, but these may not be ideal or safe. The authors advocate the double Forehead Flap for large composite defects of the nose in a subset of patients. Methods Three men and three women aged 55–87 years (average 74.7 years) were treated for composite nasal defects that resulted from cancer ( n = 5) and trauma ( n = 1). Skin and lining defects were >2 cm in every dimension. Double Forehead Flaps were raised in stages ( n = 1) or simultaneously ( n = 5), and nasal reconstruction was performed in two ( n = 1) or three stages ( n = 5). Results Patients were followed for 19.3 months (range 13–24 months). Donor sites of Flaps raised in stages healed after 3 months. When Flaps were raised together, healing required 5–13 months (average 7.6 months). There were no partial or complete Flap losses. None of the patients had infection, hematoma, or nerve injury. Satisfactory aesthetic results were achieved in every case. Conclusion The authors advocate the double Forehead Flap for large composite nasal defects in patients who are not suitable candidates for nasolabial Flaps and those who may not tolerate free tissue transfer. The advantages of this method must be weighed against the drawbacks, which include prolonged donor-site healing and elimination of the contralateral Forehead Flap.
Felipe Bochnia Cerci - One of the best experts on this subject based on the ideXlab platform.
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Paramedian Forehead Flap combined with hinge Flap for nasal tip reconstruction.
Anais Brasileiros De Dermatologia, 2016Co-Authors: Felipe Bochnia Cerci, Gerson DellatorreAbstract:Abstract: The paramedian Forehead Flap is a great option for restoration of complex nasal defects. For full-thickness defects, it may be used alone or in combination with other methods. We present a patient with a basal cell carcinoma on the distal nose treated by Mohs micrographic surgery, and a resulting full-thickness defect repaired with paramedian Forehead Flap combined with a hinge Flap. For optimal results with the paramedian Forehead Flap, adequate surgical planning, patient orientation and meticulous surgical technique are imperative. Keywords: Carcinoma, basal cell; Mohs surgery; Nose; Skin neoplasms; Surgical Flaps s INTRODUCTION The paramedian Forehead Flap (PFF) is a single Flap for res-toration of complex nasal defects. It is the mainstay for reconstruc-tion of large and deep wounds located on the distal nose (tip and ala), including full-thickness defects. 1,2 The PFF can distinctively restore contour, texture, projection of the nasal tip and convexity of the ala, especially when combined with cartilage grafting.1 For ful-l-thickness defects, PFF may be used alone or in combination with other methods to restore nasal lining.
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Paramedian Forehead Flap for nasal tip reconstruction after Mohs surgery
Journal of Surgical Dermatology, 2016Co-Authors: Felipe Bochnia CerciAbstract:The paramedian Forehead Flap is a great option for restoring complex nasal defects. Its main indications are large and deep wounds located on the distal third of the nose (tip and ala). For full-thickness defects, the paramedian Forehead Flap may be used alone or in combination with other methods. We presented a patient with a nodular basal cell carcinoma on the nasal tip and collumela treated by Mohs micrographic surgery and repaired with a paramedian Forehead Flap. Prior to reconstruction, it is essential that surgical margins are completely evaluated and free of tumor. For optimal paramedian Forehead Flap results, adequate surgical planning and meticulous technique are imperative.
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Paramedian Forehead Flap combined with hinge Flap for nasal tip reconstruction.
Anais Brasileiros de Dermatologia, 2016Co-Authors: Felipe Bochnia Cerci, Gerson DellatorreAbstract:The paramedian Forehead Flap is a great option for restoration of complex nasal defects. For full-thickness defects, it may be used alone or in combination with other methods. We present a patient with a basal cell carcinoma on the distal nose treated by Mohs micrographic surgery, and a resulting full-thickness defect repaired with paramedian Forehead Flap combined with a hinge Flap. For optimal results with the paramedian Forehead Flap, adequate surgical planning, patient orientation and meticulous surgical technique are imperative.