The Preauricular Sinus:A Novel Approach for Complete Bilateral Excision via a Modified Face-Lift Incision

Objectives/Hypothesis: To present a novel technique based on the combination of aesthetic and reconstructive techniques for the radical and safe excision of preauricular sinus along with minimal cosmetic impairing. Study Design: Case report, description of surgical method and brief overview of the literature. Methods: In a patient with bilateral preauricular sinus, we used a modified face-lift incision and SMAS-fixation instead of solely excising the sinus with skin ellipse. Results: Total removal of the bilateral fistulous systems could be achieved, along with a very aesthetically pleasing result. Conclusions: The surgical approach shown here allows a radical excision with only minimal aesthetic impairment using a shortened facelift-incision and SMAS-fixation.

Aesthetic fingertip reconstruction with partial second toe transfer

Background Fingertip defect significantly affects the appearance of the hand. The aim of this research was to evaluate the clinical effect of aesthetic fingertip reconstruction with partial second toe transfer.Methods Between July 2005 and December 2008, 17 patients underwent aesthetic fingertip reconstruction with partial second toe transfer. The mean size of fingertip defects was 0.7 cm （ranging from 0.5-1.1 cm）. Anastomosis was performed between one dominant plantar digital artery and one proper digital artery, between two dorsal digital veins of the toe and two dorsal digital veins of the finger, respectively, for the reconstruction of blood supply to the reconstructed finger. Two plantar digital nerves of the toe were then sutured to two proper digital nerves of the finger for the restoration of fingertip sensation.Results All reconstructed fingers survived completely. The follow-up period ranged from 6 to 24 months, and the appearance of the reconstructed fingertip was similar to that of the normal fingertip. Two-point discrimination of the reconstructed fingertip was （7.8±1.3） mm. The recovered pinch strength of the reconstructed finger was about （89.0±5.1）% of that of the normal finger. Donor site healed well without complications.Conclusions Partial second toe transfer is an ideal aesthetic reconstruction method for fingertip defects; it can not only achieve a satisfactory appearance of the fingertip, but can also obtain excellent sensory and motor functions.

Role of limited access dressing in achieving improved aesthetic results during resurfacing of wounds

With refinement and better understanding of Plastic Surgery,there is increasing expectation of aesthetic outcomes after resurfacing of wounds.The major problems in resurfacing procedures are tissue bulk,donor site issues,excessive scarring and distal edema due to damaged lymphatics and veins after flap harvest from adjacent areas in the extremities.Ultra-conservative debridement simplifies reconstruction by reducing the need for flaps and improves the chances of skin graft take through limited access dressing,which can improve the final aesthetic result following reconstruction.In this paper,we describe three representative cases treated under limited access dressing.