Nipple-Areolar Complex (NAC) reconstruction aims for symmetry, projection, pigmentation, durability, and minimal complications while addressing functional sensation and patient needs. Techniques include tattooing, flaps, and grafts, with careful pre-op marking and post-op care.
Also: New podcast episode, the Sunday quiz, & ganglion cyst clinical case.
Thoracic outlet syndrome (TOS) is the compression of neurovascular structures at the brachial plexus. It commonly presents with neurogenic symptoms, such as pain and tingling. Management involves physiotherapy, pain control, and surgery for severe cases.
Capsular contracture is the thickening and hardening of the capsule around breast implants, leading to pain and deformity. Classified by Baker's system (I-IV), treatment ranges from conservative management to surgical interventions such as capsulectomy.
A patient with pain and breast shape changes presents with bilateral capsular contracture post-augmentation (Baker III left, IV right). Assessment includes history, exam, & MRI. Treatment options are implant removal, capsulectomy, pocket change, or autologous augmentation.
Also: The Sunday quiz, podcast snippet, & recommended articles on reconstructive surgery.
Also: The Sunday quiz, podcast teaser, & 3 recommended articles.
Also: Sunday Quiz, Sneak Peak of Podcast upcoming episode.
A patient presents with a firm, non-compressible swelling at the left eye's outer corner, apparent since birth but worsening.
A 40-year-old woman presents with a 2x2 cm mass near her ring finger's DIPJ, painless and unchanged for 3 months.
A 3-year-old presents with isolated macrodactyly of the right index finger. The case discusses history taking, aetiology involving a Pi3KCA gene mutation, necessary investigations, a treatment algorithm, and the role of medical treatments.
Macrodactyly involves disproportionate digit overgrowth, often due to lipofibromatosis of the nerve and PiK3CA mutations. Diagnosed via X-rays, MRI, and genetic tests, it's treated surgically to debulk and stop growth. Surgical management focuses on nerve issues to reduce recurrence.
An overview of congenital dermoid cysts, benign growths from ectodermal entrapment, common in the head and neck. Focus on orbital and nasal presentations and surgical management to prevent complications.
Thatte and Thatte classify venous flaps into three types based on vein number and function. Venous flaps are infrequently used due to low survival rates and venous congestion, despite their reliable anatomy and minimal donor site morbidity.
The Mathes and Nahai Classification, introduced in 1981, describes the vascular supply to muscle and musculocutaneous flaps based on major and minor pedicles. This system is essential for planning reconstructive surgeries to ensure optimal flap survival and function.
Breast augmentation consultation: A patient seeks fuller breasts. Steps include assessing medical history, expectations, and explaining implant options.
The cervical lymph nodes of the neck are organized into levels based on their anatomical locations and drainage patterns. These nodes drain specific areas of the head and neck, aiding in identifying primary tumor sites and guiding surgical management.
Also: Sunday quiz, tuberous breast deformity, and evidence on capsular contracture.
Congenital Brachial Plexus Palsy: Upper limb movement loss at birth, often from birthing traction. Early surgical exploration recommended if no biceps function after 3 months.
Breast augmentation uses implants to enhance size and shape, with techniques tailored to patient needs and potential complications like BIA-ALCL.
Giant Cell Tumours are neoplastic lesions on tendon sheaths, often in hands. Diagnosed via physical exam and imaging, often treated with surgical excision. Recurrence is common.
A patient presents with severe, sharp thumb pain and bluish nail discoloration, suggesting a glomus tumor.
Also: Pronator Syndrome, theFellow's Corner and Evidence Deep-Dives.
A glomus tumor is a benign lesion from glomus cells in the Sucquet-Hoyer canal, often causing severe pain in young adults’ nail beds or palms. It aids in thermoregulation. Diagnosis involves imaging and histology. Excision is the main treatment; for multiple lesions, consider laser or sclerotherapy.
