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BACKGROUND: Augmentation and remodelling of the calf is becoming more and more frequent, representing a challenge for the surgeon who must consider this body zone as a functional and aesthetical whole. Historically, calf reshaping has been carried out with silicone implants, mainly in the subaponeurotic plane; nonetheless, as in other body sites it is possible to perform lipoinjection which is a reliable procedure with minimal scarring and a lasting outcome with rare, long-term complications. MATERIALS AND METHODS: Between the years 2009 and 2011, five patients (three women and two men) underwent bilateral calf liporemodelling. Follow-up was between 6 and 18 months. The larger perimeter of each calf was measured for follow-up. Magnetic resonance imaging was used to localise the injected fat at the end of the follow-up period in two of the patients. RESULTS: An average of 126.8±21.2 cc was lipoinjected into each calf. The average final augmentation in the larger perimeter of each leg was 2.8 cm. All patients obtained a good aesthetical outcome and were satisfied. No important complications were seen in this series. CONCLUSION: According to our experience and outcomes we can recommend the liporemodelling technique of the calf as a valid alternative for the reshaping of the distal third of the inferior extremity.

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BACKGROUND: The purpose of this clinical study was to establish liposuction and lipoinjection as a noncosmetic procedure in children to correct lipodystrophies. METHODS: Liposuction, fat injection, or a combination of both was performed on 30 patients between 1994 and 2006 at Roberto del Rio Hospital or Clinica Alemana, Santiago, Chile. Liposuction was indicated in patients with excessive amounts of fatty tissue or tumor-like swelling. Combined liposuction and lipoinjection was performed on patients with deficit and excess in soft tissues. Lipoinjection was used for patients with soft-tissue insufficiencies. Samples of fat obtained by liposuction were submitted to histopathologic examination. Traditional tumescent technique was used for liposuction. The supernatant obtained by simple filtration was used for fat injection. Short- and long-term postoperative follow-up included registration of complications and assessment of aesthetic and functional outcome. The kappa test was used for statistical analysis. RESULTS: Thirty patients, nine boys and 21 girls, were operated on, with an average age of 11 years (range, 4 to 17 years). A total of 43 procedures were performed: 27 liposuctions, 10 lipoinjections, and six combined procedures. Average hospital stay was 1.1 days. Of a total 20 patients who underwent liposuction, six required revision. Histopathologic study showed 19 lipomatoses and one lipoblastomatosis. Cosmetic outcomes based on Strasser scale were as follows: six excellent, 19 good, four mediocre, and one poor. CONCLUSIONS: Liposuction and lipoinjection as sole or combined procedures are safe methods for the pediatric population. They are well tolerated, with a low rate of complications and satisfactory aesthetic results.

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BACKGROUND: Fibrin glue has been used in diverse areas of plastic surgery. To the authors' knowledge, no clinical controlled trial studies have reported its use for open rhinoplasty. METHODS: A prospective, randomized, masked clinical trial was designed to demonstrate that aerosolized bovine-prepared fibrin glue used in open rhinoplasty controls skin fixation (flap movement), edema, hematomas, ecchymosis, bleeding, and cosmetic results 1 and 12 months postoperatively. The results were reviewed by two blinded plastic surgeons who assessed postoperative photographs using the Strasser score. Other items such as columella scar, pain, surgery/recovery time, and patient satisfaction also were evaluated. RESULTS: A computer system was used to randomize 22 consecutive open primary rhinoplasties. Cosmetic analysis did not differ significantly between the group redraped with fibrin glue and the control group. Patient satisfaction was the only outcome that significantly favored the active group. None of the other items or adverse events significantly differed between the two groups, including operative time and pain. CONCLUSIONS: Fibrin glue is believed to reduce bleeding and to improve the adherence of tissues. The only statistical difference in this study favored the patient satisfaction cosmetic score of the group that received fibrin glue.

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El uso de la videoscopia en la obtención de colgajos libres está aún siendo desarrollada. Comunicamos la transferencia exitosa de 10 colgajos musculares libres, seis gracilis, dos latissimus dorsi y dos rectos abdominales levantados con asistencia videoscópica e instrumental de laparoscopia. Algunos tejidos permiten su disección endoscópica debido a su ubicación subcutánea y a su fácil acceso. Los músculos gracilis, latissimus dorsi, y recto abdominal reúnen estas características. En nuestra serie, este método representó una considerable disminución del tamaño de la cicatriz y no hubo morbilidad de la zona dadora. La asistencia videoscópica puede ser utilizada en un intento de disminuir la secuela cicatricial de la zona donante en microcirugía reconstructiva.

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