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La oxigenoterapia hiperbárica (OHB) puede mejorar la cicatrización de las heridas. La hipoxia, la alteración de la angiogénesis y la inflamación prolongada son condiciones constantes que la OHB favorece su reversibilidad; hace ya muchos años que, en el listado de indicaciones reconocidas por Sociedades Científicas que rigen esta práctica, se encuentra como indicación aceptada para el tratamiento coadyuvante en injertos o colgajos en riesgo isquémico, como también en heridas refractarias; en la última década, paulatinamente, con la difusión y el aumento de las facilidades para acceder a equipos hiperbáricos, las indicaciones se extendieron al área de la cirugía plástica, para tratamiento de complicaciones posoperatorias en tejidos isquémicos o necrosados y también para preacodicionamiento preoperatorio y sostén posoperatorio de cierto grupo de pacientes con mayor riesgo de sufrir una complicación, en las lipotransferencias como coadyuvante para aumento de la preservación de una mayor cantidad de tejido graso. Las publicaciones al respecto son cada día más frecuentes, algunas presentan un pequeño número de casos, otras son estudios de cohorte retrospectivos, con un nivel de evidencia elevado. El objetivo de este artículo es presentar el concepto básico de los efectos de la OHB, referencia al estado actual de las distintas indicaciones en uso en cirugía plástica y medicina cosmética y la experiencia personal al respecto.

Hyperbaric oxygen therapy (HOT) can improve wound healing, hypoxia, alteration of angiogenesis and prolonged infl ammation are constant conditions that HOT favors its reversibility for many years now, in the list of indications recognized by Scientifi c Societies. that govern this practice, is a recognized indication for adjuvant treatment in grafts or fl aps at ischemic risk, as well as in refractory wounds; In the last decade, gradually, with the dissemination and increase in the facilities to access hyperbaric equipment, the indications were extended to the area of plastic surgery, for the treatment of post-operative complications in ischemic or necrotic tissues as well as for preconditioning. operative and post-operative support of a certain group of patients with a higher risk of suff ering a complication, in lipotransferences as an adjuvant to increase the preservation of a greater amount of fatty tissue. Publications in this regard are becoming more frequent every day, some present a small number of cases, others are retrospective cohort studies, with a high level of evidence. The objective of this article is to present the basic concept of the eff ects of HOT, reference to the current state of the diff erent indications in use in plastic surgery, and cosmetic medicine and personal experience in this regard

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OBJECTIVE: This work aims to review the existing use of robotics in plastic surgery. METHODS: A meticulous selection process identified 22 articles relevant to this scoping review. RESULTS: The literature on the use of robotics in plastic surgery is sparse. Nonetheless, this review highlights emerging benefits in microsurgery, breast reconstruction, and transoral surgery. CONCLUSION: This scoping review identifies critical articles reporting the emerging use of robotics in plastic surgery. While the scientific medical community has yet to extensively document its use, the available evidence suggests a promising future for robotics in this field.

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The sample comprised 44 volunteers who had undergone some surgical procedure and were equally divided into four groups. G1 started the therapy 24 h after the surgical procedure with the device off. G2 followed the same time pattern, 24 h, but with the device turned on. G3 and G4 started therapy three days after the surgical procedure; in G3, the device was turned off, and in G4, the device remained on during therapy; each session lasted 30 min, using 660 nm (red), energy 180 J. For all groups, the therapy started with daily use for seven days and followed the interval use of three times a week until completed 21 days. The revaluation was performed after 7 and 21 days. The results found show changes in HR at rest, systolic and diastolic BP, and in peripheral oxygen saturation, which showed a significant difference in the groups that used on-therapy (p < 0.05). In the MCGILL Scale evaluation, the mean total score showed a more accentuated drop in the groups that used ILIB, (p < 0.05). ILIB may have prevented a more significant evolution of firosis levels; however, no changes were observed in the evaluation of sleep and anxiety. The application of the ILIB in patients undergoing plastic surgery was supported in terms of hemodynamics and pain; in addition, starting the ILIB application 24 h after the procedure proved to be more advantageous.

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This article analyzes the tensions and disputes between the fields of gynecology and esthetic plastic surgery, the specialties which are authorized to perform aesthetic female genital surgeries in Brazil. Documentary materials are used, including scientific articles from the 1990s onward and institutional websites. While gynecologists have remained more cautious, recommending the surgery only for functional reasons, plastic surgeons have been more influential in publicizing these procedures and emphasizing the aesthetic dimension. Beyond professional disputes, we debate whether this phenomenon needs to be understood in light of the growing emphasis on self-improvement via biomedical resources and gender imperatives.

Este artigo analisa tensões e disputas entre o campo da ginecologia e da cirurgia plástica estética, especialidades autorizadas a realizar a cirurgia estética genital feminina no Brasil. Utiliza material documental, incluindo artigos científicos desde a década de 1990, e sites institucionais. Enquanto ginecologistas têm se mantido mais cautelosos com a prática, defendendo sua realização apenas quando há indicações funcionais, cirurgiões/ãs plásticos/as têm sido mais influentes na disseminação do procedimento, privilegiando a dimensão estética. Argumenta-se que, para além de disputas entre campos profissionais, esse fenômeno precisa ser entendido à luz da crescente ênfase no aprimoramento de si, via recursos biomédicos, e dos imperativos de gênero.

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O reconhecimento por meio da reconstrução facial forense é possível graças às pesquisas sobre as espessuras dos tecidos moles e características dos anexos faciais (olhos, boca, nariz e orelhas) e, a fidelidade dessas características são essenciais no processo do reconhecimento e posterior identificação. Na literatura científica, poucos trabalhos relacionam as orelhas à reconstrução facial forense. Este estudo tem como objetivo analisar as particularidades das orelhas, avaliando formato, tamanho, inclinação e posição, propor uma metodologia de classificação com vistas a uma maior reprodutibilidade que a forma atual existente e estabelecer relação com o biotipo facial. Diante da já referida dificuldade em se avaliar o formato da orelha foi elaborada uma abordagem mais objetiva que se mostrou eficaz quando da comparação entre o Índice Kappa (Cohen) realizado entre a forma atual e a forma proposta (de 0,63 para 0,83 intraexaminador e de 0,19 para 0,61 interexaminador). Foi também observada a predominância da orelha do tipo oval da população estudada. Foram avaliadas 99 fotografias de uma amostra de conveniência obtidas em um Pronto Socorro Odontológico particular da zona sul da cidade de São Paulo, composta por indivíduos de ambos os sexos com idade superior a 18 anos. Quanto às mensurações, o ICC intra e interexaminador obtiveram o mesmo resultado de 0,99. A análise comparativa entre os sexos revelou que o sexo masculino possui orelhas maiores quando comparado ao feminino. O estudo da inclinação da orelha em relação ao crânio mostrou um ângulo médio formado entre seu longo eixo e o Plano de Frankfurt de 73º para 76% dos homens e 69,76% das mulheres. Quanto à relação da orelha com outras estruturas, em 81,6% dos casos, o ponto mais superior da orelha coincide com a sobrancelha.

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Se describe la técnica quirúrgica denominada ninfoplastia o labioplastia. Es la reducción del tamaño de los labios menores de la vulva hipertróficos, requerida además por razones estéticas. Se realiza una reseña de sus técnicas quirúrgicas y el detalle que nosotros realizamos en la resección, con el fin de respetar la zona clitoriana. Se señalan además las complicaciones presentadas y cómo resolverlas

The surgical technique called nymphoplasty or labiaplasty is described. It is the reduction in the size of the hypertrophic labia minora of the vulva, furthermore, required for aesthetic reasons. A review is made of their surgical techniques and the detail that we carry out in the resection, in order to respect the clitoral area. The complications presented and how to resolve them are also pointed out

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Oscar Venancio Mallo (05/08/1928-16/01/2024) es considerado un pionero de la cirugía plástica infantil argentina. Organizó el primer Servicio de cirugía plástica infantil del país, en el Hospital de Niños "Ricardo Gutiérrez" en la ciudad de Buenos Aires. El prestigio de este Servicio traspasó nuestras fronteras y allí se formaron numerosos especialistas argentinos y latinoamericanos. Reconoció como sus principales maestros argentinos a José E. Rivarola en cirugía infantil y a Héctor Marino en cirugía plástica. Se describen algunos aspectos biográficos, su carrera profesional y su legado

Oscar Venancio Mallo (05/08/1928-16/01/2024) is considered a pioneer of Argentine children's plastic surgery. He organized the first Children's Plastic Surgery Service in the country, at the "Ricardo Gutiérrez" Children's Hospital in Buenos Aires City. The prestige of this Service crossed our borders and numerous Argentine and Latin American specialists were trained. He recognized José E. Rivarola in children's surgery and Héctor Marino in plastic surgery as his main Argentine teachers. Some biographical aspects, his professional career and his legacy are described.

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Introducción. El carcinoma de Merkel es un tumor maligno poco frecuente, que afecta principalmente a la población caucásica y cuya etiología guarda relación con el poliomavirus de las células de Merkel. Conlleva mal pronóstico, especialmente en estadios finales. Caso clínico. Se expone el caso de una paciente que presentaba un tumor primario facial de grandes dimensiones, con avanzado grado de extensión, afectación linfática cervical y metástasis parotídea derecha. Fue tratada mediante exéresis de la lesión primaria y cobertura con injerto de piel parcial, linfadenectomía cervical y parotidectomía ipsilateral. Resultados. Se logró mejoría importante en la calidad de vida de la paciente y sobrevida de al menos seis meses. Conclusión. Aunque no está claro el manejo óptimo del carcinoma de Merkel avanzado debido a su mal pronóstico, la cirugía favorece una mejoría en la calidad de vida del paciente y puede tener un papel clave en el manejo del carcinoma de Merkel en los estadios avanzados.

Introduction. Merkel carcinoma is a rare malignant tumor that mainly affects the Caucasian population and whose etiology is related to the Merkel cell polyomavirus. It has a poor prognosis, especially in the final stages. Clinical case. The case of a patient who presented a large primary facial tumor, with an advanced degree of extension, cervical lymphatic involvement and right parotid metastasis is described. She was treated surgically by excision of the primary lesion and coverage with partial skin graft, cervical lymphadenectomy, and ipsilateral parotidectomy. Results. A significant improvement was achieved in the patient's quality of life and survival of at least six months.Conclusion. Although the optimal management of advanced Merkel carcinoma is unclear due to its poor prognosis, surgery improves the patient's quality of life and it can play a key role in the management of Merkel carcinoma in advanced stages.

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Although infections resulting from cosmetic surgery performed outside the United States have been regularly reported, deaths have rarely been identified. During 2009-2022, 93 U.S. citizens died after receiving cosmetic surgery in the Dominican Republic. The number of deaths increased from a mean of 4.1 per year during 2009-2018 to a mean of 13.0 during 2019-2022 with a peak in of 17 in 2020. A subset of post-cosmetic surgery deaths occurring during peak years was investigated, and most deaths were found to be the result of embolic events (fat emboli or venous thromboembolism) for which a high proportion of the patients who died had risk factors, including obesity and having multiple procedures performed during the same operation. These risk factors might have been mitigated or prevented with improved surgical protocols and postoperative medical care, including prophylactic measures against venous thromboembolism. U.S. citizens interested in receiving elective cosmetic surgery outside the United States should consult with their health care professionals regarding their risk for adverse outcomes. Public health authorities can support provider education on the importance of preoperative patient evaluation and the potential danger of performing multiple cosmetic procedures in one operation.

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BACKGROUND: Major surgery triggers trauma-like stress responses linked to age, surgery duration, and blood loss, resembling polytrauma. This similarity suggests elective surgery as a surrogate model for studying polytrauma immune responses. We investigated stress responses across age groups and compared them with those of polytrauma patients. STUDY DESIGN: Patients undergoing major spinal reconstruction surgery were divided into older (age >65 years, n = 5) and young (age 18 to 39 years, n = 6) groups. A comparison group consisted of matched trauma patients (n = 8). Blood samples were collected before, during, and after surgery. Bone marrow mononuclear cells and peripheral blood mononuclear cells were analyzed using cellular indexing of transcriptomes and epitopes sequencing or single-cell RNA sequencing. Plasma was subjected to dual-platform proteomic analysis (SomaLogic and O-link). RESULTS: Response to polytrauma was highest within 4 hours. By comparison, the response to surgery was highest at 24 hours. Both insults triggered significant changes in cluster of differentiation 14 monocytes, with increased inflammation and lower major histocompatibility complex-class 2 expression. Older patient's cluster of differentiation 14 monocytes displayed higher inflammation and less major histocompatibility complex-class 2 suppression; a trend was also seen in bone marrow mononuclear cells. Although natural killer cells were markedly activated after polytrauma, they were suppressed after surgery, especially in older patients. In plasma, innate immunity proteins dominated at 24 hours, shifting to adaptive immunity proteins by 6 weeks with heightened inflammation in older patients. Senescence-associated secretory phenotype proteins were higher in older patients at baseline and further elevated during and after surgery. CONCLUSIONS: Although both major surgery and polytrauma initiate immune and stress responses, substantial differences exist in timing and cellular profiles, suggesting major elective surgery is not a suitable surrogate for the polytrauma response. Nonetheless, distinct responses in young vs older patients highlight the utility of elective spinal in studying patient-specific factors affecting outcomes after major elective surgery.

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Fissuras labiopalatinas ocorrem devido a uma falha na fusão embrionária. O modelador nasoalveolar (NAM) é uma intervenção ortopédica anterior à cirurgia labial. Os objetivos deste trabalho são: avaliar o efeito do NAM na simetria facial/arco maxilar e seu impacto psicossocial. Realizar uma revisão sistemática para investigar o impacto do NAM na simetria nasal. A metodologia utilizada foi avaliar 2 grupos (26 bebês tratados com NAM e 12 bebês não tratados com NAM) em dois tempos; antes do NAM (T1) e depois do NAM (T2). Foram analisados: perímetro do arco maxilar (PA), comprimento do arco maxilar (CA) e ângulo do freio labial (AFL), largura nasal (LN), largura bucal (LB), ângulo da columela (AC) e área da narina (AN). Estes mesmos 2 grupos foram comparados antes do NAM e após queiloplastia. O impacto da condição fissura no bebê na rotina familiar também foi avaliado. E ainda foram realizadas buscas eletrônicas considerando estudos que comparavam indivíduos submetidos à queiloplastia/NAM e indivíduos submetidos apenas à queiloplastia. Foram realizadas meta-análises, avaliação do risco de viés e da força da evidência. Nos resultados pudemos ver que houve aumento de PA e CA nos grupos NAM e Controle no período T2 em relação ao T1. O AFL foi reduzido no grupo NAM em comparação com os períodos NAM-T1 e Controle-T2. O NAM produziu uma redução no LN no período de T2 em relação ao T1. AC foi melhorado após o uso de NAM em T2. A AN foi reduzida no grupo NAM em T2 em relação ao Controle. O grupo NAM apresentou redução na largura nasal pós-NAM e queiloplastia. A largura da boca e o ângulo da columela apresentaram alterações no grupo NAM no pós-operatório. Houve redução na área da narina fissurada após o NAM. As pontuações globais do FIS foram mais altas em T1 do que em T2, configurando um impacto positivo do uso do NAM nas famílias. Nas buscas eletrônicas foram recuperados 416 artigos e nove foram incluídos. No grupo NAM houve aumento na altura das narinas e na largura e comprimento da columela. A largura das narinas e a largura bialar diminuíram no curto prazo e aumentaram no longo prazo nos indivíduos submetidos à queiloplastia e NAM. Seis estudos exibiram risco moderado de viés; três exibiram um sério risco de viés. A força da evidência variou de muito baixa a moderada. Desta forma, pudemos concluir que o tratamento NAM melhorou as medidas AFL, LN e AC, melhorando a simetria maxilar e nasal. O NAM promoveu aumento do ângulo da columela e redução das larguras da boca e do nariz, e ainda, redução da área da narina afetada pela fissura. O NAM mostrou um impacto positivo nas emoções familiares. A altura da narina e largura/comprimento columelar foram favorecidos pela queiloplastia seguida do NAM. O comprimento alar foi impactado positivamente pelo NAM.

Cleft lip and palate occur due to a failure in embryonic fusion. The nasoalveolar molding (NAM) is an orthopedic intervention prior to lip surgery. The objectives of this study are: to evaluate the effect of NAM on facial symmetry/maxillary arch and its psychosocial impact. To conduct a systematic review to investigate the impact of NAM on nasal symmetry. The methodology used was to evaluate 2 groups (26 babies treated with NAM and 12 babies not treated with NAM) in two time points; before NAM (T1) and after NAM (T2). The following were analyzed: maxillary arch perimeter (AP), maxillary arch length (AL) and labial frenum angle (LFA), nasal width (NW), buccal width (BW), columella angle (CA) and nostril area (NA). These same 2 groups were compared before NAM and after cheiloplasty. The impact of the cleft condition on the baby's family routine was also evaluated. Electronic searches were also performed considering studies that compared individuals undergoing cheiloplasty/NAM and individuals undergoing only cheiloplasty. Meta-analyses, assessment of risk of bias and strength of evidence were performed. The results showed that there was an increase in AP and AC in the NAM and Control groups in the T2 period compared to T1. LFA was reduced in the NAM group compared to the NAM-T1 and Control-T2 periods. NAM produced a reduction in LN in the T2 period compared to T1. CA was improved after the use of NAM in T2. NA was reduced in the NAM group in T2 compared to the Control. The NAM group showed a reduction in nasal width after NAM and cheiloplasty. The width of the mouth and the angle of the columella showed changes in the NAM group in the postoperative period. There was a reduction in the area of the cleft nostril after NAM. The global FIS scores were higher in T1 than in T2, configuring a positive impact of the use of NAM on families. In the electronic searches, 416 articles were retrieved and nine were included. In the NAM group, there was an increase in nostril height and columella width and length. Nostril width and bialar width decreased in the short term and increased in the long term in individuals undergoing cheiloplasty and NAM. Six studies showed a moderate risk of bias; three showed a serious risk of bias. The strength of evidence ranged from very low to moderate. Thus, we were able to conclude that NAM treatment improved LFA, NW and CA measurements, improving maxillary and nasal symmetry. NAM promoted an increase in the columella angle and a reduction in the widths of the mouth and nose, and also a reduction in the area of the nostril affected by the cleft. NAM showed a positive impact on family emotions. Nostril height and columellar width/length were favored by cheiloplasty followed by NAM. Alar length was positively impacted by NAM.

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La uretroplastía se ha convertido en el estándar de manejo de la estrechez uretral, dependiendo de la localización y etiología de esta. Los datos de los resultados a largo plazo varían dependiendo de la definición que se utilice como éxito (subjetiva u objetiva). El objetivo de esta revisión integrativa es mostrar la información disponible sobre los resultados funcionales de pacientes con estrechez uretral manejados quirúrgicamente. El estudio es una revisión integrativa que se realizó mediante una búsqueda de la literatura en PubMed. Incluimos artículos que describían resultados de pacientes sometidos a reconstrucción uretral con uretroplastia, solo hombres, en inglés o español, publicados entre 1999-2022. Incluimos 34 artículos, los cuales mostraron que, según el tipo de procedimiento realizado, las características de la estrechez uretral y las variables definidas como éxito y fracaso, los factores de riesgo asociados a la recurrencia posterior a la reconstrucción con uretroplastia en uretra fueron la presencia de comorbilidades, obesidad y etiología infecciosa. Concluimos entonces que la uretroplastia es un procedimiento que ha aumentado en los últimos años, con pocos estudios que nos comparan resultados dependiendo del tipo de procedimiento utilizado. Nuestra revisión encontró que hay mayor literatura sobre el uso de injertos de mucosa oral comparado con escición primaria y anastomosis (EPA), con unos resultados anatómicos y funcionales comparables entre ambos procedimientos. Los cuestionarios PROMS (Patient Reported Outcome Measures) son herramientas útiles para el seguimiento postoperatorio de estos pacientes.

Urethroplasty has become the standard for managing urethral stricture, depending on its location and etiology. Long-term outcome data varies depending on the definition of success used (subjective or objective). The objective of this integrative review is to show the available information on the functional results of patients with surgically managed urethral stricture. The study is an integrative review that was carried out through a literature search in PubMed, we included articles that described the results of patients undergoing urethral reconstruction with urethroplasty, only men, in English or Spanish, published between 1999-2022. The study included 34 articles, which showed that, depending on the type of procedure performed, the characteristics of the urethral stricture and the variables defined as success and failure, the risk factors associated with recurrence after reconstruction with urethroplasty in the urethra were the presence of comorbidities, obesity, and infectious etiology. In conclusion, urethroplasty is a procedure that has increased in recent years, with few studies that compare results depending on the type of procedure used. Our review found that there is more literature on the use of buccal mucosa graft (BMG) compared to excision and primary anastomotic urethroplasy (EPA), with comparable anatomical and functional results between both procedures.

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Purpose: Illicit cosmetic injections remain highly prevalent and can cause serious complications, including death. We aimed to explore existing literature regarding the use of illicit cosmetic injections globally. Methods: We searched six databases with no language restriction from inception to 2022. We included all articles focused on adult patients of any gender who received any illicit cosmetic injection. Screening and data extraction followed standards from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines. Results: After screening 629 abstracts and 193 full texts, 142 citations were included. We identified articles from 28 countries and three multi-country studies. Most were from high-income (75.3%) and upper-middle-income countries (21.8%). Of all patients whose gender identity was described, 49.9% were transgender women, and 40.8% were cisgender women. The anatomic regions most frequently injected were the buttocks (35%) and the breast (13.3%). The most frequently described complications were granuloma (41.5%), dermatological problems (41.5%), infection (35.9%), and pulmonary complications (34.5%). Conclusions: We observed the impact of illicit silicone injections, particularly on cisgender women and transgender individuals. Existing barriers must be addressed, including healthcare prejudice and inadequate knowledge about care for gender minorities. This will require educating at-risk groups and enhancing policies to regulate these procedures.

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BACKGROUND: As the demand for gender affirmation grows, teaching gender-affirming surgery (GAS) in plastic and reconstructive surgery (PRS) programs has become increasingly important. Residency applicants interested in GAS often use program web sites to explore potential training opportunities. Our study aimed to quantify the GAS training opportunities promoted on residency program web sites and determine the characteristics of programs likely to promote GAS training. METHODS: An assessment of 88 integrated PRS residency programs' web sites was conducted between 2021 and 2022. Plastic and reconstructive surgery residency and institutional webpages were queried for geographical location, training opportunities in GAS through residency or fellowship, and the number of faculty performing GAS. Descriptive statistics and multivariable regressions were used to describe and identify factors associated with increased GAS residency training opportunities. RESULTS: Twenty-six percent of PRS residencies mentioned training opportunities for GAS on their web sites. Gender-affirming surgery fellowships were offered at 7% of institutions, and an additional 7% were available via adjunct academic programs. Programs with faculty practicing GAS were 54% more likely to mention GAS on their residency page (odds ratio, 1.54; 95% confidence interval, 1.14-2.21; P = 0.009). CONCLUSIONS: Few PRS residency programs mention GAS on their web sites. As GAS becomes a more robust component of plastic surgery, appropriate information about the extent of GAS training should be available for applicants. Determining how local, state, and federal policies impact programs' abilities to highlight GAS should be investigated in future studies.

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BACKGROUND: The number of Brazilian butt lift (BBL) fatalities remains high in the United States despite numerous practice advisories geared towards patient safety and reducing the incidence of fatal pulmonary fat emboli. OBJECTIVES: This study aimed to evaluate US board-certified plastic surgeons' opinions, understanding of BBL-related mortality, and current risk-reducing surgical practices for BBL procedures. METHODS: An online 18-question survey was distributed via email by the Aesthetic Surgery Education and Research Foundation to national board-certified plastic surgeon members of the The Aesthetic Society. Survey responses were collected over 21 days on the Qualtrics platform. RESULTS: The survey response rate was 10% (n = 178). Of the 77% who performed BBL procedures, 48% (n = 80) did not use ultrasound. Approximately 60% (n = 102) of all respondents disagreed with imposing regulations to require ultrasound, with the most frequent reason being that it was unnecessary with adequate surgeon experience (45%). Plastic surgeons thought that high-volume budget clinics (n = 64) and a lack of regulations imposed on individual surgeons by boards of medicine (n = 31) were the greatest contributors to BBL mortality. CONCLUSIONS: Most US plastic surgeons did not use ultrasound for BBL procedures and did not agree that ultrasound should be required, which may partially be the result of unsuccessful educational outreach for risk-reducing practices and training for ultrasound. Regulations by the boards of medicine imposed on individual surgeons, in combination with new legislation targeted at ownership of high-volume clinics, are strongly backed by surgeon respondents as measures that may improve patient safety.

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Algunos pacientes en la tercera edad desarrollan con frecuencia diversas enfermedades, entre ellas se encuentra el cáncer de piel y la predisposición a la aparición de tumores, tanto en los párpados como en la conjuntiva. Entre los tumores epiteliales malignos se destacan: el carcinoma basocelular y el carcinoma epidermoide; con menor frecuencia, el carcinoma de células de Meibomio y el melanoma palpebral, y raramente, el carcinoma de células de Merkel. Por esta causa, se realizó la presentación de un caso clínico que recibió tratamiento en el Servicio de Cirugía Plástica del Hospital Vladimir Ilich Lenin, de Holguín, al cual se le aplicó la técnica de Mustardé por presentar tumor del párpado inferior. El objetivo fue presentar un paciente con reconstrucción palpebral postumorectomía y mostrar su resultado funcional y estético postoperatorio. Este caso evolucionó satisfactoriamente, sin aparición de complicaciones transoperatorias o postoperatorias.

Some elderly patients frequently develop various diseases, including skin cancer as well as a predisposition to the appearance of tumours, both in the eyelids and conjunctiva. Basal cell carcinoma and epidermoid carcinoma stand out among the malignant epithelial lesions; meibomian cell carcinoma and palpebral melanoma which are less common, and Merkel cell carcinoma rarely known. We present a male patient who received treatment in the plastic surgery service at "Vladimir Ilich Lenin" Hospital, in Holguín, to which Mustardé technique was applied for a tumour of the lower eyelid. An eyelid reconstruction was performed after lumpectomy which allowed us to show a postoperative functional and aesthetic result. This case evolved satisfactorily, without the appearance of intraoperative or postoperative complications.

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INTRODUCTION: obesity is one of the most common diseases worldwide, and the most effective treatment to it is the bariatric surgery. One of the negative impacts of this procedure is the body dysmorphia caused by overhanging skin. In Brazil, the national health system - Sistema Único de Sáude (SUS) - provide body contouring surgery to treat post-bariatric patients, since 2007. This article aims to describe the Brazilian public health approach to post bariatric patients and perform an analyze in the Brazilian health care database. METHODS: in Brazilian Health System database, a search for the post-bariatric procedures performed between 2007 to 2021 was done. The variables analyzed were geographic location, year, mean days of hospitalization, death, and mortality rate. Also, we evaluated the number of bariatric procedures done in the same period. Statistical analysis was performed using the Student-t and the chi-square tests and p-value <0.5 was considered significant. RESULTS: a total of 12,717 plastic surgery procedures in post bariatric patients were done, with a national prevalence of 13.8%. Dermolipectomy was the most performed procedure, with 6,719. The years of 2020 and 2021 suffered a decreased of 64.3% and 70.9% in the number of surgeries (p<0,001). Bariatric Procedures had a high rate and a higher percentage of growth comparing to post bariatric surgery (p<0,001), totalizing 93,589 surgeries. CONCLUSIONS: Brazil had a significant number of body contouring surgery, however with a low prevalence. Dermoliepctomy was the most common procedure performed. We could notice a significant impact of COVID pandemic in those procedures .

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