Manual of Aesthetic Surgery 2 (eBook)

Addresses 6
Introduction 9
A General Remark 12
The Standard Procedures 14
Breast Augmentation 15
Brachioplasty 16
Abdominoplasty 16
Thigh and Buttock Lift 17
Liposuction – Removal of Fat with the Tumescence Technique (Mang’s Solution) 19
Hair Transplantation 20
Spacelift 20
Acknowledgements 22
Foreword by M. P. Ceravolo 24
Foreword by D. L. Feinendegen 25
Foreword by P. F. Fournier 26
What is Beauty? 27
Foreword by M. S. Mackowski 34
Foreword by S. Malakhov 35
Plastic/Aesthetic Surgery in Russia – the Past and the Future 35
Foreword by D. Millesi 38
Foreword by I. Pitanguy 39
Foreword by H. U. Steinau 40
Contents 41
Breast Augmentation 43
Introduction 45
Breast Implants 47
Anatomical Overview 49
Instruments 50
Duplicate Patient Information 55
Preliminary Examinations 55
Photographic Documentation 55
Surgical Planning 56
Incision Line in the Case of Submammary Access 58
Definition of the Subsequent Breast or Implant Size by Establishing the Distance Between the Lower Margin of the Nipple and the Subsequent Inframammary Fold 59
Positioning of the Patient, Disinfection of the Operating Area 60
Tumescence 60
Submammary Incision 62
Preparation, Step 1 62
Preparation, Step 2: Precise Demonstration of the Caudal, Medial and Lateral Borders of Pectoralis Major 64
Deep, Blunt Dissection 65
Wound Revision and Hemostasis Using the Illuminated Retractor and Bipolar Tweezers 66
Determining the Size and Shape of the Implant 66
Fitting the Final Implant 68
Exact Positioning of the Implant 70
Insertion of the Redon Drain (size 10) 70
Deep Wound Closure 72
Two-Layer, Atraumatic Wound Closure Using 4.0 Monocryl 72
Dressing 74
Aftercare 74
Appendix: Breast Augmentation - Submuscular Access 76
Results 80
Literature 86
Brachioplasty 90
Introduction 91
Upper-Arm Tightening 91
Anatomical Overview 93
Instruments 94
Duplicate Patient Information 98
Preliminary Examinations 98
Photographic Documentation 98
Surgical Planning 98
Preliminary Marking of Incision Lines 98
Mang’s Fish-Mouth Technique 100
Positioning, Disinfection 100
Tumescence 100
Incision 102
Superficial Preparation 102
Deep Preparation, Hemostasis 104
Incision of the Dissected Dermofat Flap in Stages 104
Fixing of the Skin Flap with 3.0 Monocryl Key Sutures 106
Resection in Stages 106
Two-Layer Skin Closure 108
Cutaneous Sutures: Running or Intracutaneous 4.0 Monocryl 108
Dressing 110
Aftercare 110
Results 112
Literature 116
Abdominoplasty 118
Introduction 119
Tightening of the Abdominal Wall 119
Anatomical Overview 121
Instruments 123
Duplicate Patient Information 127
Preliminary Examinations 127
Photographic Documentation 127
Surgical Planning 128
Postoperative Treatment 129
Typical Findings: Indications for Tightening the Abdominal Wall 129
Marking the Individual Incision Line 131
Positioning, Disinfection 133
Tumescence 133
Incision 133
Preparation of the Lower Abdomen 135
Incision Around the Navel 135
Mobilization and Dissection of the Navel 137
Vertical Splitting of the Dermofat Flap as Far as the Base of the Navel 137
Complete Mobilization of the Umbilical Stalk 139
Dissection of the Upper Abdomen 139
Doubling of the Rectus Abdominis Fascia 141
Defining the Resection Boundaries with Upper Body Flexed at 30° 143
Repositioning of the Navel Using a V-shaped Incision 144
Pulling the Navel Out of the V-Shaped Incision with Curved Forceps 145
Positioning the Navel 145
Trimming of the Skin of the Navel and Adaptation to the V-shaped Incision 147
Closure of the Navel in Three Layers 147
Fixation of the Surplus Sections of Skin with 2.0 Monocryl Key Sutures 149
Resection of the Skin in Stages 150
Insertion of Redon Drains 151
Wound Closure in Three Layers 152
Dressing 153
Fitting the Abdominal Belt 153
Results 155
Literature 157
Thigh and Buttock Lift 160
Introduction 161
Anatomical Overview 163
Instruments 165
Duplicate Patient Information 169
Preliminary Examinations 169
Photographic Documentation 169
Surgical Planning 170
Positioning, Disinfection 171
Tumescence 171
Incision of the Skin 173
Preparation 173
Deep Dissection and Hemostasis 175
Definition of Resection Boundaries 175
Skin Resection 177
Fixation Suture on the Pubic Bone with 2.0 Monocryl 177
Second Fixation Suture on the Inguinal Ligament 179
Deep Wound Closure and Insertion of a Redon Drain (no. 10) 179
Intracutaneous Skin Closure 181
Dressing 181
Buttock Lift: Positioning, Disinfection 183
Incision Line 183
Incision 183
Wedge-Shaped Dermolipectomy 185
Transverse Incision Through the Resected Area 187
Hemostasis, Deep Wound Closure, Insertion of a Redon Drain 187
Two-Layer, Tension-Free Wound Closure 189
Dressing 189
Postoperative Treatment: Course of Action After the Operation Precautionary Measures
Results 191
Literature to Buttock Lift 193
Literature to Thigh Lift 194
Liposuction 196
Introduction 198
Instruments 199
Duplicate Patient Information 202
Preliminary Examination 202
Surgical Planning 203
Anatomy of Liposuction of the Abdomen, Hips, Thighs 203
Anatomical Overview 204
Anatomy of Liposuction of the Hips, Back, Thighs, Buttocks (Body Contouring) 205
Anatomical Overview 206
Anatomy of Liposuction of the Axilla, Chest, Hips, Lateral Side of the Thighs 207
Anatomical Overview 207
Anatomy of Liposuction of the Medial/Lateral Side of the Thighs, Knee 209
Anatomical Overview 209
Anatomy of Liposuction of the Medial Part of the Thighs, the Knees, Calves, Ankles 211
Anatomical Overview 211
Anatomy of Liposuction of the Calf and Ankles 211
Anatomical Overview 211
Anatomy of Liposuction of the Breast, Axilla, Upper Arms 213
Anatomical Overview 214
Anatomy of Liposuction of a Double Chin 215
Anatomical Overview 216
Mechanical and Manual Tumescence 217
Location of the Incision Sites from the Rear 219
Location of the Incision Sites from the Front 219
Schematic Diagram of Mang’s Tumescent Liposuction Technique 221
Cross-Section of the Skin Before Tumescence 221
Cross-Section of the Skin Following Tumescence 221
Cross-Section of the Liposuction Technique 223
Cross-Section of the Tissue 6 Months After Liposuction with Preservation of the Infrastructural Connective Tissue (ICT) 223
Technique 227
Disinfection 227
Manual Liposuction 229
Mechanical Liposuction 229
Procedure 229
Dressing 230
Aftercare 231
Results 232
Literature 237
Hair Transplantation 241
Introduction 242
Norwood Classification of Types of Hair Loss 244
Instruments 244
Basic Instrument Set (Sterilizable) 244
Instruments for Graft/Follicular Unit Preparation 246
Instruments for Micropunch Technique 248
Instruments for Microslit Technique 248
Preparation of the Patient, Hairline Design 250
Donor Area 250
Local Anesthesia, Tumescence 250
Donor Strip Harvesting 252
Skin Closure with Continuous Sutures 252
Follicular Unit Preparation (Minigrafts, Micrografts, Single Hairs) 254
Recipient Area, Holes and Slits 254
Transplantation Channels: Micropunches (a), Microdrills (b) and Erbium YAG-Laser (c) 256
Transplantation 256
Aftercare 258
Postoperative Precautions 258
Result 258
Literature 260
Adjuvant Therapies Including Spacelift 263
Introduction 265
Local Anesthesia 266
Nerve Exit Points, Supraorbital Nerve, Infraorbital Nerve, Mental Nerve 266
Biological Implants 267
Injection Technique 268
Collagen and Hyaluronic Acid 269
Crystalline Polylactic Acid 272
Contouring Using the Mang Method 274
Botulinum Toxin 276
Report – Technique 277
Mang’s Spacelift 282
Introduction 282
Indications 282
Instruments 284
Technique 284
Injection Technique 284
Diagram of the Fat Injection 290
Three-Dimensional Diagram of Fat Injection into Subcutaneous Tissue 290
Increasing the Density of the Connective Tissue Following Breakdown of Fat Droplets 292
Dermabrasion 294
Introduction 294
Report – Technique 294
Chemical Peeling 297
Introduction 297
Report – Technique 298
Erbium-YAG Laser 300
Introduction 300
Report – Technique 300
Hyal System 302
Introduction 302
Report – Technique 303
Follow-up Treatment 306
Literature 307
Prospects – What Is the Future of Aesthetic Surgery? 309