The authors report their experience on 15 cases, including reconstructive surgery of the jaws, po... more The authors report their experience on 15 cases, including reconstructive surgery of the jaws, postextraction alveolar bone regeneration, and oral implantology. The aim of the study was to evaluate the different effects on jaws' bone regeneration with or without the use of local application of platelet-rich plasma (PRP). The results we report showed the efficacy of the PRP treatment: postoperative patients' satisfaction and low-morbidity course confirmed the quality of the results. The article will help the reader to (1) understand the PRP preparation, (2) find local applications in oral and maxillofacial surgery, and (3) evaluate the general effect of PRP.
Breast cancer is the most common cancer in women and autologous fat grafting is an important clin... more Breast cancer is the most common cancer in women and autologous fat grafting is an important clinical application in treatment of post-surgical deformities. The simplicity of fat grafting procedures and the absence of subsequent visible scar prompted an increasing interest for this technique. The plasticity of adipose-derived stem cells (ASCs) obtained from stromal vascular fraction (SVF) of adult adipose tissue provided exciting perspectives for regenerative medicine and surgery. The recent discovery that SVF/ASC enrichment further ameliorates clinical efficacy of grafting ASCs suggest as ASC-mediated new adipogenesis and vasculogenesis. ASC adipogenic differentiation involves Akt activity and EGFRs, FGFRs, ERbB2 receptor-mediated pathways that also play a pivotal role in the regulation of breast cancer growth. Moreover, the finding that platelet-derived growth factors and hormones improved long-term maintenance of fat grafting raises new concerns for their use during breast reconstruction after cancer surgery. However, it remains unclear whether grafted or resident ASCs may increase the risk of de novo cancer development or recurrence. Preliminary follow-up studies seem to support the efficacy and safety of SVF/ASCs enrichment and the additional benefit from the combined use of autologous platelet-derived growth factors and hormones during breast reconstruction procedures. In the present review we highlighted the complex interplay between resident or grafted ASCs, mature adipocytes, dormant or active breast cancer cells and tumor microenvironment. Actually, data concerning the permissive role of ASCs on breast cancer progression are contrasting, although no clear evidence speaking against their use exists.
There is considerable attention regarding the role of receptor signaling and downstream-regulated... more There is considerable attention regarding the role of receptor signaling and downstream-regulated mediators in the homeostasis of adipocytes, but less information is available concerning adipose-derived stem cell (ASC) biology. Recent studies revealed that the pathways regulating ASC differentiation involve the activity of receptor tyrosine kinases (RTKs), including fibroblast growth factor, vascular endothelial growth factor, ErbB receptors and the downstream-regulated serine/threonine protein kinase B (Akt) and phosphatase and tensin homolog (PTEN) activity. RTKs are cell surface receptors that represent key regulators of cellular homeostasis but also play a critical role in the progression of cancer. Many of the metabolic effects and other consequences of activated RTKs are mediated by the modulation of Akt and extracellular signal-regulated protein kinases 1 (Erk-1) signaling. Akt activity sustains survival and the adipogenic differentiation of ASCs, whereas Erk-1 appears downregulated. The inhibition of FGFR-1, EGFR and ErbB2 reduced proliferation, but only FGFR-1 inihibition reduced Akt activity and adipogenesis. Adipogenesis and neovascularization are also chronologically and spatially coupled processes and RTK activation and downstream targets are also involved in ASC-mediated angiogenesis. The potentiality of ASCs and the possibility to modulate specific molecular pathways underlying ASC biological processes and, in particular, those shared with cancer cells, offer new exciting strategies in the field of regenerative medicine.
The authors describe their personal experience with the management of mammary asymmetries. A revi... more The authors describe their personal experience with the management of mammary asymmetries. A review of their database from January 1998 to January 2005 identified 177 patients with idiopathic breast asymmetries. All these cases had been classified previously into six groups. Bilateral asymmetric hypertrophy and unilateral hypertrophy were treated with reduction mammaplasty. Unilateral hypertrophy with amastia or hypoplasia of the contralateral
Management of complex abdominal defects remains a significant challenge for many surgeons, especi... more Management of complex abdominal defects remains a significant challenge for many surgeons, especially in contaminated fields. Currently, available biosynthetic grafts include human cadaveric dermis (AlloDerm), porcine dermal (Permacol and Strattice), and submucosal (Surgisis) sources. All these grafts are composed of an acellular collagen scaffold to provide a bridge for tissue incorporation and neovascularization. The authors describe a case report of a woman who required dual mesh explantation and successive reparative surgery using a porcine dermal matrix for a complex and infected abdominal wound. Twelve months postdischarge the patient remains well, she is pain free, and she returned home to full activities with complete wound closure and without any evidence of residual or recurrent hernia. The patient was satisfied with her cosmetic results. In conclusion, the authors' experience shows that the use of Permacol, a porcine dermal matrix, has been successful in treating an infected abdomen and a vast abdominal wall defect.
Orthodontics The Art and Practice of Dentofacial Enhancement, 2013
This article is based on a pre- and postoperative retrospective analysis of a sample of patients ... more This article is based on a pre- and postoperative retrospective analysis of a sample of patients affected by progenic syndrome who underwent maxillary bone repositioning by maxillomandibular osteotomies. Pre- and postoperative clinical, photographic, and cephalometric analysis are carried out to assess modifications of the nasal shape due to maxillary osteotomies. The sample group studied was made up of 25 patients (13 women, 12 men) who underwent orthodontic-surgical treatment for correction of maxillomandibular deformities. The sample group was divided into two groups: the first (group A) was made up of patients who underwent maxillomandibular repositioning with advancement and lowering of the maxilla, and the second (group B) comprised patients who, as a consequence of surgical repositioning, had a maxilla that was advanced and raised. Surgical treatment was based on Le Fort I and quadrangular Le Fort osteotomies. Evaluation of angular and linear measurements, derived from both photographic and cephalometric material, allowed the authors to compare the two groups of patients and the modifications of the nasal region. These results are then compared with those available from current scientific literature so as to define the predictability of nasal shape modification. In conclusion, it is inadvisable to perform rhinoplasty at the time of orthognathic surgery to correct pre-existing defects, such as a dorsal hump, a nasal base that is too wide or too narrow, a nasal pyramid deviation, or other esthetic defects resulting from orthognathic surgery.
The clinical use of platelet-rich plasma (PRP) for a wide variety of application has been reporte... more The clinical use of platelet-rich plasma (PRP) for a wide variety of application has been reportedly employed most prevalently in problematic wounds, maxillofacial and hemi-facial atrophy, Romberg Syndrome, and diabetic foot ulcers. To our knowledge, PRP has never been described in the enhancement of fat grafting during tissue-engineering application in vivo. The authors describe the preparation of PRP and its use in a series of 43 patients who underwent plastic, reconstructive, and maxillofacial surgery for chronic lower extremity ulcers (n = 18) and multiple facial applications (n = 25). PRP mixed with fat grafting was used in 76% patients affected by multiple facial diseases and in 88.9% patients affected by lower extremity ulcers. PRP injection alone was used in the remaining patients. The authors observed that after a 7.1-week and 9.7-week (average) course of twice-daily wound treatment with PRP suspended on a collagen base, 61.1% and 88.9% of chronic lower extremity ulcers underwent to 100% reepithelization compared with 40% and 60% of controls (n = 10) treated with hyaluronic acid and collagen medication. In patients treated with reconstructing three-dimensional projection of face by fat grafting and PRP, we observed a 70% maintenance of contour restoring and three-dimensional volume after 1 year compared to only 31% of controls (n = 10) treated with fat grafting alone. In vitro, PRP induced a significant increase in the number of adipose-tissue-derived stem cells compared to control cultures. These results documented that PRP accelerates chronic skin ulcer reepithelization and improves maintenance and function of fat graft in patients who underwent plastic reconstructive surgery, possibly by stimulating adipose-tissue-derived stem cell proliferation.
We analyzed 102 patients treated from 2004 to October of 2006, both men and women who had undergo... more We analyzed 102 patients treated from 2004 to October of 2006, both men and women who had undergone abdominal dermolipectomy; patients affected by hypertension or mellitus diabetes were excluded from this study. The parameters considered were age at the moment of the ...
Page 1. VIEWPOINTS GUIDELINES Viewpoints, pertaining to issues of general interest, are welcome, ... more Page 1. VIEWPOINTS GUIDELINES Viewpoints, pertaining to issues of general interest, are welcome, even if they are not related to items previously published. View-points may present unique tech-niques, brief technology up-dates, technical notes, and so on. ...
Journal of Plastic Reconstructive and Aesthetic Surgery, 2007
A simple and easy technique for reconstruction of the umbilicus was devised, with emphasis on for... more A simple and easy technique for reconstruction of the umbilicus was devised, with emphasis on forming walls of the umbilicus and a depression in a caudal direction. A quite satisfactory result was obtained. A permanent and sufficient depression for the umbilicus can be expected as a result of three-dimensional formation of walls. We also obtained a natural-looking neo-umbilicus.
We have retrospectively assessed the charts of 166 patients who underwent rhinoplasties from Marc... more We have retrospectively assessed the charts of 166 patients who underwent rhinoplasties from March of 2005 to July of 2007, in the Plastic Surgery Department of the University of Torvergata Rome, Italy. From the operation chart of each patient, we filled out a form with the following details: access incisions to the nasal bone cartilage skeleton, maneuvers performed on the inferior lateral and superior cartilages, implants and/or grafts used, procedures made to the nasal base, types of osteotomies, and number of concomitant septoplasties. All the patients were operated under total anesthesia. The results were plotted on tables and graphs. In percentages, each surgical maneuver was separately analyzed, the need for grafts or incision in relation to the total number of patients operated, thus allowing for a numerical analysis of the approaches carried out in rhinoplasty procedures performed in our department.
The authors present their experience with reconstructive nasal valve surgery, evaluating the effe... more The authors present their experience with reconstructive nasal valve surgery, evaluating the effects related to the use of a composite graft, which is a graft made of skin and cartilage, or mucosa and cartilage, and to the transposition of mucocartilaginous flaps. A sample of 15 patients (12 women and three men) selected among 452 cases treated with functional and aesthetic rhinoplasty at the Department of Plastic and Reconstructive Surgery of the "Tor Vergata" University of Rome was analyzed. Patients were between 25 and 50 years of age, with a mean age of 40 years, and were treated with secondary rhinoplasty for valvular stenosis. Of these patients, 12 had functional problems of the internal and external nasal valve, and three had internal valve stenosis. In our sample of 15 patients, respiratory symptoms improved at short- and long-term follow up. In all cases, a good aesthetic result was obtained. The patients were not satisfied with the aesthetic result in only three cases as a result of enlargement or asymmetry of the external valvular area. In 11 cases, an "open tip" rhinoplasty was performed with a retroauricular skin-cartilage composite graft to correct internal-external valvular stenosis. In all the cases of internal valvular stenosis (three patients) and in one case of internal-external valvular stenosis, a transposition of mucocartilaginous flaps with a section of the mucosa of the upper lateral cartilage was performed.
Progressive hemifacial atrophy, also known as Parry-Romberg syndrome, is an uncommon degenerative... more Progressive hemifacial atrophy, also known as Parry-Romberg syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by a slow and progressive atrophy affecting one side of the face. The incidence and the cause of this alteration are unknown. Pathogenesis of this syndrome is not clear: some authors refer the atrophy of subcutaneous system to the alteration of sympathetic system, whereas others refer it to an alteration of the nervous system referred to the encephalic level or to an interstitial neuritis of the trigeminal nerve. The most common complications that appear in association to this health disorder are as follows: trigeminal neuritis, facial, and epilepsy, the last one being the most frequent complication of the central nervous system. Characteristically, the atrophy progresses slowly for several years, and soon after, it becomes stable. Today, plastic surgery with graft of autogenous fat can be performed after stabilization of the disease. The objective of this work is, through the presentation of a clinical case, suggesting a therapeutic plan formed by 2 sequential treatments: poliglactic acid to obtain skin thickening followed by Coleman technique for reconstructing three-dimensional projection of face contour restoring the superficial density of facial tissues. The results we obtained prove the efficacy of combining these 2 treatments, and the satisfaction of the patient confirms the quality of our results.
The authors report their experience on 15 cases, including reconstructive surgery of the jaws, po... more The authors report their experience on 15 cases, including reconstructive surgery of the jaws, postextraction alveolar bone regeneration, and oral implantology. The aim of the study was to evaluate the different effects on jaws' bone regeneration with or without the use of local application of platelet-rich plasma (PRP). The results we report showed the efficacy of the PRP treatment: postoperative patients' satisfaction and low-morbidity course confirmed the quality of the results. The article will help the reader to (1) understand the PRP preparation, (2) find local applications in oral and maxillofacial surgery, and (3) evaluate the general effect of PRP.
Modifications and innovations in open-structure rhinoplasty that have occurred as this technique ... more Modifications and innovations in open-structure rhinoplasty that have occurred as this technique has evolved are discussed. In addition, the philosophy and fundamentals of open-tip approach in rhinoplasty are reexamined. A retrospective review of representative patients in a hospital practice setting was performed. All surgical procedures were conducted in a department of plastic surgery of the University of Rome Tor Vergata. The preoperative and long-term results of each patient are compared to demonstrate the effectiveness of the described techniques. The fundamental philosophy of open-tip rhinoplasty is the maintenance of the integrity and strength of the nasal skeleton. Modifications of tip grafting techniques, along with additional domal grafting techniques, and a stronger focus on domal suturing techniques result in a softer contour and lack of tip tensions while maintaining structural support.
The authors report their experience on 15 cases, including reconstructive surgery of the jaws, po... more The authors report their experience on 15 cases, including reconstructive surgery of the jaws, postextraction alveolar bone regeneration, and oral implantology. The aim of the study was to evaluate the different effects on jaws' bone regeneration with or without the use of local application of platelet-rich plasma (PRP). The results we report showed the efficacy of the PRP treatment: postoperative patients' satisfaction and low-morbidity course confirmed the quality of the results. The article will help the reader to (1) understand the PRP preparation, (2) find local applications in oral and maxillofacial surgery, and (3) evaluate the general effect of PRP.
Breast cancer is the most common cancer in women and autologous fat grafting is an important clin... more Breast cancer is the most common cancer in women and autologous fat grafting is an important clinical application in treatment of post-surgical deformities. The simplicity of fat grafting procedures and the absence of subsequent visible scar prompted an increasing interest for this technique. The plasticity of adipose-derived stem cells (ASCs) obtained from stromal vascular fraction (SVF) of adult adipose tissue provided exciting perspectives for regenerative medicine and surgery. The recent discovery that SVF/ASC enrichment further ameliorates clinical efficacy of grafting ASCs suggest as ASC-mediated new adipogenesis and vasculogenesis. ASC adipogenic differentiation involves Akt activity and EGFRs, FGFRs, ERbB2 receptor-mediated pathways that also play a pivotal role in the regulation of breast cancer growth. Moreover, the finding that platelet-derived growth factors and hormones improved long-term maintenance of fat grafting raises new concerns for their use during breast reconstruction after cancer surgery. However, it remains unclear whether grafted or resident ASCs may increase the risk of de novo cancer development or recurrence. Preliminary follow-up studies seem to support the efficacy and safety of SVF/ASCs enrichment and the additional benefit from the combined use of autologous platelet-derived growth factors and hormones during breast reconstruction procedures. In the present review we highlighted the complex interplay between resident or grafted ASCs, mature adipocytes, dormant or active breast cancer cells and tumor microenvironment. Actually, data concerning the permissive role of ASCs on breast cancer progression are contrasting, although no clear evidence speaking against their use exists.
There is considerable attention regarding the role of receptor signaling and downstream-regulated... more There is considerable attention regarding the role of receptor signaling and downstream-regulated mediators in the homeostasis of adipocytes, but less information is available concerning adipose-derived stem cell (ASC) biology. Recent studies revealed that the pathways regulating ASC differentiation involve the activity of receptor tyrosine kinases (RTKs), including fibroblast growth factor, vascular endothelial growth factor, ErbB receptors and the downstream-regulated serine/threonine protein kinase B (Akt) and phosphatase and tensin homolog (PTEN) activity. RTKs are cell surface receptors that represent key regulators of cellular homeostasis but also play a critical role in the progression of cancer. Many of the metabolic effects and other consequences of activated RTKs are mediated by the modulation of Akt and extracellular signal-regulated protein kinases 1 (Erk-1) signaling. Akt activity sustains survival and the adipogenic differentiation of ASCs, whereas Erk-1 appears downregulated. The inhibition of FGFR-1, EGFR and ErbB2 reduced proliferation, but only FGFR-1 inihibition reduced Akt activity and adipogenesis. Adipogenesis and neovascularization are also chronologically and spatially coupled processes and RTK activation and downstream targets are also involved in ASC-mediated angiogenesis. The potentiality of ASCs and the possibility to modulate specific molecular pathways underlying ASC biological processes and, in particular, those shared with cancer cells, offer new exciting strategies in the field of regenerative medicine.
The authors describe their personal experience with the management of mammary asymmetries. A revi... more The authors describe their personal experience with the management of mammary asymmetries. A review of their database from January 1998 to January 2005 identified 177 patients with idiopathic breast asymmetries. All these cases had been classified previously into six groups. Bilateral asymmetric hypertrophy and unilateral hypertrophy were treated with reduction mammaplasty. Unilateral hypertrophy with amastia or hypoplasia of the contralateral
Management of complex abdominal defects remains a significant challenge for many surgeons, especi... more Management of complex abdominal defects remains a significant challenge for many surgeons, especially in contaminated fields. Currently, available biosynthetic grafts include human cadaveric dermis (AlloDerm), porcine dermal (Permacol and Strattice), and submucosal (Surgisis) sources. All these grafts are composed of an acellular collagen scaffold to provide a bridge for tissue incorporation and neovascularization. The authors describe a case report of a woman who required dual mesh explantation and successive reparative surgery using a porcine dermal matrix for a complex and infected abdominal wound. Twelve months postdischarge the patient remains well, she is pain free, and she returned home to full activities with complete wound closure and without any evidence of residual or recurrent hernia. The patient was satisfied with her cosmetic results. In conclusion, the authors' experience shows that the use of Permacol, a porcine dermal matrix, has been successful in treating an infected abdomen and a vast abdominal wall defect.
Orthodontics The Art and Practice of Dentofacial Enhancement, 2013
This article is based on a pre- and postoperative retrospective analysis of a sample of patients ... more This article is based on a pre- and postoperative retrospective analysis of a sample of patients affected by progenic syndrome who underwent maxillary bone repositioning by maxillomandibular osteotomies. Pre- and postoperative clinical, photographic, and cephalometric analysis are carried out to assess modifications of the nasal shape due to maxillary osteotomies. The sample group studied was made up of 25 patients (13 women, 12 men) who underwent orthodontic-surgical treatment for correction of maxillomandibular deformities. The sample group was divided into two groups: the first (group A) was made up of patients who underwent maxillomandibular repositioning with advancement and lowering of the maxilla, and the second (group B) comprised patients who, as a consequence of surgical repositioning, had a maxilla that was advanced and raised. Surgical treatment was based on Le Fort I and quadrangular Le Fort osteotomies. Evaluation of angular and linear measurements, derived from both photographic and cephalometric material, allowed the authors to compare the two groups of patients and the modifications of the nasal region. These results are then compared with those available from current scientific literature so as to define the predictability of nasal shape modification. In conclusion, it is inadvisable to perform rhinoplasty at the time of orthognathic surgery to correct pre-existing defects, such as a dorsal hump, a nasal base that is too wide or too narrow, a nasal pyramid deviation, or other esthetic defects resulting from orthognathic surgery.
The clinical use of platelet-rich plasma (PRP) for a wide variety of application has been reporte... more The clinical use of platelet-rich plasma (PRP) for a wide variety of application has been reportedly employed most prevalently in problematic wounds, maxillofacial and hemi-facial atrophy, Romberg Syndrome, and diabetic foot ulcers. To our knowledge, PRP has never been described in the enhancement of fat grafting during tissue-engineering application in vivo. The authors describe the preparation of PRP and its use in a series of 43 patients who underwent plastic, reconstructive, and maxillofacial surgery for chronic lower extremity ulcers (n = 18) and multiple facial applications (n = 25). PRP mixed with fat grafting was used in 76% patients affected by multiple facial diseases and in 88.9% patients affected by lower extremity ulcers. PRP injection alone was used in the remaining patients. The authors observed that after a 7.1-week and 9.7-week (average) course of twice-daily wound treatment with PRP suspended on a collagen base, 61.1% and 88.9% of chronic lower extremity ulcers underwent to 100% reepithelization compared with 40% and 60% of controls (n = 10) treated with hyaluronic acid and collagen medication. In patients treated with reconstructing three-dimensional projection of face by fat grafting and PRP, we observed a 70% maintenance of contour restoring and three-dimensional volume after 1 year compared to only 31% of controls (n = 10) treated with fat grafting alone. In vitro, PRP induced a significant increase in the number of adipose-tissue-derived stem cells compared to control cultures. These results documented that PRP accelerates chronic skin ulcer reepithelization and improves maintenance and function of fat graft in patients who underwent plastic reconstructive surgery, possibly by stimulating adipose-tissue-derived stem cell proliferation.
We analyzed 102 patients treated from 2004 to October of 2006, both men and women who had undergo... more We analyzed 102 patients treated from 2004 to October of 2006, both men and women who had undergone abdominal dermolipectomy; patients affected by hypertension or mellitus diabetes were excluded from this study. The parameters considered were age at the moment of the ...
Page 1. VIEWPOINTS GUIDELINES Viewpoints, pertaining to issues of general interest, are welcome, ... more Page 1. VIEWPOINTS GUIDELINES Viewpoints, pertaining to issues of general interest, are welcome, even if they are not related to items previously published. View-points may present unique tech-niques, brief technology up-dates, technical notes, and so on. ...
Journal of Plastic Reconstructive and Aesthetic Surgery, 2007
A simple and easy technique for reconstruction of the umbilicus was devised, with emphasis on for... more A simple and easy technique for reconstruction of the umbilicus was devised, with emphasis on forming walls of the umbilicus and a depression in a caudal direction. A quite satisfactory result was obtained. A permanent and sufficient depression for the umbilicus can be expected as a result of three-dimensional formation of walls. We also obtained a natural-looking neo-umbilicus.
We have retrospectively assessed the charts of 166 patients who underwent rhinoplasties from Marc... more We have retrospectively assessed the charts of 166 patients who underwent rhinoplasties from March of 2005 to July of 2007, in the Plastic Surgery Department of the University of Torvergata Rome, Italy. From the operation chart of each patient, we filled out a form with the following details: access incisions to the nasal bone cartilage skeleton, maneuvers performed on the inferior lateral and superior cartilages, implants and/or grafts used, procedures made to the nasal base, types of osteotomies, and number of concomitant septoplasties. All the patients were operated under total anesthesia. The results were plotted on tables and graphs. In percentages, each surgical maneuver was separately analyzed, the need for grafts or incision in relation to the total number of patients operated, thus allowing for a numerical analysis of the approaches carried out in rhinoplasty procedures performed in our department.
The authors present their experience with reconstructive nasal valve surgery, evaluating the effe... more The authors present their experience with reconstructive nasal valve surgery, evaluating the effects related to the use of a composite graft, which is a graft made of skin and cartilage, or mucosa and cartilage, and to the transposition of mucocartilaginous flaps. A sample of 15 patients (12 women and three men) selected among 452 cases treated with functional and aesthetic rhinoplasty at the Department of Plastic and Reconstructive Surgery of the "Tor Vergata" University of Rome was analyzed. Patients were between 25 and 50 years of age, with a mean age of 40 years, and were treated with secondary rhinoplasty for valvular stenosis. Of these patients, 12 had functional problems of the internal and external nasal valve, and three had internal valve stenosis. In our sample of 15 patients, respiratory symptoms improved at short- and long-term follow up. In all cases, a good aesthetic result was obtained. The patients were not satisfied with the aesthetic result in only three cases as a result of enlargement or asymmetry of the external valvular area. In 11 cases, an "open tip" rhinoplasty was performed with a retroauricular skin-cartilage composite graft to correct internal-external valvular stenosis. In all the cases of internal valvular stenosis (three patients) and in one case of internal-external valvular stenosis, a transposition of mucocartilaginous flaps with a section of the mucosa of the upper lateral cartilage was performed.
Progressive hemifacial atrophy, also known as Parry-Romberg syndrome, is an uncommon degenerative... more Progressive hemifacial atrophy, also known as Parry-Romberg syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by a slow and progressive atrophy affecting one side of the face. The incidence and the cause of this alteration are unknown. Pathogenesis of this syndrome is not clear: some authors refer the atrophy of subcutaneous system to the alteration of sympathetic system, whereas others refer it to an alteration of the nervous system referred to the encephalic level or to an interstitial neuritis of the trigeminal nerve. The most common complications that appear in association to this health disorder are as follows: trigeminal neuritis, facial, and epilepsy, the last one being the most frequent complication of the central nervous system. Characteristically, the atrophy progresses slowly for several years, and soon after, it becomes stable. Today, plastic surgery with graft of autogenous fat can be performed after stabilization of the disease. The objective of this work is, through the presentation of a clinical case, suggesting a therapeutic plan formed by 2 sequential treatments: poliglactic acid to obtain skin thickening followed by Coleman technique for reconstructing three-dimensional projection of face contour restoring the superficial density of facial tissues. The results we obtained prove the efficacy of combining these 2 treatments, and the satisfaction of the patient confirms the quality of our results.
The authors report their experience on 15 cases, including reconstructive surgery of the jaws, po... more The authors report their experience on 15 cases, including reconstructive surgery of the jaws, postextraction alveolar bone regeneration, and oral implantology. The aim of the study was to evaluate the different effects on jaws' bone regeneration with or without the use of local application of platelet-rich plasma (PRP). The results we report showed the efficacy of the PRP treatment: postoperative patients' satisfaction and low-morbidity course confirmed the quality of the results. The article will help the reader to (1) understand the PRP preparation, (2) find local applications in oral and maxillofacial surgery, and (3) evaluate the general effect of PRP.
Modifications and innovations in open-structure rhinoplasty that have occurred as this technique ... more Modifications and innovations in open-structure rhinoplasty that have occurred as this technique has evolved are discussed. In addition, the philosophy and fundamentals of open-tip approach in rhinoplasty are reexamined. A retrospective review of representative patients in a hospital practice setting was performed. All surgical procedures were conducted in a department of plastic surgery of the University of Rome Tor Vergata. The preoperative and long-term results of each patient are compared to demonstrate the effectiveness of the described techniques. The fundamental philosophy of open-tip rhinoplasty is the maintenance of the integrity and strength of the nasal skeleton. Modifications of tip grafting techniques, along with additional domal grafting techniques, and a stronger focus on domal suturing techniques result in a softer contour and lack of tip tensions while maintaining structural support.
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Papers by Pietro Gentile