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Background: The prevalence of breast augmentation as a strategy for achieving idealized feminine proportions, consistent with contemporary beauty standards, has increased notably. This study focuses on the use of nanotextured implants, examining their efficacy in enhancing body symmetry and conforming to current aesthetic ideals., Methods: Conducted as a prospective cohort study, this research included women who underwent breast augmentation using nanotextured ergonomic implants from 2017 to 2023. A personalized methodology was applied, incorporating an array of anthropometric measurements and individual motivations to inform the selection of implants. The techniques used aimed at fostering a natural aesthetic, coupled with an extensive postoperative follow-up to evaluate outcomes and identify any complications., Results: The study involved 1000 participants, with findings indicating a marked improvement in breast and overall body proportions, in line with targeted aesthetic principles. High levels of patient satisfaction were observed, with more than 90% reporting favorable aesthetic results and a low incidence of complications. These findings emphasize the effectiveness and safety of nanotextured implants in achieving the desired aesthetic goals., Conclusions: The study underscores the efficacy of nanotextured implants in attaining balanced feminine proportions, aligning surgical results with modern beauty ideals and enhancing personal well-being. It highlights the significance of a tailored approach in breast augmentation, which encompasses not only the physical aspects of aesthetic enhancement but also the psychological and social facets of patient contentment., Competing Interests: The author has no financial interest to declare in relation to the content of this article., (Copyright © 2024 The Author. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Multiple symmetrical lipomatosis is a rare diffuse presentation of the progressive accumulation of deposits of nonencapsulated masses of adipose tissue. The characteristic image of this disease is bilateral swelling in the neck, the upper part of upper limb, pelvic rim, back, and thighs. We report a case of unusual localization of benign scrotal symmetrical lipomatosis with ultrasound and histological appearances of the scrotal lipomatous masses, together with treatment. Scrotal lipomatosis should be considered as a rare differential diagnosis of scrotal swelling, and excisional lipectomy should be considered in preference over liposuction. Patients should be offered counseling for infertility., Competing Interests: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

: Polyphenols form a diverse group of compounds containing at least two hydroxyl groups in their chemical structure. Because of the common presence in plant kingdom, polyphenols are considered a significant component of food and an important group of compounds with antioxidant properties. The absorption of polyphenols present in food depends mostly on the activity of intestinal microflora. However, little is known about the processes and interactions responsible for such phenomenon in guts ecosystem. There are only few available publications that examine the effect on polyphenols on intestinal microbiota. Therefore, this work will focus on describing the relationship between polyphenol compounds present in food and bacteria colonizing the intestines, their mechanism, and impact on human's health., Competing Interests: The authors declare no conflict of interest.

Resveratrol (3,5,4'-trihydroxystilbene) is a chemical compound belonging to the group of polyphenols and flavonoids. The aim of the present study was to determine the influence of resveratrol application along with certain modulating factors, such as 8Br-cGMP-activator of cGMP-dependent protein kinases, HA-1077-Rho-kinase inhibitor, and Bay K8644-calcium channel agonist, on VMSCs constriction triggered by phenylephrine. Resveratrol at a dose of 10 mg/kg/24 h administered for 4 weeks reduced the reactivity of the arteries to the pressure action of catecholamines. Tests performed after four weeks of resveratrol administration showed that 8Br-cGMP at the concentrations of 0.01 mM/l and 0.1 mM/l intensifies this effect. Simultaneous resveratrol and Bay K8644 administration led to a significant decrease in contractility compared to the vessels collected from animals (Res-). This effect was dependent on the concentration of Bay K8644. Resveratrol seems to be counteractive against Bay K8644 by blocking L-type calcium channels. As the concentration of HA-1077 increased, there was a marked hyporeactivity of the vessels to the pressure effects of phenylephrine. The results indicate synergy between resveratrol and Rho-kinase inhibition., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Michał Wiciński et al.)

Vitamin D deficiency amongst athletes and the general population seems to be a prominent problem. The most recognized role of vitamin D is its regulation of calcium homeostasis; there is a strong relationship between vitamin D and bone health. Moreover, its concentrations are associated with muscle function and immune response in both the general and athletic populations. Vitamin D level is strongly connected with the presence of VDRs (vitamin D receptors) in most human extraskeletal cells. Expression of multiple myogenic transcription factors enhancing muscle cell proliferation and differentiation is caused by an exposure of skeletal muscles to vitamin D. The aim of this review is to summarize current understanding of the significance of vitamin D on exercise performance and physical efficiency, as well to analyze the impact of vitamin D on multiple potential mechanisms. More high-quality research studies, considering free 25(OH)D as a better marker of vitamin D status, the baseline level of 25(OH)D and multiple pathways of vitamin D acting and usage in athletes are required.

Introduction: The aim of the study was to evaluate the clinical usefulness of a one-step nucleic acid amplification assay (OSNA) for intraoperative detection of metastases to sentinel lymph nodes (SLNs) in comparison to examination of frozen sections, and to summarize the results of previous studies., Material and Methods: We enrolled 98 patients aged 58.13 ±10.74 years treated surgically for breast cancer, and 99 biopsies of SLNs were followed by analysis of 105 SLNs. The central 1 mm slice of SLN was used for examination of frozen sections, whereas 2 outer slices of SLNs were analyzed intraoperatively with OSNA. Detection of isolated tumor cells (ITC), micrometastases or macrometastases with OSNA extended surgery to axillary lymph node dissection. Congruency of results was assessed between OSNA and examination of frozen sections., Results: One-step nucleic acid amplification assay detected metastases in 29/105 SLNs in surgery of 27/99 breasts, including ITC in 3/29 SLNs, micrometastases in 12/29 and macrometastases in 14/29. One-step nucleic acid amplification assay detected significantly more metastases to SLNs than examination of frozen sections ( p < 0.0001). All 8 inconsistent results were positive in OSNA and negative in examination of frozen sections; ITC were identified in 2/8 SLNs and micrometastases in 6/8 SLNs. Sensitivity for OSNA was calculated as 100%, specificity as 90.47%, and κ was 79.16%., Conclusions: One-step nucleic acid amplification assay analysis allows rapid and quantitative detection of mRNA CK19 with high specificity and a low rate of false positives. One-step nucleic acid amplification assay is a reliable tool for intraoperative diagnosis of whole SLNs during surgery of breast cancer. One-step nucleic acid amplification assay minimizes the need for secondary surgery and avoids delays in the adjuvant treatment., Competing Interests: The authors declare no conflict of interest.

Autologous fat transfer (AFT) is an appropriate technique for aesthetic rejuvenation of the face, aesthetic enhancement of hands, correction of the facial appearance in various disorders and constitutes a surgical alternative of treatment of numerous breast deformities ranging from distorting posttraumatic scars, post-eczema lesions, post-burn deformities to partial or total breast reconstruction. Our work is aimed to familiarize dermatologists with the technique of harvesting and implanting the aspirate of adipose cells in patients consulted for deformities of the breast. In addition, the review summarizes the most common applications of AFT in the breast reconstructive procedures. In summary, AFT is an oncologically safe, relatively complication-free, minimally invasive surgical technique, which can be used to correct a wide range of deformities, which are commonly seen by dermatologists, in the area of the face, trunk and extremities. The procedure can correct a wide range of breast deformities, from contour or single quadrant deformities up to the state after mastectomy., Competing Interests: The authors declare no conflict of interest.

Eyelids form the protective eye apparatus. Loss of upper or lower eyelid can lead to infection, vision impairment or even blindness. Although there are many techniques for upper or lower eyelid reconstruction, there are only few articles to report simultaneous reconstruction of both eyelids. The aim of this study is to present a two-stage eyelid reconstruction method using the forehead flap. A 60-year-old woman was admitted to our Department with animal bite wounds in the left periorbital area. During the first operation, the eyelid defect was covered with forehead flap and in the second stage, horizontal incision was created in the flap above the eyeball to form a palpebral fissure. During this two-step surgical treatment, both eyelids of the left eye were reconstructed. The length and width of palpebral fissure were 30 mm and 14 mm, respectively. The patient was satisfied with the surgery outcomes. Reconstruction of both eyelids with forehead flap supplied by the frontal branch of the superficial temporal artery provides the elementary protection to the eyeball, enables vision preservation and offers good aesthetic result.

Objectives: To evaluate the level of oxidative damage to membrane lipids due to the breast cancer surgery in the early postoperative period., Patients and Methods: Blood samples were collected on the preoperative day and 24 hours postoperatively in 71 women operated for breast cancer, and preoperatively in 38 female patients with benign breast tumour. Lipid peroxidation (LPO) in the blood samples was estimated by measuring the concentrations of malondialdehyde+4-hydroxyalkenals (MDA+4-HDA) with spectrophotometry., Clinical Data Included: tumour site, tumour histological findings, cancer stage, grade, tumour volume, state of lymph nodes, type of surgery for breast, type of surgery for axilla., Results: Blood LPO level was similar in breast cancer patients and benign tumour patients (2.01±0.46 nmol/ml vs. 1.92±0.39 nmol/ml, respectively; p>0.05). In cancer patients, MDA+4-HDA increased on the first postoperative day, i.e. from 2.01±0.46 nmol/ml to 2.58±0.98 nmol/ml (p=0.0001). In women with benign breast tumour, LPO did not relate to the histological finding (p=0.8915). In the breast cancer group, preoperative LPO did not correlate with age, tumour volume and number of metastatic lymph nodes. Level of MDA+4-HDA was similar in stages I/II (2.03±0.46 nmol/ml) compared to stages III/IV (1.69±0.26 nmol/ml, p=0.1521). Consequently, levels of MDA+4-HDA did not relate to disease stage (p=0.1364)., Conclusions: Surgery for breast cancer causes peripheral increase in oxidative damage to macromolecules in the early postoperative period. Therefore, perioperative antioxidant supplementation should be considered.

Implants used for two-stage breast reconstruction are selected exclusively on the basis of the directly measured linear parameters. Therefore, the relevant implant is not always chosen despite the wide range of available products. The aim was to analyze the clinical usefulness of three-dimensional (3D) imaging in the breast implant selection. In 50 patients after unilateral two-stage breast reconstruction, height, width, projection and total volume of both breasts were triply obtained with measuring tape (anthropometric method), thermoplastic casting (thermoplastic method) and 3D imaging (optical method). We measured skin fold thickness with skin caliper. In the optical method, we subtracted the covering tissues and calculated the parameter - "estimated breast implant volume" (EBIV), together with the corresponding "anthropometrically estimated breast implant volume" (aEBIV) in the anthropometric method. Reliability of the three methods was described as repeatability and accuracy, both quantified with parameters: "technical error measurement" (TEM) and "reliability factor" (R). Repeatability showed variation among the repeated measurements. Accuracy determined variability between the real volume of the implant used for reconstruction and the obtained volumetric parameters. Repeatability was the highest for the optical method, comparing to anthropometric and thermoplastic methods (p<0.0001). Accuracy was the highest in the optical method for EBIV, comparing to aEBIV in the anthropometric method and the total volume in three methods (p<0.0001). Level of accuracy for EBIV was in the range of variability among the commercially available implants (p>0.05). In conclusion, implants for breast reconstruction are precisely selected with the 3D scanning method, in comparison to widely used direct measurements or thermoplastic casting., (© 2013 Published by Elsevier Ltd.)

We identified the optimal operative technique of unilateral otoplasty among cartilage-scoring or posterior-suturing methods. All unilateral otoplasties repaired in South East Scotland in 10 years were analyzed. Using visual analog scale, outcomes were scored by blinded professional panel and by patients. Case notes were interrogated for postoperative complications. Of 81 patients, 40 with full photographic records were included in the study. Cosmetic outcomes and symmetry scores in patients who underwent posterior suturing with fascial flap were significantly better than cartilage scoring and posterior suturing without fascial flap. Early complications were significantly more common in cartilage-scoring and posterior-suturing techniques without fascial flap than posterior suturing with fascial flap. In conclusion, posterior suturing with fascial flap represents cosmetically superior technique in unilateral otoplasty. It allows for intraoperative adjustment of posterior sutures, resulting in symmetric ears. The technique seems to be associated with fewer short-term complications, often responsible for pediatric patient distress.

Acne inversa (AI, hidradenitis suppurativa, Velpeau's disease, Verneuil's disease) is a severe, chronic inflammatory dermatosis of unknown etiology, detected on the basis of clinical symptoms more frequently in women than in men. Purulent lesions in the form of nodules and inflammatory tumors, fistulas and scars are present in the areas with hair follicles and apocrine glands, most commonly on the armpits, groin, around the anus and pubic region. Acne inversa can lead to physical and mental disorders. Unfortunately, it is often misdiagnosed and ineffectively treated. The paper presents a case of a 46-year-old patient who was successfully treated surgically for AI around the anus and buttocks by excision of the changes and closure of the wound with local flaps and split-thickness skin grafts, taken with dermatome from the rear surface of the thighs. Surgical treatment is the method of choice in the treatment of severe AI.

Background: Associations between breast cancer and thyroid disorders are reported in numerous studies. Relationships between thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and breast cancer have been previously demonstrated. However, no analysis has been performed concerning an association between thyrotropin (TSH) receptor antibodies (TSHRAb) and breast cancer. The aim of the study was to evaluate the prevalence of breast cancer or benign breast tumors in patients with Graves' disease and to analyze a possible relationship between Graves' disease and these two groups of breast diseases with emphasis to epidemiology and laboratory findings., Patients and Methods: Clinical and laboratory details of 2003 women hospitalized for endocrine disorders were retrospectively analyzed, using an unpaired Student's t-test, logistic regression analysis, χ2 test of independence or the two-sided ratio comparison test., Results: The coexistence of Graves' disease and breast cancer was statistically significant. We observed TSHRAb and TgAb more frequently in patients with breast cancer. We found that TSHRAb is the only variable possessing predictive value for breast cancer., Conclusions: The strong relationship between Graves' disease and breast cancer is proposed. We suggest that TSHRAb could be described as a positive determinant of breast cancer. The present data call attention to the usefulness of screening for breast cancer in long-term follow-up of patients with autoimmune thyroid disorders, especially of those with Graves' disease. Similarly, screening for autoimmune thyroid disorders should be performed in patients with nodular breast disease. Additionally, the article draws ideas for further research in order to develop targeted treatment for more successful outcome in patients with breast cancer.

Preoperative, accurate measurement of spatial parameters of the external nose could be essential in the postoperative assessment of rhinoplasty. The aim of the study was to analyse the relevance of three-dimensional (3D) imaging in aesthetic evaluation after operation, to provide a standardised algorithm of nasal shape measurements, which will enable the development of software for assessing the nose before and after rhinoplasty, to perform analysis of spatial changes of both its shape and asymmetry by the new protocol of measurements. Fifty-four patients were examined preoperatively and 6 months postoperatively. The following nasal parameters were determined: rates of proportion, angles, and spatial parameters. After the operation, statistically significant differences were observed in all parameters. In conclusion, a 3D scanner can be used as a tool to assess the results of rhinoplasty. This protocol of measurements describes spatial changes of the nose shape resulting from the operation.

In patients with organ transplantation as compared to the general population the risk of cancer is significantly increased. The most common changes are malignant tumors of the skin, constituting 30-65% of malignant tumors found in recipients. Potential risk factors for skin cancer after a transplant operation are: solar radiation, immunosuppressive therapy, genetic factors, infection with HPV and skin cancer transmission before transplantation. In contrast to the immunocompetent population, skin cancers in transplant recipients are dominated by squamous cell carcinoma, followed by basal cell carcinoma. Squamous cell carcinoma in patients after transplantation is characterized by a strong tendency to give local recurrences and distant metastases. Due to the high risk of developing skin cancer in transplant recipients, preventive oncology plays an important role in the long-term care of patients after transplantation. This includes: sun protection, education, and early treatment of patients with precancerous lesions. It is also stressed that systematic dermatologic studies need to be carried out in patients after transplantation surgery. The paper contains basic information about skin cancers in organ transplant recipients: epidemiology, potential risk factors, treatment and prognosis. The paper presents also a case of patient who developed squamous cell carcinoma of the skin 3 years after renal transplantation.

Background: The purpose of this study was to propose a surgical algorithm for revision otoplasty, based on an evaluation of patient concerns, desires, and clinical findings. A series of instructive cases is presented., Methods: Thirty-six patients with an average age of approximately 15 years (range, 6 to 61 years), who underwent revision otoplasty between 2006 and 2011, were included. Demographic data, complications, indications for revision surgery, and operative details were retrieved from case notes and preoperative and postoperative photographs. Aesthetic outcomes were assessed by three independent plastic surgery consultants using a survey with 15 questions., Results: Indications for revision otoplasty included recurrent prominence/undercorrection, distortion of scaphoid fossa, distortion of antihelical fold, hypertrophic conchal bowl, and telephone ear. The relevant surgical technique was performed according to the patient's concerns and aspirations in line with the proposed protocol of treatment and included the following: posterior suturing, conchal bowl reduction, reconstruction with conchal cartilage, or reconstruction with costal cartilage., Conclusions: Otoplasty is performed frequently in young patients, and unsuccessful surgery can have a negative impact on their quality of life. Suturing techniques are safer than sculpting techniques, which can cause permanent ear deformity. Complications after sculpting techniques can lead to ear reconstruction. The proposed algorithm for revision otoplasty addresses the whole variety of ear deformations, providing the surgical options available to address these abnormalities.

Background: Hamartoma is a benign developmental disorder. This focal malformation is composed of mature tissues normally observed in a given organ but randomly distributed, often in disturbed quantitative ratio, with growth rate similar to that of the surrounding tissues. Congenital smooth muscle hamartoma presents as flesh-colored or variably pigmented plaque or macule. To our knowledge this is the first case of congenital smooth muscle hamartoma of the nipple reported in the available literature., Case: A 44-year-old woman with a history of left breast cancer, for which she had mastectomy and axillary node clearance in 2007, presented to the plastic surgery outpatient department to discuss the reconstructive surgery of the left breast and to evaluate her right hypertrophic nipple. After surgical excision of the right nipple-areola complex, histopathological result revealed a previously unreported lesion of the nipple. Diagnosis of congenital smooth muscle hamartoma of the nipple was made after literature review of the previously described cases of congenital smooth muscle hamartoma., Conclusion: Congenital smooth muscle hamartoma of the nipple should be considered in the differential diagnosis of tumors of the nipple. Differentiating congenital smooth muscle hamartoma of the nipple from other types of nipple lesions avoids unnecessary excision of this benign condition.

Our aim was to assess the use of the internet for patients considering rhinoplasty, to identify the influence of the medical information acquired, and to review favourable and adverse aspects of the acquired knowledge online. A prospective study was conducted on 106 patients listed for post-traumatic or aesthetic rhinoplasty. We surveyed 18 questions to evaluate demographic and sociological data, and the importance of the information acquired from the internet. Respondents searched online for description of operations, contact with other patients, and with the surgeon, and for preoperative and postoperative pictures. Patients who were considering aesthetic rhinoplasty were given medical information by a third party or from the internet, and those who were having post-traumatic corrections were usually referred by their general practitioner. We conclude that the internet is an important source of medical information about rhinoplasty for patients, but it does not contain enough data. It plays an essential part, particularly for those patients having the operation for aesthetic reasons, in contrast to those having post-traumatic correction. Reviewing and certifying the plastic surgical websites would validate certified services. Independent, direct contact with the doctor helps patients to obtain more accurate, personalized knowledge. In addition, surgeons should support patients by giving them a list of verified websites, which would contribute to increased doctor-patient communication.

Background: Presently, breast cancer detection is delayed in Poland and, thus, the only other option for patients is amputation and breast reconstruction (immediate or delayed). Reconstructive methods are based on using the patient's own tissue (pedicled or free myocutaneous flaps) or implants (a tissue expander, which is later exchanged for a prosthesis or an expandable implant)., Objective: To evaluate the aesthetic results of a delayed two-stage breast reconstruction with the use of implants (expander and prosthesis) in patients who have previously undergone cancer-related mastectomy., Methods: From 2006 to 2009, 54 patients (34 to 65 years of age) underwent reconstruction at least one year after their mastectomy and adjuvant chemotherapy; three women also received x-ray therapy. All women underwent a two-stage treatment with a tissue expander, which was later exchanged for a prosthesis., Results: Outcomes of the surgery (evaluated by the physician and the patient at least six months after all stages of reconstruction) were found to be very good in 42 patients and good in 12 patients. After amputation and x-ray therapy in two cases, a fistula developed, which necessitated implant removal., Conclusions: After amputation, breast reconstruction with implants (expander and prosthesis) provides good aesthetic results. The method is mildly burdening to the patient and does not cause severe scarring. Symmetrization of the second breast is often recommended; however, the cost is not covered by the national health system. In principle, earlier x-ray therapy disqualifies the application of implants. Dividing reconstruction into two stages (expander and prosthesis) allows for possible correction of prosthesis placement.

Objectives: To determine the prevalence of Internet use by patients considering rhinoplasty and to identify the impact of such information on their decisions., Methods: Prospective analysis of the impact of information received via the Internet by patients considering rhinoplasty on their decision-making prior to surgery. Eighty six patients, scheduled for post-traumatic or aesthetic rhinoplasty, received a questionnaire, consisting of 19 questions, which sought to evaluate their perception of the importance of the Internet information to them and also collected relevant demographic and sociological data., Results: Respondents searched online for descriptions of medical procedures, information about how to contact other patients, pre- and post-operative pictures and making contact with a doctor. Patients considering aesthetic rhinoplasty received medical information from a third party or via the Internet. Individuals requiring post-traumatic surgical treatment were usually referred by family doctor., Conclusion: Patients planning nasal aesthetic surgery form their opinions after consulting friends and searching the Internet, which can act as an important medical assistance.

Background: The popularity of body piercing procedures is increasing around the world. Body piercing, depending on the age and social group, is believed to involve up to 51% of the general population. Complications following piercing procedures are variable., Objective: To present an unusual complication after lower lip piercing - embedding of a stud into the lip - and to determine why it occurred from the side of the mucous membrane and not from the side of the skin., Methods: A 21-year-old man presented to the plastic surgery outpatient clinic with embedding of piercing into the lower lip. Results In lateral X-ray film, a metallic shadow was observed in the area of the oral soft tissues. The length of the stick was only 8 mm. In this patient, a stick that was too short in relation to the thickness of the lip was used. In this situation, the ends of the stud pressed too strongly on the surrounding tissues. Consequently, this may have caused necrosis of the mucous membrane and embedding of the stud into the lip., Conclusion: The observations described confirm a higher susceptibility to mechanical pressure of the mucous membrane than of the skin. An increasing rate of complications after body piercing reflects a lack of medical knowledge in individuals performing such procedures.