The internal nasal valve provides most of the upper airway resistance; therefore, many surgical techniques have been developed to reconstruct and widen this sensitive area of the nasal airway. Twenty patients participated in this study to compare the effects of 2 techniques (spreader grafts and modified spreader flap) on the true valve area and the average valve area after rhinoplasty according to standard axial computed tomography on admission and 6 months following the surgery. The mean follow-up time was 10.2 months. After rhinoplasty, the average valve area increased in all patients who underwent the spreader graft or modified spreader flap techniques. The preoperative average valve areas for patients undergoing the spreader graft and spreader flap techniques were (37.10 ± 16.45 mm2) and (36.86 ± 10.56 mm2), respectively, whereas the postoperative results were (48.58 ± 12.85 mm2) for those who underwent the spreader graft technique and (56.22 ± 19.06 mm2) for those who underwent the modified spreader flap technique. Both techniques resulted in significant radiological and clinical improvement with a good correlation between the subjective and objective tests. Level of Evidence IV.

Background Thoracodorsal artery perforator (TDAP) flap and muscle‐sparing latissimus dorsi (MSLD) flap have been frequently used for axillary coverage after hidradenitis suppurativa (HS) excision. However, none showed superiority to others. This study compared both flaps to define the ideal option, highlighting flap outcomes and functional and aesthetic results. Methods A retrospective study was conducted to compare both flaps that were used for axillary reconstruction in nine patients with bilateral HS Hurley stage III between 2017 and 2020. Eight TDAP and 10 MSLD flaps underwent functional evaluation using shoulder abduction angle (SA); the Disabilities of the Arm, Shoulder, and Hand (DASH) score; visual analog scale (VAS) for pain; and the Dermatology Life Quality Index (DLQI) questionnaires. Aesthetic assessment included the Scar Cosmesis Assessment and Rating (SCAR) scale and arm–chest interval. Results The mean operating time was 194.4 ± 51.58 and 128.5 ± 31.45 min for TDAP and MSLD (p = .009), respectively. Flap complications were significantly higher in the TDAP group (p = .034). There was no significant difference between both groups regarding SA; DASH, DLQI, VAS, and SCAR scale (p > .05). The mean arm–chest interval was significantly longer in the MSLD than in the TDAP group by 6.9 mm (p = .001). Conclusions TDAP and MSLD are comparable versatile flaps to eradicate axillary HS with higher TDAP flap complications. Although the TDAP flap is less bulky than the MSLD flap, the MSLD flap shortens the harvesting time without a significant difference in functional outcomes and scar results.

Background: Permanent fillers were previously used to fix wrinkles associated with aging as they were considered a reasonable choice for facial rejuvenation. However, the subsequent removal of permanent fillers is of great concern to surgeons before performing a facelift surgery. Many studies have evaluated the outcomes of facelift surgery; however, we sought to evaluate the outcomes of facelift surgery which required removal of fillers beforehand. Methods: This retrospective cohort study evaluated the outcomes of 50 patients with regard to patient satisfaction and postoperative complications of facelift surgery with removal of permanent filler under local anesthesia. A short scar rhytidectomy with superficial muscular aponeurotic system plication was performed. Preoperative and postoperative photographs were analyzed by two independent surgeons to report asymmetry scores ranging from one to three (one none, two slight, and three obvious asymmetries). Patient satisfaction scores were also recorded. Results:The preoperative presentations of the permanent filler were asymmetry (82%) and disfiguring facial edema (26%). Removing fillers under local anesthesia is generally tolerable, with 56% of patients tolerating rhytidectomy. The degree of the participants' satisfaction after follow-up was satisfactory; two-thirds of patients (62%) were satisfied. There was a significant difference between surgeons' preoperative and postoperative assessment of asymmetry scores (P < 0.05). Conclusions: Permanent filler removal with concomitant face-neck lift surgery has satisfactory outcomes. The procedure length was primarily determined by the patient's skin characteristics and the severity of the local condition.

Background: Recurrence of the symptoms of median nerve entrapment over the wrist remains a challenging problem and in most cases it is secondary to recurrent adhesions around the median nerve, vascularized tissue coverage is one of the most successful treatments to relieve pain and prevent recurrence.Material and Methods: Fifteen patients were involved in this study with recurrent or persistent carpal tunnel syndrome to study benefit of vascularized wrapping of median nerve by tubed adipofascial radial artery perforator flap.Results: Marked improvement had been observed in nerve conduction studies, visual analogue scale and grip strength with no recurrence for one year postoperatively.Conclusion: Radial artery perforator adipofascial flap have the advantage of good volume and vascularity providing protection and vascular supply to the severed median nerve.

cartilage. Based on the results of the study, there was a significant improvement in all evaluation parameters in the postoperative period compared with the preoperative period in both groups in terms of AVA, whereas there was no significant difference between the 2 techniques in the postoperative period.Based on our experience with rhinoplasty, we have the following comments on some aspects of the study:1) As the authors noted in their article, the study was conducted on a limited number of patients (20 patients). In studies conducted to determine the effectiveness, a high number of patients are required to statistically compare 2 different techniques. A higher number of patients included in the study will provide more data and ensure an accurate and robust interpretation of statistical results.2) The mean follow-up period of patients is 10.2 months. How was the interval of follow-up times for patients (minimum and maximum follow-up periods)? We currentlyConflict of interest and sources of funding: none declared.