Background Immediate breast reconstruction in 1 stage using permanent implants is gaining popularity and can be performed with or without the use of acellular dermal matrices. This study aimed to investigate the results of breast implants placed submuscularly without acellular dermal matrix and assess the factors affecting surgical complications. Methods From November 2009 to March 2018, 138 patients underwent immediate breast reconstruction with permanent submuscular implants after concomitant skin-sparing or nipple-sparing mastectomies in a single institution. All implants were covered with sufficient soft tissue under a submuscular pocket. Results One hundred thirty-eight patients were enrolled, and a total of 196 breasts were operated. The average age and body mass index (BMI) of the patients were 44.9 ± 8.8 years and 23.7 ± 3.6 kg/m2, respectively. The majority of the mastectomies were therapeutic (81%). The average volume of implants was 389 ± 89 mL, and the mean follow-up was 33 months. The overall complication rate was 17% (n = 23), with skin necrosis being the most common complication followed by infections. Having a BMI equal to or greater than 25 kg/m2 was found to be a statistically significant predictor for overall complications (P = 0.002), whereas smoking history, age, and implant volume were not statistically significant. Conclusions Immediate breast reconstruction in 1 stage using permanent implants can be performed with acceptable complication rates and cosmetic outcomes. Our study demonstrated that high BMI is a risk factor for overall complications. With proper patient selection and surgical technique, implants could be completely covered under a submuscular pocket.

The Limberg-like rectangular flap can be used as a salvage option in complicated skin-reducing mastectomies and can be considered as a safe and effective method because of its easy-to-use nature, low cost, and no need for microsurgery experience.

Winer nodüler kalsinozis, doğumda ya da erken çocukluk çağı döneminde görülen asemptomatik, sert, sarı ya da beyaz renkte nodüler tarzda görülen, idiopatik kalsinozis kutisin bir alt formudur. Winer nodüler kalsinozis üzerinde ülserasyon gelişimi oldukça nadirdir. Ulaşılabilen Türkçe ya da İngilizce literatürde bugüne kadar Winer nodüler kalsinozis ile karişabilecek malign cilt lezyonundan bahseden benzer yazı ya da vakaya rastlanılmamıştır. Bu yazıda, sol kulak heliksinde beyaz renkte, üzeri ülsere, 3x2 mm boyutlarında nodüler lezyon şikayetiyle ailesi tarafından kliniğimize getirilen üç yaşında çocuk olgu sunuldu. Lezyonun ülsere olması, makroskobik görüntüsü ve güneş maruziyetinin en sık olduğu kulak heliksinde yerleşimi nedeniyle ön tanı olarak skuamöz hücreli karsinom düşünüldü.

Renal cell carcinoma (RCC) can metastasize to various organs of the body. The skin is an uncommon site for metastasis. However, if metastasis to skin occurs, scalp is a common area. We present a 77-year-old male patient, with a 12-year history of RCC. In the current presentation, he was hospitalized due to hematuria, fatigue, electrolyte imbalance, and deteriorating kidney functions. After the patient was stabilized, he was referred to the plastic surgery clinic due to an unusual, extremely large, hemorrhagic, ulcerative, and vegetative mass on his scalp. Total excision of the scalp mass was performed and, it was noted that the calvarium was intact and the defect was grafted. Histology report of the specimen confirmed to metastatic RCC. Clinicians need to keep in mind that large cutaneous lesion can be a metastasis from an internal malignancy.

Bacak distalinde ve ayakta görülen metastatik malign melanomlar genellikle inguinal lenf noduna metastaz yaparlar. Popliteal fossa ise nadir görülen ilk nodal metastaz alanıdır. Alt ekstremite melanomlarının popliteal metastaz oranları %3 ila %7 arasındadır. Eş zamanlı olarak inguinal ve popliteal lenf nodu metastazları ise oldukça nadir görülmektedir. Biz bu makalede, palpe edilebilen popliteal lenf nodu metastazı olan fakat hem klinik muayenede hem de pozitron emisyon tomografisi (PET) görüntülemesinde inguinal metastaza dair herhangi bir bulgu olmadığı halde histopatolojik sonuçlara göre inguinal lenf nodlarında metastaz görülen, topukta malign melanom olgusunu sunmaktayız. Bu olgu ile hem klinik muayenede hem de görüntüleme yönteminde inguinal metastaza dair bir bulgu saptanmasa dahi, popliteal ve inguinal bölgelere eş zamanlı olarak lenf metastazı ihtimali olabileceği cerrahların dikkatine sunulmuştur.