Preoperative CTA allows accurate perforator mapping and evaluation of the dominant vascularity. It helps the surgeon to get an ideal designing of the chimeric ALT flap with two skin paddles based on individual perforators, but only one vascular anastomosis in reconstruction of full thickness buccal defects.

This study investigated gender, caponization and exogenous estrogen effects on lipids, bone and blood characteristics in Taiwan country chickens. Thirty male chickens were caponized at 8 weeks (capons); 15 capons were injected with estrogen (5 mg/bird estradiol 3-benzoate) every 2 weeks from 8 to 28 weeks, and 15 sham-operated male (shams) chickens and 15 females were selected for this trial. The results showed that the shams had lower relative abdominal and chest subcutaneous fat than females (P < 0.05). The estrogen-treated capons had greater relative abdominal and chest subcutaneous fat than shams and capons (P < 0.05), which might result from higher blood very low-density lipoproteins and triacylglycerol concentrations (P < 0.05). Caponization could dramatically increase relative abdominal fat (506%; P < 0.05). The shams had higher tibia weight and biomechanical properties, such as maximum bone strength and bending moment values than the capons (P < 0.05). Tibia biomechanical properties were reduced by estrogen treatment (P < 0.05). The females obtained the lowest biomechanical value in all treatments (P < 0.05). Histological examination revealed cavity formation in the cortical bone of estrogen-treated capons and female chickens, which suggested that estrogen reduced bone biomechanical properties by destroying its structural integrity.

No abstract

Breast deformities after augmentation with injectable materials carried out by uncertified medical personnel present challenging problems. Materials include liquid silicone, paraffin, polyacrylamide hydrogels, and unknown gels. They usually cause granulomatous reactions, erythema, pain, and even skin necrosis. Tender masses that cannot be differentiated from breast cancers are the major concern. This retrospective study presents the authors' experience in managing 10 symptomatic injected breasts in five patients during the past 8 years. Subcutaneous mastectomies were carried out using periareolar, inverted "T", or inframammary approaches combined with breast reconstruction using bilateral pedicled transverse rectus abdominis myocutaneous (TRAM) flaps. All flaps survived well and gave a satisfactory cosmetic appearance. There was no major complication or late occurrence of breast cancers over the following 8 years. Injectable materials used for breast augmentation should be prohibited until more scientific data are available about the long-term effect of these materials in breast tissues. Once the injected breasts become symptomatic, subcutaneous mastectomy and reconstruction with bilateral pedicled TRAM flaps is a reasonable option for the patient.