Jurnal Rekonstruksi dan Estetik

A COMBINATION TECHNIQUE OF AUTOLOGOUS AUGMENTATION AND BREAST LIFTING IN HYPOPLASTIC-THIRD GRADE PTOTIC BREAST: A CASE REPORT

2024-03-18T12:13:16+07:00

Highlights:

This case shows autoaugmented mastopexy as a natural alternative to silicone implants for patients seeking breast enhancement.
The combination of breast lift and autoaugmentation using the patient’s own tissue is presented as an effective method for achieving a firmer breast appearance while maintaining a natural look.
The use of tailored preoperative design, including breast ultrasound, enhances surgical safety and outcomes.

Abstract:

Introduction: Breast ptosis is a common concern among women due to factors such as aging, pregnancy, breastfeeding, and weight loss. To achieve a beautiful breast shape, mastopexy (breast lift) with augmentation is often required. This case report highlights the relevance of the chosen augmentation method in addressing ptosis.

Case Illustration: A 30-year-old woman had breast ptosis after her 2nd child and wanted a breast lift to have lifted and firmer breasts. Due to limited fat tissue available for transfer and her refusal to use silicone implants, the patient chose autoaugmented mastopexy. Before surgery in August 2022, breast ultrasound showed abnormalities. Preoperative design was made to determine skin and pedicle positions, using a wise pattern with a superior pedicle to lift the nipple-areola complex (NAC) and an inferior pedicle for autoaugmentation. Surgery was done carefully to achieve symmetry and desired result.

Discussion: Breast tissue changes a lot during and after pregnancy and hormonal factors increases the risk of ptosis. According to Regnault classification, the patient was classified as 3rd degree ptosis. While prosthetic implants are common in breast surgery, the patient declined that option. Autoaugmented mastopexy offers a more natural result without the risks of implants.

Conclusion: Breast lift with autoaugmentation is suitable for patients with breast ptosis seeking a firmer appearance without added volume. This technique utilizes the patient's own tissue to achieve satisfactory results, although outcomes may vary depending on individual factors.

IMPLEMENTATION OF AN OCCLUSAL WAFER IN SEVERE MANDIBULAR FRACTURE CASES WITH POST-ORIF MALOCCLUSION: A CASE SERIES

2024-04-16T14:55:50+07:00

Highlights:

This study shows that occlusal wafers can effectively correct malocclusion in patients with segmental mandibular fractures after ORIF plating.
Occlusal wafers help reshape the dental arch within 2 to 4 weeks, reduce surgery time, and simplify follow-up care, making them a valuable option for surgeons.

Abstract:

Introduction: Improper treatment of severe mandibular fractures can lead to malocclusion, which poses a significant challenge for reconstructive surgeons. The occlusal wafer provides an effective solution for managing malocclusion following ORIF plating of maxillofacial fractures during the one-month postoperative evaluation period. Made from acrylic resin, the occlusal wafer serves as an intermediate guide in orthognathic surgery. It helps reposition the maxilla, adjust the mandible, and modify the jawbones to achieve ideal occlusion. The device can reshape the dental arch to any pre-planned position within 2 to 4 weeks.

Case Illustration: We present two cases of patients with segmental fractures.Case 1: A 26-year-old male also had segmental fractures of the left angle and right body of the mandible. He achieved occlusion after ORIF plating; however, malocclusion developed during the three-week follow-up. Case 2: A 28-year-old female presented with segmental fractures of the left angle and right body of the mandible. She initially achieved occlusion after ORIF plating, but malocclusion was noted during the one-month follow-up.

Discussion: Both of these patients had segmental fractures and experienced malocclusion following ORIF plating, but occlusion was achieved after occlusal wafer installation.

Conclusion: The use of an occlusal wafer facilitates optimal occlusion, streamlines the surgical procedure by reducing operating time, and enhances the ease of postoperative monitoring. This approach proves particularly valuable in cases where ORIF plating has been performed yet ideal occlusal alignment remains unachieved.

COMPLETE UNILATERAL CLEFT LIP SURGERY USING MODIFIED ROTATION-ADVANCEMENT FLAP TO ENHANCE AESTHETIC APPEARANCE IN RSPAL DR. RAMELAN HOSPITAL: A CASE SERIES

2024-07-29T06:22:27+07:00

Highlights:

Complete unilateral cleft lip influences not only the aesthetics of the face but also the functionality of the lip, nose, and upper jaw (maxilla).
The surgery aims to establish a symmetrical, functional, and visually appealing contour of the lip, vermilion border, and nasal structure.
The modified rotation-advancement flap represents a valuable approach for complete unilateral cleft lip repair surgery.

ABSTRACT

Introduction:

Unilateral cleft lip is a common congenital anomaly affecting the upper lip and nose, impacting both aesthetics and function. Advances in surgical techniques have enhanced cleft lip repair, with the rotation-advancement flap being a notable method. This study examines the outcomes of a modified Millard’s rotation-advancement flap technique, developed and refined over 14 years. Case Illustration: Between September 2023 and February 2024, four patients with complete unilateral cleft lip and associated nasal deformity were treated at RSPAL Dr. Ramelan Hospital. Each patient underwent cleft lip repair using the modified rotation-advancement flap technique.

Case Illustration: Four patients presented with complete unilateral cleft lip with nose deformity came to RSPAL Dr. Ramelan Hospital between September 2023 and February 2024, We performed cleft lip surgery using the modified rotation-advancement flap for each patient.

Discussion: Surgical outcomes showed excellent symmetry, proper vermilion border alignment, and minimal scarring. Complications were rare, with no instances of wound dehiscence or infection. The study discusses the aesthetic and functional improvements achieved with this technique, underscoring its effectiveness in treating complete unilateral cleft lip and enhancing patient quality of life.

Conclusion: The Modified Rotation-Advancement Flap technique provides a valuable approach for unilateral cleft lip repair, yielding satisfactory aesthetic and functional results. Further research with long-term follow-up and larger sample sizes is needed to confirm its efficacy and refine the technique.

A COMBINATION OF CHEEK FLAP, CARTILAGE INSERTION, AND FAT TRANSFER ON POST-TRAUMA LOWER EYELID ECTROPION RECONSTRUCTION

2024-09-30T12:06:35+07:00

Highlights:

This study introduces an innovative approach for post-traumatic ectropion reconstruction in children by combining Mustarde rotational cheek flap, cartilage insertion, and fat transfer.
This method effectively addresses the challenges of cicatricial ectropion caused by injuries or burns, leading to improved, durable, and cost-effective outcomes in restoring eyelid function and volume.

Abstract:

Introduction:Ectropion correction surgery is a procedure designed to restore the anterior lamella to its anatomical position. This study aims to propose a combination of cheek flap and fat transfer as a method for post-traumatic ectropion reconstruction surgery.

Case Illustration:A 10-year-old girl presented with ectropion caused by scar formation and volume loss in the infraorbital region following a traumatic incident seven years prior. The procedures performed in this case included a Mustarde rotational cheek flap to reconstruct the scar tissue in the infraorbital region that led to the ectropion, pure ear cartilage insertion to repair the damaged tarsal plate or tarsus, and fat transfer to address the volume loss in the infraorbital area. The donor fat was harvested from the inguinal region

Discussion: The rationale for using the Mustarde rotational cheek flap, cartilage insertion, and fat transfer was based on the wide donor area, particularly in cases where the vertical dimension exceeds the horizontal dimension. This approach is believed to yield better outcomes compared to other methods, such as skin grafts. In this case, fat transfer was employed to restore the volume lost beneath the scar tissue following trauma. This combination technique is thought to be more durable and to provide superior results compared to alternative methods, while also being economically advantageous.

Conclusion: The combination of the Mustarde rotational cheek flap, cartilage insertion, and fat transfer is believed to improve the outcomes of the reconstruction procedure following scar tissue release and correction of volume loss beneath the scar.

EARLY CLEFT LIP REPAIR: A LONG TERM FOLLOW-UP

2024-07-15T02:18:38+07:00

Highlights:

Early cleft repair benefits patients by reconstructing near-normal lip anatomy that persists after ten to fifteen years.
The early procedure did not result in muscular or maxillary hypoplasia in long-term follow-ups; rather, development occurred in tandem with normal growth.

Abstract:

Introduction: Published reports on the long-term outcomes of cleft lip surgery within the Indonesian population are limited, especially for those treated early in the neonatal period. This study presents follow-up data on early-managed cases, aiming to objectively evaluate the long-term results of such management.

Case Illustration: A newborn with a complete unilateral cleft lip and palate had surgery on day two, achieving a symmetrical lip and nasal base. At 12 months, cleft palate surgery was performed. Fifteen years later, the patient sought a lip revision, expressing satisfaction with the results and opting against further procedures. Case 2: Another newborn with an incomplete cleft underwent surgery on day five, followed by palate repair at 12 months. Ten years later, the parents reported satisfaction with the outcomes and no desire for further revisions.

Discussion: The discussion focused on the merit of early management and no negative impact on muscular and maxillary growth.

Conclusion: The positive effects of early management through muscle management were observed in the long-term follow-up, as shown in these two reported cases.

Jurnal Rekonstruksi dan Estetik, December 2024

2024-11-28T10:19:11+07:00

Back Matter

HELMET USE COMPLIANCE SURVEY FOR CRANIOFACIAL TRAUMA PREVENTION AMONG MOTORCYCLISTS IN JAYAPURA CITY RING ROAD

2024-10-24T11:12:54+07:00

Highlights:

This study provides insights on helmet compliance among motorcyclists in Jayapura City to help prevent head injuries.
The analysis shows non-compliance with helmets, especially on the Jayapura Ring Road, where up to four people ride a single motorbike.
Consequently, accidents causing head injuries result in greater health and humanitarian impacts.

Abstract:

Introduction: Compliance with helmet use by motorcycle riders and passengers passing through the highway is one of the important factors in preventing craniofacial injuries and head injury. This study designed to survey and evaluate the compliance with helmet use among motorcyclists and passengers on the ring road in Jayapura City.

Methods: This time-based survey study observed compliance with helmet use by motorcycle riders and passengers passing through the Jayapura city ring road for 14 days of observation at three-time orders (morning, afternoon, and evening). Analysis of the collected data was carried out descriptively.

Results: The results showed that during the study period, there were 6,411 motorcycles passing through, 18,602 motorcycle passers-by were at moderate risk of injury due to not wearing helmets (MR-IV) and 11,849 were at high risk (HR-II). The peak of non-compliance with helmet use occurred in the afternoon period (T3). The results showed that 71.92% of the HR-V group did not obey helmet use; 184.82% of the HR-II group did not obey helmet use. While non-compliance with helmet use in the MR-IV group even reached 290.15%.

Conclusion: Helmet use compliance among motorcycle riders and passengers on the Jayapura Ring Road is low, increasing their risk of head injuries in accidents. This highlights the need for strategies to reduce helmet non-compliance in Jayapura City. The study focuses on one of the busiest routes, and further research is needed to assess helmet compliance on other busy routes in the city for a more comprehensive understanding.

CLINICAL PROFILE AND MANAGEMENT OF HYPERTROPHIC SCARS AT DR. SOETOMO GENERAL ACADEMIC HOSPITAL SURABAYA, INDONESIA

2024-11-08T13:46:49+07:00

Highlights:

Most hypertrophic scar patients were aged 17 to 25, mainly female, and the scars were mostly caused by burns on the face and upper extremities.
Surgical techniques were the most common treatment, with most scars measuring 1 to 5 cm².

Abstract:

Introduction: Scars is a prevalent clinical concern that is often more complex than commonly perceived. Hypertrophic and keloid scars results from atypical wound healing responses following trauma, characterized by an excessive deposition of connective tissue. In Indonesia, there are remains a paucity of data on the clinical profile and management of hypertrophic scars. To address this gap, researchers conducted a descriptive study to systematically examine various variables associated with hypertrophic scars, aiming to enhance understanding and inform more effective management strategies.

Methods: This research is a retrospective descriptive analysis utilizing secondary data from medical records of patients with hypertrophic scars treated at Dr. Soetomo General Academic Hospital in Surabaya during the 2019 – 2020 period. The data were collected and processed according to key variables, including age, gender, occupation, etiology, anatomical location of the hypertrophic scars, scar size, and therapeutic interventions.

Results:The number of patients with hypertrophic scars at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from 2019 to 2020 was 68. Most patients were aged 17 to 25 years. The gender distribution was nearly equal, with 50% male and 50.9% female patients. Among the patients, 12.5% and 43% were students. Burns caused 37.5% and 25% of cases. The most common scar locations were the face (25%) and upper extremities (25%). Most scars measured 1 to 5 cm² (25%). The most common treatment was surgical techniques (80% and 48%).

Conclusion: Most hypertrophic scar patients were aged 17 to 25 years, predominantly female, and students. The primary cause of the scars was burns, with the scars most commonly located on the face and upper extremities. The majority of scars measured between 1 and 5 cm², and surgical techniques were the most widely used therapy.

Jurnal Rekonstruksi dan Estetik, December 2024

2024-11-29T15:52:19+07:00

Front Metter Vol.9. No.2 December 2024