Background: Numerous techniques have been described for the correction of gynaecomastia. Surgical excision has been an effective treatment for gynaecomastia. Recently, there has been a shift from the open approach to liposuction. The purpose of this study to illustrate the advantages of using liposuction in treatment of gynecomastia Patients and methods: a total of 12gynaecomastia patients were treated in this study, 11 patients were treated by liposuction only and one case was treated by liposuction and open excision of breast disc. Their ages ranged from 22 to 38years.A vacuum assisted liposuction removing the fatty tissue was performed through a small incision Results: The amount of aspirated fat ranged from 200 to 850 cc. The mean infiltration volume per breast in vacuum-assisted liposuction was 500 ml (200–1000 ml). The mean follow-up time was 4 months (range: 3–12months).All patients were satisfied with the improvements in their chest shapes Conclusion: Use of liposuction in treatment of gynecomastia reduces the conspicuous scars, down-time morbidity and postoperative complications compared to subcutaneous mastectomy and leads to uniformly good esthetic results.

Background: Various surgical techniques and modalities have been used to treat scars, but non showed definite efficacy controlling that abnormally-placed fibrous tissue. Contractile forces of healing in addition to the nature of primary injury greatly influence the final scar appearance. Atrophic depressed scars are a major challenge that a Plastic Surgeon may ever face. Lack of dermal skin layer should be replaced for a perfect reconstructive surgery result. Objective: To augment the atrophic depressed scars with autologous tissue that is already present in-place reaching aesthetically pleasant reconstructive results; the de-epithelized scar tissue itself. Methods: Thirty-seven(37) patients with atrophic and depressed scars (caused by trauma) were surgically treated with scar revision surgery where the authors employed the scar tissue itself after being de-epithelized for augmentation of the absent or abundant atrophic scars’ dermal layer. The assessment of the results was conducted by comparison of the before and after surgery photographic documentation 6 months following segmentation surgery as well as patients’ satisfaction. Results: dramatic improvement of the scar morphology with good patients’ satisfaction has been obtained.

Background: Various surgical techniques and modalities have been used to treat scars, but non showed definite efficacy controlling that abnormally-placed fibrous tissue. Contractile forces of healing in addition to the nature of primary injury greatly influence the final scar appearance. Atrophic depressed scars are a major challenge that a Plastic Surgeon may ever face. Lack of dermal skin layer should be replaced for a perfect reconstructive surgery result. Objective: To augment the atrophic depressed scars with autologous tissue that is already present in-place reaching aesthetically pleasant reconstructive results; the de-epithelized scar tissue itself. Methods: Thirty-seven(37) patients with atrophic and depressed scars (caused by trauma) were surgically treated with scar revision surgery where the authors employed the scar tissue itself after being de-epithelized for augmentation of the absent or abundant atrophic scars’ dermal layer. The assessment of the results was conducted by comparison of the before and after surgery photographic documentation 6 months following segmentation surgery as well as patients’ satisfaction. Results: dramatic improvement of the scar morphology with good patients’ satisfaction has been obtained.

Background: The majority of plantar ulcers occur because of diabetic neuropathy, most frequently over the first metatarsal head. Plantar reconstruction is challenging because of the unique anatomical features of this region. The ideal surgical management for plantar wounds is reconstruction with local plantar tissue. Patients 75 patients with plantar ulceration of the forefoot underwent surgery. Ages ranged from 25 years to 63 years, with a mean age of 49 years. Half the patients (37) had ulcers located medially, 26 in the central and 12 on the lateral aspect of the foot. Methods: Local transposition flaps were used in all cases. Laterally-based flaps were used for the most common medial ulcers, medial-based flaps used for lateral ulcers, and sometimes both medial and lateral based flaps were used for central ulcers. Results: 65 (86.7%) patients had primary healing of their wounds with good cosmetic outcome.4 (5.3%) patients had mild flap compromise with delayed healing, 3 (4%) patients experienced a small dehiscence and 3 (4%) patients had ischemia of distal one cm of flap. Conclusion: In this series of 75 patients, surgical excision and reconstruction of forefoot ulcers with local flaps has proven successful in over 85% of cases.

Background The reconstruction of scalp alopecia is necessary for improvement of cosmetically displeasing scars. V-Y-C or V-Y-S plasties are simple procedures that conserve tissues in the repair of round skin defects.We aimed to review our experience with the V-Y-C and V-Y-S plasties for correction of acquired alopecia and attempted to construct a simple management algorithm. Methods Twenty patients with acquired alopecia of the scalp were corrected by using V-Y-C or V-Y-S plasties. There were 16 males and 4 females. Their age ranged from 4 to 30 years, with an average age of 19 years. V-Y-S plasty was performed in nine patients, while 11 cases were reconstructed by V-Y-C plasty. Results V-Y-C or V-Y-S plasties provided coverage of good quality in most cases. There was only one case of superficial distal sloughing, which responded nicely to postoperative dressing and healed spontaneously without any surgical intervention. There were no major complications. Conclusion The V-Y-C or V-Y-S plasties are easy and simple one-stage operations for correction of acquired alopecia. Satisfactory aesthetic outcomes and minimal morbidity make these plasties excellent options for repairing alopecia

Background The reconstruction of scalp alopecia is necessary for improvement of cosmetically displeasing scars. V-Y-C or V-Y-S plasties are simple procedures that conserve tissues in the repair of round skin defects.We aimed to review our experience with the V-Y-C and V-Y-S plasties for correction of acquired alopecia and attempted to construct a simple management algorithm. Methods Twenty patients with acquired alopecia of the scalp were corrected by using V-Y-C or V-Y-S plasties. There were 16 males and 4 females. Their age ranged from 4 to 30 years, with an average age of 19 years. V-Y-S plasty was performed in nine patients, while 11 cases were reconstructed by V-Y-C plasty. Results V-Y-C or V-Y-S plasties provided coverage of good quality in most cases. There was only one case of superficial distal sloughing, which responded nicely to postoperative dressing and healed spontaneously without any surgical intervention. There were no major complications. Conclusion The V-Y-C or V-Y-S plasties are easy and simple one-stage operations for correction of acquired alopecia. Satisfactory aesthetic outcomes and minimal morbidity make these plasties excellent options for repairing alopecia

BACKGROUND: Breasts are an integrai part of feminine beauty and breast symmelry is a key lo beautlful formo Severe breasl asymmelry can be psychologically dislurbing, especially for teenagers. Correction of breast asymmetry may present a challenge for plastlc surgeons. PATlENTS AND METHODS: 72 cases of breast asymmetry complalning of varying degree and etlology of breasl asymmelry, treated between December 2009 and December 2012. Their age ranged from 18 lo 65 years, with Ihe mean age was 34 years. Every palient conducted doctor interview for good psychological analysls. Preoperallve clinical assessment of the specific anatomical deformity, a good surgical pian, subsequent surgical treatment modalities, esthetic outcome, and patient's satisfactlon were evaluated. Surgical modalilies used in Ihls series included augmentation mammaplasty, reduction mammaplasty, mastopexy, T.R.A.M flap, multiple z plasties, Thoracodorsal flap, and nipple and areola reconstructlon. Ali patlents were done under generai anesthesia. RESULT: 25% palients (18fl2) had breast asymmetry alter mastectomy, 20.8 % patients (15/72) had virginal hypertrophy asymmetry, 16.7 % patients (12/72 ) presented by breast asymmetry alter burn, 12.5% patients (9/72) presented by bilateral developmental hypoplasla with small-volume asymmetry, 12.5% patients (9fl2) had Poland's syndrome, 8.3% patients (6/72) liad a iatrogenic breast asymmetry following breast surgery and 4.2% patients (3/72) presented by breast asymmetry following hemi- Irunk atrophy. 9 of 72 patients were found to have a minor complication, whereas 2 of 72 were found to have a major complication. CONCWSION: The common cause of breast asymmelry Ihat ultlmalely undergo surgery in Upper Egypt was post maslectomy and the least type was breasl asymmetry following heml- Irunk atrophy. Patients' satisfaction were 83.3%, while 73% was the physician' satisfaction. The keys to successful treatment are to deline Ihe nalure of the asymmelry, respect the aesthetic goals of·the patient, and perform a well thought out surglcal pian.

BACKGROUND: Breasts are an integrai part of feminine beauty and breast symmelry is a key lo beautlful formo Severe breasl asymmelry can be psychologically dislurbing, especially for teenagers. Correction of breast asymmetry may present a challenge for plastlc surgeons. PATlENTS AND METHODS: 72 cases of breast asymmetry complalning of varying degree and etlology of breasl asymmelry, treated between December 2009 and December 2012. Their age ranged from 18 lo 65 years, with Ihe mean age was 34 years. Every palient conducted doctor interview for good psychological analysls. Preoperallve clinical assessment of the specific anatomical deformity, a good surgical pian, subsequent surgical treatment modalities, esthetic outcome, and patient's satisfactlon were evaluated. Surgical modalilies used in Ihls series included augmentation mammaplasty, reduction mammaplasty, mastopexy, T.R.A.M flap, multiple z plasties, Thoracodorsal flap, and nipple and areola reconstructlon. Ali patlents were done under generai anesthesia. RESULT: 25% palients (18fl2) had breast asymmetry alter mastectomy, 20.8 % patients (15/72) had virginal hypertrophy asymmetry, 16.7 % patients (12/72 ) presented by breast asymmetry alter burn, 12.5% patients (9/72) presented by bilateral developmental hypoplasla with small-volume asymmetry, 12.5% patients (9fl2) had Poland's syndrome, 8.3% patients (6/72) liad a iatrogenic breast asymmetry following breast surgery and 4.2% patients (3/72) presented by breast asymmetry following hemi- Irunk atrophy. 9 of 72 patients were found to have a minor complication, whereas 2 of 72 were found to have a major complication. CONCWSION: The common cause of breast asymmelry Ihat ultlmalely undergo surgery in Upper Egypt was post maslectomy and the least type was breasl asymmetry following heml- Irunk atrophy. Patients' satisfaction were 83.3%, while 73% was the physician' satisfaction. The keys to successful treatment are to deline Ihe nalure of the asymmelry, respect the aesthetic goals of·the patient, and perform a well thought out surglcal pian.

Although with the reported versatility, vascular reliability, and easy harvesting and elevation of the gastrocnemius muscle flap, still it is used for a narrow aspect of reconstructions including only small and nearby defects. The flap is unfortunately full of limited applications, unreachable coverage, and soft tissue shortage. In this work, we are presenting 20 cases of gastrocnemius muscle flap of different etiologies, in which we applied a group of modifications to have a higher grade of applicability, more arc of rotation, and more tissue surface area. The validity of these modifications was intraoperatively tested in different defect sites and sizes to report if they are really meaningful. All flaps had survived with no complications. We have summarized these modifications in four golden rules, making these muscle flaps more versatile and more applicable. An algorithm is suggested as a leading tool for the best choice of the gastrocnemius muscle units in different situations.