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Öğe Axillary lipogranuloma mimicking carcinoma metastasis after silicone breast implant rupture: A case report(Elsevier Sci Ltd, 2013) Gundeslioglu, A. Ozlem; Hakverdi, Sibel; Erdem, Ozlem; Ozen, E. Cigdem; Inan, Irfan; Emlik, DilekSilicone-gel-filled breast implants have been widely used for breast augmentation and reconstruction after mastectomy. However, silicone implants have some well-known complications, such as implant rupture, which requires surgical intervention. Dissemination of silicone particles out of the implant causes a granulomatous reaction, a phenomenon known as silicone granuloma, in breast parenchyma as well as axillary, breast and chest wall lymph nodes, which mimics breast cancer metastasis. However, lipogranuloma after silicone breast implant rupture has not been reported in the literature, although it is a common complication after mineral oil or liquid silicone injection. We present a case report of an axillary lymphadenopathy resulting from lipogranuloma after silicone-gel-filled implant rupture. Review of the literature suggests that this is the first report of a lipogranuloma resulting from implant rupture. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Öğe Cleft Lip Nose Correction Combining Open Rhinoplasty With the Dibbel Technique(Lippincott Williams & Wilkins, 2015) Gundeslioglu, Ayse Ozlem; Altuntas, Zeynep; Inan, Irfan; Bilgen, Fatma; Jasharllari, Lorenc; Karaibrahimoglu, AdnanCleft lip nose rhinoplasty is a challenging procedure because of the different presentation and severity of the deformity. Due to this presentation type, there is still no standard procedure correcting all the components of the deformity although a number of techniques have been published in literature. In this study, the effectiveness of the combination of open rhinoplasty and the Dibbel technique with nasal sill augmentation was evaluated. We hereby report our experience with 7 patients who had unilateral cleft lip nose deformity with slumped lower lateral cartilage and underprojected and deformed dome, operated on between September 2010 and April 2013 by 1 surgeon. The mean age of the patients at the time of surgery was 24.5 years (18-38 years) and the patients were followed up for an average of 18.5 months (6-31 months). All patients were operated on with open rhinoplasty and Dibbel technique combination with nasal sill augmentation. Frontal, lateral, oblique, and basilar photographs were obtained preoperatively and postoperatively for each patient. Nasal projection, columella height, nasolabial angle, nasal sill symmetry, and base width were measured on the photographs for comparison of preoperative and postoperative results. All patients' medial and lateral cantus distances were used for photographic standardization. The results demonstrated that there was a statistically significant increase in nasal projection (2.13 +/- 0.28mm preoperatively versus 2.31 +/- 0.08mm postoperatively; P = 0.018), columella height (1.07 +/- 0.25mm preoperatively versus 1.21 +/- 0.18mm postoperatively; P = 0.028), nostril apex height (1.11 +/- 0.15mm preoperatively versus 1.22 +/- 0.11mm postoperatively, P< 0.028), nasolabial angle (77.71 +/- 8.74mm preoperatively versus 91.33 +/- 6.49mm postoperatively; P< 0.05), and nasal sill symmetry (0.42 +/- 0.15mm preoperatively versus 0.27 +/- 0.07mm postoperatively; P< 0.05), and a significant decrease of alar width (2.35 +/- 0.44mm versus 2.16 +/- 0.32mm postoperatively; P = 0.018) on the affected side in response to surgery. The results of this study demonstrated that the Dibbel technique and open rhinoplasty combination with nasal sill augmentation is an effective and safe method for the correction of cleft lip nose deformity in respect to nasal symmetry.Öğe THE EFFECT OF ADIPOSE TISSUE STROMAL VASCULAR FRACTION COMBINED WITH PLATELET-RICH PLASMA ON IRRADIATION-INDUCED CAPSULAR CONTRACTURE AROUND SILICONE IMPLANTS(Medknow Publications & Media Pvt Ltd, 2014) Gundeslioglu, Ayse Ozlem; Inan, Irfan; Tezcan, Yilmaz; Toy, Hatice; Emlik, Dilek; Aktan, Murad; Duman, SelcukThe exact reason and pathogenesis of capsule formation around breast implant after cosmetic and reconstructive breast enhancement is still unclear. However, recent studies and clinical observations regarding the application of adipose-derived mesenchymal stem cells around implanted biomaterials have shown encouraging results. In this study, the effects of the adipose-derived stromal vascular fraction combined with platelet-rich plasma on capsule formation around silicone implants were investigated in irradiated rats. After implantation of silicones implants bilaterally on the rat dorsal area, both sides were irradiated with 10-Gy as single fraction electron beam irradiation. Following radiation, the mixture of stromal vascular fraction and platelet-rich plasma was injected to right sides of the animals. Left sides were injected with same amount of saline as a control. On day 30, capsule around the implants was evaluated in regarding the capsular thickness by ultrasonography, histopathology and immunohistochemical examination. The results demonstrated that there is no statistically significant difference between the treated and non-treated groups in ultrasonographic, histopathologic, and immunohistochemical evaluations. These preliminary results demonstrated that adipose-derived stem cells with platelet rich plasma do not have efficiency for integration of tissue and silicone implants and to reduce capsule formation and further studies are requiredÖğe TISSUE EXPANDER APPLICATIONS FOR EXTREMITIES(Medknow Publications & Media Pvt Ltd, 2013) Gundeslioglu, Ayse Ozlem; Ince, Bilsev; Dadaci, Mehmet; Inan, Irfan; Selimoglu, Muhammed Nebil; Toksoz, Mustafa Rasid; Ozen, Emine CigdemIntroduction: Tissue expanders have been frequently used in reconstructive surgery in order to obtain the necessary skin for the reconstruction of local or distant tissue defects because of their ability to form skin tissues of the same color, same sense and tissue quality with the defective field. Despite this fact, tissue expander applications for extremities have been shunned because of the high risk of complications. This study presents our approach to patients who had tissue expander applications for upper or lower extremities for various reasons, the technical details of the applications, and the results achieved from these patients alongside with literature. Material and Method: The data of a total of 15 patients who presented to our clinic between September 2010 and January 2013 and who had tissue expander applications for their extremities were retrospectively evaluated. The patients' data were evaluated regarding age, sex, etiological factor, the localization and size of the possible defect, the number, type, sizes, and volume of tissue expander applications, the size of the defect following excision, and complications. Results: 6 out of 15 patients covered by the study were male, while 9 were female. The mean age of the patients was 20.4 years (9-36). The tissue expander was applied to 11 fields for the upper extremities in 9 patients while it was applied to 8 fields for the lower extremities in 6 patients. 4 of the tissue expander applications for the upper extremities were applied for tattoo removal. The etiological reason for the lower extremities was traumatic scar or burn scar in all patients. The volumes of the used tissue expanders varied between 50 and 750 cc. The average expander volume was 168.3 cc (50-340 cc) for the upper extremities while it was 457.8 cc (60-750 cc) for the lower extremities. In 13 of 15 patients (86%) the expansion process was completed without any major complication. Conclusion: Although there is a widespread prejudice against tissue expander applications for extremities, it is possible to achieve successful results in cases where the appropriate implant was placed through the right technique and in cases where the expansion process was spread in time in mini volumes.Öğe Transfer of the Fifth Finger to Replace an Amputated Thumb: A Preliminary Study(Sage Publications Inc, 2015) Ince, Bilsev; Gundeslioglu, Ayse Ozlem; Cicekcibasi, Aynur Emine; Dadaci, Mehmet; Inan, Irfan; Buyukmumcu, MustafaAmputation of the thumb causes not only loss of significant functional use of the hand but also psychological and social problems. The procedures of toe-to-thumb transfer, pollicization, or metacarpal extension are recognized and well-documented options in thumb reconstruction. Although these techniques have been successfully applied, they have some disadvantages. This study aims to test the feasibility of the fifth finger for thumb reconstruction. The fifth finger was released following exploration of the digital artery, vein, nerve, and flexor and extensor tendons, including the flexor retinaculum. The digital vein and the extensor tendon of the fifth finger were separated at the level of the metacarpophalangeal joint. The proximal phalanx of the fifth finger was cut smoothly at the level of the metacarpophalangeal joint with a saw. The deep flexor tendons, digital arteries, and nerves were preserved. The proximal phalanx of the released fifth finger was fixed to the first metacarpal bone. The digital vein of the first finger was anastomosed to the digital vein of the fifth finger by microsurgery. Angiography was done after the transfer. Exploration till the flexor retinaculum enabled thumb transfer without any restriction of movement in all 10 cadaver fingers. The average total surgical time was 135 +/- 12 minutes. Flow from both radial and ulnar arteries was demonstrated in the transferred fifth finger by angiography. The technique appears to be feasible for thumb reconstruction by preserving digital arteries and nerves in a relatively short time, but further important aspects have to be assessed in further clinical studies.
