Plastics Cases Misc

Question 1

What is abdominoplasty?

Answer 1

• Excision of infra-umbilical skin and fat via elliptical or W shaped incisions
• Undermining to the level of the costal margin
• Closure of upper to lower skin flaps, with reinsertion of umbilicus
• Often combined with plication of anterior rectus sheath to correct rectus diastasis

Question 2

How is umbilicus blood supply maintained in abdominoplasty?

Answer 2

Its blood supply is maintained by a pedicle from the rectus sheath

Question 3

When is abdominoplasty performed?

Answer 3

-Cosmetic e.g. address post partum skin excess, post massive weight loss

Question 4

What are the potential complications of abdominoplasty?

Answer 4

EARLY:

• DVT/PE
• Wound infection
• Wound dehiscence
• Skin necrosis (esp smokers)
• Haematoma
• Seroma
• Umbilical necrosis

LATE:

• scarring
• altered sensation
• revisional surgery to dog ears

Question 5

What is BCC and how does it behave?

Answer 5

Malignant tumour comprised of cells from the basal layer of skin. Usu slow growing and locally invasive but without tendency to met.

• Commonest malignant skin tumour in white races
• face at greater risk than other sun exposed areas

Question 6

What causes BCC?

Answer 6

• sunlight exposure and ionising radiation
• burn and vax scars
• arsenicals
• immunosuppression
• genetic predisposition
• malignant change in sebaceous naevi and other adnexal hamartomas

Question 7

How do BCCs present?

Answer 7

• Pink, pearly nodules with surface telangiectasia

- may be ulcerated, encrusted, pigmented

Question 8

What is Gorlin’s syndrome?

Answer 8

Alzheimer’s disease inheritance, multiple BCCs, palmar pits, jaw and sebaceous cysts, rib and vert abN, dural calcification.

Question 9

How are BCCs treated?

Answer 9

Surgical cure following excision with 2-5mm margins
30% incompletely excised tumours recur
-radiotherapy, cryosurgery and curettage prone to recurrence