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    Central Pedicle Reduction in Gigantomastia Without Free Nipple Graft
    (LIPPINCOTT WILLIAMS & WILKINS, 2016) Karacor-Altuntas, Zeynep; Dadaci, Mehmet; Ince, Bilsev; Karamese, Mehtap; Savaci, Nedim
    Background Various pedicle techniques have been described in breast reduction surgery. However, in cases of massive hypertrophy, the free nipple graft technique is still being performed by some surgeons out of fear of losing the nipple-areolar complex (NAC). As such, we evaluated patients with severe gigantomastia who underwent the central pedicle horizontal scar reduction mammaplasty technique. Methods The records of 257 patients who underwent the central pedicle reduction technique were retrospectively reviewed. The demographic properties of the patients and the distances from the midclavicular point to the nipple were recorded. Patients whose distance from the midclavicular point to both nipple areolar complexes (NACs) was 38 cm or greater were included in this study. Resection weights and postoperative complications were evaluated. Results The distance from the midclavicular point to both NACs was 38 cm or greater in 53 patients (106 breasts). The age range of the patients was 17 to 73 years, and the mean body mass index was 39.6 kg/m(2). The range of distances from the midclavicular point to the nipple was 38 to 52 cm. The weight of the breast tissue excised ranged between 1450 and 2785 g. None of the patients experienced total nipple loss postoperatively, and all of the patients were satisfied with the aesthetic results. Conclusion We were able to reduce all of the breasts safely, without using the free nipple grafting technique, even in very large breasts. This study shows that the central pedicle horizontal scar reduction technique is a very safe and effective method for use in massive reductions. Therefore, we strongly recommend using the central pedicle reduction mammaplasty technique in cases of gigantomastia.
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    Craniofacial Implant-Retained Auricular Prosthesis: A Case Report
    (ALLEN PRESS INC, 2013) Dilber, Erhan; Koc, Ozlem; Ozturk, Atiye Nilgun; Karamese, Mehtap
    Implants provide patients with a safe and reliable method for anchoring auricular prostheses that enable restoration of their normal appearance and offer improved quality of life. In this case report, an auricular prosthesis was fabricated for a patient who had lost his right external ear in a traffic accident. Extraoral implants and bar-and-clip retention for the proper connection of the auricular prosthesis to the implant were used.
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    Intra-articular platelet-rich plasma injection for the treatment of temporomandibular disorders and a comparison with arthrocentesis
    (CHURCHILL LIVINGSTONE, 2015) Hanci, Mustafa; Karamese, Mehtap; Tosun, Zekeriya; Aktan, Tahsin Murad; Duman, Selcuk; Savaci, Nedim
    Background: Temporomandibular joint (TMJ) internal derangements are progressive painful conditions and cause joint dysfunction, joint sound, malocclusion, and locking of the mouth. Conservative and invasive techniques can be used for the treatment of TMJ internal derangements. The objective of the present study was to examine the benefit of an intra-articular platelet-rich plasma (PRP) injection and to compare this with arthrocentesis. Methods: Twenty patients (female: male; 15: 5; age 26, 3 +/- 9.3 years) for a total of 32 joints with reducible anterior disc dislocation, as confirmed by Magnetic Resonance Imaging (MRI), were divided into two groups. PRP was used for the study group, and arthrocentesis was used for the control group. Pain intensity, maximal interincisal opening, and TMJ sounds were assessed and compared for evaluation of treatment success. Results: There was a statistically significant reduction in pain intensity and joint sound and an increase in mouth opening in the study group when compared with the control group. Conclusions: This study shows that intra-articular PRP injection for the treatment of reducible disc displacement of the TMJ is a more effective method than arthrocentesis. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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    Management of temporomandibular joint ankylosis with temporalis fascia flap and fat graft
    (CHURCHILL LIVINGSTONE, 2013) Karamese, Mehtap; Duymaz, Ahmet; Seyhan, Nevra; Keskin, Mustafa; Tosun, Zekeriya
    Aim: Temporomandibular joint (TMJ) ankylosis is a serious problem that restricts jaw mobility and causes disturbances in facial and mandibular growth. The purpose of this paper is to present an easy and versatile method for the treatment of TMJ ankylosis to decrease postoperative complications such as re-ankylosis. Material and method: Eleven patients who presented with ankylosis of the TMJ underwent surgical release. After performing gap arthroplasty through a preauricular approach, the temporalis fascia flap was transposed to the gap. An autogenous fat graft was then obtained from the abdomen and used as interpositional material. The follow-up time was 3-5 years. Results: Re-ankylosis did not occur in any of the patients, and all had satisfactory mouth opening. Conclusion: Surgical treatment of TMJ ankylosis with gap arthroplasty, interposition of the temporalis fascia flap and fat grafting is an effective and easily procedure for preventing of re-ankylosis. The autogenous nature and close proximity to the joint are the main advantages of the temporalis fascia flap when compared with other interpositional materials, and the fat graft provides additional support by reducing pressure. (C) 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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    Reconstruction with galeal frontalis flap of depressed forehead region in progressive hemifacial atrophy
    (LIPPINCOTT WILLIAMS & WILKINS, 2008) Duymaz, Ahmet; Karabekmez, Furkan Erol; Tosun, Zekeriya; Keskin, Mustafa; Karamese, Mehtap; Savaci, Nedim
    Parry-Romberg syndrome is characterized by progressive hemifacial atrophy that is the lack of tissue (generally soft tissue and rarely bone and muscle) in the atrophic area of the face. The etiology and the incidence of this pathologic process are uncertain, but it is relatively rare and self-limited. The objective of this study is to present 21-year-old female patient with progressive hemifacial atriophy who was reconstructed with composite galeal frontalis flap. Although many reconstructive methods have been described, reconstruction of both eyebrow deficiency and forehead atrophy with composite galeal frontalis flap was not described before.
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    Scleral Perforation Complicating Titanium Mesh Plaque in Orbital Blowout Fracture
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) Koktekir, Bengu Ekinci; Bakbak, Berker; Karamese, Mehtap; Gedik, Sansal; Tosun, Zekeriya
    A 27-year-old man who underwent a previous reconstruction surgery for left orbital blowout fracture and recent revision surgery for left cicatricial ectropion was admitted to the ophthalmology outpatient clinic with a 20-mm irregular conjunctival and scleral incision in the left eye at the 6-o'clock position. The scleral and conjunctival incisions were repaired, and during the operation, the anterior end of the titanium mesh plate was visible at the inferior orbital rim. The plastic surgery team removed the irritating end of the plate. Obvious adherence of periocular tissues onto the titanium implant and fibrovascular ingrowth through the implant were seen during this operation. The possible mechanism for the misdirection of the anterior end of the implant might be explained by iatrogenic rotation during the revision of the cicatricial ectropion. To the best of our knowledge, this is the first reported case demonstrating scleral incision caused by an orbital titanium implant.