Maria Wiedner - Academia.edu (original) (raw)

Papers by Maria Wiedner

Springer eBooks, Dec 21, 2007

Phlebologie (Stuttgart), Feb 20, 2020

European Surgery-acta Chirurgica Austriaca, Apr 1, 2013

SummaryBackgroundIn the past decade, overweight and morbid obesity in Europe have come to be near... more SummaryBackgroundIn the past decade, overweight and morbid obesity in Europe have come to be nearly as common as in the United States. Fifty percent of the Austrian population is overweight, and nearly a quarter of that number is morbidly obese. In Germany and Austria, 8 % of children are morbidly obese. The costs for the treatment of this new epidemic and its consequences put considerable strain on health budgets that are already stretched to the limit. Hence, the main emphasis is on the treatment of those who are already ill, and on prevention. Treatment of obesity is a long-term proposition. The many comorbidities can be improved by weight reduction, whereby plastic surgery also plays a role. Bariatric surgery is the surgical option of treatment. But when that works, deformity due to obesity is replaced by disfiguring flaccid skin after weight loss. Body contouring with plastic surgery is the only way to correct this problem.MethodsPlastic surgery after massive weight loss must be planned on an individual basis. Preferably, even before a weight-reduction regime has begun, is the best time to discuss with the patient the corrections and total body concept. This will improve emotional stability, patient satisfaction, and has a positive effect on social reintegration at the end of treatment.ResultsFull-body contouring will usually require two or more very time consuming operations. The result correlates directly with initial body mass index. Complications are frequent but can often be managed with conservative measures. Many of them are a matter of shape. Patients should be made aware of possible corrections in advance. Complications after surgery are much more frequent with a BMI above 35.ConclusionsThe plastic surgeon concludes the weight-reduction program by removing the last traces of the original obesity.

Journal für Ästhetische Chirurgie, 2020

Die Behandlung der periorbitalen Region ist nach wie vor eine sehr anspruchsvolle Chirurgie. Nebe... more Die Behandlung der periorbitalen Region ist nach wie vor eine sehr anspruchsvolle Chirurgie. Neben der Operation selbst, spielt die richtige präoperative Diagnostik eine wichtige Rolle. Ein wichtiges Merkmal dabei ist die Unterscheidung zwischen positivem und negativem Vektor. Patienten mit einem negativen Vektor haben ein hohes Risiko, postoperativ eine Unterlidfehlstellung zu entwickeln. Aus diesem Grund sind wir dazu übergegangen, Patienten mit einem negativen Vektor und einem pathologischen Hertel-Wert routinemäßig nicht mit einer klassischen Unterlidkorrektur zu behandeln. Hier hat sich bei uns das subperiostale Midfacelift nach Hester als Standardverfahren durchgesetzt. Das wirksamste Mittel zur Behandlung von Tränensäcken bei negativem Vektor und Malar-Bags ist das subperiostale Midfacelift. Es verkürzt den Lid-Wangen-Abstand und verblendet die periorbitalen „retaining ligaments“. Außerdem verleiht es dem Unterlid Volumen und gibt einen stabilen Halt. Durch die Art des Verfahrens verwandelt es auch einen vorbestehenden negativen in einen neutralen oder sogar positiven Vektor. In erfahrenen Händen ist das Midfacelift das ideale Verfahren für die Behandlung von Malar-Bags und die ästhetische Korrektur der Unterlider bei negativem Vektor. Treatment of the periorbital region is still a very demanding surgical procedure. In addition to the operation itself the correct preoperative diagnostics play an important role. In this context an important feature is the differentiation between positive and negative vectors. Patients with a negative vector have a high risk of postoperatively developing a lower eyelid malposition. For this reason, patients with a negative vector and a pathological value with the Hertel exophthalmometer are no longer routinely treated with a classical lower eyelid correction. Instead the subperiosteal midface-lift according to Hester has become established as the standard procedure. The most effective means of treatment of lacrimal sacs with a negative vector and malar bags is a subperiosteal midface-lift. It reduces the eyelid-cheek distance and blends the periorbital retaining ligaments. Furthermore, it confers volume to the lower eyelid and provides a stable support. Due to the nature of the procedure a previously existing negative vector is transformed into a neutral or even positive vector. In experienced hands the midface-lift is the ideal procedure for treatment of malar bags and the aesthetic correction of lower eyelids with a negative vector.

Annals of burns and fire disasters, Jan 30, 2013

Split skin grafting is a widely used technique for reconstructing skin defects. Although a vast n... more Split skin grafting is a widely used technique for reconstructing skin defects. Although a vast number of different coverage options for donor sites have become available in daily clinical practice, no optimum dressing material has been found to date. For this reason, we conducted a globally-distributed online survey to poll for the properties of such an "ideal" donor site dressing, possibly leading to an improved clinically-driven direction of future wound dressing developments. A total of 69 respondents from 34 countries took part in the questionnaire, resulting in a response rate of 13.8% (69/500) over a 1-month period. The majority of respondents rated the characteristics of an "ideal" donor site dressing to be either "essential" or "desirable" as follows: lack of adhesion to the wound bed ("essential": 31/69, 44.9%; "desirable": 30/69, 43.5%); pain-free dressing changes ("essential": 38/69, 55.1%; "desir...

Journal für Ästhetische Chirurgie, 2020

Hintergrund Die Augen und Periorbitalregion spielen eine ausschlaggebende Rolle bei der Ausstrahl... more Hintergrund Die Augen und Periorbitalregion spielen eine ausschlaggebende Rolle bei der Ausstrahlung von Schönheit und Jugend. Die Oberlidblepharoplastik ist nicht zuletzt deswegen eine der häufigsten okuloplastischen Eingriffe weltweit. Fragestellung Vorgestellt werden Befunde der Periorbitalregion, die mehr als eine klassische Oberlidblepharoplastik erforderlich machen. Material und Methoden Die häufigen Altersveränderungen im Bereich der Oberlider werden anhand der speziellen Anatomie erläutert sowie volumenmodulierende Zusatzmaßnahmen bei der Oberlidblepharoplastik in ihren wesentlichen Schritten vorgestellt und an klinischen Beispielen demonstriert. Ergebnisse Als Folge des Alterungsprozesses kommt es zusätzlich zur Dermatochalasis häufig auch zu einer individuellen, periorbitalen Volumenveränderung und speziellen Befunden wie „lateral hooding“, vermehrtes ROOF-Fett („retroorbicularis oculi fat“) oder einer kompensierten Oberlidptosis. Die sog. A‑frame-Deformität kann physiologisch sein, aber ist nicht selten die Folge übermäßiger Fettresektion nach vorangegangener Lidplastik. Diese Befunde gilt es zu erkennen und bei der Oberlidblepharoplastik mithilfe von geeigneten Techniken zu korrigieren. Hierzu gehören ROOF-Fettresektionen, das Internal-brow-fixation-Verfahren, die Reposition des nasalen Fettpads und die Korrektur einer Oberlidptosis. Diskussion Eine umfassende Kenntnis der anatomischen Veränderungen infolge der Gesichtsalterung ist grundlegend, um bei der Oberlidblepharoplastik ein natürliches und jugendlicheres Ergebnis zu erzielen. Die wesentlichen Ziele sind die Wiederherstellung der Sichtbarkeit der Oberlidplatte, eine regelrechte Positionierung der Augenbrauen sowie Volumenerhalt bzw. -modulation. Die aufgeführten Maßnahmen können dabei für das spätere Resultat entscheidend sein. Background The eyes and periorbital region play a decisive role in the expression of beauty and youth. Not least because of this, upper eyelid blepharoplasty is one of the most frequent oculoplastic operations worldwide. Objective Volumetric aspects of the periorbital region, which require more than a classical upper eyelid blepharoplasty are presented. Material and methods The frequent age-related changes in the region of the upper eyelids are described based on the special anatomy and the essential stages of volume modulating additional measures during upper eyelid blepharoplasty are presented and demonstrated based on clinical examples. Results Due to the aging process individual periorbital volume changes and specific findings, such as lateral hooding, enlarged retro-orbicularis oculi fat (ROOF) and compensated upper eyelid ptosis can occur in addition to dermatochalasis. The so-called A‑frame deformity can be physiological but can also be a sequel to excessive fat resection after upper eyelid blepharoplasty. These changes should be identified and corrected during upper eyelid blepharoplasty using suitable techniques, such as ROOF resection, the internal brow fixation procedure, repositioning of the nasal fat pad and the correction of upper eyelid ptosis. Conclusion Comprehensive anatomic knowledge about facial aging is necessary to achieve a natural and more youthful looking result after upper eyelid blepharoplasty. The main goal is the restoration of upper eyelid visibility, a proper positioning of the eyebrows and the preservation or modulation of periorbital volume. The mentioned actions can be decisive for the later outcome.

Aesthetic Plastic Surgery

Background The COVID-19 pandemic has upended graduate medical education globally. We investigated... more Background The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic surgery residents across the world. Methods We administered an online survey capturing training inputs before and during the pandemic and retrieved residents’ expected learning outputs compared with residents who completed their training before COVID. The questionnaire reached residents across the world through the mobilization of national and international societies of plastic surgeons. Results The analysis included 412 plastic surgery residents from 47 countries. The results revealed a 44% decline (ranging from − 79 to 10% across countries) and an 18% decline (ranging from − 76 to across 151% countries) in surgeries and seminars, respectively, per week. Moreover, 74% (ranging from 0 to 100% across countries) and 43% (ranging from 0 to 100% across countries) of residents expected a negative COVID-19 impact ...

Aesthetic Plastic Surgery, 2022

Hintergrund: Verschiedene Ursachen können eine plastische Rekonstruktion des Skrotums und Penissc... more Hintergrund: Verschiedene Ursachen können eine plastische Rekonstruktion des Skrotums und Penisschafts erforderlich machen. Hierzu zählen foudroyant verlaufende Entzündungen (Abszesse, Fournier-Gangrän), traumatische Verletzungen, Fehlbildungen oder onkologische Folgen. Zur Defektdeckung[zum vollständigen Text gelangen Sie über die oben angegebene URL]

Einleitung: Die Mammareduktionplastik gilt als Goldstandard für die Therapie der symptomatischen ... more Einleitung: Die Mammareduktionplastik gilt als Goldstandard für die Therapie der symptomatischen Makromastie. In der Literatur werden Komplikationsraten nach Mammareduktion mit 40 bis 50 Prozent angegeben. Zu den Komplikationen zählen Blutungen, Serome, Infektionen, Wundheilungsstörungen,[zum vollständigen Text gelangen Sie über die oben angegebene URL]

The US FDA in the fourth quarter of 2017 reviewed and approved a request by one of the breast imp... more The US FDA in the fourth quarter of 2017 reviewed and approved a request by one of the breast implant manufacturers for a change in the Directions for Use (DFU) that removed warnings regarding the use of Betadine (Povidone-iodine, "PI"). Formerly, in 2000, there were concerns by the agency[for full text, please go to the a.m. URL]

Einleitung: Die Liposuktion stellt das Standardverfahren für die chirurgische Behandlung des Lipö... more Einleitung: Die Liposuktion stellt das Standardverfahren für die chirurgische Behandlung des Lipödems dar. Durch die heutzutage verwendete "wet" Technik ist die Komplikationsrate im Vergleich zur anfänglichen "dry" Technik weitaus geringer. Menge und Zusammensetzung[zum vollständigen Text gelangen Sie über die oben angegebene URL]

Plastic and Aesthetic Research, 2020

Lipedema is a frequently unrecognized and misdiagnosed disorder of the fatty tissue of extremitie... more Lipedema is a frequently unrecognized and misdiagnosed disorder of the fatty tissue of extremities and hips, which affects almost purely women. The beginning of the disease usually occurs with hormonal changes, such as puberty, pregnancy, or menopause. Women suffer from pain, easy bruising, and disfigurement, which may lead to early immobility and social stress. Accurate diagnosis and treatment are essential. The differentiation between obesity and lipedema is difficult, as these two different entities often occur together. Other differential diagnoses are lymphedema, benign lipohypertrophy, and Dercum's disease. A therapy targeting the underlying cause of lipedema is not available because the exact etiology of the disorder is not clarified yet. Decongestive physical therapy is the basic conservative treatment, which is usually necessary lifelong. However, liposuction has led to a paradigm shift in the treatment of lipedema. The purposes of this article are to describe the symptoms and treatment options of the still fairly unknown disease Lipedema and to show the distinctions to its differential diagnoses.

Fragestellung: Die Verwendung von kollagenen Matrices hat in den letzten Jahren nicht nur in der ... more Fragestellung: Die Verwendung von kollagenen Matrices hat in den letzten Jahren nicht nur in der rekonstruktiven und der Verbrennungschirurgie stark zugenommen, sondern auch in der ästhetischen Chirurgie immer mehr Einsatzgebiete gefunden. Parallel zu den Indikationen hat sich die Anzahl der unterschiedlichen[for full text, please go to the a.m. URL]

Einleitung: In Europa ist die Faltenbehandlung mit Botulinum Toxin Typ A die häufigste ästhetisch... more Einleitung: In Europa ist die Faltenbehandlung mit Botulinum Toxin Typ A die häufigste ästhetische, nicht invasive Behandlungsmethode, wobei diese Therapie in Österreich 20,3% aller kosmetischen Behandlungen ausmacht. Ziel dieser doppelblinden, randomisierten Studie war es, die d[for full text, please go to the a.m. URL]

Einleitung: Läsionen subkutaner Nerven treten nach phlebochirurgischen Eingriffen mit einer Inzid... more Einleitung: Läsionen subkutaner Nerven treten nach phlebochirurgischen Eingriffen mit einer Inzidenz von bis zu 40% auf. Auch über die Verletzung von Nervenstämmen wird immer wieder berichtet. Während die sensiblen Ausfälle nach Läsionen subkutaner Nerven funktione[for full text, please go to the a.m. URL]

European Surgery, 2013

SummaryBackgroundWith the increasing rate of obese people, the number of patients who again loose... more SummaryBackgroundWith the increasing rate of obese people, the number of patients who again loose massive weight correlates. These patients suffer from their extensive excess of skin and seek for body-contouring surgery. The most common plastic surgical procedures after massive weight loss are abdominoplasties and lower body lifts.MethodsIn our retrospective review from 2000 to 2010, we present data on patient demographics, operative procedures, early-somatic and late-formal complications, and revision surgeries.ResultsSomatic complications occurred in 45 abdominoplasty patients (18 %), surgical revision was necessary in 16 of these patients (7 %). In the lower body lift group, 14 patients (29 %) suffered from somatic complications and 8 (16 %) of them needed revision surgery. Deforming late complications were seen in 25 (10 %) of the abdominoplasty patients and in 1 (2 %) of the lower body lift patients. Revision surgery for formal complications was performed in 21 of the abdominoplasty patients (9 %) and in the 1 lower body lift patient. Sixty-eight additional body-contouring procedures were performed in the abdominoplasty group, 13 in the lower body lift group.ConclusionsWith the increasing number of massive weight loss patients, the need for body-contouring surgeries ascends. The larger amount of excess skin in these patients requires adapted operation methods. Therefore, lower body lift procedures are nowadays performed more often in relation to abdominoplasties alone. With the expansion of surgical treatment the rate of complications rise.

Obesity Surgery, 2015

As bariatric surgery becomes ever more popular, so does body-contouring surgery to eliminate exce... more As bariatric surgery becomes ever more popular, so does body-contouring surgery to eliminate excess skin after radical weight loss. To date, the literature has described a number of risk factors affecting the postoperative outcome. Our study aimed to define those factors more closely, focusing on abdominoplasty ("tummy tuck") patients who suffered intra- and postoperative complications. The study collective included 205 patients over 5 years (2001-2006) who underwent dermolipectomy at our department. The mean follow-up was 5.94 years. Every abdominoplasty was performed under general anesthesia with intraoperative one-dose antibiotic. The analysis included a complete review of all medical records. Statistical analysis was performed with the R-2.5.0 Software for Windows. The overall rate for major complications that required operative revision and/or antibiotics was 10.2 %, including 2.9 % cases of infections. Forty-one percent had minor complications, such as seromas, hematomas, wound healing problems, and wound dehiscences. The logistic regression models demonstrated that smoking combined with the age, a BMI higher than 30 kg/m(2), and the amount of removed tissue (measured in g) lead to significantly more wound healing problems in nearly all age groups. The probability of infections correlated with later drain removal. Regardless of the amount of tissue removed, no main risk factor for complications could be identified. A complication-free course and good outcome can be best achieved with careful patient selection and preoperative planning.

Einleitung: Bei den angeborenen Gefäßanomalien muss man prinzipiell Vaskuläre Tumore und Vaskulär... more Einleitung: Bei den angeborenen Gefäßanomalien muss man prinzipiell Vaskuläre Tumore und Vaskuläre Malformationen unterscheiden. Diese Unterscheidung ist für die Wahl der Therapie absolut entscheidend. Leider ist sie noch wenig bekannt und führt sowohl bei bildgebenden [for full text, please go to the a.m. URL]

Supplemental material, supplement_material for Helpful, albeit hazardous! Esophageal stem-cell in... more Supplemental material, supplement_material for Helpful, albeit hazardous! Esophageal stem-cell injection in systemic sclerosis by Franziska Durchschein, Florentine Moazedi-Fuerst, Sonja Kielhauser, Angelika Lackner, Maria Wiedner, Horst Koch, Ivo Justich and Andreas Eherer in Therapeutic Advances in Musculoskeletal Disease

Springer eBooks, Dec 21, 2007

Phlebologie (Stuttgart), Feb 20, 2020

European Surgery-acta Chirurgica Austriaca, Apr 1, 2013

SummaryBackgroundIn the past decade, overweight and morbid obesity in Europe have come to be near... more SummaryBackgroundIn the past decade, overweight and morbid obesity in Europe have come to be nearly as common as in the United States. Fifty percent of the Austrian population is overweight, and nearly a quarter of that number is morbidly obese. In Germany and Austria, 8 % of children are morbidly obese. The costs for the treatment of this new epidemic and its consequences put considerable strain on health budgets that are already stretched to the limit. Hence, the main emphasis is on the treatment of those who are already ill, and on prevention. Treatment of obesity is a long-term proposition. The many comorbidities can be improved by weight reduction, whereby plastic surgery also plays a role. Bariatric surgery is the surgical option of treatment. But when that works, deformity due to obesity is replaced by disfiguring flaccid skin after weight loss. Body contouring with plastic surgery is the only way to correct this problem.MethodsPlastic surgery after massive weight loss must be planned on an individual basis. Preferably, even before a weight-reduction regime has begun, is the best time to discuss with the patient the corrections and total body concept. This will improve emotional stability, patient satisfaction, and has a positive effect on social reintegration at the end of treatment.ResultsFull-body contouring will usually require two or more very time consuming operations. The result correlates directly with initial body mass index. Complications are frequent but can often be managed with conservative measures. Many of them are a matter of shape. Patients should be made aware of possible corrections in advance. Complications after surgery are much more frequent with a BMI above 35.ConclusionsThe plastic surgeon concludes the weight-reduction program by removing the last traces of the original obesity.

Journal für Ästhetische Chirurgie, 2020

Die Behandlung der periorbitalen Region ist nach wie vor eine sehr anspruchsvolle Chirurgie. Nebe... more Die Behandlung der periorbitalen Region ist nach wie vor eine sehr anspruchsvolle Chirurgie. Neben der Operation selbst, spielt die richtige präoperative Diagnostik eine wichtige Rolle. Ein wichtiges Merkmal dabei ist die Unterscheidung zwischen positivem und negativem Vektor. Patienten mit einem negativen Vektor haben ein hohes Risiko, postoperativ eine Unterlidfehlstellung zu entwickeln. Aus diesem Grund sind wir dazu übergegangen, Patienten mit einem negativen Vektor und einem pathologischen Hertel-Wert routinemäßig nicht mit einer klassischen Unterlidkorrektur zu behandeln. Hier hat sich bei uns das subperiostale Midfacelift nach Hester als Standardverfahren durchgesetzt. Das wirksamste Mittel zur Behandlung von Tränensäcken bei negativem Vektor und Malar-Bags ist das subperiostale Midfacelift. Es verkürzt den Lid-Wangen-Abstand und verblendet die periorbitalen „retaining ligaments“. Außerdem verleiht es dem Unterlid Volumen und gibt einen stabilen Halt. Durch die Art des Verfahrens verwandelt es auch einen vorbestehenden negativen in einen neutralen oder sogar positiven Vektor. In erfahrenen Händen ist das Midfacelift das ideale Verfahren für die Behandlung von Malar-Bags und die ästhetische Korrektur der Unterlider bei negativem Vektor. Treatment of the periorbital region is still a very demanding surgical procedure. In addition to the operation itself the correct preoperative diagnostics play an important role. In this context an important feature is the differentiation between positive and negative vectors. Patients with a negative vector have a high risk of postoperatively developing a lower eyelid malposition. For this reason, patients with a negative vector and a pathological value with the Hertel exophthalmometer are no longer routinely treated with a classical lower eyelid correction. Instead the subperiosteal midface-lift according to Hester has become established as the standard procedure. The most effective means of treatment of lacrimal sacs with a negative vector and malar bags is a subperiosteal midface-lift. It reduces the eyelid-cheek distance and blends the periorbital retaining ligaments. Furthermore, it confers volume to the lower eyelid and provides a stable support. Due to the nature of the procedure a previously existing negative vector is transformed into a neutral or even positive vector. In experienced hands the midface-lift is the ideal procedure for treatment of malar bags and the aesthetic correction of lower eyelids with a negative vector.

Annals of burns and fire disasters, Jan 30, 2013

Split skin grafting is a widely used technique for reconstructing skin defects. Although a vast n... more Split skin grafting is a widely used technique for reconstructing skin defects. Although a vast number of different coverage options for donor sites have become available in daily clinical practice, no optimum dressing material has been found to date. For this reason, we conducted a globally-distributed online survey to poll for the properties of such an "ideal" donor site dressing, possibly leading to an improved clinically-driven direction of future wound dressing developments. A total of 69 respondents from 34 countries took part in the questionnaire, resulting in a response rate of 13.8% (69/500) over a 1-month period. The majority of respondents rated the characteristics of an "ideal" donor site dressing to be either "essential" or "desirable" as follows: lack of adhesion to the wound bed ("essential": 31/69, 44.9%; "desirable": 30/69, 43.5%); pain-free dressing changes ("essential": 38/69, 55.1%; "desir...

Journal für Ästhetische Chirurgie, 2020

Hintergrund Die Augen und Periorbitalregion spielen eine ausschlaggebende Rolle bei der Ausstrahl... more Hintergrund Die Augen und Periorbitalregion spielen eine ausschlaggebende Rolle bei der Ausstrahlung von Schönheit und Jugend. Die Oberlidblepharoplastik ist nicht zuletzt deswegen eine der häufigsten okuloplastischen Eingriffe weltweit. Fragestellung Vorgestellt werden Befunde der Periorbitalregion, die mehr als eine klassische Oberlidblepharoplastik erforderlich machen. Material und Methoden Die häufigen Altersveränderungen im Bereich der Oberlider werden anhand der speziellen Anatomie erläutert sowie volumenmodulierende Zusatzmaßnahmen bei der Oberlidblepharoplastik in ihren wesentlichen Schritten vorgestellt und an klinischen Beispielen demonstriert. Ergebnisse Als Folge des Alterungsprozesses kommt es zusätzlich zur Dermatochalasis häufig auch zu einer individuellen, periorbitalen Volumenveränderung und speziellen Befunden wie „lateral hooding“, vermehrtes ROOF-Fett („retroorbicularis oculi fat“) oder einer kompensierten Oberlidptosis. Die sog. A‑frame-Deformität kann physiologisch sein, aber ist nicht selten die Folge übermäßiger Fettresektion nach vorangegangener Lidplastik. Diese Befunde gilt es zu erkennen und bei der Oberlidblepharoplastik mithilfe von geeigneten Techniken zu korrigieren. Hierzu gehören ROOF-Fettresektionen, das Internal-brow-fixation-Verfahren, die Reposition des nasalen Fettpads und die Korrektur einer Oberlidptosis. Diskussion Eine umfassende Kenntnis der anatomischen Veränderungen infolge der Gesichtsalterung ist grundlegend, um bei der Oberlidblepharoplastik ein natürliches und jugendlicheres Ergebnis zu erzielen. Die wesentlichen Ziele sind die Wiederherstellung der Sichtbarkeit der Oberlidplatte, eine regelrechte Positionierung der Augenbrauen sowie Volumenerhalt bzw. -modulation. Die aufgeführten Maßnahmen können dabei für das spätere Resultat entscheidend sein. Background The eyes and periorbital region play a decisive role in the expression of beauty and youth. Not least because of this, upper eyelid blepharoplasty is one of the most frequent oculoplastic operations worldwide. Objective Volumetric aspects of the periorbital region, which require more than a classical upper eyelid blepharoplasty are presented. Material and methods The frequent age-related changes in the region of the upper eyelids are described based on the special anatomy and the essential stages of volume modulating additional measures during upper eyelid blepharoplasty are presented and demonstrated based on clinical examples. Results Due to the aging process individual periorbital volume changes and specific findings, such as lateral hooding, enlarged retro-orbicularis oculi fat (ROOF) and compensated upper eyelid ptosis can occur in addition to dermatochalasis. The so-called A‑frame deformity can be physiological but can also be a sequel to excessive fat resection after upper eyelid blepharoplasty. These changes should be identified and corrected during upper eyelid blepharoplasty using suitable techniques, such as ROOF resection, the internal brow fixation procedure, repositioning of the nasal fat pad and the correction of upper eyelid ptosis. Conclusion Comprehensive anatomic knowledge about facial aging is necessary to achieve a natural and more youthful looking result after upper eyelid blepharoplasty. The main goal is the restoration of upper eyelid visibility, a proper positioning of the eyebrows and the preservation or modulation of periorbital volume. The mentioned actions can be decisive for the later outcome.

Aesthetic Plastic Surgery

Background The COVID-19 pandemic has upended graduate medical education globally. We investigated... more Background The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic surgery residents across the world. Methods We administered an online survey capturing training inputs before and during the pandemic and retrieved residents’ expected learning outputs compared with residents who completed their training before COVID. The questionnaire reached residents across the world through the mobilization of national and international societies of plastic surgeons. Results The analysis included 412 plastic surgery residents from 47 countries. The results revealed a 44% decline (ranging from − 79 to 10% across countries) and an 18% decline (ranging from − 76 to across 151% countries) in surgeries and seminars, respectively, per week. Moreover, 74% (ranging from 0 to 100% across countries) and 43% (ranging from 0 to 100% across countries) of residents expected a negative COVID-19 impact ...

Aesthetic Plastic Surgery, 2022

Hintergrund: Verschiedene Ursachen können eine plastische Rekonstruktion des Skrotums und Penissc... more Hintergrund: Verschiedene Ursachen können eine plastische Rekonstruktion des Skrotums und Penisschafts erforderlich machen. Hierzu zählen foudroyant verlaufende Entzündungen (Abszesse, Fournier-Gangrän), traumatische Verletzungen, Fehlbildungen oder onkologische Folgen. Zur Defektdeckung[zum vollständigen Text gelangen Sie über die oben angegebene URL]

Einleitung: Die Mammareduktionplastik gilt als Goldstandard für die Therapie der symptomatischen ... more Einleitung: Die Mammareduktionplastik gilt als Goldstandard für die Therapie der symptomatischen Makromastie. In der Literatur werden Komplikationsraten nach Mammareduktion mit 40 bis 50 Prozent angegeben. Zu den Komplikationen zählen Blutungen, Serome, Infektionen, Wundheilungsstörungen,[zum vollständigen Text gelangen Sie über die oben angegebene URL]

The US FDA in the fourth quarter of 2017 reviewed and approved a request by one of the breast imp... more The US FDA in the fourth quarter of 2017 reviewed and approved a request by one of the breast implant manufacturers for a change in the Directions for Use (DFU) that removed warnings regarding the use of Betadine (Povidone-iodine, "PI"). Formerly, in 2000, there were concerns by the agency[for full text, please go to the a.m. URL]

Einleitung: Die Liposuktion stellt das Standardverfahren für die chirurgische Behandlung des Lipö... more Einleitung: Die Liposuktion stellt das Standardverfahren für die chirurgische Behandlung des Lipödems dar. Durch die heutzutage verwendete "wet" Technik ist die Komplikationsrate im Vergleich zur anfänglichen "dry" Technik weitaus geringer. Menge und Zusammensetzung[zum vollständigen Text gelangen Sie über die oben angegebene URL]

Plastic and Aesthetic Research, 2020

Lipedema is a frequently unrecognized and misdiagnosed disorder of the fatty tissue of extremitie... more Lipedema is a frequently unrecognized and misdiagnosed disorder of the fatty tissue of extremities and hips, which affects almost purely women. The beginning of the disease usually occurs with hormonal changes, such as puberty, pregnancy, or menopause. Women suffer from pain, easy bruising, and disfigurement, which may lead to early immobility and social stress. Accurate diagnosis and treatment are essential. The differentiation between obesity and lipedema is difficult, as these two different entities often occur together. Other differential diagnoses are lymphedema, benign lipohypertrophy, and Dercum's disease. A therapy targeting the underlying cause of lipedema is not available because the exact etiology of the disorder is not clarified yet. Decongestive physical therapy is the basic conservative treatment, which is usually necessary lifelong. However, liposuction has led to a paradigm shift in the treatment of lipedema. The purposes of this article are to describe the symptoms and treatment options of the still fairly unknown disease Lipedema and to show the distinctions to its differential diagnoses.

Fragestellung: Die Verwendung von kollagenen Matrices hat in den letzten Jahren nicht nur in der ... more Fragestellung: Die Verwendung von kollagenen Matrices hat in den letzten Jahren nicht nur in der rekonstruktiven und der Verbrennungschirurgie stark zugenommen, sondern auch in der ästhetischen Chirurgie immer mehr Einsatzgebiete gefunden. Parallel zu den Indikationen hat sich die Anzahl der unterschiedlichen[for full text, please go to the a.m. URL]

Einleitung: In Europa ist die Faltenbehandlung mit Botulinum Toxin Typ A die häufigste ästhetisch... more Einleitung: In Europa ist die Faltenbehandlung mit Botulinum Toxin Typ A die häufigste ästhetische, nicht invasive Behandlungsmethode, wobei diese Therapie in Österreich 20,3% aller kosmetischen Behandlungen ausmacht. Ziel dieser doppelblinden, randomisierten Studie war es, die d[for full text, please go to the a.m. URL]

Einleitung: Läsionen subkutaner Nerven treten nach phlebochirurgischen Eingriffen mit einer Inzid... more Einleitung: Läsionen subkutaner Nerven treten nach phlebochirurgischen Eingriffen mit einer Inzidenz von bis zu 40% auf. Auch über die Verletzung von Nervenstämmen wird immer wieder berichtet. Während die sensiblen Ausfälle nach Läsionen subkutaner Nerven funktione[for full text, please go to the a.m. URL]

European Surgery, 2013

SummaryBackgroundWith the increasing rate of obese people, the number of patients who again loose... more SummaryBackgroundWith the increasing rate of obese people, the number of patients who again loose massive weight correlates. These patients suffer from their extensive excess of skin and seek for body-contouring surgery. The most common plastic surgical procedures after massive weight loss are abdominoplasties and lower body lifts.MethodsIn our retrospective review from 2000 to 2010, we present data on patient demographics, operative procedures, early-somatic and late-formal complications, and revision surgeries.ResultsSomatic complications occurred in 45 abdominoplasty patients (18 %), surgical revision was necessary in 16 of these patients (7 %). In the lower body lift group, 14 patients (29 %) suffered from somatic complications and 8 (16 %) of them needed revision surgery. Deforming late complications were seen in 25 (10 %) of the abdominoplasty patients and in 1 (2 %) of the lower body lift patients. Revision surgery for formal complications was performed in 21 of the abdominoplasty patients (9 %) and in the 1 lower body lift patient. Sixty-eight additional body-contouring procedures were performed in the abdominoplasty group, 13 in the lower body lift group.ConclusionsWith the increasing number of massive weight loss patients, the need for body-contouring surgeries ascends. The larger amount of excess skin in these patients requires adapted operation methods. Therefore, lower body lift procedures are nowadays performed more often in relation to abdominoplasties alone. With the expansion of surgical treatment the rate of complications rise.

Obesity Surgery, 2015

As bariatric surgery becomes ever more popular, so does body-contouring surgery to eliminate exce... more As bariatric surgery becomes ever more popular, so does body-contouring surgery to eliminate excess skin after radical weight loss. To date, the literature has described a number of risk factors affecting the postoperative outcome. Our study aimed to define those factors more closely, focusing on abdominoplasty ("tummy tuck") patients who suffered intra- and postoperative complications. The study collective included 205 patients over 5 years (2001-2006) who underwent dermolipectomy at our department. The mean follow-up was 5.94 years. Every abdominoplasty was performed under general anesthesia with intraoperative one-dose antibiotic. The analysis included a complete review of all medical records. Statistical analysis was performed with the R-2.5.0 Software for Windows. The overall rate for major complications that required operative revision and/or antibiotics was 10.2 %, including 2.9 % cases of infections. Forty-one percent had minor complications, such as seromas, hematomas, wound healing problems, and wound dehiscences. The logistic regression models demonstrated that smoking combined with the age, a BMI higher than 30 kg/m(2), and the amount of removed tissue (measured in g) lead to significantly more wound healing problems in nearly all age groups. The probability of infections correlated with later drain removal. Regardless of the amount of tissue removed, no main risk factor for complications could be identified. A complication-free course and good outcome can be best achieved with careful patient selection and preoperative planning.

Einleitung: Bei den angeborenen Gefäßanomalien muss man prinzipiell Vaskuläre Tumore und Vaskulär... more Einleitung: Bei den angeborenen Gefäßanomalien muss man prinzipiell Vaskuläre Tumore und Vaskuläre Malformationen unterscheiden. Diese Unterscheidung ist für die Wahl der Therapie absolut entscheidend. Leider ist sie noch wenig bekannt und führt sowohl bei bildgebenden [for full text, please go to the a.m. URL]

Supplemental material, supplement_material for Helpful, albeit hazardous! Esophageal stem-cell in... more Supplemental material, supplement_material for Helpful, albeit hazardous! Esophageal stem-cell injection in systemic sclerosis by Franziska Durchschein, Florentine Moazedi-Fuerst, Sonja Kielhauser, Angelika Lackner, Maria Wiedner, Horst Koch, Ivo Justich and Andreas Eherer in Therapeutic Advances in Musculoskeletal Disease