Michael Miroshnik - Academia.edu (original) (raw)
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Papers by Michael Miroshnik
Eplasty, 2012
Objective: The aim of this surgical procedure was to definitively correct severe recurrent upper ... more Objective: The aim of this surgical procedure was to definitively correct severe recurrent upper and lower bilateral eyelid ectropion after 2 attempts with full-thickness skin grafts. It was necessary to repair all 4 eyelids with forehead skin. Middle lamella support was required. Methods: Bilateral median forehead flaps, which were well vascularized by the supratrochlear vessels, were chosen for this procedure to utilize the readily available forehead tissue. The median forehead flap can be easily positioned to cover the entire eyelid. Furthermore, the flap could be split in half, without the risk of vascular compromise. Middle lamella support was provided with a cartilage graft from the nasal septum. Results: At 4 months, the patient no longer suffered from exposure keratopathy and both forehead flaps had healed well. At 12 months, the functional and cosmetic outcomes of this procedure were acceptable. Conclusions: This method of surgery can be effective in the young, in whom the ...
Post-pregnancy physical changes to the body seem to affect some women more harshly than others an... more Post-pregnancy physical changes to the body seem to affect some women more harshly than others and certain body parts are particularly susceptible to change following the stresses endured during the gravid state. The abdominal area and breasts, as they are directly involved in the process, usually experience the most obvious changes. Other secondary areas however, such as the arms, buttocks, thighs, labia minora and lower legs are often also adversely affected due to the weight and hormone fluctuations that occur. Moreover, changes within the skin itself are frequently found by most mothers. Features such as cellulite, stretch marks (striae) and skin thinning may occur; again being reflective of the major physical and hormonal changes that a woman has undergone during her pregnancy period.
With the promise of minimal side effects, virtually no downtime, quick, minimally uncomfortable p... more With the promise of minimal side effects, virtually no downtime, quick, minimally uncomfortable procedural times and reasonable costs, it's little wonder a steadily growing proportion of the population are considering the procedures.
BACKGROUND Previous aesthetic breast surgery algorithms have not addressed the importance of eval... more BACKGROUND Previous aesthetic breast surgery algorithms have not addressed the importance of evaluating the native inframammary fold before primary breast augmentation. In the authors' experience, assessment of native inframammary fold anatomy significantly impacts surgical planning and technique. Failure to adequately evaluate and manage the inframammary fold leads to many of the common problems of the lower pole, including double-bubble deformity. METHODS The authors assessed the inframammary fold preoperatively in 2192 consecutive patients undergoing primary breast augmentation between June of 2014 and December of 2018. A novel classification of inframammary fold morphology was devised based on review of standardized preoperative photographs. Outcome assessment was performed postoperatively at 3-month intervals. RESULTS The authors identified four clear inframammary fold subtypes based on their clinical appearance, ranging from the nonexistent type F0 to the well-formed and f...
Plastic and Reconstructive Surgery - Global Open
Eplasty, 2012
The aim of this surgical procedure was to definitively correct severe recurrent upper and lower b... more The aim of this surgical procedure was to definitively correct severe recurrent upper and lower bilateral eyelid ectropion after 2 attempts with full-thickness skin grafts. It was necessary to repair all 4 eyelids with forehead skin. Middle lamella support was required. Bilateral median forehead flaps, which were well vascularized by the supratrochlear vessels, were chosen for this procedure to utilize the readily available forehead tissue. The median forehead flap can be easily positioned to cover the entire eyelid. Furthermore, the flap could be split in half, without the risk of vascular compromise. Middle lamella support was provided with a cartilage graft from the nasal septum. At 4 months, the patient no longer suffered from exposure keratopathy and both forehead flaps had healed well. At 12 months, the functional and cosmetic outcomes of this procedure were acceptable. This method of surgery can be effective in the young, in whom the Mustarde cheek advancement fails, or when ...
Plastic and reconstructive surgery. Global open, 2013
Background : Laparoscopic cholecystectomy was introduced into Australia in early 1990. Its rapid ... more Background : Laparoscopic cholecystectomy was introduced into Australia in early 1990. Its rapid increase in acceptance was, however, tempered by reports of an increased incidence of bile duct injury. The aim of this study was to report on the incidence of biliary tract injuries in a single unit, comment on the way they were managed and look at strategies to prevent them. Methods : A retrospective audit was conducted on laparoscopic cholecystectomies performed between January 1992 and March 2001. The data was collated from patient medical record files and yielded a total of 1216 procedures. Results : There were 899 women (74%) and 317 men (26%), with an age range of 13-92 years. Most of the procedures were performed on an elective (94%) rather than emergent basis (6%). There was one bile duct injury (0.09%) and seven bile leaks (0.63%). The single injury involved common bile duct obstruction by a misplaced clip and was successfully managed by cholangio-enteric bypass. Of the seven bile leaks, three were from the cystic duct stump, two from the gallbladder bed, and two were unidentified, settling conservatively. Of the five patients actively treated, two underwent therapeutic laparoscopy, two proceeded to laparotomy, and one was managed successfully by endoscopic stenting. Conclusions : Single-centre studies such as this are important in ensuring that standards of surgery are maintained in a community setting.
ANZ Journal of Surgery, 2002
Background : Laparoscopic cholecystectomy was introduced into Australia in early 1990. Its rapid ... more Background : Laparoscopic cholecystectomy was introduced into Australia in early 1990. Its rapid increase in acceptance was, however, tempered by reports of an increased incidence of bile duct injury. The aim of this study was to report on the incidence of biliary tract injuries in a single unit, comment on the way they were managed and look at strategies to prevent them. Methods : A retrospective audit was conducted on laparoscopic cholecystectomies performed between January 1992 and March 2001. The data was collated from patient medical record files and yielded a total of 1216 procedures. Results : There were 899 women (74%) and 317 men (26%), with an age range of 13-92 years. Most of the procedures were performed on an elective (94%) rather than emergent basis (6%). There was one bile duct injury (0.09%) and seven bile leaks (0.63%). The single injury involved common bile duct obstruction by a misplaced clip and was successfully managed by cholangio-enteric bypass. Of the seven bile leaks, three were from the cystic duct stump, two from the gallbladder bed, and two were unidentified, settling conservatively. Of the five patients actively treated, two underwent therapeutic laparoscopy, two proceeded to laparotomy, and one was managed successfully by endoscopic stenting. Conclusions : Single-centre studies such as this are important in ensuring that standards of surgery are maintained in a community setting.
Eplasty, 2012
The aim of this surgical procedure was to definitively correct severe recurrent upper and lower b... more The aim of this surgical procedure was to definitively correct severe recurrent upper and lower bilateral eyelid ectropion after 2 attempts with full-thickness skin grafts. It was necessary to repair all 4 eyelids with forehead skin. Middle lamella support was required. Bilateral median forehead flaps, which were well vascularized by the supratrochlear vessels, were chosen for this procedure to utilize the readily available forehead tissue. The median forehead flap can be easily positioned to cover the entire eyelid. Furthermore, the flap could be split in half, without the risk of vascular compromise. Middle lamella support was provided with a cartilage graft from the nasal septum. At 4 months, the patient no longer suffered from exposure keratopathy and both forehead flaps had healed well. At 12 months, the functional and cosmetic outcomes of this procedure were acceptable. This method of surgery can be effective in the young, in whom the Mustarde cheek advancement fails, or when ...
Eplasty, 2012
Objective: The aim of this surgical procedure was to definitively correct severe recurrent upper ... more Objective: The aim of this surgical procedure was to definitively correct severe recurrent upper and lower bilateral eyelid ectropion after 2 attempts with full-thickness skin grafts. It was necessary to repair all 4 eyelids with forehead skin. Middle lamella support was required. Methods: Bilateral median forehead flaps, which were well vascularized by the supratrochlear vessels, were chosen for this procedure to utilize the readily available forehead tissue. The median forehead flap can be easily positioned to cover the entire eyelid. Furthermore, the flap could be split in half, without the risk of vascular compromise. Middle lamella support was provided with a cartilage graft from the nasal septum. Results: At 4 months, the patient no longer suffered from exposure keratopathy and both forehead flaps had healed well. At 12 months, the functional and cosmetic outcomes of this procedure were acceptable. Conclusions: This method of surgery can be effective in the young, in whom the ...
Post-pregnancy physical changes to the body seem to affect some women more harshly than others an... more Post-pregnancy physical changes to the body seem to affect some women more harshly than others and certain body parts are particularly susceptible to change following the stresses endured during the gravid state. The abdominal area and breasts, as they are directly involved in the process, usually experience the most obvious changes. Other secondary areas however, such as the arms, buttocks, thighs, labia minora and lower legs are often also adversely affected due to the weight and hormone fluctuations that occur. Moreover, changes within the skin itself are frequently found by most mothers. Features such as cellulite, stretch marks (striae) and skin thinning may occur; again being reflective of the major physical and hormonal changes that a woman has undergone during her pregnancy period.
With the promise of minimal side effects, virtually no downtime, quick, minimally uncomfortable p... more With the promise of minimal side effects, virtually no downtime, quick, minimally uncomfortable procedural times and reasonable costs, it's little wonder a steadily growing proportion of the population are considering the procedures.
BACKGROUND Previous aesthetic breast surgery algorithms have not addressed the importance of eval... more BACKGROUND Previous aesthetic breast surgery algorithms have not addressed the importance of evaluating the native inframammary fold before primary breast augmentation. In the authors' experience, assessment of native inframammary fold anatomy significantly impacts surgical planning and technique. Failure to adequately evaluate and manage the inframammary fold leads to many of the common problems of the lower pole, including double-bubble deformity. METHODS The authors assessed the inframammary fold preoperatively in 2192 consecutive patients undergoing primary breast augmentation between June of 2014 and December of 2018. A novel classification of inframammary fold morphology was devised based on review of standardized preoperative photographs. Outcome assessment was performed postoperatively at 3-month intervals. RESULTS The authors identified four clear inframammary fold subtypes based on their clinical appearance, ranging from the nonexistent type F0 to the well-formed and f...
Plastic and Reconstructive Surgery - Global Open
Eplasty, 2012
The aim of this surgical procedure was to definitively correct severe recurrent upper and lower b... more The aim of this surgical procedure was to definitively correct severe recurrent upper and lower bilateral eyelid ectropion after 2 attempts with full-thickness skin grafts. It was necessary to repair all 4 eyelids with forehead skin. Middle lamella support was required. Bilateral median forehead flaps, which were well vascularized by the supratrochlear vessels, were chosen for this procedure to utilize the readily available forehead tissue. The median forehead flap can be easily positioned to cover the entire eyelid. Furthermore, the flap could be split in half, without the risk of vascular compromise. Middle lamella support was provided with a cartilage graft from the nasal septum. At 4 months, the patient no longer suffered from exposure keratopathy and both forehead flaps had healed well. At 12 months, the functional and cosmetic outcomes of this procedure were acceptable. This method of surgery can be effective in the young, in whom the Mustarde cheek advancement fails, or when ...
Plastic and reconstructive surgery. Global open, 2013
Background : Laparoscopic cholecystectomy was introduced into Australia in early 1990. Its rapid ... more Background : Laparoscopic cholecystectomy was introduced into Australia in early 1990. Its rapid increase in acceptance was, however, tempered by reports of an increased incidence of bile duct injury. The aim of this study was to report on the incidence of biliary tract injuries in a single unit, comment on the way they were managed and look at strategies to prevent them. Methods : A retrospective audit was conducted on laparoscopic cholecystectomies performed between January 1992 and March 2001. The data was collated from patient medical record files and yielded a total of 1216 procedures. Results : There were 899 women (74%) and 317 men (26%), with an age range of 13-92 years. Most of the procedures were performed on an elective (94%) rather than emergent basis (6%). There was one bile duct injury (0.09%) and seven bile leaks (0.63%). The single injury involved common bile duct obstruction by a misplaced clip and was successfully managed by cholangio-enteric bypass. Of the seven bile leaks, three were from the cystic duct stump, two from the gallbladder bed, and two were unidentified, settling conservatively. Of the five patients actively treated, two underwent therapeutic laparoscopy, two proceeded to laparotomy, and one was managed successfully by endoscopic stenting. Conclusions : Single-centre studies such as this are important in ensuring that standards of surgery are maintained in a community setting.
ANZ Journal of Surgery, 2002
Background : Laparoscopic cholecystectomy was introduced into Australia in early 1990. Its rapid ... more Background : Laparoscopic cholecystectomy was introduced into Australia in early 1990. Its rapid increase in acceptance was, however, tempered by reports of an increased incidence of bile duct injury. The aim of this study was to report on the incidence of biliary tract injuries in a single unit, comment on the way they were managed and look at strategies to prevent them. Methods : A retrospective audit was conducted on laparoscopic cholecystectomies performed between January 1992 and March 2001. The data was collated from patient medical record files and yielded a total of 1216 procedures. Results : There were 899 women (74%) and 317 men (26%), with an age range of 13-92 years. Most of the procedures were performed on an elective (94%) rather than emergent basis (6%). There was one bile duct injury (0.09%) and seven bile leaks (0.63%). The single injury involved common bile duct obstruction by a misplaced clip and was successfully managed by cholangio-enteric bypass. Of the seven bile leaks, three were from the cystic duct stump, two from the gallbladder bed, and two were unidentified, settling conservatively. Of the five patients actively treated, two underwent therapeutic laparoscopy, two proceeded to laparotomy, and one was managed successfully by endoscopic stenting. Conclusions : Single-centre studies such as this are important in ensuring that standards of surgery are maintained in a community setting.
Eplasty, 2012
The aim of this surgical procedure was to definitively correct severe recurrent upper and lower b... more The aim of this surgical procedure was to definitively correct severe recurrent upper and lower bilateral eyelid ectropion after 2 attempts with full-thickness skin grafts. It was necessary to repair all 4 eyelids with forehead skin. Middle lamella support was required. Bilateral median forehead flaps, which were well vascularized by the supratrochlear vessels, were chosen for this procedure to utilize the readily available forehead tissue. The median forehead flap can be easily positioned to cover the entire eyelid. Furthermore, the flap could be split in half, without the risk of vascular compromise. Middle lamella support was provided with a cartilage graft from the nasal septum. At 4 months, the patient no longer suffered from exposure keratopathy and both forehead flaps had healed well. At 12 months, the functional and cosmetic outcomes of this procedure were acceptable. This method of surgery can be effective in the young, in whom the Mustarde cheek advancement fails, or when ...