Browsing by Author "Seyhan, A"

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    Immediate hair transplantation into a newly closed wound to conceal the final scar on the hair-bearing skin
    Seyhan, A; Yoleri, L; Barutçu, A
    Many exposed parts of a human body are mostly hair bearing, for example, scalp, facial skin (beards on men), and brows. A surgical procedure on these areas leaves a visible scar, which looks like a hairless line even after optimal wound conditions. Beveling the incision parallel to the hair follicle has been proposed to preserve the follicles oil the wound edges. However, the closest row of hair follicles in both wound edges is usually affected by the surgical procedure, namely, incision, hemostasis, and suturing. Ultimately, the best result carl be visible as a hairless line, which may be somewhat wider than the actual scar. The conspicuousness of such a scar results from its linear continuity and hairlessness.(1) To prevent this effect, we inserted hair minigrafts or micrografts between the wound edges immediately after wound closure.
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    A Double-Layered, Stepped Spreader Graft for the Deviated Nose
    Seyhan, A; Ozden, S; Gungor, M; Celik, D
    Background: In deviated noses, a beveled hump resection is recommended to preserve the shorter nasal wall. Even with this precaution, in some patients, the shorter wall does not reach the planned dorsal level when the lateral wall is transposed toward the midline after the lateral osteotomy. Method: A double-layered, stepped spreader graft was used on the shorter wall side to construct symmetrical lateral nasal walls. The composite graft was constructed by fixing a smaller cartilage graft to the side of the dorsal border of a slightly larger than normal standard spreader graft. The smaller graft component adds height to the shorter lateral wall while the larger one functions as a usual spreader graft. Results: Stepped spreader grafts were used in 4 primary and 2 secondary rhinoplasty cases. All compound grafts were harvested from the septal cartilage except for one of the secondary cases, in which auricular cartilage was used. Two patients received a usual spreader graft on the contralateral side. Postoperatively, none of the patients exhibited significant recurrent deviation, and acceptable symmetrical dorsal esthetic lines were obtained in all patients. Conclusion: This technique should be considered whenever the height of the lateral wall is shorter than desired after centralization of a deviated nose. Reconstruction of the shorter wall by adding height with a stepped spreader graft results in a more stable dorsum that resists relapse. Dorsal esthetic lines can also be reconstructed at the same time.
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    RECONSTRUCTION OF LABIUM MINUS HYPERTROPHY TAKING INTO ACCOUNT ANATOMICAL DIFFERENCES
    Güngör, M; Sir, E; Çelik, D; Seyhan, A; Yoleri, L
    Introduction: In labioplasty, wedge resection is a preferential method because of easy application and good results. In the identified wedge resection models certain zones and usually certain angles have been recommended. However, it's obvious that each enlarged labium minus shows different properties from another. The most protuberant portion, the excess volume and skin laxity are different for each case. Therefore, the zone of the triangle that will be resected and the apical angle should be planned specially for each case. Thus, we determined wedge resection zone and apical angle taking into account patient's anatomy. Material and Methods: We evaluated retrospectively 14 patients underwent labioplasty with this method. 11 (78.5 percent) patients underwent central, 2 (14.2 percent) patients underwent inferior and 1 (7.1 percent) patient underwent two different zones (central and inferior) wedge resections. We also excised redundant preputium clitoris in 2 (14.2 percent) patients. In wedge resection, apical angle varied between 60120 degrees. Results: In all patients, the labia minoras were covered by the labia majoras. None of the patients showed introitus narrowing and scar contraction. All of the patients reported that preoperative complaints disappeared or diminished. 9 (64.2 percent) patients evaluated postoperative satisfaction degree as very good and 5 (35.7 percent) patients as good. Complications were observed in 2 (% 14.2) patients. In 1 patient dehiscence of the suture line and in 1 patient asymmetry occurred. Conclusions: The results of this study demonstrate that we can get successful results when taking into account each labium minus anatomical differences.
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    A large family with type IV radial polydactyly
    Seyhan, A; Akarsu, N; Keskin, F
    This study examines one of the largest pedigrees with radial polydactyly type IV (uncomplicated polysyndactyly) comprising a total of 69 individuals, of whom 26 have been affected over six generations. Typical manifestations of the pedigree were bilateral radial and ulnar digital duplications, as well as syndactyly between the middle and ring fingers and the second and third toes, There was no craniofacial anomaly in any of the 17 cases examined physically, This observation suggests that radial polydactyly type IV and Greig craniofacial-synostosis syndrome with similar digital manifestations are clinically-distinct entities.
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    Three-dimensional modeling of nasal septal deviation
    Seyhan, A; Ozaslan, U; Sir, E; Ozden, S
    Background: Some deviated nasal septa can never be straightened completely due to their 3-dimensional (3-D) nature. Based on a Study of models and clinical cases, a basic classification and treatment strategy was proposed for 3-D septal deviations. Methods: basic types of 3-D septal L struts were crafted from pieces of thick plastic sheeting. By a carefully placed through-and-through incision in the angle area and overlapping the resultant segments, the models became 2 dimensional (2-D). We used this technique intraoperatively, in some cases resecting the overlapping area of septal tissue, along with a septal extension graft, in 11 patients who were followed up for more than 6 months. Results: External nasal deviation due to a deviated septum was obvious in 5 cases, and all were relieved postoperatively. Preoperative breathing difficulties were improved in 7 of 8 patients. Conclusion: Correction of 3-D septal L deformity can be successfully performed by constructing 2-D L struts by making a full-thickness incision of the angle area and then overlapping the segments. This approach is especially beneficial in those having a septal extension graft that need a perfectly straight caudal septum upon which to fix the extension graft.
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    Early diagnosed but late treated subungual melanoma
    Sahin, MT; Ozturkcan, S; Seyhan, A; Demireli, P; Turel-Ermertcan, A
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    Management of the Lateral Walls in Crooked Nose
    Seyhan, A
    In crooked noses, the lateral walls are different in shape and symmetry. Although the septum is very important to obtain a straight nose, identical and symmetrical lateral walls are needed for a straight looking nasal dorsum. As well as the septum, lateral walls also contribute in nasal skeletal support and stability. Thus, obtaining identical and symmetrical lateral walls is important. In order to obtain symmetrical and stable lateral walls, the requirements are to equalize the height, to set in a symmetric location and finally to stabilize the symmetry. These requirements must be taken into consideration while performing the steps of rhinoplasty, namely, hump resection, osteotomies and stabilization by spreader grafts or flaps. Here, we describe the management of the lateral walls in crooked nose in 7 cases.
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    Needle-guided shave excision with ultrasonographic assistance
    Seyhan, A; Tarhan, S; Türkdogan, P
    Background. A lack of control in the deep margin of shave excision is a drawback of this technique. Objective. To describe a more precise shaving technique by sonography with the use of a fine injector needle as a depth marker. Methods. After having examined the invasion levels of 40 benign skin lesions, a fine injector needle was intentionally threaded into the dermis horizontally just beneath the required shaving plane. Correct placement of the needle was ensured by sonographic examination after possible reinsertion trials. Large lesions needed several needles to be inserted. The tissue above the needles was then shaved off, whereas the deep dermal layer was protected. Results. Histologic examination revealed that 77% of superficial and intermediate-thickness lesions were removed totally without disturbing the derma-fat junction. Conclusion. The needle-guided technique was found to be effective in the control of the deep margin of shave excision.
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    A simplified use of septal extension graft to control nasal tip location
    Seyhan, A; Ozden, S; Ozaslan, U; Sir, E
    Background: For defining the shape and projection of the nasal tip, the bilateral and symmetric batten-type septal extension grafts proposed by Byrd and colleagues have drawbacks. The main problems are stiffness of the nasal tip and thickening of the septum in the nasal valve area. Methods: Since 1998, unilateral single-batten grafts, and more frequently, bilateral asymmetric batten grafts as compared with Byrd's bilateral symmetric application, have been used for 72 patients in our facility. Results: At the 6-month postoperative follow-up assessment, tip projection was found to be satisfactory in 61 patients. Less than desired projection occurred in three cases and overprojection in two cases. Nasal lobule deviation was evident in one patient. The loss of the columellar break point was evident in five cases. Conclusion: Unilateral or asymmetric bilateral batten grafts facilitate adjustment of the nasal tip intraoperatively. This technique results in a more pliable nasal tip in the horizontal plane. Construction of a three-layered cartilage in the nasal valve area is not needed, and the nasal airway is preserved. With this modification, a reliable and predictable nasal tip location is obtained with a minimum of graft usage.
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    The lapel technique - Reply
    Seyhan, A
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    A case of large mucinous adenocarcinoma arising in a long-standing fistula-in-ano
    Erhan, Y; Sakarya, A; Aydede, H; Demir, A; Seyhan, A; Atici, E
    Background. Chronic anal fistulas are not rare conditions, however, the development of a carcinoma in a long-standing fistula-in-ano is rare. Methods: The case of a 77-year-old male with a large perianal mucinous adenocarcinoma arising in a long-standing fistula-in-ano is presented. Results: Perianal biopsy revealed mucinous adenocarcinoma. Abdominal CT, double contrast barium examination and flexible sigmoidoscopy revealed no other tumoral lesion in the colon and rectum. Conclusion: The patient underwent abdominoperineal resection including wide tumor excision on the gluteal region. The final reconstruction was performed by bilateral gracilis musculocutaneous flaps. Due to clinical and histopathological evidence it was thought that a curative resection had been performed. To date he is clinically disease free. Copyright (C) 2003 S. Karger AG, Basel.
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    Autologous Breast Augmentation Using Abdominal Dermis Fat Strip Grafts: A Preliminary Report
    Seyhan, A; Tarhan, S
    Abdominoplasty and augmentation mastopexy are often performed in the same operation. Although silicone breast implants are usually used for breast augmentation, resected abdominal dermis fat tissue can be used for this purpose. We describe a new autologous breast augmentation technique using dermis fat grafts obtained from a simultaneous abdominoplasty operation. This new technique was used in eight breasts of four patients who requested abdominoplasty and augmentation mastopexy operations in the same session. First, excess abdominal skin was de-epithelized. Dermis fat strips were harvested either in situ or extracorporeally from this area. The prepared strips were then inserted into the pectoralis major muscle during the mastopexy operation. The patients were followed up for 7 months to 6 years. No infection or other problems regarding the technique were observed. Magnetic resonance imaging obtained from one patient showed graft survival after 2 years. A slight augmentation, presumably 50 to 100 mL, was observed per breast in all of the patients. Dermis fat strips obtained from an abdominoplasty operation can be used to obtain slight augmentation during mastopexy in patients requesting both of these operations in the same session. Validation of this new technique requires more experience with additional patients.