Cosmetic Reconstruction Research Articles

Craniofacial and Airway Morphology in Down Syndrome: A Cone Beam Computed Tomography Case Series Evaluation.

Background: Down syndrome (DS) is a genetic condition characterized by an extra copy of chromosome 21, resulting in various physical and cognitive features. This study aimed to comprehensively analyze the dental and craniofacial morphology of individuals with DS using Cone Beam Computed Tomography (CBCT). Methods: Six individuals with DS, comprising five males and one female aged 17 to 35 years, underwent CBCT scanning. Radiographic assessments included dentition, occlusion, paranasal sinuses, airway, skull bones, and suture calcification. Linear and angular cephalometric measurements were performed, and airway analysis was conducted using Dolphin 3D imaging software v.11. Results: The study revealed prognathic maxilla in five patients, prognathic mandible in four, and bimaxillary protrusion in two. Dental findings included microdontia, enamel hypoplasia, and congenitally missing teeth, with maxillary and mandibular third molars most commonly absent. Sinus abnormalities, delayed suture closure, and cervical spine anomalies were also observed. Conclusion: These findings contribute to a deeper understanding of DS-related craniofacial characteristics and emphasize the importance of considering these morphometric features in clinical management strategies for individuals with DS. This study's limited sample size underscores the significance of radiographic assessment in planning interventions such as cosmetic reconstructions, prosthetic rehabilitation, or orthodontic treatment for individuals with DS.

Principles of reconstruction. Like with like and flap thinning: two essential tools

The "like with like" and the "flap thinning" are two workhorse principles the surgeon must keep in mind to achieve a functional and cosmetic reconstruction of the hand. These principles are underpinned by a thorough knowledge of anatomy and functional hand units, with a wide range of reconstructive procedures that must be finalized to the necessity of the impaired structures. "Like with like" means that a lost tissue must be replaced with another one that can be compared in appearance and function. In addition, good cosmetic is often associated with good function because the complex attempt to get a proper aesthetic always traduces itself into a better functional reconstruction. "Flap thinning" is essential because soft tissue injuries of the hand represent a more difficult reconstructive challenge than similar injuries elsewhere, and the need for thin tissue to wrap the superficial noble structures of the hand is constant. However, the procedure of thinning a flap can be dangerous and must adhere to the vascular architecture of the flap. This paper aims to review and briefly summarize the current literature in this field.

Aesthetic Sideburn Reconstruction Using an Expanded Hair Bearing Skin Flap With Natural Hairline.

Hairline is the marginal line of hair growth on the scalp. Patients with sideburn defects, caused by tumor resection, severe infection, or burns, might have low self-esteem and mental stress. The purpose of this article was to explore a surgical method of applying the expanded scalp flap with natural hairline for cosmetic reconstruction of hairline, so as to provide reference for future clinical work. In this study, a retrospective analysis was conducted on 23 patients in the plastic surgery ward of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from January 2015 to December 2018, who underwent expanded scalp flap cosmetic reconstruction of the sideburns with natural hairline (14 males and 9 females; average age, 18.7 ± 13.7 years). The follow-up time was 8 to 44 months. Patient satisfaction rate (scored 4 or more) was 95.7%, with an average score of 4.59. A total of 16 patients were very satisfied, and 6 were satisfied. There were 21 patients who had good flap survival, and 2 patients who had venous congestion at the distal end of the flap. One case relieved voluntarily 3 days postsurgery, and the other case had partial skin necrosis at the distal end, healing phase II. These 2 cases were classified as grade I according to the Clavien-Dindo classification. In 9 of the patients, the reconstructed sideburn presented a natural look with good hair angle and great size and shape, with average scores of 4.61, 4.52, and 4.48. The scars at the donor site were inconspicuous, and there were no complaints (average score, 4.61). The rest of the patients received satisfactory appearances after surgery. In conclusion, the technique described above presented a fine method for sideburn reconstruction. Based on the achieved aesthetic scores of our study, as well as the high patient satisfaction rate (95.7%), the aforementioned technique is acceptable for both surgeons and patients.

Metabolic effects of lipectomy and of adipose tissue transplantation.

The goal of this study was to review the metabolic effects of fat transplantation. Fat (adipose tissue [AT]) transplantation has been performed extensively for many years in the cosmetic reconstruction industry. However, not all fats are equal. White, brown, and beige AT differ in energy storage and use. Brown and beige AT consume glucose and lipids for thermogenesis and, theoretically, may provide greater metabolic benefit in transplantation. Here, the authors review the metabolic effects of AT transplantation. Removal of subcutaneous human AT does not have beneficial metabolic effects. Most studies find no benefit from visceral AT transplantation and some studies report harmful effects. In contrast, transplantation of inguinal or subcutaneous AT in mice has positive effects. Brown AT transplant studies have variable results depending on the model but most show benefit. Many technical improvements have optimized fat grafting and transplantation in cosmetic surgery. Transplantation of subcutaneous AT has the potential for significant metabolic benefits, although there are few studies in humans or using human AT. Brown AT transplantation is beneficial but not readily feasible in humans thus ex vivo "beiging" may be a useful strategy. AT transplantation may provide clinical benefits in metabolic disorders, especially in the setting of lipodystrophy.

Functional Restoration of Laminar Flow Prevented Late In-Stent Restenosis Better Than Anatomical Coronary Cosmetic Reconstruction: An Angiographic, Artificial Intelligence, and Machine Learning Analysis

Functional Restoration of Laminar Flow Prevented Late In-Stent Restenosis Better Than Anatomical Coronary Cosmetic Reconstruction: An Angiographic, Artificial Intelligence, and Machine Learning Analysis

Augmented reality–assisted craniofacial reconstruction in skull base lesions — an innovative technique for single-step resection and cranioplasty in neurosurgery

Defects of the cranial vault often require cosmetic reconstruction with patient-specific implants, particularly in cases of craniofacial involvement. However, fabrication takes time and is expensive; therefore, efforts must be made to develop more rapidly available and more cost-effective alternatives. The current study investigated the feasibility of an augmented reality (AR)–assisted single-step procedure for repairing bony defects involving the facial skeleton and the skull base. In an experimental setting, nine neurosurgeons fabricated AR-assisted and conventionally shaped (“freehand”) implants from polymethylmethacrylate (PMMA) on a skull model with a craniofacial bony defect. Deviations of the surface profile in comparison with the original model were quantified by means of volumetry, and the cosmetic results were evaluated using a multicomponent scoring system, each by two blinded neurosurgeons. Handling the AR equipment proved to be quite comfortable. The median volume deviating from the surface profile of the original model was low in the AR-assisted implants (6.40 cm3) and significantly reduced in comparison with the conventionally shaped implants (13.48 cm3). The cosmetic appearance of the AR-assisted implants was rated as very good (median 25.00 out of 30 points) and significantly improved in comparison with the conventionally shaped implants (median 14.75 out of 30 points). Our experiments showed outstanding results regarding the possibilities of AR-assisted procedures for single-step reconstruction of craniofacial defects. Although patient-specific implants still represent the gold standard in esthetic aspects, AR-assisted procedures hold high potential for an immediately and widely available, cost-effective alternative providing excellent cosmetic outcomes.

Toolkit for the management of breast implants and the importance of Informed educated consent.

Breast implants have had a long and chequered history of periodic regulatory activity and class actions and are associated with significant medium and long term health risks, including the development breast implant associated anaplastic large cell lymphoma (BIA-ALCL).1–3. NSW Health through the Agency of Clinical Innovation has just released a toolkit for the management of breast implants.4 These are the result of collaborative clinical consensus across leaders in plastic and reconstructive surgery, breast surgery and radiology with support from the Surgical Services Taskforce and evidence directorate of the agency. Input was also sought from health consumers to ensure that the language and structure of the information was both comprehensive and accessible to women who were either considering either cosmetic augmentation or reconstruction and/or have breast implants in place.

Excision and Cosmetic Reconstruction of Villar's Nodule

Villar's Nodule was first described in 1886. Its prevalence is estimated to be between 0.5 to 1.2%1-3. It frequently leads to cyclic pain and bleeding from the umbilicus. Imaging frequently aids in confirming the diagnosis, identifying the extent of the disease, surgical planning, and patient counseling. Magnetic Resonance Imaging (MRI) is frequently resorted to over ultrasound due to the value of T2-weighted images consistently identifying characteristic hemosiderin concentrations with signs of hemorrhage4-6.

Karapandzic Flap for Functional & Cosmetic Reconstruction of Lower Lip Cancer with Review of Literature

The incidence and prevalence of lip and oral cavity cancer has increased over the last decade, worldwide and in India. It ranks at 1st position in males in india, all ages, in 2020. Lips are essential organ of the body which carries dynamic role in facial expression, speech, sensuality, deglutition. Resection of central, large, lower lip cancer creates a more than 2/3rd large defect. Covering of this defect with maintenance of oral competency is a difficult task for a treating surgeon. Number of techniques are described for covering of large lower lip defects. Out of these techniques, karapandzic flap is a successful, accepted, simple, easy to learn reconstructive procedure with good cosmetic results. It is a modification of Gillie’s fan flap and it involves unilateral or bilateral full-thickness circumoral advancement-rotation flaps. The feature which distinguishes it from other techniques is preservation of neuro-vascular integrity, symmetry and oral competency. We are reporting a case of an elderly gentleman with large, central, lower lip cancer who underwent oncological resection with reconstruction by karapandzic flap technique.

Patient-reported Outcomes following Implant Removal for Breast Implant Illness

PURPOSE: Current evidence has not linked breast implants to autoimmune or other systemic diseases; however, women continue to pursue explantation due to a heterogenous constellation of symptoms referred to as “breast implant illness” (BII). Although BII has no clear medical definition, pathophysiological explanation or diagnostic testing, a subset of patients report symptomatic improvement after explantation. Although several studies have attempted to clarify and better define this phenomenon, none have considered patient satisfaction and quality of life following implant removal. This study aims to assess patient reported satisfaction with the removal of implants through the use of the BREAST-Q. METHODS: Patients who underwent breast implant removal due to concerns for BII were asked to complete the augmentation BREAST-Q. Additionally, a survey was administered that queried 35 different BII-related symptoms and their response to implant removal. Questions specifically referencing the implants were removed because they were not applicable to this cohort. Consistent with scoring guidelines, missing data were replaced with the mean of remaining scores as long as 50% of questions were still completed. Outcomes in this cohort were compared with normative data for all modules this information was available for. Furthermore, satisfaction for patients who underwent explantation alone was compared with those who pursued explantation with cosmetic reconstruction. RESULTS: Of the 29 patients who underwent implant removal for BII, 16 patients (55.2%) completed the BREAST-Q and symptom survey. Mean age was 49.1 ± 10.8, and mean BMI was 25.1 ± 8. Interestingly, all patients were Whites. En bloc capsulectomy was requested by patients and performed in 100% of cases. The average time between augmentation and implant removal was 11.3 ± 6.2 months. Only 11 patients (68.8%) underwent implant removal and the other five underwent a cosmetic procedure (either autologous reconstruction or mastopexy) in addition to implant removal. Subjects report on average a total of 13.1 symptoms with brain fog, fatigue, chest discomfort, and anxiety being the most common. On average, symptoms of 14.9% of patients did not improve, those of 48.1% partially improved, and those of 37.0% were completely resolved. Compared with normative data, BII patients with implant removal alone had scores comparable to those of normative BREAST-Q data in the psychosocial well-being (P = 0.928), sexual well-being (P = 0.819), and satisfaction with breast modules (P = 0.529). They had lower scores for physical well-being (17 versus 86, P < 0.001). Upon subgroup analysis, implant removal with cosmetic procedures had a higher score in the satisfaction with breast module when compared with implant removal alone (76 versus 48, P = 0.022), though no other differences were seen. CONCLUSIONS: Concurrent with previous literature, patients with BII report some degree of symptomatic improvement after removal of implants. Patient-reported outcomes are similar to normative data in recently augmented patients. However, despite reported improvement of symptoms, physical well-being remains lower for patients with breast implant illness even after implant removal. Implant removal may be combined with cosmetic procedures to improve satisfaction with breasts. These results may aid in preoperative patient counseling.

Facial Reconstruction and Cosmetology - A Review

Facial reconstruction can be used to identify unknown human skeletal remains when other techniques beunsuccessful. Through this review, we try to assessment the different methods of facial reconstruction statedin literature. There are several techniques of doing facial reconstruction, which vary from two dimensionaldrawings to three-dimensional clay models. With the advancement in 3D technology, a rapid, efficient andcost-effective computerized 3D reconstruction method has been developed which has brought down thegrade of mistake before come across. Recognition allows the involved administration activities to make alist of assumed victims. This list can then be pointed down and a positive identification may be given bythe more conventional method of forensic field. Facial reconstruction allows visual identification by theindividual’s family and associates to become easy and more definite. And here cosmetic reconstruction alsoplays a best role in investigating the criminals and legal part.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL): Quantifying the direct economic costs of post-treatment radiological surveillance.

e19574 Background: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was recognised by the WHO in 2016 as a rare sub-type of peripheral T-cell, non-Hodgkin lymphoma (NHL), characterized by an indolent clinical course and excellent prognosis. Little evidence exists on the role of post-treatment imaging surveillance with variable practices across the world. Recent UK guidelines recommend that routine surveillance imaging should not be offered to BIA-ALCL patients, in line with national/international recommendations for other NHLs. The aim of this study was to quantify the direct economic costs (DEC) of post-treatment BIA-ALCL routine radiological surveillance at our institution compared to the DEC if UK guidelines were followed. Methods: Following IRB approval a retrospective analysis of a prospectively maintained database of BIA-ALCL patients at The Royal Marsden Hospital was performed. DECs were estimated using current (2020) NHS tariffs for radiological investigations. Imaging undertaken for symptomatic problems/non-BIA-ALCL related concerns was excluded. Results: Eleven patients [median age: 49 years (IQR 45-52)] were treated for BIA-ALCL between 2015-2020 following cosmetic augmentation (n = 6) or breast reconstruction (n = 5). Median time from first implant surgery to BIA-ALCL diagnosis was 11 years (IQR 8-12). Patients presented with effusion (n = 7), mass (n = 2) or effusion and mass (n = 2). One patient had neoadjuvant CHOP/brentuximab, all 11 had explantation with en bloc total capsulectomy, 1 had adjuvant CHOP. Median follow-up was 38 months (IQR 12-47) with no local or distant relapses. Two patients did not have any radiological surveillance and 1 had follow-up elsewhere. The remaining 8 patients had a combination of PET/CT (n = 10), CT (n = 2), breast ultrasound (n = 6), mammogram (n = 4) and breast MRI (n = 1) as routine imaging follow-up not guided by clinical concerns. This represents evolving practice at our institution as the UK guidelines were published in 2021. Total cost of routine imaging surveillance was £10,396 ($14,396) with median cost of £1,953 ($2,705) per patient [IQR £526-2029 ($728-2,810)]. This cost could have been saved based on current guidelines recommending no routine surveillance for patients with no symptoms or clinical concerns. Conclusions: This data demonstrates that omission of routine post-treatment imaging surveillance, as per the recent UK guidelines, would result in a median DEC saving of £1,953 ($2,705) per patient at our institution. No local or distant relapses where identified within the follow-up period, in line with the existing literature suggesting BIA-ALCL has a very low risk of relapse and excellent prognosis. These findings provide a value-based analysis to further support the recommendation not to perform routine post-treatment imaging surveillance in patients with BIA-ALCL.

Functional and Cosmetic Reconstruction of Floating Thumb: A Thumb-preserving Technique.

For the severely hypoplastic thumb, including floating thumb, it is difficult to acquire function while preserving the thumb. Pollicization using the index finger after removing the hypoplastic thumb is usually indicated for such cases. However, most parents of children undergoing surgery for deformed hands desire retaining the digit number, 1 thumb and 4 fingers. A floating thumb has a neurovascular band in its pedicle, and we can identify and divide the band with precision for preservation, although it seems impossible to retain it. For acquiring function while retaining the thumb, we developed carpometacarpal arthroplasty of the floating thumb. For the first stage, the fourth metatarsal head was transferred to the first metacarpal base, followed by third metatarsal half-slip transfer to the space of the excised fourth metatarsal head with the first web plasty using a dorsal sliding flap. Second stage surgery was performed ∼6 months after the first stage. For creating stable opponensplasty, the abductor digiti minimi tendon was anchored to the ulnar side of the metacarpophalangeal joint; for extension, extensor indicis proprius transfer to the hypoplastic extensor pollicis longus tendon was performed; for flexion, ring finger flexor digitorum superficialis transfer to the hypoplastic flexor pollicis longus tendon was performed. In general, the functional results were acceptable with a high degree of family satisfaction, although in some cases function was limited to simple object holding. We explain the surgical procedures to preserve the thumb while gaining function as well as appearance using high-quality illustrations, figures, and videos. This should be helpful for surgeons who want children with hypoplastic thumbs to have both 5 digits and reasonable functional ability.

Simultane Implantation von Epithesenankern und Bonebridge zur Versorgung großer Ohrmissbildungen

Surgical treatment with bone conduction hearing implants and epitheses for ear malformations offer the right combination of hearing rehabilitation and cosmetic reconstruction. The surgical procedure is often performed in two-stage surgical steps. This project aimed to gain experience with a procedure in which the hearing implant and the epithesis anchors are inserted simultaneously. Four ears of three patients (nf = 1, nm = 2) with severe ear malformations (type III, according to Weerda) received a Bonebridge and an epithesis anchor with three base posts in one operation each. Previously, the indication for the use of a bone conduction implant using the active middle ear implant (aMEI) score, according to Frenzel (2013), had been established. All patients scored 4 points each in the aMEI-score, indicating an unfavorable prognosis for successful implantation of an active middle ear implant. The treatment with a Bonebridge and an epithesis anchor was performed without complications. Postoperatively, the initial audiological fitting and the application of the magnetic abutment were performed after 4 weeks. Audiometry showed a functional gain of up to 30 dB and an improved speech comprehension. The epithesis was shaped like the contralateral ear. After treatment, patients were satisfied with the audiological and cosmetic results. The simultaneous surgical procedure with a bone conduction hearing implant and epithesis anchor is a good option for the treatment of ear malformations. The aMEI-score was a helpful instrument for the indication. The procedure reduced the surgical risk and the time and effort required for treatment.

Influence of skull biometrics on cosmetic reconstruction after incisivectomy and nasal planectomy reconstruction in dogs.

To identify biometric skull measurements that are associated with tension and excess narrowing of the resultant nasal aperture during cosmetic nasal planectomy reconstruction. Ex vivo study. Twenty cadavers of mesocephalic dogs. Cosmetic reconstruction was performed after incisivectomy and nasal planectomy. Preoperative and intraoperative skull measurements included width of the nasal planum, rostral and caudal maxilla, labial flap, and maxilla at ostectomy site; the length of the nose, labial flap, and philtrum incision; lip thickness; and philtrum placement. Ratios of select width to length measurements were calculated. Correlation was tested between skull biometrics and tension during reconstruction as well as resulting opening of the nasal aperture. Breeds included golden retriever, pit bull, Labrador retriever, beagle, shepherd, basset hound, boxer mix, cocker spaniel, and Great Dane. No biometric ratios were predictive of procedural success. The most important objective measurements that were significantly correlated with inferior outcome included width of the nasal planum (>3 cm), width of the caudal maxilla (>6.2 cm), lip thickness (>0.5 cm), width of the labial flap (>2.9 cm), length of the incision created to make the cosmetic "philtrum" (longer incisions >2.8 cm), and philtrum placement (more dorsal placement). Tension during reconstruction and decreased resultant nasal aperture were associated with wider facial features and thicker lips as well as directly impacted by cosmetic philtrum design and placement. Standardized preoperative measurements may help guide clinical decision making in choosing and executing a nasal planectomy reconstructive technique.

The chest wall gender divide: females have better cardiopulmonary function and exercise tolerance despite worse deformity in pectus excavatum

Pectus excavatum (PE) is a chest wall deformity of variable severity and symptomatology. Existing female-specific literature highlights breast asymmetry and cosmetic reconstruction. We sought to evaluate gender differences in cardiopulmonary function. Cardiac MRIs, pulmonary function tests (PFTs), and cardiopulmonary exercise tests (CPETs) were reviewed in 345 patients undergoing preoperative evaluation for PE. Regression modeling was used to evaluate associations between gender and clinical endpoints of cardiopulmonary function. Mean age was 15.2years, 19% were female, 98% were white. Pectus indices included median Haller Index (HI) of 4.8, mean depression index (DI) of 0.63, correction index (CI) of 33.6%, and Cardiac Compression Index (CCI) of 2.79. Cardiac assessment revealed decreased right and left ventricular ejection fraction (RVEF, LVEF) in 16% and 22% of patients, respectively. PFTs and CPETs were abnormal in ~ 30% of patients. While females had deeper PE deformities-represented by higher pectus indices-they had superior function with higher RVEF, LVEF Z-scores, FEV1, VO2 max, O2 pulse, work, and breathing reserve (p < 0.05). Despite worse PE deformity and symptomatology, females had a better cardiopulmonary function and exercise tolerance than males. Further research is needed to assess the precise mechanisms of this phenomenon and postoperative outcomes in this population.

The Pectus Excavatum Gender Divide – Females Have Better Cardiopulmonary Function and Exercise Tolerance Despite Worse Deformity

Objective: Pectus excavatum (PE) is a common chest wall deformity with variable severity and symptomatology. More common in males, this condition has been rarely studied in female cohorts. Most of the existing literature for females focuses on breast asymmetry and cosmetic reconstruction. We sought to evaluate gender differences in the patterns of cardiopulmonary compromise and functional impairment in this population. Methods: Results …

Modification of the position of the angulus oris with a rotation flap and a YV flap in lip reconstruction.

Functionally, the lip serves to prevent food and drink from spilling out of the beginning of the gastrointestinal tract, and it is also used for vocalization. In addition, the lip has cosmetic importance as part of the face involved in making expressions, and in many cultures, it is considered to be sexually appealing. The results of lip reconstruction procedures must therefore be both functionally and cosmetically satisfactory. When the orbicularis oris muscle and oral mucosa are excised, functional reconstruction is prioritized. In contrast, if there are no functional problems, cosmetic reconstruction is the main focus. This case involved the reconstruction of a right upper lip defect caused by a dog bite. When the skin defect was covered with a local flap, the right angulus oris shifted medially, so we incorporated a YV flap at the right angulus oris to modify its position and allow for a cosmetically satisfactory result. We believe that this method can be used not only for cases in which asymmetry of the angulus oris is expected to occur at the time of lip reconstruction, but also for cases in which it has already occurred in the initial operation.

Female Cosmetic Genital Reconstruction: a Review of Current Trends, Treatments, and Techniques

To examine the peer-reviewed publications on the topic of female cosmetic genital surgery (FCGS) and discuss recent trends, the factors motivating patients to request these procedures, and the controversy surrounding them. In studies with the primary goal being esthetic improvement (e.g., labiaplasty), post-operative satisfaction rates are generally high. When procedure outcomes are focused more on functional aspects, such as enhancement of sexual function and response, statistically significant improvements are also reported after treatment. Complication rates vary across treatment sites and operating physicians. While FCGS procedures continue to rise, great variation still exists across patient-centered outcomes, treatment modalities offered, and quality of published studies examining outcomes. Small sample sizes and lack of standardization across study centers make scientifically validating existing data challenging. Consensus across disciplines pertaining to standardization of procedures and outcomes is necessary to optimize patient satisfaction, care, and safety.

Outcome following cosmetic rostral nasal reconstruction after planectomy in 26 dogs.

To report the outcome and owner satisfaction after planectomy for nasal planum neoplasia with cosmetic reconstruction with bilateral labial mucocutaneous rotation flaps in dogs. Multi-institutional, retrospective case series. Twenty-six client-owned dogs. Medical records were searched for dogs that had undergone the procedure. Signalment, diagnosis, surgery, complications, requirement for revision surgery, recurrence, and survival information were recorded. Owners were contacted by telephone about their dog's quality of life after the procedure and their satisfaction with their dog's outcome. Twenty-five dogs underwent radical planectomy, and 1 dog underwent resection of the nasal planum. Twenty-four dogs had a diagnosis of squamous cell carcinoma, 1 had a diagnosis of atypical adenocarcinoma, and 1 had a diagnosis of a mast cell tumor. Complications occurred in 19 (73%) dogs, with 9 dogs requiring revision surgery; 1 dog not surviving to discharge. Median survival time was 1542 days (range, 3-2010). Recurrence of the primary tumor was suspected in 2 (7.7%) dogs, both with narrow or incomplete excision. Among 11 owners interviewed, 10 were satisfied with their dog's appearance, and 8 reported they would consent to the procedure again. Dehiscence was common after this procedure, but local tumor control and survival times were excellent. Owner satisfaction was high, although preoperative client education is vital. This technique should be considered as a viable option for dogs with nasal planum neoplasia given the high rate of recurrence with less aggressive treatment. Complications common following surgery, but do not persist long term and survival times were excellent.