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Handbook Quiz Cases PhD Publications Partners Upload Case About Sign up Login




LEARN PLASTIC-, BREAST- AND RECONSTRUCTIVE SURGERY

Handbook Cases

Learn through the Handbook, Quizzes, Cases and Danish PhD Publications.

Created by Danish, Swedish, Norwegian, German and Swiss Plastic Surgeons.

To Help Patients Around the World.



VIDEO




PEARLS

 * Always use Diligence (careful and persistent work) and intelligence.
 * Have a Plan A, B and C in case the recipient vessel is not usable.
 * Practice using magnifying glasses (loup glasses).
 * Train yourself to look after perforator vessels near the defect using
   ultrasound before a standard resection.

1


STEP 1: BILOBE FLAP DESIGN

Pivot point of the rotation arc is placed at distance of 1x radius from the
lateral border of the defect. Lobe 1 is placed at approx. 45 degrees and lobe 2
at 90 degrees following the arc from the tip of the defect.

 * Lobe 1 width equals the defect, while the height extends beyond the arc with
   a few millimeters
 * Lobe 2 width is slightly smaller than lobe 1, while the height is 1,5x lobe 1

2


STEP 2: BILOBE FLAP RAISED

The tumor has been excised with free histologic margins. A circular excision
defect of 11x12mm is to be reconstructed. The bilobe flap is raised in the
sub-fascial plane and transposed into the defect.

 * Further sub-fascial undermining of nasal skin is often necessary
 * Avoid tension on lobe 1 on the nasal tip

3


STEP 3: CLOSURE

Closure is performed using a few absorbable vicryl 5-0 sutures and then nylon
5-0 sutures. First, the lobe 2 donor site on the proximal nose is closed.
Thereafter the lobe 1 donor site defect and at last the primary defect are
closed.

 * Skin correction by excision of redundant skin by a burrows triangle is often
   necessary
 * Nylon sutures are removed after 7-8 days

Learn step-by-step





See tips and tricks








Winners 2024


CASE COMPETITION WINNERS

Congratulations to 1st, 2nd and 3rd place in the case competition. Special
thanks to the expert panel, the participants and the team. All submissions can
be found under Cases.


Danish Winners 2024

1st place


THE SKAERLUND-STAIRWAY APPROACH TO RECONSTRUCTION OF UPPER EYELID DEFECTS

2nd place


CLOSURE OF LARGER TIP DEFECT BY A MODIFIED PENG-FLAP WITH EXTENDED NASOFRONTAL
DISSECTION

3rd place


REVOLVING DOOR FLAP


International Winners 2024

1st place


PUSHING THE LIMITS OF UNILATERAL AUTOLOGOUS BREAST RECONSTRUCTION

2nd place


HYPOTHENAR HAMMER SYNDROME AFTER MINOR INJURY TO THE HAND

3rd place


UNCONVENTIONAL RECONSTRUCTION OF A COMPLEX GENITAL DEFECT

Browse by chapter


HANDBOOK

 * Case Competition 2024 Overview
 * Case Competition 2023 Oveview
 * Basic Surgical Technique, Knots and Sutures
 * Breast Cancer Pathology and Histology
 * Breast Surgery
 * Breast Reconstruction
 * Burn Surgery
 * Excision of Facial Tumors
 * Facial Trauma
 * Facial Flaps
 * Massive Weight Loss Surgery

 * Microsurgery
 * Melanoma
 * Non-Melanoma Skin Cancer
 * Oncologic Treatment of Breast Cancer
 * Preoperative Assessment
 * Skin Transplantation
 * Suturing Technique
 * Scrubbing In for Surgery
 * Surgical Instruments
 * Wound Management
 * History of Plastic Surgery

Handbook

--------------------------------------------------------------------------------

 * Case Competition 2024 Overview
 * Case Competition 2023 Oveview
 * Basic Surgical Technique, Knots and Sutures
 * Breast Cancer Pathology and Histology
 * Breast Surgery
 * Breast Reconstruction
 * Burn Surgery
 * Excision of Facial Tumors
 * Facial Trauma
 * Facial Flaps
 * Massive Weight Loss Surgery
 * Microsurgery
 * Melanoma
 * Non-Melanoma Skin Cancer
 * Oncologic Treatment of Breast Cancer
 * Preoperative Assessment
 * Skin Transplantation
 * Suturing Technique
 * Scrubbing In for Surgery
 * Surgical Instruments
 * Wound Management
 * History of Plastic Surgery

Ressources

--------------------------------------------------------------------------------

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 * Dictionary
 * Disclaimer
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© PlastSurgeon




HANDBOOK

 * Case Competition 2024 Overview
 * Case Competition 2023 Oveview
 * Basic Surgical Technique, Knots and Sutures
 * Breast Cancer Pathology and Histology
 * Breast Surgery
 * Breast Reconstruction
 * Burn Surgery
 * Excision of Facial Tumors
 * Facial Trauma
 * Facial Flaps
 * Massive Weight Loss Surgery

 * Microsurgery
 * Melanoma
 * Non-Melanoma Skin Cancer
 * Oncologic Treatment of Breast Cancer
 * Preoperative Assessment
 * Skin Transplantation
 * Suturing Technique
 * Scrubbing In for Surgery
 * Surgical Instruments
 * Wound Management
 * History of Plastic Surgery

 * Handbook
 * Quiz
 * Cases
 * Case competition
 * Dictionary
 * About
 * PhD Publications
 * Partners
 * Sign up
 * Login


HANDBOOK

 * Case Competition 2024 Overview
 * Case Competition 2023 Oveview
 * Basic Surgical Technique, Knots and Sutures
 * Breast Cancer Pathology and Histology
 * Breast Surgery
 * Breast Reconstruction
 * Burn Surgery
 * Excision of Facial Tumors
 * Facial Trauma
 * Facial Flaps
 * Massive Weight Loss Surgery

 * Microsurgery
 * Melanoma
 * Non-Melanoma Skin Cancer
 * Oncologic Treatment of Breast Cancer
 * Preoperative Assessment
 * Skin Transplantation
 * Suturing Technique
 * Scrubbing In for Surgery
 * Surgical Instruments
 * Wound Management
 * History of Plastic Surgery

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