Papers by Alexandre E C Mansur
Rev. bras. cir. plást, 2016
Springer eBooks, 2010
Nowadays, obesity is epidemic all around the world. Statistics of some studies report the prevale... more Nowadays, obesity is epidemic all around the world. Statistics of some studies report the prevalence of obesity in more than 1.7 billion people in the world. In the United States, around 5% of people have morbid obesity. This health problem has a lot of causes that include the sedentary life and the foods habits [1]. An important aspect of body contouring after massive weight loss is the reshape of the breast and the upper body. The treatment requires the correct diagnoses and understanding of the anatomy. There are a lot of different types of breast after the patient lost weight. Usually, the ptosis and the laxity of the skin are extensive and is common the decreased inframammary crease in continues with the upper back roll. Some patients have an adequate quantity of fat and glandular tissue to perform the mastopexy. But in general, despite excess skin, the breast lose majority of fat, and has excess of skin and tissue in the lateral aspect of the breast and the back (the upper back roll).
Plastic and Reconstructive Surgery, Feb 1, 2008
Background: Endoscopic brow lift has become widely accepted as a method for rejuvenation of the u... more Background: Endoscopic brow lift has become widely accepted as a method for rejuvenation of the upper third of the face, mainly to achieve eyebrow elevation. In this study, the authors quantified eyebrow elevation after videoendoscopic subperiosteal technique and followed up the heights of the eyebrows at different postoperative intervals. Methods: Seventy-two patients were submitted to endoscopic subperiosteal brow lift, and photographic evaluation was performed preoperatively and at different intervals postoperatively. From an interpupillary line, three different measurements on each side were obtained up to the superior border of both eyebrows. The distance between the medial eyebrows was also measured. Results were analyzed statistically by using the t test. Results: Comparing preoperative values and those obtained at 5 months postoperatively, significant augmentation in medial, central, and lateral height of both eyebrows was noted (p Ͻ 0.05). Analyzing a group of 38 patients with mean postoperative times of 8.5 and 3.5 months, it was noted that there is spontaneous and significant augmentation in the medial height of both eyebrows (p Ͻ 0.05). A third group (24 patients) was analyzed at mean postoperative times of 3.5 and 24 months. The later follow-up showed continuous and significant elevation of the medial, central, and lateral height of both eyebrows (p Ͻ 0.05). The distance between medial eyebrows did not show any statistical difference. Conclusion: Subperiosteal endoscopic brow lift showed clinical and statistical effectiveness in correcting eyebrow ptosis, promoting also a spontaneous and progressive elevation of eyebrows, without enlarging the interbrow distance.
Statistical Modelling, 2020
We propose a multivariate regression model to deal with multiple outcomes along with repeated mea... more We propose a multivariate regression model to deal with multiple outcomes along with repeated measures in the context of longitudinal data analysis. Our model allows for flexible and interpretable modelling of the covariance structure within outcomes by using a linear combination of known matrices, while the generalized Kronecker product is employed to take into account the correlation between outcomes. We present maximum likelihood estimation along with extensions of the classical multivariate analysis of variance and multiple comparison hypothesis tests to deal with multivariate longitudinal data. The model and the associated multivariate hypothesis test are motivated by a prospective study conducted to compare three aesthetic eyelid surgery techniques, namely blepharoplasty, endoscopic forehead lift and endoscopic forehead lift associated with blepharoplasty. The effect of the techniques was assessed using measurements of a horizontal line through pupil centre and then three vert...
Aesthetic Plastic Surgery, 2020
Simultaneous breast augmentation and mastopexy is very challenging often considered to be one of ... more Simultaneous breast augmentation and mastopexy is very challenging often considered to be one of the most difficult cosmetic breast surgeries. Although a patient is sometimes better served with 2 separately staged procedures, the demand for single-stage combined augmentation mastopexy is increasing associated with increasing demands for larger implants. Combining these 2 operations presents special problems because of the interplay of opposing forces. To avoid bottoming out, wound dehiscence, and ultimately implant extrusion, it is essential to provide proper coverage and support of the inferior breast pole. The goal of this report is to illustrate the benefit of an inferiorly based fascioglandular flap in providing adequate breast lower pole support in simultaneous breast augmentation mastopexy.
Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery, 2016
Braquio-dorso-mamoplastia: cirurgia do contorno corporal da região superior do tronco após grande... more Braquio-dorso-mamoplastia: cirurgia do contorno corporal da região superior do tronco após grandes perdas ponderais Introduction: In Brazil, 88000 bariatric surgeries were performed in 2014. After weight loss, deflation occurs around the trunk, with sagging and folding of excess skin of the breasts in the posterior dorsal region. We, therefore, propose a surgical procedure to treat upper region of the entire trunk, including breasts, side and rear back, and arms. Objective: To present a personal experience in brachial-dorsal mammoplasty surgeries. Method: We operated 13 patients from 2007 to 2014, 11 women and two men. Results: The average age was 41.9 years. The brachial-dorsal mammoplasty was performed in all patients. In three cases, L-brachial-dorsal mammoplasty was performed, due to lower latero-posterior deformity. The average surgery duration was 4 hours and 30 minutes. The average Body Mass Index (BMI), before bariatric surgery, was 53.5 kg/m². Weight loss ranged from 47 to 114 kg. The pre-surgery BMI ranged from 23 to 39 kg/m². There were no cases of infection, large dehiscence or seroma. Two patients developed hematoma, requiring a new intervention for drainage. Conclusion: Deformities of the thoracic region in patients with large weight loss are variable, requiring several surgical treatments that should address the entire chest as a single anatomical area. It is important to understand the deformity that each patient presents and adapt the surgical approach accordingly. The main indication for a brachialdorsal mammoplasty is lateral drop of the inframammary fold.
Acta Cirurgica Brasileira, 1998
Desde os mais remotos tempos pesquisam-se incessantemente drogas que acelerem o processo cicatric... more Desde os mais remotos tempos pesquisam-se incessantemente drogas que acelerem o processo cicatricial normal. No Hospital de Clínicas da UFPr preconiza-se a limpeza de feridas limpas com solução salina de NaCl a 0,9%. Alguns serviços têm utilizado empiricamente o Agarol® e o Trigliceril® na confecção do curativo após este procedimento. Este estudo objetivou avaliar experimentalmente a evolução de feridas cutâneas, em ratos, produzidas por incisão cirúrgica tratadas com solução de NaCl a 0,9%, Agarol® e Trigliceril® . Utilizou-se 24 ratos, divididos em três grupos: C, controle, submetido à troca diária de curativo após limpeza com solução de NaCl a 0,9%; grupo A com aplicação de Agarol® e grupo T com aplicação de Trigliceril®. Verificou-se que no terceiro e décimo quarto dias de pós-operatório o Agarol<FONT FACE="Symbol">â</FONT> e o Trigliceril<FONT FACE="Symbol">â</FONT> não influenciaram o processo cicatricial. No sétimo dia de pós-operat...
Plastic and Reconstructive Surgery, 2008
Background: Endoscopic brow lift has become widely accepted as a method for rejuvenation of the u... more Background: Endoscopic brow lift has become widely accepted as a method for rejuvenation of the upper third of the face, mainly to achieve eyebrow elevation. In this study, the authors quantified eyebrow elevation after videoendoscopic subperiosteal technique and followed up the heights of the eyebrows at different postoperative intervals. Methods: Seventy-two patients were submitted to endoscopic subperiosteal brow lift, and photographic evaluation was performed preoperatively and at different intervals postoperatively. From an interpupillary line, three different measurements on each side were obtained up to the superior border of both eyebrows. The distance between the medial eyebrows was also measured. Results were analyzed statistically by using the t test. Results: Comparing preoperative values and those obtained at 5 months postoperatively, significant augmentation in medial, central, and lateral height of both eyebrows was noted (p Ͻ 0.05). Analyzing a group of 38 patients with mean postoperative times of 8.5 and 3.5 months, it was noted that there is spontaneous and significant augmentation in the medial height of both eyebrows (p Ͻ 0.05). A third group (24 patients) was analyzed at mean postoperative times of 3.5 and 24 months. The later follow-up showed continuous and significant elevation of the medial, central, and lateral height of both eyebrows (p Ͻ 0.05). The distance between medial eyebrows did not show any statistical difference. Conclusion: Subperiosteal endoscopic brow lift showed clinical and statistical effectiveness in correcting eyebrow ptosis, promoting also a spontaneous and progressive elevation of eyebrows, without enlarging the interbrow distance.
Aesthetic Plastic Surgery, 2007
Mammaplasty for patients who have experienced massive weight loss involves some concepts that dif... more Mammaplasty for patients who have experienced massive weight loss involves some concepts that differ from those that apply to mammaplasty for normal patients. Breast anatomic characteristics make this procedure a very challenging situation. The authors present their experience with a new mammaplasty technique using an extended thoracic wall flap associated with a loop of pectoralis. This procedure is a simple and reproducible method for patients with massive weight loss that results in a pleasing breast shape and long-lasting results.
Acta Cirurgica Brasileira, 1999
Objetivou-se conhecer a influência do ultra-som na cicatrização colônica em ratos e avaliar os fi... more Objetivou-se conhecer a influência do ultra-som na cicatrização colônica em ratos e avaliar os fios de aço e náilon na vigência desta terapia. Utilizou-se 64 ratos machos Wistar divididos em protocolos. Protocolo 1 com 32 ratos submetidos a anastomose colônica com fio de náilon divididos em 2 grupos C (controle), e T (terapêutico). O grupo T realizou a terapia com ultra-som de alta freqüência, na região dorsal. O subgrupo sacrificado no 3o dia, recebeu ultra-som no 1o e 2o dias pós-operatório. E o no 7o, terapia no 4o, 5o e 6o P.O. No Protocolo 2 anastomoses com aço, subdivididos da mesma forma. E no Protocolo 3 comparou-se os grupos T do náilon e aço. Avaliou-se pressão de ruptura à insuflação (PRI) e estudo histológico. Resultados: Protocolo 1 no 3o dia a PRI foi maior no grupo T (p=0,001) e no 7o dia não houve diferença (p=0,0950). No Protocolo 2 no 3o dia não houve diferença na PRI (p=0,3060) e no 7o dia a PRI foi maior no C (p=0,0010). No Protocolo 3 no 3o dia a PRI foi maior n...
Aesthetic Plastic Surgery, Nov 22, 2007
Mammaplasty for patients who have experienced massive weight loss involves some concepts that dif... more Mammaplasty for patients who have experienced massive weight loss involves some concepts that differ from those that apply to mammaplasty for normal patients. Breast anatomic characteristics make this procedure a very challenging situation. The authors present their experience with a new mammaplasty technique using an extended thoracic wall flap associated with a loop of pectoralis. This procedure is a simple and reproducible method for patients with massive weight loss that results in a pleasing breast shape and long-lasting results.
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Papers by Alexandre E C Mansur