Publications by authors named "Dario Melita"

54 Publications

Gynecomastia and Chest Masculinization: An Updated Comprehensive Reconstructive Algorithm.

Aesthetic Plast Surg 2021 May 3. Epub 2021 May 3.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

Background: Gynecomastia is a common finding in males. Clinical aspect varies widely in world populations showing peculiar hallmarks according to different body shapes reflecting personal expectations; therefore, a surgical plan must be tailored on individual basis to all type of patients.

Materials And Method: A total of 522 patients, treated for bilateral gynecomastia from January 2007 to January 2019, were included and reviewed in this retrospective study. Considering physical status BMI, muscular trophism, hypertrophy of the mammary region, nipple-areola disorder, gland and skin cover consistency, a four-tier classification system has been used to classify the deformity and to assess a surgical plan. In all cases, a subcutaneous mastectomy was performed under direct vision.

Results: No recurrence of the deformity was observed as well as major complications such as necrosis, and high level of satisfaction was observed in all groups. No breast cancer was found at the histological examinations Operative time ranged from 25 minutes up to 120 minutes and hospitalization time ranged from 1 to 3 days.

Conclusion: Since the physical status is strictly related to the clinical features of the disorder, a comprehensive classification system and a reconstructive algorithm are proposed.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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http://dx.doi.org/10.1007/s00266-021-02275-7DOI Listing
May 2021

Endoscopic Axillary Approach Improves Patient Satisfaction of Gynecomastia Subcutaneous Mastectomy: A Cross-Sectional Study using the BODY-Q Chest Module.

Aesthetic Plast Surg 2021 Jan 15. Epub 2021 Jan 15.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-02086-2DOI Listing
January 2021

The Vacuum-Assisted Breast Biopsy System is an Effective Strategy for the Treatment of Gynecomastia.

Aesthetic Plast Surg 2021 Jan 5. Epub 2021 Jan 5.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-02053-xDOI Listing
January 2021

Circumlateral Vertical Augmentation Mastopexy for the Correction of Ptosis and Hypoplasia of the Lower Medial Quadrant in Tuberous Breast Deformity.

Aesthetic Plast Surg 2021 Jan 5. Epub 2021 Jan 5.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-02055-9DOI Listing
January 2021

"Bifidus Pedicle", the Use of Bilobed Superomedial Pedicle for Breast Reshaping Following Upper Outer Quadrantectomy: A New Oncoplastic Breast Surgery Technique.

Aesthetic Plast Surg 2021 Jan 5. Epub 2021 Jan 5.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-02059-5DOI Listing
January 2021

Expected Reduction of the Nipple-Areolar Complex over Time After Treatment of Gynecomastia with Ultrasound-Assisted Liposuction Mastectomy Compared to Subcutaneous Mastectomy Alone.

Aesthetic Plast Surg 2021 06 30;45(3):1350-1351. Epub 2020 Nov 30.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-02052-yDOI Listing
June 2021

Changes in Lid Crease Measurements in Levator Advancement for Ptosis.

Ann Plast Surg 2021 Jun;86(6):731

Plastic and Reconstructive Microsurgery - Careggi University Hospital, Florence Italy

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http://dx.doi.org/10.1097/SAP.0000000000002530DOI Listing
June 2021

A Modified Technique Using Levator Aponeurosis-Muller Muscle-Reinforced Plication for Blepharoptosis Correction.

Ann Plast Surg 2021 03;86(3):365

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy

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http://dx.doi.org/10.1097/SAP.0000000000002496DOI Listing
March 2021

D-SUN Method to Prevent Double-Bubble Deformity in Broad Base Breasts with High-Rising Inframammary Fold.

Aesthetic Plast Surg 2021 04 6;45(2):817-818. Epub 2020 Jul 6.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-01856-2DOI Listing
April 2021

Infraorbital groove correction by microfat injection after lower blepharoplasty.

J Plast Reconstr Aesthet Surg 2020 12 18;73(12):2239-2260. Epub 2020 May 18.

Plastic and Reconstructive Microsurgery - Careggi University Hospital, Florence, Italy. Electronic address:

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http://dx.doi.org/10.1016/j.bjps.2020.05.004DOI Listing
December 2020

Evaluation of Residual Neuro-Muscular Integrity in the Orbicularis Oculi Muscle After Lower Eyelid Transcutaneous Blepharoplasty According to Reidy Adamson-s Flap.

Aesthetic Plast Surg 2020 10 26;44(5):1577-1583. Epub 2020 May 26.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

Background: The aging process affects skin, muscle and fat of the eyes in a different manner. Their individual rejuvenation would require specific surgical treatment according to their particular demands during lower eyelid blepharoplasty. This would require the separate management of the skin and the muscle by separating them into two different flaps. Basing on the anatomy, during sub-ciliary myocutaneous incision in conventional lower eyelid transcutaneous blepharoplasty most of innervations of the lower orbicularis oculi muscle are transected and denervation sequelae at the pretarsal orbicularis oculi muscle would be expected. However, sub/ciliary approach is still popular. The absence of signs or symptom of denervation of in our large case series even though injury to the motor innervation of the orbicularis oculi muscle during the operation led the authors to investigate the discrepancy between the anatomical concept and clinical outcomes. The study aimed to investigate the residual functionality of the orbicularis oculi muscle after lower eyelid transcutaneous blepharoplasty according to Reidy Adamson-s flap.

Materials And Methods: Ten patients were enrolled in the study. Orbicularis oculi muscle functionality was investigated with electroneurography before and at least 6 months after the surgical procedure. Investigated parameters are: Compound Muscle Action Potential (CMAP) as expressions of quantity of activated muscular fibers by the electrical stimulation of the facial nerve. Pre- and post-op collected data were compared and statistically analyzed.

Results: The mean age was 52.9; minimum follow-up 6 months; twenty eyes were investigated; 1 patient was excluded. Postoperative data did not show any significant reduction in the CMAP at all.

Conclusion: The study suggests that the buccal branch and medial branch of the zygomatic nerve of the facial nerve supplies efficiently to the orbicularis oculi innervation.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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http://dx.doi.org/10.1007/s00266-020-01783-2DOI Listing
October 2020

Our 10 Years' Experience in Breast Asymmetry Correction.

Aesthetic Plast Surg 2020 10 14;44(5):1898-1899. Epub 2020 May 14.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-01746-7DOI Listing
October 2020

Why do We Need Anatomical Implants? Science and Rationale for Maintaining Their Availability and Use in Breast Surgery.

Aesthetic Plast Surg 2021 04 2;45(2):822-824. Epub 2020 Apr 2.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-01694-2DOI Listing
April 2021

Prospective Analysis and Comparison of Periareolar Excision (Delivery) and Pull-Through Technique for the Treatment of Gynecomastia.

Aesthetic Plast Surg 2020 06 17;44(3):1089-1090. Epub 2020 Mar 17.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale dei Mille 129, 50131, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-020-01676-4DOI Listing
June 2020

Autologous Fat Grafting with Percutaneous Fasciotomy and Reduction of the Nipple-Areolar Complex for the Correction of Tuberous Breast Deformity in Teenagers.

Aesthetic Plast Surg 2020 04 26;44(2):611-612. Epub 2019 Dec 26.

Plastic and Reconstructive Microsurgery, CTO Careggi University Hospital, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-019-01591-3DOI Listing
April 2020

Breast Asymmetry, Classification and Algorithm of Treatment: Our Experience.

Aesthetic Plast Surg 2020 02 4;44(1):247-248. Epub 2019 Oct 4.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-019-01506-2DOI Listing
February 2020

Minimally Invasive Conjoint Fascial Sheath Suspension for Blepharoptosis Correction.

Aesthetic Plast Surg 2019 12 16;43(6):1683-1684. Epub 2019 Aug 16.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale dei Mille 129, 50131, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-019-01470-xDOI Listing
December 2019

Re: A novel method to insert drain atraumatically after liposuction in gynecomastia.

Indian J Plast Surg 2018 Sep-Dec;51(3):342-343

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

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http://dx.doi.org/10.4103/ijps.IJPS_106_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440363PMC
April 2019

Surgical Calf Augmentation Techniques: Personal Experience, Literature Review and Analysis of Complications.

Aesthetic Plast Surg 2019 08 13;43(4):973-979. Epub 2019 Mar 13.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Via Valdichiana 88, 50127, Florence, Italy.

Background: More attention is paid to calf appearance, both in males and females, and several surgical techniques are available. Different studies have been published over time for calf augmentation, but, to the best of our knowledge, no comprehensive literature review and complications analysis have been published.

Objectives: The aim of the study is to analyse the overall complication rate of calf augmentation surgical procedures and complication rates associated with the investigated techniques, namely subfascial implant placement, submuscular implant placement and fat grafting or lipofilling. Demographic analysis, including age and gender, is also performed.

Materials And Methods: A literature review on the PubMed database was performed for clinical studies regarding calf augmentation surgical procedures. The authors selected and analysed 26 articles among the actual literature on this field and reported personal experience in calf augmentation surgery.

Results: Twenty-six studies, published from 1993 to 2018, were included in the study for a total amount of 1498 patients, with a total of 2629 calves treated. Three different surgical techniques have been reviewed, excluding medical procedures: subfascial implant augmentation (n = 1929), submuscular implant augmentation (n = 435) and fat grafting (n = 265). The overall complication rate was 4.4883%. Calf augmentation with subfascial implants presented a total complication rate of 5.702%. The submuscular implant placement complication rate was 0.92%. Fat grafting presented a global complication rate of 1.509%.

Conclusions: Calf augmentation, with all reviewed surgical techniques, has a low rate of complications compared to other body contouring procedures, but a high rate of satisfaction among patients. Fat grafting has the lowest rate of complications, but multiple sessions are required. Specific complications of implants, such as capsular contracture, malposition or rupture, are less common compared to the use of implants for other cosmetic purposes. Procedures should always be performed by experienced plastic surgeons.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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http://dx.doi.org/10.1007/s00266-019-01347-zDOI Listing
August 2019

Penile reconstruction in a newborn following complicated circumcision: A case report.

Int J Surg Case Rep 2018 22;53:370-371. Epub 2018 Nov 22.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

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http://dx.doi.org/10.1016/j.ijscr.2018.11.034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257942PMC
November 2018

Refinements in Tear Trough Deformity Correction: Intraoral Release of Tear Trough Ligaments: Anatomical Consideration and Clinical Approach.

Aesthetic Plast Surg 2018 Dec 8;42(6):1576-1581. Epub 2018 Oct 8.

Department of Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

Background: Correction of tear trough (TT) deformity is a crucial aspect of facial rejuvenation. Because the anatomical origins of TT deformity lie in the TT ligaments, which firmly attach the dermis to the periosteum, the release of TT ligaments should be considered when performing an etiological correction. The aim of this paper is to propose an alternative method for TT deformity correction, comprising use of filler together with the release of TT ligaments. This technique was compared to the procedure of only percutaneous filler.

Methods: From January 2014 to December 2015, 10 patients were enrolled in the study for recurrence of TT deformity. All the patients underwent TT ligament release and filler injections; all had been previously treated with percutaneous hyaluronic acid injection without ligament release. Under local anesthesia, the TT ligaments were detached using a blunt cannula introduced directly in the supra periosteal plane through an intraoral access. Once the ligament was released, the TT depression was evenly recontoured with a very small amount of filler. The clinical data, digital images, evaluations of outcomes, including patient satisfaction rates were collected and compared.

Results: Adding the procedure of TT ligament release to filler injections showed satisfactory results, avoiding an unnatural puffy appearance. The comparison between the two different methods showed improved outcomes and increased patient satisfaction with minor patient discomfort among those who underwent TT ligament release.

Conclusion: Because TT ligaments are among the etiologic factors of TT deformity, they have a strong impact on procedures that are designed to improve TT deformity; therefore, TT ligament release should always be considered to obtain satisfactory, natural results.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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http://dx.doi.org/10.1007/s00266-018-1245-4DOI Listing
December 2018

Effects of Cutaneous Negative Pressure Application on Perforator Artery Flow in Healthy Volunteers: A Preliminary Study.

J Reconstr Microsurg 2019 Mar 15;35(3):189-193. Epub 2018 Aug 15.

Department of Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

Background:  The creation of skin flaps based on small perforator vessels is an increasingly popular procedure nowadays; the optimization of their blood supply enhances surgical success. This study evaluates the effects on the flowmetries of 7 days' negative pressure application on the skin surface overlying the muscle fascia emergence of periumbilical perforators of the deep inferior epigastric artery (DIEA).

Methods:  Ten volunteer participants were enrolled. In each subject, one periumbilical perforator of the DIEA was identified on each side of the abdomen using an eco-color-Doppler. One of them was used as the control group, while the other (the study group) underwent 80 mm Hg negative pressure for 7 days. The flowmetries of both perforators were measured before and after the application of negative pressure wound therapy.

Results:  After the application of negative pressure, randomly applied on the skin surface over one of the two selected periumbilical perforators, an increase in the flowmetries was observed in both groups of perforators (2.74 cm/s;  < 0.0001). The relative flowmetry increase in the control group was 9.55% (2.735 cm/s), while in the study group it was 44.03% (8.748 cm/s).

Conclusion:  The application of negative pressure system on the skin surface over the muscle fascia emergence of the selected periumbilical perforators showed an increase in flowmetry. Although this is a preliminary study, this simple and economical procedure before surgery could be usefully employed to increase the rate of success in microsurgical procedures.
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http://dx.doi.org/10.1055/s-0038-1668157DOI Listing
March 2019

Clinical Characteristics of Asymmetric Bilateral Gynecomastia: Suggestion of Desirable Surgical Method Based on a Single-Institution Experience.

Aesthetic Plast Surg 2018 12 9;42(6):1716-1717. Epub 2018 Aug 9.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-018-1161-7DOI Listing
December 2018

Classification and Treatment of Adult Buried Penis.

Ann Plast Surg 2018 10;81(4):508

Plastic and Reconstructive Microsurgery-Careggi University Hospital, Florence, Italy

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http://dx.doi.org/10.1097/SAP.0000000000001574DOI Listing
October 2018

Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution.

Plast Reconstr Surg 2018 08;142(2):235e-236e

Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy.

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http://dx.doi.org/10.1097/PRS.0000000000004555DOI Listing
August 2018

Evaluation of Glandular Liposculpture as a Single Treatment for Grades I and II Gynecomastia.

Aesthetic Plast Surg 2018 12 4;42(6):1707-1708. Epub 2018 Jun 4.

Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-018-1156-4DOI Listing
December 2018

Experience of Immediate Ambulation and Early Discharge After Tumescent Anesthesia and Propofol Infusion in Cosmetic Breast Augmentation.

Aesthetic Plast Surg 2018 10 7;42(5):1410-1411. Epub 2018 Feb 7.

Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-018-1094-1DOI Listing
October 2018

Discussion on "Gynecomastia Surgery-Impact on Life Quality: A prospective Case-Control Study".

Ann Plast Surg 2018 02;80(2):193-194

Department of Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy Department of Plastic and Reconstructive Surgery, University of Bari, Foggia, Italy; Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.

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http://dx.doi.org/10.1097/SAP.0000000000001172DOI Listing
February 2018

Discussion: Management of Tuberous Breast Deformities: Review of Long-Term Outcomes and Patient Satisfaction with BREAST-Q.

Aesthetic Plast Surg 2018 06 4;42(3):901-902. Epub 2018 Jan 4.

Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy.

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http://dx.doi.org/10.1007/s00266-017-1066-xDOI Listing
June 2018