Publications by authors named "R A Ersek"

116 Publications

Vaginal labiaplasty: defense of the simple "clip and snip" and a new classification system.

Aesthetic Plast Surg 2013 Oct 9;37(5):887-91. Epub 2013 Jul 9.

, 630 West 34th Street, Austin, TX, 78705, USA.

Vaginal labiaplasty has become a more frequently performed procedure as a result of the publicity and education possible with the Internet. Some of our patients have suffered in silence for years with large, protruding labia minora and the tissue above the clitoris that is disfiguring and uncomfortable and makes intercourse very difficult and painful. We propose four classes of labia protrusion based on size and location: Class 1 is normal, where the labia majora and minora are about equal. Class 2 is the protrusion of the minora beyond the majora. Class 3 includes a clitoral hood. Class 4 is where the large labia minora extends to the perineum. There are two principal means of reconstructing this area. Simple amputation may be possible for Class 2 and Class 4. Class 2 and Class 3 may be treated with a wedge resection and flap advancement that preserves the delicate free edge of the labia minora (Alter, Ann Plast Surg 40:287, 1988). Class 4 may require a combination of both amputation of the clitoral hood and/or perineal extensions and rotation flap advancement over the labia minora.
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http://dx.doi.org/10.1007/s00266-013-0150-0DOI Listing
October 2013

Large-volume liposuction and prevention of type 2 diabetes: a preliminary report.

Aesthetic Plast Surg 2012 Apr 19;36(2):438-42. Epub 2011 Aug 19.

Personique Surgery Center, Austin, TX, USA.

This report presents a preliminary study investigating the effects of large-volume liposuction on the parameters that determine type 2 diabetes. The study enrolled 31 patients with a body mass index (BMI) exceeding 30 kg/m(2) over a 1-year period. All the liposuction procedures were performed with the patient under local anesthesia using ketamine/valium sedation. Pre- and postoperative blood pressure, fasting glucose, glycosylated hemoglobin (HbA1C), weight, and BMI were evaluated for 16 of the 30 patients who returned for a follow-up visit 3 to 12 months postoperatively. The average aspirate was 8,455 ml without dermolipectomy and 5,795 ml with dermolipectomy. The data reveal a trend of improvement in blood sugar levels associated with weight loss that helps the patients. The average blood sugar level dropped 18% in our return patients, and the average weight loss was 9.2%. The average drop in BMI was 6.2%, and HbA1C showed a decrease of 2.3%. The patients with the best weight loss had the best reduction in blood sugar level and blood pressure. No transfers to the hospital and no thromboebolism occurred for any of the 31 patients. One dehiscence, two wound infections, and three seromas were reported. The authors hypothesize that large-volume liposuction in their series may have motivated some to diet, which could be explored in a larger series with control groups. Liposuction alone did not improve obesity but helped to motivate some of the patients to lose weight. These patients had the best results.
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http://dx.doi.org/10.1007/s00266-011-9798-5DOI Listing
April 2012

Further experience with permafacial implants for lip augmentation: a review of 100 implants.

Aesthet Surg J 2011 Jul;31(5):488-92

Background: Although fillers and surgical lip lifts are effective ways of treating the perioral area, both have inherent downsides. Fillers lack permanence, and lip lifts do not address the issue of fullness.

Objectives: The authors present the results of a long-term follow-up study of Permafacial implants (SurgiSil LLC, Plano, Texas) for lip augmentation. This report is a follow-up from their first publication. The original publication demonstrated the benefit of the procedure at the time of a facelift. The present study reports a long-term follow-up on all of the authors' first 50 patients.

Methods: The authors' original publication demonstrated the benefits of inserting Permafacial implants concurrent with a facelift procedure. In this long-term follow-up study, the results of the first 100 implants (50 patients) are presented; this initial group of patients was followed up for one to two years. Implant migration, lip function, implant position, sensation, and patient satisfaction are reviewed.

Results: Very few complications were reported; they included migration with revision, along with patient-requested size adjustments or removal. No extrusions were reported. The degree of patient satisfaction with these implants was high.

Complications: Although the authors initially experienced a significant migration rate, a modification in technique reduced this rate over the long term. Permafacial implants are an effective method of increasing fullness in the lip area, and they are associated with few complications and high patient satisfaction.
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http://dx.doi.org/10.1177/1090820X11411474DOI Listing
July 2011

The art of custom silicone implants for difficult deformities.

Aesthet Surg J 2010 Sep;30(5):720-4

Patients who present for unilateral correction of anatomical deformities require development of a mirror image prosthesis. Moulage casting techniques offer a viable option for accurate design from which a custom implant can be fashioned, allowing surgeons to place a device that is unique to each patient's needs. The authors discuss the advantages of working with an experienced artist to develop these castings and present two cases of successful implantation after moulage casting.
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http://dx.doi.org/10.1177/1090820X10380710DOI Listing
September 2010
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