Pathologies comprising more than half the length of the trachea are a challenge to the reconstructive surgeon. Innovative tracheal transplantation techniques aim to offer the patient a curative solution with a sustained improvement in quality of life. This review summarizes the authors’ experience with the rabbit as a versatile model for research regarding tracheal transplantation. Because of the segmental blood supply of the trachea, it is not feasible to transplant the organ together with a well-defined vascular pedicle. As such, the key element of successful tracheal transplantation is the creation of a new blood supply. This vascularized construct is created by prelaminating the rabbit trachea heterotopically, within the lateral thoracic fascia. After prelamination, the construct and its vascular pedicle are transferred to the orthotopic position in the neck. This model has become gold standard because of the advantages of working with rabbits, the anatomy of the rabbit trachea, and the reliability of the lateral thoracic artery flap. In this paper, the key elements of surgery in the rabbit are discussed, as well as the tracheal anastomosis and the harvest of the lateral thoracic artery flap. Practical tips and tricks are presented. The data described in this review represent the fundaments of ongoing translational research in the center over the past twenty years.

Aim: Effects of rhinoplasty were already studied from many points of view: otherwise poor is scientific production focused on changes of voice after rhinoplasty. This preliminary study analyzed objectively and subjectively these potential effects on 19 patients who underwent exclusively closed rhinoplasty.

Methods: This preliminary evaluation was conducted from September 2012 to May 2013 and 19 patients have undergone primary rhinoplasty with exclusively closed approach (7 males, 12 females). All patients were evaluated before and 6 months after surgery. Each of them answered to a questionnaire (Voice Handicap Index Score) and the voice was recorded for spectrographic analysis: this system allowed to perform the measurement of the intensity and frequency of vowels (“A” and “E”) and nasal consonants (“N” and “M”) before and after surgery. Data were analysed with the Mann-Whitney test.

Results: Sixteen patients showed statistically significant differences after surgery. It was detected in 69% of cases an increased frequency of emission of the consonant sounds (P = 0.046), while in 74% of cases the same phenomenon was noticed for vowel sounds (P = 0.048).

Conclusion: Many patients who undergo rhinoplasty think that the intervention only leads to anatomical changes and improvement of respiratory function. The surgeon should instead accurately inform patients about the potential effects on the voice. This preliminary study reveals the significant effects of closed rhinoplasty on the human voice.

Aim: The aim of this study is to evaluate the efficacy of the protocol of nanofat and platelet-rich plasma (PRP) infiltration and fractional CO₂ laser resurfacing for face atrophic scars by acne and to analyse patient’s satisfaction with the original questionnaire.

Methods: From March 2014 to June 2015, 30 patients with acne scarsonthe cheeks were selected for this pilot study. Patients were evaluated pre- and postoperatively by a physical examination, photographs and ultrasound scan with a 22 MHz probe to measure subcutaneous tissue thickness. All patients were treated by infiltration of nanofat and PRP. The production of PRP was achieved by RegenLab THT tube^® method.

Results: Preoperative thickness of subcutaneous tissue of patients from group A was 0.532 mm, whilst preoperative thickness of subcutaneous tissue of patients from group B was 0.737 mm. Postoperative thickness of subcutaneous tissue was 1.201 mm in group A and 1.367 mm in group B. The improvement of thickness of subcutaneous tissue was 0.668 mm in group A and 0.630 mm in group B. The authors applied a t-test on unpaired data, comparing the difference in thickness obtained with the treatment both in group A and in group B, with a P = 0.7289 (not significant). All patients in both groups had a treatment benefit.

Conclusion: Combined approach with nanofat, PRP and CO₂ laser seems to be effective to improve trophic scars, however, infiltration alone proved to significantly increase skin and subcutaneous tissue thickness. QoL-Q confirmed the impact of acne scars on the face in social life and relationships.

Amyloidosis is an uncommon disorder characterized by extracellular deposition of abnormal proteins. Breast involvement has rarely been reported and can clinically be misdiagnosed as breast cancer. A 60-year-old woman presented with a 3-mm diameter mass in the right breast close to a silicon implant positioned 20 years before. A core biopsy, performed to rule out breast cancer, showed amyloid deposit. Further exams confirmed a systemic amyloid light chain amyloidosis. After few months the mass increased causing breast volume and shape distortion. Since breast cancer may be the cause of amyloid deposits or be hidden by it, the patient underwent a bilateral skin sparing mastectomy and expander and fat grafting breast reconstruction. The resection specimens showed amyloid deposits only, no evidence of cancer. At 2 years follow-up, no breast amyloidosis recurrence was shown. Breast amyloidosis is rare but can occur in a plastic surgeon’s practice. It is mandatory to rule out a comitant breast cancer or systemic amyloidosis.