brahmanand clinic

marking for breast reduction Partial mastectomy scar Tram flap marked out internal mammary vessel dissected out Microvascular anastomosis done primary closure and lateral muscle mass Lie of vascular pedicle before final closure final closure  both breast shape 40 year old female developed right breast cancer which was excised partilly . Hence completion mastectomy and right axillary dissection was done . Right breast was reconstructed with muscle sparing tram flap and left breast was reduced by lejour method. Lejour method is superior pedicle reduction technique which results in linear scar well accepted by patients. Tram flap was raised by sparing lateral muscle and including only medial component . Inferior epigastric artery of flap was connected to internal mammary vessels .  Drains were placed and flap was monitored for vascularity for 5 days and patient discharged there of. Nipple reconstruction and any other revision are d

length of penis and urethera Dorsal aspect Pre op view and flaps marked Flap during dissection with blood vessels after tourniquet release labial flaps for scrotal reconstruction , clitoral dissection, anterior vaginal flap for  urethral advancement vaginectomy in progress vaginectomy vaginectomy completed labial flaps to reconstruct scrotum sac microvascular anastomosis in groin Groin wound Dr wound closed A 30 year female under went Sex reassignment surgery . It is a major surgery consisting of many procedure clubbed together   1 Vaginectomy : Removal of vaginal wall  2scrotal reconstruction ; Raising labial flaps to form scrotum  3mastoidoplasty ; Elongating clitoris and releasing from its attachment  4uretheral elongation ; Urethral elongation from anterior vaginal wall flap  5 penile reconstruction.   Radial fore arm flap to form penis and urethra   Patient came after one ye

good union rail road fixator used uniting bone These are X rays of patients of gap nonunion of fracture tibia ,who have under gone ipsilateral vascularised fibula graft . All these patients were young men who had closed fracture tibia which has gone into non union with resultant shortening. Pedicled vascularized ipsilateral fibula was used to bridge the bone gap and fix the fracture .Rail road fixator was used to stabilize the construct and support it. One screw was always used in lower end to fix the bone graft. All these patients had good union , time taken to full weight bearing was around one year on average. Ranging from six months to 18 months.no patient has infection or wound healing issues.  Rail road fixator was removed once the  good radiological and clinical union was achieved. It is a good option for patients and places where financial, technical constraints prohibit extensive microsurgical exercise. Dr Adhishwar Sharma MB,