- Body Surgery
- Facial surgery
- Non-surgical procedures
- Plastic surgery history Plastic surgeons
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Since syphilis and leprosy proliferate in the Renaissance, It is necessary to resume facial reconstructive techniques. In the 15th century the Branca family, from Catania (Sicily), retrieves the old Indian flap for the repair of defects of the face, especially the nasals2, 3. The one who initiates This stage is Gustavo Branca. At first he used the flaps of cheek and, later, the front, but both he as his son Antonio faced the risk of large scars in the donor area, this is why they devised and began to use the flap made with the skin from the arm, which we know as a method Italian5. Antonio Branca took the necessary skin of the biceps area, making a pedicled flap, carrying the end distal to the area that had suffered the loss of tissue, in this case, the nasal pyramid, then immobilized for 20 days, using a strong sling. After that time the flap was hooked, appearing a rudimentary nose, and this allowed them to cut the pedicle and replace it in the donor area. Subsequently, the procedure was completed by remodeling the reconstructed nose. This intervention, whose authorship is related to the family Branca, it was never published, however it acquired great notoriety, which contributed to its being known outside of Italy. Interestingly, this technique was published in detail in a book of surgery: Von Pfolspenndt’s book on the treatment of wounds with bandages, in 1460, and that was not released until about 400 years then, in the form of a manuscript. It seems that the family Vianeo, who lived in Calabria, had contact with the Branca, of those who could learn this surgical technique. But it is around 1497 when a great surgeon trained in University of Padua, Benedetti, published Anatomiae Sive History Corpus Humani, consisting of five volumes, and in it describes the flap or Italian method. It includes curious aspects, such as the influence of the cold on the skin, as it retracts (figure 8) the aesthetic results are worse. Fioravanti of Bologna also published, in 1560, this technique1, 2, 3, 7. But medicine will acquire its true scientific dimension from 1597, the year in which Tagliacozzi, born in Bologna in 1545, published in Venice, De Curtorum Chirugia per Insitionem, the first specific treatise on plastic surgery. He studied medicine in Bologna, considered one of the best universities of the time, which was later Professor of Surgery2, 5, 6, 7. According to Tagliacozzi, it was necessary to replace what “nature had granted and bad luck had deteriorated. ” He also used the skin of the front side of the arm, ensuring that for your success It should only be done with skin, without a muscular plane. East graft attached it to the nasal stump by a suture and then applied the complicated bandage that we see, whose only mission was to keep the arm and nose together. Tallaba, with very good criteria, the largest grafts in the area that he had to cover, because he had observed that, by of shrinkage, these shrunk dramatically, and others sometimes they were necrosed because their irrigation was defective (figure 9). The nose created had a lower consistency and the color was also different and, therefore, the appearance and texture were not the same, but at the end of the process, which was long, painful and requiring the immobilization of the patient a minimum of 15-20 days, the result was satisfactory, from the aesthetic point of view. This surgeon He strove to mitigate the aesthetic consequences produced by syphilis and leprosy, but the Ecclesiastical Hierarchy came to him consider a “possessed of the devil”, to whom they attributed their professional successes After his death, in 1599, both his work like that of the Branca, were forgotten during more than 200 years It was in 1831, when the work of Tagliacozzi is reissued by the Prussian surgeon Johann Friedrich Dieffenbach (1792- 1847) 3, 6, 7, which got the reconstructive surgery of the nose would revive again. Dieffenbach in 1845 tries to correct large or crooked noses through incisions in the skin and fracturing the nasal bones.