Second Opinion is a difficult problem for every doctor put in this situation. In this position, we must not let ourselves be influenced, in any way, by the judgment of the first clinician, who formed a diagnosis. But not judging the “evidence” that led to the formation of the first diagnosis is difficult. This case presentation reveals the influence of a diagnosis assumed to be correct from the first interpretation. The patient, from the rural area, presents herself to the doctor following a trauma from falling down the stairs. A soft tissue ultrasound is performed and it is interpreted to be a hematoma. Afterwards, the lesion stagnates in size without progressing towards resorption. After repeating the ultrasound, its interpretation is influenced by the first ultrasound investigation supporting the same diagnosis. As a result, the patient is not guided to make a radical therapeutic decision. The presentation in our clinic was decided by the patient for a “second opinion” and, as a result, all the investigations carried out did not take into account the results previously stated by the patient during the clinical examination in the specialized outpatient clinic. The tumor was one with unimpressive dimensions but disturbing in appearance, without influencing the functionality of the forearm. The patient does not complain of pain or paresthesia in the area occupied by the tumor. She was clinging to deep plans and immovable in front of them.

Breast cancer is the most common type of cancer found in women after skin cancer. It is also the second cause of cancer death in women after lung cancer. The incidence of breast cancer has decreased in the last decade due to the discontinuation of hormone replacement therapy in postmenopausal women The majority of women with breast cancer are in an early stage at the moment of detection and are eligible for breast conservation therapy and receive some form of systemic or local adjuvant therapy like chemotherapy or radiotherapy depending on the histological type of the tumor.
Acellular dermal matrices or ADM for short are processed dermis that can be used as an adjuvant to local flap reconstruction or as the primary material for reconstruction of the nipple. In this article we discuss the case of a 42 year old woman with breast carcinoma who underwent mastectomy and breast reconstruction with silicone gel implant and ADM and answered a set of questions created to optimize the patient journey from diagnosis to reconstruction and follow-up.

This article comes as a presentation of the clinical experience in the plastic surgery department. Gather the experience of 3 clinical cases, more representative, with different histopathological tumors, of important dimensions that occupied a large part of the facial anatomical unit, the nose. The article is structured by presenting the risk factors that are the causes of malignant lesions and by recalling the therapeutic options and general principles of addressing large lesions. Malignant lesions that occur most frequently in the nose are reviewed. We consider that it is a serious health problem, with various consequences, of a functional nature, which can affect the airways and aesthetically that can lead to a reconsideration of self-respect and the perception of the affected person towards his peers. The approach of the cases was done sequentially. The first surgical stage involved the excision of the lesion with the oncological safety limit, the defect being larger than the lesion and the more elaborate therapeutic options on the reconstruction scale. The first operative stage ended each time with covering the defect with a graft to have the confirmation of the histopathological examination, free of the tumor. The second stage of the treatment involved lifting the flap and accommodating it. The last surgical stage involved the sectioning of the pedicle and its reintegration into the donor area.