• Title/Summary/Keyword: Aesthetic surgery

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Long-term stability after multidisciplinary treatment involving maxillary distraction osteogenesis, and sagittal split ramus osteotomy for unilateral cleft lip and palate with severe occlusal collapse and gingival recession: A case report

  • Kokai, Satoshi;Fukuyama, Eiji;Omura, Susumu;Kimizuka, Sachiko;Yonemitsu, Ikuo;Fujita, Koichi;Ono, Takashi
    • The korean journal of orthodontics
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    • v.49 no.1
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    • pp.59-69
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    • 2019
  • In this report, we describe a case involving a 34-year-old woman who showed good treatment outcomes with long-term stability after multidisciplinary treatment for unilateral cleft lip and palate (CLP), maxillary hypoplasia, severe maxillary arch constriction, severe occlusal collapse, and gingival recession. A comprehensive treatment approach was developed with maximum consideration of strong scar constriction and gingival recession; it included minimum maxillary arch expansion, maxillary advancement by distraction osteogenesis using an internal distraction device, and mandibular setback using sagittal split ramus osteotomy. Her post-treatment records demonstrated a balanced facial profile and occlusion with improved facial symmetry. The patient's profile was dramatically improved, with reduced upper lip retrusion and lower lip protrusion as a result of the maxillary advancement and mandibular setback, respectively. Although gingival recession showed a slight increase, tooth mobility was within the normal physiological range. No tooth hyperesthesia was observed after treatment. There was negligible osseous relapse, and the occlusion remained stable after 5 years of post-treatment retention. Our findings suggest that such multidisciplinary approaches for the treatment of CLP with gingival recession and occlusal collapse help in improving occlusion and facial esthetics without the need for prostheses such as dental implants or bridges; in addition, the results show long-term post-treatment stability.

Outcomes Associated with Nasal Reconstruction Post-Rhinectomy: A Narrative Review

  • John, Jithin;Gupta, Rohun;Grossbauer, Anne;Chung, Michael;Sethna, Anita;Abboud, Michel;Cox, Eric;Hart, Justin;Folbe, Adam;Chaiyasate, Kongkrit
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.184-194
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    • 2022
  • The face and the external nose define an individual's physical appearance. Nasal deformities can cause facial disfigurement along with unwanted psychological repercussions. Nasal deformities range in severity, with the most severe cases being indications for a rhinectomy, due to the complexity of the nasal defect. According to published literature, there is no consensus among otolaryngologists and plastic surgeons on which technique or flap use is preferred in terms of complications, aesthetic outcome, or patient satisfaction. The goal of this study is to provide a comprehensive analysis of published studies on nasal reconstruction following rhinectomy. Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines for writing systematic reviews, a systematic review was conducted. Four databases were searched using a search strategy. These articles were then imported into the COVIDENCE software and went screening and thorough article review. After screening 2,237 articles, 23 studies were then extracted for data collection analysis. We collected data from 12 case series, 4 case studies, 1 prospective case series, and 4 retrospective chart review studies. The most commonly reported flaps were forehead flaps, superior extended nasal myocutaneous island, forearm free flaps, anterolateral thigh (ALT) free flap, medial femoral condyle free flap (n = 8), and zygomaticus implants (n = 6), and retained nasal prosthesis. Although not specifically indicated by a certain number, the most common indication for the rhinectomy was malignancy, followed by traumas, postsurgical complications, radionecrosis, and congenital nasal malformations.

Pleomorphic Adenoma of the Upper Lip: A Case Report (윗 입술에서 발생한 다형선종: 증례보고)

  • Tae Hyun Kim;Seong Heum Jeong;Chung Hun Kim
    • Korean Journal of Head & Neck Oncology
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    • v.40 no.1
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    • pp.33-36
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    • 2024
  • Pleomorphic adenoma (PA) is a commonly occurring benign tumor originating in the salivary glands. The incidence is mostly in the parotid glands (85%) followed by minor salivary glands (10%). Pleomorphic adenoma from minor salivary glands of the lips is a rare neoplasm. Here, we present a case of a patient with PA in the upper lip, reporting a common neoplasm in a rare site. A 82-year-old male with a slowly progressing swelling that occurred 20years ago on the upper white lip. This tumor is not associated with pain and tenderness. The mass was about 1.5x1.5cm sized, circumscribed, sessile and firm on the external upper lip without oral side bulging (Fig. 1). The tumor was removed completely with a elliptical incision under local anesthesia. The encapsulated mass was measured 0.9x0.9x0.6cm. On histology, a well-circumscribed growth was seen comprising epithelial and stromal components. The epithelial component formed glandular structures lined by round-to oval cells having small nuclei, pink cytoplasm and myoepithelial basal cell layer while the stroma had a fibromyxoid appearance(Fig. 2). Postoperatively wound was well healed without recurrence after 6months. Pleomorphic adenoma of the upper lip is a rare neoplasm, especially not intraoral growth. For aesthetic good result, the mass was removed without hesitation. It is required a high index of suspicion and a long-term follow-up because it could recur and rarely be transformed into malignancy.

Immediate implant placement in areas of aesthetic priority (상악 전치부에서 단일 치아 발거 후 즉시 임플란트 식립)

  • Lee, Seung-Hoon;Kim, Young-Sung;Kim, Won-Kyung;Lee, Young-Kyoo
    • Journal of Periodontal and Implant Science
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    • v.37 no.3
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    • pp.637-646
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    • 2007
  • Implants placed immediately after tooth extraction have been shown to be a successfully predictable treatment modality. Several clinical papers suggest that placing implants immediately after tooth extraction may provide some advantages: reduction of the number of surgical procedures or patient visits, preservation of the dimensions of alveolar ridge, and shortening of the interval between the removal of the tooth and the insertion of the implant supported restoration. In this case report, three patients received single immediate implant placements to replace a maxillary anterior tooth at the time of extraction. As the three cases were somewhat different, treatment protocols had to be modified as follows: Case 1. Immediate implant placement with healing abutment connection. Case 2. Immediate implant placement with immediate provisionalization. Case 3. Immediate implant placement with Guided Bone Regeneration(GBR). Every implant of these cases was placed in proper position buccolingually, mesiodistally and apicocoronally, The procedures following implantation such as immediate provisionalization and GBR were free of problem. Healing of each case was uneventful. In all cases, treatment outcomes were mostly satisfactory and the results maintained during follow-up periods. However, one case (Case 3) showed some papilla loss due to failure in delicate soft tissue handling during surgery. This papilla loss was compromised by prosthetic means. In conclusion, immediate implant placement in the fresh extraction socket can be a valid and successful option of treatment in aesthetic area. Moreover, this treatment protocol seems to maintain the preexisting architecture of soft and hard tissues in most cases.

The Combined Effect of Autologous Fat Injection and Liposculpture for Gluteal Reshaping in Koreans (한국인에 있어 둔부몸매교정(Gluteal Reshaping)을 위한 자가지방주입술 및 지방흡입술의 효과)

  • Kim, Jee-Hoon;Hong, Jin-Joo
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.861-866
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    • 2011
  • Purpose: Together with the breast, buttocks are an important element of attractive body contour. To make a beautiful buttocks, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. The authors investigated characteristic features of buttocks in Koreans and report about the results of liposculpture and autologous fat injection for improving buttock's contour. Methods: We performed a retrospective study of 21 patients who would like to gluteal reshaping. We checked about buttock's ptosis, projection, depression, gluteal retraction and excessive fat accumulation around buttocks. Depending on it, we performed liposculpture and autologous fat injection. Under general anesthesia, we harvested fat from excessive fat accumulation areas around buttocks, and injected into buttocks medio-superiorly. Postoperatively, pillows were positioned on the bed not to press the buttocks which were injected with the fat. Results: Based on the shape of buttocks, A-shape is seen in 4 cases (19%), V-shape 3 cases (14%), squareshape 9 cases (43%), round-shape 5 cases (24%). Based on the Gonzalez's ptosis grading method, 1 degree ptosis is 1 case (4%), 2 degree ptosis is 6 cases (29%), 3 degree ptosis is 8 cases (38%), 4 degree ptosis is 6 cases (29%). There were no complications such as infection, hematoma, pain, dysparethesia. The subjective assessment of surgical results by patients was excellent. Conclusion: To make a beautiful buttock, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. Liposculpture and autologous fat grafting are very safe, useful and easy methods for improving buttock's contour.

Evaluation of facial appearance in patients with repaired cleft lip and palate: comparing the assessment of laypeople and healthcare professionals

  • Alhayek, Samar;Alsalem, Mohammed;Alotaibi, Yazeed;Omair, Aamir
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.5.1-5.5
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    • 2019
  • Background: The present study aimed to determine whether laypeople and professionals rate the facial appearance of individuals with repaired complete unilateral or bilateral cleft lip and palate (UCLP, BCLP) similarly based on viewing full facial images. Methods: The study followed a cross-sectional analytical design where five young patients aged 10 to 14 years, who had completed all stages of their unilateral or bilateral cleft lip and palate treatment (bilateral: three, unilateral: two), were evaluated by two groups. The assessment was done by laypeople and 97 qualified professionals (33 orthodontists, 32 plastic surgeons, and 32 oral and maxillofacial surgeons). Professionals were not involved in any stage of the patients' treatment. Results: The facial appearance assessment of the professional groups on different facial aesthetics was significantly lower than that of laypeople, and they had higher perceived need for further treatment. On the other hand, laypeople had higher aesthetic ratings and lower perceived need for further treatment. Differences were also observed between the assessments of the professional groups. Participants who had lower aesthetic assessments of the repair tended to report a higher influence of cleft lip and palate on social activities and professional life. Conclusion: Differences in perception exist between healthcare professionals and laypeople. The discrepancies between the professional groups could be attributed to different treatment modalities and protocols.

Enzyme-Histochemical Study of Philtral Orbicularis Oris Muscle Fiber Types in Korean Male Cadaver (한국인 성인남성 사체에서 시행한 인중 구륜근 섬유들의 효소-조직화학적 분석)

  • Yu, Myung-Sook;Park, Jung-Min;Lee, Hee-Su;Lee, Suk-Keun;Kang, Ji-Young;Eo, Mi-Young;Lee, Jong-Ho;Kim, Soung-Min
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.2
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    • pp.47-56
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    • 2009
  • The orbicularis oris muscle (OOM) is a very important muscle that originate from the second branchial arch and is innervated by the facial nerve. The aim of this study was to elucidate distribution types of two muscle fibers that composing OOM by using enzyme-histochemical examinations and tried to make a basis for a clinical application. The fresh frozen tissues from the superior and inferior portions of the OOM were taken from post mortem 65-year-old Korean male adult. Total five different sagittal sections were used on the midline of the philtrum, the middle portion of lower lip, the mouth corner, and each midlateral side of upper and lower mouth. We used enzyme-histochemical staining such as Periodic Acid-Schiff (PAS), Succinic Dehydrogenase (SDHase), reduced Nicotinamide Adenine Dinucleotide-Tetrazolium Reductase (NADH-TR), Adenosine Triphosphatase (ATPase) in pH 9.4, 4.6 and 4.3, and Modified Gomori Trichrome. There were about 30.24 % type 1 muscle fiber and 65.40 % type 2 muscle fiber in the midline of the philtrum (p < 0.05). Enzyme-histochemical staining is very useful and innovative method to elucidate characteristics of muscle fibers. We expect that chiloplasty and reconstruction of the lip portions for cleft lip patients, based on these results, are better to recovery function and aesthetic. However, we have some problems as an intramuscular variability and the inter-individual variation etc. Therefore we have to make progress these studies continuously to overcome these problems.

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365 nm LED laser treatment on beagle for gingival whitening without gum dermabrasion (잇몸 박피술 없는 치은 미백을 위한 비글에서 365 nm LED 레이저 치료)

  • Lee, Sung-Ho;Kim, Ryun Kyung;Seo, Na-Ri;Lim, Ho-Kyung;Byun, Soo-Hwan;Lim, Young-Joon;Kim, Soung-Min;Lee, Jong-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.2
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    • pp.117-122
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    • 2016
  • Purpose: Gingival whitening is one of dental treatment purposes which is close to treating aesthetic disorders. Initial gingival whitening treatment was done by dermabrasion using a high power Diode Laser. However, this treatment method cannot be free from any infection or pain after the treatment. Therefore, we have decided to progress gingival whitening treatment using a low power LED laser. Materials and Methods: The laser was irradiated on pork meat then the safety of output power, temperature change and skin denaturalization was measured. Bison 365 nm LED laser was irradiated on oral mucosal pigment of a 15 - 20 kg beagle for 15 min for 1 - 2 weeks, one or two times each. Any pigment loss was checked through Hematoxyline-Eosin staining. Results: The melanin pigments at the area of 365 nm LED Laser irradiation were decreased. Conclusion: The 365 nm LED Laser proposed in this study is considered to compensate the bleaching effect achieved by either using Diode laser or surgical methods.

Reconstruction of the Finger using Rerouting the Transverse Digital Palmar Arch in the Crushing or Avulsion Injured Finger (짓니긴 및 벗겨진 손상에서 가로손가락손바닥활을 이용한 손가락 재건)

  • Choi, Hwan-Jun;Lee, In-Soo;Choi, Chang-Yong;Kim, Mi-Sun;Kim, Jun-Hyuk
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.59-66
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    • 2010
  • Purpose: In the finger, there are three major palmar arches in the arterial system. The location of this arches are constant. The middle and distal transverse arches are consistently large (almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. This paper describes our experiences in reconstruction and replantation of the finger using rerouting the transverse digital palmar arch. Methods: 31 patients with injuries according to our classification were treated from March of 2005 to October of 2008. In this study the authors subdivided injuries into those with amputation distal to the insertion of the flexor digitorum profundus (Class I, 31 fingers); those with amputation distal to the insertion of the flexor digitorum superficialis (Class II, 4 fingers). Replantation was performed using the artery-only technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration or converting the arch. Venous drainage was provided by an external bleeding method with partial nail excision, medical leech, and repaired margin. Results: The success rate was 87% (n=27) in class I and 75% (n=4) in class II. The authors conclude that crushing and complete avulsion injuries & amputations are salvageable, with acceptable functional results in select patients, especially those with amputation distal to the insertion of the flexor digitorum superficialis. Conclusion: We performed replantation and reconstruction with only-arterial transposing anastomosis successfully, resulting in good recovery of aesthetic and functional outcome. Three major digital palmar arches, especially distal two branches, give us additional treatment options. In the finger replantation and reconstructive techniques using rerouting healthy the transverse digital palmar arch increase the survival rate of the finger.

Regeneration of total tissue using alveolar ridge augmentation with soft tissue substitute on periodontally compromised extraction sites: case report (치주질환 원인의 심한 골소실을 동반한 발치와에 대한 치조제 증강술과 연조직 대체제를 이용한 조직 재생 효과: 증례보고)

  • Yerim Oh;Jae-Kwan Lee;Heung-Sik Um;Beom-Seok Chang;Jong-bin Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.276-284
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    • 2023
  • After tooth extraction, alveolar bone is resorbed over time. Loss of alveolar bone and reduction of upper soft tissue poses difficulties in future implant placement and long-term survival of the implant. This case report focuses on increasing the soft and hard tissues at the implant placement site by using alveolar ridge augmentation and a xenogeneic collagen matrix as a soft tissue substitute in an extraction socket affected by periodontal disease. In each case, the width of the alveolar bone increased to 6 mm, 8 mm, and 4 mm, and regeneration of the interdental papilla around the implant was shown, as well as buccal keratinized gingiva of 4 mm, 6 mm, and 4 mm, respectively. Enlarged alveolar bone facilitates implant surgery, and interdental papillae and keratinized gingiva enable aesthetic prosthesis. This study performed alveolar ridge augmentation on patients with extraction sockets affected by periodontal disease and additionally used soft tissue substitutes to provide a better environment for implant placement and have positive effects for aesthetic and predictive implant surgery.