• Archives of Plastic Surgery
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• v.38 no.6
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• pp.845-850
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• 2011

Purpose: In general, orientals including Korean, have a mesocephalic face whereas Caucasians, among the western, have a dolichocephalic face. Unlike the western, in orientals including Korean, prominent malar bones are recognized as stubborn and unattractive appearance. That is why reduction malarplasty is one of the most popular aesthetic surgical procedure in Korea. Many surgical methods to reposition prominent malar bones have been performed by means of a coronal incision or a combined incisions, using both the intraoral and the external incision. Bicoronal approach has advantage such as wide operative field, easy to maintain symmetry and possibility of combining facial lift but has shortcoming, such as external scars, long operative time, and the possibility of facial nerve or artery injury. Intraoral approach has advantages of short operative time, simplicity of procedure and no external scar. But this approach is associated with problems of cheek drooping, limited exposure and difficulty in making symmetry. Methods: During 8 years, we performed a reduction malarplasty without internal fixation through an minimal intraoral incision and dissection in 39 patients. Results: The patients were followed for 46 months, with satisfactory results and no cheek drooping. There was no patient who want to revise the inappropriate operative result such as asymmetry and incomplete correction. Conclusion: We conclude that minimal intraoral incision and dissection could acquire satisfactory result of reduction malarplasty along with prevention of cheek drooping.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.250-257
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• 2007

Purpose: Aging changes of midface include drooping of lower lid, wrinkles of malar area, orbitomalar groove and deepening of nasolabial fold from drooping of malar fat pad. Improvement of lower lid can be achieved through lower blepharoplasty, but improvement of cheek can not be gained. Superficial subciliary cheek lift(by Moelleken, 1996) is a method that lifts malar fat pad through extended subciliary incision. We obtained simultaneous improvement of lower lid, malar wrinkles and orbitomalar groove with modification of this technique. Methods: From December 2003 to January 2006, we performed this method on 21 patients among volunteers for lower blepharoplasty who wanted to correct orbitomalar groove and malar wrinkles. Under local anesthesia, lateral extension of subciliary incision is done 1cm from the lateral orbital rim. Skin-muscle flap is elevated, and dealing of orbital fat and septum is the same as with ordinary lower blepharoplasty. After downward subcutaneous dissection through extended incision, exposing the upper 1/3 level of malar fat pad, superolateral fixation is done to superior deep temporal fascia. Excision of the upper part of fat pad is performed, if needed. After excision of overlapped skin-muscle flap, skin closure is done. Results: We obtained satisfactory results with this simple method for improvement of orbitomalar groove and malar wrinkles among patients for lower blepharoplasty. During a follow-up period of 5 months on the average, no revision was performed. Conclusion: Under local anesthesia, lower blepharoplasty and improvement of orbitomalar groove and malar wrinkles can be achieved at the same time. It is good for patients who do not want conventional midface-lifting. But surgeons should select patients and perform cautiously for it may leave a scar of the extended incision that require over 2 months for maturation and it is insufficient for improvement of nasolabial fold compared to conventional mid face-lifts.

• The Journal of the Korean dental association
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• v.58 no.2
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• pp.103-113
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• 2020

Background: Reduction malarplasty is one of the most popular facial contouring surgeries in east Asia for making patients' faces smaller. Currently in Korea, reduction malarplasty surgeries are performed mostly at plastic surgery clinics, but few cases are done at oral and maxillofacial surgery clinics. The reason might be because of post-operative complications after reduction malarplasty, such as undercorrection, overcorrection, asymmetry, cheek drooping, malunion, pain and noise. Those complications should be uneasy to be handled by oral and maxillofacial surgeons, however, they can be prevented by knowing the effective and safe reduction malarplasty techniques. Therefore, in this article the author as an oral and maxillofacial surgeon, would like to suggest safe and effective surgical methods for reduction malarplasty customized for Korean patients. Method: L- shape osteotomy of zygomatic body was performed with intraoral approach via vestibular incision, and the zygomatic arch was osteotomized with extraoral approach via sideburn incision. Then zygomatic complex was separated and rotated mesio-superiorly without removal of a bony strip and fixed with miniplates and microplates without making a bony gap. Conclusion: Surgical results were favorable and satisfied by the patients without cheek drooping, malunion, undercorrection and asymmetry.

• Journal of the Korean Institute of Telematics and Electronics B
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• v.31B no.9
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• pp.101-111
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• 1994

The human face can provide a great deal of information in regard to his/her race, age, sex, personality, feeling, psychology, mental state, health condition and ect. If we pay a close attention to the aging process, we are able to find out that there are recognizable phenomena such as eyelid drooping, cheek drooping, forehead furrowing, hair falling-out, the hair becomes gray and etc. This paper proposes that the method to estimate the age by analyzing these feature components for the facial image. Ang we also introduce the method of facial image synthesis in accordance with the cange of age. The feature components according to the change of age can be obtainec by dividing the facial image into the 3-dimensional shape of a face and the texture of a face and then analyzing the principle component respectively using 3-dimensional model. We assume the age of the facial image by comparing the extracted feature component to the facial image and synthesize the resulted image by adding or subtracting the feature component to/from the facial image. As a resurt of this simulation, we have obtained the age changed ficial image of high quality.

• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.101-104
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• 2008

Purpose: Diplopia and cosmetically unacceptable enophthalmos are the major complications of blow out fracture. Prolapse of orbital tissue into the sinuses, enlarged orbital volume, atrophy of orbital fat and loss of support of orbital walls play a role in the pathogenesis of enophthalmos. To correct post-traumatic enophthalmos, freeing of incarcerated orbital contents combined with reduction of bony orbital volume and reconstruction of suspensory support of globe is necessary. But remained enophthalmos after surgical treatment is difficult to correct completely. In this case, the authors performed implant insertion for affected orbit and endoscopic orbital decompression for unaffected orbit for correction of late enophthalmos. Method: We reviewed a girl patient with right inferomedial orbital wall blow out fracture, right zygoma fracture treated at our hospital for correction of enophthalmos. An 18-year-old female had sustained posttraumatic enopthalmos. Two surgical management was performed for correction blow out fracture at the other hospital. But residual diplopia, enophthalmos, cheek drooping were found. And then she transferred to our hospital. She had severe enophthalmos(5 mm) also had diplopia and extraocular muscle limitation. We performed operation for correction of enophthalmos. After operation, she showed minimal improvement of diplopia and enophthalmos(3 mm). The authors make plan for operation for correction enophthalmos due to cosmetical improvement. Implant insertion was performed for affected orbit. For unaffected orbit, nasoendoscopic medial orbital wall decompression was proceeded. Result: Correction of enophthalmos was found after operation and was maintained for nine years follow-up. Patient expressed satisfaction for the result. Conclusion: To correct persistant enophthalmos, we could have satisfactory result with orbital wall reconstruction on affected eye and decompression on unaffected eye.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.3
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• pp.171-177
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• 1993

The prominent malar region has been recognized a sign of youth and beauty in caucasian who generally have a dolichocephalic and long face. But in the orients, especially Koreans who generally have a mesocephalic or brachycephalic face, it is considered an agressive, unesthetic facial appearance. So many patients require the shaving of prominent malar eminence and arch, and many methods of its reduction have been devised. For the exposure of malar complex, infraorbital skin incision, intraoral approach, preauricular approach, supraauricular scalp incision, and coronal approach have been used. And for the reduction of bony structure, direct shaving, contouring and repositioning of the malar complex after extirpation, and medially fracture of zygomatic arch have been used with its own merits. We performed the reduction malarplasty through intraoral approach. After two parallel oeteotomy at medial part of the zygomatic bone, the midsegment is removed. The posterior arch of zygoma was bended or green stick fractured. When more correction was required, the posterior arch was fractured medially through the step incision at skin. This method has a some advantages. Compared with the method for extirpation of malar complex, the infection rate is diminished, the resorption is small because of no free bone graft. And cheek drooping is prevented. Compared with the method of coronal approach, the surgical trauma is minimal. Now we report some cases of reduction malarplasty performed through intraoral approach and disscus the surgical technique and results.

• The Journal of Internal Korean Medicine
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• v.15 no.1
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• pp.176-209
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• 1994

1. The Jung-Sa(正邪) of the Excessive Liver-Symptoms belongs to the eleven symptoms, there are blue face, blue thin fingernail, anger, fancy of larg body, dizziness, eye flame, Bell's palsy, hard swelling pain at braest, side pain going on the belly from the side, side pain and movement at the left side. 2. The Mi-Sa(微邪) of the Excessive Liver-Symptoms belongs to the four symptoms, there are meat in eye, edema in cheek, lack of appetite and diarrhea. 3. The Juk-Sa(賊邪) of the Excessive Liver-Symptoms belongs to the only one symptom, this is nosebleeding. 4. The Hu-Sa(虛邪) of the Excessive Liver-Symptoms belongs to the three symptoms, there are scrotum constraction, strain in belly and constipation. 5. The Sil-Sa(實邪) of the Excessive Liver-Symptoms belongs to the twenty eight symptoms, there are red eye, raised eyes(兩眼上?), spitting blood, sternocostal turgid pain, turgidity in belly, drooping testis, vomiting water acid, sickening, belching, confusion, impatience, frequent forgetfulness, headache, giddness, eye pain, deaf, ringing in the ear, feeling inverse, drying mouth, stuffiness sensation in the chest, chest pain, stuffiness sensation in the belly, bellyache, quadriplegia, spasm of extremities, tremor, alternate spells of fever and chills, high fever and strain in muscle. 6. Those symptoms, Red corner of the eye, red face, swelling on the forehead, stiff-neck and back strong, opisthotonos, constracture of the limbs, vomiting yellow bitter water, speech impediment, epilepsy, depression, strong tongue, different thing in throat, fullness and distention of the gastric region, feeling sick and tenesmus, have no connected with the Excessive Liver-Symptoms(肝實證) 7. The Excessive Liver-Symptoms(肝實證) is connected with the ganjabyoung(肝自病) and Hwa(火) which the pathology is, than because Mock(木) is excessive and Mock-Saeng-Hwa(木生火), the ganjabyoung(肝自病) and Sil-Sa(實邪) are many. 8. There are the sixteen symptoms with the exception of The Excessive Liver-Symptoms(肝實證), because supposed that the scholars in medicine included the union syndroms(合病), the combine syndroms(兼病) and the analysis of symptoms(辨證) in The Analysis of Five Visceral Symptoms. 9. During consideration of the symptoms at the above statements, where are many causes by Gan-Pung(肝風), there is difficult of distinction between the excessive Liver-Symptoms(肝實證) and C.V.A(Cerebral Vascular Attack). Because than NaeKyung(內經) distinguished between the excessive Liver-Symptoms(肝實證) and C.V.A., the future medical specialists connected with the excessive Liver-Symptoms(肝實證) and C.V.A.. 10. An appearance of Sang-Hwa(相火) that the liver possessed is divided into an appearance of Hwa(火), there will be making a study att the more necessary. 11. The cuases of each syndroms are consist of the origins of syndroms, its pathology and the positions where the syndroms appeared, I consider that is the various ways how judge the syndroms except the Five Pathogenic Factors(五邪). 12. If more than study will be achieved in all, the new definition will be standed about the Excessive and Deficient Five Visceral Syndroms(五臟虛實證), I consider this will be the foundation data that study the Oriental Medicine and the important data that is a judgement standard of clininc.