• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.101-107
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• 2010

Purpose: The free flap has been widely used as one stage reconstructive procedure the skin and soft tissue defect. The secondary adjuvant operations are often needed for better results as functional and aesthetic compartment. Therefore, we focus on the secondary adjuvant surgeries for better outcome after free flaps. Methods: One hundred ninety six consecutive patients underwent free flaps between January, 2002 and February 2009. The cases constituted ninety two male patients and one hundred four female patients. For the patients who got free flap operation, we investigated secondary adjuvant operations what type of procedures was applied according to the reconstructed sites. All clinical data were based on the patient's medical records. Results: Of one hundred ninety six patients in whom free flap was performed, a total of eighty two patients(41.8%) received the secondary adjuvant operation. Because of many patients got multiple secondary adjuvant operations, the number of the secondary adjuvant operation become one hundred fifty five cases. The most common used procedure is a liposuction, and the second one is a lipoinjection. Conclusion: As the secondary adjuvant operation like a liposuction, lipoinjection, etc., satisfaction for operative result was increased in the aspects of function and aesthetics. So the secondary adjuvant operation in free flap surgeries contributed in raising the patient's quality of life.

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.465-470
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• 2008

Purpose: Reduction malarplasty is a popular aesthetic surgery for contouring wide and prominent zygoma. However a few patients complain postoperative results and want to revise the midfacial contour. We analyzed the etiology of unfavorable results and treated unsatisfied midfacial contours after reduction malarplasty. Methods: Total 53 patients were performed secondary operation for correction of unfavorable results after primary reduction malarplasty from elsewhere. Midfacial contour was evaluated with plain films and three-dimensional computed tomography. Unfavorable midfacial contours were corrected by secondary malarplasty. Flaring of zygomatic arch was reduced with infracturing technique and prominent zygomatic body was reduced with shaving. Drooped or displaced zygoma complex has been suspended to higher position and fixed with interosseous wiring. As adjuvant procedure, autologous fat injection has been performed in the region of depressed zygomatic body region. Results: The etiology of unfavorable midfacial contour after reduction malarplasty was classified into 7 categories: undercorrection of zygomatic arch(n=8), undercorrection of zygomatic arch and undercorrection of zygomatic body(n=6), undercorrection of zygomatic arch and overcorrection of zygomatic body(n=28), overcorrection of zygomatic body(n=3), simple asymmetry(n=4), malunion(n=2) or nonunion(n=2). Slim and balanced malar contour was achieved with treatment. And most of the patients were satisfied with the results of the surgery. Conclusion: To prevent the unfavorable results after reduction malarplasty, complete analysis of facial contour, choice of appropriate operation technique, precise osteotomy under direct vision, and security of zygoma position are important.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.5-8
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• 2016

Background: Lobular keloid appears to be a consequence of hypertrophic inflammation secondary to ear piercings performed under unsterile conditions. We wish to understand the pathogenesis of lobular keloids and report operative outcomes with a literature review. Methods: A retrospective review identified 40 cases of lobular keloids between January, 2005 and December, 2010. Patient records were reviewed for preclinical factors such as presence of inflammation after ear piercing prior to keloid development, surgical management, and histopathologic correlation to recurrence. Results: The operation had been performed by surgical core extirpation or simple excision, postoperative lobular compression, and scar ointments. Perivascular infiltration was noted in intra- and extra-keloid tissue in 70% of patients. The postoperative recurrence rate was 10%, and most of the patients satisfied with treatment outcomes. Conclusion: Histological perivascular inflammation is a prominent feature of lobular keloids. Proper surgical treatment, adjuvant treatments, and persistent follow-up observation were sufficient in maintaining a relatively low rates of recurrence.