• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.86-89
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• 1997

Neurofibromatosis, now termed neurofibromatosis type I, is known as a congenital and familial disease presenting abnormalities of the skin, nervous system, bones, and soft tissue. We experienced a case of extremely large neurofibromatosis which developed on the orbital and temporal region of a 24-year-old man. The tumor was widely excised including normal skin margin, outer table of cranium, a part of zygoma and maxilla. Bony defect was reconstructed by rib bone graft and secondary cosmetic correction of blepharoptosis was performed using supratarsal fixation in postoperative 6 months.

• Archives of Plastic Surgery
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• v.50 no.1
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• pp.26-29
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• 2023

Cryptotia is a rare congenital auricular deformity among Caucasians but more common in Asians. Various operative techniques have been described, such as skin graft, V-Y plasty, Z plasty, and islands skin flap. Among those techniques, V-Y plasty has many advantages and is indicated for severe cases. However, several problems remain when this method is adopted, such as conspicuous scars and lowered hairline. To overcome these problems, the authors have developed a new technique, multiple V-Y advancement modification, which stitches the skin flaps together to a tight, discrete central focal point. This technique has the advantage of hiding scars behind the earlobe, providing enough skin for the deformed areas, minimizing the condition of the hairline being lowered and auriculocephalic sulcus depth.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.782-786
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• 2005

Pressure sores are a common complication of hospitalized patients. However, It is often impossible to correct surgically because the general conditions of these patients are poor. It is known that the hydrogel has a powerful autolytic effect by providing moist environments and facilitates wound healing and hydrocolloid dressing is also known to promotes granulation tissue formation and epithelialization. The patients were treated with hydrogel(Purion $gel^{(R)}$, Coloplast A/S, Denmark) and hydrocolloid dressing (Comfeel Plus Transparent $Dressing^{(R)}$, Coloplast A/S, Denmark) after surgical debridement of pressure sores progressed to stage III(n=2) and IV(n=7). This combination treatment could facilitate to debride the nectrotic tissue and promote granulation tissue formation epithelialization simultaneously. We could achieve complete healing of pressure sores using the combination treatment without requiring surgical correction. In conclusion, hydrogel in combination with hydrocolloid dressing is effective in acheiving complete healing of progressed pressure sores.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.461-464
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• 2010

Purpose: Blepharoptosis can result from either congenital or acquired causes. Blow out fracture or facial bone fracture including blow out fracture can be one of the causes. Authors experienced 3 cases of severe blepharoptosis after blow out fracture treated only with observation after reduction of associated fracture. Methods: Reconstruction of orbital wall was conducted on all cases diagnosed as blow out fracture using 3 dimensional computed tomography, and conservative treatment was done on accompanying severe blepharoptosis. Results: At the time of injury, all cases showed severe blepharoptosis requiring frontalis muscle transfer for correction. But blepharoptosis was recovered in an average of 18 weeks without any surgical procedure except reconstruction of orbital wall. Conclusion: Once Blepharoptosis occurred after blow out fracture, thorough evaluation must be done at first. If definitive cause of blepahroptisis cannot be found as authors' cases, injury of oculomotor nerve may result in blepharoptosis. So, as for blepharoptosis after blow out fracture, conservative treatment following reconstruction of fractured orbital wall can be one of good management.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.695-698
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• 2010

Purpose: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. Methods: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a $2.8{\times}3.1\;cm$-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. Results: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. Conclusion: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.187-192
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• 2008

Purpose: Generally speaking, most of Korean have smaller eyes than those of Caucasian and they have epicanthus with narrow palpebral fissure. It makes external appearance looking dull because the length of the palpebral fissure is short and there is a epicanthus. In case the function of the levator muscle is weak, their eyes look much smaller. Epicanthus and weak levator muscle function make the eyes look dull. The above mentioned, authors want to introduce double eyelid operation, epicanthoplasty, levator plication to extend and lengthen the palpebral fissure. Methods: From August 2001 to August 2004, there were 138 cases that had double eyelid operation with epicanthoplasty or levator plication. the 69 cases of them had double eyelid operation and epicanthoplasty, the 33 cases of them had double eyelid operation and levator plication and the 36 cases of them had double eyelid operation and epicanthoplasty and levator plication. Results: After the operation, the length and height of the eyelid are improved remarkably, and most of the patients were satisfied. The length of the eyelid is improved 3 to 5mm($3.4{\pm}0.5mm$) in case of the epicanthoplasty, the width of the eyelid is improved 3 to 4mm($3.1{\pm}0.3mm$) by the levator plication. The length of the eyelid is improved 3 to 5($3.4{\pm}0.4mm$) and the width is improved 2 to 4mm($2.9{\pm}0.5mm$) by the epicanthoplasty used levator plication. Conclusion: The improvement of the eyelid length is almost the same as epicanthoplasty and levator plication are done simultaneously. But the improvement of the eyelid width is less shorter when epicanthoplasty and levator plication are done simultaneously than the case of levator plication alone. This is because there is a tension influencing on the limitation of widening palpebral fissure to fix the epicanthal tendon. This method is recommendable for the patients who want to have much bigger eyes.

• Archives of Craniofacial Surgery
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• v.23 no.4
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• pp.178-182
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• 2022

Postoperative temporal hollowing is a common complication of craniotomy. Damage and repositioning of the temporalis muscle can lead to a depression in the temporal side of the skull with inferior bulging, worsening aesthetic outcomes. We report a case of cranioplasty with three-dimensional (3D) printed mesh involving an additional correction using a temporalis muscle sling to help address this problem. A 3D-printed bioabsorbable mesh was prepared based on preoperative facial computed tomography, and was fixed to the hollowed area for tissue augmentation. The temporalis muscle was elevated and fanned out to its original position, and a sling was attached to a screw that was fixed to the mesh. For reinforcement, an additional sling was attached to another screw fixed to the mesh 2-3 cm vertically above the first screw. Aesthetic results were confirmed immediately after surgery and later during outpatient follow-up. Both depression and lateral bulging were resolved, and there was no delayed drooping of the temporalis muscle on 6-month follow-up. There were no complications, and the patient was satisfied with the appearance. This is a simple yet effective technique with a low risk of complications, and should be considered for postoperative temporal hollowing patients, especially those with severe lateral bulging.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.739-743
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• 2005

Subcondylar fractures have generally been treated by intermaxillary fixation except in cases where there is an absolute indication for open reduction. The reason behind a less aggressive surgical approach lies on the inherent difficulties in manipulating fragments in such a small area at the risk of damaging facial nerves or vessels such as the internal maxillary artery. However, long-term follow-up studies showed that conservative treatment of subcondylar fractures results in disturbances of occlusal function, deviation of the mandible, internal derangement of the temporomandibular joint, and ankylosis of the joint. We carried out open reduction of dislocated subcondylar fractures in 14 patients from 2000 to 2004 by a retromandibular approach. After the reduction of fractured bone, two H-shaped miniplates with 6 holes were fixed with screws at the anterior and posterior surfaces of the subcondyle. The retromandibular approach allowed good access and easy manipulation of the subcondyle. Immediate relief from malocclusion and correction of mandibular midline shifting were observed in all patients. Late temporomandibular dysfunction and ankylosis were not observed. Open reduction with plate osteosynthesis made it possible to avoid IMF in 7 of the 14 patients. The present study shows that open reduction through this retromandibular approach can produce good outcome in adult patients with subcondylar fracture.

• Archives of Craniofacial Surgery
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• v.18 no.4
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• pp.277-281
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• 2017

Traumatic cleft earlobes are a common problem encountered by plastic and reconstructive surgeons. Various techniques have been reported for the repair of traumatic cleft earlobes. Usually, the techniques of split earlobe repair are divided into two categories, namely straight- and broken-line repairs. Straight-line repair is simple and easy, but scar contracture frequently results in notching of the inferior border of the lobule. It can be avoided by the broken-line repair such as Z-plasty, L-plasty, or a V-shaped flap. Between April 2016 and February 2017, six patients who presented with traumatic cleft earlobe underwent surgical correction using a combination of the inverted V-shaped excision technique and vertical mattress suture method. All the patients were female and had a unilateral complete cleft earlobe. No postoperative notching of the inferior border the lobule occurred during 6-16 months of follow-up. Without the use of a broken-line repair, both the patients and the operators attained aesthetically satisfactory results. Therefore, the combination of the inverted V-shaped excision technique and vertical mattress suture method is considered useful in the treatment of traumatic cleft earlobes.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.593-598
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• 2005

Although several suspension biomaterials have been considered to be relatively safe and convenient, varying degrees of resorption have required repeated percutaneous injection. In the previous animal study the authors have reported that cultured human fibroblasts suspended in $Restylane^{(R)}$, which is modified hyaluronic acid, could produce human dermal matrices and prolong the effect of this gel. This study was undertaken to evaluate the clinical efficacy of this method. A total of 11 patients ranging from 25 to 57 years of age were included in this study between January of 2002 and December of 2003. All the patients were treated for the purpose of augmentation rhinoplasty. $1{\times}10^7/ml$ or $1.5{\times}10^7/ml$ cultured fibroblasts were suspended in 0.7 to 1.4 ml of $Restylane^{(R)}$. The implants were transferred to a 1-ml syringe and injected subcutaneously to the nose of the patients. Among 11 patients, long term follow-up for more than 1 year was possible in 6 patients. The injected implants remained in site without evidence of resorption or loss of correction. All the patients were satisfied with long term results of this method. There was no complication during the follow-up period.