• Archives of Plastic Surgery
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• v.37 no.4
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• pp.351-360
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• 2010

Purpose: As the influence of mass media increases, the general standard of attractiveness or beauty of a face also changes. The primary purpose of the study is to find out the factors of the attractive and beautiful face recognized by public. Methods: We picked out standard model photography and operated with Adobe$^{(R)}$ Photoshop$^{(R)}$ and Monariza$^{(R)}$ virtual plastic surgery program. The contour of face, eye, nose, forehead, zygoma, chin and proportion of upper, middle, lower face were changed. The interview survey was conducted through structured standard photo for 310 respondents. That was utilized in the final analysis. Multiple regression analysis was executed by SPSS 12.0. It was used to deal with statistical data and all the other necessary analysis. Results: According to general characteristics of the respondents, many differences were found in preferred face and facial aesthetic subunits. The younger generation preferred the lozenge and inverted triangle shape contour. The respondents over 40 of age preferred the egg shape contour. In chin and zygoma contour, the respondents at the age of 20 preferred distinctly small chin and relatively small lower face. On the other hand, the respondents over 40 of age preferred the wide zygoma relatively. In the proportion of upper, middle, lower face, 51.0% of respondents answered 1 : 1 : 1. If they want to have an aesthetic operation, they preferred protruding forehead. Also they preferred the small chin and V-shaped chin in frontal view. Conclusion: Many respondents preferred to have a plastic surgery for the better facial subunit. The statistical evidence from this study suggests that the harmony and balance of facial aesthetic subunits make attractive and beautiful face.

• Archives of Craniofacial Surgery
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• v.23 no.3
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• pp.95-102
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• 2022

The challenges of successful nasal reconstruction, which are related to the anatomical complexity of the region, have been extensively studied. Revisional operations are often required to achieve proper nasal reconstruction, with results resembling the premorbid nasal status. This is necessary to ensure the quality of life of skin cancer patients. Fundamental nasal reconstruction requires both proper soft tissue coverage and proper function. However, earlier studies in the field primarily focused on the functional aspect of nose reconstruction, although the cosmetic aspect is also an important factor to consider. In response to this need, many recent studies on nose reconstruction have proposed various refinement strategies to improve aesthetic satisfaction. Most plastic surgeons accept the nasal aesthetic subunit principle as a standard for nasal reconstruction. This review outlines the commonly used surgical refinement options and management strategies for postoperative complications based on the subunit principle. In patients with nasal defects, a proper technical strategy might help minimize revision operations and optimize the long-term results.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.379-386
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• 2014

Background Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstruction of vulvar defects restores form and function for the purpose of coitus, micturition, and defecation. Many surgical options exist for vulvar reconstruction. The purpose of this article is to present our experience with vulvar reconstruction. Methods From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most common cause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget's disease of the vulva. Method s of reconstruction ranged from primary closure to skin grafting to the use of pedicled flaps. Results The main complications were that of long term hypertrophic and/or unaesthetic scarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexual intercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis. Conclusions We present a subunit algorithmic approach to vulvar reconstruction based on defect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstruction of a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap was superior because of the well-concealed donor scar. We advocate the routine use of these 2 flaps for vulvar reconstruction.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.361-368
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• 2010

Purpose: Authors tried to analyze the influence of individual facial aesthetic subunits on the cognition of facial attractiveness in public and suggest a mathematical model which explain the facial attractiveness. Methods: Independent facial aesthetic subunits are extracted from facial photographs from three women (11 frontal and 7 lateral aesthetic subunits). Each facial subunits of three women are rated in terms of relative rank by 164 peoples (68 man and 96 woman, average age was 32.4, and ranged ${\pm}$ 9.8 years). $x^2$-test and categorical regression analysis were performed. Results: There was no difference in the aesthetic preference in terms of ages or sexes in large. Beautification of individual aesthetic subunits can predict the overall facial attractiveness up to 42.1% in frontal face (Adjusted $R^2$=0.421, F=6.39, p=0.000 < 0.05) and 22.7% in lateral face (Adjusted $R^2$=0.227, F=4.42, p=0.000 < 0.05). Aesthetic appearance of eyes (p=0.001), upper face (p=0.034) in frontal face and midface (p=0.000) in lateral face are statistically important factors in the cognition of facial attractiveness. Conclusion: Authors experimently proved that harmony and balance among facial aesthetic subunits are the most important factors, in embarking on facial aesthetic plastic surgery, for better enhancement of facial attractiveness.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.480-483
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• 2019

Repairing surgical defects of the nose is still challenging due to its tridimensional shape and its aesthetic concern. Difficulty in reconstructing nasal subunits lies in their contour, skin texture and limited availability of adjacent skin. For lower nasal dorsum and supra-tip regions, we design a new combined local flap as existing local flaps may give disappointing results. This combination flap was performed on two patients for reconstruction of the lower nasal dorsum area after basal cell carcinoma excision. Size of the excision ranged from 20 to 25 mm diameter and safe margins were obtained. The defects were reconstructed with a local flap that combined a rotation nasal flank flap and a V-Y advancement nasolabial flap. Excision and reconstruction were performed in a one-stage surgery under intravenous sedation and local anesthesia. There were no postoperative complications and no flap loss occurred. Aesthetic and functional results after 6 months postoperatively were satisfying without modification of nasal shape. This flap is reliable and offers interesting functional and aesthetic outcomes. It can be considered as a new reconstruction alternative for supra-tip and lower nasal dorsum skin defects performed in a one-stage procedure under local anesthesia.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.390-399
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• 2017

Background This article aims to investigate current perceptions of beauty of the general public and physicians without a specialization in plastic surgery performing aesthetic procedures. Methods A cross-sectional and interviewing questionnaire was administered to 290 people in Seoul, South Korea in September 2015. The questionnaire addressed three issues: general attitudes about plastic surgery (Q1), perception of and preferences regarding Korean female celebrities' facial attractiveness (Q2), and the relative influence of each facial aesthetic subunit on overall facial attractiveness. The survey's results were gathered by a professional research agency and classified according to a respondent's gender, age, and job type ($95%{\pm}5.75%$ confidence interval). Statistical analysis was performed using SPSS ver. 10.1, calculating one-way analysis of variance with post hoc analysis and Tukey's t-test. Results Among the respondents, 38.3% were in favor of aesthetic plastic surgery. The most common source of plastic surgery information was the internet (50.0%). The most powerful factor influencing hospital or clinic selection was the postoperative surgical results of acquaintances (74.9%). We created a composite face of an attractive Korean female, representing the current facial configuration considered appealing to the Koreans. Beauty perceptions differed to some degree based on gender and generational differences. We found that there were certain differences in beauty perceptions between general physicians who perform aesthetic procedures and the general public. Conclusions Our study results provide aesthetic plastic surgeons with detailed information about contemporary Korean people's attitudes toward and perceptions of plastic surgery and the specific characteristics of female Korean faces currently considered attractive, plus trends in these perceptions, which should inform plastic surgeons within their specialized fields.

• Archives of Plastic Surgery
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• v.45 no.3
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• pp.253-258
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• 2018

Background The nasolabial flap is ideal for reconstruction of the nasal alar subunit due to its proximity, color and contour match, and well-placed donor scar. When raised as a random-pattern flap, there is a risk of vascular compromise to the tip with increased flap length and aggressive flap thinning. Surgical delay can greatly improve the chances of tip survival, allowing the harvest of longer flaps with greater reach. Methods We describe our technique of lengthening the nasolabial flap through multiple delay procedures. A bipedicled flap was first raised and then transferred as a unipedicled flap with a 6:1 length-to-width ratio. During the delay process, the flap tip was thinned to the subdermal layer. Results In our case series of seven patients, defects as far as the medial canthal area and contralateral ala were reconstructed successfully with no incidence of tip necrosis or flap loss. The resultant flaps were thin enough to be folded over for the reconstruction of alar rim defects. Conclusions We highlight the success of our surgical technique in creating thin and robust nasolabial flaps for the reconstruction of full-thickness defects around the nose.

• Archives of Craniofacial Surgery
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• v.19 no.2
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• pp.148-151
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• 2018

The nose is an important landmark of the face and its shape and beauty is of significant concern. The columella is the subunit between the two nostrils that provides support and projection to the nasal tip and has functional role in nostrils, as well as aesthetic. Ethiology for columellar absence or deficiency is diverse, and it is one of the most complex nasal subunits to reconstruct because of its narrow horizontal dimension, its tenuous vascularity and limited availability of adjacent tissue. We present a patient with columellar, membranous septum and upper lip defect, due to oncological resection. The lip reconstruction was designed using advancement of two upper lip edges with the technique of webster perialar/nasocheek advancement. However, the perialar/nasocheek tissue which is usually discarded was used as inferiorly based skin flaps to reconstruct the membranous septum, columellar skin and nasal vestibule lining. Rib cage cartilage graft was used as columellar strut for support. At 1-year follow-up, the patient has good nasal contour and projection. Scaring of the columella is very subtle. This is a versatile way for successful reconstruction of a columella and large central facial defect in one-stage operation. It is a method which provides very satisfactory aesthetic result with minimum patient morbidity and discomfort.