• 대한두개안면성형외과학회지
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• 제22권3호
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• pp.161-163
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• 2021

The soft tissue triangle is an easily recognizable subunit of the nose. Therefore, deformities in this region resulting from trauma or complications after cosmetic surgery can have serious cosmetic impacts. Various reconstruction choices exist for deformities such as depression of the soft triangle but choosing the most appropriate treatment in each case remains a challenge. In the case described herein, a patient underwent augmentation rhinoplasty with a silastic implant and experienced implant exposure in the soft triangle area. After implant removal, the patient complained of depression in this area. The authors effectively solved this problem through a de-epithelialized composite tissue graft. In this report, we present this case and review similar cases of reconstruction of the soft triangle.

• Archives of Plastic Surgery
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• 제47권6호
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• pp.574-582
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• 2020

Background Several oncoplastic approaches have been implemented in recent years to enhance cosmetic results and to reduce complications. The round block technique is a volume displacement technique for breast reconstruction after breast-conserving surgery (BCS). However, its indications are currently limited according to tumor location, and its cosmetic results and complications have not been clearly established. We hypothesized that the round block technique could produce favorable cosmetic results without major complications regardless of tumor location or nipple-tumor distance, below a certain resected tumor volume and tumor-breast volume ratio. Methods All breast reconstructions using the round block technique after BCS were included in this analysis. Patients' data were reviewed retrospectively to investigate complications during follow-up, and clinical photos were used to evaluate cosmetic results. The relationships of tumor location, nipple-tumor distance, tumor volume, and the tumor-breast volume ratio with cosmetic results were investigated. Results In total, 108 breasts were reconstructed. The mean resected tumor volume was 30.2±15.0 mL. The cosmetic score was 4.5±0.6 out of 5. Tumor location, nipple-tumor distance, tumor volume, tumor-breast volume ratio, radiotherapy, and chemotherapy had no significant effects on cosmetic results or complications. There were no major complications requiring reoperation. Conclusions Breast reconstruction using the round block technique after BCS can lead to good cosmetic results without major complications regardless of the tumor location, nippletumor distance, radiotherapy, or chemotherapy. Below the maximum tumor volume (79.2 mL) and the maximum tumor-breast volume ratio (14%), favorable results were consistently obtained.

• Archives of Plastic Surgery
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• 제48권6호
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• pp.660-669
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• 2021

Background The demand for aesthetic procedures continues to grow globally, particularly in East Asian countries. The popularity of specific aesthetic procedures varies, however, depending on the particular East Asian geographical region being studied. This study aimed to evaluate the experiences of and attitudes toward aesthetic procedures in five East Asian countries/regions, including China, Japan, South Korea, Hong Kong, and Taiwan. Methods To recruit participants, an online questionnaire was designed and distributed on social media networks between May 2015 and March 2016. The statistical analysis was conducted using SPSS software, version 22.0. Results A total of 3,088 people responded (approximately 600 in each country/region). Of these, 940 participants (47.8%) responded that they had experienced at least one aesthetic procedure in the past. Taiwan had the highest number of participants who had experienced at least one procedure (264/940, 41%), with primarily non-surgical experiences. Only in South Korea did surgical cosmetic experiences exceed non-surgical cosmetic experiences (55.9% vs. 44.1%). The popularity of particular procedures and the motivation for undergoing aesthetic procedures varied by country. Conclusions The popularity of aesthetic procedures continues to evolve. Similar trends were observed across the East Asian regions; however, each country had its unique demands and preferences. The information provided by this study can help aesthetic plastic surgeons further understand the patients in their corresponding region, customize their practice, and develop the requisite skills.

• 대한두개안면성형외과학회지
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• 제20권6호
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• pp.382-387
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• 2019

Background: Defects of the nasal ala and tip have a complex three-dimensional structure that makes them challenging to reconstruct. Many reconstructive options have been described for nasal ala and tip defects, ranging from primary closure to local flaps and skin grafts. However, it is difficult to determine which method will yield the best cosmetic results in each individual case. Thus, the purpose of this study was to determine which surgical procedures for reconstructing defects of the nasal ala and tip have better cosmetic results. Methods: From 2008 to 2018, 111 patients underwent surgery to reconstruct skin defects after resection of skin cancer in the nasal ala or tip. Their charts were reviewed to obtain data on age, sex, surgical location, size of the defect, surgical method, and cosmetic results using a visual analog scale (VAS). Results: For nasal ala reconstruction, the most commonly used surgical technique was the nasolabial flap (n= 42). This method also had the highest VAS score (7/10). The most commonly selected surgical method for nasal tip reconstruction was the bilobed flap (n= 13), and bilobed flaps and primary closure had the highest VAS score (7/10). Conclusion: Nasolabial flaps showed excellent cosmetic results for the reconstruction of nasal ala defects, while primary closure and bilobed flaps yielded excellent cosmetic results for the reconstruction of nasal tip defects.

• Archives of Plastic Surgery
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• 제41권1호
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• pp.85-88
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• 2014

To improve the cosmetic results of removing epidermal cysts, minimally invasive methods have been proposed. We proposed a new minimally invasive method that completely removes a cyst through a small hole made by a $CO_2$ laser. Twenty-five patients with epidermal cysts, which were 0.5 to 1.5 cm in diameter, non-inflamed, and freely movable, were treated. All of the patients were satisfied with the cosmetic results. This method is simple and results in minimal scarring and low recurrence rates without complications.

• Archives of Plastic Surgery
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• 제35권1호
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• pp.96-99
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• 2008

Purpose: A meningoencephalocele is a congenital malformation involving herniation of the meninges and cerebral tissue through a defect in the skull. For the patient with frontoethmoidal meningoencephalocele with hypertelorism, the removal of the meningoencephalocele without correction of the combined hypertelorism is not enough for getting a good cosmetic appearance. Correction of the hypertelorism is needed for cosmetic problem. We experienced a case of simultaneous correction of frontoethmoidal meningoencephalocele with hypertelorism. Methods: The meningoencephalocele was removed and the hypertelorism was corrected by central segment technique. The bone defects were filled with autogenous bone dusts. And the nose was reconstructed by a calvarial bone graft. Results: The patient had a good cosmetic appearance without any neurological complications without serious complications. Conclusion: We experienced a case of simultaneous correction of frontoethmoidal meningoencephalocele with hypertelorism. And a brief review of related literatures is given.

• Archives of Plastic Surgery
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• 제47권1호
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• pp.70-77
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• 2020

Background As the demand for cosmetic surgery continues to rise, plastic surgery programs and the training core curriculum have evolved to reflect these changes. This study aims to evaluate the perceived quality of current cosmetic surgery training in terms of case exposure and educational methods. Methods A 16-question survey was sent to graduates who completed their training at a U.S. plastic surgery training program in 2017. The survey assessed graduates' exposure to cosmetic surgery, teaching modalities employed and their overall perceived competence. Case complexity was characterized by the minimum number of cases needed by the graduate to feel confident in performing the procedure. Results There was a 25% response rate. The majority of respondents were residents (83%, n=92) and the remaining were fellows (17%, n=18). Almost three quarters of respondents were satisfied with their cosmetic training. Respondents rated virtual training as the most effective learning modality and observing attendings' patients/cases as least effective. Perceived competence was more closely aligned with core curriculum status than case complexity, i.e. graduates feel more prepared for core cosmetic procedures despite being more technically difficult than non-core procedures. Conclusions Despite the variability in cosmetic exposure during training, most plastic surgery graduates are satisfied with their aesthetic training. Incorporation of teaching modalities, such as virtual training, can increase case exposure and allow trainees more autonomy. The recommended core curriculum is adequately training plastic surgery graduates for common procedures and more specialized procedures should be consigned to aesthetic fellowship training.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.680-686
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• 2008

Purpose: Breast conserving surgery(BCS) for breast cancer has a common treatment protocol. Oncoplastic surgery represents a form of BCS which combines both a cosmetic mammoplasty approach and oncologic resection for the treatment of breast cancer. Depending on the tumor site, BCS can make an unsatisfactory cosmetic result, especially in inferiorly placed tumors. This study describes the use of oncoplastic techniques for inferiorly located breast tumors in immediate partial mastectomy reconstruction. Methods: From September of 2006 to February of 2008, these techniques were used in 11 patients at the ${\bigcirc}{\bigcirc}$ hospital. After BCS was preceded, breast reshaping by oncoplastic techniques were selected depending on the location and size of the tumor within the breast as well as the size of breast itself. Oncoplastic techniques after partial mastectomy included 'Wise pattern (inverted T)' reduction mammoplasty, 'vertical pattern' mammoplasty, 'J-pattern' mammoplasty. In order to improve the cosmetic outcome, repositioning of the nipple areola complex(NAC) or reshaping of the contralateral breast may be considered additionally. Results: These techniques have been used in 11 patients. The mean age was 51 and the average follow-up period was 8 months. Eleven of these patients underwent the 'Wise pattern(inverted T)' reduction mammoplasty(n=6), 'vertical pattern' mammoplasty(n=3) and 'J-pattern' mammoplasty(n=2). There was one wound dehiscence during the follow-up periods. This complication was treated by conservative approach. The overall cosmetic result was evaluated in 6 months. The majority of patients were satisfied at the cosmetic result. Conclusion: Oncoplastic techniques in inferiorly located breast tumors could be a reasonable and safe option for breast cancer patients who desire conserving surgery with esthetical breast.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.550-555
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• 2014

Background Nipple reconstruction following breast mound reconstruction is the final step in breast reconstruction. Although nipple reconstruction is a simple surgery, the psychological aspects of nipple reconstruction are thought to be important. Nipple projection is a key factor in determining patient satisfaction with the surgery. In the present study, the Hammond flap technique was introduced for nipple reconstruction. Methods Twenty-six patients who had undergone breast reconstruction from February 2008 to March 2012 were enrolled in this prospective study. All patients were evaluated based on preoperative photos, and their nipple diameters and heights were measured. Postoperative evaluation was conducted 3, 6, 9, and 12 months following nipple reconstruction. A questionnaire on patient satisfaction with the nipple reconstruction was administered 12 months after nipple reconstruction. Moreover, the same plastic surgeon scored nipple projection and overall cosmetic result of the new nipple. Results The mean projection was 4.4 mm (range, 3-6 mm), and it well matched the contralateral nipple. Twelve months following nipple reconstruction, the mean reduction rate in the nipple projection was 43.6%. Patients were satisfied or very satisfied with the nipple projection and the overall cosmetic result in 80.7% cases. Conclusions In the present study, compared with other techniques, the use of the Hammond flap technique in nipple reconstruction showed competitive results with regard to nipple projection and patient satisfaction.

• Archives of Plastic Surgery
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• 제42권1호
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• pp.46-51
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• 2015

Background In all branches of medicine, it is the surgeon's responsibility to provide the patient with accurate information before surgery. This is especially important in cosmetic surgery because the surgeon must focus on the aesthetic results desired by the patient. Methods An experimental protocol was developed based on an original questionnaire given to 72 patients. The nature of the responses, the patients' motivation and expectations, the degree of patient awareness regarding the planned operation, and the patients' perceptions of the purpose of the required consent for cosmetic surgery were all analyzed using Fisher's exact test. Results Candidates for abdominal wall surgery had significantly more preoperative psychological problems than their counterparts did (P=0.035). A significantly different percentage of patients under 40 years of age compared to those over 40 years of age searched for additional sources of information prior to the operation (P=0.046). Only 30% of patients with a lower educational background stated that the preoperative information had been adequate, whereas 92% of subjects with secondary schooling or a postsecondary degree felt that the information was sufficient (P=0.001). A statistically significant difference was also present between patients according to their educational background regarding expected improvements in their quality of life postoperatively (P=0.008). Conclusions This study suggests that patients require more attention in presurgical consultations and that clear communication should be prioritized to ensure that the surgeon understands the patient's expectations.