• Archives of Plastic Surgery
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• 제35권5호
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• pp.545-552
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• 2008

Purpose: The transaxillary approach for breast augmentation has been advocated for patients and surgeons for several decades. However, this blind technique had many disadvantages including, traumatic dissection, difficult hemostasis, displacement of implants, and ill-defined asymmetrical location of inframammary crease. In the present study, the precise endoscopic electrocautery dissection was applied to eliminate the limits of blunt dissection throughout the procedures. Methods: From December 2006 to December 2007, a total of 103 patients with an average age of 29.5 years underwent endoscopic assisted transaxillary dual plane augmentation mammoplasty. The mean implant size was 243 cc with the range between 150 and 350 cc. Through a 4 cm axillary incision, electrocautery dissection for submuscular pockets was carried out under the endoscopic control. The costal origin of pectoralis muscle was completely divided to expose subcutaneous tissue and to make type I dual plane. Results: Using the endoscopic dissection, we achieved good aesthetic results including a short recovery period, less morbidity, and symmetrical well-defined inframammary crease. Type I dual plane procedure could support the consistent inframammary fold shape and be applied to most patients without breast ptosis. Minor complications did not occur, however, four major complications of capsular contracture occurred. Conclusion: In contrast to the era of the blind techniques, endoscopic assisted transaxillary dual plane breast augmentation can now be performed effectively and reproducibly. With Its advantage, the axillary application of endoscopy for augmentation mammaplasty is useful to achieve the optimal cosmetic outcomes.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.228-234
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• 2011

Purpose: Reconstruction of chest wall has always been a challenging problem. Muscle flaps for chest wall reconstruction have been helpful in controling infection, filling dead space and covering the prosthetic material in this challenge. However, when we use muscle flaps, functional and cosmetic donor site morbidities could occur. The authors applied and revised various partial muscle flaps and combination use of them to cover the prosthetic material for the chest wall reconstruction and evaluated the usefulness of partial muscle flaps. Methods: This study included 7 patients who underwent chest wall reconstruction using partial muscle flap to cover prosthetic material from 2004 to 2008. The pectoralis major muscle was used in anterior 2/3 parts of it leaving lateral 1/3 parts of it. The anterior 2/3 parts of the pectoralis major muscle were used while lateral 1/3 parts were left. In case of the rectus abdominis muscle flap, we used upper half of it, or we dissected it around its origin and then advanced to cover the site. The latissimus dorsi muscle flap was elevated with lateral portion of it along the descending branch of the thoracodorsal artery. If single partial muscle flap could not cover whole prosthetic material, it would be covered with combination of various partial muscle flaps adjacent to the coverage site. Results: Flap coverage of the prosthetic material and chest wall reconstructions were successfully done. There occurred no immediate and delayed post operative complications such as surgical site infection, seroma, deformity of donor site and functional impairment. Conclusion: When we use the muscle flaps to cover prosthetic material for chest wall reconstruction, use of the partial muscle flaps could be a good way to reduce donor site morbidity. Combination of multiple partial flaps could be a valuable and good alternative way to overcome the disadvantages of partial muscle flaps such as limitation of volume and size as well as flap mobility.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.251-256
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• 2017

The most important environment of human being is the human being itself. So we have been sensitive to the appearance of ours and others at the same time. This writing aims for locating origins of the face and discerning differences [1] between the face of humans and those of other animals [2]. The face assumes a substantial significance not merely as a body function, but, above all, a means of expressions and features being looked at. The face is an important means of communication to humans as social animals. Knowledges about the various faces of the face are useful to become a efficient specialist as an extensive generalist because the face is a regular patron to the plastic surgery. The face in Korean consists of two elements of eol (the soul or the mind) and gul a residing place). When Wittgenstein says "the face is the soul of the body," his semantics corresponds to the Korean meaning. The meaning of the face in Korean is summed up in five ways. (1) the head or the front of the face with the eye, the nose and the mouth, (2) reputation or honor, (3) the general description of the psychological state, such as "the face of sadness", (4) a figure person representing a particular area, such as "Sun Dong-yul is the face of the Korean baseball community," (5) the primary imagery of the things and the event, such as "He is the face of the 4.19 Revolution." As such, the word "face", referring to a body part, extends its usages in a wide variety of contexts. What image do you convoke when you think of a person? With rare exceptions, you are most likely to invoke the face of the person. The face has come to be a byword for one's reputation or honor, and a pronoun for an expression of the essence of the thing and the event. This is presumably true of other languages. That is because human beings are equipped with the universal rule of language. A comprehensive understanding of the face is a must for cosmetic surgeons whose main responsibility is to sculpt and repair the face (Fig. 1).

• 대한두개안면성형외과학회지
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• 제11권2호
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• pp.91-94
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• 2010

저온 열처리법은 두개안면골 종양의 절제 후 재건에 있어 간단하고, 믿을만하며, 모양이 우수하고, 경제적이면서 또한 오랫동안 유지가 가능한 방법이다. 이 방법은 종양 재발의 걱정없이 생물학적으로 융합이 가능함과 동시에 기계적인 강도가 높은 장점을 가지고 있다. 따라서 두개안면골의 양성종양뿐만 아니라 절제가 가능한 악성종양의 경우에도 재건 시 우선적으로 고려해볼 만한 방법으로 사료된다.

• Archives of Plastic Surgery
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• 제37권2호
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• pp.191-194
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• 2010

Treatments of severely incurved toenails cause anatomical changes and cosmetic problems, even though they provide adequate symptom relief. Incurved toenail patients treated with a K-D$^{(R)}$ (S&C Biotech, Seoul, South Korea) the new device for correcting curved nail deformity were investigated retrospectively. This study surveyed 12 patients(18 cases) who had been treated for severe ingrown toenails using K-D$^{(R)}$ from May 2008 to March 2009, and examined their subjective satisfaction before and after the treatment. The average age of the participants was 39 (ranging from 27 to 52), and 8 of them were male and 4 female. The treatment was applied after the patients were given a thorough explanation about the tool and the treatment, and questionnaire surveys were conducted before the treatment and after 3 months on the average from the treatment. In the survey, the respondents were asked about pain, restriction on activities, and the selection of shoes. For each item, symptoms with a given point were presented, and the respondents' scores were compared between the surveys before and after the treatment. According to the results of the questionnaire survey, pain increased from 14 out of 40 before the treatment to 39 after, activity restriction increased from 11 to 30, and shoe selection increased from 20 to 30. The average total score increased from 45 to 98, and this suggests a considerable enhancement in the patients' subjective satisfaction. The average period of the application of K-D$^{(R)}$ was $20.3{\pm}9.4$ days, and in all the cases, ingrown toenails were corrected within three weeks.

• Medical Lasers
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• 제10권3호
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• pp.161-169
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• 2021

Background and Objectives Fractional microneedle radiofrequency systems are popular options to increase elasticity in aging skin. Laser-assisted drug delivery is a promising method for the epidermal injection of topically applied drugs and cosmetic ingredients. This study assesses the safety and efficacy of topical delivery of L-ascorbic acid, vitamin E, and ferulic acid after fractional microneedle radiofrequency treatment for reducing photodamage. Materials and Methods In this prospective, single-center, split-face, controlled pilot study, six women (mean age, 48.0 years; range, 35-57 years; Fitzpatrick skin types III and IV) exhibiting mild to moderate photodamage, underwent a single session of fractional microneedle radiofrequency treatment. The patients were instructed to apply the antioxidant formulation to only one side of the face. Patients were evaluated 3 days, 7 days, and 4 weeks thereafter, using three-dimensional imaging and ultrasound. Ex vivo, the full-thickness human skin was used for molecular and histological evaluation. Statistical analysis was achieved by applying t-tests, Mann-Whitney U tests, and one-way analyses of variance. Results Compared to the untreated side, the antioxidant-treated side exhibited a significant increase in dermal thickness (10.32% vs. 17.54%, p < 0.05), but not in skin elasticity (4.76% vs. 4.69%, p > 0.05). The difference in erythema between the sides was statistically not significant (p > 0.05). In the ex vivo model, expression of FGF2 in the skin was significantly increased after application of the antioxidant formulation, as compared to results obtained subsequent to fractional microneedle radiofrequency treatment only (p < 0.01). Conclusion This study demonstrates that for the treatment of photodamaged skin, laser-assisted delivery of the antioxidant formulation is a safe and effective adjuvant modality following fractional microneedle radiofrequency.

• Archives of Plastic Surgery
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• 제50권3호
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• pp.248-253
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• 2023

Metal fixation systems for cranial bone flaps cut by a drill are convenient devices for cranioplasty, but cause several complications. We use modified craniotomy using a fine diamond-coated threadwire saw (diamond T-saw) to reduce the bone defect, and osteoplasty calcium phosphate cement without metal fixation. We report our outcomes and tips of this method. A total of 78 consecutive patients underwent elective frontotemporal craniotomy for clipping of unruptured intracranial aneurysms between 2015 and 2019. The follow-up periods ranged from 13 to 66 months. The bone fixation state was evaluated by bone computed tomography (CT) and three-dimensional CT (3D-CT). The diamond T-saw could minimize the bone defect. Only one wound infection occurred within 1 week postoperatively, and no late infection. No pain, palpable/cosmetically noticeable displacement of the bone flap, fluid accumulations, or other complications were observed. The condition of bone fixation and the cosmetic efficacy were thoroughly satisfactory for all patients, and bone CT and 3D-CT demonstrated that good bone fusion. No complication typical of metal fixation occurred. Our method is technically easy and safety, and achieved good mid-term bone flap fixation in the mid-term course, so has potential for bone fixation without the use of metal plates.

• 대한정형외과학회지
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• 제52권1호
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• pp.40-48
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• 2017

목적: 족부 및 족관절부의 연부조직 결손은 해부학적 한계와 기능적 특성상 선택할 수 있는 재건술의 폭이 비교적 적은 편으로 미용 및 기능적 필요로 인하여 동일 하퇴부의 추가 반흔을 피하고자 하는 경우 그 선택의 폭은 더 줄어들게 된다. 저자들은 이런 경우 전외 측 대퇴 천공지 피판술을 시행하였고 그 임상적 결과를 보고하고자 한다. 대상 및 방법: 총 16예가 대상에 포함되었고 남자 12명, 여자 4명, 평균 나이는 34세였다. 연부조직 결손의 가장 흔한 원인은 외상으로 9예였다. 추시기간은 평균 33개월이었고 피판의 평균 크기는 146 cm²로 피판의 생존 및 합병증, 보행 여부 등을 평가하였다. 결과: 총 16예의 피판 중 15예는 성공적으로 생존하였으며 1예에서는 환자의 조기 보행으로 인한 천층 일부 괴사로 피부이식술을 추가하여 호전되었다. 모든 환자들에게서 보조 기구 없이 독립 보행이 가능하여 피판이 보행에 지장을 준 경우는 없었고 최종 추시까지 잔존하는 특별한 합병증은 없었다. 결론: 족부 및 족관절 연부조직 결손의 재건에 있어 이차 치유나 단순 봉합, 또는 유경 피판술 등의 방법으로 피복이 어려운 경우 전외측 대퇴 천공지 피판술은 안전하면서도 얇게 결손 부위를 피복할 수 있어 유용한 유리 피판술로 생각된다.