• Title/Summary/Keyword: Cosmetic scar

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Reduction of Closed Frontal Sinus Fractures through Suprabrow Approach

  • Hahn, Hyung Min;Lee, Yoo Jung;Park, Myong Chul;Lee, Il Jae;Kim, Sue Min;Park, Dong Ha
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.230-237
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    • 2017
  • Background: The traditional approach for reduction of frontal sinus fractures is coronal incision. Inherent complications of the coronal approach include long scar, hair loss, and long operation time. We describe a simple approach for the reduction of frontal sinus anterior wall fractures using a suprabrow incision that is commonly used for brow lift. Methods: From March 2007 to October 2016, the authors identified patients with anterior wall frontal sinus fractures treated by open reduction through a suprabrow incision. Only cases with photographic/radiographic documentation and a minimum follow-up of 6 months were included. The incision line was designed to be at the upper margin of the eyebrow. Medical records and radiographic data were retrospectively reviewed. Surgical outcomes, cosmetic results, and complication were assessed. The patient scale of the patient and observer scar assessment scale was used to assess patient satisfaction for incisional scar at the 6-month follow-up. Results: Thirty-one patients underwent fracture reduction through a suprabrow approach during the study period, with a mean follow-up of 41 months. No patients showed any recurrent displacement, eyebrow asymmetry, or infection during follow-up. Thirteen patients reported their forehead paresthesia postoperatively, and 12 of them had preoperative symptom. One patient complained of incisional scar and underwent scar revision. All patients were satisfied with their eyebrow and forehead contour. Conclusion: The suprabrow approach allowed for an accurate reduction of the fractures in the anterior wall frontal sinus by providing direct visualization of the fracture. This transcutaneous approach can effectively restore forehead contour with acceptable postoperative complications and patient satisfaction.

Intraoral Approach and K-Wire Fixation of Zygomatic Tripod Fractures (강선 고정술을 이용한 관골골절의 치료)

  • Choi, See-Ho
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.85-92
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    • 1988
  • To avoid external facial scar which resulted from ordinary infraorbital and lateral eyebrow incision in surgical treatment of zygomatic tripod fractures, the author used intraoral incision and K-wire fixation method in 37 selected patients. This method contraindicated for the patient with multiple comminuted zygomatic fracture, patient combined with hard palatal fracture, and patient combined with herniated orbital floor fracture. The advantages of this method are simple, no external facial scar, and operate under direct visual field. The postoperative results were satisfactory. Balanced facial symmetry and good cosmetic results were obtained.

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Correction of pixie ear: infraauricular skin redraping method

  • Kim, Jun Hyeok;Yang, Young Bin;Oh, Deuk Young
    • Archives of Craniofacial Surgery
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    • v.23 no.4
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    • pp.187-189
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    • 2022
  • Patients with pixie ear have an attached, tapering, and low-set earlobe. Traditional methods usually describe excision of the caudal portion of the lobule and reattachment in a more superior position. The present report suggests a simplified skin redraping method for correction of pixie ear. The procedure provides easy method to design and perform, which only requires elevation and trimming of the skin. Other ancillary procedures, such as flap design, anchoring, plication, and subdermal fixation, are not required. This method produces satisfactory results. Postoperative scar is invisible because the incision is on the retroauricular region, and the corrected earlobe has a more natural appearance than the repositioned earlobe. Moreover, skin redraping avoids tension, which contributes to minimization of the postoperative scar.

Thoracoscopic Pneumonectomy (흉강경을 이용한 전폐절제술)

  • 성숙환
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.808-811
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    • 1994
  • We reported a successful right pneumonectomy using video assisted thoracoscopy for endobronchial tuberculosis. Thoracoscopic surgery has many advantages in spite of its technical difficulties. These advantages include good cosmetic effects, short hospital stay, decreased postoperative morbidity, and good postoperative pulmonary function.The patient was young unmarried female, and her right lung was nearly total obstructed by endobronchial tuberculous dissemination and secondary pulmonary infection. The procedure was a little complicated by inadequate placements of the thoracoscopic ports and 5cm length utility thoracotomy incision. Minimal pain killer was needed only two days after operation and scar of operative wound was very satisfying. Postoperative course was unusual and the patient was discharged 7 days after operation.

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Axillary Approach for Thyroidectomy under Operating Microscope (수술현미경하 액와접근 갑상선 절제술)

  • Choi, Jong-Ouck;Jun, Byung-Sun;Lee, Jang-Woo;Lee, Dong-Jin;Sohn, Hang-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.32-36
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    • 2007
  • Background and Objective:A post-operative hypertrophic scar of the anterior neck is the leading complaint of the patients who underwent conventional thyroid surgery. In order to minimize the post-operative scar of the anterior neck, we performed thyroidectomy via axillary approach using operating microscope and a specialized retractor to determine technical feasibility. Patients and Methods:From January 2005 to December 2006, we performed thyroidectomy via axillary approach under operating microscope(f=400mm, ${\times}2.5$;OPMI $pico^{(R)}$;Zeiss, Germany) for benign unilateral nodule in 25 cases(all female, average age 34.5yrs). Under general anesthesia less than 7cm of skin incision was made in the axilla of ipsilateral side. A subcutaneous tunnel went over the pectoralis major muscle and the clavicle, and then through the sternocleidomastoid muscle and sternothyroid muscle was excised. The area around the thyroid was sufficiently dissected, and then a retractor designed for exposure via axillary approach was placed within the tunnel and under operating microscope thyroidectomy was performed. Results:There were 17 cases of thyroid nodulectomy and 8 cases of subtotal lobectomy. The mean average operative time was 102.64minutes. Postoperative complications included one case of postoperative bleeding, one case of temporary vocal cord paralysis, two cases of delayed wound healing, two cases of paresthesia of shoulder and arm, and two cases of hypertrophic scar of the axilla. Postoperative histopathology includes 17 cases of adenomatous hyperplasia, six cases of cyst, and two cases of follicular adenoma. For all cases hospitalization period was two days. Conclusion:Thyroidectomy via axillary approach under operating microscope has a good cosmetic advantage without a post-operative scar of the anterior neck. The procedure is simple due to direct vision using operating microscope, easy to identify important structures by magnifying them, and therefore surgical time can be reduced.

Partial Eyebrow Reconstruction with Bilateral Advancement Flap and Tattooing (양측 전진피판과 문신을 이용한 부분 눈썹 결손의 치험례)

  • Yoon, Jung Ho;Hong, Jong Won;Kim, Young Seok;Roh, Tai Suk;Rah, Dong Kyun
    • Archives of Craniofacial Surgery
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    • v.11 no.1
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    • pp.37-40
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    • 2010
  • Purpose: Reconstruction of eyebrow defects after wide excision of the benign and malignant tumors present a cosmetic challenge to the plastic surgeon. There were several methods for reconstruction of partial eyebrow defect with local flaps except hair bearing composite graft. We introduce simple eyebrow reconstruction with bilateral advancement flap and tattooing on the idea that eyebrow tattooing is popular permanent eyebrow makeup among elderly Korean women. Methods: The flaps were designed on both ends of the eyebrow defect along the upper and lower margin of the eyebrow. Both flaps were cut, undermined and were moved centrally to cover the defect. Both flaps were attached along the vertical suturing line. The rest of each flap was sown with dog-ears revised minimally. Scar lines would be hidden along the natural borders of the eyebrow if possible. The resulting vertical scar finally was covered with hair. After 8 months, eyebrow tattooing would be done to camouflage eyebrow shortening and scar. Results: Partial eyebrow defect was reconstructed successfully with bilateral advancement flap and tattooing. The postoperative scar was inconspicuous and eyebrow looked symmetric. Conclusion: We recommend partial eyebrow reconstruction with bilateral advancement flap and tattooing for the elderly Korean female patients after excision of small tumor in and around eyebrow region.

Early cicatricial lagophthalmos release with pentagonal wedge resection of the scar, fat redistribution, and full-thickness skin grafting

  • Chung, Chan Min;Tak, Seung Wan;Lim, Hyoseob;Cho, Sang-Hun;Lee, Jong Wook
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.49-52
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    • 2020
  • The specialized structure of the upper eyelid ensures complete closure of the eye and eyeball sealing. An upper eyelid injury can cause various symptoms associated with eyeball trauma, not just scar formation or eyelid deformity. In this report, we describe a case of lagophthalmos observed after wound repair in a patient with a crushing injury caused by a grinder. Several surgical techniques are used to treat lagophthalmos or scar contracture. In most cases, a releasing procedure is performed after 6 months of initial repair. However, if the patient has severe symptoms that are not relieved by conservative care, early revision is inevitable. We describe a case of early lagophthalmos successfully resolved with pentagonal wedge resection, fat redistribution, and full-thickness skin grafting. After the revisional surgery, we observed that the patient regained the ability to completely close the injured eyelid, with restoration of function and favorable cosmetic outcomes. Pentagonal wedge resection to release a retracted structure, fat redistribution to prevent readhesion, and full-thickness skin grafting for enough amount of skin to regain upper eyelid function is useful for scar release and lagophthalmos following crushing injuries of the upper eyelid.

Removal of Breast Cancer and Immediate Breast Reconstruction by Periareolar Approach (유륜주위절개법을 통한 유방암 수술 및 즉시 유방재건술)

  • Park, Su-Sung;Lee, Keun-Cheol;Kim, Seok-Kwun;Joh, Se-Heon;Park, Jung-Min
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.148-154
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    • 2011
  • Purpose: As the Korean life style is becoming westernized at a rapid pace, the rate of breast cancer is growing at the same time. So, the case of breast reconstruction after mastectomy increases, too. Points of breast reconstruction are symmetry, scar, size, and shape. Especially symmetry and scar are more important than others for Korean. This study is aimed to identify the method of breast reconstruction that accomplished the best results in terms of symmetry and scar. Methods: A total 15 patients were operated on from March of 2005 to July of 2009. The 5 patients were reconstructed by mammoreduction method after periareolar incision, the 7 patients were reconstructed by pectoralismajor transfer with implant after periareolar incision, and 3 patient were reconstructed by both breast augmentation. Results: Follow up period was 20.2 months on average and no complications such as breast deformity were observed. In symmetry of breast, the satisfaction score of periareolar approach is 4.4 and the satisfaction score of other approaches are 4.2 (p>0.05). But in scar of breast, the satisfaction score of periareolar approach is 4.6 and the satisfaction score of other approaches is 3.4 (p<0.05). Conclusion: In conclusion, Author's method of breast reconstruction after removal of breast cancer through periareolar incision is effective method in patients who care about aesthetic result after mastectomy.

Free Flaps for Old High Tension Electrical Burns Around the Wrist (고압 전기감전시 발생한 수근관절 주위의 진구성 연부조직 결손에 대한 유리 피판술)

  • Kim, Hyoung-Min;Jeong, Chang-Hoon;Lee, Gee-Heng;Koh, Young-Seok
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.68-72
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    • 1998
  • With the advent of microvascular free-tissue transfer, this single stage resurfacing method for large scar and soft tissue defects around the wrist in the patients of electrical burn has distinctive advantage over the conventional multistage pedicle-flap transfer. Between 1992 and 1996, we treated 9 cases of 8 patients who had large scar around the wrist due to old electrical burn with free flaps as a preparation of staged tendon graft. Mean age was 30.3 years and average scar area was $6{\times}11cm$. The length of time the injury and free flaps was 9 months on an average. Prior to the free flap, we performed the angiography to all patients in order to evaluate the circulation of the forearm and hand and to choose the recipient vessel. In all cases, proximal ulnar arteries in the forearm remained intact and all radial arteries remained intact in 8 of 9 cases on angiogram. The interosseous arteries were well visualized in all cases. We used the ulnar arteries as a recipient artery. The types of flaps used were f scapular cutaneous flaps, 2 dorsalis pedis flaps and a radial forearm flap. Flap survial was 100 percents with satisfactory functional and cosmetic results. Free flaps using ulnar artery as a recipient artery is one of the useful reconstruction methods for the resurfacing of large scar around the wrist in the patients of old electrical burn.

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A Comparative Study of Surgical Treatment in the Ruptured Achilles Tendon: Minimal incision and Open repair (아킬레스건 파열의 수술적 치료 비교: 최소 절개 봉합술과 관혈적 봉합술)

  • Kong, Gyu-Min;Gwak, Heui-Chul;Kim, Jeon-Gyo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.3
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    • pp.181-189
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    • 2012
  • Purpose: The purpose of this study was to compare and analyse the clinical outcomes of minimal incision repair and open repair in ruptured Achilles tendon. Materials and Methods: We retrospectively analyzed the outcomes of 10 patients with minimal incision repair (group 1) and 19 patients with open repair (group 2) from February 2007 to June 2011. The postoperative clinical evaluations were done by Arner-Lindholm scale, AOFAS score, overall patient's satisfaction and cosmetic satisfaction of scar. Results: There was no statistical difference between two groups in Arner-Lindholm scale, AOFAS score, overall patient's satisfaction (p=1.21, 0.87, 1.07). There was statistically high rate of cosmetic satisfaction in group 1(p<0.001). There were no complications in group 1. Complications occurred in three patients (deep infection, rerupture, deep vein thrombosis) of group 2. Conclusion: Treatment of minimal incision repair in Achilles's tendon ruptures showed high rate of cosmetic satisfaction and low rate of complication's, but there were no significant differences with open repair in other clinical outcomes. The minimal incision repair could be recommended as one of the effective treatment for the Achilles's tendon ruptures.