• Archives of Plastic Surgery
• /
• v.48 no.5
• /
• pp.473-482
• /
• 2021

Background The increasing number of bilateral breast cancer patients has been accompanied by a growing need for bilateral mastectomy with immediate reconstruction. However, little research has investigated the complications and aesthetic outcomes related to bilateral reconstruction. Therefore, we analyzed retrospective data comparing the outcomes of bilateral reconstruction using deep inferior epigastric perforator (DIEP) flaps or implants. Methods This study included 52 patients (24 DIEP group and 28 implant group) who underwent bilateral mastectomy with immediate reconstruction between 2010 and 2020. Patient demographics, surgical characteristics, and complications were recorded. The difference between the left and right position of the nipple-areolar complex with respect to the sternal notch point at the clavicle was measured, and breast symmetry was evaluated. Results The average weight of breasts reconstructed with DIEP flaps (417.43±152.50 g) was higher than that of breasts with implants. The hospitalization period and operation time were significantly longer in the DIEP group. Early complications were significantly more common in the implant group (36.53%) than in the DIEP group. The angles between the nipples and the horizontal line were 1.09°±0.71° and 1.75°±1.45° in the DIEP and implant groups, respectively. Conclusions Although the surgical burden is lower, breast reconstruction using implants requires greater attention with respect to implant positioning, asymmetry, and complications than DIEP flap reconstruction. DIEP flap reconstruction has a prolonged operation time and a high risk of flap failure, but yields excellent cosmetic results and does not require intensive follow-up. Patients should be consulted to determine the most suitable option for them.

• Medical Lasers
• /
• v.8 no.1
• /
• pp.13-18
• /
• 2019

Background and Objectives High-intensity focused ultrasound (HIFU) can produce small zones of thermal damage. A HIFU procedure is non-invasive and it can achieve rejuvenation of facial skin. Fractional CO₂ laser resurfacing delivers thermal damage to the pixilated columnar zone of the skin and so evoke collagen remodeling, the same as HIFU. In many cases, the patients who want rejuvenation with HIFU are also good candidates for cutaneous photorejuvenation such as can be accomplished via fractional CO₂ resurfacing. If patients are treated in a single session by remodeling both the superficial and deep compartments of skin by using both modalities, then improvement in rhytides and tightening of sagging skin will optimize the aesthetic result. Materials and Methods Between May 2014 and January 2018, a total of 44 patients were treated with combination HIFU and fractional CO₂ laser resurfacing according to our protocol. First, the HIFU was applied to the entire face with an average of 300 treatment lines. Immediately after HIFU treatment, the ultrasound gel was washed off and then fractional CO₂ laser resurfacing was performed. We evaluated the patients using 4-point grading scales. The clinician examined the skin for evidence of complications after the completion of treatment. Results All the patients' skin quality showed improvement. Further. the clinical results after duel modality treatment were substantially better than that after the use of either modality alone. The recovery times and the incidence of adverse events when quickly and consecutively performing both treatments were similar as compared to those with employing stepwise treatment. We encountered no complications whatsoever. Conclusion When compared with stepwise therapy, combination therapy with HIFU and fractional CO₂ resurfacing offers better, safer and more effective clinical results. Thus, for targeting multiple layers of aging facial skin, this combination therapy can be safely performed in a single treatment session.

• The Journal of the Korean bone and joint tumor society
• /
• v.1 no.2
• /
• pp.244-248
• /
• 1995

Glomus tumor is uncommon tumor with an incidence of about 1% in soft tissue tumors and the single most common location is the subungual region of the finger. Many reports have emphasized that glomus tumors were difficult to diagnose and that the result of surgical removal was good, but nail deformity has received little attention. Most of authors removed the entire nail or partially splitted the nail to exposure the nail bed and tumor. Nobody reported whether nail deformity after operation was present or not. But, an abnormal nail is both a cosmetic and a functional problem in that catches on objects. In this study, our attention was postoperative nail deformity as well as the results of surgical removal. Seven patients(eight cases) who were diagnosed as a subungal glomus tumor in the hand were treated by surgical excision without removal of the nail and followed over twenty two months. And then we report on our experience with 8 cases of subungual glomus tumor which were successfully treated by complete excision without nail deformity.

• Journal of Korean Neurosurgical Society
• /
• v.59 no.3
• /
• pp.242-246
• /
• 2016

Craniosynostosis is the premature fusion of calvarial sutures, resulting in deformed craniofacial appearance. Hence, for a long time, it has been considered an aesthetic disorder. Fused sutures restrict growth adjacent to the suture, but compensatory skull growth occurs to accommodate the growing brain. The primary goal for the management of this craniofacial deformity has been to release the constricted skull and reform the distorted shape of the skull vault. However, the intellectual and behavioral prognosis of affected children has also been taken into consideration since the beginning of the modern era of surgical management of craniosynostosis. A growing body of literature indicates that extensive surgery, such as the whole-vault cranioplasty approach, would result in better outcomes. In addition, the age at treatment is becoming a major concern for optimal outcome in terms of cosmetic results as well as neurodevelopment. This review will discuss major concerns regarding neurodevelopmental issues and related factors.

• Journal of Chest Surgery
• /
• v.26 no.1
• /
• pp.54-58
• /
• 1993

Simultaneous bilateral bleb resection was done through bilateral transaxillary thoracotomy in 10 patients with spontaneous pneumothorax during the period from May 1991 to Novemver 1992 in whom bilateral bulla or bleb was detected with using simple chest X-ray and chest CT scanning. To compare the effectiveness of bilateral transaxillary thoracotomy, we investigated 10 unilateral transaxillary thoracotomy patients with spontaneous pneumothorax and two clinical reports from other institutes which dealt the results of bilateral bleb or bulla resection through median sternotomy also. In bilateral transaxillary thoracotomy group,mean operation time was 115 minute,mean intraoperative bleeding was 329 cc, mean postoperative hospital stay was 7.5 days. Postoperative ABGA[Arterial Blood Gas Analysis] was in normal range and postoperative recovery rates of FVC[Forced Vital Capacity], FEV1[Forced Expiratory Volume at 1 second], TV[Tidal Volume] were 84.3%, 93.4%, 88.7%,respectively. In median sternotomy group,mean operation time was 129 minute,mean intraoperative bleeding was 490 cc, mean postoperative hospital stay was 12.4 days. Postoperative ABGA was in normal range and postoperative recovery rates of FVC, FEV1 were 97.3%, 97.4%, respectively. In unilateral transaxillary thoracotomy group, postoperative ABGA was in normal range also and postoperative recovery rates of FVC, FEV1, TV were 91.6%, 99.0%, 96.0%,respectively. In conclusion, simultaneous bilateral bleb resection through bilateral transaxillary thoracotomy should be considered in pneumothorax patients with bilateral bleb or bulla because of cost-effectiveness[reducing hospital days] and better cosmetic result without any impairment in recovery of respiratory function.

• Biomedical Science Letters
• /
• v.15 no.1
• /
• pp.81-86
• /
• 2009

Lasers are necessity in our life related to the fields of medicine and cosmetic surgery. With 808 nm diode laser and $CO_2$ laser, we made some wounds on a dorsum of rat by laser irradiation. All of irradiations shows thermal effects on the whole region of skin tissues. They make wound damage depending on laser power and irradiation time. Because a collagen is plays an important role in tissue repair, we studied collagen accumulation in wound tissue. For wound healing, collagen accumulation was found in the near region of damage in epidermis and dermis layer of the rat skin. In case of the quantitative analysis of collagen in wound tissue, the amount of collagen in wound tissue by $CO_2$ laser irradiation is higher than that of 808 nm diode laser irradiation. And re-epithelialization was significantly faster in wound by $CO_2$ laser irradiation compared with that of 808 nm diode laser irradiation.

• The Journal of Korean Physical Therapy
• /
• v.16 no.1
• /
• pp.60-69
• /
• 2004

Many methods have been described for the early intervention of adolescent idiopathic scoliosis. Adolescent idiopathic scoliosis is lateral and rotational spinal curvature in absence of associated congenital or neurologic abnormalities, the most common type of scoliosis observed in child and young adults, and refers to curves that develop after the age of $10{\sim}18$. The curves of adolescent idiopathic scoliosis have the potential to progress rapidly during growth. Curves are currently universally measured by the Cobb's method and Ferguson method. Some curves do not remain small, these may be mildly or severely progressive and the ribs on the convex side of the curve separate, and those on the concave side ribs approximate so rib undergoes deformation with rib humping. The latter may make angles that can affect vestibular system, balance, sensory, especially cardipulmonary function. Intervention for adolescent idiopathic scoliosis is based on the patient's age, the angular value of the curve, the maturity of their skeleton, and the topography. The purpose of intervention for adolescent idiopathic scoliosis consists of knowing how to go to the best approach the correction of the lateral curve and rotational deformity holding the achieved for the remainder of spinal growth, preventing significant cosmetic abnormality, pain and cardiopulmonary complication, control the muscle imbalance and proprioceptive postural disturbances, be less need for radical surgery to avoid early surgery.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.6
• /
• pp.457-471
• /
• 2020

Fingers are body parts with a complex structure and essential functions that are the most prone to trauma. The principle of treatment for finger fractures is to determine the balance between obtaining stable fracture fixation and early joint movement. Despite proper treatment, there are many cases of functional and cosmetic problems caused by stiffness or deformation as complications. This review article introduces the latest knowledge in the treatment of finger fractures focusing on fractures and dislocations around the interphalangeal joints, including joint surface damage, which is difficult to treat and leads to poor results. This article consists of fracture cases and describes the methods and solutions to address these complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.31 no.5
• /
• pp.409-416
• /
• 2005

Purpose of study: The temporomandibular joint (TMJ) occupies a key functional role in mastication and contributes to normal deglutition, speech as well as cosmesis. When a large amount of mandible including the condyle head is resected, it is very difficult to reconstruct it as a functional unit. In this retrospective study, we present the functional, radiographic and cosmetic results of reconstructed temporomandibular joint using free fibular flap. Patients and Methods: Total 12 patients (M:F = 6:6) who underwent condylar reconstruction with the fibular flap were interviewed and examined by radiographs and Bio-PAK$^{(R)}$. Mean follow up periods was $47.7{\pm}20.0$ months and the average age was $38.7{\pm}15.3$ years. Remodeling of condyle and function of TMJ were evaluated and facial contour was judged subjectively. Results: All flaps were viable and no immediate postoperative complication had happened. One patient showed decreased mouth opening, so interpositional gap arthroplasty was performed. The resorption rates of reconstructed fibular were minimal and the condyle heads were changed into domeshaped neocondyle after 2 years. All patients had normal diet and no speech difficulty was reported. Nine patients were satisfied with their facial contour but three patients complained about the depression of cheek. Conclusion: The reconstruction of TMJ with free fibular flap was reliable methods and very effective means of restoring mandibular function. The functional and morphologic results were excellent and showed little complications.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.23 no.3
• /
• pp.281-288
• /
• 2001

Lymphangiomas are relatively rare benign tumors of the lymphatic system, characterized by congenital lymphatic malformation such as anastomosis or obstuction of the lymphatic channels. There are most frequently diagnosed in children younger than 3years. In contrast to that of the hemangioma, the sex distribution of the lymphangioma is nearly evenly divided. The head and neck lymphangioma represents about $70{\sim}75%$ of all lymphangiomas, and they are difficult to manage. Spontaneous regression is rare, and rapid intermittent enlargement occurs secondary to infection or trauma. Enlargement may cause serious sequelae such as airway obstruction, feeding difficulties, and cosmetic problems. Treatments previously used for lymphangiomas include surgical excision and intralesional injection of sclerosants. Problems associated with surgical excision include the risk of cosmetically unacceptable scarring and the risk of damage to surrounding vital stricture and the high risk of incomplete excision. The sclerosants previously used have numerous other local and systemic side effects. This report describes a case that was successfully treated using OK-432 as a new sclerosant drug and secondary surgical excision for congential cavenous lymphangioma extensively enlarged to tongue, mouth floor and submandibular region.