• Archives of Plastic Surgery
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• 제37권1호
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• pp.26-30
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• 2010

Purpose: Common complications of immediate breast reconstruction with implant are capsular contracture, malposition of implant, hematoma and seroma. Especially, the most severe complication is implant exposure caused by inflammation or necrosis of skin flap margin of mastectomy site. This article reports the experience of cases of salvage in such an exposure of implant. Methods: From July, 2002 to Feb., 2009, sixty-five patients who underwent immediate breast reconstruction with implant were retrospectively analyzed. Exposure of implant was happened in 5 of 65 patients and they were treated at out patient district. Two of five patients were reconstructed with saline implnt and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$ and Serratus muscle flap. Remaning three patients were reconstructed with silicone implant and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$. Results: In the group of patients who underwent reconstruction with saline implant, implant exposure was found in one patient due to partial necrosis of the margin of skin flap and debridement and primary repair were done. In the other one patient, dressing with antibiotic ointment were done. And debridement and primary repair were proceeded. In the group of patients who underwent reconstruction with silicone implant, implant exposure was found in one patient. After removal of the implant, tissue expansion was done and a new silicone implant was inserted. Implant exposure were found in the other two patients, antibiotics ointment application and primarily repaired. Conclusion: It was the common knowledge that the exposed implant should be removed. But salvage of the exposed implants may be possible with proper treatment. Four of five patients (80%) with exposed breast implant were salvaged with conservative management.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.739-742
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• 2008

Purpose: Breast augmentation is one of the common procedures in plastic surgery today. The shape, size and insertion plane of the implant is decided preoperatively by physical examination of the breast. Pectus excavatum is one of the most common anomalies of chest wall, characterized by a depression of the anterior chest wall. For patients with a mild type of pectus excavatum, the main purpose of the treatment is aesthetic rather than functional improvement. Two most surgical treatment options for skeletal deformity are the Ravitch technique and minimally invasive Nuss repair. Other options for soft tissue repair are implant insertion and autologous soft tissue augmentation. We performed a surgical operation with Nuss procedures and breast augmentation for a patient with mild pectus excavatum and hypoplastic breast. Methods: A 32 year-old female was presented with hypoplastic breast. Preoperative chest CT was performed, showing pectus excavatum. After Nuss procedure, we inserted saline implant(275 cc textured round breast implant, moderate profile) submuscularly to restore adequately projected breast. Results: Patient's postoperative course was uneventful without any complication. After 6 months of follow-up period, the patient had an excellent result, with high patient satisfaction and no complications. Conclusion: For patients with a mild type of pectus excavatum, who do not have cardiopulmonary symptoms and requires for aesthetic improvement, this simple approach with Nuss procedure and breast augmentation achieves excellent aesthetic correction with low complication rate and high patient satisfaction.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.182-188
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• 2011

Purpose: The buttocks region has been associated with allure and sex appeal for centuries. Gluteal implants enable buttocks remodeling in a way that is not possible in other methods. One of the reasons that render gluteal implant surgeries unpopular is the fear of complications, the main problems being seroma, wound dehiscence, extrusion, and a visible or palpable implant. The authors present the XYZ technique, which provides anatomical reference points to guide the intramuscular dissection procedure in a feasible and safe way, resulting in a lower complication rate. Methods: The XYZ procedure was done for buttock augmentation on 8 patients from December 2009 to June 2010. Patient's ages ranged from 27 to 44 with a mean age of 36. Seven patients were applied the 250cc sized Elastomer implants with one patient 290cc sized implant. Preoperative marking was done with the patients in the standing position. Bisection of the gluteus maximus muscle was done at the midpoint thickness to create a plane for implant insertion, which is called the sandwich plane. Results: The 8 cases were performed safely without major complications. However one patient had minor wound dehiscence, and was managed with conservative treatment. Another patient had a discomfort on the buttocks for a long time. The patients were followed up for average 6 months. All patients were satisfied with the aesthetic results. Conclusion: In performing the XYZ technique for gluteal augmentation, the surgeon must split the muscle into two equal halves with anatomical reference points to guide the muscle detachment in a symmetrical way at an adequate depth. This method provides a guideline for the surgeon in determining the ideal plane during intramuscular dissection and gives predictable results with low complication rates. Intramuscular gluteoplasty with gluteal implants offers predictable, aesthetically pleasing results without contour irregularities and only a low incidence of major complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.34.1-34.14
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• 2015

Background: Over the past 30-40 years, various carbon implant materials have become more interesting, because they are well accepted by the biological environment. The traditional carbon-based polymers give rise to many complications. The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon). The aim of this study is to present the long-term clinical results of carbon/carbon implants, and the results of the scanning electron microscope and energy dispersive spectrometer investigation of an implant retrieved from the human body after 8 years. Methods: Mandibular reconstruction (8-10 years ago) was performed with pure (99.99 %) carbon implants in 16 patients (10 malignant tumours, 4 large cystic lesions and 2 augmentative processes). The long-term effect of the human body on the carbon/carbon implant was investigated by comparing the structure, the surface morphology and the composition of an implant retrieved after 8 years to a sterilized, but not implanted one. Results: Of the 16 patients, the implants had to be removed earlier in 5 patients because of the defect that arose on the oral mucosa above the carbon plates. During the long-term follow-up, plate fracture, loosening of the screws, infection or inflammations around the carbon/carbon implants were not observed. The thickness of the carbon fibres constituting the implants did not change during the 8-year period, the surface of the implant retrieved was covered with a thin surface layer not present on the unimplanted implant. The composition of this layer is identical to the composition of the underlying carbon fibres. Residual soft tissue penetrating the bulk material between the carbon fibre bunches was found on the retrieved implant indicating the importance of the surface morphology in tissue growth and adhering implants. Conclusions: The surface morphology and the structure were not changed after 8 years. The two main components of the implant retrieved from the human body are still carbon and oxygen, but the amount of oxygen is 3-4 times higher than on the surface of the reference implant, which can be attributed to the oxidative effect of the human body, consequently in the integration and biocompatibility of the implant. The clinical conclusion is that if the soft part cover is appropriate, the carbon implants are cosmetically and functionally more suitable than titanium plates.

• Journal of Periodontal and Implant Science
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• 제36권4호
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• pp.925-938
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• 2006

The aim of this study was to systematically investigate the complications of single implant-supported restorations followed more than 5-year. Thirty-five studies were selected for the systematic review. A total of 3932 single implants were included at the beginning of studies. Thirty-one implants were removed before loading and 91 implants after loading. The overall implant loss rate was 3.1 %. Implant losses were concentrated on the period between loading and 2-year follow-up, and, after a stable period, increased after 5-year follow-up. The mean marginal bone loss at single-tooth implants was well within 0.2 mm/year, i.e., acceptable annual bone loss by the implant success criteria. However, considerable amounts of single implants suffered a marginal bone loss at implant more than 0.2 mm/year. Fistula was a frequent biological complication in the early studies. The most frequent technical problem was a screw loosening, but its frequency was reduced after the use of a gold screw and torque controller. Within the limits of this study, the complications of single implants might be underestimated due to the lack of information about the biological and technical complications available in the relevant literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.281-285
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• 2011

Sinus floor elevation is a predictable and standard procedure for the treatment of the posterior maxilla before insertion of dental implants. Although overall complication rates are low, complications can occur including sinus membrane perforation, infection of sinus, swelling and hemorrhage. The most common complication is membrane perforation. Recently, various techniques and materials for repair of perforation to the sinus membrane have been proposed. The purpose of this article is to report on various techniques and materials that can be used for repair of perforations to the sinus membrane. The search protocol used was the following electronic database: Pubmed, with a time limit from 1998 to 2009. The key words such as 'sinus lift', 'sinus augmentation', 'sinus floor elevation', 'sinus graft', 'sinus perforation', 'repair of sinus perforation' and 'repair of sinus membrane' were used, alone and in combination, when searching the database. Various techniques have been proposed to manage of perforation of sinus membranes. These include that the use of collagen membranes, demineralized freeze-dried human lamellar bone sheets, processed human allografts, lamella bone, buccal fat pads and suturing. Implant success rate ranges from 69.9% to 98.9%.

• 대한두개안면성형외과학회지
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• 제16권1호
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• pp.35-38
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• 2015

Alloplastic implants have been used to repair orbital wall fractures in most cases. Orbital hemorrhage is a rare complication of these implants and has been reported rarely in Korea. The purpose of this article is to report a late complication case focusing on their etiology and management. A 20-year-old male patient underwent open reduction with Medpor (porous polyethylene) insertion for bilateral orbital floor fractures. The initial symptom occurred with proptosis in the right side as well as vertical dystopia, which had started 4 days earlier, 8 months after surgery. Any trauma history after the surgery was not present. We performed an exploration and removal of hematoma with Medpor titanium meshed alloplastic implant. A case of delayed orbital hematoma following alloplastic implant insertion was identified. It occurred within the pseudocapsule of the implant. One week after surgery, overall symptoms improved successfully, and no complications were reported during the 11-month follow-up period. Although rare, orbital hemorrhage is a potential complication of alloplastic orbital floor implants, which may present many years after surgery. As in the case presented, delayed hematoma should be included in the differential diagnosis of late proptosis or orbital dystopia.

• 대한치과의사협회지
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• 제53권5호
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• pp.298-306
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• 2015

Bacterial infection after implant installation or bone graft is a serious complication. Bone grafts represent a temporary foreign body lacking vascularisation and are therefore of increased susceptibility to infection, which may be introduced either intraoperatively or postoperatively. Bone graft-associated infections are due to biofilm formation on the surface of the bone graft and often require removal of the infected bone graft with substantial graft failure. In this review, the implant and graft related infection, the role of biofilm and the management will be discussed.

• 대한치과의사협회지
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• 제58권9호
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• pp.573-582
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• 2020

Today, maxillary sinus graft is considered to be the most prognostic of bone augmentation surgery as a preprosthetic treatment. Implant survival rates of more than 95% can be expected if appropriate decisions are made on the basis of implants, implant surface morphology, and use of a shield over the maxillary sinus front-wall. In addition, maxillary sinus grafty has a low rate of complications, and even if complications occur during or after maxillary sinus graft, most are localized and easily recovered.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권1호
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• pp.60-65
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• 2013

The maxillary floor sinus augmentation is considered as a safe and predictable procedure to ensure optimal implant placement. However, this procedure may have a variety of intra-surgical or post-surgical complications, also the major drawback of the procedure is deemed maxillary sinusitis. This case is a very unusual delayed occurrence of acute maxillary sinusitis after simultaneous maxillary sinus augmentation, using xenograft and implant placement. This report describes a serious complication of the maxillary sinus augmentation.