• Archives of Plastic Surgery
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• v.40 no.5
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• pp.564-569
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• 2013

Background Scalp defects may be caused by various etiological factors, and they represent a significant surgical and aesthetic concern. Various surgical techniques can be applied for reconstructive work such as primary closure, skin grafting, pedicled or free flaps. In this article, the authors share their clinical experience with scalp operations using the technique of local flaps and discuss the application of this method from the perspective of not only the size of the defect, but also in relation to the anatomical area, quality of surrounding tissue, and patient's condition. Methods During the period from December 2007 to December 2012, 13 patients with various scalp defects, aged 11 to 86 years, underwent reconstruction with local pedicle flaps. The indications were based on the patients' condition (age, sex, quality of surrounding tissue, and comorbidities) and wound parameters. Depending on the size of the defects, they were classified into three groups as follows: large, 20 to 50 $cm^2$; very large, 50 to 100 $cm^2$; extremely large, 100 $cm^2$. The location was defined as peripheral (frontal, temporal, occipital), central, or combined (more than one area). We performed reconstruction with 11 single transposition flaps and 1 bipedicle with a skin graft on the donor area, and 2 advancement flaps in 1 patient. Results In all of the patients, complete tissue coverage was achieved. The recovery was relatively quick, without hematoma, seroma, or infections. The flaps survived entirely. Conclusions Local flaps are widely used in scalp reconstruction since they provide healthy, stable, hair-bearing tissue and require a short healing time for the patients.

• Journal of Chest Surgery
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• v.18 no.1
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• pp.62-68
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• 1985

10 patients with mitral regurgitation associated with various congenital cardiac anomalies were treated by reconstructive techniques in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the period of 2 years from 1982 to 1984. There were mitral valvular cleft in one case, chordae tendineae rupture associated with congenital multiple cardiac-anomalies [VSD, PDA, prolapse of aortic non-coronary cusp through VSD] in one case, elongated chordae tendineae after removal of left atrial myxoma in one case, and mitral annular dilatation associated with VSD in 3 cases, large PDA in 2 cases, aortic regurgitation [bicuspid valve] in one case, and unknown origin in one case. Owing to the various pathology above mentioned, reconstructive surgical approach to mitral incompetence is accordingly complicated and a combination of the following different procedures were properly used case by case, that is, suture of chordae tendineae, shortening of elongated chordae tendineae, closure of VSD, ligation of PDA, aortic valvuloplasty, mitral annuloplasty with mattress suture, etc. All patients were survived and they have been excellent postoperative results.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.578-582
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• 2018

Teratomas can occur in almost any region of the body and are the most common extragonadal germ cell childhood tumors. However, craniofacial teratomas are rare. Craniofacial teratomas can present unique features and cause significant functional and aesthetic concerns. There are complex lesions that can have components intra-cranially and extra-cranially. Therefore, their management requires significant multi-stage multidisciplinary surgical procedures. Herein, we present a case of craniofacial teratoma in a child with the phenotype of proboscis lateralis that highlights some of the pertinent point of the diagnosis and management of congenital neonatal teratomas.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.559-563
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• 2017

Supported by recent literature on the signs of aging of the middle and lower face, our clinical research has documented a loss of volume of the deep structural components of the central face and a progressive descent of the nasolabial fat and the jowl fat, leading to facial fragmentation. The signs that appear around the age of 45 to 50 years are well targeted by the mini-invasive technique described here. We focused on refitting the jowl fat and the nasolabial fat associated with cutaneous tightening. The use of absorbable barbed sutures (Quill) led to significant improvements, enabling the fitting of fat on fat. In the past 4 years, 167 operations were performed using this technique. The clinical results were very satisfactory, yielding a natural effect caused by the mobilization and strong fixation of the nasolabial fat and the jowl fat in the direction opposite to their displacement.

• Archives of Plastic Surgery
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• v.46 no.3
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• pp.267-271
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• 2019

A 70-year-old man complained imbalance while walking, inability to perform ankle flexion, and could not stand on tip-toe 3 months after injury. The ankle looked swollen with loss of Achilles contour and obvious gait disturbance. Magnetic resonance imaging shows a 5-cm Achilles tendon gap. Subsequently, surgery was performed to solve the neglected Achilles tendon rupture. Patient was put under general anesthesia with a regional block. Using a nontourniquet technique, a reconstructive procedure was performed using a half-width autologous Achilles tendon graft, which was attached to the calcaneal prominence with wire in a double strand Bunnell fashion. As for the proximal stump, double core Bunnell/modified Kessler suturing was carried out to suture the graft to Achilles stump. To increase the vascularization, an ipsilateral gastrocnemius fascial flap with a distally based-pedicle was harvested to wrap around the tendon graft. At a 6-month follow-up, the patient was able to stand on tip-toe and had also regained a normal gait.

• Archives of Craniofacial Surgery
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• v.23 no.5
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• pp.232-236
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• 2022

Post-traumatic enophthalmos and hypoglobus are common sequelae of facial bone fractures, even after reduction surgery. They are associated with functional and esthetic issues, which may lower the quality of life. These deformities frequently present late, and adequate correction is difficult. We report three cases of late inferior orbital rim reconstructions with three-dimensional printed implants to help resolve these problems. The average duration between the traumatic event and surgery was 3 years and 4 months. One patient was treated with a completely absorbable implant and exhibited satisfactory results until the implant started to biodegrade at 1 year and 9 months after surgery. Two patients were treated with a permanent implant and demonstrated satisfactory results. However, longer follow-up periods were needed. There were no complications such as infection, diplopia, or restriction of ocular motion and the patients were satisfied with the esthetic results.

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.785-786
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• 2022

The anterolateral thigh (ALT) flap has been extensively discussed in the literature as it allows for a wide variety and depth of tissues for complex wound coverage. Thanks to many cadaveric and angiographic studies of the subdermal plexus, it is to date ascertained that tailoring ALT thickness can be safely performed without compromising flap outcomes or causing additional morbidity. Recently, the authors applied and described a simpler, safer, and less time-consuming superthin ALT perforator (ALTP) free flap harvesting technique. The aim of this article is to show the versatility of the adipofascial flap harvested around the chosen perforators, which allowed us to safely expand the usage of ALTP superthin flaps.

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.79-81
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• 2015

Rheumatoid arthritis is a long lasting autoimmune disorder that primarily affects joints, and patients with rheumatoid arthritis are predisposed to development of chronic skin ulcers. In addition, skin ulcers with rheumatoid arthritis tend to persist despite treatment because of sustained inflammation and poor healing capacity. Treatment of skin ulcers involves medications, wound coating agents, and surgical procedures including skin grafting, however, wound dressing or skin grafts are generally excluded because of excessive cost and time and poor intake rate. The dorsal metacarpal artery perforator (DMAP) flap, a vascular island flap for coverage of soft tissue defects on the fingers, provides promising results including matched quality and color. We experienced a case of DMAP flap for reconstruction of a rheumatoid ulcer, and a DMAP flap may be considered as a good faithful option for treatment of patients with rheumatoid ulcer.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.200-204
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• 2018

Fibrous dysplasia (FD) is a rare, benign bone disease with abnormal bone maturation and fibroblastic proliferation. Optimal treatment of zone 1 craniofacial FD is radical resection and reconstruction. To achieve of structural, aesthetic, and functional goals, we use three-dimensionally designed calvarial bone graft for reconstruction of zygomatic defect after radical resection of FD. The authors used a rapid-prototyping model for simulation surgery for radical resection and immediate reconstruction. Donor site was selected from parietal bone reflect shape, contour, and size of defect. Then radical resection of lesion and immediate reconstruction was performed as planned. Outcomes were assessed using clinical photographs and computed tomography scans. Successful reconstruction after radical resection was achieved by three-dimensional calvarial bone graft without complications. After a 12-month follow-up, sufficient bone thickness and symmetric soft tissue contour was well-maintained. By considering three-dimensional configuration of zygomaticomaxillary complex, the authors achieved satisfactory structural, aesthetic and functional outcomes without complications.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.539-542
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• 2011

Purpose: Despite the increasing number of patients with HIV (human immunodeficiency virus) infection, surgical experience with these patients remains limited in aesthetic and reconstructive surgery. The authors performed breast reconsruction with free TRAM (Transverse Rectus Abdominis Muculocutaneous) flap in HIV infected patient firstly in Korea. Methods: A 53-years-old female with HIV positive underwent delayed breast reconstruction with free TRAM flap and 6 months lateral nipple reconstruction was performed. All procedures were performed according to the HIV infection control guidelines provided by the Korea Centers for Disease Control and Prevention. Results: There were no complications such as infection, hematoma and flap loss and symmetry of breast was achieved. Conclusion: When the operation is performed in line with the guidelines of HIV infection control, breast reconstruction with free flap is possible and can obtain successful results.