• 대한치과교정학회지
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• 제50권5호
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• pp.336-345
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• 2020

Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky-Kaban types and growth stages. Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; Tx-Mod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; Tx-Mod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky-Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky-Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001). However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky-Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05). Conclusions: These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.319-324
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• 2018

Perforator flaps are becoming increasingly common, and as primary thinning techniques are being developed, the need for secondary contouring of flaps is decreasing. However, many reconstructive flap procedures still incorporate secondary debulking to improve the functional and aesthetic outcomes. Direct excision, liposuction, tissue shaving with an arthroscopic cartilage shaver, and skin grafting are the four major methods used for secondary debulking. Direct excision is primarily applied in flaps where the skin is redundant, even though the volume is not excessive. However, due to the limited range of excision, performing a staged excision is recommended. Liposuction can reduce the amount of subcutaneous tissue of the flap and protect the vascular pedicles. However, the main drawback of this method is its limited ability to remove fibrotic tissues, for which the use of a shaver may be more convenient. The main drawback of using a shaver is that it is difficult to simultaneously remove excess skin. Skin grafting enables the removal of sufficient excess tissue to recover the contour of the normal limb and to improve the color match, facilitating excellent aesthetic results.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.371-376
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• 2007

Purpose: The earlobe is one of the areas which are most vulnerable to trauma. Various auricular diseases need compression treatment. We report a new compression method using magnetic disks. Methods: Seventeen patients with auricular diseases were treated from October 2002 to September 2006. The mean age was 29.1 years. The diseases details were osteochondroma in 2 patients; cauliflower's ears in 2 patients; acute otohematoma in 1 patient; and hypertrophic scars in 11 patients. The most common cause of their disease was ear piercing. The mean follow-up period was 8.9 months. All surgical procedures were performed under local anesthesia. To compress immediately, a pair of magnetic disks was applied to the anterior and posterior surface of the earlobe. Results: The results were generally good. Major complications, such as recurrence, necrosis, dehiscence, or infection, did not occur. Conclusion: A pair of magnetic disks are useful compression tool in various auricular diseases.

• 대한두개안면성형외과학회지
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• 제22권1호
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• pp.38-44
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• 2021

Background: The free flap surgical method is useful for the reconstruction of head and neck defects. This study retrospectively analyzed the results of head and neck reconstructions using various types of free flaps over the past 30 years. Methods: Between 1989 and 2018, a total of 866 free flap procedures were performed on 859 patients with head and neck defects, including 7 double free flaps. The causes of vascular crisis and salvage rate were analyzed, and the total flap survival rate calculated among these patients. Additionally, the survival and complication rates for each flap type were compared. Results: The 866 cases included 557 radial forearm flaps, 200 anterolateral thigh flaps, 39 fibular osteocutaneous flaps, and 70 of various other flaps. The incidence of the vascular crisis was 5.1%; its most common cause was venous thrombosis (52.3%). Salvage surgery was successful in 52.3% of patients, and the total flap survival rate was 97.6%. The success rate of the radial forearm flap was higher than of the anterolateral flap (p< 0.01), and the primary sites of malignancy were the tongue, tonsils, and hypopharynx, respectively. Conclusion: The free flap technique is the most reliable method for head and neck reconstruction; however, the radial forearm free flap showed the highest success rate (98.9%). In patients with malignancy, flap failure was more common in the anterolateral thigh (5.5%) and fibular (5.1%) flaps.

• 대한두경부종양학회지
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• 제38권2호
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• pp.33-36
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• 2022

Squamous cell carcinoma is the most common cancer occurring in the oral cavity and oncologic wide cancer excision is a major cause of large lip defects. Large lower lip defect reconstruction with good functional and aesthetic results has always presented a challenge for plastic surgeons. There are various lower lip reconstruction methods depending on its size, location, and surgeon's expertise. This is a case of a large defect spanning more than two-thirds of the lower lip after wide excision due to squamous cell carcinoma. The Karapandzic flap was used to reconstruct the defect with a commissuroplasty carried out in a second operation, which yielded a relatively good functional and aesthetic result. No recurrences or metastases were observed within a one year follow-up period.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권2호
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• pp.191-198
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• 1991

안모비대칭은 심미적 정서적으로 영향을 줄 뿐만 아니라 기능적인 장애를 초래하는 경우도 있다. 안모비대칭은 안면골 중에서 특히 하악골과 관련된 경우가 많은데 이는 하악골이 안면하부의 연조직을 지지하므로 작은 위치, 형태 변화에도 두드러지게 나타나기 때문이다. 비대칭안모를 초래하는 하악과두의 거대증은 Hyperplasia, Hypertrophy, 골증, 외골증, 골연골증, 연골육종 등을 들 수 있다. 비대칭안모 분류는 여러 학자에 의해 다양하게 분류되지만 Bruce와 Hayward는 Deviation prognathism, Unilateral macroganthia, Unilateral condylar hyperpiasia로 분류한 바 있다. 과증식된 하악과두의 절제술은 1856년 Humphry에 의해 최초로 시행된 후 여러 학자들에 의해 성공적으로 시행되고 있다. 본 증례에서는 Unilateral condylar hyperlpasia와 골연골종으로 인한 안모비대칭 환자로써 Condylectomy, Le Fort I osteotomy, Vertical ramus osteotomy, Mandibular inferior border ostectomy, Genioplasty 등을 시행하여 심미적 기능적으로 양호한 결과를 얻었기에 이를 보고하는 바이다.

• Archives of Plastic Surgery
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• 제44권5호
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• pp.457-468
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• 2017

Background Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. Methods A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. Results According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. Conclusions The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권1호
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• pp.35-44
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• 1997

The most critical factor in determining which type of implant to be used would be the available bone of the patient. Usually a minimum of 5mm in the bone width and 8mm in the bone height is necessary to ensure primary implant stability and maintain the integrity of bone contact surface. Placement of implant is limited by the several anatomic strutures such as maxillary sinus, floor of the nose, inferior alveolar neurovascular bundle and nasopalatine foramen, etc. When severe resorption of alveolar ridge is encountered, implant placement would be a problematic procedure. A number of techniques to improve the poor anatomic situations have been proposed. This article reports 4 cases of patients using surgical procedures such as blade implant technique, cortical split technique in the anterior maxillary area, sinus lifting and lateral repositioning of inferior alveolar nerve, We treated dental implant candidates with unfavorable alveolar ridge utilizing various surgical techniques, resulted in successful rehabilitation of edentulous ridge.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권2호
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• pp.100-106
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• 2013

There are many challenges for reconstruction after intraoral tumor resection. Especially, palatomaxillary reconstruction has two primary goals: closure of the oronasal communication and re-creation of proper myomucosal function. Prosthodontic treatment using obturator and several surgical procedures are selected depending on the size and site of the defect, the difficulty of operative procedure, operation time and donor site problem. Above all, it is considered that radial forearm free flap is the first choice for palatal reconstruction. Our department introduces a novel method using tunnelized-facial artery myomucosal island flap for palatomaxillary defect reconstruction, which can successfully reduce donor-site morbidity, and duration of surgery and hospitalization.

• 대한두개안면성형외과학회지
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• 제19권3호
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• pp.231-234
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• 2018

A schwannoma is a benign tumor that develops from Schwann cells. It is known to occur more frequently in women than men, and about one third of schwannoma cases occur in the head and neck area. It is also known to originate mainly in the auditory nerve. However, it is rarely associated with the trigeminal nerve, and especially, schwannomas related to the infraorbital nerve are very rare. we report a rare case of a schwannoma involving the infraorbital branch of the trigeminal nerve in a 45-year old male adult. The patient underwent physical examination and magnetic resonance imaging. The mass was approached through subciliary approach that is familiar to the plastic surgeon and completely resected. Histopathological findings showed pointed to a benign schwannoma. Infraorbital nerve schwannoma is difficult to distinguish from other diseases by means of clinical symptoms, physical findings, or imaging. In spite of its rarity, infraorbital nerve schwannoma may be considered a possible diagnosis in the case of mass on cheek. Assessment by computed tomography or magnetic resonance imaging is necessary for proper diagnosis. About the surgical approach, excision through the subciliary approach should be considered rather than the direct transfacial approach in view of stability, cosmetic effects, and familiarity.