• Archives of Plastic Surgery
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• v.50 no.6
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• pp.535-540
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• 2023

Background Abdominoplasty with abdominal plication increases intra-abdominal pressure (IAP) and has been previously associated with limited diaphragmatic excursion and respiratory dysfunctions. Many factors found in abdominoplasties and among postbariatric patients predispose them to a higher occurrence. This study aims to evaluate the impact of abdominal plication among postbariatric patients, assess whether the plication increases their IAP, and analyze how these IAP correlate to their postoperative outcome. Methods This prospective study was performed on all patients who underwent circumferential Fleur-De-Lis abdominoplasty. For this intended study, the IAP was measured by an intravesical minimally invasive approach in three stages: after the initiation of general anesthesia, after a 10-cm abdominal wall plication and skin closure, and 24 hours after the procedure. Results We included 46 patients, of which 41 were female and 5 were male. Before the bariatric procedure, these patients had an average maximum weight of 121.4 kg and an average maximum body mass index of 45.78 kg/m²; 7 were grade I obese patients, 10 were grade II, and 29 were grade III. Only three patients were operated on with a gastric sleeve and 43 with gastric bypass. We presented six patients with transitory intra-abdominal hypertension in the first 24 hours, all of them from the grade I obesity group, the highest presented was 14.3 mm Hg. We presented 15% (7/46) of complication rates, which were only four seroma and five dehiscence; two patients presented both seroma and wound dehiscence. Conclusion Performing a 10-cm abdominal wall plication or greater represents a higher risk for intra-abdominal hypertension, slower general recovery, and possibly higher complication rate in patients who presented a lower degree of obesity (grade I) at the moment of the bariatric surgery.

• Archives of Craniofacial Surgery
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• v.25 no.1
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• pp.22-26
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• 2024

Background: This study analyzed the demographic characteristics of patients with facial palsy who were treated using either dynamic or static procedures. This study aimed to compare the frequency of procedure implementation and age distribution between the two groups. Methods: This study retrospectively analyzed the medical records of patients treated for facial palsy at a single institution from 2014 to 2022. Among cases included in our study, dynamic procedures involved cross-facial nerve graft and latissimus dorsi or gracilis muscle flap transfer. Static procedures included gold weight insertion, canthopexy, browlift, and thread lift/static slings. Results: Among the 31 patients included in our study, eight (25.8%) incorporated dynamic techniques, and the average age of patients was 44.75 years (range, 24-68 years) with a male to female ratio of 1:4. The remaining 23 patients (74.2%) underwent a static procedure, of which the average age was 59.17 years (range, 23-81 years) which was statistically significantly higher than the average age of 44.75 of dynamic patients (p= 0.013). Regarding the timing of treatment after diagnosis, no patient underwent dynamic procedures more than 20 years after initial diagnosis. A greater diversity in the timing of treatment was observed in the static group. All patients who underwent dynamic procedures were treated using static procedures during the study period. Conclusion: Because aesthetics-based static techniques are typically quick outpatient procedures that can be performed under local anesthesia, our study shows that these are often preferred treatments for all age groups, especially for debilitated or older patients. Further research is required to investigate the long-term functional outcomes of these surgical techniques in a wider population of patients.

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.50-55
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• 2015

In the hand, few vessels can be classified as 'perforators'. Even today, the debate continues on whether or not branches of the digital artery should be considered as perforators. However, 'perforator' and 'perforator flaps' have become extremely popular within the microsurgery literature, and as such, the terminology has found widespread adoption across the hand surgery field. The finger is the most important sensory organ for tactile stimulation. The glabrous skin can be distinguished between the fingertip and the proximal tissue, with the fingertip having a higher functional and, therefore, reconstructive priority. Thus, sacrifice of the proximal glabrous skin can be justified in the reconstruction of fingertip defects. In this paper, the author reviews two flaps, 'lateral digital artery perforator flap' and 'volar digital artery perforator flap', both of which uses short branches of the digital artery as a vascular pedicle and are useful in fingertip construction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.2
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• pp.55-61
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• 1990

Patients with facial paralysis, in whom nerve damage is irreparable or in whom the innervation of the paralyzed musculature cannot be restored by nerve suture, grafting, or cross-face nerve transplantation, should be offered some form of reconstructive static and dynamic aid. Temporalis muscle-fascia unit used as a circumorbital sling and motor unit is a dynamic controlled reconstructive procedure, but it has several disadvantages such as wide surgical exposure, bulky-looking at lateral canthal area, insufficient voluntary control. This is a case report of facial palsy of posttraumatic lagophthalmos of 41-year-old male, which was corrected by temporalis muscle-tendon transfer with plantaris tendon transplantation.

• Archives of Craniofacial Surgery
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• v.16 no.2
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• pp.92-95
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• 2015

A keratoacanthoma is a rapidly growing cutaneous tumor that spontaneously involutes in most instances. A giant keratoacanthoma is a rare variant and are characterized by lesions larger than 20 mm in diameter. We report a 56-year-old man with a rapidly growing tumor of the right cheek, which was diagnosed as keratoacanthoma. The mass was excised completely under general anesthesia, followed by Limberg flap for reconstruction. Intraoperative frozen section histology suggested the lesion to be a well-differentiated squamous cell carcinoma, whereas final histopathology was consistent with keratoacanthoma. We herein report the first case of a giant keratoacanthoma treated with surgical excision in Korea and discuss the clinical and histopathological features of keratoacanthoma, with a review of the literature.

• Archives of Plastic Surgery
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• v.39 no.1
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• pp.11-17
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• 2012

Management of posttraumatic enophthalmos can present as a challenge to the reconstructive surgeon, particularly in cases of late presentation. This article reviews the pertinent anatomy of the orbit, diagnostic modalities, indications for surgery, and surgical approaches as they relate to the treatment of posttraumatic enophthalmos. Internal orbital reconstruction has evolved to an elegant procedure incorporating various biologic or alloplastic implants, including anatomical pre-bent implants. Successful repair of late enophthalmos has been demonstrated in multiple recent studies and is likely related to the precision with which orbital anatomy can be restored.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.582-588
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• 2005

Digital imaging is emerging as a standard method for patient documentation in clinical setting. Managing patient expectations before aesthetic surgery can greatly improve patient satisfaction after surgery. The patient who visited for plastic surgery wants a predicted figure after the operation. A virtual plastic surgery software is necessary in order to satisfy the desire of patients. Adobe $Photoshop^{(R)}$ is the professional standard in desktop digital imaging, offers indispensable new features for graphic and web design, photography, and video. Using imaging technology, it takes just minutes to realistically simulate the results of double eyelid operation, liposuction, rhinoplasty or any other aesthetic procedure. The aim of this study is to analyze the significance of the digital image processing and to introduce the virtual plastic surgery using Adobe $Photoshop^{(R)}$.

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.39-42
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• 2021

Schwannomas are benign tumors of neuroectodermal origin and can be found in any part of the body. Although schwannomas are common in the head and neck region, they are rare in the auricle. Auricular schwannomas are rarely symptomatic but the mass itself or a surgical procedure to remove it may disrupt the complicated structure of the auricle. We report a rare case of auricular schwannoma with a literature review and describe the surgical technique used in this case.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.588-593
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• 2014

Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF). We conducted a pre- and postoperative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was $7.2{\pm}0.5$, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of $8.5{\pm}0.7$ and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.16-22
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• 2019

Background Various surgical techniques have been used to correct Tessier number 7 craniofacial cleft, which involves macrostomia, ear deformity, and hemifacial microsomia. To achieve symmetrical and satisfactory results in patients with macrostomia, the authors performed a 1-mm medial overcorrection on the cleft side and evaluated the results of this procedure. Methods A retrospective medical record review of patients diagnosed with Tessier number 7 craniofacial cleft from March 1999 to February 2017 was performed. Using clinical photographs, outpatient clinic records, and operative records, information was recorded regarding concurrent congenital anomalies, postoperative complications, and follow-up. Using Photoshop CS2, the length of both sides of the lip was compared. The ratio of these lengths was calculated to evaluate lip symmetry. Results Of the patients treated at the Department of Plastic and Reconstructive Surgery at Kyungpook National University Chilgok Hospital, 11 (male-to-female sex ratio, 7:4) were diagnosed with Tessier number 7 craniofacial cleft. Concurrent congenital anomalies included skin tag, hemifacial microsomia, and cleft palate. The mean duration of follow-up was $78.273{\pm}72.219$ months and the mean ratio of the lengths of both sides of the lip was $1.048{\pm}0.071$. Scar widening occurred as a postoperative complication in some patients. No cases of wound infection, bleeding, or wound dehiscence occurred. Conclusions For the successful correction of macrostomia, plastic surgeons should consider both functional and aesthetic problems of the lip. Adequate repair of the orbicularis oris muscle, skin closure with Z-plasty, and medial overcorrection of the neo-oral commissure led to good results in our patients.