• Archives of Plastic Surgery
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• v.36 no.3
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• pp.322-326
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• 2009

Purpose: Severe type of inverted nipple (cannot be pulled out above the areola plane by manipulation, grade III) usually cannot be corrected by a relatively simple purse - string suture technique. Most patients want to avoid visible scars. To treat the severe case and avoid visible stigma, we introduce this invisible dermal flap method. Methods: This new surgical procedure makes bilateral incisions on the sidewall of nipple and dissections vertically to free the ducts from the contracted tissues. After dissection, the tunnel is formed. We insert "dermal flaps" into the tunnel underneath nipple base. Then through - and - through sutures are performed vertically (6 o'clock and 12 o'clock positions) and the purse - string suture is added with 4 - 0 nylon. Results: We had treated 35 primary inverted nipples (grade III) in 27 patients and 13 recurrent nipples in 7 cases. The results were excellent in 45 nipples (93.7%). All but 3 recurred cases was fully or very satisfied with the results. Conclusion: This technique is effective for the correction of severe inverted nipples and recurrent cases. We can avoid the visible scars on the areola surface.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.155-160
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• 2006

Although several reports have been introduced about dual plane augmentation mammaplasty, the description of periareolar approach dual plane augmentation mammaplasty was few. This article describes specific characteristics, and different classification and techniques for the periareolar dual plane breast augmentation while postoperative scars resulted from inframammary crease approach caused complaints. A total of 124 patients(248 breasts) had periareolar dual plane augmentation surgery from 1998 to 2004. Anatomic implants were used in 43 cases. Most of the patients were satisfied with the outcomes of periareolar dual plane augmentation. Periareolar dual plane augmentation mammaplasty adjusts implant and tissue relationships to ensure adequate soft-tissue coverage while optimizing implant-breast parenchymal dynamics to offer increased benefits and fewer faults compared to a single pocket location in a wide range of breast types with minimal scars. Two types of dual plane classifications are discussed in this study for the periareolar approach exclusively. The boundaries of retroglandular dissection remain constant, as the costal origin of pectoralis major are divided. Type A dual plane implies that the inferior edge of pectoralis muscle lies below the inferior areolar border, and type B dual plane implies that the inferior edge lies above the superior areolar border.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.811-813
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• 2009

Purpose: Congenital cleft earlobe is relatively rare malformation and defective type congenital cleft earlobes are reconstructed with mainly local flap methods rather than primary closure or z - plasty. Various methods are introduced but many of these remain visible scars or require complex operative techniques. We designed a new and simple method of reconstruction for defective type cleft earlobe. Methods: On the posterior surface of the auricle and mastoid area, S - shaped line was drawn continuously. One arc is for turnover hinge flap to make the anterolateral surface of the earlobe, and the other is for transposition flap to reconstruct the posterolateral surface. The donor site of the transposition flap was closed primarily. Results: Four patients were operated by S - shaped flap design method. They were all female and two were right side and others were left. We obtained aesthetically satisfactory postoperative results with inconspicuous scars at the posterior side of the auricle. In one case, minor revision was performed because of insufficient blood supply of the hinge flap. Conclusion: We can reconstruct defective type cleft earlobe with new, simple S - shaped design for hinge flap and transposition flap.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.570-574
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• 2013

Background The elliptical excision is the standard method of removing benign skin lesions, such as congenital melanocytic nevi. This technique allows for primary closure, with little to no dog-ear deformity, but may sacrifice normal tissue adjacent to the lesion, resulting in scars which are unnecessarily long. This study was designed to compare the predicted results of elliptical excision with those resulting from our excision technique. Methods Eighty-two patients with congenital melanocytic nevus on the face were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. After an incision on one side of the nevus margin, subcutaneous undermining was performed in the appropriate direction. The skin flap was pulled up and approximated along several vectors to minimize the occurrence of dog-ear deformity. Results Overall, the final wound length was 21.1% shorter than that achieved by elliptical excision. Only 8.5% of the patients required dog-ear repair. There was no significant distortion of critical facial structures. All of the scars were deemed aesthetically acceptable based on their Patient and Observer Scar Assessment Scale scores. Conclusions When compared to elliptical excision, our technique appears to minimize dogear deformity and decrease the final wound length. This technique should be considered an alternative method for excision of facial nevi.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.8 no.4
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• pp.854-860
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• 2004

The result of fingerprint matching is different as the quality or the state of input fingerprint image. We can extract the false direction information when the quality of fingerprint is degraded by the noise or the scars of the ridges. The information of the direction is very important for the elimination of the false minutia, the measurement of the ridge distance, matching, finding of cores and deltas. We need the method which can compensate or correct the false information of directions because the false directions include serious errors in the fingerprint recognition. We propose a method which can compensate or correct the false direction of fingerprint with a \alpha$-trimmed mean filter followed by LPF to reconstruct the false direction information when fingerprints are corrupted by scars.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.105-110
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• 2007

Purpose: The major drawback of submuscular augmentation of the ptotic breast is a "double-bubble" deformity. If a traditional mastopexy is added to correct the ptosis, there would be additional scars. This article describes simultaneous periareolar mastopexy with dual plane or subfascial breast augmentations. Methods: A series of 81 patients with grade I or II ptosis underwent the procedure from 1999 to 2005. Out of these, dual plane augmentation was done in 71 cases and subfascial plane in 10. After periareolar skin excision, an incision is made perpendicularly down to the fascia of pectoralis. At the lower pole, all breast implants are inserted into the subfascial plane. In case of upper pole thickness of above 20 mm, we inserted the implant into the subfascial plane, whereas below 20 mm, we inserted that into the submuscular plane. Results: No major complications were noted and patients' satisfactory score was high. This technique avoids the "double-bubble" deformity and leaves a minimal periareolar scar. Conclusion: Simultaneous periareolar mastopexy/breast augmentation is useful for correction of the ptotic breast, increasing the volume of breast and providing the natural breast shape with minimal scars. We consider that subfascial plane augmentation with periareolar mastopexy to be an alternative for cases with breast upper pole thickness of at least above 20 mm.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.102-105
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• 2020

Malignant skin tumors and precancerous lesions have a predilection to be located in the nasal dorsum or sidewall. Although invasive reconstructions have been presented, no simple and suitable method has yet been reported for this area. The flap presented herein, named the lateral nasal advancement flap, is designed on the adjacent lateral region of the sidewall or nasal dorsum and advanced in the medial direction. Two Burow's triangles are removed in the upper and lower portions of the flap: the upper triangle along the nasofacial sulcus and the lower triangle along the nasofacial sulcus and/or the alar groove. Excellent results were obtained in the two clinical cases described in this report. Neither a trap door deformity nor dog-ears developed in either case. The postsurgical scars followed the aesthetic lines and became inconspicuous. A distinct angle was formed in the nasofacial sulcus without anchor sutures. This surgical procedure is technically simple and is performed under local anesthesia. Although the flap is a cheek-based advancement flap, postsurgical scars do not remain in the cheek; instead, they are located in the nasofacial sulcus and alar groove. The lateral nasal advancement flap is recommended for reconstruction of the nasal sidewall and dorsum.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.79-83
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• 2019

Robotic surgery facilitates surgical procedures by employing flexible arms with multiple degrees of freedom and providing high-quality 3-dimensional imaging. Robot-assisted nipple-sparing mastectomy with immediate reconstruction is currently performed to avoid breast scars. Four patients with invasive ductal carcinoma underwent robot-assisted nipple-sparing mastectomy and immediate robot-assisted expander insertion. Through a 6-cm incision along the anterior axillary line, sentinel lymph node biopsy and nipple-sparing mastectomy were performed by oncologic surgeons. The pectoralis major muscle was elevated, an acellular dermal matrix (ADM) sling was created with robotic assistance, and an expander was inserted into the subpectoral, sub-ADM pocket. No patients had major complications such as hematoma, seroma, infection, capsular contracture, or nipple-areolar necrosis. The mean operation time for expander insertion was 1 hour and 20 minutes, and it became shorter with more experience. The first patient completed 2-stage prosthetic reconstruction and was highly satisfied with the unnoticeable scar and symmetric reconstruction. We describe several cases of immediate robot-assisted prosthetic breast reconstruction. This procedure is a feasible surgical option for patients who want to conceal surgical scars.

• Medical Lasers
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• v.8 no.2
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• pp.90-93
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• 2019

The treatment of keloid and hypertrophic scars (HTSs) remains one of the most difficult challenges, with a high recurrence rate regardless of the method of treatment. The latest trend in scar management is a combined approach using multiple modalities that are individualized to the patient and that would provide successful results for keloid and HTSs. There are previous reports that stromal vascular fraction (SVF) is effective for scar remodeling. Based on these reports, we introduced the concept of a combination treatment using SVF injection and fractional ablative CO₂ laser. In this report, we present a 21-year-old woman who was involved in a car accident. A defect on her foot was covered with a skin graft, but the scars became elevated, which turned out to be HTSs. She was treated with a fractional ablative CO₂ laser for five sessions. A month later, SVF injection and fractional ablative CO₂ laser were conducted simultaneously. The result of a year's follow-up showed a flattened scar with resolution of pigment deposition. In conclusion, the combination treatment for HTSs with SVF injection and ablative fractional CO₂ laser is one of the modalities to achieve an excellent outcome for treating HTS.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.269-276
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• 1997

Purpose : To evaluate the effects of surgical excision followed by radiation therapy for Prevention of keloids and hypertrophic scars. Materials and Methods : From October 1987 to April 1995, radiation therapy was applied to 167 sites in 106 patients with surgical excision in an attempt to prevention of recurrence against keloids and hypertrophic scars. The main etiology of the keloids and hypertrophic scars were surgery in $49.2\%,\;trauma\;in\;25.0\%,\;ear-piercing\;in\;5.4\%,\;and\;burn\;in\;5.4\%$, The Patients' ages ranged from 3 to 70 years with a median of 32 years. Radiation therapy used ranged from 6 to 8MeV electron beam. Radiation therapy was delivered within 24 hours of surgical excision. Several dose schedules were used, varing from 400cGy in 1 daily fraction to 1900cGy in 4 daily fractions. The average total dose was 1059cGy, and the average dose per fraction was 433cGy. All patients were followed up from 24 to 114 months with a median follow up of 49 months. Results : The overall recurrence rate was $12.6\%$ (21/167) The overall 1-year and 2-year recurrence rates were $10.2\%\;and\;11.4\%$, respectively Among 21 recurrent sites, seventeen sites $(81\%)$ were confirmed within 12 months after surgical excision. Period to recurrence ranged from 1 month to 47 months with a median recurrence time of 9.6 months, The history of previous therapy was only a significant factor in recurrence. Twenty-four patients had history of previous therapy recurrence rates was significantly higher in this group than those without history of Previous therapy $(22.6\%\;vs.\;11.0\%,\;p=0.04)$. There was no serious complication related to radiation therapy. Conclusion : This study suggests that surgical excision followed by radiation therapy is an effective method of preventing keloids and hypertrophic scars.