• Title/Summary/Keyword: Scar reduction

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Breast Reduction through an Inframammary Incision (유방밑주름절개식 유방축소수술)

  • Hong, Yoon-Gi;Sim, Hyung-Bo
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.169-174
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    • 2010
  • Purpose: Reduction mammaplasty is a procedure with a relatively high patient satisfaction rate, however, associated scarring around the areola can be a serious problem. This study proposes a new modification of the breast reduction procedure by means of an inframammary incision alone. Methods: The breast is marked out preoperatively with standing position. Under the general anesthesia, an inframammary incision of approximately 7 - 8 cm is done. The subcutaneous plane is made in the lower pole of the breast, then the subglandular plane is entered and a sharp dissection is made up to 2 cm below the areola. The breast is mobilized from the chest wall and a cone-shaped parenchyme is removed in en-block except from the retroareolar central part. The remaining both pillars are gathered together with absorbable sutures and the base of the gland is narrowed to project the breast forward. The wound is closed in a layered fashion and taping of the breast mound is applied to redistribute the breast skin. Results: 21 patients (36 breasts) underwent this procedure from December 2004 to December 2009. Average follow up was 9 months (ranged from 6 months to 12 months). No major complication occurred. Most patients were pleased with the breast size, shape, and scars. However, 2 patients complained their hypertrophic scars which were corrected by revision. Conclusion: This technique is a simple approach to mild to moderate breast reduction through an inframammary incision alone. And, this technique provides an option with minimal complications and invisible scarring, which is especially important in the young patient group.

Late-onset Brachial Artery Occlusion caused by Subclavian Artery Stenosis after Clavicular Fracture: A Case Report

  • Cho, Chul-Hyun;Song, Kwang-Soon;Min, Byung-Woo;Bae, Ki-Cheor
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.175-175
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    • 2008
  • We report a rare case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture. When he referred to us, the right hand were pale and the radial and ulnar pulses at the wrist were absent. CT-angiogram showed compression of subclavian artery by excessive scar tissue beneath the fracture site and angiography revealed stenosis of subclavian artery with thrombus and complete obstruction of blood flow in the brachial artery with emboli. Therefore, we performed embolectomy. 2 years after operation, patient was essentially asymptomatic except mild pain after long standing elevation of arm. We recommend that minimal soft tissue dissection should be needed in the operative treatment of clavicular fracture, especially soft tissue beneath the clavicle should be protected maximally.

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Lubricating Characteristics of Diesel Fuel (경유의 윤활특성)

  • 신성철;강익중
    • Tribology and Lubricants
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    • v.16 no.5
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    • pp.332-340
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    • 2000
  • The reduction of sulfur content in the diesel fuel has caused the poor lubricity of diesel fuel in the distributor type injection pumps of diesel engines that use the diesel for lubrication of their moving parts. To investigate the reason for poor lubricity of low sulfur diesel fuels, the wear scar diameters by HFRR (High Frequency Reciprocating Rig) were measured on the diesel fuels from Korean markets and the results were compared with their physical and chemical properties. Also, the lubricity change and the improvement effects on lubricity additives for the ultra low sulfur diesel fuel, were made experimentally, that will be regulated to a maximum of 0.005 wt% from about 2005 were evaluated. As a result, a good correlation was found between the wear scar diameter and the polyaromatic compound which includes heterocyclic compound in the diesel fuel. It was also found that the content of polyaromatic compound including heterocyclic compound was affected by the amount of desulfurization treatment fraction. And the lubricity additives with ester base were more effective than that with acid base on the ultra low sulfur diesel fuel. Therefore, it is suggested that the factors affecting the lubricity stated above should be taken into account to improve the lubricity property of the diesel fuel in the refining process.

Tranilast-delivery surgical sutures to ameliorate wound healing by reducing scar formation through regulation of TGF-β expression and fibroblast recruitment

  • Choi, Sung Yoon;Kim, Byung Hwi;Huh, Beom Kang;Jeong, Woong;Park, Min;Park, Hyo Jin;Park, Ji-Ho;Heo, Chan Yeong;Choy, Young Bin
    • Journal of Industrial and Engineering Chemistry
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    • v.67
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    • pp.469-477
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    • 2018
  • We describe surgical sutures enabled with the local, sustained delivery of a TGF-${\beta}$ inhibitory drug, tranilast. To fabricate drug-delivery sutures, we separately prepared a tranilast-loaded strand using poly (lactic-co-glycolic acid), which was then physically braided with a surgical suture already in clinical use. By this method, the drug-delivery sutures maintained the mechanical strength and allowed the modulation of drug release profiles by simply altering the tranilast-loaded strand. The drug-delivery sutures herein released tranilast for up to 14 days. When applied to animal models, scarring was indeed reduced with diminished TGF-${\beta}$ expression and fibroblast numbers during the entire 21 day testing period.

Prevention for Collapse Using Aqua Splint® in Zygoma Arch Fractures (관골궁 골절 환자에서 함몰 방지를 위한 Aqua splint®를 이용한 보호대)

  • Seo, Woo Jin;Kim, Chang Yeon;Hwang, Weon Jung;Kim, Jeong Tae
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.813-817
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    • 2007
  • Purpose: The zygomatic arch is a key element which composes the facial contour. In many cases of zygomatic arch fracture, it is difficult to fix rigidly the fractured segments. If reduced bone segments were not fixed rigidly, they are proven to be displaced by mastication or unintentional external forces. So, unfixed zygomatic arch fracture after reduction may require a external device of prevention of collapse. We introduce a new protector which stabilizing the fractured segments to prevent for collapse of the reduced zygomatic arch fracture. Methods: After reduction of zygomatic arch with blind approach(Gillies', Dingman or Keen's approach), bone segments was pulled with percutaneous traction suture in medial aspect of zygomatic arch. Then, the suture was fixed with Aqua $splint^{(R)}$, externally. And intraoperative and postoperative X-ray was done. The splint was removed on 14 days after the operation. Results: 5 patients were treated with this method. 4 patients of total patients had no collapse in zygomatic arch. There was minimal collapse in one patient. Postoperative complications such as facial nerve injury, mouth opening difficulty, contour deformity, infection, scar were not observed. Conclusion: In comparison with other techniques, this technique has several advantages which are simple and easy method, short operation time, no scar, less soft tissue injury, and facilitated removal of splint. Therefore, Aqua $splint^{(R)}$ would be a good alternative to prevent for collapse in unstable zygomatic arch fractures

Male Nipple Reduction using Modified Pentahedral Excision (변형된 오면체 모양 절제법을 이용한 남성 유두축소술)

  • Yoon, Sang Yub;Kang, Min Gu
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.779-783
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    • 2009
  • Purpose: Male hypertrophic nipples can lead to psychological distress and physical discomfort. The authors present a new technique of male nipple reduction and describe its advantages Methods: The neonipple is designed to reduce diameter and height of nipple while preserving the subdermal plexus. After the central wedge excision, additional four triangular section of nipple skin is excised. One of the remaining two flaps is amputated partially and both flaps were approximated using 4 - 0 PDS and 6 - 0 Nylon sutures. Results: Between December of 2007 and January of 2009, 52 nipple reductions were performed in 30 male patients(mean = 29.5 years). Postoperative recovery was rapid and few complications were encountered. The mean diameter of the hypertrophic nipple was $9.1{\pm}2.5mm$(range, 7 to 15 mm). The mean diameter of the neonipple was $5.0{\pm}0.7mm$(range, 4 to 6 mm), with an average reduction of $3.8{\pm}0.6mm$(range, 2 to 11 mm). At follow-up, the neonipple had a natural appearance, with less projection and an inconspicuous scar. Conclusion: The wedge and triangular skin excision and partial amputation are easy to perform and yields consistent results. This technique decreases both the diameter and height of any size nipple and can be modified to meet patient preferences.

Retromandibular Approach for the Open Reduction of Fractured Mnadibular Condyle (하악과두 골절의 관혈적 정복술을 위한 하악 후방 접근법)

  • Kim, Hak-Kyun;Kim, Su-Gwan;Kang, Dong-Wan;Oh, Sang-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.22 no.4
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    • pp.283-288
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    • 2006
  • There are several manners for surgical approaches to the mandibular condyle. With the retromandiular approach, the condyle and fracture are exposed directly and allow for good inspection and reduction. The retromandibular scar is very well camouflaged and practically invisible. The aim of this study was to evaluate clinical results of retromandibular approach for the reduction and fixation of fractured mandibular condyles. We described postoperative complications such as temporary facial nerve weakness involving the marginal mandibular branch, mouth opening limitation and malocclusion in 13 patients with mandubular condylar fractures; 11 subcondylar fractures and 2 condylar neck fractures. The follow-up period was longer than 6 months in all patients. The retromandibular approach was successful in all subcondylar fracture cases. 2 patients with condylar neck fracture had mouth opening limitation and temporary marginal nerve palsy longer than 3 months. But there were no cases of permanent nerve injury and malocclusion. Our findings indicate that retromandibular approach is an easy and safe technique for subcondylar fracture but not for condylar neck fracture.

Case Report of Transparotid Approach of Mandibular Subcondylar Fracture (하악골 과두하 골절의 이하선 경유 접근법을 통한 관혈적 정복술 증례보고)

  • Moon, Mincheol;Oh, Suk Joon;Koh, Seoung Hoon
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.33-36
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    • 2009
  • Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

Prevention of Cheek Drooping in Intraoral Reduction Malarplasty without Internal Fixation (볼처짐 최소화를 위한 최소절개 및 박리 관골 축소 성형술)

  • Park, Dong-Kwon;Choi, Jae-Hoon;Lee, Jin-Hyo;You, Young-June
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.845-850
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    • 2011
  • Purpose: In general, orientals including Korean, have a mesocephalic face whereas Caucasians, among the western, have a dolichocephalic face. Unlike the western, in orientals including Korean, prominent malar bones are recognized as stubborn and unattractive appearance. That is why reduction malarplasty is one of the most popular aesthetic surgical procedure in Korea. Many surgical methods to reposition prominent malar bones have been performed by means of a coronal incision or a combined incisions, using both the intraoral and the external incision. Bicoronal approach has advantage such as wide operative field, easy to maintain symmetry and possibility of combining facial lift but has shortcoming, such as external scars, long operative time, and the possibility of facial nerve or artery injury. Intraoral approach has advantages of short operative time, simplicity of procedure and no external scar. But this approach is associated with problems of cheek drooping, limited exposure and difficulty in making symmetry. Methods: During 8 years, we performed a reduction malarplasty without internal fixation through an minimal intraoral incision and dissection in 39 patients. Results: The patients were followed for 46 months, with satisfactory results and no cheek drooping. There was no patient who want to revise the inappropriate operative result such as asymmetry and incomplete correction. Conclusion: We conclude that minimal intraoral incision and dissection could acquire satisfactory result of reduction malarplasty along with prevention of cheek drooping.

Clinical Application and Effects of Sodium Hyaluronate-Carboxymethylcellulose (Guardix®) in Surgery of Ankle Fractures (족관절 골절 수술에서의 유착방지제(Guardix®)의 효과 연구)

  • Kim, Gab Lae;Kwon, Hwan Jin
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.151-155
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    • 2017
  • Purpose: Reducing tenderness or pain on the ankle joint and improving the range of motion are thought to be possible using hyaluronate-based anti-adhesive agents. On the other hand, there are more aspects to be studied regarding the incidence of complications, such as resting pain, tenderness, and stiffness, after surgery. Therefore, the aim of this study was to prove the effectiveness of the agents after ankle fracture surgery. Materials and Methods: Patients, who underwent open reduction and internal fixation surgery due to ankle joint fractures from June 2015 to May 2016, were studied prospectively. Thirty patients of them received a $Guardix^{(R)}$ injection during their surgeries and were included in the injection group. The other 30 patients were included in the control group. Postoperatively, tenderness on the scar, a delay in wound healing, and the active range of motion were evaluated at 2, 6, and 12 weeks after surgery. Results: A significant difference in tenderness on the scar was observed 2 weeks after surgery. On the other hand, there was no significant difference at 6 and 12 weeks after the surgery. The agent-using group showed a 6.7% delay in wound healing and a 93.3% nondelaying. In the non-using group, the delay was 63.3%, while non-delay was 36.7% (p<0.001). The group that underwent $Guardix^{(R)}$ usage showed an effective result in the visual analogue scale, which was statistically significant (p<0.001). The result at 6 and 12 weeks after surgery showed a significant difference. Conclusion: Improvement was observed in the patients who underwent a $Guardix^{(R)}$ injection, regarding the range of motion, visual analog scale, and healing of the wound postoperatively.