• Archives of Plastic Surgery
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• v.37 no.4
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• pp.465-468
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• 2010

Purpose: Soft tissue deformity and skin defect after tumor resection in the periorbital area can cause trouble in the function of eyelid as well as in the aspect of external appearance. Therefore, as cosidering reconstruction in periorbital area, detailed assessment of both functional and aesthetic property are required. thus, the purpose of this study is to examine an appropriate reconstruction through clinical cases. Methods: A 14-year-old girl with congenital giant hairy nevus on right periorbital area was selected. Her first visit to our plastic surgery outpatient clinic was on July 2006. Since then, she has undergone staged removal of lesions and reconstruction by various flap technique such as pedicled island flap, forehead galeal flap, paramedian forehead flap, cheek rotation & advancement flap. Results: In the case of this girl, most lesions were removed and replaced by normal skins. Although there was the difference of skin color after skin graft, such difference was not noticeable and section scar by skin flaps was slight. There was no obvious dysfunction in the eyelids and the girl and her parents were satisfied with results after the surgery. Conclusions: In the reconstruction of soft tissue defect or soft tissue deformity and contracture, it is required to choose appropriate reconstruction method, considering aesthetic and functional aspects depending on aesthetic unit sufficiently.

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.68-79
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• 2010

Lower abdominal tissue is regarded as an ideal donor site for the breast reconstruction because it provides large skin territory and huge amount of soft tissues enough to the breast size. However it is not easy for the surgeon to reconstruct the really natural breast, and needs the learning curve with long time experience. Author represent the various reconstruction procedures for the breast using lower abdominal tissue such as muscle sparing free TRAM, DIEP, and SIEA free flaps to reinsure like breast. Indications, and selection of reconstructive methods, surgical timing, selection of donor sites and recipient vessel of these flaps were reviewed. In addition, detailed procedures, surgical tips and secondary adjuvant procedures are described for more symmetry of reconstructed breast. The muscle sparing free TRAM, DIEP, and SIEA free flaps would be enough to provide supple, huge amount of well vascularized tissue for the breast, if these flaps were selected for the appropriate indication according to patient's general condition, obesity, the opposite breast and abdominal tissue condition. Lower abdominal tissue was able to provide versatile designs with sufficient adipose tissue without compromising the integrity of abdominal wall.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.759-764
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• 2007

Purpose: Various types of flaps, with their own advantages and disadvantages, have been described for reconstruction of soft tissue defect with exposure of tendons, bones, or joints in the hand or foot. Local flaps with random vascularity have a limitation by their length. Free flaps are time-consuming procedure that may require the sacrifice of some major vessels. The ideal flap for covering soft tissue defects of the hand or foot must provide subcutaneous tissue that tendons can glide through which, supply enough subcutaneous tissue for cover of vital neural, bony, vascular and joint structures, and it has to be aesthetically pleasing. The adipofascial flap fulfills these criteria. It allows immediate or early closure of difficult wound of hand and foot in an easy way, and is especially indicated for small to medium-sized defects. Methods: From October 2005 to December 2006, seven cases underwent this procedure to reconstruct soft tissue defect on hand or foot. Results: All flaps survived completely, and no complications were observed. Conclusion: The adipofascial flap is a convenient flap for coverage of soft tissue with exposure of vital structure in the hand or foot, and provide several advantages, as following; easy and safe, short operating time, one stage procedure, thinness and good pliability of the flap, preservation of the major vascular pedicles, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.24 no.1
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• pp.13-24
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• 2015

With the development of treatment of hard and soft tissue around the implants, the implant restoration is increasingly used in the maxillary anterior region which is very important aesthetically. However, the aesthetic reconstruction of the maxillary anterior region is still challenged. Three following conditions should be fully satisfied for aesthetic prosthesis restoration; reconstruction of hard tissue, soft tissue and harmonic prosthesis. In this case report, hard and soft tissue augmentations were performed at atrophied maxillary incisor. Additionally, customized impression coping and provisional restoration were used to make the final restoration.

• Archives of Plastic Surgery
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• v.50 no.1
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• pp.10-16
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• 2023

Background The chest wall defects can be caused by various reasons. In the case of malignant tumor resection of the chest wall, it is essential to reconstruct the chest wall to cover the vital tissue and restore the pulmonary function with prevention of paradoxical motion. With our experience, we analyzed and evaluated the results and complications of the chest wall reconstructions followed by malignant tumor resection. Methods From 2013 to 2022, we reviewed a medical record of patients who received chest reconstruction due to chest wall malignant tumor resection. The following data were retrieved: patients' demographic data, tumor type, type of operation, method of chest wall reconstruction of the soft and skeletal tissue and complications. Results There were seven males and six female patients. The causes of reconstruction were 12 primary tumors and one metastatic carcinoma. The pathological types were seven sarcomas, three invasive breast carcinoma, and three squamous cell carcinomas. The skeletal reconstruction was performed in six patients. The series of the flap were eight pedicled latissimus dorsi (LD) myocutaneous flaps, two pectoralis major myocutaneous flap, two vertical rectus abdominis myocutaneous free flap, and one LD free flap. Among all the cases, only one staged reconstruction and successful reconstruction without flail chest. Most of the complications were atelectasis. Conclusion In the case of accompanying multiple ribs and sternal defect, skeletal reconstruction would need skeletal reconstruction to prevent paradoxical chest wall motion. The flap for soft tissue defect be selected according to defect size and location of chest wall. With our experience, we recommend the reconstruction algorithm for chest wall defect due to malignant tumor resection.

• Archives of Craniofacial Surgery
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• v.23 no.3
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• pp.95-102
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• 2022

The challenges of successful nasal reconstruction, which are related to the anatomical complexity of the region, have been extensively studied. Revisional operations are often required to achieve proper nasal reconstruction, with results resembling the premorbid nasal status. This is necessary to ensure the quality of life of skin cancer patients. Fundamental nasal reconstruction requires both proper soft tissue coverage and proper function. However, earlier studies in the field primarily focused on the functional aspect of nose reconstruction, although the cosmetic aspect is also an important factor to consider. In response to this need, many recent studies on nose reconstruction have proposed various refinement strategies to improve aesthetic satisfaction. Most plastic surgeons accept the nasal aesthetic subunit principle as a standard for nasal reconstruction. This review outlines the commonly used surgical refinement options and management strategies for postoperative complications based on the subunit principle. In patients with nasal defects, a proper technical strategy might help minimize revision operations and optimize the long-term results.

• The Journal of the Korean dental association
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• v.47 no.3
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• pp.122-130
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• 2009

For the successful guided bone regeneration(GBR) of maxillary bony defect, proper soft tissue coverage is one of the most important things. Soft tissue dehiscence can be most common reason of osseous reconstruction failure. If a vascular supply to the graft should not develop from the host tissue, then the graft may also foil. Both of these prerequisites can be aided by judicious use of the buccal fat pad(BFP). Many methods for adequate soft tissue coverage have been proposed and the use of the BFP is one of them. BFP is useful in posterior maxillary area, can cover larger area and have higher blood flow than other methods. so the use of the BFP may offer protection and early blood supply to maxillary bone graft. This report describes the history, anatomy, blood flow, and clinical usefulness with two clinical cases.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.28 no.2
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• pp.74-85
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• 2019

The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. A newer technique, VIP-CT (Vacularized Interpositional Periosteal Connective Tissue) graft has been introduced as an alternative to these technique which allows the clinicians perform large volume soft tissue augmentation in esthetic sites with a single procedure. The advantages of the VIP-CT graft technique are that it allows the reconstruction of large soft tissue deficiency, with little constriction postoperatively. Furthermore, it facilitates improved hard tissue augmentation due to the additional blood supply and improved bone healing by mesenchymal cells. Moreover, this technique reduces patient discomfort and treatment time. This clinical report describes the procedure of bone augmentation during immediate implantation in facial dehiscence defect, especially Vascularized Interpositional Periosteal Connective Tissue(VIP-CT) graft for aesthetic anterior soft tissue.

• Imaging Science in Dentistry
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• v.45 no.1
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• pp.31-39
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• 2015

Purpose: This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. Materials and Methods: CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. Results: The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. Conclusion: Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.105-112
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• 1995

Soft tissue sarcomas are malignant tumors that arise in the extraskeletal connective tissues of the body. And the clinical behavior of soft tissue sarcomas is characterized by a tendency to extensively invade surrounding soft tissues as well as early metastatic dissemination. Difficulties were encounted when soft tissue sarcomas invade the major vessels. There are a few reprots about the reconstruction of the major vessels after resection of soft tissue sarcomas. We have treated 3 cases of the soft tissue sarcomas involving the major artery. After marginal excision of the tumor mass, the involved major artery was reconstructed with Gortex artificial vessel graft and we could salvage the patient's extremity.