• Archives of Plastic Surgery
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• 제36권2호
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• pp.194-199
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• 2009

Purpose: The orbital fat buldging may cause irregular contour of lower eyelid, which is not youthful appearance. The conventional method of fat excision may cause the eyeball to move backward and downward, making enopthalmia is inevitable. The transcutaneous approach to reach the orbital septum can increase the risks of scleral show resulting from scarification at the level of the septum orbicularis junction and damaging the vertical motor branches of the preseptal orbicularis oculi muscle of the lower eyelid. Method: From July 2007 to March 2008, total of 21 patients underwent transconjunctival capsulopapebral fascia fixation procedure. In 8 patients, the herniated fat pad of the lower eyelid was relocated back into the orbit without external skin excision using capsulopalpebral fascia fixation. But in 13 patients, excision of redundant skin of the lower eyelid was performed using pinching technique, not involving orbicularis oculi muslce. In 5 patients, lateral canthotomy was done bilaterally for good visual field. In 6 patients, lateral canthopexy was also combined to correct loosening of lower eyelid. Results: Most of the patients were satisfied after at least 5 months of follow up. No patient showed scleral show. But 2 patients complained of undercorrection slightly, without secondary operation in 1 patient and re - capsulopalpebral fascia fixtation through transconjunctival approach in another patient. Conclusion: Orbital fat repositioning using transconjunctival capsulopalpebral fascia fixation is a good procedure to show youthful appearance without increasing the risk of scleral show and also showed fast recovery compared to the conventional transcutaneous approach.

• Archives of Plastic Surgery
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• 제47권5호
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• pp.467-472
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• 2020

Background Dimples on the cheeks can make the smile look more cheerful and attractive. Therefore, some people who do not have dimples may choose to undergo dimple creation surgery. Although dimple surgery is quite common, those desiring this procedure often lack information about it. Therefore, we conducted the present study to share our surgical tips and clinical experiences regarding safe dimple creation surgery. Methods This study included 2,048 patients who underwent dimple creation surgery at our plastic surgery clinic between April 2010 and June 2014. These patients were selected from those who displayed no scarring from injury or tumor removal in the central face during the presurgical evaluation. Medical records were used to identify the age and sex of each patient, the location of dimple creation, any postoperative complications, reoperation, and the reason for reoperation. Results Of the 2,048 patients, 159 (7.7%) underwent reoperation. The reason for reoperation was undercorrection in 78 cases (49.0%), disappearance of the dimple in 62 cases (38.9%), and overcorrection in nine cases (5.6%). Five patients (3.1%) had their stitches removed to eliminate the created dimple because they changed their minds, and five patients (3.1%) had their stitches removed because of infection. No patients reported complications after reoperation, and no other complications, such as hyperpigmentation or foreign body reaction, were observed. Conclusions Safe surgery with minimal complications and satisfying cosmetic results can be achieved via accurate knowledge of the relevant anatomy and its relationship with dimples, as well as appropriate surgical methodology.

• 한국안광학회지
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• 제9권1호
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• pp.93-104
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• 2004

일상생활에서 안정 피로가 없는 편안한 시생활을 위해서는 완전한 굴절 교정뿐만 아니라 완전한 양안시 교정을 필요로 한다. 그것을 위해서는 먼저 존재 하고 있는 각 비정시의 정량적 값에 대한 정확한 이해가 필수적이다. 일반 굴절 검사가 하나의 시표만으로는 행해 질수 없는 것처럼 각비정시(angular ametropia, associated phoria) 검사도 역시 하나의 시표만으로는 불가능 하다. 그 이유는 대부분의 각비정시는 주시 시차를 동반하기 때문이다. 완전한 각비정시 검사를 위해서는 최소한 3종류의 검사 시표가 필요하다. 이 사실은 각 양안 검사 시표의 융합 자극 형태를 기초로 설명 될 수 있다. 이 3종류의 검사가 모두 시행 되지 않으면 대부분의 경우 저교정이 될 수 있다.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.53-62
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• 2011

Purpose: Even though Augmentation rhinoplasty is very popular surgical procedure, it is not easy to obtain ideal materials for augmentation. Many different synthetic materials are used but frequent complications are seen such as infection, extrusion, deform, and dislocation. Autologous tissues were used for augmentation rhinoplasty. We used dermofat graft and fat injection in augmentation rhinoplasty minimizing these problems. Methods: From 2006 to 2009, we used autologous tissues in augmentation rhinoplasty in 40 patients, 20 patients with dermofat graft and other 20 patients were treated with fat injection only. Dermofats were harvested from sacral area. gluteal fold, groin and preexisting scar tissue. Dermofats were inserted with small stab wound and fat tissues were injected as Coleman's technique. The patients were followed up 6 months to 5 years. Results: Most of the patients were satisfied in shape and height the nose. Early complications such as hematoma, infection and seroma were not found. Secondary fat injection was performed in 3 patients (15%) of dermofat graft group instead of 7 patients (35%) of fat injection only group. Conclusion: We obtained satisfactory results in augmentation rhinoplasty with dermofat graft and fat injection. Secondary fat injections were more often in fat injection group than dermofat graft group. Dermofat graft and fat injection could be another alternative technique for augmentation rhinoplasty and fat injection could be a secondary adjunctive treatment for undercorrection due to absorption.

• Archives of Plastic Surgery
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• 제43권4호
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• pp.352-359
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• 2016

Background The objective of this study was to develop a new surgical technique by combining traditional abdominoplasty with liposuction. This combination of operations permits simpler and more accurate management of various abdominal deformities. In lipoabdominoplasty, the combination of techniques is of paramount concern. Herein, we introduce a new combination of liposuction and abdominoplasty using deep-plane flap sliding to maximize the benefits of both techniques. Methods Deep-plane lipoabdominoplasty was performed in 143 patients between January 2007 and May 2014. We applied extensive liposuction on the entire abdomen followed by a sliding flap through the deep plane after repairing the diastasis recti. The abdominal wound closure was completed with repair of Scarpa's fascia. Results The average amount of liposuction aspirate was 1,400 mL (700-3,100 mL), and the size of the average excised skin ellipse was $21.78{\times}12.81cm$ (from $15{\times}10$ to $25{\times}15cm$). There were no major complications such as deep-vein thrombosis or pulmonary embolism. We encountered 22 cases of minor complications: one wound infection, one case of skin necrosis, two cases of undercorrection, nine hypertrophic scars, and nine seromas. These complications were solved by conservative management or simple revision. Conclusions The use of deep-plane lipoabdominoplasty can correct abdominal deformities more effectively and with fewer complications than traditional abdominoplasty.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1995년도 춘계학술대회
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• pp.95-100
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• 1995

This study investigated the effects of mechanical factors involved in several corneal refractive surgeries on the surgical outcomes. Then we proposed possible new techniques from the mechanical point of a view utilizing finite element method. The models studied are: circumferential keratetomy, combination of excimer laser photorefractive keratectomy and circumferential keratotomy for myopia treatment, arcuate keratotomy for astigmatism treatment. The cornea was assumed to be nonlinear elastic and almost incompressible material as the most soft tissue in the human body. In the circumferential keratotomy the effect of the incision location was investigated. The angle and location of the incision were varied to predict the surgical outcomes in the arcuate keratotomy. The finite element analysis results showed that the location of incision was a critical factor affecting the surgical outcomes in the circumferential keratotomy. In the combination of the excimer laser photorefractive keratectomy and circumferential keratotomy, it was predicted that the circumferential can increase or decrease the refractive power depending on the incision location or it can be used to adjust the overcorrection of undercorrection. In the arcuate keratotomy for astigmatism, the most diopter changes were predicted when the location and the angle of the incision were 3.0mm from the apex and $90^{\circ}$, respectively. In the arcuate keratotomy, the effects of an incision were studied within the incision area as well as outside the incision area. Also, the arcuate keratotomy with two incisions located on the opposite area of the cornea was also studied. As a conclusion, the finite element method is a useful technique in the area of corneal refractive surgeries to develop new techinques.

• 대한두개안면성형외과학회지
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• 제20권1호
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• pp.24-30
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• 2019

Background: Closed reduction of the fracture under general or local anesthesia with elevators or forceps is widely used to treat nasal bone fractures. However, operating under general anesthesia increases the risk of morbidity and raises the cost of management. Furthermore, using forceps or elevators may cause undercorrection, new fractures, mucosal damage, and nasal hemorrhage. We therefore performed manual reduction under local anesthesia, using the little finger, to minimize the demerits of treatment under general anesthesia with forceps or elevators and aimed to assess functional and aesthetic outcomes, and patient satisfaction. Methods: Patients who visited the plastic and reconstructive surgery department between November 2016 and November 2017 with nasal bone fractures and treated by a single surgeon were prospectively followed up. Patients with simple unilateral or bilateral nasal bone fractures were treated with bedside finger reduction under local anesthesia and patients with comminuted nasal bone or septal fractures were scheduled for closed reduction under general anesthesia. Results: Of 84 patients, 28 met the inclusion criterion and underwent bedside finger reduction under local anesthesia. Twenty-seven patients (96.4%) were successfully contacted via telephone for survey. Twenty-three (85.2%) showed good and three (11.1%) showed fair results. All 27 patients (100%) were satisfied with their postoperative function and 25 (92.6%) were satisfied with their postoperative aesthetic result. Twenty-five patients (92.6%) preferred the finger reduction method under local anesthesia over closed reduction under general anesthesia. Conclusion: Finger reduction under local anesthesia in patients with mild unilateral or bilateral nasal bone fractures is an easy and efficient procedure with high patient satisfaction and favorable postoperative functional and aesthetic outcomes.

• 대한두개안면성형외과학회지
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• 제22권4호
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• pp.193-198
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• 2021

Background: Nasal bone fractures are frequently encountered in clinical practice. Although fracture reduction is simple and correction requires a short operative time, low patient satisfaction and relatively high complication rates remain issues for many surgeons. These challenges may result from inaccuracies in fracture recognition and assessment or inappropriate surgical planning. Findings from immediate postoperative computed tomography (CT) scans and those performed at 4 to 6 weeks postoperatively were compared to evaluate the accuracy and outcomes of nasal fracture reduction. Methods: This retrospective study included patients diagnosed with nasal bone fractures at our department who underwent closed reduction surgery. Patients who did not undergo additional CT scans were excluded from the study. Clinical examinations, patient records, and radiographic images were evaluated in 20 patients with nasal bone fractures. Results: CT findings from immediately after surgery and a 1month follow-up were compared in 20 patients. Satisfactory nasal projection and aesthetically acceptable results were observed in patients with accurate correction or mild overcorrection, while undercorrection was associated with unfavorable results. Conclusion: Closed reduction surgery for correcting nasal bone fractures usually provides acceptable outcomes with relatively few complications. If available, immediate postoperative CT scans are recommended to guide surgeons in the choice of whether to perform secondary adjustments if the initial results are unsatisfactory. Based on photogrammetric data, nasal bone reduction with accurate correction or mild overcorrection achieved acceptable and stable outcomes at 1 month postoperatively. Therefore, when upward dislocation is observed on postoperative CT, one can simply observe without a subsequent intervention.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.69-74
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• 2021

Background In inferomedially rotated zygomatic fractures sticking in the maxillary sinus, it is often difficult to achieve complete reduction only by conventional intraoral reduction. We present a new intraoral reduction technique using a Kirschner wire and its clinical outcome. Methods Among 39 inferomedially impacted zygomatic fractures incompletely reduced by a simple intraoral reduction trial with a bone elevator, a Kirschner wire (1.5 mm) was vertically inserted from the zygomatic body to the lateral orbital rim in 17 inferior-dominant rotation fractures and horizontally inserted to the zygomatic arch in nine medial-dominant and 13 bidirectional rotation fractures. A Kirschner wire was held with a wire holder and lifted in the superolateral or anterolateral direction for reduction. Following reduction of the zygomaticomaxillary fracture, internal fixation was performed. Results Fractures were completely reduced using only an intraoral approach with Kirschner wire reduction in 33 cases and through an additional lower lid or transconjunctival incision in six cases. There were no surgical complications except in one patient with undercorrection. Postoperative 6-month computed tomography scans showed complete bone union and excellent bone alignment. Four patients experienced difficulty with upper lip elevation; however, these problems spontaneously resolved after manual tissue lump massage and intralesional steroid (Triamcinolone) injection. Conclusions We completely reduced infraorbital rim fractures, zygomaticomaxillary buttresses, and zygomaticofrontal suture fractures in 84% of patients through an intraoral approach alone. Intraoral Kirschner wire reduction may be a useful option by which to obtain effective and powerful reduction motion of an inferomedially rotated zygomatic body.

• 한국안광학회지
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• 제14권4호
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• pp.71-75
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• 2009

목적: 광주지역에서 근시안경 착용 초등학생을 대상으로 착용안경의 굴절상태와 사위 및 단안PD 상태를 파악해 보고자 한다. 방법: 근시안경 착용 초등학생 145명(290안)을 대상으로 사위 및 단안PD 검사 후 자각적 타각적 굴절검사를 실시하였다. 결과: 1. 양안 2.00D이상 굴절성부등시에 해당되는 학생은 4명(3%)으로 나타났다. 2. 남학생 저교정 시력 19명 중 부등시는 9명(47%)이며 여학생 저교정 시력 25명 중 부등시는 16명(64%)으로 나타났다. 3.67명의 근시안경 착용 남학생중 동공중심과 안경의 광학중심점이 일치된 안경은 30%(양안), 동공중심과 광학중심점이 불일치된 안경은 70%(양안)이다. 78명의 근시안경 착용 여학생의 경우 동공중심과 안경의 광학중심점이 일치된 안경은 23%(양안), 동공중심과 광학중심점이 불일치된 안경은 77%(양안), 동공중심거리와 안경의 광학중심점 거리는 남녀 모두 안경의 광학중심점 거리가 더 크게 나타났다. 4. 사위검사결과 원거리에서 정위가 14%, 외사위는 63%, 내사위는 23%이다. 근거리에서 정위가 10%, 외사위는 76%, 내사위는 14%로 나타났다. 결론: 부정확한 굴절 검사와 잘못된 PD로 안경을 착용하면 안정피로 및 사위를 유발시킬 수 있기 때문에 정확한 굴절검사와 단안PD를 측정하여 안경을 착용 하는 것이 좋을 것 같다.