• 복식
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• 제40권
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• pp.81-93
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• 1998

It is necessary to research shape of the breast of girls at adolescence for developing well-fit brassiers. 313 participants reside in Chonju and Kunsan were gathered for body measurement. The conclusion of this study can be summarized as follows. 1) The Analysis of Body Shape by Measurement. Comparing Age GroupⅠ(aged 10 to 12)' measurement with Age GroupⅡ(aged 13 to 15)', Each items has statistical significance. Two groups differed in the length, girth, depth, width items. 2) Factor Analysis of Body Measurement (1) Age GroupⅠ'characteristics were categorized Three Factor : Breast size and breast apex length. Breast volume, Length of the Breast part. (2) Age GroupⅡ' characteristics consist of four factors, which are named as breast size and its jut (first factor), breast volume (second factor), contour of breast profile & its jut (third factor), shoulder length (fourth factor). 3) Characteristics of Breast Shape. (1) Breast shapes of Age GroupⅠ are classified into three types. Types 1 is a protruded and more voluminous shape. Type 2 is the most voluminous and breast fatness is highest. Type 3 is the smallest and flat shape growing now. (2) Breast shapes of Age GroupⅡ are also classified into three types. Type 1 is the longest in length and middle in fatness, voluminous in size. Type 2 is the smallest in stature and the slimmest in fatness in breast shape. Type 3 is middle in length, the fattest and the most voluminous in breast.

• Archives of Plastic Surgery
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• 제45권5호
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• pp.484-489
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• 2018

Large and ptotic breast reconstruction in patients who are not candidates for a transverse rectus abdominalis myocutaneous flap and revision surgery for the contralateral breast remains challenging. We developed a novel breast reconstruction technique using a latissimus dorsi myocutaneous (LD m-c) flap set at the posterior aspect of the reconstructed breast, combined with an anatomical silicone breast implant (SBI), following tissue expander surgery. We performed the proposed technique in four patients, in whom the weight of the resected tissue during mastectomy was >500 g and the depth of the inframammary fold (IMF) was >3 cm. After over-expansion of the lower portion of the skin envelope by a tissue expander, the LD m-c flap was transferred to cover the lower portion of the breast defect and to achieve a ptotic contour, with the skin paddle set at the posterior aspect of the reconstructed breast. An SBI was then placed in the rest of the breast defect after setting the LD m-c flap. No major complications were observed during the follow-up period. The proposed technique resulted in symmetrical and aesthetically satisfactory breasts with deep IMFs, which allowed proper fitting of the brassiere, following large and ptotic breast reconstruction.

• 복식문화연구
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• 제13권3호
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• pp.329-343
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• 2005

This study purposed to classify the somatotype of early adolescent girls based on the physical characteristics. For this purpose, a total of 529 girls aged between 10 and 14 were measured and data were collected from 42 anthropometric measurements and 41 photographic measurements per a person. According to the results of classifying somatotype based of the factor analysis, 176 students ($33.3\%$) were type 1, which is short and thin. In students of this type, the breast did not develop, the belly was stuck out as in the body shape of latter childhood, and the contour of the body had not been formed yet. This somatotype was named Type A. Another 176 students ($33.3\%$) were type 2, which is tall and somewhat thin. In students of this type, the breast and the hip developed well, so the contour of the body was quite clear. This somatotype was named Type X. Lastly, 177 students ($33_4\%$) were type 3, which is fattest among the three types. In students of this type, the breast developed but the waist and the hip were not voluminous. This somatotype was named Type H.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.681-686
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• 2010

Purpose: Obese proportion is increasing universally, estimating more than a billion. So reducing the weight became one of the topic in medical market. Not only diet, exercise, medication, but also many surgical procedures are being developed, such as sleeve gastrectomy, gastric bypass surgery. After massive weight loss, skin excess and laxity occurs, leading to unsatisfying body contour. Body contouring surgery including abdominoplasty, breast reduction is performed when skin excess is present in abdomen and breast. When skin excess is present circumferentially, belt dermolipectomy is the treatment of choice. Methods: A 23-year-old man had weight gain since he was 12 of age. A year before visiting to our department, his height was 168 cm, weight was 150 kg and body mass index (BMI) was 53.15 kg/$m^2$. The patient lost 55 kg of his weight through exercise and diet control. When he visited again, his weight was 95 kg and BMI was 33.66 kg/$m^2$. In physical examination, skin excess and laxity was seen in both breast and abdomen circumferentially and lateral folds were seen in the back. Abdominal contour deformity (Pitman classification type 6) and pseudogynecomastia (grade 3) were present in both breast. Belt dermolipectomy of abdomen, both breast and lateral folds was performed, resecting 6,400 g of tissue and additive 1,200 g through revisional operation. Results: The patient lost 6,500g of his weight and BMI reduced by 2.3 kg/$m^2$. The patient's hospital course was uneventful during 5 weeks of hospitalization and he was satisfied with his final body contour. Conclusion: Body contouring with belt dermolipectomy in patient who has circumferential skin excess and laxity after massive weight loss can be a treatment of choice.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.75-79
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• 2009

Purpose: The transverse rectus abdominis musculocutaneous(TRAM) flap is the most commonly used autogenous tissue flap for breast reconstruction. Postoperatively, partial flap loss or fat necrosis are relatively common and it may result in a smaller breast volume with marked contour irregularities. These defects are not easy to reconstruct with local tissue rearrangement or with breast implants. The current authors present the results of 2 patients who underwent Latissimus dorsi(LD) flap reconstruction to correct partial flap or fat necrosis that developed after TRAM flap breast reconstruction. Method: Case1: A 50 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively partial flap necrosis was developed. Secondary breast reconstruction using LD flap was done. Case2: A 51 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively fat necrosis was developed. Secondary breast reconstruction using LD flap was done. Results: Secondary breast reconstruction using LD flap survived completely and produce successful reconstruction. There was no significant complication in both patients. Conclusion: LD flap provides sufficient, vascularized skin and soft tissue. The flap can be molded easily to replace deficient tissue in all areas of the breast. These attributes make it an ideal candidate for salvage of the partially failed TRAM flap breast reconstructio.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.105-110
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• 2001

Breast reconstruction is an aesthetically critical procedure and should be peformed to match the opposite breast in shape, contour, and position. Many methods were introduced to reconstruct the breast with autogenous tissue. But, free tissue transfer for breast reconstruction has become common method. The transverse rectus abdominis myocutaneous flap technique has been a widely accepted method of breast reconstruction after mastectomy, since the first introduction of free abdominoplasty flap in 1979. In breast reconstruction with a free flap the selection of suitable recipient vessels remains one of the most critical decision for surgeon. The most common recipient site for free flap breast reconstruction is the axillar system. But, the use of the axillary system as a recipient site limits flap movement and flexibility in breast shaping. The use of internal mammary vessels as a recipient site be able to achieve ideal breast symmetry, but that technique require the rib resection. The selection of suitable recipient vessels is most important for successful free tissue transfer. We have performed breast reconstruction with TRAM flaps anastomozed to the internal mammary vessel perforator. We came to the conclusion that this vessel perforator is useful as a recipient site in cases of immediate breast reconstruction with free TRAM flap.

• Archives of Plastic Surgery
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• 제44권5호
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• pp.413-419
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• 2017

Background In breast reconstruction using implants after unilateral mastectomy, it is challenging to create a natural, ptotic contour, and asymmetry is a potential drawback. To achieve breast symmetry and an ideal shape for both breasts, we performed contralateral augmentation in patients undergoing breast reconstruction with implants. Methods Patients underwent unilateral mastectomy and 2-stage reconstruction. During the second stage of the procedure, contralateral augmentation mammoplasty was performed. Preoperatively, we obtained the patients' demographic information, and we then assessed breast volume, the volume and dimensions of the inserted implants, and complications. Breast symmetry was observed by the surgeon and was assessed by measuring the disparity between the final volume of each breast. Results Contralateral augmentation was performed in 52 cases. When compared to patients who did not undergo a contralateral balancing procedure, patients who received contralateral augmentation were younger, thinner, and had smaller breasts. During implant selection for contralateral augmentation, we chose implants that were approximately 1 cm shorter in width, 1 level lower in height, and 1 or 2 levels lower in projection than the implants used for reconstruction. The postoperative breast contours were symmetric and the final volume discrepancy between each breast, which was measured by 3-dimensional scanning, was acceptable. Conclusions We demonstrate that contralateral augmentation can be recommended for patients who perceive their breasts to be small and not beautiful in order to achieve an ideal and beautiful shape for both breasts. Furthermore, this study offers guidelines for selecting the implant that will lead to the optimal aesthetic outcome.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.376-383
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• 2012

Background No consensus has been reached regarding the outcome of management of local recurrence after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. This study demonstrated the presentation, management, and outcomes of local recurrence after immediate TRAM breast reconstruction. Methods A comparison was conducted among 1,000 consecutive patients who underwent immediate breast reconstruction with a pedicled TRAM flap (TRAM group) and 3,183 consecutive patients who underwent only modified radical mastectomy without reconstruction (MRM group) from January 2001 to December 2009. The presentation, treatment, and outcome including aesthetics and overall survival rate were analyzed. Results Local recurrences occurred in 18 (1.8%) patients (TRAM-LR group) who underwent TRAM breast reconstruction and 38 (1.2%) patients (MRM-LR group) who underwent MRM only (P=0.1712). Wide excision was indicated in almost all the local recurrence cases. Skin graft was required in 4 patients in the MRM-LR group, whereas only one patient required a skin graft to preserve the mound shape in the TRAM-LR group. The breast mound was maintained in all 17 patients that survived in the TRAM-LR group even after wide excision. The overall survival rate was 94.4% in the TRAM-LR group and 65.8% in the MRM-LR group (P=0.276). Conclusions Local recurrence after immediate TRAM flap breast reconstruction could be detected without delay and managed effectively by multiple modalities without reducing overall survival rates. Breast mound reconstruction with soft autologous tissue allowed for primary closure in most of the cases. In all of the patients who survived, the contour of their reconstructed breast remained.

• Radiation Oncology Journal
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• 제33권1호
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• pp.50-56
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• 2015

Purpose: To investigate the coverage of axillary lymph node with tangential breast irradiation fields by using virtual lymph node (LN) analysis. Materials and Methods: Forty-eight women who were treated with whole breast irradiation after breast-conserving surgery were analyzed. The axillary and breast volumes were delineated according to the Radiation Therapy Oncology Group (RTOG) contouring atlas. To generate virtual LN contours, preoperative fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans with identifiable LN were fused with the CT scans, and the virtual LN contour were delineated on the CT. Results: The median level I and II axillary volume coverage percentages at the $V_{D95%}$ line were 33.5% (range, 5.3% to 90.4%) and 0.6% (range, 0.0% to 14.6%), respectively. Thirty-one LNs in 18 patients were delineated (26 in level I and 5 in level II). In the level I axilla, 84.6% of virtual LNs were encompassed by the 95% isodose line. In the level II axilla, by contrast, none of the virtual LNs were encompassed by the 95% isodose volumes. There was a substantial discrepancy between the RTOG contouring atlas-based axillary volume analysis and the virtual LN analysis, especially for the level I axillary coverage. The axillary volume coverage was associated with the body mass index (BMI) and breast volume. Conclusion: The tangential breast irradiation did not deliver adequate therapeutic doses to the axillary region, particularly those in the level II axilla. Patients with small breast volumes or lower BMI showed reduced axillary coverage from the tangential breast fields. For axillary LN irradiation, individualized anatomy-based radiation fields for patients would be necessary.

• 전자공학회논문지SC
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• 제42권5호
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• pp.51-58
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• 2005

본 논문에서는 유방 초음파 볼륨영상에서 진단하고자 하는 종양 영역을 율왜곡 기반(rate-distortion based) 시드영역 확장 법으로 분할하는 알고리듬을 제안한다. 제안된 분할법에서는 율은 윤곽의 거친 정도를 나타내고 왜곡은 영역의 동질성 정도를 나타내는데, 흉부 종양 볼륨으로부터 획득한 2차원 단면 영상에서 설정된 초기 시드영역에서 시작하여 이러한 율과 왜곡을 동시에 최소화하는 주위영역 중 하나씩 시드영역으로 병합한다. 이러한 병합은 시드영역의 윤곽 화소당 평균 율왜곡 비용이 최대가 될 때까지 반복적으로 수행한다. 이렇게 함으로써 최종 시드영역은 동질성이 잘 유지되고 부드러운 윤곽을 갖게 된다. 마지막으로 모든 단면 영상에 있는 최종 시드영역의 윤곽들을 이용하여 3차원 흉부 종양을 추출한다. 실험 결과, 제안한 방법이 초음파 데이터에 대하여 평균 에러율이 약 4% 미만으로 나타났다.