• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.3
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• pp.149-155
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• 2015

Surgical approaches to the condylar fracture include intraoral, preauricular, submandibular, and retromandibular approaches. Each approach has its own advantages and disadvantages. When a patient needs esthetic results and an intraoral approach is not feasible, the transmasseteric antero-parotid facelift approach is considered. This approach permits direct exposure and allow the surgeon to fixate the fractured unit tangentially. Tangential fixation is critical to osteosynthesis. Disadvantages of the transmasseteric antero-parotid facelift approach include damage to the facial nerve and a longer operation time. However, after the initial learning curve, facial nerve damage can be avoided and operation time may decrease. We report three cases of subcondylar fractures that were treated with a transmasseteric antero-parotid facelift approach. Among these, two cases had trivial complications that were easily overcome. Instead of dissecting through the parotid gland parenchyma, the transmasseteric antero-parotid facelift approach uses transmasseteric dissection and reduces facial nerve damage more than the retromandibular transparotid approach. The esthetic result is superior to that of other approaches.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.37-41
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• 2000

Background and Objectives: The most commonly used incision for parotidectomy is modified Blair incision, but it has unsatisfactory cosmetic result due to long exposed scar in the neck. Therefore, we introduce an alternative approach with more acceptable scar named modified facelift incision. We report it's techniques, indications and disadvantages with our experiences. Materials and Methods: During the 1999, 15 patients were underwent parotidectomies using modified facelift incision. We studied the postoperative complications and the cosmetic results respectively. Results: There were 11 benign tumors, 3 malignant tumors, and 1 chronic inflammation. Total parotidectomy was performed in 2 malignant tumors and chronic parotitis patients. The others has superficial parotidectomy. In terms of operation field, there was no difference between classical incision and facelift incision. Partial facial nerve palsy was noted in 2 cases, who required sacrifice of branches of facial nerve because of malignant tumor invasion. There were no specific complications associated with this type of approach. Postoperative cosmetic results were satisfactory in all cases. Conclusion: Modified facelift incision provides better cosmetic result than conventional incision without narrowing of operation field. We believe that it is a safe alternative approach to all parotidectomy cases especially to women and patient with keloid skin. The only limitation of this incision is poor adaptability for combining neck dissection.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.138-142
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• 1999

Background and objectives : During the last century, various incisions for parotidectomy has introduced and among them, the modified Blair incision has been the one most commonly used. The modified facelift incision, in another hand, has only been introduced and applied recently for better aesthetic results, but also has been criticized for its potentially limited anterior exposure. The purpose of this study is to compare the modified facelift incision with the modified Blair incision in its indications, results and complications. Materials and methods : All parotidectomies done at Kang-nam St. Mary's Hospital for benign parotid masses from Jan. 1995 to Aug. 1998 were reviewed. They were then divided into 2 groups according to their surgical approach, and the parameters included age, gender, complications length of follow-ups, the aesthetic results and the pt's satisfaction. Results : There were no significant differences in the incidence of complications in both groups and the aesthetic results and patient's satisfaction were greater in the modified facelift group. Conclusion : The modified facelift incision provides improved aesthetic results in patients with benign parotid masses without the disadvantage of limited exposure and complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.40.1-40.7
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• 2015

Surgical procedures for parotidectomy had been developed to gain adequate approach, prevent morbidity of nerve, and give esthetic satisfaction. We performed two cases of parotidectomy through facelift incision. One case was reconstructed with superficial musculoaponeurotic system (SMAS) flap and sternocleidomastoid (SCM) muscle rotated flap at the parotid bed. In second case, same procedures were performed, but collagen membrane was additionally implanted for prevention of Frey's syndrome. After surgery, two cases showed esthetic results without neck scar and hollow defect on parotid bed area.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.276-282
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• 2017

Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure. In general, a systolic blood pressure goal of <150 mm Hg and a diastolic blood pressure goal of >65 mm Hg are recommended. This article discusses the causes of increased blood pressure and the treatment methods for perioperative hypertension during the preoperative, intraoperative, and postoperative periods, in order to find ways to maintain normal blood pressure in patients during surgery. Further, in this paper, we review the causes of perioperative hypertension, such as anxiety, epinephrine, pain, and postoperative nausea and vomiting. The treatment methods for perioperative hypertension are analyzed according to the following 3 operative periods, with a review of the characteristics and interactions of each drug: preoperative antihypertensive medicine (atenolol, clonidine, and nifedipine), intraoperative intravenous (IV) hypnotics (propofol, midazolam, ketamine, and dexmedetomidine), and postoperative antiemetic medicine (metoclopramide and ondansetron). This article focuses on the knowledge necessary to safely apply local anesthesia with IV hypnotics during facelift surgery without the assistance of an anesthesiologist.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.25.1-25.6
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• 2017

Background: The conventional transcervical resection for submandibular gland disease has some risks and an unsatisfactory cosmetic result. Recently, robot-assisted surgery has been developed as a plausible substitute for conventional surgery which provides an excellent cosmetic outcome. Case presentation: The authors performed robot-assisted sialadenectomy via modified facelift incision using the da Vinci Xi surgical system (Intuitive Surgical Inc., CA, USA) with two endowrist arms (monopolar curved scissors and Maryland bipolar forceps) successfully in a 44-year-old female patient who suffered from sialolith and severe atrophic submandibular gland. Conclusions: If similar studies are done in the future, this robot-assisted sialadenectomy may become established as an alternative to existing disadvantageous surgical methods.

• 대한두경부종양학회:학술대회논문집
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• 1999.12a
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• pp.265.2-266
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• 1999

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.111-125
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• 2015

Patients with thick skin mainly exhibit the aging processes of sagging, whereas patients with thin skin develop wrinkles or volume loss. Asian skin is usually thicker than that of Westerners; and thus, the sagging of skin due to aging, rather than wrinkling, is the chief problem to be addressed in Asians. Asian skin is also relatively large in area and thick, implying that the weight of tissue to be lifted is considerably heavier. These factors account for the difficulties in performing a facelift in Asians. Facelifts can be divided into forehead lift, midface lift, and lower face lift. These can be performed individually or with 2-3 procedures combined.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.388-391
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• 2019

Schwannoma is a slow-growing, well-demarcated, benign soft tissue tumor of the peripheral nerve sheath. It commonly develops in the head and neck region, usually in the parapharyngeal space. In this case, a 42-year-old woman visited the outpatient department to manage a painless mass on her left cheek. She had no history of concern and no neurological symptoms were observed. In the enhanced computed tomography scan, a 2.8×2.8×1.8 cm, heterogeneously enhanced tumor was detected in the left masseter muscle. A tumor resection under general anesthesia was planned. For the resection, a facelift incision was chosen; branches of the facial nerve were identified and retrogradely dissected. A well-marginated, yellowish, solid mass was found in the left masseter muscle. The mass was excised and given a histopathological diagnosis of schwannoma. A definite diagnosis of schwannoma, originating in the masseter muscle, is difficult to arrive at with radiographic findings alone; it is often misdiagnosed as intramuscular hemangioma. Histopathological examinations, including fine-needle aspiration or histological biopsy after surgery, are necessary. Using a facelift incision with retrograde facial nerve dissection, tumor resection in an intramasseteric lesion can be performed efficiently, without nerve damage, or leaving conspicuous scars on the face.

• Korean Journal of Head & Neck Oncology
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• v.30 no.1
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• pp.23-27
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• 2014

Low-grade myofibroblastic sarcoma is a rare disorder of malignant soft tissue tumor and is usually occurred various regions that often manifests in the head and neck region. The most common clinical presentation of this entity is non-tender cervical lymphadenopathy. This disease usually presents high possibility of local recurrence and low possibility of distant metastasis. We report a rare case of low-grade myofibroblastic sarcoma occurring in the sternocleidomastoid muscle and invading to the mastoid tip. A 56-year-old male visited the clinic with a complaint of slowly growing postauricular mass for 6 months. Mass originating from sternomastoid muscle and invasion to mastoid tip was observed by imaging studies. Surgical complete excision with simple mastoidectomy was performed via modified facelift approach. The histopathologic findings revealed malignant spindle cell tumor with positive staining with smooth muscle actin. The patient has no recurrence for 2years without any complication.