• Archives of Plastic Surgery
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• 제44권6호
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• pp.559-563
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• 2017

Supported by recent literature on the signs of aging of the middle and lower face, our clinical research has documented a loss of volume of the deep structural components of the central face and a progressive descent of the nasolabial fat and the jowl fat, leading to facial fragmentation. The signs that appear around the age of 45 to 50 years are well targeted by the mini-invasive technique described here. We focused on refitting the jowl fat and the nasolabial fat associated with cutaneous tightening. The use of absorbable barbed sutures (Quill) led to significant improvements, enabling the fitting of fat on fat. In the past 4 years, 167 operations were performed using this technique. The clinical results were very satisfactory, yielding a natural effect caused by the mobilization and strong fixation of the nasolabial fat and the jowl fat in the direction opposite to their displacement.

• 대한후두음성언어의학회지
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• 제23권2호
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• pp.111-118
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• 2012

Botulinum toxin is a potent neurotoxin that is produced by the bacterium Clostridium botulinum. The agent causes muscle paralysis by preventing the release of acetylcholine at the neuromuscular junction of striated muscle. Botulinum toxin A (Botox, AllerganInc., Irvine, California) is the most potent of seven distinct toxin subtypes that are produced by the bacterium. The toxin was initially used clinically in the treatment of strabismus caused by hypertonicity of the extraocular muscles and was sub-sequently described in the treatment of multiple disorders of muscular spasticity and dystonia. In treating patients with Botox for blepharospasm, Carruthers and Carruthers [5] noticed an improvement in glabellar rhytids. This ultimately led to the introduction and development of Botox as a mainstay in the treatment of hyperfunctional facial lines in the upper face. Since its approval by the U.S. Food and Drug Administration for the treatment of facial rhytids (2002), botulinum toxin A has expanded into wide-spread clinical use. Forehead, glabellar, and periocular rhytids are the most frequently treated facial regions. Indications for alternative uses for Botox in facial plastic and reconstructive surgery are expanding. These include a variety of well-established procedures that use Botox as an adjunctive agent to enhance results. In addition, Botox injection is finding increased usefulness as an independent modality for facial rejuvenation and rehabilitation. The agent is used beyond its role in facial rhytids as an effective agent in the management of dynamic disorders of the face and neck. Botox injection allows the physician to precisely manipulate the balance between complex and conflicting muscular interactions, thus resetting their equilibrium state and exerting a clinical effect. This article will address some of the new and unique indications on Botox injection in the face (the lower face and neck, combination with fillers). Important points in terms of its clinical relevance will be stressed, such as an understanding of functional facial anatomy, the importance of precise injections, and correct dosing all are critical to obtaining natural outcomes.

• 한방안이비인후피부과학회지
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• 제25권3호
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• pp.150-159
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• 2012

Objective : The purpose of this study was to evaluate the effect of korean herbal cosmetics for facial skin elasticity. Methods : We recruited patients and divided them to cosmetics group and control group randomly. We provided korean herbal cosmetics to cosmetics group and subjects in cosmetics group applied the provided cosmetics for 4 weeks. Control group waited and applied cosmetics that had previously used for 4 weeks. We assessed all subjects in 0 week, 2 weeks and 4 weeks. Primary assessment instrument was moire topography photo scale. Second assessment instrument was skin moisture, oiliness and elasticity which assessed with skintouch system v1.0, detox/regeneration questionnaire score and self-evaluating facial wrinkle/looseness score. Result : Moire topography photo scale improved in cosmetics group than control group significantly. Skin moisture and elasticity assessed with skintouch system improved in cosmetics group than control group significantly while skin oiliness assessed with skintouch system have not improved significantly. Detox/regeneration questionnaire score and self-evaluating facial wrinkle/looseness score improved in cosmetics group than control group significantly. Conclusion : Korean herbal cosmetics application might be effective method for facial skin elasticity.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.572-579
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• 2015

Background Facial rejuvenation can be achieved using a variety of techniques. Since minimally invasive procedures for face lifting have become popular because of their convenience and short operating time, numerous minimally invasive surgical procedures have been developed. In this study, a nonabsorbable polypropylene mesh is introduced as a new face lifting instrument, with the nasolabial fold as the main target area. In this paper, we report the efficacy and safety of a polypropylene mesh in midface rejuvenation. Methods Thirty-three subjects with moderate-to-severe nasolabial folds were enrolled from two medical institutions for a noncomparative single-sample study. A mesh was inserted above the superficial muscular aponeurotic system layer, reaching the nasolabial folds through a temporal scalp incision. After 3 weeks, the temporal end of the mesh was pulled to provide a lifting effect. Then, the mesh was fixed to the deep temporal fascia using nonabsorbable sutures. To evaluate efficacy, we compared the scores on the Wrinkle Severity Rating Scale and a visual analog scale for patient satisfaction between the baseline and 7 weeks postoperatively. In addition, we evaluated safety based on the incidence of adverse events. Results The treatment was deemed effective at improving wrinkles in 23 of 28 cases, and patient satisfaction improved significantly during the study period. There were seven cases of skin or subcutaneous tissue complications, including edema and erythema, but there were no suspected serious adverse events. Conclusions Face lifting using a nonabsorbable mesh can improve nasolabial folds without serious adverse effects. Thus, this technique is safe and effective for midface rejuvenation.

• Journal of Acupuncture Research
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• 제29권2호
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• pp.29-36
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• 2012

The purpose of this article is to review all the wrinkle treatments reported so far, and to introduce a method of dermal subcision, especially localized fine wrinkles. In order to remove wrinkles, laser, ulthera and drug therapy are commonly used in western medicine while Miso facial rejuvenation acupuncture, $Jung-An$ acupuncture and needle-embedding therapy are used in oriental medicine. However, as researches on fine wrinkles have been insufficiently conducted until now. Dermal subcision stated in this study is considered to be a safe and effective way to ameliorate fine linear-shaped wrinkles around or below eyes and mouth by increasing the circulation of qi and blood. also, reproducing dermal layer. More and further related cases and researches are expected in the future.

• Medical Lasers
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• 제9권2호
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• pp.184-186
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• 2020

Lower eyelid blepharoplasty is a popular facial rejuvenation surgery that restores the infraorbital region. The procedure is performed by removing excessive fatty tissues, muscles, and other unnecessary structures. The structure of the eyelid differs from person to person and is quite complex; therefore, numerous side effects are expected. Common lower eyelid blepharoplasty complications are asymmetrical faces, retrobulbar hemorrhage, blurred vision, and ectropion. This paper reports a case of a prominent periorbital vein after lower eyelid blepharoplasty. The prominent periorbital vein after surgery is a rare side effect that has not been reported to the best of the author's knowledge. This case was treated with a long-pulse 1,064-nm neodymium:yttrium-aluminum-garnet laser.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.42-45
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• 2012

Background : Conservative techniques designed to block or delay the aging process have been utilized in various ways for many years. However, their effects can be relatively minimal and short-term in most cases compared to surgery. The objective of this study was to evaluate the efficacy and safety of gold thread implantation for the treatment of periorbital wrinkles. Methods : A total of 78 consecutive patients who showed mild to severe periorbital wrinkles were deemed appropriate candidates, including 69 women and 9 men ranging from 31 to 59 years (mean, 47 years). Six gold threads about 4 cm in length were inserted subdermally in each patient at intervals of about 0.5 cm. Follow-up assessments were performed 1, 4, and 12 weeks after the procedure. The efficacy was rated by the physician using the Wrinkle Severity Rating Scale and patients who made global assessments of changes in periorbital wrinkles using the Visual Analog Scale. Adverse events were monitored throughout the course of the study. Results : The patients showed significant improvements after the procedure. There were minor complications such as foreign body sensation in the eye (2.63%) and eye pain (1.32%) that improved spontaneously without any specific treatments. Conclusions : Subdermal implantation of gold thread improves the appearance of periorbital wrinkles and does not appear to have serious side effects. Insertion of gold thread may be an effective and safe method for facial rejuvenation.

• 대한임상검사과학회지
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• 제50권3호
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• pp.217-224
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• 2018

매선요법은 다른 시술에 비해 비침습적이고, 인체 내에서 생분해가 일어나는 물질로 제작되기 때문에 성형수술에서 각광받고 있다. 상업적으로 이용가능한 매선의 종류로는 poly-L-lactic acid (PLLA), polycarprolactone (PCL), polydioxanone (PDO) 등이 있으나, 매선으로 사용되는 생분해성 물질들의 종류에 따른 차이점이나, 콜라겐을 형성하는데 있어서 매선의 어떤 부분이 결정적으로 작용하는지에 대한 연구는 잘 알려져 있지 않다. 따라서 이 연구에서는 현재 판매되고 있는 3가지 생분해성 물질(PLLA, PCL, PDO)로 만들어진 매선을 동물모델에서 그 효과를 비교하고, 매선의 콜라겐생성능에 미치는 영향 인자가 무엇인지를 분석하였다. 매선을 랫드의 등에 삽입하여 2주, 4주, 8주, 12주동안 경과를 관찰하고 특수염색을 통해 콜라겐의 생성 정도를 비교하였다. 매선에 의한 조직학적 변화를 관찰하기 위해서, 조직검체는 H&E, Masson's trichrome, Herovici's collagen stain이 진행되었다. 그 결과 3가지 모두 다 동일한 시기에 비슷한 양의 신생콜라겐을 형성하는 것을 관찰할 수 있었고, 3가지 매선 모두 type 3의 콜라겐을 형성하는 것을 확인할 수 있었다. 또한 생성되는 콜라겐의 양은 매선이 피부조직에 닿는 면적이 크면 클수록 증가하는 것을 관찰할 수 있어 한 번의 시술만으로도 많은 양의 매선이 들어갈 수 있는 PDO cavern타입의 매선이 가장 많은 콜라겐을 형성하는 것을 확인할 수 있었다.

• Archives of Plastic Surgery
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• 제43권5호
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• pp.402-410
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• 2016

Background In an increasing number of lawsuits doctors lose, despite providing preoperative patient education, because of failure to prove informed consent. We analyzed judicial precedents associated with insufficient informed consent to identify judicial factors and trends related to aesthetic surgery medical litigation. Methods We collected data from civil trials between 1995 and 2015 that were related to aesthetic surgery and resulted in findings of insufficient informed consent. Based on these data, we analyzed the lawsuits, including the distribution of surgeries, dissatisfactions, litigation expenses, and relationship to informed consent. Results Cases were found involving the following types of surgery: facial rejuvenation (38 cases), facial contouring surgery (27 cases), mammoplasty (16 cases), blepharoplasty (29 cases), rhinoplasty (21 cases), body-contouring surgery (15 cases), and breast reconstruction (2 cases). Common reasons for postoperative dissatisfaction were deformities (22%), scars (17%), asymmetry (14%), and infections (6%). Most of the malpractice lawsuits occurred in Seoul (population 10 million people; 54% of total plastic surgeons) and in primary-level local clinics (113 cases, 82.5%). In cases in which only invalid informed consent was recognized, the average amount of consolation money was KRW 9,107,143 (USD 8438). In cases in which both violation of non-malfeasance and invalid informed consent were recognized, the average amount of consolation money was KRW 12,741,857 (USD 11,806), corresponding to 38.6% of the amount of the judgment. Conclusions Surgeons should pay special attention to obtaining informed consent, because it is a double-edged sword; it has clinical purposes for doctors and patients but may also be a litigation strategy for lawyers.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.659-666
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• 2010

Purpose: Blepharoplasty plays a vital role in facial rejuvenation. Aging eyelids are the result of relaxation of lid structures as the skin, the orbicularis muscle, and mainly the septum, with subsequent protrusion or pseudoherniation of intraorbital fat contents. Traditional blepharoplasty has often involved the excision of excessive lax skin and muscle and removal of fat, leaving the eyelid unnatural and even causing the brow ptosis. The authors propose the septal approach through which the amount of skin excision can be decreased and solid fixation can be achieved in the upper blepharoplasty. Methods: From November 2007 to February 2010, total of 15 patients underwent upper blepharoplasty with septal approach. In 9 patients, orbital septum anchored into the orbital periosteum only. But in 6 patients, the attenuated septum was strengthened through shortening and fixing into orbital periosteum with non-absorbable suture. Results: Pleasing results were obtained from most of the patients. But one patient who had septum anchoring procedure complained of slight undercorrection, therefore secondary operation with septum shortening procedure was followed. Conclusion: We found that the method using orbital septum fixation into orbital periosteum has several advantages: less amount of skin excision, less recurrence rate, and more natural appearance. And the results were reliable and satisfactory.