The nose is the most prominent area of the face, therefore susceptible to trauma and skin cancer. When small sized defect is in nasal tip, it results in disturbance of the facial harmony even if replantation, composite graft, skin graft or median forehead flap has been used for the reconstruction. So it is needed that the best method reconstruction is performed according to the degree of defect or deformity. And at the same time the physiology and anatomy of nose were clarified and its aesthetic subunits were employed. How can we cover the about 3 cm sized nasal defect in nasal tip with cartilage exposure? At first, we can think forehead island flap is most appropriate. We performed 7 cases of the forehead island flap for reconstruction of the defect in nasal tip(4 cases: cancer, 3 cases: trauma) from March, 2001 to August, 2004. This result was satisfactory in the point of texture, color, donor scar, and there were no complication such as wound disruption, infection, flap atrophy, and hematoma. The advantages of forehead island flap are: 1) No injury of deep vessel and nerve, 2) control of shape and volume, 3) Short operation time, 4) primary closure of donor site, 5) one stage operation. Also, forehead island flap can cover the defect in nose where skin graft and local flap can not cover. But, operator always must take care for flap congestion and donor site scar. We thought forehead island flap is one of the best option of reconstruction of nasal tip defect.
Atrophy ; Cartilage ; Cicatrix ; Congenital Abnormalities ; Estrogens, Conjugated (USP) ; Forehead* ; Hematoma ; Humans ; Nose ; Physiology ; Replantation ; Skin ; Skin Neoplasms ; Tissue Donors ; Transplants ; Wounds and Injuries

In many reports on the reconstruction of an orbital blowout fracture, CT(computed tomography) imaging has been used for postoperative evaluation. However, in most cases, only one plane of the CT scan was presented, which may not be sufficient for accurate evaluation. This study reviewed the CT scans presented in the related 49 articles (56 cases), and investigated our patients (150 cases) to investigate where were the most frequent unfavorable reconstructions, and to determine which planes should be presented for accurate evaluation. One plane of the CT scan was presented in 70% of the cases. On the other hand, 30% of the cases presented two planes of the CT scans. In our cases, the most prevalent sites for an unfavorable reconstruction were the posterior portion of the inferior wall, and the posterior and the inferior portion of the medial wall. In order to accurately evaluate an orbital wall reconstruction, at least two planes of a CT scan are needed. For an inferior wall evaluation, both the middle and the posterior planes of the coronal section or both the coronal and the sagittal sections are necessary. In addition, for the medial wall evaluation, both the axial and the coronal sections or both the middle and the posterior planes of the coronal section are required.
Hand ; Humans ; Orbit* ; Tomography, X-Ray Computed*

Reconstruction of calvarial bone defects from congenital anomaly or from bone loss due to traumatic or neoplastic processes remains a significant problem in craniofacial surgery and neurosurgery. To facilitate bone regeneration, there have been many trials such as autologous bone graft or allograft, and the addition of demineralized bone matrix and matrix-derived growth factor. Guided bone regeneration is one of the methods to accelerate bone healing for calvarial bone defects especially in children. Pericranium is one of the most usable structure in bone regeneration. It protects the dura and sinus, and provides mechanical connection between bone fragments. It supplies blood to bone cortex and osteoprogenitor cells and enhances bone regeneration. For maximal effect of pericranium in bone regeneration, authors used pericranium as a flap for covering calvarial defects in surgeries of 11 craniosynostosis patients and achieved satisfactory results: The bone regeneration of original cranial defect in one year after operation was 74.6%(+/-8.5%). This pericranial flap would be made more effectively by individual dissection after subgaleal dissection rather than subperiosteal dissection. In this article, we reviewed the role of pericranium and reported its usefulness as a flap in surgery of craniosynostosis to maximize bone regeneration.
Allografts ; Bone Matrix ; Bone Regeneration ; Child ; Craniosynostoses* ; Equipment and Supplies ; Humans ; Neoplastic Processes ; Neurosurgery ; Transplants

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.
Cerebrospinal Fluid ; Debridement ; Ear Canal ; Free Tissue Flaps* ; Fungi ; Humans ; Meningitis ; Otitis ; Parotid Gland ; Rectus Abdominis* ; Skin ; Temporal Bone ; Tissue Donors

Skull base tumors have been determined inoperable because it is difficult to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. However, recently, the advent of sophisticated diagnostic tools such as computed tomography and magnetic resonance imaging as well as the craniofacial and neurosurgical advanced techniques enabled an accurate determination of operative plans and safe approach for tumor excision. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amenable to local tissue closure. The purpose of this study is to analyze experiences of skull base reconstruction and to evaluate long term survival rate and complications. All cranial base reconstructions performed from July 1993 to September 2000 at Department of Plastic and Reconstructive Surgery of the Seoul National University Hospital were observed. The medical records were reviewed and analysed to assess the location of defects, reconstruction method, existence of the dural repair, history of preoperative radiotherapy and chemotherapy, complications and causes of death of the expired patients. There were 12 cases in region II, 8 cases in region I and 1 case in region III according to the Irish classification of skull base. Cranioplasty was performed in 4 patients with a bone graft and microvascular free tissue transfer was selected in 17 patients to reconstruct the cranial base and/or mid-facial defects. Among them, 11 cases were reconstructed with a rectus abdominis musculocutaneous free flap, 2 with a latissimus dorsi muscluocutaneous free flap, 1 with a fibular osteocutaneous free flap, 2 with a scapular osteocutaneous free flap, and 1 with a forearm fasciocutaneous free flap, respectively. During over 3 years follow-up, 5 patients were expired and 8 lesions were relapsed. Infection(3 cases) and partial flap loss(2 cases) were the main complications and multiorgan failure(3 cases) by cancer metastasis and sepsis(2 cases) were causes of death. Statistically 4-years survival rate was 68%. A large complex defects were successfully reconstructed by one-stage operation and, the functional results were also satisfactory with acceptable survival rates.
Cause of Death ; Classification ; Drug Therapy ; Follow-Up Studies* ; Forearm ; Free Tissue Flaps ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Neoplasm Metastasis ; Plastics ; Radiotherapy ; Rectus Abdominis ; Seoul ; Skull Base* ; Skull* ; Superficial Back Muscles ; Survival Rate ; Transplants

Reconstruction of the lower lip requires consideration of several factors. There should be retained sensation, maintenance of oral sphincter function, and a large enough opening for the mouth. In addition, it is important to achieve an aesthetically acceptable appearance. Webster's modification of Bernard operation is one of good methods which satisfy above mentioned goals. The purpose of this article is to present the results and review the perioperative problems after reconstruction of the lower lip by this operation. We reviewed seven patients after surgical reconstruction by the same method between January of 1996 and December of 2003. Five patients were male and two were female. The mean follow-up period was 15 months. We obtained functionally and cosmetically acceptable appearance after reconstruction. Most of the reconstructed lower lips were large enough for full mouth opening, but one patient required additional commissuroplasty, and one other patient was treated with wound revision for dehiscence resulting from protrusion of mandibular lateral incisor tooth. All other patients accepted their facial appearance. In conclusion, careful planning and consideration for dental problems and proper closure tension may ensure satisfactory outcome & lower lip competence, when using this modified operative method for lower lip reconstruction.
Carcinoma, Squamous Cell* ; Female ; Follow-Up Studies ; Humans ; Incisor ; Lip* ; Male ; Mental Competency ; Mouth ; Sensation ; Tooth ; Wounds and Injuries

Recently, as standard of living has been improving and awareness of well-being has been generalized, people's desire pursuing beauty has been spreading across the world. We made a survey with 184 graduating high school girls in December 2003. According to the survey. 57.6% of them knew about plastic surgery, 41.8% of them knew well about whole field of plastic surgery, and 60.3% of them wanted to have an aesthetic surgery. 44.6% got an information about an aesthetic surgery from general public and 27.6% from TV, respectively. Regarding the use of aesthetic surgery, 59.8% answered that it makes them more confident about themselves rather than just to be beautiful. 78.8% of them have complaints about how they look. Finally, as the personal desire to make themselves look beautiful to others increases, so does the interest in aesthetic plastic surgery. In conclusion, as the society of plastic and reconstructive surgeons, we still need more effort for the correct cognition and awareness of plastic surgery among general public.
Beauty ; Cognition* ; Female ; Humans ; Socioeconomic Factors ; Surgery, Plastic*

The aim of this study is to establish anatomical dimension of the lip in young population in Korean, using specially designed soft ware with photographic image. We measure 13 anatomical dimensions of lips in 2,229 young people. (917 male, 1312 female, Aged from 18-33 years. Average age 19.7). Statistical analysis of these measurements of large population could offer useful information in facial plastic surgery. The mean measurements are as follows 1. Lengths (male/female) Widths of philtrum: 1.11+/-0.19cm/1.02+/-0.21cm Heights of philtrum: 1.6+/-0.24cm/1.47+/-0.21cm Heights of cupid bow: 0.88+/-0.16cm/0.83+/-0.16cm Height of upper vermilion: 0.74+/-0.16cm/0.70+/-0.15cm Height of lower vermilion: 1.08+/-0.17cm/1.02+/-0.15cm Height of upper lip(Rt.): 1.24+/-0.2cm/1.23+/-0.2cm Height of upper lip(Lt.): 1.24+/-0.2cm/1.17+/-0.19cm Half horizontal length of lip: 2.2+/-0.26cm/2.11+/-0.2cm Horizontal length of lip: 4.41+/-0.4cm/4.25+/-0.36cm Height of lower face: 7.1+/-0.58cm/6.52+/-0.6cm 2. Angles Nasolabial angle: 97.77+/-11.97degrees/95.5+/-11.34 degrees Mentolabial angle: 133.88+/-14.65 degrees/129.27+/-13.67 degrees Angle of Cupid's bow: 111.65+/-13.99degrees/116.75+/-16.2 degrees Previous reported photogrammetric measurements was difficult to implement to surgical practice. Because these were printed photographies of the same size. Therefore, in this study, we can measure a lot of objects and items more conveniently and correctly by using proportional program on computer after taking a digital photograph. Consequently, proportional measurements with photogrammetry of lip could be useful and corrective substitute for anthropometrical measuring. These data could be useful reference for preoperative consultation, surgical planning and learning anatomical measurement of lips and adjacent structures.
Adolescent ; Anthropometry ; Female ; Humans ; Learning ; Lip* ; Male ; Photogrammetry ; Photography ; Surgery, Plastic

Low-power laser(LPL) delivers a small amount of energy without elevation of tissue temperature. LPL has been reported to have biostimulation effects including anti-inflammatory, analgesic, regenerative, immunocorrective, and vasodilative effects. However, the effect of LPL on hair growth has rarely been studied. We investigated the effect of LPL on hair growth in the mouse. After depilation of back skin of mice, we classified the mice into 4 groups: control, laser irradiated group, MoandMore(R) applied group, and Spella 707(R) applied group. Laser irradiation or application of these drugs were performed on the back skin of the mice for 30 days. The results are summarized as follows. Hair growth of control was first observed at 13 days after depilation, and complete hair regrowth was observed at 25 days. Hair growth of both laser irradiation group and MoandMore(R) applied group was first observed at 9 days after depilation, and complete hair regrowth was observed at 20 days. Hair growth of Spella 707(R) applied group was firstly observed at the 9 days after depilation, and complete hair regrowth was observed at the 15 days. Hair growth started at the irradiation site in the laser irradiation group, but it started at the random sites in other groups. In conclusion LPL irradiation have a stimulating effect on the hair growth in the mouse.
Animals ; Hair Removal ; Hair* ; Mice ; Skin

Chemotactic migration of bone forming cell, osteoblast, is an important event during bone formation, bone remodeling, and fracture healing. Migration of cells is mediated by adhesion receptors, such as integrins, that link the cell to extracellular matrix ligands, type I collagen, fibronectin, laminin and depend on interaction between integrin and extracellular ligand. Our study was designed to investigate the effect of extracellular matrix like fibronectin, laminin, type I collagen on migration of osteoblast. Migration distance and speed of MC3T3-E1 cell on extracellular matrix-coated glass were measured for 24 hours using 0.01% type I collagen, 0.01% fibronectin, 100 microliter/ml laminin. The migration distance and speed of MC3T3-E1 cell was compared using a video-microscopy system. To determine migration speed, cells were viewed with a 4 phase- contrast lens and video recorded. Images were captured using a color CCD camera and saved in 8-bit full-color mode. The migration distance on 0.01% type I collagen or 0.01% fibronectin was longer than that on 100microliter/ml laminin-coated glass. The migration speed on fibronectin-coated glass was 68 micrometer/hour which was fastest. The migration speed on type I collagen-coated glass was similar with that on fibronectin-coated glass. The latter two migration speeds were faster than that on no-coated glass. On the other hand, the average migration speed on laminin-coated glass was 37micrometer/hour and not different from that of control group. In conclusion, the extracelluar matrix ligands such as type I collagen and fibronectin seem to play an important role in cell migration. The type I collagen or fibronectin coated scaffold is more effective for migration of osteoblast in tissue engineering process.
Bone Remodeling ; Cell Movement ; Collagen ; Collagen Type I ; Extracellular Matrix* ; Fibronectins ; Fracture Healing ; Glass ; Hand ; Integrins ; Laminin ; Ligands ; Osteoblasts ; Osteogenesis ; Tissue Engineering