There are several methods for restoring the temporal peaks. The most important point is the variable density and angulation of the hair, which ultimately give a soft and natural look. The current technique produces zones of variable density and helps to restore naturalness.
Alopecia ; Hair ; Hair Follicle

Glomus tumors are benign neoplasms that are usually found in the subungual area, and are painful upon palpation. The typical treatment of choice is surgical excision. In rare cases, glomus tumors are observed as large-sized clusters, and are classified as atypical tumors known as glomangiomatosis. While surgical excision is the accepted standard of care, this proves difficult because of the tumors' large size and satellite lesions. We present the successful treatment of asymptomatic glomangiomatosis is situated on the left flank area by a combination of surgical excision and pulsed dye laser, which minimized the risk of scar formation.
Cicatrix ; Glomus Tumor ; Lasers, Dye* ; Palpation ; Standard of Care

Among various types of supernumerary nipples, intra-areolar polythelia (IAP) is an extremely rare congenital malformation. The authors report a case of a young woman with unilateral IAP on her right breast. The patient was 24 years old; she had had it since she was 5 or 6 years old, and it had enlarged 3 to 4 years before presentation to our clinic. Surgical excision was performed under local anesthesia as a prophylaxis against breast cancer and cosmetic problems.
Anesthesia, Local ; Breast ; Breast Neoplasms ; Female ; Humans ; Nipples ; Reconstructive Surgical Procedures

The umbilicus is of paramount aesthetic importance for the abdomen, and its absence can be psychologically distressing to patients for cosmetic reasons. An aesthetically-pleasing umbilicus tends to be small and vertically oriented in nature, with superior hooding and shadow, inferior retraction and slope, and a position at the topmost level of the iliac crest. A 42-year-old woman had undergone delayed breast reconstruction using a transverse rectus abdominis myocutaneous (TRAM) flap. Unfortunately, the patient developed umbilical necrosis following surgery. She underwent complete surgical debridement, which resulted in a large vertical scar. Delayed umbilical reconstruction was performed with four transposition flaps. The patient underwent follow-up at 11 months postoperatively, and the umbilicus had a satisfactory appearance. This case shows that using four transposition flaps can yield sufficient depth and an aesthetically pleasing shape for the umbilicus.
Abdomen ; Abdominoplasty ; Adult ; Cicatrix ; Debridement ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Necrosis ; Rectus Abdominis ; Surgical Flaps ; Umbilicus

A 6-year-old female presented to our hospital with clitoromegaly. On physical examination, she demonstrated evidence of precocious pubic hair and clitoromegaly. The relaxed clitoris measured 3.7 cm in length. Her uterus was undetectable on diagnostic transvaginal ultrasonography and abdomen-pelvis computed tomography (CT) with otherwise normal-appearing internal female genitalia. We planned reduction clitoroplasty with preservation of the dorsal neurovascular pedicle to maintain sensitivity of the glans clitoris. After surgery, the patient demonstrated good recovery. The parents of the patient were satisfied with the surgical results. The patient was discharged without complications on hospital day 6.
Child* ; Clitoris ; Female* ; Genitalia, Female ; Hair ; Humans ; Parents ; Physical Examination ; Ultrasonography ; Uterus

Many injection materials have been used in cosmetic surgery for soft-tissue contour correction or breast augmentation. In China, Amazingel injection mammaplasty had been used widely because the procedure was non-invasive and easy to perform. But, numerous complications have been reported after injection of Amazingel composed of polyacrylamide gel such as breast pain, hardening, deformity, lump, gel migration, etc. In this article, we report a case of a 37-year-old Chinese female who complained of breast discomfort and deformity after Amazingel injection. We safely eliminated Amazingel and reconstructed the breasts with silicone implants. We could achieve aesthetically tolerable results.
Adult ; Asian Continental Ancestry Group ; Breast Implants ; Breast* ; China ; Congenital Abnormalities ; Female ; Humans ; Hydrogel* ; Mammaplasty ; Mastodynia ; Silicon ; Silicones ; Surgery, Plastic

BACKGROUND: There has been increasing interest in facial contouring procedures throughout Asian countries. As such, botulinum toxin A injections for masseteric hypertrophy have become a common procedure provided to patients who desire non-surgical correction of a square-angled mandible. We published a retrospective review of our initial results and our technique and treatment protocol in 2005. We also completed a long-term follow-up of the results (average follow-up period of 4.28 years) and the efficacy of repeated injections in 2010. The purpose of the current study is to systematically evaluate the changes to the masseter muscle at weekly intervals to determine the physiologic effects of botulinum toxin A injection. METHODS: Eight patients were prospectively followed on a weekly basis after botulinum toxin A injection for masseteric hypertrophy. Eight patients were followed for 15 weeks and four patients were followed for 25 weeks. Changes in the thickness of the muscle were recorded and analyzed. RESULTS: A reduction in the muscle thickness was found during the clenching phase of the muscle in the first week followed by a reduction in thickness during the resting phase in the second week. The reduction in muscle thickness continued until the eleventh week after which there was a gradual, but incomplete, return of muscle thickness over the study period. CONCLUSIONS: There is a predictable, phasic reduction in muscle thickness after botulinum toxin A injection for masseteric hypertrophy. This reduction first occurs during the clenching phase followed by a concomitant reduction during the resting phase. Maximal size reduction occurs at 11 weeks followed by gradual muscle size recovery.
Asian Continental Ancestry Group ; Botulinum Toxins* ; Botulinum Toxins, Type A* ; Clinical Protocols ; Follow-Up Studies ; G0 Phase ; Humans ; Hypertrophy* ; Mandible ; Masseter Muscle* ; Nerve Block ; Prospective Studies ; Retrospective Studies

BACKGROUND: Patients with deviated nose frequently present concomitant nasal bone as well as septal deviation. Many surgical methods have been developed to address such septal deviation, along with various osteotomy techniques to correct bone deviation. The authors performed medial and paramedian osteotomies to treat deviated nose with mild hump, and utilized the acquired wedge shaped bone graft to achieve septal reposition and bony vault correction. METHODS: From October 2014 through June 2015, 10 patients with nasal bone deviation that showed sufficient lateral nasal wall angle but deviated dorsum and septum on their preoperative facial computed tomography were included in this study. The authors performed open rhinoplasty to expose the planned osteotomy site, and conducted medial and paramedian osteotomy that resulted in the separation of a wedge-shaped bone fragment. Bony septum deviation was then treated with the swing door maneuver, and the resected 2 to 3 mm portion of the nasal bone was stabilized by inserting the wedge-shaped bone graft acquired from the previous osteotomy procedures. Consecutive clinical examinations were followed on postoperative 1, 3, and 6 months to observe any recurrences. RESULTS: All patients were satisfied with their surgical results, and no recurrent deviations were noted. CONCLUSIONS: Precise bone resection and transposition is essential for a successful corrective rhinoplasty. However, medial and lateral osteotomy are not mandatory procedures in all cases, and the nasal wedge bone graft that was utilized to support the treated septal bone may have aided in sustaining the surgical correction.
Bone Transplantation ; Humans ; Nasal Bone ; Nose* ; Osteotomy* ; Recurrence ; Rhinoplasty* ; Transplants*

BACKGROUND: The neck is not only the first area to show aging but it also represents the persona of the individual. The understanding of the aging process of the neck is essential for neck rejuvenation. The purpose of this study was to evaluate the outcomes and safety of elastic lift in relation to neck region lifting. METHODS: Forty-seven patients with sagging and laxity of the neck skin treated by elastic lift were enrolled in this study from November 2015 to February 2016. To evaluate the safety of elastic lift, a retrospective chart review was conducted. We used an automatic skin diagnosis system to evaluate the efficacy of elastic lift. RESULTS: Forty-five patients were female and 2 patients were male. The mean age of the patients was 45.3 years and their mean follow-up period was 3 months. There were no major complications requiring the removal of the elastic thread during the follow-up period. The median skin laxity grade score was 5 (4-5) preoperatively; the median skin laxity grade score was 3 at 3 months postoperatively. In comparing the skin grade score at these two points in time, there was a statistically significant difference (P < 0.01). CONCLUSIONS: Neck rejuvenation using elastic lift is a safe and effective procedure in selected patients with moderate sagging and laxity of the neck skin.
Aging ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Lifting ; Male ; Neck* ; Rejuvenation* ; Retrospective Studies ; Skin

BACKGROUND: Accessory tragus is an abnormal ear structure that has the shape of a nodule or a papule. The existing surgical method is very simple, wherein an elliptical incision is made around the lesion and the underlying cartilage is removed. However, this method may leave a depressed or dimpled scar and may cause chondrodermatitis. METHODS: We corrected the accessory tragus by a new method using triangular flaps, and the procedure was performed in eight patients. Out of the four triangular flaps, which were created by drawing lines that connected the left and the right sides and the superior and inferior surfaces of the accessory tragus and quartering them, two flaps that faced each other were excised. Once the cartilaginous tissue inside was verified and removed up to the base to the greatest extent possible, the remaining two triangular flaps were sutured and the remaining skin margin of the flap was trimmed. RESULTS: None of the patients had any wound problems related to the surgery, and none of them complained of chondrodermatitis up to 6 months postoperatively. No depression or dimple was observed externally up to 6 months after the operation, and the z-shaped scar, which was created by the crossing over of the triangular flaps, was not as visible as a linear scar. CONCLUSIONS: Correction of an accessory tragus by using the triangular flaps introduced in this study provides a wider operative view through a smaller incision, while preventing the formation of dimples or a depression after the operation.
Branchial Region ; Cartilage ; Cicatrix ; Congenital Abnormalities ; Crossing Over, Genetic ; Depression ; Ear ; Humans ; Methods* ; Skin ; Surgical Flaps ; Wounds and Injuries