Routine preoperative tests such as BT/CT, PT/PTT and CBC, could not test abnormal hemostasis that take drugs and health functional food. We used platelet function analyzer (PFA(R))-100, to evaluate preoperative bleeding tendencies. From November 2008 to February 2010, 306 surgical patients were tested preoperative PFA in our hospital. There are 2 tests in PFA(R)-100. The Pre Operative EPI (collagen/epinephrine) assay tests extrinsic platelet function, whereas the Pre Operative ADP (collagen/adenosine diphosphate) assay tests intrinsic platelet function. We divided normal and abnormal groups by the PFA(R)-100 assay tests. If either of results were abnormal in the two tests, the patient was divided to the abnormal group. 306 surgical patients were observed with hemorrhagic complications. All of the patients were divided normal and abnormal groups by the PFA(R)-100 test result. The normal group was made up of 286 (93.5%) patients, the abnormal group was made up of 20 (6.5%) patients. We observed each group hemorrhage complication including sever echymosis and hematoma, and analyzed each group complication rate. There were 9 (3.1%) cases of complication in the normal group. There were 3 (15.0%) cases of complication in the abnormal group. To evaluate preoperative bleeding tendency, PFA(R)-100 can be complementary examination with previous routine blood coagulation tests.
Adenosine Diphosphate ; Blood Coagulation Tests ; Blood Platelets ; Functional Food ; Hematoma ; Hemorrhage ; Hemostasis ; Herbal Medicine ; Humans ; Platelet Function Tests ; von Willebrand Diseases

Facial rejuvenation using Botulinum toxin A is one of the most popular aesthetic procedures. Many cosmetic applications of Botulinum toxin A are under evaluation. Intradermal injection of Botulinum toxin A is a variation of the intramuscular injection technique and remains relatively new technique. This evaluates the effects of intradermal injection of Botulinum Toxin A on facial wrinkle lines. Thirty patients were included to undergo intradermal injections of Botulinum toxin A on forehead, cheek and periorbital area. Three sessions of injection were performed for 10 days. Clinical photograpahs were taken for 24 weeks, and evaluated patient's satisfaction and objective improvement of facial wrinkle lines. Improvement in patient's satisfaction and facial wrinkle line was noted in the post-treatment photographs. This effect was lasted for about 12 weeks. The intradermal injection of Botulinum toxin A is effective method for facial rejuvenation without obvious side effects.
Botulinum Toxins ; Cheek ; Cosmetics ; Forehead ; Humans ; Injections, Intradermal ; Injections, Intramuscular ; Rejuvenation

Blepharoptosis patients use frontalis muscle unconsciously to widen eye, and it results in several aesthetic problems-such as forehead wrinkling and elevated eyebrow. So forehead wrinkling and elevated eyebrow can be resolved with correction of blepharoptosis. We evaluated the change of eyebrow height in 30 patients who were corrected blepharoptosis through photogrammetry. The mean age of the patients was 36.8 years old and the mean follow up periods were 6 months. Horizontal line passing medial and lateral canthal corner in both eyes was drawn in Photopshop. From the horizontal line, 3 vertical lines perpendicular to this line were drawn passing medial and lateral canthal corner and the vertically oriented center of the pupil. Eyebrow height was measured through these 3 vertical lines. The average length of decreased value of the eyebrow height were 3.64 mm in H1, 3.31 mm in H2, 2.79 mm in H3. In unilateral cases, 2.42 mm in H1, 2.86 mm in H2, 2.78 mm in H3, and in bilateral cases, the decreased values were 4.25 mm in H1, 3.53 mm in H2, 2.79 mm in H3. From this study, the author would like to introduce the method to calculate the changes of eyebrow height after blepharoptosis correction and the values objectively.
Blepharoptosis ; Eye ; Eyebrows ; Follow-Up Studies ; Forehead ; Humans ; Muscles ; Photogrammetry ; Pupil

Cryptotia is a rare congenital anomaly among Caucasian but more common auricular malformation in Asia. Cryptotia characterized by the anterosuperior portion of the auricle lying beneath mastoid skin. From May of 2005 to May of 2010, three cryptotia were operated on. We use mastoid fasciocutaneous flap (MFF) raised from mastoid region and post-auricular area. And two triangular flaps (TF) which are raised from temporal region can release tension of skin and cover defect of skin. Note that two-thirds of the skin paddle should be taken from the mastoid region. After ear release, MFF and two TF are rotated into the defect. For appropriate correction of the cartilage deformity, the conchal cartilage should be pulled cephalad and fixed to the temporal periosteum. All the patients had a satisfaction for operation. There was no case of partial or full through skin necrosis. There was no wound dehiscence and relapse. The mastoid fasciocutaneous flap is a simple technique, retaining the depth of the auriculocephalic sulcus. This technique can correct deformity of cartilage at same time. There was no distorting hair line, skin color dismatching, visible scar and wound dehiscence.
Asia ; Cartilage ; Cicatrix ; Congenital Abnormalities ; Deception ; Ear ; Hair ; Humans ; Mastoid ; Necrosis ; Periosteum ; Recurrence ; Skin

People with ordinary faces want their faces more attractive, and thus various attempts have been made to reduce the size of the upper and lower face. We therefore have designed the shortening foreheadplasty, in which an excision was made on the part of the upper face skin using a trichophytic incision and the defect was widely avulsed and pulled forward down to be sutured. Participants included 115 patients who had visited our hospitals from January 2006 to June 2012. As a preoperative evaluation, we performed a gliding test to decide the size of the forehead skin laxity. As an operation method, a zigzag incision was designed and the skin was excised using a trichophytic incision, and the scalp flap was fixed using Endotine(R). Of a total of 115 patients, the shortening of forehead was in the range of 7mm to 20mm with the average 14.19mm. In order to help patients have small faces that meet the condition for the beauty, we performed a shortening foreheadplasty. In this surgery, the forehead skin was excised using a trichophytic incision and the scalp flap was dissected in the subgaleal plane, we could obtain favorable outcomes by minimizing the tension by sufficiently avulsing the scalp flap after the incision and fixing the flap with Endotine(R), and minimizing the formation of postoperative scar.
Beauty ; Cicatrix ; Forehead ; Humans ; Scalp ; Skin ; Surgical Flaps

Structural micro-fat graft is one of the surgical techniques for facial rejuvenation, and it is reliable for correction of sunken upper eyelids especially. However, several factors may influence surgical outcomes substancially. The author introduces the modified micro-fat graft to correct sunken eyelids and multiple eyelid folds to make better results. A series of 162 patients who underwent the refined structural micro-fat graft were included in this study. The purified fat was injected into the subcutaneous and sub-orbicularis oculi muscle layer of the upper eyelids through the 19-gauge cannula with 1 ml syringe. After the operation, all patients were followed up on 2 weeks, 1 month, 3 months, 6months, and 1 year. Clinical photographs were taken every visit and the author evaluated the volume and symmetry of the eyelids and checked the satisfaction of each patient and any complications. Among the 162 patients, 156 patients were satisfied with the upper eyelid volume after primary fat graft and other 6 patients were performed secondary fat graft. Even though the volume of the fat was sufficient, 4 patients showed palpable fat nodule during the follow-up period. Modified micro-fat graft is a simple, safe, and alternative method to correct sunken eyelids and multiple eyelid folds.
Blepharoplasty ; Catheters ; Eyelids ; Follow-Up Studies ; Humans ; Muscles ; Rejuvenation ; Syringes ; Transplants

Today, adipose tissue derived mesenchymal stem cells (ADSC) have gained a great interest in various medical fields due to the characteristics of its self-renewal and multilineage differentiation capacity. The stromal vascular fraction (SVF) of adipose tissue is known to contain mesenchymal stem cells and it is obtained by processing the lipoaspirate which is usually collected from tumescent liposuction. In this study, we reviewed the records of patient epidemiology and results of SVF isolation. 30 patients (8 males and 22 females) had been underwent tumescent liposuction between April 2012 and January 2013, and the collected lipoaspirates were processed to isolate SVF in GMP facility in CHA Bundang Medical Center. The average stem cell count per 1 cc of lipoaspirate was 52,252 +/- 26,704 and cell count including red blood cells per 1cc of lipoaspirate was 970,607 +/- 873,436. The stem cell viability was proven to be 84 +/- 4%. Bacteria were not detected in all the SVF samples. Compared to previous reports concerning the yield of SVF, our results coincide well with the results of previous studies. Because there were no domestic report about the yield and viability of SVF, this report may provide a reference value of the Korean SVF for the clinicians who want to use SVF as a therapeutic purpose.
Adipose Tissue ; Adult Stem Cells ; Bacteria ; Cell Count ; Erythrocytes ; Humans ; Lipectomy ; Male ; Mesenchymal Stromal Cells ; Reference Values ; Stem Cells

Augmentation mammoplasty with anatomical breast implant, which was first introduced in Korea in February 2012, is expected to increase along with the round implant. This study reports the early experience of a single surgeon with this implant to Korean female patients. A total of one hundred patients who performed augmentation mammoplasty with Replicon(R) (POLYTECH Health & Aesthetics, Dieburg, Germany), a kind of anatomical breast implant, from February 2012 to August 2012 were studied. Patient's satisfaction with breast shape and touch was assessed using linear analogue scales with a maximum score of 5. All of the patients received augmentation mammoplasty for cosmetic purpose. Ninety-one patients were satisfied with their results. Neither implant malrotation nor capsular contracture was checked during the average follow up period of 7.9 months. Even though it is a preliminary report of early studies, we can see that anatomical implant is suitable for Korean female patients who have small breast, mild ptotic breast and constricted lower pole, given that anatomical implant proved excellent results in this studies.
Breast ; Breast Implantation ; Breast Implants ; Contracture ; Cosmetics ; Esthetics ; Female ; Follow-Up Studies ; Humans ; Korea ; Mammaplasty ; Weights and Measures

Breast augmentation of ptotic micromastia is relatively difficult procedure than simple augmentation. Surgeon must make into account many variables, ptosis degree, chest wall size, shape, asymmetry, nipple and inframammary fold level, soft tissue characteristic etc. One-stage mastopexy augmentation procedure has higher patient acceptance because this limits the number of sick days and the need for hospital care, and it is also less expensive. Because of two procedures that has opposite effect to soft tissue be done in the same time, there can be high incidence of unfavorable outcomes and complications. Some well known doctors recommend that 2-step procedure of mastopexy folllowed by augmentation can be much better option. It can make more predictable result and it is also safe in soft tissue problem and vascularity. In one stage augmentation mastopexy, high and extrahigh projection implants have often been promoted for augmenting glandular ptotic breast, emphasizing the role of implant projection to the sagging parenchyma and skin of lower pole of breast anteriorly to "lift" the breast and "correct" the ptosis. High and extra high profile implants may contribute projection, but they are not the best choice for correction of glandular ptosis. It has several negatives, additional parenchymal atrophy, lower pole skin stretch and thinning and visible and palpable rippling. All of these tissue consequences are irreversible and uncorrectable. Optimal implant design for augmentation of glandular ptotic breast is full height, moderate profile, shaped, textured, form stable implant.
Atrophy ; Breast ; Breast Implants ; Female ; Humans ; Incidence ; Mammaplasty ; Models, Anatomic ; Nipples ; Sick Leave ; Silicone Gels ; Skin ; Thoracic Wall

The Natrelle(TM) 410 (Allergan Inc., Irvine, CA, USA) shaped, form-stable silicone gel implant was introduced in Europe in 1993. Its "form stability" relates to increased cohesiveness or stiffness of the gel filler, allowing the implant to maintain its shape in the upright position. The anatomical form-stable implant is helpful for reducing ripples and provides more natural looking due to less upper pole fullness, so it has some benefits for the thin patients. And it provides more expansion to the lower pole, it has also benefits for the ptotic breasts or constricted breasts. I have experienced 69 cases with anatomical form-stable implants (52 Polytech Replicon(R) (POLYTECH Health & Aesthetics, Dieburg, Germany) implants, 85 Natrelle(TM) 410 implants) from February to December of 2012. The most common used implants are MF295 g of Natrelle(TM) 410 and high profile 315 g of Polytech Replicon(R). I did reoperations for 2 breasts of 2 patients. One was due to hematoma and the other was due to displacement. Both cases are my early experiences of shaped implants. There is no other complication yet. I need longer follow-up period for the appropriate evaluation. In my early experiences, the results of anatomical form-stable implants seem to make less fullness of upper pole, less ripples, more tightness, and similar recovery periods in contrast with the results of round textured implants.
Breast ; Breast Implants ; Displacement (Psychology) ; Esthetics ; Europe ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Mammaplasty ; Models, Anatomic ; Silicone Gels