There is more incidence of epicanthal fold in oriental and sometimes the epicanthal fold serves as an unacceptable appearence, so many seek cosmetic improvement in the medial canthal area to eliminate the epicanthal folds. Epicanthoplasty can give the aesthetic improvement by lenthening the palpebral fissure, thus producing the image of a larger and open-eye and especially it can enhance the aesthetic result of the double-lid procedure, but the epicanthal area is delicate and prone to produce a noticeable scar after epicanthoplasty, which is due to multiple incision and undue tension during the epicanthoplasty. We present a simple, tension free, and reproducible method of Z-epicanthoplasty based on our experience with 84 cases performed during the past 10 months in oriental eyelids. The advantages of this procedure are simplicity in design and minimal scaring produced in the medial canthal area without fear of hypertrophic scar as compared with complexed W-plasty, four flap, or Y-V plasty, which require multiple incision or undue tension and often creates unsightly scarring.
Cicatrix ; Cicatrix, Hypertrophic ; Eyelids ; Incidence

No abstract available.
Cicatrix, Hypertrophic* ; Skin*

No abstract available.
Cicatrix, Hypertrophic ; Toes

No abstract available.
Carcinoma, Basal Cell ; Cicatrix, Hypertrophic

No abstract available.
Carcinoma, Basal Cell ; Cicatrix, Hypertrophic

Burns ; complications ; Cicatrix, Hypertrophic ; therapy ; Humans

PURPOSE: We evaluated the surgical correction for upper lid epiblepharon and epicanthal fold. METHODS: Epiblepharon repair of the upper lid and epicanthoplasty were performed for patients who had a significant epicanthal fold, by which resultant cilia-cornea touch would be expected of the epiblepharon repair alone. From June, 1998 to February, 2004, 21 patients were operated on and 7 of the patients had Down's syndrome. RESULTS: The mean age of the patients at the time of the surgery was 8.6 years. In all the patients, the epicanthal folds were type 3, according to the Park's classification. Thirteen patients, including Down's syndrome patients, underwent modified Y-V advancement and eight patients underwent root Z-epicanthoplasty. The cilia-cornea touch was relieved in all of the patients except for those with Down's syndrome. Hypertrophic scar was seen in 7 patients with modified Y-V advancement and in 1 patient with root Z-epicanthoplasty until postoperative 3 months. CONCLUSIONS: Epiblepharon repair along with epicanthoplasty was effective in relieving cilia-cornea touch in children with upper lid epiblepharon and significant epicanthal fold. Root Z-epicanthoplasty can be recommended for growing children, considering that it provides moderate degree epicanthal correction and does not leave noticeable scar.
Child* ; Cicatrix ; Cicatrix, Hypertrophic ; Classification ; Down Syndrome ; Humans

BACKGOUND: Pulsed dye laser (PDL) is recommended as a good treatment for scars and keloids. However, there has been no absolute indications and standard laser parameters. Some proposed that only hypertrophic and atrophic/flat scars were effectively treated, but others reported that all scars and even keloids responded well to PDL treatment. OBJECTIVE: To determine whether 595nm PDL treatment is effective for scars and keloids, and if so, which group responds better to treatment between the atrophic/flat scars group and hypertropic scars/keloids group. METHOD: Twenty-two patients (skin types III-V) with scars and keloids were treated with 595nm PDL (0.45 or 1.5 msec, 4-8J/cm(2), 7mm spot size). Eleven patients had hypertrophic scars/keloids (6 had hypertropic scars, 5 had keloids), and eleven patients had atrophic/flat scars. After several treatments of each lesion, the results were evaluated by extent of the patient's satisfaction and comparision of pre-and post-laser photography and divided into the four categories: excellent, good, fair and poor. RESULTS: The clinical improvement and patient's satisfaction were better in the atrophic/flat scars group than the hypertrophic scars/keloid group. With keloid potients, the result of treatment were found to be particularly poor. CONCLUSION: From our results, only atrophic/flat scars respond well to 595nm PDL treatment, and hypertrophic scars and keloids should be excluded from this treatments method.
Cicatrix* ; Cicatrix, Hypertrophic ; Humans ; Keloid* ; Lasers, Dye* ; Photography

PURPOSE: Pressure garment is the most effective tool in treatment of burn scar hypertrophy. But most patients feel discomfort to pressure garment. So tubular compressive bandage (TCB; Tubifast™) is widely used as a substitute. We checked daily pressure of tubular pressure bandage for 6 days and tried to find out the proper use. METHODS: Three doctors and two nurses were included in this study. They wore the TCB on both arms. One arm worn with one layer and the other arm with two layers. For six days, we checked the average pressure on arm and forearm with Picopress®. We used the SPSS (PASW statistics 18) as a statistics. RESULTS: During the first three days the pressure was markedly declined on both arm and forearm when with two layers. After then the pressure showed plateau. But one layer showed slow and continuous declining. The plateau pressure was above 10 mmHg with two layers and below 7 mmHg with one layer. CONCLUSION: Wearing the tubular compressive bandage (TCB; Tubifast™) is better with two layers than one layer and must be changed it in every 4 days.
Arm ; Bandages* ; Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Clothing ; Forearm ; Humans ; Hypertrophy

BACKGROUND: Triple advancement flap has been recently introduced to close the skin defect after Mohs microscopic surgery. OBJECTIVE: The aim of this study is to evaluate the clinical advantage of the modified triple advancement flap compared with rhomboid excision and closure. METHODS: The modified triple advancement flap was performed on nine patients with skin cancer. We observed the clinical course after surgery and compared the scar length and the amount of removed normal skin in triple advancement flap with those in rhomboid excision and primary closure, by using an image-analyzing program. RESULTS: The overall cosmetic and functional result was good. Partial flap necrosis was detected in one of nine patients, and hypertrophic scar developed in one of nine patients. The average scar length from the modified triple advancement flap was 102.1 mm, whereas it was 95.0 and 111.0 mm in 1:3 and 1:3.5 rhomboid excision with closure. The amount of removed skin was 716.3 mm2 in modified triple advancement flap, whereas it was 794.0 mm2 (1:3) and 1116.9 mm2 (1:3.5) in rhomboid excision with closure. CONCLUSION: The triple advancement flap might be used to close a defect in the area of trifurcation or bifurcation of skin tension lines, to spare the normal surrounding tissue as much as possible.
Cicatrix ; Cicatrix, Hypertrophic ; Humans ; Necrosis ; Skin Neoplasms ; Skin*