In cryptotia the upper part of the auricle is buried beneath the temporal scalp, so the upper auriculocephalic sulcus is absent and auricular cartilage deformity is accompanied. The goals of surgical correction of cryptotia are to release the upper ear from temporal scalp to restore auriculocephalic sulcus, and to correct the cartilage deformity. Authors have experienced 23 auricles in 14 patients with cryptotia to correct cryptotia using lotus flower shaped V-Y advancement flap for the upper auricular skin deficiency and scoring for cartilage deformity. Lotus flower shaped flap is designed above superior pole of auricle. Designed flap has wider lower third than conventional V-Y flap. After complete exposure of upper auricular cartilage, cartilage deformity is corrected by scorings on lateral surface of the scapha and medial surface of the superior crus of antihelix. For construction of auriculocephalic sulcus, the flap is advanced inferiorly about 1 cm and 3 stab incisions on the flap are made at the expected auriculocephalic sulcus. The cinch suture is done between dermal layer of the stab incisions and auriculocephalic sulcus cartilage with 4-0 Prolene . Packing gauze is tied at corrected scapha for contour maintenance. A satisfactory contour of scapha and antihelical crus and deep auriculocephalic sulcus were maintained postoperatively. However, hypertrophic scar formation was found due to tension. Our method is similar to Ono's method in triangular flap shape. But the lotus flower shaped flap has wider lower 1/3 than Ono's triangular flap and provides sufficient skin for formation of auriculocephalic sulcus without additional rhomboid flap elevation in front of the ear.
Cartilage ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Ear ; Ear Cartilage ; Flowers* ; Humans ; Lotus* ; Polypropylenes ; Scalp ; Skin ; Sutures*

The purpose of this article is to review the past history of hand surgery briefly and to overview of a vision of hand surgery over next generations in republic of Korea. There were three characteristics of the past history of digit replantation in Korea. Due to the tremendous use of press machine, the replantation surgery for finger amputation had been developed rapidly from 1980's to 1990's period. Also new microsurgery techniques had been introduced such as toe pulp free flap for digit reconstruction. These techniques had been developed based on the medical health insurance system for the factory employees. Future of hand surgery in Korea can be anticipated as followings: operative microscopy and robotics may help surgeons to anastomosis very tiny micro-vessels; the functional recovery of fingers and hands will be more important; incidence of degenerative disease, musculoskeletal system disorder due to excessive use and injury during sports will increase; new materials such as artificial joint will be used more frequently according to the innovation of tissue engineering and regenerative medicine; specialist system for hand surgeon will be settled. Since there are a lot of hand surgeon who has a mission to alleviate patient's pain and injury, there will be a continuous growth of hand surgery in Korea.
Amputation ; Family Characteristics ; Fingers ; Free Tissue Flaps ; Hand ; Humans ; Incidence ; Insurance, Health ; Joints ; Korea ; Microscopy ; Microsurgery ; Missions and Missionaries ; Musculoskeletal Diseases ; Replantation ; Republic of Korea ; Robotics ; Specialization ; Sports ; Tissue Engineering ; Toes ; Vision, Ocular

The inferior pyramidal dermal technique has many advantages in various reduction mammoplasty procedures. It has been possible to increase the amount of breast tissue removed, which enhances the quality of the final result. However, the main disadvantage of this method is the large and long reverse T scars, particularly in Asian women. Twenty breasts of 10 patients, who underwent an operation by the inferior pyramidal dermal technique with several modification from March 1989 to March 2001 were followed up. The mean age was 35 and the mean follow up period was 5.5 years. The mean resection amount was 692 gm per breast. In order to prevent a boxy breast, the inferior margin of the medial flap had a gentle curve, and the lateral flap had a "lazy S" contour. A small triangle of the skin was leaved with its base on the inframammary fold to relieve the T-junctional tension. In order to ensure nipple projection, the skin was deepithelialized at the recipient site for the relocated nipple-areola complex and 2 cm around areola. Because the vascular supply to the nipple-areola complex of the pyramidal flap was derived from the intercostal perforating vessels, the full-thickness removal of the skin from the pyramidal flap was made to reduce the operation time. A sufficient parenchyma resection beneath the lateral flap was performed to minimize a boxy breast. A postoperative hyperpigmented scar became light after 2 years and was inconspicuous after 3 years. An immediate postoperative boxy breast was noticed. However, it has been observed that there was gradual increase in the distance from the inframammary fold to the areola, because of the descent of the breast parenchyma due to gravity, along with the displacement of the nipple-areola complex superiorly. It is believed that this problem can be overcome by pedicle trimming, medial and superior fixation sutures with the nipple areola complex 1-2cm being situated below the expected position.
Asian Continental Ancestry Group ; Breast ; Cicatrix ; Female ; Follow-Up Studies* ; Gravitation ; Humans ; Mammaplasty ; Nipples ; Skin ; Sutures