Forehead deep wrinkles make man's face ugly. Especially, in case that a young people has short forehead, one or two forehead deep wrinkles is likely go give a aggressive impression to people. Traditional forehead lift basically not only perfrom the selective excision of frontalis muscle which cause forehead wrinkles, but extend the width of forehead by practical lift through scalp excision. Recently, various filling materials such as collagen have been developing, and laser resurfacing and endoscopic plastic surgery has gradually been generalized, so the frequency of the traditional forehead lift which needs the extensive operation through coronal incision is gradually diminished. But collagen injection is repeatedly taken every regular times and it has a weak point that the width of forehead cannot be regulated. Laser resurfacing can't solve the problem of deep wrinkles. The purpose of endoscopic brow lift which has been generalized currently is mainly brow lift, and so this method is not good for deep wrinkles because it can't modualte frontalis muscle which cause forehead transverse wrinkles. Recently it has been reported that Alloderm composed of dermal collagen from cadavar skin is universally used in covering as well as filling up soft tissue defect and its usability is also successful. Authors recently correct three young persons who have forehead deep wrinkles by combination of endoscopic forehead lift and subcutaneous Alloderm implantation under the wrinkles for 2 years. At first, we extended the width of forehead and smoothed the depth of wrinkles by endoscopic brow lift. After having endoscopic operation, we inserted Alloderm in subcutaneous pocket and performed suspension suture outside. The average increase of forehead width is 5 mm and all patients had corrected transverse wrinkles remarkably. During the 9 months, wrinkles didn't recur and implanted Alloderm also didn't absorbed. As a better method, authors reported that combining endoscopic brow lift with Alloderm implantation for the correction of short forehead and deep wrinkles could be used in place of traditional forehead lift.
Collagen ; Forehead* ; Humans ; Scalp ; Skin ; Surgery, Plastic ; Sutures

Flap survival is critical to the success in reconstructive surgery, there have been many investigations to increase the blood supply to the flaps such as surgical delay and pharmacologic delay. Prostaglandin(PG) is released from various tissues including blood vessel in response to physical stimulus. Among the Prostaglandins, PGE1 has been proven to be a vasodilatation property and many authors have demonstrated its effect to increase blood supply after random cutaneous flap surgery. Clinically, however, muscle flap or musculocutaneous flap is more significantly used in reconstructive surgery and hemodynamic effects of PGE1 of this type of flap are still not documented. The authors designed the random muscle flap to study the hemodynamic effects of PGE1 of the muscle flap. Superior based rectus muscle flap was elevated from rats and the superior epigastric artery, its major vascular pedicle, was ligated to create the random-type muscle flap. Twenty two rats were divided into two experimental groups and each group had 11 rats; Group I: No drugs Group II: PGE1 injection group for 7 postoperative days intraperitoneally The average muscle flap survival rate of group I was 46+/-3.0 precent and it had a higher survival rate than the control group(23+/-4.3%). The muscle flap survival rates showed significant differences between the two groups (p< 0.005) This study shows that the administration of the PGE1, in clinical usage of the rare random muscle flap with a pedicle injury or musculocutaneous flap with the risk of distal cutaneous flap necrosis, such as TRAM flap, which might be much safer and popular.
Alprostadil ; Animals ; Blood Vessels ; Epigastric Arteries ; Hemodynamics ; Myocutaneous Flap ; Necrosis ; Prostaglandins ; Rats* ; Rectus Abdominis* ; Survival Rate ; Vasodilation

Background: In Asian women who undergo facelift procedures, satisfying results are achieved for facial rhytides, but sometimes there are postoperative complaints concerning the mandibular angle. Unlike Caucasians, Asians generally have a prominent mandibular angle. Accordingly, bone contouring surgery must be considered, since the bones of the face serve as the frame for facelift surgery. We investigated the effects of simultaneously performing mandibular angle reduction and facelift to achieve an oval facial contour and a youthful face. Methods: We evaluated 17 Asian women who simultaneously underwent mandibular angle reduction and facelift between April 2016 and May 2018. The clinical results were assessed based on preoperative and postoperative photographs and the Global Aesthetic Improvement Scale. Results: Surgery was successful in all cases. Postoperatively, improvements in facial rhytides and appropriate mandibular contours were achieved. All patients were satisfied with the outcomes. Some patients experienced short-term complications, such as hematoma and numbness of the skin above the incision line; however, these complications improved. Serious long-term complications were not noted. Conclusions Highly satisfying outcomes can be achieved with combined mandibular angle reduction and facelift for Asian women with a wide and rectangular face.

Background: In Asian women who undergo facelift surgery, satisfactory results are typically achieved with regard to facial rhytides, but concerns have been reported regarding the postoperative appearance of the malar prominence region. Anatomically, compared to Caucasians, Asians have thick skin and a wide and short facial geometry. Asians generally exhibit zygomatic protrusion; accordingly, bone contouring surgery, which alters the base frame used in a facelift, should be considered. We aimed to investigate the effects of simultaneous reduction malarplasty and facelift to achieve appropriate malar repositioning and a youthful-looking face. Methods: We assessed 16 Asian women who underwent simultaneous reduction malarplasty and facelift between March 2014 and March 2018. The clinical results were assessed based on preoperative and postoperative photographs and Global Aesthetic Improvement Scale scores. Results: Surgery was successful in all cases. Postoperative improvement with regard to facial rhytides and appropriate malar repositioning were achieved. All patients were satisfied with the outcomes. Some patients experienced short-term complications, but their conditions improved. Serious long-term complications were not noted. Conclusions Highly satisfactory outcomes can be achieved with combined reduction malarplasty and facelift for Asian women with wide faces.

Untill now, dermofat graft has usually been used for repair or supplement of soft tissue for cosmetic cause. Generally, scar in the center portion of neck, left after tracheostomy, may cause skin traction and discomfort during swallowing due to adhesion in trachea or cricoid cartilage in high rates. In these cases, usual scar revision techniques maybe cannot correct the skin retraction and swallowing discomfort. We, therefore, solved the problems of skin traction and discomfort during swallowing, by first removing the preexisting scar in the center portion of neck, then, dissecting the surroundings after performing autodermofat graft. From September 2002 to September 2003, we performed autodermofat graft in 6 cases having skin traction and discomfort during swallowing. In all cases, symptoms were resolved, and adverse effects of infection, hematoma and calcifications did not occur. In the results of 10 months follow-up, there were no recurrence and cosmetic and functional results were acceptable.
Cicatrix* ; Cricoid Cartilage ; Deglutition ; Follow-Up Studies ; Hematoma ; Neck* ; Recurrence ; Skin ; Trachea ; Tracheostomy ; Traction ; Transplants*

PURPOSE: The number of coronary interventions is increasing in Korea. Medical team tend to underestimate the radiation that is used during coronary interventions. For this reason if a person who underwent coronary intervention are less likely to be diagnosed with chronic radiodermatitis. METHODS: From March 1, 2012 to February 28, 2017, patients who had a history of coronary intervention visited our plastic surgery clinic with chronic ulceration on the back, shoulders, and scapula. Subjects were classified by age, sex, lesion location, size, medication, time of exposure, onset after last exposure, treatment method, complication, and recurrence. RESULTS: 5 cases were reported, two in the left scapula, one in the right scapular, one in the mid back, and one in the below right axilla. Coronary interventions were performed twice in two patients and three times in a patient. The average exposure time was 84 minutes. The average elapsed time after for last exposure was three years and 3 months ago and ranged from 1 year to 10 years. The size of ulcer lesions was 11.1 cm² on average. All patients underwent debridement of the dead tissue and flap surgery. CONCLUSION: Patients with a history of coronary intervention should be aware of the possibility of chronic radiation dermatitis if they come with chronic scarring or ulcerative chronic wounds with a clear border at the back, shoulders and scapula. So accurate diagnosis based on the patient's medical history is important and awareness of medical team who perform coronary interventions is also necessary.
Axilla ; Cicatrix ; Debridement ; Dermatitis ; Diagnosis ; Fluoroscopy ; Humans ; Korea ; Methods ; Radiodermatitis* ; Recurrence ; Scapula ; Shoulder ; Surgery, Plastic ; Ulcer ; Wounds and Injuries

Sialoblastoma and hepatoblastoma of neonate were very rare cancer. We present a case of concurrent sialoblastoma with hepatoblastoma associated with chromosomal anomaly.
Hepatoblastoma* ; Humans ; Infant, Newborn*

Pressure sore is usually developed by repeated or persistent pressure given to fixed regions. Due to increase in old ages, paraplegia or quadriplegia by traffic accidents and industrial accidents, the incidence of pressure sore is increasing. V.A.C.(R)(vacuum assisted closure, KCI Inc, U.S.A.) has been highly effective for accelerating wound healing, however, high cost and the use of special equipment have been preventing it from popular use. We applied the negative pressure of wall suction (100-150mmHg) with Medifoam B(R)(Hydrophilic polyurethane foam, Ildong Pharm, Co., Korea) on pressure sore wound instead of expensive dressing foam of V.A.C.(R) So, we could accelerate wound healing without special equipment or incurring high cost. We were able to reduce the cost to 10% with Medifoam B(R) and wall suction dressing compared with V.A.C.(R) In this aspect, the technique explained above seems to be clinically useful.
Accidents, Occupational ; Accidents, Traffic ; Bandages ; Incidence ; Paraplegia ; Polyurethanes ; Pressure Ulcer* ; Quadriplegia ; Suction ; Wound Healing ; Wounds and Injuries