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.

PURPOSE: Poly-N-acetyl glucosamine(PGlcNAc) nanofiber-based materials, produced by a marine microalga, have been characterized as effective hemostatic and angiogenic agents. The similarity between PGlcNAc patch and the natural extracellular matrix allows it to support new healthy tissue growth in an injured area and to encourage fluid absorption. In this study, we hypothesized that a poly-N-acetyl glucosamine fiber patch(PGlcNAc patch) may enhance wound healing in the db/db mouse. METHODS: PGlcNAc patches were applied on one square centimeter, full-thickness, skin wounds in the db/db mouse model. Wounds(n=15 per group) were dressed with a PGlcNAc nanofiber patch for 1 hour(1h), 24 hours(24h) or left untreated(NT). After the application time, patches were removed and wounds were allowed to heal spontaneously. The rate of wound closure was evaluated by digital analysis of unclosed wound area in course of time. At day 10, wounds(n=7 per group) were harvested and quantified with immunohistochemical markers of proliferation(Ki-67) and vascularization (platelet endothelial cell adhesion molecule, PECAM-1). RESULTS: Wounds dressed with PGlcNAc patches for 1 hour closed faster than control wounds, reaching 90% closure in 16.6 days, nine days faster than untreated wounds. Granulation tissue showed higher levels of proliferation and vascularization following 1h treatment than the 24h and NT groups. In addition to its hemostatic properties, the PGlcNAc material also appears to accelerate wound closure in healing-impaired genetically diabetic mice. CONCLUSION: This material, with its combination of hemostatic and wound healing properties, has the potential to be effective agent for the treatment of complicated wounds.
Absorption ; Acetylglucosamine ; Animals ; Endothelial Cells ; Extracellular Matrix ; Glucosamine ; Granulation Tissue ; Mice ; Nanofibers ; Skin ; Wound Healing

The bilobed flap is often used when the primary closure of a skin defect is difficult. We applied a simple and rational method to design a bilobed flap for closure of scalp defect that reconstruction was comparatively difficult. In our method, two triangle flaps are designed; the angle of the first flap is three-fourths the angle of a rhombus at the defect site, and the angle of the second flap is also three-fourth that of the first flap. We applied it to five patients with scalp defect and obtained favorable result. The location of the defect was the parietal region in two cases. the occipital region in two cases. the frontal region in one case. We found that the alopecia by scar formation could be minimized with the designed bilobed flap. The suture line, being "Z" shape, was unnoticeable due to hair line stream. There are several advantages of this method for use in reconstruction of scalp defect such as, easy design and elevation of the flap and short operation time.
Alopecia ; Cicatrix ; Hair ; Humans ; Rabeprazole ; Rivers ; Scalp* ; Skin ; Sutures

Eccrine spiradenoma is an uncommon benign adnexal tumor originating from the eccrine sweat gland. We diagnosed a eccrine spiradenoma on a 55-year-old man with histopathologic confirmation upon biopsy followed by complete resection, who had visited our clinic with a chief complain of occipital scalp mass. The solitary eccrine spiradenoma occurring in the scalp is rarely to be seen and should be considered as a differential diagnosis for a solitary cystic mass of the scalp.
Biopsy ; Bone Cysts ; Diagnosis, Differential ; Humans ; Middle Aged ; Scalp* ; Sweat Glands

The goal of auricular cartilage harvest is to obtain a sufficient amount for reconstruction and to minimize the change in ear shape. The cartilage can be harvested by a posterior or anterior approach, and each method has advantages and disadvantages. The posterior approach presents the advantage of scar concealment, but there are limits to the amount of cymba cartilage that may be harvested. In contrast, the anterior approach may cause a noticeable scar. However, as cartilage is collected, the anterior approach provides a view that facilitates the preservation ear structure. In addition, it is possible to obtain a greater amount of cartilage. From January 2014 to December 2015, we harvested auricular cartilage graft material in 17 patients. To prevent the development of trapdoor scars or linear scar contracture, short incisions were made on the superior border of the cymba and cavum. Two small and narrow incisions were made, resulting in suboptimal exposure of the surgical site, which heightens the potential for damaging the cartilage when using existing tools. To minimize this, the authors used a newly invented ball-type elevator. All patients recovered without complications after surgery and reported satisfaction with the shape of the ear.
Autografts ; Cartilage* ; Cicatrix ; Contracture ; Ear ; Ear Cartilage ; Elevators and Escalators ; Humans ; Methods ; Tissue and Organ Harvesting ; Transplants