The challenges of successful nasal reconstruction, which are related to the anatomical complexity of the region, have been extensively studied. Revisional operations are often required to achieve proper nasal reconstruction, with results resembling the premorbid nasal status. This is necessary to ensure the quality of life of skin cancer patients. Fundamental nasal reconstruction requires both proper soft tissue coverage and proper function. However, earlier studies in the field primarily focused on the functional aspect of nose reconstruction, although the cosmetic aspect is also an important factor to consider. In response to this need, many recent studies on nose reconstruction have proposed various refinement strategies to improve aesthetic satisfaction. Most plastic surgeons accept the nasal aesthetic subunit principle as a standard for nasal reconstruction. This review outlines the commonly used surgical refinement options and management strategies for postoperative complications based on the subunit principle. In patients with nasal defects, a proper technical strategy might help minimize revision operations and optimize the long-term results.

No abstract available.

The problems of foreign body injection such as vaseline, paraffine, mineral oil for penile augmentation done by illegal medical practitioners are tissue inflammation, necrosis, granuloma formation, deformity and erectile dysfunction. The treatment of these complication are composed of foreign body removal and resurfacing of denuded penis. Many resurfacing procedures are introduced such as split thickness skin graft, flap-to-graft conversion method, scrotal flap, groin flap and free flap. Skin graft is the simplest method with minimal donor site morbidity, but there are some complications like scar contracture, hypertrophic scar and difficulty of erection. Thick split thickness skin graft can prevent these complications. We measured the length, circumference and surveyed erectile function with International Index of Erectile Function(IIEF) after long-term follow up. Increase in mean length and circumference at erection are 43% and 36%, respectively, compared to resting, and the survey with IIEF had a better result than that of normal control group. We found preserved erectile function without scar contracture and hypertrophic scar. Thick split thickness skin graft is the good method for treatment of penile vaselinoma with simplicity, minor donor site morbidity and preservation of erectile function.
Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Erectile Dysfunction ; Follow-Up Studies ; Foreign Bodies ; Free Tissue Flaps ; Granuloma ; Groin ; Humans ; Inflammation ; Male ; Mineral Oil ; Necrosis ; Paraffin ; Penis ; Petrolatum ; Skin* ; Tissue Donors ; Transplants*

BACKGROUND: Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. METHODS: We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. RESULTS: Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. CONCLUSIONS: A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.
Dermis ; Extremities ; Fluorescein ; Free Tissue Flaps ; Heel ; Humans ; Injections, Intravenous ; Lighting* ; Methods ; Necrosis ; Skin Transplantation ; Skin* ; Soft Tissue Injuries ; Tissue Donors ; Tissue Survival ; Transplants*

No abstract available.
Fluoroscopy*

No abstract available.
Dermoid Cyst* ; Eyebrows*

BACKGROUND: Rectus abdominis muscle and abdominal subcutaneous fat tissue are useful for reconstruction of the chest wall, and abdominal, vaginal, and perianal defects. Thus, preoperative evaluation of rectus abdominis muscle and abdominal subcutaneous fat tissue is important. This is a retrospective study that measured the thickness of rectus abdominis muscle and abdominal subcutaneous fat tissue using computed tomography (CT) and analyzed the correlation with the patients' age, gestational history, history of laparotomy, and body mass index (BMI). METHODS: A total of 545 adult women were studied. Rectus abdominis muscle and abdominal subcutaneous fat thicknesses were measured with abdominopelvic CT. The results were analyzed to determine if the thickness of the rectus abdominis muscle or subcutaneous fat tissue was significantly correlated with age, number of pregnancies, history of laparotomy, and BMI. RESULTS: Rectus abdominis muscle thicknesses were 9.58 mm (right) and 9.73 mm (left) at the xiphoid level and 10.26 mm (right) and 10.26 mm (left) at the umbilicus level. Subcutaneous fat thicknesses were 24.31 mm (right) and 23.39 mm (left). Rectus abdominismuscle thickness decreased with age and pregnancy. History of laparotomy had a significant negative correlation with rectus abdominis muscle thickness at the xiphoid level. Abdominal subcutaneous fat thickness had no correlation with age, number of pregnancies, or history of laparotomy. CONCLUSIONS: Age, gestational history, and history of laparotomy influenced rectus abdominis muscle thickness but did not influence abdominal subcutaneous fat thickness. These results are clinically valuable for planning a rectus abdominis muscle flap and safe elevation of muscle flap.
Adult ; Body Mass Index ; Female ; Gestational Age ; Humans ; Laparotomy ; Muscles ; Pregnancy ; Rectus Abdominis ; Retrospective Studies ; Subcutaneous Fat ; Subcutaneous Fat, Abdominal ; Thoracic Wall ; Umbilicus

Postburn scar contracture for ankle is commonly treated with contracture release procedure and skin graft but contracture recurrence rate is high. Contracture in grafted skin is inversely related to the graft thickness but full-thickness skin graft is limited in large defect coverage. Using ADM for ankle joint defect which was following ankle postburn scar contracture release procedure with grafting split-thickness skin may be an alternative reconstructive option. We present a 63-year-old man with postburn scar contracture and Marjolin ulcer on his left ankle. He originally had limited ankle movement function but surgical resection of skin malignancy and surrounding scar tissue released the ankle. Coverage using ADM and STSG was performed and NPWT was used for graft fixation. Ankle range of motion was satisfactory at postoperative follow-up. The ADM and STSG with NPWT could be considered an alternative reconstruction option after contracture release for ankle.
Acellular Dermis* ; Ankle ; Ankle Joint ; Cicatrix* ; Contracture* ; Follow-Up Studies ; Humans ; Middle Aged ; Negative-Pressure Wound Therapy* ; Range of Motion, Articular ; Recurrence ; Skin Transplantation ; Skin* ; Transplants* ; Ulcer

Foreign body (FB) impaction in the maxillofacial area could be caused by knives, glass fragments, and vegetative materials. We present the rare case of a 62-year-old man with a large glass FB in the left cheek retained for over 40 years. He had traffic accident over 40 years ago and glass fragments impacted on his left cheek. Glass fragments were retained around the zygomatic arch with dimpled scar and unclear serous discharge, but other facial motor or sensory dysfunction was not observed. We confirmed three glass fragments with radiologic examination including plain radiograph and computed tomographic image. Under general anesthesia, impacted glass fragments were removed through the direct incision on the dimpled scar and the additional incision on the left lateral canthal area. Remnant FBs were not seen on an intraoperative C-arm radiograph. After 2 days of irrigation for inflammation control, the dimpled wound was sutured. The wound was healed without major complication and the original dimpled scar was much improved.
Accidents, Traffic ; Anesthesia, General ; Cheek ; Cicatrix ; Foreign Bodies ; Glass* ; Humans ; Inflammation ; Middle Aged ; Wounds and Injuries ; Zygoma

BACKGROUND: Previous research has related obesity to body dissatisfaction and low self-esteem. This study aimed to evaluate this relation between obesity and distress about appearance. METHODS: We performed a cross-sectional study using data from the Korea Youth Risk Behavior Web-based Survey for 288,390 participants assessed from 2009 to 2012. The participants were categorized according to body mass index; obese, overweight, healthy weight, and underweight. The relation between obesity and distress was analyzed using simple and multiple logistic regression with complex sampling adjusted for age, sex, region of residence, economic level, parental education level, alcohol consumption, and smoking habits as confounders. RESULTS: The adjusted odds ratio (AOR) was higher for participants with obesity (AOR for healthy weight = 1.15 [95% confidence interval {CI}, 1.08–1.22]; AOR for overweight = 1.85 [95% CI, 1.72–1.98]; AOR for obese = 2.45 [95% CI, 2.27–2.64]; reference = underweight, P < 0.001). In males, healthy weight was associated with an AOR below 1 (AOR for healthy weight = 0.92 [95% CI, 0.85–0.99]; AOR for overweight = 1.26 [95% CI, 1.14–1.38]; AOR for obese = 1.66 [95% CI, 1.50–1.84], P < 0.001). In females, higher AORs were associated with obesity (AOR for healthy weight = 1.44 [95% CI, 1.33–1.57]; AOR for overweight = 2.71 [95% CI, 2.45–2.99]; AOR for obese = 3.71 [95% CI, 3.32–4.14], P < 0.001). CONCLUSION: Obesity is related to distress about appearance, and the relation is stronger in girls than in boys.
Adolescent* ; Alcohol Drinking ; Beauty ; Body Mass Index ; Body, Physical Appearance ; Cross-Sectional Studies ; Education ; Female ; Humans ; Korea ; Logistic Models ; Male ; Obesity* ; Odds Ratio ; Overweight ; Parents ; Risk-Taking ; Smoke ; Smoking ; Stress, Psychological ; Thinness