A number of techniques have been introduced for the correction of inverted nipples, many of which are time-consuming, involve extensive incision and dissection around the nipple, or result in undesirable outcomes. Only two surgical methods were performed depending upon the patient's demand for nursing. When a patient desired breast-feeding the modified Teimourian method with pursestring was executed to preserve lactiferous ducts while the modified Hartampf method with purse-string severing the ducts was performed on a patient who did not want breast-feeding. These two methods were both simple and non-invasive. The reinversion rates were compared and analyzed for 73 nipples followed up for between 3 months and 2 years. Eversion was maintained in 89% of nipples. Invaginated nipples showed an increased tendency to reinvert postoperatively compared to umbilicated types(13.6% vs 6.9%). The duct-preserving method also tended to reinvert 3 times more than the duct-dividing method(14.3% vs. 4.2%).
Humans ; Nipples* ; Nursing

No abstract available.
Breast*

No abstract available.
Female ; Mammaplasty*

The axillary technique is the most popular approach to breast augmentation among Korean women. Transaxillary breast augmentation is now conducted with sharp electrocautery dissection under direct endoscopic vision throughout the entire process. The aims of this method are clear: both a bloodless pocket and a sharp non-traumatic dissection. Round textured or anatomical cohesive gel implants have been used to make predictable well-defined inframammary creases because textured surface implants demonstrated a better stability attributable to tissue adherence compared with smooth surface implants. The axillary endoscopic technique has greatly evolved, and now the surgical results are comparable to those with the inframammary approach. The author feels that this technique is an excellent choice for young patients with an indistinct or absent inframammary fold, who do not want a scar in the aesthetic unit of their chest.
Axilla ; Breast Implants ; Breast* ; Cicatrix ; Electrocoagulation ; Endoscopes ; Female ; Humans ; Mammaplasty ; Thorax

Gynecomastia is an abnormal increase in the volume of the male breast. There are three main types of gynecomastia: glandular, fatty-glandular, and fatty. The fatty type can be treated by liposuction alone. However, patients affected by gynecomastia with significant glandular enlargement do not respond to suction alone and may require sharp dissection or skin reduction that leaves scars and deformities disturbing to the patients. The UAL was used for the correction of gynecomastia, and the cavitated and emulsified breast tissues were removed by Rosenberg cannula through 1-cm incision at the inframammary crease. Series of 27 cases(54 breasts) were reviewed from 1999 - 2000 with mean follow-up of 6 months. The volume of aspirates ranged from 120 to 330 cc per breast. There were no major complications such as skin flap necrosis or hematoma. Two reoperations were performed for the underresected cases and both responded to liposuction well. The patient safisfaction was high and most of them were pleased with the scars and shapes of the breasts. This procedure can minimize scars and reduce the incidence of contour problem such as saucer deformity, and avoid the sensory disturbances. Patients can return to full activities in 48 hours.
Breast ; Catheters ; Cicatrix ; Congenital Abnormalities ; Follow-Up Studies ; Gynecomastia* ; Hematoma ; Humans ; Incidence ; Lipectomy* ; Male ; Necrosis ; Skin ; Suction

No one technique provides an optimal outcome for all body contouring patients. There are many surgical options for abdominoplasty. Among these, this abdominoplasty without undermining consists of liposuction around abdominal subcutaneous fatty tissue, excision of lower abdominal flap. The procedure allows aggressive thinning and sculpting of abdominal flap. This operation minimizes the dead space, which often leads to postoperative complications, and preserves neurovascular supply to the abdominal skin. From 1999 to 2004, 18 patients underwent the abdominoplasty without undermining, resulting in high satisfaction rates with no significant complications, such as, pulmonary embolism and deep vein thrombosis. Patients could return to normal activity within a week. This abdominoplasty without undermining is an effective and safe alternative with low complication rate and enhances aesthetic results compared to traditional abdominal surgery.
Abdomen ; Abdominoplasty* ; Adipose Tissue ; Humans ; Lipectomy ; Postoperative Complications ; Pulmonary Embolism ; Skin ; Venous Thrombosis

PURPOSE: The transaxillary approach for breast augmentation has been advocated for patients and surgeons for several decades. However, this blind technique had many disadvantages including, traumatic dissection, difficult hemostasis, displacement of implants, and ill-defined asymmetrical location of inframammary crease. In the present study, the precise endoscopic electrocautery dissection was applied to eliminate the limits of blunt dissection throughout the procedures. METHODS: From December 2006 to December 2007, a total of 103 patients with an average age of 29.5 years underwent endoscopic assisted transaxillary dual plane augmentation mammoplasty. The mean implant size was 243 cc with the range between 150 and 350cc. Through a 4cm axillary incision, electrocautery dissection for submuscular pockets was carried out under the endoscopic control. The costal origin of pectoralis muscle was completely divided to expose subcutaneous tissue and to make type I dual plane. RESULTS: Using the endoscopic dissection, we achieved good aesthetic results including a short recovery period, less morbidity, and symmetrical well-defined inframammary crease. Type I dual plane procedure could support the consistent inframammary fold shape and be applied to most patients without breast ptosis. Minor complications did not occur, however, four major complications of capsular contracture occurred. CONCLUSION: In contrast to the era of the blind techniques, endoscopic assisted transaxillary dual plane breast augmentation can now be performed effectively and reproducibly. With Its advantage, the axillary application of endoscopy for augmentation mammaplasty is useful to achieve the optimal cosmetic outcomes.
Breast ; Contracture ; Cosmetics ; Displacement (Psychology) ; Electrocoagulation ; Endoscopy ; Female ; Hemostasis ; Humans ; Imidazoles ; Mammaplasty ; Nitro Compounds ; Pectoralis Muscles ; Subcutaneous Tissue

PURPOSE: The capsular contracture has been the most common complication of augmentation with breast implant, a side effect quite difficult to treat. The latest trends in the correction of capsular contracture include total capsulectomy or conversion of implant pocket. In this study, in an attempt to correct capsular contracture, the authors performed reoperation which involved capsulectomy through peri-areolar approach and dual- plane conversion. The authors hereby report the clinical results of such correction of capsular contracture and examine the efficacy. METHODS: The authors selected 46 patients who were admitted to the clinic from January 2004 to January 2007 (37 months), and performed dual-plane conversion through solely peri-areolar approach. Two types of operation were done: dual-plane conversion from subglandular plane or from submuscular plane. RESULTS: The average follow-up time after conversion to the dual-plane position was 10 months. During the follow-up period, 83.1% of patients recovered from capsular contracture and were Baker class I, and in 10.9% the condition had relapsed into Baker class II or III contracture. CONCLUSION: This study has proven the effectiveness of the dual-plane conversion operation for correcting established capsular contracture after previous augmentation mammaplasty. In this study, all cases of dual-plane conversion operation was performed through peri-areolar approach, which can prevent the occurrence of visible scar on inframammary fold.
Breast Implants ; Cicatrix ; Contracture ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Reoperation

The absence of the nipple-areolar complex(NAC) in men are seldom stated, as a result of trauma, burn, mastectomy, or after the correction of extreme bilateral gynecomastia. A total of 50 healthy men aged 21 to 27 years were examined. We recorded the configuration (dimensions and shape) and the location of the NAC with respect to fixed skeletal anatomic landmarks. Of the 50 subjects examined, 44 had oval and 6 had a round NAC. The mean diameter for a round NAC was 24.3 mm. The center of the NAC was in the fourth intercostal space in 41 volunteers and in the fifth intercostal space in 9 of the subjects. To localize the NAC on the chest wall, at least three reproducible measurements proved to be necessary, composed of a horizontal line(distance from the midsternal line to the nipple, A), a medial oblique line(distance from the sternal notch to the nipple, B) and a lateral oblique line(distance from the acromioclavicular joint to the nipple, C). Using these three parameters, we recommend that the appropriate location can be calculated derived from the circumference of the chest.
Acromioclavicular Joint ; Adult* ; Anatomic Landmarks ; Burns ; Gynecomastia ; Humans ; Male ; Mastectomy ; Nipples ; Thoracic Wall ; Thorax ; Volunteers

PURPOSE: Gynecomastia is an abnormal increase in the volume of the male breast. Patients affected by gynecomastia with significant glandular enlargement may respond to suction alone and/or sharp dissection and excision. The purpose of this report is to introduce the indications and results of authors' two techniques. METHODS: The diameter of parenchyme was determined by a pinch test after liposuction. For the parenchymal diameter less than 4cm, ultrasound-assisted liposuction was performed, in conjunction with the "pull- out technique" to effectively remove the fibrofatty tissue of the male breast through a single 5-7mm incision. For the parenchymal diameter more than 4cm, ultrasound-assisted liposuction and excision were applied through 2.5cm periareolar approach. RESULTS: A total of 94 patients (185 breasts) underwent the operation from October 2000 to October 2003 and mean follow-up period was 12 months. The volume of aspirates ranged from 50 to 450 cc per breast. There were no major complications such as skin flap necrosis. Five reoperations were performed for 1 hypertrophic scar, 2 under-resected and 2 hematoma cases. The patient's satisfaction was high and most of them were pleased with the shape of the breasts and scars. CONCLUSION: These procedures can minimize scars and reduce the incidence of contour problem such as saucer deformity, and provides consistent results. Patients can return to full activities in 48 hours. It can be offered as an option for the treatment of gynecomastia.
Breast ; Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Follow-Up Studies ; Gynecomastia* ; Hematoma ; Humans ; Incidence ; Lipectomy* ; Male ; Necrosis ; Skin ; Suction