An advantage of breast augmentation with injectable fillers is that the desired size can be determined and achieved under local anesthesia with a short recovery time. However, a high complication rate is a critical disadvantage. Some fillers are challenging to remove, resulting in breast deformity and scarring. Five patients who underwent surgery to manage a foreign body in the breasts in 2021 were enrolled in this study. Two had copolyamide filler injections, while the other three had polyacrylamide hydrogel filler injections. A physical examination was performed, and preoperative and intraoperative photographs were obtained. Two patients underwent subcutaneous mastectomy because most of the filler had infiltrated into the normal breast tissue. In contrast, the other patients underwent filler removal and debridement because most of the filler had remained separate from the normal breast tissue. All patients who had a subcutaneous mastectomy and one who underwent only filler removal underwent immediate breast reconstruction with cohesive gel implants. The other patients rejected immediate reconstruction, and only filler removal was performed. All patients recovered without complications. We propose an algorithm for diagnosis and treatment based on our cases, which we hope can help clinicians manage the complications of filler injections for breast augmentation.

BACKGROUND: The purpose of this study was to identify the status of Successful Aging among the elderly aged 65 and over in rural areas and to compare factors related with Successful Aging between “kyung-ro-dang” users and non-users. METHODS: A total of 181 elderly aged 65 or older were selected from four districts (Heung-upri, Mejiri, Sajerri, and Daeanri) of Wonju city. A survey method using face to face interviews was applied to collect information. Successful aging was measured on a 5-point Likert-type scale using the successful aging scale developed for the Korean elderly, which indicates the higher the score, the higher the level of successful aging. Descriptive statistics, bivariate, and multivariate analyses were computed; the level of significance was set at 5%. Hierarchical polynomial regression was applied to find out the factors associated with successful aging. RESULTS: Of the total, 112 elders used kyung-ro-dang and 69 elders who did not use kyung-ro-dang. The level of successful aging of the elderly was higher among kyung-ro-dang users than non-users. The factors related to successful aging among kyung-ro-dang users were walking and social participation. Users who walk more than 4 times per week and social participation activities have a higher level of satisfaction. In the case of non-users, a higher level of monthly income, having a spouse, social support, and social participation associated with a higher level of successful aging. CONCLUSION Monthly income, social participation, and social factors were found to be related to successful aging along with physical and mental health conditions among the elderly in rural areas. Therefore, it can be concluded that income, social as well as mental and physical factors, are more critical for successful aging in the rural community care in Korea.

PURPOSE: Schwannoma is a slow-growing, encapsulated benign peripheral nerve tumor that originates from the Schwann cell of the nerve sheath. Schwannoma most frequently involves the major nerve. Schwannoma of the foot is rare. This is a report of our experience with a small, deep-seated, and non-palpable schwannoma occurring in the foot. METHODS: A 42-year-old woman presented with the plantar pain of the right foot during 2 years. Physical examination did not identified a palpable mass. She made a clinical diagnosis of plantar fasciitis and was conservatively treated 2 years ago. Since her plantar foot pain was aggravated, she was recently visited again. For the evaluation of her plantar foot pain, sonographic examination of the whole right foot was performed, and it revealed a small hypoechoic hetergenous, deep-seated mass beneath the plantar aponeurosis. At operation, a 0.7x0.6x0.4cm sized, ovoid, yellowish grey mass was removed. RESULTS: Histology was confirmed that the mass was a benign schwannoma. There were no postoperative complications. CONCLUSION: Unsusual case of a schwannoma with the plantar foot pain during 2 years is presented. It should be recognized a small, deep-seated, non-palpable schwannoma as a possible cause of plantar foot pain.
Adult ; Fasciitis, Plantar ; Female ; Foot ; Humans ; Neurilemmoma ; Peripheral Nervous System Neoplasms ; Physical Examination

Most patients with hangman's fracture frequently responded to consertvative therapy consisted of skeletal traction and halo vest, and surgery to stabilize or reduce further injury is seldom necessary. But occasionally operative stabilization may be necessary and can be achiveed satisfactorilly through anterior or posterior approach. Anterior interbody fusion at the G2-3 interspace has advantages of immediate bony stabilization with preservation of rotatory motion compared with posterior approach.
Humans ; Traction

No abstract available.
Gynecomastia ; Male ; Tennis

PURPOSE: Vaccum-assisted closure(VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. METHODS: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. RESULTS: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. CONCLUSION: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.
Bandages ; Bites and Stings ; Compartment Syndromes ; Drainage ; Edema ; Hand ; Hypogonadism ; Incidence ; Mitochondrial Diseases ; Myoglobin ; Necrosis ; Negative-Pressure Wound Therapy ; Ophthalmoplegia ; Perfusion ; Snake Bites ; Snakes ; Vacuum ; Venoms

Background: In August 2019, the Ministry of Food and Drug Safety and the Korean Society of Plastic and Reconstructive Surgeons confirmed the first case report of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in Korea and provided recommendations. This study was conducted to evaluate the impact of the first case report of BIA-ALCL on patients and whether the impact could be mitigated through expert recommendations. Methods: A retrospective chart review was performed of patients who underwent implant-based breast reconstruction using Biocell textured breast implants at Soonchunhyang University Hospital. After the first case report of BIA-ALCL and informing the patients via text messages, the pattern of outpatient visits and the proportion and indications of outpatient office visitors who received reoperations were analyzed. Results: After the first BIA-ALCL case report in Korea, 12 patients underwent reoperations due to other complications identified incidentally, while only three patients underwent prophylactic surgery. Among the patients who underwent reoperation after the Allergan issues, 76.7% received implant exchange. There was no significant difference in the proportion of reoperation types before and after the Allergan issues and the transmission of text messages (P=0.700). Conclusions Despite the major issues, outpatients were managed successfully according to our recommendations. The study found a low rate of regular outpatient visits; however, our efforts increased this rate. Therefore, methods for appropriate information delivery are needed for outpatient visits, as well as a system for regular monitoring. As experts, plastic surgeons should provide responsible leadership in this situation to relieve patients’ concerns.

Background: We report our experiences with prepectoral placement breast implant surgery using Supporix (HansBioMed), a porcine acellular dermal matrix (PADM), for cosmetic and reconstructive indications. The clinical efficiency, safety, and cost-effectiveness of PADM were also discussed. Methods: A single-center, retrospective study was designed from December 2017 to December 2019. The participants were Korean women who underwent PADM-assisted prepectoral breast implant surgery performed by two surgeons. All complications were registered and analyzed. A systematic review and meta-analysis of complication rates after PADM-assisted prepectoral breast implant surgery were conducted for comparison with other studies. A subgroup analysis was performed according to the operation type: the cosmetic breast surgery (CBS) group, the immediate implant-based breast reconstruction (IIBR) group, and the delayed implant-based breast reconstruction (DIBR) group. Results: Twenty breasts in 16 patients were included in our study (median follow-up period, 8.25 months). In a systematic review, 20 publications with a total of 2,504 breasts in 1,921 women were quantitively analyzed. The overall complication rates in our study and other studies were 14% and 24% in the total group analysis, 0% and 12% in the CBS group, 62% and 26% in the IIBR group, and 0% and 28% in the DIBR group, respectively. Conclusions Our data support the effectiveness of PADM-assisted prepectoral breast implant surgery, which was comparable to other studies. PADM was effective for reducing seroma and hematoma in the revision CBS group and the DIBR group. In the IIBR group, it was helpful in preventing implant loss and explantation.

Copolyamide fillers, such as Aquafilling, have been used off-label for breast augmentation in many countries, including Korea. However, safety concerns have arisen due to reported complications, including induration, masses, mastalgia, firmness, asymmetry, migration, infection, and dimpling. We report the case of a 33-year-old woman who presented with distant migration of copolyamide breast filler to the left lower abdomen and inguinal area following mammography for breast cancer screening. This case highlights the potential risks associated with the migration of copolyamide breast fillers, particularly in the context of cancer screening procedures, and emphasizes the importance of awareness and vigilance among clinicians and patients.

Since April 2015, post-mastectomy breast reconstruction has been covered by the Korean National Health Insurance Service (NHIS). The frequency of these procedures has increased very rapidly. We analyzed data obtained from the Big Data Hub of the Health Insurance Review and Assessment Service (HIRA) and determined annual changes in the number of breast reconstruction procedures and related trends in Korea. We evaluated the numbers of mastectomy and breast reconstruction procedures performed between April 2015 and December 2018 using data from the HIRA Big Data Hub. We determined annual changes in the numbers of total, autologous, and implant breast reconstructions after NHIS coverage commenced. Data were analyzed using Microsoft Excel. The post-mastectomy breast reconstruction rate increased from 19.4% in 2015 to 53.4% in 2018. In 2015, implant reconstruction was performed in 1,366 cases and autologous reconstruction in 905 (60.1% and 39.8%, respectively); these figures increased to 3,703 and 1,570 (70.2% and 29.7%, respectively) in 2018. Free tissue transfer and deep inferior epigastric perforator flap creation were the most common autologous reconstruction procedures. For implant-based reconstructions, the rates of directto-implant and tissue-expander breast reconstructions (first stage) were similar in 2018. This study summarizes breast reconstruction trends in Korea after NHIS coverage was expanded in 2015. A significant increase over time in the post-mastectomy breast reconstruction rate was evident, with a trend toward implant-based reconstruction. Analysis of data from the HIRA Big Data Hub can be used to predict breast reconstruction trends and convey precise information to patients and physicians.