Keloids represent a dysregulated response to cutaneous wounding that results in an excessive deposition of extracellular matrix. However, the molecular mechanisms underlying this pathologic deposition of extracellular matrix still remain to be elucidated. In this study, the effects of anti-keloid drugs (triamcinolone(R), 5-FU(R), bleomycin(R), verapamil(R)) on the expression of fibronectin and TGF-beta and its receptor in keloid fibroblasts were evaluated in vitro. Human keloid fibroblasts(KFs) and normal human dermal fibroblasts(NHDFs) were isolated from earlobe keloids. Immunoprecipitation and Western blot of fibronectin, ELISA of TGF-beta secretion and Western blot of TGF-beta receptor were performed using the primary cultured fibroblasts treated with various drugs. TGF-beta secretion was increased in keloid fibroblasts compared to NHDFs. TGF-beta promoted fibronectin synthesis in keloid fibroblasts. These results substantiate the hypothesis that the elevated levels of TGF-beta play a potential role in keloid pathogenesis. 5-FU suppressed profoundly TGF-beta secretion. Triamcinolone and verapamil inhibited significantly fibronectin synthesis and secretion, and also suppressed TGF-beta receptor expression in keloid fibroblasts. In conclusion, it is postulated that the combination of low dose of 5-FU and triamcinolone or verapamil may be useful in keloid treatment by the additive effect of different anti-keloid action.
Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Extracellular Matrix ; Fibroblasts* ; Fibronectins* ; Fluorouracil ; Humans ; Immunoprecipitation ; Keloid* ; Receptors, Transforming Growth Factor beta ; Transforming Growth Factor beta ; Triamcinolone ; Verapamil ; Wounds and Injuries

Oriental hump nose is characterized by mild degree of the hump, broad dorsum, low nasal height and drooping tip. The conservative rasping of hump or humpectomy and osteotomy is too invasive to the patient with mild hump and may yield unnecessary complications for example under or over correction, nasal stenosis. For these reasons we have performed augmentation tip plasty by shield graft with columellar strut using autogenous conchal cartilage and resection of the depressor septi nasi muscle to 8 patients with mild hump. All patients have been very satisfied with the result and no serious complications were noted.
Cartilage ; Constriction, Pathologic ; Humans ; Nose ; Osteotomy ; Transplants

The authors presented 'A study on the knowledge about the field of plastic surgery(I)' decade ago. Since then, the cognition toward a plastic surgery might be altered by the evolution of internet and social atmosphere taking count of outward appearance. Therefore the authors studied again about the cognition to the plastic surgery. The subjects were total 1812 of high school and college students residing in Seoul, Korea from October through December in 2003 and 1812 students are consisted of 839 male and 973 female. The contents of questionnaire are as follows: 1. The cognition to the plastic surgery. 2. The cognition to the difference between plastic surgery and orthopedic surgery. 3. The cognition to the operation performing in the filed of plastic surgery. 4. The known operation kinds of plastic surgery. 5. The experience of plastic surgery operation. We compared the results of this survey with that in 1992. The results of research showed 15.1% increase in the cognition to the plastic surgery, 5.6% increase in the cognition to the difference between plastic surgery and orthopedic surgery and 9% increase in the cognition to the operation performing in the filed of plastic surgery. In the known operation kinds of plastic surgery, a double-eyelid operation was the most well known and followed by rhinoplasty and augmentation mammoplasty, but in 1992, a double-eyelid operation was followed by rhinoplasty and rhytidectomy. In the experience of plastic surgery operation, the result showed 6.3 %, which has more than doubled in the last 10 years. Increase of the cognition to the plastic surgery is inspired, but that results is localized to aesthetic field.
Atmosphere ; Cognition ; Female ; Humans ; Internet ; Korea ; Male ; Mammaplasty ; Orthopedics ; Surveys and Questionnaires ; Rhinoplasty ; Rhytidoplasty ; Seoul ; Surgery, Plastic

Augmenatation rhinoplasty may be effectively accomplished with alloplastic materials. However, certain circumstances mandate the use of autologous grafts(e.g., dorsal augmentation that exceeds 8 mm and patient intolerance of alloplastic implants). Rib or costal cartilage graft have gained wide-spread use in rhinoplasty. Rib cartilages are pliable and soft but they easily undergo warpage, whereas solid bone graft frequently lead to an unnatural hardness of the nasal tip and dorsal resorption. The rib/costal cartilage combination graft(=autogenous chondro-osseous rib grafting) are excellent alternatives. In this study 12 patients received 14 rib grafts harvested in the 7th or 8th rib. Materials were used as cantilevered dorsal onlay grafts, columellar struts, and tip grafts. During 8 months of follow up periods, most patients have firm and stabilized nasal dorsum with soft and mobilized tip without prominent complications such as infection, protrusion, mobilization, etc. In conclusion, this autogenous chondro-osseous rib grafting technique can be an effective and safe method in the primary or secondary rhinoplasty.
Cartilage* ; Follow-Up Studies ; Hardness ; Humans ; Inlays ; Rhinoplasty* ; Ribs ; Transplants*

The authors present the treatment for gynecomastia that combines the use of ultra sound assisted liposuction with or without power assisted liposuction and periareolar partial excision. This method effectively removes the fibrous tissue and fat tissue of the male breast. From july of 2000 to october of 2004, total 17patients were treated in this fashion. Pressure vest was applied immediately after operation. It was performed as out patient desk based operation. The results from the operation demonstrated a smooth musculine chest contour with well concealed scar. The procedure is technically straightfoward and provide consistent results. It can be offered as an effective option for the treatment of gynecomastia.
Breast ; Cicatrix ; Gynecomastia* ; Humans ; Lipectomy* ; Male ; Thorax ; Ultrasonography*

An inverted nipple may have both functional and aesthetic problems such as loss of lactability and hygiene. The inverted nipple may be congenital or caused by trauma, mastitis, mammmoplasy and breast cancer. Many procedures have been described for creating the normal anatomic configuration of the retracted nipple. For correcting the inverted nipple, the authors choose surgical procedure according to the grade of inverted nipple and the need of lactation. A total 37 nipples in 20 patients were operated on from February of 2001 to February of 2005. The patients were classified into 3 grades according to Han and Hong's grading system of inverted nipple. We applied modified Elsahy method to the group of patients in Grade I and patients in Grade II with need of lactation, and we applied Broadbent-Woolf method to the group of patients in Grade III and Grade II with need of lactation. Recurrence was found in 1 case corrected by modified Elshay method and no recurrence was found in those corrected by Broadbent-Woolf method. The patients' satisfaction score was 4.6 points in 5 points perfect score system. We prevented recurrence of inverted nipple with patients' satisfaction by applying different operative procedures according to the grade and patients' need of lactation.
Breast Neoplasms ; Female ; Humans ; Hygiene ; Lactation ; Mastitis ; Nipples* ; Recurrence ; Surgical Procedures, Operative

The shape of supratarsal fold in double eyelid operation can be generally divided into two types: infold and outfold. Infold means that the double eyelid line commences beneath the medial epicanthus and extends wider laterally. Outfold means that the double eyelid line commences above the medial epicanthus and extends parallel to the lateral side. In the case of the young Korean generation, the infold eyelids are recognized much closer to the natural-looking eyelid type. The statistics suggested that 68% of the 20s women had the infold type naturally. To the ordinary Korean people, the preferred one has been recognized as the infold which looks more natural because most of the unartificial double eyelids belong to the infold group. In addition, the survey by the before-operation images showed the tendency to prominently prefer the infold. This research was studied based on the target of 979 women among the random consultation-patients, whose ages are from 17 to 30 years old. The average age of the target women was 22.4. The preference study of these patients was conducted through showing various shapes of double eyelid made by a pin and referring them to the before/after-operation images of other patients. The eyelid shapes were classified into the following three types. Infold, Inward fold and Outfold. In this classification, inward fold means that the double eyelid line commences above the medial epicanthus and extends wider laterally. The results of this survey suggested that inward fold accounted for the most, 421 persons(43.0 percent), followed by the Infold 296 (30.2 percent) and the outfold 262(26.8 percent). This result is opposite to the statistics that the ordinary people commonly prefer the infold type because the shape looks natural and unartificial.
Adult ; Classification ; Eyelids* ; Female ; Humans

A cosmetically pleasing shape of the umbilicus is essential, especially in aesthetic operation. Umbilical restoring should always be aimed at creating an umbilicus of sufficient depth and good morphology with less scarring. But such a goal is often difficult to attain. The author's reduction umbilicoplasty is a useful technique in case of abnormal large umbilicus after abdominoplasty. The operation renders better aesthetic result. Technically, the procedure is easy to do and learn. The important steps are the following; the first step is reduction of original umbilicus' circle. The second step is umbilical fixation to the fascia wall using anchoring suture. The third step is cinching suture for decrease "the window" of abdominal flap and this step is more important than other steps. Finally, the suture performed between "the window" and reduced umbilicus. I operated the abdominal large umbilicus using above reduction umbilicoplasty. So, I reviewed that case and discussed the literatures.
Abdominoplasty* ; Cicatrix ; Fascia ; Sutures ; Umbilicus*

Reconstruction of the umbilicus is not a frequent event. Umbilical restoring should always be aimed at creating an umbilicus of sufficient depth and good morphology(circular and cylinder shape) with less scarring. A wide range of techniques has been described to reconstruct neoumbilicus; nevertheless, a perfect result is difficult to obtain. I provide another alternative to reconstruct the umbilicus using defatting, anchoring and purse-string suture. The important steps are the following; the first step is defatting of 2.0cm umbilicus' circle. The second step is to umbilical fixation to the fascia wall using anchoring suture. The third step is purse-string suture to decrease new formative umbilicus and to make the circular and cylinder shape umbilicus. The author's method is a simple, easy and useful technique and renders better aesthetic result. So, I reviewed two cases and discussed the literatures.
Cicatrix ; Fascia ; Sutures* ; Umbilicus*

A nipple can be reconstructed either by nipple sharing or local flap. But donor site scar is inevitable when nipple is reconstructed with local flap method. The scar which remains inside the nipple areolar complex can be hidden by medical tattooing, but elongated scar, which cross over the areolar border leads to poor esthetic result. So as to solve this problem, we used purse string suture method. We reconstructed nipple with C-V flap for 9 patients who previously reconstructed breast with extended latissimus dorsi flap. Purse string suture with 3-0 nylon was used for donor site closure. We minimize 10.7% of the scar length with this method. Enhancement of nipple projection due to the flattening of V limb was attained in addition. We expect the reduction of V-limb of C-V flap and amount of absorption of the reconstructed nipple with purse string suture method.
Absorption ; Breast ; Cicatrix ; Extremities ; Humans ; Nipples* ; Nylons ; Superficial Back Muscles ; Sutures ; Tattooing ; Tissue Donors