We present our experience with autologous fat injection and collager implantation in the treatment of facial atrophy. The surgical teclinigues are described for injecting the colagen into the nasolabial fold and collecting fat from the lower abdomen and then injecting the fat into the depressed site on the face. There were no serious complications without slowly progressive, volume reduction. We think that, these techniques could have a plae in the treatment of problems relatcd to facial depression. However, a longer follow-ups and more clinical experiences will be needed in order to reach some definite conclusions.
Abdomen ; Atrophy ; Collagen* ; Depression ; Follow-Up Studies ; Nasolabial Fold

A 67-year-old man noted a 4×6cm sized, erythematous, erosive, oozing patch on the penile shaft, which resisted conservative therapy for three years. Histopathologic examination revealed typical findings of extramammary Paget's disease. Interestingly, nests of Paget's cells in some hair follicular structures were shown in the middermis. The lesion was excised by microscopically controlled excision, using the fresh-tissue technique. There were histologically involved areas extending to quite a distance beyond the clinically normal appearing skin. Mohs micrographic surgery might offer the unique advantage of effective surgical treatment with microscopically controlled tumor free borders in the extramammary Paget's disease.
Aged ; Hair ; Humans ; Mohs Surgery ; Paget Disease, Extramammary* ; Skin

A technique for the chemical fixation of cutaneous tumors followed by serial excision using microscopic control has been developed since the mid 1930s. Mohs micrographic surgery is the most reliable and cost effective treatment modslity, offering maximal preservaticn of normal tissue and therefore the lowest functional and cosmetic morbidity in the cancer treatments. We report a case of basal cell carcinoma treated with Mohs micrographic surgery and reconstructed with nasalis myocutaneous sliding flap. The pstient was a 56-year-old woman, who had a been sized basal cell carcinoma on her nasal tip for the previous 3 years. The lesion was removed under complete microscopical control using fresh tissue technique. The defect healed with atrophic scar formation ore and half months later. To remove scar tissue and to gsin proper cosmetic results, reconstruction with nasalis myocutaneous sliding flap was performed successfully.
Carcinoma, Basal Cell* ; Cicatrix ; Female ; Humans ; Middle Aged ; Mohs Surgery

A 30-year-old man developed basal cell carcinoma 3 years ago which showed as a pea sized, crusted nodule with extending pigmentation and telangiectasia on the inner side of the right lower eyelid. Five stages of Mohs micrographic surgery were required for the complete eradication of all tumor cells in the lesions of the nodule and extending pigmentation. The defect following the surgery was 4.5 × 3.5cm and was too large to repair with a primary closure or simple single flap. So, the defect was repaired with a combined flap of glabellar bilobed and cheek rotation. We report that the combined flap of glabellar bilobed and cheek rotation is a useful and relatively simple method for the reconstruction of a large defect on the inner side of the lower eye-lid area.
Adult ; Carcinoma, Basal Cell ; Cheek ; Eyelids ; Humans ; Methods ; Mohs Surgery* ; Peas ; Pigmentation ; Telangiectasis

BACKGROUND: Acne scars are not effectively corrected by a single treatment modality because of their widely varied depths and widths. OBJECTIVE: This study was performed to assess the effectiveness of staged combinations of several surgical modalities in the treatment of various acne scars. METHODS: Chemical peeling, CO₂ laserbrasion, scar excision, punch grafting, and dermabrasion were included in this study as surgical modalities. Initially, chemical peeling was performed on all patients and then CO₂ laserbrasion, scar excision and punch grafts were used for deep scars. Finally, dermabrasion was done for the remaining scars. Questionnaires were completed for clinical assessments by the patients and clinicians. RESULTS: Clinicians assessed the results as "excellent and good" in 75% of patients. However, only 53% of patients gave this same result. The degree of satisfaction escalated as the followup periods and number of chemical peeling procedures increased and as the sequence of the 3 staged operation progressed. CONCLUSION: We suggest that the principle of 3 staged operations would be effective in the treatment of patients with various types of acne scars.
Acne Vulgaris* ; Cicatrix ; Dermabrasion ; Follow-Up Studies ; Humans ; Transplants

BACKGROUND: Punch grafts and punch elevation can be useful for the correction of deep pitting or round atrophic acne scars. The traditional punch elevation technique gives inadequete results. Even round scars leave a retraction space and do not always heal well. OBJECTIVES & METHODS: To improve the cosmetic results of traditional punch elevation and thus promote the use of punch elevation instead of punch grafting, we performed punch elevation with purse-string sutures on 10 patients with acne, pox & atrophic scars. We performed dermabrasion or CO2 laserbrasion after 8 weks. RESULTS: Nicely fit margins of the punch elevation site with purse-string suture left no retraction spaces and enhanced the aesthetic results. CONCLUSION: Punch elevation is a simple, satisfactory method of improving cosmetic results in scars. The Purse-string suture technique can make it a more valuable tool for surgery of facial scars, because it overcomes of disadvantages the punch elevation.
Acne Vulgaris* ; Cicatrix* ; Dermabrasion ; Humans ; Suture Techniques ; Sutures* ; Transplants

Giant congenital melanocytic nevi may lead to severe cosmetic and psychosocial problems. Another important problem is the relatively high potential to undergo malignant transformation. The management of congenital melanocytic nevi remains controversial as there is no universal agreement. We report two cases of giant congenital melanocytic nevi which were removed by curettage and dermatomes. There is relatively less intra and postoperative morbidity using these methods than with other treatment modalities. They were also considered as acceptable surgical methods and there are potentially more pleasing cosmetic results.
Curettage* ; Nevus, Pigmented*

No abstract available.
Hair*

BACKGROUND: The transposition flap is one of the most useful methods of facial reconstruction after Mohs micrographic surgery of the basal cell carcinoma, but occasionally some variations are needed. OBJECTIVE: We present our experience with several variations of the transposition flap to overcome the disadvantages of classic rhomboid flaps. METHODS: We performed the Webster 30-degree angle flap on the lower eyelid, the double 30-degree angle flap on the temple area and the nasolabial flap on the ala nasi. RESULTS: These variations of the transposition flap gave no complications such as ectropion, tissue distortion, protrusion, or trapdoor deformity. CONCLUSION: The variations of the transposition flap in our cases might be of help in selecting the ideal method in facial reconstruction.
Carcinoma, Basal Cell* ; Congenital Abnormalities ; Ectropion ; Eyelids ; Methods ; Mohs Surgery*

A 22-year-old woman with no history of trauma or other diseases presented with a slowly enlarging firm nodule with a central pointed opening on the right chest. An excisional biopsy revealed a pilomatricoma associated with an epidermoid cyst. Histopathologically, an epidermoid cyst located in the deep dermis was lined mostly by keratin-forming stratified squamous epithelium but focally had columns of shadow cells that projected from the epithelial lining of the cyst into the lumen. The lumen also contained masses of shadow cells, unattached to the epithelial lining. In the stroma surrounding the cyst, numerous masses of shadow cells with giant cell reaction and focal calcification were seen, which were in turn surrounded by a connective tissue capsule. These features are similar to those seen in infundibular cysts associated with Gardner's syndrome. Since epidermoid cysts and pilomatricomas originate in common from the pilosebaceous unit and pilomatricomas begin as infundibular matrix cysts, we suggest that they can occur simultaneously, although rarely, in a healthy person.
Biopsy ; Connective Tissue ; Dermis ; Epidermal Cyst* ; Epithelium ; Female ; Gardner Syndrome ; Giant Cells ; Humans ; Pilomatrixoma* ; Thorax ; Young Adult