Despite the fact that benign skin lesions can undergo malignant transformation, the necessity and timing of the surgical resection have yet to be established. In this study, we analyse three cases of benign-appearing skin lesions, which were found to be carcinomatous on histologic examination and review the literature regarding the importance of prophylactic removal of benign-appearing skin lesion. The first and second cases were female patients wishing for cosmetic surgery. The first patient had a benign-appearing lesion on dorsum nasi, and the second patient had an inconspicuous lesion right along the right nasolabial fold. The third patient was a middle-aged male with a pigmented lesion on the left cheek, who presented to the clinic only after having met the operating surgeon through an acquaintance outside the hospital setting. All of the lesions were suspected to be of benign nature and were excised for cosmesis only. However, histologic examination of these lesions showed that the first two tumors were basal cell carcinoma with the last tumor being squamouse cell carcinoma. Thus, it is considered that removal of benign like skin lesion will result in good prognosis of patients scheduled to undergo other surgery.
Carcinoma, Basal Cell ; Cheek ; Female ; Humans ; Male ; Nasolabial Fold ; Nevus ; Prognosis ; Skin Neoplasms ; Skin* ; Surgery, Plastic

Skin cancers usually occur on the face and so successive cutaneous reconstruction after surgery is very important for the patients' quality of life. Cutaneous reconstruction is especially difficult when the defects after surgery involve the nasolabial fold. The nasolabial folds run from each side of the nose to the corners of the mouth, separating the cheeks from the upper lip. This area has complex contours, unique skin color and texture and the limited availability of mobile adjacent skin. We reconstructed such a defect after Mohs micrographic surgery for basal cell carcinoma of the nasolabial fold area, and we used a subcutaneous island pedicle flap and periosteal suspension suture. Herein we report on the details with the pictures, and we discuss the cosmetic effect and limitations of this method.
Carcinoma, Basal Cell ; Cheek ; Cosmetics ; Lip ; Mohs Surgery ; Mouth ; Nasolabial Fold ; Nose ; Quality of Life ; Skin ; Skin Neoplasms ; Sutures

BACKGROUND: Recent advances in hyaluronic acid (HA) fillers and radiofrequency (RF) devices have been made in the context of skin rejuvenation and cosmetic surgery. Moreover, combination regimens with both techniques are currently being developed. OBJECTIVE: The present study was designed to examine the clinical and histologic effects of a new needle that incorporates an RF device for HA injections. METHODS: A new intradermal needle RF device (INNOfill; Pacific Pharma, Korea) was assessed in the present study. In the animal arm, procollagen production was measured by using enzyme-linked immunosorbent assay, the filler volume was quantified by incorporating a dye with filler, and the filler distribution was assessed through the changes in tissue structure. In the human arm, the efficacy of the combination regimen was assessed by using the wrinkle severity rating scale (WSRS). RESULTS: In the animal study, RF treatment increased procollagen production in a time-dependent fashion. The total volume was significantly increased with the RF treatment when compared with the filler injections alone, and lasted for up to 7 weeks after treatment. Additionally, the filler distribution was reduced in animals treated with RF when compared with the untreated group. In the human study, the nasolabial folds of subjects treated with RF before filler injections exhibited a significantly greater change in the WSRS score from baseline when compared with the nasolabial folds treated with filler injections alone. CONCLUSION: A new device incorporating RF treatment before HA filler injection may represent a biocompatible and long-lasting advance in skin rejuvenation.
Animals ; Arm ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hyaluronic Acid* ; Longevity* ; Nasolabial Fold ; Needles ; Procollagen ; Rejuvenation* ; Skin* ; Surgery, Plastic

Botulinum toxin type A is a neurotoxin produced by clostridium botulinum that blocks the presynaptic release of acetylcholine at the neuromuscular junction. This blockade of the neuromuscular junction is definitive, but the existence of nerve sprouting explains the reversible nature of the paralysis induced by injection of this toxin. The clinical effect appears between the 3rd and 7th day after injection. The author had experienced 218 cases from January 1999 to September 1999. We injected toxin on forehead (96 cases), glabella (91 cases), crow's feet (88 cases), neck (12 cases), nasolabial fold (9 cases), masseter muscle (8 cases), and chin (7 cases). The author obtained wrinkles decreased significantly. The effect during the period of activity of the toxin, which lasted 3 to 6 months after injection and masseter muscle area lasted 6 to 9 months. The advantage of botulinum toxin injection is the effective treatment with wrinkles in upper half of face and neck and no disturbance in daily life. The disadvantage of botulinum toxin injection is the feeling of masked face after injection, short duration, and sometimes unwilling facial expression.
Acetylcholine ; Botulinum Toxins* ; Botulinum Toxins, Type A ; Chin ; Clostridium botulinum ; Facial Expression ; Foot ; Forehead ; Masks ; Masseter Muscle ; Nasolabial Fold ; Neck ; Neuromuscular Junction ; Paralysis ; Surgery, Plastic*

BACKGROUND: Classical flaps for perinasal defect reconstruction, such as forehead or nasolabial flaps, have some disadvantages involving limitations of the arc of rotation and two stages of surgery. However, a perforator-based flap is more versatile and allows freedom in flap design. We introduced our experience with reconstruction using a facial artery perforator-based propeller flap on the perinasal area. We describe the surgical differences between different defect subtypes. METHODS: Between December 2005 and August 2013, 10 patients underwent perinasal reconstruction in which a facial artery perforator-based flap was used. We divided the perinasal defects into types A and B, according to location. The operative results, including flap size, arc of rotation, complications, and characteristics of the perforator were evaluated by retrospective chart review and photographic evaluation. RESULTS: Eight patients were male and 2 patients were female. Their mean age was 61 years (range, 35-75 years). The size of the flap ranged from 1 cmx1.5 cm to 3 cmx6 cm. Eight patients healed uneventfully, but 2 patients presented with mild flap congestion. However, these 2 patients healed by conservative management without any additional surgery. All of the flaps survived completely with aesthetically pleasing results. CONCLUSIONS: The facial artery perforator-based flap allowed for versatile customized flaps, and the donor site scar was concealed using the natural nasolabial fold.
Arteries* ; Cicatrix ; Estrogens, Conjugated (USP) ; Female ; Forehead ; Freedom ; General Surgery ; Humans ; Male ; Nasolabial Fold ; Nose ; Perforator Flap ; Retrospective Studies ; Surgical Flaps* ; Tissue Donors

Recently, injectable dermal fillers have become important alternatives to surgical procedures for the correction of facial wrinkles. Bovine collagen is the first approved material for filler injection, and several studies have shown its efficacy. However, the risk of developing an allergic reaction and xenogenic transmission of bovine spongiform encephalopathy remain among its disadvantages. In this randomized, double-blinded, split-face study, we compared the efficacy and safety of a porcine collagen filler (TheraFill(R)) with that of a bovine collagen filler (KOKEN(R)) for nasolabial fold correction. A total of sixty one patients with mild to severe nasolabial fold were randomized to receive TheraFill(R) and KOKEN(R) on contralateral sides of the face. During the 12-month follow-up period, improvement in the Wrinkle-Severity Rating Scale score was slightly higher in TheraFill(R) group than KOKEN(R) group, although the difference was not statistically significant. No serious adverse reactions were observed and both materials were tolerable in most cases. In conclusion, the long-term effect of TheraFill(R) on nasolabial fold correction was comparable to that of KOKEN(R), and it may be a good alternative to bovine collagen filler.
Adult ; Aged ; Animals ; Biocompatible Materials/therapeutic use ; Cattle ; Collagen/adverse effects/*therapeutic use ; Dermatologic Surgical Procedures/*methods ; Double-Blind Method ; Face/surgery ; Female ; Follow-Up Studies ; Humans ; Injections, Intradermal ; Male ; Middle Aged ; Nasolabial Fold/*surgery ; Prospective Studies ; Skin Aging ; Surgery, Plastic/*methods ; Swine ; Treatment Outcome