In obese children, the phallus may be camouflaged by excessive deposition of fat at prepubic area. Recently, concealed penis has begun to receive the more attention about possibility of its urologic correction. Between February 1993 and February l994, we treated 5 patients with concealed penis. All patients were prepuberty, their phalli are palpated normal in size and no specific abnormal findings were detected in preoperative evaluation including physical examination, laboratory examinations (CBC, platelet, PT, PTT, liver function test, urinalysis, hormonal assay, chromosomal study). 2 of 5 patients were circumcised and 1 of 5 patient had a history of penoplasty without liposuction. The phallus length were measured 0cm to 0.5cm (mean 0.2cm) preoperatively, 3.5cm to 4.5cm (mean 4.0cm) postoperatively and 3.5cm to 4.2cm (mean 3.9cm) at 3 months after operation. In conclusion, we suggest that penoplasty using liposuction produces a good functional and cosmetic results.
Blood Platelets ; Child ; Humans ; Lipectomy* ; Liver Function Tests ; Male ; Penis* ; Physical Examination ; Urinalysis

PURPOSE: Perceiving the experience that MRD1 is increased after small-incision double-eyelid operation, it has been statistically verified the improvement of MRD1 retrospectively. Therefore, we suggest new interpretation for Korean-specific small eye and more definite classification for ptosis. METHODS: In operation, we made 3 small incisions according to the line designed on upper eyelid and removed some soft tissues including connective tissues. Then, figure-of-8 continuous buried ligation was performed through the incision windows. This study is a retrospective study, measures MRD1 changes and excursion distance change of eyelid margine and eyebrow using pre- and post-operative photos of 14 patients. RESULTS: Postoperative photos were taken on the 4th day and all of 14 patients had an improvement in MRD1 statistically. The excursion distance of upper eyelid was improved in half of patients, though not in the range of statistical verification. It was statistically confirmed that the movement of eyebrow was reduced after operation. CONCLUSION: It is thought that MRD1 improvement without any operation on levator complex means that soft tissue including connective tissue eliminated in operation restricts the movement of upper eyelid. It is defined such factors as burden factors and such phenomenon as burdened eyelid. It is thougt that Korean's small eye is mainly burdened eyelid and cosmetic improvement may be obtaind even by removing such burden factors.
Blepharoptosis ; Classification ; Connective Tissue ; Eyebrows ; Eyelids ; Humans ; Ligation ; Retrospective Studies

In the maxillofacial surgery, close care is mandatory during operation and anesthesia. The surgical field is limited since most procedure is done through the mouth. In this situation, airway management and blood pressure controls are keystone. So, the induced hypotensive anesthesia is essential to the maxillofacial surgery for bleeding control and accurate operation. One hundred and ninety-eight cases of maxillofacial surgery was carried out under induced hypotensive anesthesia from 1991 to 1999. Authors divided them into 4 groups based on the anesthetic protocol. In group 1(n = 43) inhalation anesthetics(enflurane, halothane) and sodium nitroprussde(SNP) were used; in group 2(n = 99) inhalation anesthetics(enflurane), SNP and labetalol were used; In group 3(n = 27) inhalation anesthetics(enflurane) and labetalol were used; In group 4(n = 29) total intravenous anesthesia(propofol, fentanyl, midazolam) was applied with SNP, and esmolol(or labetalol). The patient records were retrospectively studied during the operation and anesthesia, including degree of fluctuation in the mean arterial blood pressure, amounts of the blood loss and transfusion during the operation, complications, and the period of hospitalization. Mean operation time of 4 groups decreased in order. The blood pressure was controllable without reflex tachycardia in beta-blocker using groups. Amount and incidence of transfusion was smaller in total intravenous anesthesia group. However there were no significant differences in total admission days and ICU stay periods between 4 groups.
Airway Management ; Anesthesia ; Anesthesia, Intravenous ; Arterial Pressure ; Blood Pressure ; Fentanyl ; Hemorrhage ; Hospitalization ; Humans ; Incidence ; Inhalation ; Labetalol ; Mouth ; Reflex ; Retrospective Studies ; Sodium ; Surgery, Oral ; Tachycardia

PURPOSE: The history of biometry dates back to ancient Greek. The ideal body ratio from biometry is used as a guideline in many works of art. Biometry is also used as a medical standard to determine normal or abnormal. Since the biometry of face is so complicated, many surgeons tend to regard preoperative evaluation as a bother and substitute medical records with some photographs. We introduce a new method to measure MRD1 and levator function using digital photographs, which becomes widely used lately. METHODS: MRD1 can be measured with the primary- gaze-view photo which is magnified by PhotoshopR 7.0.1. The distance from coneal reflex of ring flash to upper eyelid margin is converted to mm-unit using the piece of ruler attached on the patient's face. Levator function can be measured with up-gaze-view photo and down-gaze-view photo which are superimposed on another. The excursion distance of upper eyelid margin (a) and the excursion distance of eyebrow (b) are measured respectively. The levator function can be assessed through subtraction of two values (a-b). This method is simple and precise and can be applied directly to patient without photos. RESULTS: Using magnified digital photos and computer, this method can reduce personal error and instrumental error. Taking some digital photos doesn't take long time, so it can reduce the effort of preoperative evaluation and discomfort of patients. CONCLUSION: Digital photo-biometry is useful for retrospective study. Especially reducing personal error, it is useful when the number of specimens is huge. New levator function test is much more useful for Asian- specific eyes than Berke's method allowing frontalis muscle compensation.
Biometry ; Compensation and Redress ; Eyebrows ; Eyelids ; Humans ; Medical Records ; Reflex ; Retrospective Studies

PURPOSE: The presence of epicanthal fold and the absence of supratarsal fold are characteristics of Korean eyelids. There has been many surgical procedures to eliminate medial epicanthal fold but those procedures focus on the lengthening of horizontal palpebral fissure and the shortening of intercanthal distance so that the shape of eye had tendency to be sharp. The authors suggest that the supermedial shifting of epicanthal fold enhance the aesthetic result. METHODS: From Sep 2006 to May 2007, total 17 women(mean age 22) with Type III epicanthal fold underwent epicanthoplasty using author's modified Uchida method. The design for epicanthoplasty was drawn superolaterally along epicanthal fold and split V-W plasty was done to shift the epicanthal fold superomedially. Also non-incisional double-eyelid operation was underwent. RESULTS: The epicanthal fold was shifted in superomedially, intercanthal distance was shortened and double-eyelid was achieved. The patients were satisfied with the result and no major complication was noted. CONCLUSION: This method can be effective in correcting the epicanthal fold of Korean eyelid by shifting the epicanthal fold superomedially to make the shape of eye aesthetically without noticeable scar.
Cicatrix ; Eyelids ; Humans ; Sterilization, Tubal*

In plastic and reconstructive craniomaxillofacial surgery, careful preoperative planning is essential to get a successful outcome. Many craniomaxillofacial surgeons have used imaging modalities like conventional radiographs, computed tomography(CT) and magnetic resonance imaging(MRI) for supporting the planning process. But, there are a lot of limitations in the comprehension of the surgical anatomy with these modalities. Medical models made with rapid prototyping (RP) technique represent a new approach for preoperative planning and simulation surgery. With rapid prototyping models, surgical procedures can be simulated and performed interactively so that surgeon can get a realistic impression of complex structures before surgical intervention. The great advantage of rapid prototyping technique is the precise reproduction of objects from a 3-dimensional reconstruction image as a physical model. Craniomaxillofacial surgeon can establish treatment strategy through preoperative simulation surgery and predict the postoperative result.
Comprehension ; Models, Anatomic ; Plastics ; Reproduction

Korean small eyes are characterized in thickness and pseudoptosis of the skin of the upper eyelid. They also have a large amount of subcutaneous and preaponeurotic fat. The hypertrophic orbicularis oculi muscles and the lower positioned transverse ligaments are included in their structural characteristics. These special features act as various burden factors in Korean double eyelid operation. Just burden factors restrict the movement of the upper eyelid and so Korean eyes looks like Ptosis (pseudoptosis). For creation of double fold eyelid, we performed continuous 2-loop single stitch buried suture to make an en bloc fixation with dermis, levator aponeurosis and Muller muscle through three small incisions. And then we tried to eliminate the burden factors through small sized lateral incision. After removal of the external sutures at postoperative 3 days, we obtained our intended double fold lines such as in-fold, in-ward fold and out fold successfully and only experienced minor complications such as edema, ecchymosis and loss of fold. And also the range of excursion in the upper eyelid improved without levator shortening or any other operation such as a sling. The objective of this article is to share our experience and to introduce our method of treating Korean pseudoptotic eyes by using 2-loop en bloc fixation through three small incisions with various reviews of literature.
Dermis ; Ecchymosis ; Edema ; Eyelids ; Ligaments ; Muscles ; Skin ; Sutures