No abstract available.
Fungi ; Silicone Gels

PURPOSE: Predicting the change in breast size for a specific patient's need is a challenging problem in breast augmentation. We intended to investigate the post-augmentation degree of breast size according to the size of cohesive silicone gel implant. METHODS: To predict post-augmentation breast size, we measured 100 patients' pre-and postoperative 3 month's bust circumference. All patients were performed by total subfascial breast augmentation with moderate profile cohesive silicone gel implant through areolar omega (transareolar-perinipple) incision. RESULTS: According to this study, each additional one pair of 100mL in implant size yielded an approximate 1.5cm increase in bust circumference(p=0.006). CONCLUSION: From this result, we conclude that each additional one pair of 100mL in implant volume yielded about 1.5cm increase in bust circumference. Although this result may not be applied to every patient, we believe that it yields a practical chart that can help to predict the amount of increase in breast size with the use of cohesive silicone gel implant of a specific size preoperatively.
Breast ; Humans ; Silicone Gels

No abstract available.
Female ; Mammaplasty* ; Prostheses and Implants* ; Rupture* ; Silicone Gels*

Keloids are benign fibrcus growths which extend beyond the original wound and rarely regress. Available methods of treatment include surgical excision, radiotherapy, intralesional steroid injection, cryotherapy, systemie. chemotherapy, zinc tape strapping, pressure, silicon gel and combined therapy. Postoperative irradiation is a useful and effective method of eradication or prevent.ion of keloid. We describe two cases of the prevention of keloids associated with postoperative irradiation.
Cryotherapy ; Drug Therapy ; Keloid* ; Radiotherapy ; Silicone Gels ; Wounds and Injuries ; Zinc

Highly cohesive, form-stable cohesive gel implants were introduced in 1993. This resulted in a paradigm shift in breast augmentation surgery. With the introduction of shaped textured implants, surgeon started to think in terms of shape and dimensions rather than volume and cup size. Basically most aspects of such breast augmentations are different. The way of selecting implants is different. Patient preoperative markings, surgical techniques, postoperative recommendations and results also differ. These are not mere new types of implant, but they represent a new concept in breast augmentation surgery. Surgeons who believe that form stable implants behave in the same way as non-form stable implants will tend to plan, select implants and perform surgery in traditional ways. Unfortunately, they are bound to encounter significantly more complications and problems. These implants are recently available in Korea since 2012 and will provide patients and surgeons with the ability of enhanced outcome and results if used properly; however there needs to be a transition from round cohesive gel implant thought process to a more comprehensive approach for the typical Korean plastic surgeon.
Breast ; Breast Implants ; Female ; Humans ; Korea ; Mammaplasty ; Models, Anatomic ; Silicone Gels

PURPOSE: The main problem for reoperation after augmentation mammoplasty is contraction of the capsule surrounding a breast implant and it tends to be recur after second surgery. The author studied that intracapsular injection of triamcinolone could reduce the recurrence of capsular contracture. METHODS: Twenty-six cases of capsular contracture, undertaken at the M.D. Clinic between July 2002 and August 2004, were reviewed. Age, types of previous implant, reoperation methods including triamcinolone injection, and recurrence rates were retrospectively evaluated. RESULTS: Two cases (7.7%) were in their twenties, 14 (53.9%) in their thirties, 7 (26.9%) in their forties and 3 (11.5%) in their fifties. The types of previous implant were as followed: 24 (92.3%) saline, 2 (7.7%) silicone gel, 14 (53.9%) textured type and 12 (46.1%) smooth type. The reoperation methods were as followed: capsulectomy in 4 (15.4%), subpectoral conversion in 1 (3.9%), subpectoral conversion with an intracapsule injection of triamcinolone in 2 (7.7%), capsulotomy in 7 (26.9%) and capsulotomy with an intracapsule injection of triamcinolone in 12 (46.2%). Recurrence occurred in 1 capsulectomy (25%), 1 subpectoral conversion (100%), 0 subpectoral conversion with injection (0%), 4 capsulotomy (57%) and 1 capsulotomy with injection (8.3%). CONCLUSION: The injection of triamcinolone into the capsule following an implant replacement was effective in patients with a capsular contracture after augmentation mammoplasty. It seems to be an effective rational therapy for primary high risk cases with more advanced technique.
Breast Implants ; Contracture* ; Female ; Humans ; Mammaplasty* ; Recurrence ; Reoperation ; Retrospective Studies ; Silicone Gels ; Triamcinolone*

BACKGROUND: Keloid is one of the most frustrating clinical problems in wound healing. There are numerous treatments for keloids such as surgical excision, steroid injection, radiation therapy, laser, silicone gel application and so on. Surgical excision of a keloid is generally not accepted as a first treatment of choice. However, there have been many reports of successful cosmetic results from specialized surgical treatments such as intra-lesional/intra- marginal excision with or without post surgical adjuvant treatments. OBJECTIVE: The aims of this study areto evaluate the effectiveness of intralesional excision of keloids, the optimal surgical conditions and the proper adjuvant therapy after surgery. METHODS: We analyzed the medical records and clinical photographs of 20 patients who underwent intra-lesional excision of their keloids and who had regular follow-ups for at least for 3 months. The clinical outcomes were assessed by three independent physicians based on their interpretation of the photographs before and after surgery with using a global assessment 5 point scale that ranged from bad, poor, fair and good to excellent. RESULTS: General surgical outcomes after intra-lesional excision: the average improvement score was 4.05 after intra-lesional excision and adjuvant therapy. The average improvement score after intra-lesional excision was 4.71 for ear keloids and 2.83 for keloids in other areas (p=0.000). The average improvement score after intra-lesional excision was 5 for earlobe keloids and 4.42 for ear-helix keloids (p=0.014). The average improvement score was 3.92 for the steroid intra-lesional injection and topical silicone gel combination treatment group after intra-lesional excision and the average improvement score was 4.29 for the single topical silicone gel treatment group (p=0.858). CONCLUSION: Although surgery is not a first treatment of choice for the management of keloids, large recalcitrant keloids need massive surgical removal for faster clinical results. In this study, we found that surgery, and especially intra-lesional excision, is not an absolute contraindication for treating keloids and this is sometimes considered as the first treatment of choice, and especially for ear keloids. However, a more careful surgical approach is necessary for the case of keloids that develop in other areas. Further studies about the optimal surgical indications for keloids and the recommended adjuvant therapy after surgery are necessary.
Cosmetics ; Ear ; Follow-Up Studies ; Humans ; Keloid ; Laser Therapy ; Medical Records ; Silicone Gels ; Wound Healing

The perfect breasts are supposed to be symmetrically balanced and proportionate to the rest of the body with softness, good-position, and mobility to respond to gravity and postural change. But saline filled implants have some disadvantages compared to silicone gel implant. Their low viscosity creates an unnatural feeling and suboptimal aesthetic result, their deflation offers the most important complication such as rippling or size reduction of breast. Therefore precise preoperative design, exact procedure and appropriate postoperative care are essential to optimal result. In past 5 years, we have performed the transaxillary subpectoral augmentation mammaplasty using saline filled implants on 183 female patients whose breasts were hypoplastic and followed up 58 months maximally. All patients were assisted with endoscopy. We employed round, textured type implant with the size ranging from 120cc to 270 cc and overinflated them 10 to 20% beyond its original volume. The overall result was satisfactory but some cases of capsular contracture, deflation, implant displacement and infection were found. On the basis of our experience, we suggest some critical points so as to obtain the best result: what conforms to the patients anatomy and satisfies her goal at the same time. First of all, preoperative design in accordance with the dimension is very important. The best dimension for each patient depends on the definition of the ideal base width of the breast. Secondly, exact subpectoral dissection using endoscopy, no-touch technique for the implant is essential to achieve excellent results. Finally, postoperative self management must not be ignored.
Breast ; Contracture ; Endoscopy ; Female ; Gravitation ; Humans ; Mammaplasty* ; Postoperative Care ; Self Care ; Silicone Gels ; Viscosity

Keloids are benign fibrous tumors which extend beyond the original wound. Methods of treatment include surgical excision, radiotherapy, intralesional steroid injection, cryotherapy, silicon gel and combined therapy. Postoperative irradiation or steroid injection could be an effective method for prevention of recurrence after surgical treatment. We report a case of earlobe keloid which occurred after ear piercing. It was treated by excision and saved autograft using the overlying skin of the keloid and then immediate corticosteroid intrawound injection after excision.
Autografts* ; Body Piercing ; Cryotherapy ; Keloid* ; Radiotherapy ; Recurrence ; Silicone Gels ; Skin ; Wounds and Injuries

BACKGROUND: Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel. METHODS: Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared. RESULTS: Thoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group. CONCLUSIONS: The thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.
Breast ; Female ; Free Tissue Flaps ; Glycosaminoglycans ; Humans ; Mammaplasty ; Mastectomy ; Necrosis ; Nipples ; Silicone Gels ; Thorax