Although orthognathic surgery has been performed at the maxilla and the mandibular ramus to obtain a normal functional occulsion and aesthetic improvement of the face, deformities of the chin and disproportion of the soft tissue have been left. Mandibular set-back or advancement usually leaves soft tissue redundancy or deficiency along with its displacement. We have combined genioplasty with orthognathic surgery after intermaxillary fixation through a separate incision to get aesthetic improvement in the chin area in 28 patients. The authors obtained the aesthetic profile of the chin and lower lip according to various soft tissue analysis as follows: 1) The depth of the mentolabial fold 2) The distance from the E-line to labrale inferius (LI) 3) N-ANS/ANS-Me The soft tissue disproportion and residual deformities which were not usually corrected by the orthognathic surgery alone could be improved by combining it with genioplasty.
Chin ; Congenital Abnormalities ; Genioplasty* ; Humans ; Lip ; Maxilla ; Orthognathic Surgery

Soft tissue expansion technique has been a very useful method for the reconstruction of scalp defects and alopecia since the scalp is an unyielding tissue allowing minimal distension in traditional local flap surgery. As a result, there has been wide use of the tissue expansion method in the reconstruction of scalp defect and treatment of alopecia in the plastic surgery. There have been many concerns about histomorphologic changes of the overlying skin and the underlying structure resulting from tissue expansion. We also know that progressive tissue expansion induces increased mitotic activity of the epidermis and thining of the dermis in the overlying skin, as well as significant gross, histologic bony erosion in the underlying structure. However, little informations have been reported about the changes of the hair and pilocebaceus units in scalp expansion. We compared the horizontal sections of the expanded scalp and its longterm histologic changes with a normal unexpanded scalp specimen as a control. The terminal hair proportions to the vellus hair both increased. There was a 32% decrease in follicular units, a 24% decrease in terminal hair, and a 23% decrease in total hairs 8 week after scalp expansion compared to the normal unexpanded scalp. The perifollicular inflammatory changes and fibrosis observed in the full expanded scalp specimen disappeared within 12 weeks after removal of the expander and the flap transposition. In our observation, tissue expansion at the hair-bearing scalp did not precipitate any adverse changes on the hair follicles. On the contrary, we observed that secondary scalp expasion could be safetly performed 3 months after the first scalp expansion.
Alopecia ; Dermis ; Epidermis ; Fibrosis ; Hair Follicle* ; Hair* ; Humans* ; Scalp* ; Skin ; Surgery, Plastic ; Tissue Expansion*

The coronal incision is a useful approach to the upper and middle thirds of the facial skeleton, but injury of the frontal branch of the facial nerve can be possible. The authors experienced 56 cases from 31 patients in which trauma to the temporal fat pad and the facial nerve was avoided by dissecting beneath the deep layer of the deep temporal fascia during temporal dissection in subperiosteal face lift, frontofacial monobloc advancement, Le Fort III osteotomy, and open reduction of zygomatic arch fracture. The advantages of this approach include avoiding injury to the facial nerve and minimal bleeding, thereby allowing for an easy and more rapid procedure. Furthermore, there was no development of postoperative temporal depression. This approach is particularly useful for subperiosteal face lifts, procedures requiring exposure of the zygomatic arch, or procedures requiring access to the mid face.
Adipose Tissue* ; Depression ; Facial Nerve ; Fascia ; Hemorrhage ; Humans ; Osteotomy ; Rhytidoplasty ; Skeleton ; Zygoma

Since osteogenesis in the distraction site of the membranous bone has been well proved in histological studies, distraction osteogenesis of the craniofacial skeleton has become popular as an alternative to conventional orthognathic surgical procedures. Nowadays, mandibular distraction has been applied to balance the mandibular asymmetry in various methods. Bone distraction is not a new idea. The technique was already described by many other authors. One of the most important points of view in the distraction osteogenesis is effective elongation of hypoplastic mandible with preservation of the inferior alveolar nerve and tooth bud. From May 1997 to November 2000 we performed 15 distraction osteogenesis of mandible using our new short sagittal ramus osteotomy in patients with hemifacial microsomia. Our short sagittal ramus osteotomy could effectively lengthen the hypoplastic mandible and avoid the injury to the inferior alveolar nerve or tooth bud.
Goldenhar Syndrome* ; Humans ; Mandible* ; Mandibular Nerve ; Orthognathic Surgical Procedures ; Osteogenesis ; Osteogenesis, Distraction* ; Osteotomy* ; Skeleton ; Tooth

Suturectomy and distraction was thought to be an optimistic solution in craniosynostosis during growth period, but there is no protocol when to stop distraction. Twelve six-week-old New Zealand white rabbits were randomly assigned to four groups; control, suturectomy, distraction, overdistraction. Immobilization was made by methyl cyanoacrylate adhesive for 6 weeks. The last two groups were mechanically distracted with custom-made spring expanders for 3 and 6 weeks. Subsequent growth effects of coronal suture separation were assessed by serial radiographic cephalometry. Cephalometric analysis revealed that there were statistically significant differences in the inclinations of growth distances between four groups, but there is no statistically significant difference between four groups in distance between defined cephalometric points at the beginning and 18 weeks later. In histomorphologic studies, widened intersutural spaces were filled and stabilized with newly deposited bone. In conclusion, growth rates were adapted in experimental craniosynostosis after distraction osteogenesis in growing rabbits, having no concern with presence of distraction, extent of distraction after suturectomy.
Adhesives ; Cephalometry ; Craniosynostoses* ; Cyanoacrylates ; Immobilization ; Osteogenesis, Distraction* ; Rabbits* ; Sutures

BACKGROUND: The incidence of hypotrichosis of pubis and atrichia pubis is relatively higher in oriental countries including Korea. OBJECTIVE: The aim of this study was to develop a treatment method to increase the density and to improve the distribution pattern of pubic hair in these patients. METHODS: Testosterone cream(5%) was applied to ten patients for six months. Then, the individual hair transplantation from the parietotemporal region of the scalp with the specially devised mini-punch was performed. Around the mons pubis, transplantation with 2-3mm punch was done. Postoperatively, the application of testosterone cream was done twice a day. RESULTS: Nine of ten patients were satisfied with the final results. Testosterone cream helped to increase the density of pubic hair. Transplanted hairs showed curling to some extent and did not grow like as it were at donor site. CONCLUSION: The advantage of this method is to make the appearance of pubic hairs more natural by controlling the direction and numbers of transplanting hairs at the time of operation and by making the hair denser with pre- and post-operative application of testosterone cream. The authors hope many dermatologic surgeons to use this new treatment approach for atrichia pubis and hypotrichosis of pubis.
Hair ; Hope ; Humans ; Hypotrichosis* ; Incidence ; Korea ; Scalp ; Testosterone* ; Tissue Donors

The goals of reduction mammoplasty are to remove the appropriate amount of breast tissue and to make the nice cone-shaped breast. For these goals, various methods have been used and newly introduced. Recently, as women's interest in cosmetic attractiveness increases, surgeons make attempts to minimize postoperative scars. Periareolar approach has an advantage of invisible postoperative scar, but has many disadvantages - flattening of breast shape, recurrence of breast ptosis, hypertrophy and widening of periareolar scar, enlargement and distortion of areola caused by tension. After Benelli introduced Round block technique, this approach became one of the most popular methods. The characteristics of Round block technique are periareolar approach, superiorly based dermoglandular pedicle, criss-cross mastopexy, and Round block suture. Authors modified periareolar Round block technique to adjust to Korean women and have operated on 11 patients since 1997. We focused on medializing the lateral portion of inframammary fold and avoiding asymmetry and protrusion of nipple-areolar complex. Round block suture with uniform thickness and length must be applied at the same time to prevent areolar complications. In design, authors referred to the statistical analysis on Korean female. The results are aesthetically and functionally satisfactory and there has been no significant complication. In conclusion, this method is effective for young woman or mild macromastia with moderate ptosis. Besides, an accurate understanding of each step of operative procedure and enough knowledge of anatomy and physiology of the breast are essential.
Breast ; Cicatrix ; Female ; Humans ; Hypertrophy ; Mammaplasty* ; Physiology ; Recurrence ; Surgical Procedures, Operative ; Sutures

Purpose: This study aims to enhance the performance of deep learning models for segmenting thin anatomical structures in medical images by introducing a label-preserving data-augmentation strategy. Materials and Methods: We developed a data-augmentation technique that applies geometric transformations and their inverses sequentially to input images while preserving the corresponding labels. This method was evaluated on inner ear magnetic resonance images for the automatic segmentation of semicircular canals characterized by thin and circular structures. The dataset included both internal and external samples. For the internal dataset, 70 subjects were used for model training and eight subjects for internal validation. Images were acquired using a 3 tesla magnetic resonance imaging scanner with a three-dimensional high-resolution T2 sequence, and ground-truth segmentations were manually annotated by an experienced radiologist. For external validation, four subjects from a public dataset (Vestibular-Schwannoma-SEG dataset, part of The Cancer Imaging Archive) with high-resolution T2 images for inner ear analysis were used. We performed quantitative evaluations using metrics such as Dice, intersection over union (IoU), 95% Hausdorff distance (HD), and average surface distance (ASD). A qualitative visual assessment was also performed. Results: The proposed model exhibited improved performance in semicircular canal segmentation in both quantitative and qualitative evaluations. Metrics such as Dice, IoU, 95% HD, and ASD indicated better performance than conventional methods. Conclusion The proposed label-preserving data augmentation method improves the segmentation of thin anatomical structures in medical images and offers a robust and efficient solution for enhancing deep learning models in medical imaging.

Purpose: This study aims to enhance the performance of deep learning models for segmenting thin anatomical structures in medical images by introducing a label-preserving data-augmentation strategy. Materials and Methods: We developed a data-augmentation technique that applies geometric transformations and their inverses sequentially to input images while preserving the corresponding labels. This method was evaluated on inner ear magnetic resonance images for the automatic segmentation of semicircular canals characterized by thin and circular structures. The dataset included both internal and external samples. For the internal dataset, 70 subjects were used for model training and eight subjects for internal validation. Images were acquired using a 3 tesla magnetic resonance imaging scanner with a three-dimensional high-resolution T2 sequence, and ground-truth segmentations were manually annotated by an experienced radiologist. For external validation, four subjects from a public dataset (Vestibular-Schwannoma-SEG dataset, part of The Cancer Imaging Archive) with high-resolution T2 images for inner ear analysis were used. We performed quantitative evaluations using metrics such as Dice, intersection over union (IoU), 95% Hausdorff distance (HD), and average surface distance (ASD). A qualitative visual assessment was also performed. Results: The proposed model exhibited improved performance in semicircular canal segmentation in both quantitative and qualitative evaluations. Metrics such as Dice, IoU, 95% HD, and ASD indicated better performance than conventional methods. Conclusion The proposed label-preserving data augmentation method improves the segmentation of thin anatomical structures in medical images and offers a robust and efficient solution for enhancing deep learning models in medical imaging.

Purpose: This study aims to enhance the performance of deep learning models for segmenting thin anatomical structures in medical images by introducing a label-preserving data-augmentation strategy. Materials and Methods: We developed a data-augmentation technique that applies geometric transformations and their inverses sequentially to input images while preserving the corresponding labels. This method was evaluated on inner ear magnetic resonance images for the automatic segmentation of semicircular canals characterized by thin and circular structures. The dataset included both internal and external samples. For the internal dataset, 70 subjects were used for model training and eight subjects for internal validation. Images were acquired using a 3 tesla magnetic resonance imaging scanner with a three-dimensional high-resolution T2 sequence, and ground-truth segmentations were manually annotated by an experienced radiologist. For external validation, four subjects from a public dataset (Vestibular-Schwannoma-SEG dataset, part of The Cancer Imaging Archive) with high-resolution T2 images for inner ear analysis were used. We performed quantitative evaluations using metrics such as Dice, intersection over union (IoU), 95% Hausdorff distance (HD), and average surface distance (ASD). A qualitative visual assessment was also performed. Results: The proposed model exhibited improved performance in semicircular canal segmentation in both quantitative and qualitative evaluations. Metrics such as Dice, IoU, 95% HD, and ASD indicated better performance than conventional methods. Conclusion The proposed label-preserving data augmentation method improves the segmentation of thin anatomical structures in medical images and offers a robust and efficient solution for enhancing deep learning models in medical imaging.