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

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

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

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

The Asian face is generally shorter and wider than western face whose face is dolichocephaly. Therefore the reduction malarplasty is one of the common aesthetic surgery performed in Asians. As the number of cases of aesthetic reduction malarplasty including osteotomy technique of zygoma body increase, the complications related to the osteotomy also increase. Among the various complications, if the ostotomized zygoma body does not heal or reunite, it may cause a serious problem not only to the surgeon but also to the patients. From June 2002 to July 2003, the authors experienced 5 patients whose zygoma body did not reunite after reducing their malar prominence at other clinic. Their major complains were subjective discomfort at the operated site, depression on malar eminence, abnormal click sound on mouth opening, etc. None of them had any evidence of rigid fixation on their osteotomy of the zygoma body. The Rib bone was harvested and grafted to the bone gap due to the nonunion of zygoma body. All grafted bones were rigidly fixed and survived. In conclusion, bone to bone contact without soft tissue impingement should be preserved for the bone healing after zygoma body osteotomy. Therefore the rigid fixation method of osteotomy is the fundamental element during the operation. The rib bone interpositional graft can be one of the solution methods in the unfortunate nonunion cases.
Asian Continental Ancestry Group ; Depression ; Humans ; Mouth ; Osteotomy ; Ribs ; Transplants ; Zygoma*

The object of this study is to introduce a novel method of foreheadplasty. The new foreheadplasty can lower the anterior hairline and results in reduction of the vertical forehead length and mid-face lift can be performed at the same time. A 54 year-old female who had a long forehead visited the clinic for rejuvenation of the mid-face. The authors performed dual-vector foreheadplasty and were able to lower the anterior hairline by the advancement of the posterior scalp flap. Mid-face lift was performed by elevation of the malar fat pads. The surgical results were analyzed by measuring the length of the forehead before and 2 years after the surgery. Medical photographs were taken at the same period. The preoperative length of the forehead was 75.5 mm and decreased to 63.0 mm after the surgery. The shortened forehead was well maintained even 2 years after the operation (63.3 mm). The patient suffered from partial sensory loss of the parietal region but resolved simultaneously after 2 months. No other complications, such as, hypertrophic scarring, infection, prolonged inflammation and alopecia occurred. In conclusion the dual-vector foreheadplasty is a relatively simple and safe way to lower the anterior hair line with the elevation of the mid-face.
Adipose Tissue ; Alopecia ; Cicatrix, Hypertrophic ; Female ; Forehead ; Hair ; Humans ; Inflammation ; Rejuvenation ; Rhytidoplasty ; Scalp

Total auricular reconstruction with autogenous tissue remains one of the greatest technical challenges for reconstructive plastic surgeons because of the ear's complex morphology with delicately convoluted cartilages and very thin skin. In a successfully created ear, a natural three-dimensional illusion visualized from the patient's profile, frontal, and posterior views is crucial. Accordingly ear framework should have adequate lateral aspect as well as suitable frontal aspect even before being lifted to this purpose. For this goal, rib cartilage should be harvested from three-dimensionally adequate area. It is the most essential point in framework fabrication that the baseblock should have semi-cup curvature via multiple parallel cuts made on its medial surface. Between January 1999 and May 2003, we performed 29 cases of total ear reconstruction with autogenous rib cartilage graft using this scoring technique and obtained satisfactory results, which showed more natural appearance visualized from the patient's profile, frontal, and posterior views.
Cartilage ; Ear* ; Illusions ; Ribs ; Skin ; Transplants