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Easy Method to Determine Skin Excision Amount in Upper Blepharoplasty.

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):737-740.

The aging change that occur to the upper eyelid is the obscurity of the position of eyelid crease by the appearance of redundant upper eyelid skin and fold displacement. The solution is to raise the eyelid crease of the affected upper eyelid through the excision of excess soft tissue. Despite of many descriptions of blepharoplasty in the literature, marking the upper lid skin excision has not been well described. Many operators advocate use of a forceps to measure the amount of skin to be excised. But this method is not accurate and may result asymmetric double folds especially in less- experienced operators. Thus we present easy, accurate, and simple method to determine the amount of the skin to be excised as follows: The lower incision is drawn 6-8mm apart from the lid margin in sitting position while gently pulling upward the upper eyelid. While the marking pen is held at the level of the lower incision line, upper lid return to initial natural position, then a mark is made at the same level. After this procedure is repeated at several points, the dots are connected to a continuous line for the upper line of skin excision.
Aging ; Blepharoplasty* ; Eyelids ; Skin* ; Surgical Instruments

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Application of Medifoam B(R) & Negative Pressure Therapy for the Auxiliary Treatment of Pressure Sore.

June Hyuk LEE ; Ho Jik YANG

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):733-736.

Pressure sore is usually developed by repeated or persistent pressure given to fixed regions. Due to increase in old ages, paraplegia or quadriplegia by traffic accidents and industrial accidents, the incidence of pressure sore is increasing. V.A.C.(R)(vacuum assisted closure, KCI Inc, U.S.A.) has been highly effective for accelerating wound healing, however, high cost and the use of special equipment have been preventing it from popular use. We applied the negative pressure of wall suction (100-150mmHg) with Medifoam B(R)(Hydrophilic polyurethane foam, Ildong Pharm, Co., Korea) on pressure sore wound instead of expensive dressing foam of V.A.C.(R) So, we could accelerate wound healing without special equipment or incurring high cost. We were able to reduce the cost to 10% with Medifoam B(R) and wall suction dressing compared with V.A.C.(R) In this aspect, the technique explained above seems to be clinically useful.
Accidents, Occupational ; Accidents, Traffic ; Bandages ; Incidence ; Paraplegia ; Polyurethanes ; Pressure Ulcer* ; Quadriplegia ; Suction ; Wound Healing ; Wounds and Injuries

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A Case Report of Maxillary Reconstruction by Using Vascularized Calvarial Bone and Free Rectus Abdominis Myocutaneous Flap.

Choong Jae LEE ; Joong Kyeong KIM ; Se ll LEE

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):729-732.

Total maxillectomy usually results in defects on anterior, posterior, medial and lateral wall of the maxilla besides the palate and the orbit floor. The traditional reconstructive approaches to maxillectomy include skin grafting to line the internal cavity and palatal prosthesis to obturate the palate and serve as a denture. This method is easy to detect tumor recurrence by direct examination. The drawback of this method is that the infection rate is very high and it can not yield structural support to the upper midface. It is not possible to repair the maxillary defects effectively when using only the hard tissue like bone. The reconstruction by using soft tissue makes it possible to repair the defects on the medial nasal wall, eye socket and the palate, but it is impossible to reconstruct the malar eminence. Therefore, the transfer of soft and hard tissue is recommended for the ideal and effective reconstruction of the defect after the total maxillectomy. We have acquired satisfactory results for both fuctional and aesthetical purposes in the cancer patient who received the maxillectomy by using the vascularized calvarial bone and the free rectus abdominis myocutaneous flap.
Dentures ; Humans ; Maxilla ; Myocutaneous Flap* ; Orbit ; Palate ; Prostheses and Implants ; Rectus Abdominis* ; Recurrence ; Skin Transplantation

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Experience of Recurrent Periprosthetic Infection After Augmentation Mammaplasty.

Seung Il JUNG ; Young Cheun YOU ; Won Yong YANG ; Jun PARK

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):723-728.

Infection following insertion of a breast implant is relatively uncommon, with an overall incidence of less than 4 percent, but can be devastating. Although its management options may be antibiotic therapy along with active surgical regimen like drainage, mechanical irrigation, debridement and implant removal, the efficacy of aforementioned therapeutic regimen is unclear in some cases, thus can be challenging. In particular cases of being chronic and refractory to therapy, spreading of infection which was originally localized in the periprosthetic space-over adjacent tissues by an aggressive curettage at the early stage appears to play a major role. Months elapse before a complete resolution of the infection, and it can also cause serious physical and mental issues in patients. Based on clinical and operative findings in four cases of a chronic, refractory and recurrent periprosthetic infection following an aggressive initial debridement and curettage, we suggest that surgeon should be watchful against debridement and curettage at the early stage of infection and pay special attention to make an accurate and limited curettage using endoscopy.
Breast Implants ; Curettage ; Debridement ; Drainage ; Endoscopy ; Female ; Humans ; Incidence ; Mammaplasty*

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A Case of Facial-nerve Neurofibroma in Parotid Gland.

In Gue KIM ; Sug Won KIM ; Yoon Kyu CHUNG ; Chul Hwan SEUL

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):719-722.

The incidence of solitary neurofibroma of the facial nerve originating from the parotid region is extremely low, and there are two cases reported in Korea to our knowledge. We report a case of neurofibroma in parotid gland in a 17-year-old male. The patient had a slow growing, nontender parotid mass on the right side without facial paralysis & lymphadenopathy. He had systemic neurofibromatosis and family history. CT scan showed a 3x3cm sized eliptical, well demarkated mass that was located in the anterior portion of the superficial lobe and outside of masseter muscle. The mass was well-enhanced and surgically removed with minimal nerve injury. Histopathologic examination indicated neurofibroma. Thus, we report this case to discuss intraparotid neurofibroma compared with Schwannoma.
Adolescent ; Facial Nerve ; Facial Paralysis ; Humans ; Incidence ; Korea ; Lymphatic Diseases ; Male ; Masseter Muscle ; Neurilemmoma ; Neurofibroma* ; Neurofibromatoses ; Parotid Gland* ; Parotid Region ; Tomography, X-Ray Computed

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Iliac Vein Compression Syndrome with Chronic Leg Ulcer: A Case Report.

Gwang seog SEO ; Paik Kwon LEE ; Jong Won RHIE ; Sang Tae AHN

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):714-718.

Iliac vein compression syndrome is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein thrombosis, severe leg edema and ulceration. We experienced a 55-year-old male patient with recurrent left leg ulcer for 15 years. Skin grafting had been done three times, but none of them healed the patient. Femoral venography showed a complete occlusion of the left common iliac vein. Palma-Dale bypass grafting procedure(crossover saphenous vein bypass grafting) and arteriovenous fistula formation was done. The leg ulcer healed two months after the operation.
Arteriovenous Fistula ; Edema ; Humans ; Iliac Artery ; Iliac Vein* ; Leg Ulcer* ; Leg* ; Male ; May-Thurner Syndrome* ; Middle Aged ; Phlebography ; Saphenous Vein ; Skin Transplantation ; Transplants ; Ulcer ; Venous Thrombosis

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A Standardized Model of Partial Thickness Burn in Domestic Pig.

Sungchul PARK ; Daegu SON ; Kwangyu PARK ; Kihwan HAN

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):707-713.

A standardized animal model with an identical burn wound depth is necessary to carry out a study on burn wound healing. It should be easy to operate, reliable and reproducible. The authors used pigs because they histologically resembles human skin most. The method of getting the pigs burned embodied a standardized burn models by using a digitally controlled aluminum thermal block designed by the authors. Nine pigs were burned by maintaining the heat at 70degrees C for 10 seconds, 15 seconds and 20 seconds, respectively, and at 80degrees C, 85degrees C, 90degrees C, 95degrees C and 100degrees C, every 5 seconds, 10 seconds and 15 seconds, for a total of 54 contact burn wounds. And another six pigs were burned at same contact time and temperature (n=3). Another three pigs were burned by maintaining the heat at 80degrees C for 10 seconds to produce 30 more contact burn wounds (n=30). After wounding, the burned skin was biopsied, stained with H&E and observed under microscopy. Two pathologists measured the vertical distance between the basement membrane and dermal tissue of the deepest burned tissue. The depth of burn increased at a regular phase in proportion to the temperature and the time of increasing temperature. The depth of 30 biopsies of the burned tissue at 80degrees C for 10 seconds was similar statistically. Therefore, the standardized burn model of a pig, made by using digitally controlled aluminum thermal block is highly simple, reliable and reproducible for a standardized burn model, and will be very helpful in the study of burn wound healing.
Aluminum ; Basement Membrane ; Biopsy ; Burns* ; Hot Temperature ; Humans ; Microscopy ; Models, Animal ; Skin ; Sus scrofa* ; Swine ; Wound Healing ; Wounds and Injuries

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Effect of Retinoic Acid Derivatives Using Polyethylene Glycol(PEG), Polyvinyl Pyrrolidone(PVP) on Dermal Wound Healing.

Won Seok JUNG ; Jin Han CHA ; Yang Woo KIM ; Han Jung KIM

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):701-706.

Retinoids are compounds with pleiotropic functions, selectively targeting certain skin structures. They are vitamins which must be derived from diet because retinol(vitamin A) is not synthesized in the body, and also they are hormones with intracrine activity, because retinol is transformed into molecules that bind to nuclear receptors, exhibit their activity, and are subsequently inactivated. Enhanced healing of full-thickness skin wounds has been demonstrated in early wound healing studies. OBJECTIVE: Our purpose is to observe the chemical and histologic effects of topical retinoid derivatives(0.05%) applied directly to the dermal wound of guinea pig. METHODS: We prepared five kinds of retinoid derivative, applied each one on the wound on back of guinea pig. After 4 and 8 weeks, each wound was observed under microscope and analyzed for the amount of the collagen. RESULTS: Among the newly developed retinoid derivatives, PVP-RA(ester form) was the most effective in wound healing of the dermal damaged guinea pig. CONCLUSION: Retionid derivatives were effective in dermal wound healing if well prepared.
Animals ; Collagen ; Diet ; Guinea Pigs ; Polyethylene* ; Polyvinyls* ; Receptors, Cytoplasmic and Nuclear ; Retinoids ; Skin ; Tretinoin* ; Vitamin A ; Vitamins ; Wound Healing* ; Wounds and Injuries*

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Configuration and Anthropometry of the Nose and Upper Lip in Newborn Around Gwangju-Jeonnam Area.

Yu Jin LEE ; Jeong Yeol YANG ; Seung Chan LEE ; Gyeong RO ; Ji Seoun CHEON

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):692-700.

Cleft lip and palate are common defects in congenital deformity. Nose deformity is most common among various facial deformities at the center of face. So we must operate to correct the deformity at the earliest stage to give the patients and parents mental relief from anxiety. It is also necessary to establish the facial anthropometry in newborns, because of the current trend of early intervention, such as fetal surgery, lip adhesion, and use of nasoalveolar molding devices. But there is a lack of literature and research on newborns. So we carried out this research to form base data for operations. The nose of 90 newborns in Gwangju-Jeonnam area were analyzed quantitatively, based on 13 facial measuring points and 18 anthropometric values taken directly from the face of newborns. The relationship between the nasal measurements were studied in 11 proportion indices. Followings are our results for newborns. Width of the nasal root was 13.9mm. Width of the nose was 22.1mm. Width of the columella was 4.5mm. Height of the nose was 22.6 mm. Length of the nasal bridge was 20.1mm. Nasal tip protrusion was 8.9 mm. Width of the nostril floor was 6.4mm. Thickness of the nasal ala and length of the nasal ala were 4.0mm, 15.4mm. Length of the columella was 3.9mm. The most common nostril shape was Type II(0-45 degrees in inclination of the nostril axis from the horizontal). Nasal index was 97.8. Columella-nasal tip protrusion length index was 43.9. The development of the columella was relatively incomplete in the case of newborns. The normal indices could be used clinically in identifying it's normality as well as morphologic characteristics of the craniofacial structures. They also could be used in different diagnosis between the morphologically similar congenital craniofacial anomalies, in preoperative design, and assessing the effect of the operation.
Anthropometry* ; Anxiety ; Axis, Cervical Vertebra ; Cleft Lip ; Congenital Abnormalities ; Diagnosis ; Early Intervention (Education) ; Fungi ; Humans ; Infant, Newborn* ; Lip* ; Nose* ; Palate ; Parents

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The Classification and Clinical Characteristics of the Crow`s Feet in Koreans.

Kyo Jin CHOO ; Dae Hwan PARK ; Ki Young AHN ; Chul Hong SONG

Journal of the Korean Society of Plastic and Reconstructive Surgeons.2004;31(5):687-691.

Most common signs of human aging often include skin fold and wrinkles in the lateral canthal area. It is called "crow's feet". The accordion-like activity of the orbicularis oculi muscle during movements of facial expression accentuates this phenomenon because the muscle shortens but the skin does not. The purpose of this study is to present the classification of the crow's feet and to look for it's clinical characteristics in Koreans. The pictures of lateral view of the crows feet in 105 patients taken with digital camera are classified by their age, sex, types and degree of direction. Results show that there are three types of crows feet such as upper, lower and bidirectional types. Bidirectional type is the most common type(85%), lower directional type is 15% and upper directional type is 5%. In thirties, bidirectional type is 50% but the rate of this type increases in older groups. So in over sixties, bidirectional type is almost 100%. There are no differences between the two sexes. The degree of the direction of wrinkles increases in thirties and forties, but in fifties or over no difference was seen. In summary, this study could be helpful to decide the procedure in correction of the crow's feet.
Aging ; Classification* ; Crows ; Facial Expression ; Foot* ; Humans ; Skin

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