1.Outcomes of Mandibular Reconstruction Using Free Flap After Head and Neck Cancer Resection and Approaches for Improvement
Unubold E ; Denis S ; Odontungalag Ts ; Yanjinlkham M ; Amarsanaa G ; Tsetsegkhen N ; Gantsetseg G ; Battsengel B ; Gan-Erdene B ; Bat-Erdene M ; Bulganchimeg S ; Ganbaatar Yu ; Odkhuu J ; Enkh-Orchlon B
Mongolian Journal of Health Sciences 2025;87(3):82-89
Background:
Reconstruction of mandibular and maxillary defects resulting
from malignant tumors has remained a complex challenge in recent years. Defects
caused by tumors—as well as trauma, inflammatory diseases, and congenital
anomalies—lead to impaired essential functions such as mastication,
swallowing, and speech. Prior to the 1950s, reconstruction of maxillofacial
hard tissue was not commonly performed. Instead, metal plates were used to
reestablish bony continuity, and surrounding tissues were utilized to close soft
tissue defects, without effectively restoring function.
With modern advances in three-dimensional (3D) virtual planning, it is now possible
to accurately plan free bone flaps for reconstructing jaw defects. During
surgery, manually bending reconstruction plates to fit donor bone precisely is
often not feasible. Preoperative 3D planning allows for precise fabrication of
surgical guides and fixation plates, improving accuracy and significantly reducing
operative time. Additionally, incorporating dental implant planning into
the reconstruction process facilitates restoration of both structural and functional
outcomes.
Aim:
To evaluate the outcomes of mandibular defect reconstruction using
scapular free flaps in Mongolia and explore potential approaches to optimize
the technique.
Materials and Methods:
This was a case study series. Data from reconstructive
surgeries performed at the National Cancer Center of Mongolia, Central
Dental Hospital, and the Mongolia-Japan Hospital were collected. Variables
included patient age and sex, etiology of the mandibular defect, size of the
scapular bone segment, operative time, ischemia time of the free flap, number
of vascular anastomoses performed, and pedicle length.
For 3D planning, CT scans of the patient's head and lower limb (slice thickness
<1 cm) were used to generate 3D models via the 3D Slicer software. Cutting
guides for the mandible and scapula (ASIGA), as well as the reconstruction
models (AMS), were printed using a 3D printer.
Results:
A total of 400 free flap reconstructions were performed during the
study period. Of these, 29 cases involved reconstruction of mandibular defects
using scapular free flaps. The mean age of patients was 40.0 ± 18.3 years,
with 52% (15 patients) being female. The etiologies of the defects included
malignant tumors (13 cases, 45%), benign tumors (6 cases, 21%), and pre-existing
defects (10 cases, 34%).
In one case, tumor resection and mandibular reconstruction were performed
using 3D planning. The total operative time was 9 hours and 30 minutes, and
the ischemia time was 2 hours and 40 minutes.
Conclusion
Between 2012 and 2025, a total of 29 mandibular reconstructions
using scapular free flaps were performed in Mongolia. Traditional reconstruction
methods were associated with prolonged ischemia time. The use of
3D surgical planning has shown potential in significantly reducing ischemia
time and improving surgical outcomes.
2.Pyogenic Granuloma Arising from a Port-Wine Stain on the Scalp: A Case Report and Literature Review
Kunyong SUNG ; Chanho JEONG ; Sang-Yeul LEE
Korean Journal of Head and Neck Oncology 2025;41(1):9-12
Pyogenic granulomas (PGs), also known as lobular capillary hemangiomas, are common reactive lesions that are non-neoplastic in nature. While they typically present as isolated lesions, they can rarely develop from preexisting port-wine stains (PWSs). PWS-associated PGs may occur spontaneously but are often linked to pregnancy or prior treatments such as laser therapy, intense pulsed light therapy, or radiotherapy. Here, we report a rare case of a PG arising from a PWS on the parietal scalp of a 27-year-old man with no history of trauma or prior treatment for his PWS. Given the potential for secondary lesion development in PWS, regular monitoring is essential, particularly in patients with associated risk factors.
3.Surgical Deroofing of Auricular Pseudocysts: Two Case Reports
Kunyong SUNG ; Heejeong PARK ; Seung Ho LEE ; Sang-Yeul LEE
Korean Journal of Head and Neck Oncology 2025;41(1):5-8
An auricular pseudocyst is an uncommon, benign cystic lesion that frequently occurs in the auricles of middle-aged male patients, characterized histologically by an intracartilaginous, non-epithelial-lined cystic space. This report presents two cases of auricular pseudocysts successfully treated using deroofing procedures, with excellent long-term outcomes observed at 6-month and 5-year follow-up, respectively. Although various treatment modalities may be employed for these lesions, surgical deroofing is considered a conventional and reliable option that provides low recurrence rates and superior aesthetic outcomes.
5.Surgical management of bilateral dorsal hand complications following Artecoll injections: a case report
Seung Ho LEE ; Suk Joon OH ; Kun Yong SUNG
Archives of Aesthetic Plastic Surgery 2025;31(2):55-58
We report a case of bilateral hand complications following Artecoll injections that were successfully managed with surgical excision and reconstruction using MatriDerm and split-thickness skin grafts. Notably, the patient experienced no postoperative foreign body reactions and achieved excellent functional outcomes, with a complete range of motion at 3.5 years postoperatively. This case underscores the effectiveness of MatriDerm-assisted reconstruction in achieving both functional and aesthetic results.
6.Efficacy of artificial intelligence-based skin analysis for calculating wrinkle improvement and skin firmness after simultaneous radiofrequency and high-intensity focused ultrasound therapy: a retrospective clinical study
Woohyuk YOON ; Hea Kyeong SHIN
Archives of Aesthetic Plastic Surgery 2025;31(2):46-54
Background:
Quantitative skin assessments have transitioned from subjective evaluations to objective approaches. However, clinical application has remained limited due to high costs and reliance on specialized equipment. High-intensity focused ultrasound and radiofrequency are the two most widely used noninvasive modalities for skin tightening and wrinkle improvement. This study investigated investigate the efficacy of artificial intelligence (AI)-based skin analysis as a more accessible and cost-effective tool for assessing skin firmness and wrinkle improvement.
Methods:
A retrospective analysis was conducted on 34 patients treated simultaneously with high-intensity focused ultrasound and bipolar radiofrequency between January and February 2025. AI-based skin assessments, evaluating firmness and wrinkle scores, were obtained pre-treatment, immediately post-treatment, and at a 2-month follow-up. Standardized clinical photographs were independently evaluated by two blinded human raters. Logistic regression and correlation analyses were conducted to determine alignment between AI and human evaluations.
Results:
AI analysis showed significant improvements in both firmness and wrinkle scores immediately after treatment and at the 2-month follow-up (P<0.05). Human evaluations demonstrated high inter-rater agreement (Cohen’s κ=0.72–0.91). Logistic regression analyses indicated that changes in AI scores significantly predicted human-rated treatment effectiveness at both time points (area under the curve [AUC] for firmness=0.86; AUC for wrinkles=0.73–0.93). Spearman correlation coefficients and the Mann-Whitney U test further supported strong alignment between AI and human assessments.
Conclusions
This study validates the clinical utility of AI-based skin analysis as a reliable quantitative measure for evaluating wrinkle improvement and skin tightening following energy-based rejuvenation treatments. Its predictive validity aligns well with expert human judgment, particularly at delayed follow-up.
7.Post-blepharoplasty ectropion management: therapeutic benefits of platelet-rich plasma and polydeoxyribonucleotide injections
Hyung Woo WANG ; Han Earl LEE ; Seong Oh PARK ; Youn Hwan KIM
Archives of Aesthetic Plastic Surgery 2025;31(2):41-45
Background:
Ectropion, a common complication after lower blepharoplasty, causes significant patient discomfort and dissatisfaction, yet effective treatments remain lacking. In this study, we evaluated the efficacy of intradermal injections of polydeoxyribonucleotide (PDRN) and platelet-rich plasma (PRP) for scar regeneration and the rapid recovery of temporary ectropion following lower blepharoplasty.
Methods:
This retrospective study analyzed 21 cases of ectropion among 420 patients who underwent transcutaneous lower blepharoplasty between January 2020 and October 2022. PDRN and PRP were injected intradermally into the lower eyelid, with patients monitored at 1- or 2-week intervals. We investigated patient satisfaction, the total number of injections administered, and the time to complete improvement of the ectropion.
Results:
The average time for complete ectropion resolution was 9.3 weeks, with a relatively high patient satisfaction rating (mean, 4.3 out of 5). Ten primary cases responded well to a single injection, whereas all six patients with previous operations required two or more injections. The rate of improvement was faster than previously reported, likely due to the enhanced collagen synthesis and anti-inflammatory effects of PDRN, along with the tissue repair and angiogenic properties of PRP.
Conclusions
Intradermal injections of PDRN and PRP demonstrated promising results in rapidly resolving ectropion after lower blepharoplasty, thereby reducing patient discomfort and increasing overall satisfaction.
8.Nipple swab culture profile as a potential predictor of postoperative complications in autologous breast reconstruction: a retrospective study
Sun-Hyeok KIM ; Yi-Jun MOON ; Seung-Pil JUNG ; Hyung-Chul LEE ; Jae-Ho CHUNG ; Eul-Sik YOON
Archives of Aesthetic Plastic Surgery 2025;31(2):35-40
Background:
The nipple is a potential source of pathogens because its lactiferous ducts act as direct conduits from the nipple–areolar complex to the breast parenchyma. Our previous studies identified breast microbiota as a factor in postoperative complications following immediate breast reconstruction using silicone implants and acellular dermal matrix. This study aimed to investigate the correlation between preoperative nipple swab microbiota and the incidence of surgical site infections (SSIs) after autologous breast reconstruction.
Methods:
We conducted a retrospective chart review of patients who underwent autologous breast reconstruction following total mastectomy. Preoperative nipple swab cultures were obtained. Patient demographics, surgical characteristics, and complication rates were compared between culture-positive and culture-negative groups. Microbiological data, including antibiotic‑resistance profiles, were collected.
Results:
Among 39 reconstructed breasts, 18 (46.9%) had positive preoperative nipple cultures. The mean duration of drain placement was significantly longer in the culture‑positive group (14.39±3.96 days) than in the culture‑negative group (12.14±2.76 days, P=0.045). Methicillin‑susceptible Staphylococcus epidermidis accounted for 55.0% of isolates. Of the four SSIs observed, three occurred in patients with positive preoperative cultures.
Conclusions
Although pathogen strains differed between preoperative and postoperative settings, obtaining preoperative nipple microflora cultures and determining antibiotic‑resistance profiles can guide immediate antibiotic selection for SSIs and enhance postoperative management.
9.Rare Prevotella bivia infection after liposuction and fat graft: two case reports
Jooyeop LEE ; In Sik YUN ; Tai Suk ROH ; Young Seok KIM ; Kyunghyun MIN
Archives of Aesthetic Plastic Surgery 2025;31(1):21-25
Liposuction and fat grafting are commonly employed to improve body contouring. While postoperative infections are infrequent, severe complications like necrotizing fasciitis can arise, potentially destroying the aesthetic results. Prevotella bivia is an anaerobic, Gram-negative rod bacterium commonly found in the vaginal mucosa, with increased prevalence in cases of bacterial vaginosis. Infections caused by this species can lead to necrotizing fasciitis or extensive tissue necrosis, necessitating prompt diagnosis during the acute phase. This report presents two severe cases of infection caused by P. bivia following fat harvesting and grafting procedures. These cases required multiple debridements, skin grafts, and fasciotomies for management.
10.Mobile application-based monitoring in post-breast reconstruction surgery: current trends and future directions
Archives of Aesthetic Plastic Surgery 2025;31(1):1-9
Mobile apps are frequently utilized in various medical fields for postoperative care, yet there is limited research concerning their application among breast reconstruction patients. This paper examines the development of mobile apps for postoperative care and discusses key considerations for their design and implementation in the context of breast reconstruction patients. Mobile apps provide a holistic approach to recovery, featuring personalized recovery plans, wound monitoring, pain tracking, medication management, virtual consultations, and emotional support. These functionalities improve patient outcomes, facilitate communication between patients and healthcare providers, and enhance engagement with the recovery process. Advanced digital healthcare technologies are revolutionizing patient care, particularly in home settings, by improving monitoring capabilities and telemedicine, thus increasing access and efficiency. For mobile apps to be successfully adopted in postoperative care, it is crucial to address regulatory, financial, and engagement challenges to ensure they deliver sustained value to both patients and healthcare providers. Future research should aim to extend these solutions to plastic surgery and other medical disciplines to improve recovery outcomes for a broad range of patient populations.

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