Background: The practice of medicine by uncertified personnel is a common concern in public healthcare. Although the introduction of the Korean National Health Insurance Service has significantly reduced the number of these cases, the problem persists in the field of aesthetics. Herein, we report an outbreak of devastating facial stigmata in patients treated with illegal cosmetic procedures. Methods: During 1 week in November 2021, five patients presented to Bucheon St. Mary’s Hospital for the management of identical patterns of severe facial scarring. Each patient had been treated for “skin rejuvenation” by a single unlicensed practitioner. Months of needling therapy by the practitioner, aimed at resolving the problem, only aggravated the scarring. The victims visited our hospital after the practitioner ceased to answer their calls. The patients had similar presentations with multiple prominent scars on both cheeks. Ectropion of the right lower eyelid due to scar contracture was observed in one patient. Results: Five monthly treatments with intralesional triamcinolone injection and laser therapy were performed. Despite thorough management, the patients were left with improved but distinctive stigmata on their faces. Conclusions Cases of illegal aesthetic procedures are difficult to prosecute because the patients have implicitly agreed to the procedure. Therefore, active legislative measures should be adopted to prevent further victimization. Public education on the dangers of illegal aesthetic practices is also necessary.

Frontal sinus fractures are common traumatic injuries of the head and neck, accounting for 8% of facial fractures. When a severe frontal sinus fracture and a naso-ethmoid-orbital fracture occur together, a postoperative contour deformity is highly likely. A pericranial flap is a reliable and versatile tool for craniofacial reconstruction. The authors fabricated an anteriorly-based pericranial flap in multiple layers to camouflage the fracture site and augment the brow ridge for volumization. Open reduction and pericranial flap coverage using this method (dubbed the “Persian carpet” method) were successfully performed in a 26-year-old male patient with a comminuted frontal bone fracture and a naso-ethmoid-orbital fracture.

The emphasis on tip plasty in Asian rhinoplasty has led to heightened concerns about complications regarding nasal tip skin. Although uncommon, these complications can cause tremendous frustration to surgeons when encountered. Conventional methods such as skin graft or healing by secondary intention cause an unpleasant scar. Instead, an extended dermofat graft in revision rhinoplasty enables both replacement of the dorsal implant and adequate coverage of the nasal tip without modifying the previous tip plasty. A patient who experienced nasal tip skin thinning after augmentation rhinoplasty was treated successfully with an extended dermofat graft. The authors believe that this is a solid method for managing patients with nasal tip skin complications.

Virginal mammary hypertrophy (VMH), also known as juvenile mammary hypertrophy, is characterized by excessive enlargement of the breasts. Especially in adolescent patients, this condition can cause a negative body image to develop and result in significant psychological stress. Furthermore, social problems can arise from difficulties in finding appropriately-fitting attire and having trouble exercising. Although the mechanism of VMH has not been fully elucidated, several associated drugs have been identified. In this report, we present a 15-year-old female patient with Wilson disease who developed macromastia after administration of penicillamine for 8 months. Despite cessation of penicillamine for 3 months, the condition remained stable; thus, reduction mammoplasty was performed. After surgery, the patient was able to return to activities of daily living. Although rare, physicians should be aware of the fact that penicillamine can cause VHM. Therefore, patients with Wilson disease should be checked regularly for changes in breast volume in order to minimize possible complications.

Frontal sinus fractures are common traumatic injuries of the head and neck, accounting for 8% of facial fractures. When a severe frontal sinus fracture and a naso-ethmoid-orbital fracture occur together, a postoperative contour deformity is highly likely. A pericranial flap is a reliable and versatile tool for craniofacial reconstruction. The authors fabricated an anteriorly-based pericranial flap in multiple layers to camouflage the fracture site and augment the brow ridge for volumization. Open reduction and pericranial flap coverage using this method (dubbed the “Persian carpet” method) were successfully performed in a 26-year-old male patient with a comminuted frontal bone fracture and a naso-ethmoid-orbital fracture.