Background: We report our experiences with prepectoral placement breast implant surgery using Supporix (HansBioMed), a porcine acellular dermal matrix (PADM), for cosmetic and reconstructive indications. The clinical efficiency, safety, and cost-effectiveness of PADM were also discussed. Methods: A single-center, retrospective study was designed from December 2017 to December 2019. The participants were Korean women who underwent PADM-assisted prepectoral breast implant surgery performed by two surgeons. All complications were registered and analyzed. A systematic review and meta-analysis of complication rates after PADM-assisted prepectoral breast implant surgery were conducted for comparison with other studies. A subgroup analysis was performed according to the operation type: the cosmetic breast surgery (CBS) group, the immediate implant-based breast reconstruction (IIBR) group, and the delayed implant-based breast reconstruction (DIBR) group. Results: Twenty breasts in 16 patients were included in our study (median follow-up period, 8.25 months). In a systematic review, 20 publications with a total of 2,504 breasts in 1,921 women were quantitively analyzed. The overall complication rates in our study and other studies were 14% and 24% in the total group analysis, 0% and 12% in the CBS group, 62% and 26% in the IIBR group, and 0% and 28% in the DIBR group, respectively. Conclusions Our data support the effectiveness of PADM-assisted prepectoral breast implant surgery, which was comparable to other studies. PADM was effective for reducing seroma and hematoma in the revision CBS group and the DIBR group. In the IIBR group, it was helpful in preventing implant loss and explantation.

BACKGROUND: During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. METHODS: This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20–38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization. RESULTS: The mean follow-up period was 14 months (range, 6–24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160–300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery. CONCLUSIONS: Endoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.
Axilla ; Breast Implants* ; Breast* ; Cicatrix ; Contracture ; Electrocoagulation ; Endoscopes ; Fascia ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Prostheses and Implants ; Reoperation

BACKGROUND: The objective of this study was to develop a new surgical technique by combining traditional abdominoplasty with liposuction. This combination of operations permits simpler and more accurate management of various abdominal deformities. In lipoabdominoplasty, the combination of techniques is of paramount concern. Herein, we introduce a new combination of liposuction and abdominoplasty using deep-plane flap sliding to maximize the benefits of both techniques. METHODS: Deep-plane lipoabdominoplasty was performed in 143 patients between January 2007 and May 2014. We applied extensive liposuction on the entire abdomen followed by a sliding flap through the deep plane after repairing the diastasis recti. The abdominal wound closure was completed with repair of Scarpa's fascia. RESULTS: The average amount of liposuction aspirate was 1,400 mL (700-3,100 mL), and the size of the average excised skin ellipse was 21.78×12.81 cm (from 15×10 to 25×15 cm). There were no major complications such as deep-vein thrombosis or pulmonary embolism. We encountered 22 cases of minor complications: one wound infection, one case of skin necrosis, two cases of undercorrection, nine hypertrophic scars, and nine seromas. These complications were solved by conservative management or simple revision. CONCLUSIONS: The use of deep-plane lipoabdominoplasty can correct abdominal deformities more effectively and with fewer complications than traditional abdominoplasty.
Abdomen ; Abdominal Wound Closure Techniques ; Abdominoplasty ; Asian Continental Ancestry Group* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Fascia ; Humans ; Lipectomy ; Necrosis ; Pulmonary Embolism ; Seroma ; Skin ; Venous Thrombosis ; Wound Infection

BACKGROUND: The objective of this study was to develop a new surgical technique by combining traditional abdominoplasty with liposuction. This combination of operations permits simpler and more accurate management of various abdominal deformities. In lipoabdominoplasty, the combination of techniques is of paramount concern. Herein, we introduce a new combination of liposuction and abdominoplasty using deep-plane flap sliding to maximize the benefits of both techniques. METHODS: Deep-plane lipoabdominoplasty was performed in 143 patients between January 2007 and May 2014. We applied extensive liposuction on the entire abdomen followed by a sliding flap through the deep plane after repairing the diastasis recti. The abdominal wound closure was completed with repair of Scarpa's fascia. RESULTS: The average amount of liposuction aspirate was 1,400 mL (700-3,100 mL), and the size of the average excised skin ellipse was 21.78×12.81 cm (from 15×10 to 25×15 cm). There were no major complications such as deep-vein thrombosis or pulmonary embolism. We encountered 22 cases of minor complications: one wound infection, one case of skin necrosis, two cases of undercorrection, nine hypertrophic scars, and nine seromas. These complications were solved by conservative management or simple revision. CONCLUSIONS: The use of deep-plane lipoabdominoplasty can correct abdominal deformities more effectively and with fewer complications than traditional abdominoplasty.
Abdomen ; Abdominal Wound Closure Techniques ; Abdominoplasty ; Asian Continental Ancestry Group* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Fascia ; Humans ; Lipectomy ; Necrosis ; Pulmonary Embolism ; Seroma ; Skin ; Venous Thrombosis ; Wound Infection

The axillary technique is the most popular approach to breast augmentation among Korean women. Transaxillary breast augmentation is now conducted with sharp electrocautery dissection under direct endoscopic vision throughout the entire process. The aims of this method are clear: both a bloodless pocket and a sharp non-traumatic dissection. Round textured or anatomical cohesive gel implants have been used to make predictable well-defined inframammary creases because textured surface implants demonstrated a better stability attributable to tissue adherence compared with smooth surface implants. The axillary endoscopic technique has greatly evolved, and now the surgical results are comparable to those with the inframammary approach. The author feels that this technique is an excellent choice for young patients with an indistinct or absent inframammary fold, who do not want a scar in the aesthetic unit of their chest.
Axilla ; Breast Implants ; Breast* ; Cicatrix ; Electrocoagulation ; Endoscopes ; Female ; Humans ; Mammaplasty ; Thorax

No abstract available.
Female ; Fibromatosis, Aggressive ; Mammaplasty ; Silicones

Cerebral hemorrhage is one of the most common causes of dysphagia. In many cases, dysphagia gets better once the acute phase has passed. Structural lesions such as thyromegaly, cervical hyperostosis, congenital web, Zenker's diverticulum, neoplasm, radiation fibrosis, and retropharyngeal abscess must be considered as other causes of dysphagia as well. Retropharyngeal abscess seldom occur in adults and if it does so, a search for a prior dental procedure, trauma, head and neck infection is needed. The symptoms may include neck pain, dysphagia, sore throat, and in rare cases, dyspnea accompanied by stridor. We present a case and discuss a patient who had dysphagia and neck pain after a cerebral hemorrhage. Testing revealed a retropharyngeal abscess. The symptoms were successfully treated after the administration of antibiotics.
Adult ; Anti-Bacterial Agents ; Cerebral Hemorrhage ; Craniocerebral Trauma ; Deglutition Disorders ; Dyspnea ; Humans ; Hyperostosis ; Neck ; Neck Pain ; Pharyngitis ; Radiation Pneumonitis ; Respiratory Sounds ; Retropharyngeal Abscess ; Subarachnoid Hemorrhage ; Zenker Diverticulum

Paraneoplastic neurologic syndrome is a group of assorted disorders resulting from damage to the nervous system in cancer, remote from primary site, and not related to metastasis, infection, or metabolic disorder associated with cancer. Patient with small cell lung cancer sometimes shows various neurological syndromes, but patient with non-small cell lung cancer rarely shows neurologic syndromes and few antineuronal antibodies have been found. Here, we report a case of 53-year-old male patient who developed ptosis and extraocular muscular limitation of left eye due to third and forth cranial nerve palsy in non-small cell lung cancer without brain metastasis. These neurologic symptoms improved after lobectomy without any other treatment immunotherapy.
Antibodies ; Brain ; Carcinoma, Non-Small-Cell Lung ; Cranial Nerve Diseases ; Cranial Nerves ; Eye ; Humans ; Immunotherapy ; Male ; Middle Aged ; Neoplasm Metastasis ; Nervous System ; Neurologic Manifestations ; Paraneoplastic Syndromes ; Paraneoplastic Syndromes, Nervous System ; Small Cell Lung Carcinoma

PURPOSE: Reduction mammaplasty is a procedure with a relatively high patient satisfaction rate, however, associated scarring around the areola can be a serious problem. This study proposes a new modification of the breast reduction procedure by means of an inframammary incision alone. METHODS: The breast is marked out preoperatively with standing position. Under the general anesthesia, an inframammary incision of approximately 7-8cm is done. The subcutaneous plane is made in the lower pole of the breast, then the subglandular plane is entered and a sharp dissection is made up to 2cm below the areola. The breast is mobilized from the chest wall and a cone-shaped parenchyme is removed in en-block except from the retroareolar central part. The remaining both pillars are gathered together with absorbable sutures and the base of the gland is narrowed to project the breast forward. The wound is closed in a layered fashion and taping of the breast mound is applied to redistribute the breast skin. RESULTS: 21 patients(36 breasts) underwent this procedure from December 2004 to December 2009. Average follow up was 9 months(ranged from 6 months to 12 months). No major complication occurred. Most patients were pleased with the breast size, shape, and scars. However, 2 patients complained their hypertrophic scars which were corrected by revision. CONCLUSION: This technique is a simple approach to mild to moderate breast reduction through an inframammary incision alone. And, this technique provides an option with minimal complications and invisible scarring, which is especially important in the young patient group.
Anesthesia, General ; Breast ; Cicatrix ; Cicatrix, Hypertrophic ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Patient Satisfaction ; Skin ; Sutures ; Thoracic Wall

PURPOSE: Several methods of the nipple reduction have been reported. However, the methods described previously are difficult or have some demerits. This study proposes a simple technique for reduction of the nipple height as well as diameter. METHODS: The purposed nipple height is marked. A pentahedral design of excision was marked around thenipple. Local anesthetic solution was infiltrated and a 4- 0 Nylon traction suture was applied at the nipple apex. Excision of the nipple inside both two triangles and a rectangle was made. Remaining two flaps were approximated using 5-0 Nylon simple interrupted sutures. However, a part of wound closure was not done in the central area of the nipple. RESULTS: Eighty-three patients (166 nipples) underwent this procedure from December 1999 to December 2008. Follow-up period ranged from 6 months to 2 years with a mean of 10 months. Seventy-eight patients were female and 5 patients were male. No major complications occurred and remaining scars were very inconspicuous. CONCLUSION: This simple technique has the advantage of nipple reduction in both height and diameter, and provides good aesthetic outcomes.
Cicatrix ; Female ; Follow-Up Studies ; Humans ; Imidazoles ; Male ; Nipples ; Nitro Compounds ; Nylons ; Sutures ; Traction