Nodular fasciitis is the most common benign mesenchymal tumor that can be mistaken both clinically and pathologically for soft tissue sarcoma due to its infiltrative growth pattern. It most commonly appears in the extremities and trunk. However, occurrence in the zygomatic area is extremely rare. We present a case of 28-year-old man, who was characterized with a firm, tender, clearly visible mass in his left zygomatic area. We performed a local excision, together with microscopic and immunohistochemical analysis. The mass was eventually diagnosed as nodular fasciitis in the zygomatic area. No postoperative oncological treatment was done and the postoperative follow-up was maintained up to the present time without any tumor recurrence. Nodular fasciitis should be considered in the differential diagnosis when a rapid growing subcutaneous mass is detected in this area. Accurate diagnosis, appropriate treatment and follow-up are mandatory to avoid overly aggressive treatment and limit treatment-related morbidities. Moreover, the disease itself and its surgical treatment may cause aesthetic compromise and the aesthetic implications have been discussed.
Adult ; Diagnosis, Differential ; Extremities ; Fasciitis ; Follow-Up Studies ; Humans ; Recurrence ; Sarcoma

The nasal manifestations of the Wegener's granulomatosis commonly results in destruction of the cartilaginous support of the nose and a severe saddle nose deformity. It is so difficult to correct the saddle nose deformity because surgeons have fear about relapse of the Wegener's granulomatosis and cannot use the septal cartilage as a donor site. However we reconstructed the deformity with chondro-osseous rib graft successfully. A 49-year-old woman had a saddle nose deformity after resecting Wagener's granulomatosis, and suffered from not only aesthetic problem but also dyspnea and nasal airway obstruction while physical exercise. She underwent a rhinoplasty with rib graft. The correction came out to be successful and the nasal airway complaint was resolved. She had a recurrence of Wegener's granulomatosis at postoperative 6 months and was admitted for medical treatment of the inflammation at the nasal septum. The follow-up computed tomographic image study revealed good maintenance of the graft. Saddle nose deformity that arises from Wagener's granulomatosis should be reconstructed with chondro-osseous rib graft. Even though the disease might recur, influence to the grafted cartilage is minimal. Active treatment with plastic surgery is thought to be no problem for reconstruction.
Bone Transplantation ; Cartilage ; Congenital Abnormalities ; Dyspnea ; Exercise ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Middle Aged ; Nasal Obstruction ; Nasal Septum ; Nose ; Nose Deformities, Acquired ; Porphyrins ; Recurrence ; Rhinoplasty ; Ribs ; Surgery, Plastic ; Tissue Donors ; Transplants ; Wegener Granulomatosis

Recently, new epicanthoplasty methods with reduced scarring have been developed, such as skin redraping method, periciliary epicanthoplasty, etc. Although these methods increase the length of horizontal palpebral fissure, the remnant skin and orbicularis oculi muscle portion that covers one third of medial canthus reduce satisfaction of aesthetic outcome. In order to overcome this limitation, the authors performed redraping after direct excision of medial orbicularis oculi muscle and excess skin to correct epicanthal fold. From April of 2006 to March of 2009, the authors performed medial epicanthoplasty using direct excision and redraping method to correct epicanthal folds in the eyelids of 72 Asian patients. The epicanthoplasty was performed combining with incisional or non-incisional double eyelid operation, ptosis correction, augmentation rhinoplasty and lateral canthal lengthening. Mean follow up was 11 months(6 months to 2 years). Most of the patients were satisfied with the results. Our technique has delivered esthetically superior results with minimal postoperative scar and no major complication. The advantages of our direct excision and redraping technique are as follows: 1) simple in design, 2) versatile in its application, 3) double fold looks clear especially in the medial 1/3 by eliminating the redundant skin and orbicularis muscle.
Asian Continental Ancestry Group ; Blepharoplasty ; Cicatrix ; Eyelids ; Follow-Up Studies ; Humans ; Muscles ; Rhinoplasty ; Skin

Botulinum toxin A injection to reduce glabellar lines has become one of the most popular procedures in facial rejuvenation. 5-site injection is generally accepted: into the procerus muscle at the midline and each corrugator muscle at its inferomedial and superolateral aspects. The superolateral injection site is above the pupil and approximately 1cm above the bony orbital rim. According to our observation, corrugator muscles are not either symmetric or tightly related to the surface anatomical landmarks such as pupils and bony orbital rims. Therefore when glabellar lines were treated by surface anatomical landmarks, in the case of asymmetrical corrugator, it was not precisely targeted to obtain sufficient paralytic effects. Herein, we suggest functional anatomy-based Botulinum toxic A injection to correct glabellar frown lines and its theoretical backgrounds. Between 1999 and 2007, 329 patients were enrolled in the study. 86 patients between 1999 and February of 2001 were injected by the traditional injection method. Later 243 patients were treated by the functional anatomy-based injection. By the new method, injection points were determined by observing glabellar furrows and skin fine wrinkles after repetition of muscle contraction. By this method, we could enhance the cosmetic effects and heighten patients' satisfaction.
Aging ; Botulinum Toxins ; Cosmetics ; Humans ; Muscle Contraction ; Muscles ; Orbit ; Pupil ; Rejuvenation ; Skin

As the breast of woman is considered as a symbol of femininity, the shoulder of man is regarded as a symbol of masculinity. Narrow shoulders disallow proper fitting of male clothing and result disproportionately large and unbalanced facial look in men. The purpose of this article was to evaluate the aesthetic outcomes of shoulder augmentation using soft silicone in patients with narrow shoulders. From April 2009 to July 2010, 21 male patients received shoulder augmentation by using silicone implants in the subfascial space of the deltoid muscle. The silicone implant was prefabricated according to the shape of the lateral portion of the deltoid muscle, and placed in subfascial pocket. After the operation, the shoulder width was increased by 6.6cm on average and patients were satisfied with their augmented shoulders, giving them more sharp figure when wearing their clothes. The firmness of the soft silicone is similar that of the deltoid muscle, and the curvature of the implant looks like a natural deltoid muscle. The subfascial position of the implant does not limit the range of motion of the shoulder joint. The authors expect that shoulder augmentation will take part in a new entity of body contouring surgery.
Breast ; Clothing ; Deltoid Muscle ; Female ; Femininity ; Humans ; Male ; Masculinity ; Range of Motion, Articular ; Shoulder ; Shoulder Joint ; Silicone Elastomers

Up to this date, the forehead contouring augmentation surgery was perfomed with silicone or microfat graft. However, augmentation with silicone has given complications such as postoperative infection, extrusion, long linear scar, and displacement of implant. Moreover, augmentation using microfat graft often requires re-operation due to fat resorption. Surgical technique was performed in 10 patients from September 2008 to April 2009. Eight patients had macrogenia and two had prognathism. Particulated bone was harvested from squared mandibular bone. The particulated mandibular bone was then grafted on the frontal bone through a 2cm incision posteriorly to the midforehead line. As a result from the three-dimensional Computer Tomogram, the frontal bone was engrafted 6 months after the particulated bone graft. Even though, traditional concept using prothesis for forehead augmentation is still popular, the author suggests autologous augmentation can make better facial contour which is named as 'facial bone redistribution concept'. Facial bone redistribution concept is the distribution of residual bone(mandible or zygoma) to deficient area(frontal bone) to achieve better facial contour. To achieve better survival rate of bone, bone marrow stem cell and platelet rich plasma(PRP) should be applied in next study to increase the survival rate of particulated bone.
Blood Platelets ; Bone Marrow ; Bone Transplantation ; Cicatrix ; Displacement (Psychology) ; Facial Bones ; Forehead ; Frontal Bone ; Humans ; Mandible ; Prognathism ; Silicones ; Stem Cells ; Surgery, Plastic ; Survival Rate ; Transplants

A variety of dermal fillers is available and has been used for soft tissue augmentation. Fillers used in rhinoplasty are minimally invasive and can help patients who are concerned with surgical procedures and recovery time. Nevertheless, there have been many reports about unsatisfactory results and complications using fillers for augmentation rhinoplasty. The unsatisfactory results include ill defined lateral aspect of nose, widening of injected filler, migration, and overcorrection. Therefore, the filler materials should be used according to its properties and nasal anatomical characteristics.
Acrylic Resins ; Humans ; Hyaluronic Acid ; Nose ; Rhinoplasty

Breast enhancement is usually achieved through insertion of alloplastic implants. Such procedures are invasive, need general anesthesia, take a long down-time and carry risks of complication such as infection, capsular contracture, rupture of implants, leakeage, and displacement. But the high purity and biocompatible nature of hyaluronic acid(HA) gel, together with its combination of biodegradability and long-term persistency following implantation make it an attractive material for breast enhancement. Subglandular injection of HA gel was found to be well tolerated, and high rates of patient satisfaction with out any serious complication.
Anesthesia, General ; Breast ; Contracture ; Displacement (Psychology) ; Female ; Hyaluronic Acid ; Mammaplasty ; Patient Satisfaction ; Rupture

As increasing demands for facial soft tissue augmentation by injection and minimal invasive procedures, filler has become increasingly popular and a suitable method for patients' demands. Over several decades, many filler products have been introduced. Successful clinical application of filler products requires a thorough understanding of their compositions, effects, and rheology. This study reviewed filler products according to the classification of effect duration: permanent, semipermanent, temporary.
Collagen ; Hyaluronic Acid ; Rheology

The V-Y advancement flap has been widely used for the reconstruction of cutaneous defects. However, direct closure is impossible without undue tension. To overcome this limitation, the present study introduces a modified design of V-Y advancement flap with two horns and assesses its clinical outcome for facial reconstruction. From June, 2009 through June, 2010, twelve cases of skin tumors were surgically excised and reconstructed with this modified V-Y flap. Defects were located in nasolabial, nasojugal fold, cheek and lower eyelid region. Modified V-Y advancement flap was designed with lateral limbs like horns of V-flap and two horns were extended to the end point of the defect. Design and movement of this flap was demonstrated with photographs and the clinical outcome was described. All flaps survived with primary healing. The follow-up period ranged from 1 month to 12 months with a mean of 5.5 months. Neither short-term nor long-term postoperative complications such as flap necrosis, hematoma, infection were noted. All twelve patients were pleased with their postoperative results and no recurrence of malignant skin tumor was observed. This modified V-Y advancement flap with two horns is a safe, easy, versatile and reliable method for functional and esthetic reconstruction of facial defects.
Animals ; Cheek ; Extremities ; Eyelids ; Facial Injuries ; Facial Neoplasms ; Follow-Up Studies ; Hematoma ; Horns ; Humans ; Necrosis ; Postoperative Complications ; Recurrence ; Skin ; Surgical Flaps