Comparison of outcomes between simultaneous fat grafting and filler injection with transconjunctival fat removal for improvement of the lower eyelid contour

Background@#Mid-facial aging is associated with various changes, particularly around the lower eyelid, where these changes manifest as herniation of orbital fat, sagging of soft tissue around the zygoma, and the tear trough deformity. We improved the lower eyelid contour via transconjunctival orbital fat removal and the use of either an autologous fat graft or filler injection. @*Methods@#Between June 2016 and July 2018, 100 patients aged 23–48 years underwent autologous fat grafts (group A: 50 patients, 100 eyes) or filler injections (group B: 50 patients, 100 eyes). The mean follow-up period was approximately 3 months. The results of surgery were evaluated using a visual analog scale (VAS) to assess patient satisfaction and with preoperative and postoperative scores determined by three plastic surgeons according to the grading system for lower eyelid contour deformity devised by Barton et al. @*Results@#The mean VAS score was 8.48 in group A and 8.92 in group B, but the difference was not statistically significant. The percentage of postoperative improvement from preoperative grade I deformity to grade 0 was 97.7% in group A and 100% in group B. The percentage of improvement from preoperative grade II deformity to grade 0 was 96.0% in group A and 96.1% in group B, and the percentage of improvement from grade III deformity to grade 0 in was 66.7% in group A and 75% in group B. @*Conclusions@#Filler injection can be an alternative to fat grafting for improvement of the lower eyelid contour after transconjunctival orbital fat removal.

Rejuvenating Effects of Facial Hydrofilling using Restylane Vital

BACKGROUND: Morphological changes that accompany aging, such as wrinkles and skin laxity, are particularly prominent on facial skin. Recently, facial rejuvenation using the hydrofilling effect of hyaluronic acid (HA) filler has been employed for improvement of skin texture. In this study, we studied rejuvenating effects of stabilized HA (Restylane Vital) through direct intradermal injections. METHODS: A total of 30 female patients underwent a series of procedures on face, including three sessions at intervals of four weeks. A total of 2 mL of Restylane Vital was injected along the whole face using an automatic injector. Improvement of skin surface roughness, elasticity, brightness, moisture, and fine wrinkles was evaluated. Patient satisfaction was evaluated, and pictures of patients were taken at each visit and 6 months after last treatment session. Scoring for each patient was performed by three doctors according in five subjects. Moisture, oil and elasticity were measured before the procedure and before the last treatment in 10 patients. RESULTS: The majority of patients (77%) were satisfied with the therapeutic outcomes. Approximately 66% of patients responded that the effects of this procedure persisted for longer than four months, and the majority of patients (77%) wanted to undergo this procedure again and would recommend this procedure to acquaintances. Regarding doctors' evaluation, scores for improvement of skin surface roughness, elasticity, and brightness were significantly higher than those for improvement of moisture and fine wrinkle. CONCLUSIONS: Intradermal injection of HA can have a rejuvenating effect on dry and tired facial skin, especially in improvement of skin surface roughness.

Acute Bone Remodeling after Reduction of Nasal Bone Fracture on Computed Tomography Imaging

BACKGROUND: A number of studies have reported complication after reduction of nasal bone fractures. Among complicated cases, some showed improvement in shape of the nose with passage of time. Therefore, we examined these changes using computed tomography (CT) images taken over intervals. METHODS: CT scans of 50 patients with new nasal bone fractures were reviewed, and the images were compared amongst preoperative, immediately postoperative, and one month scans. Changes in nasal bone shape, were evaluated based on the angle of nasal bone arch between the nasal bone and frontal process of maxilla, overall shape of arch, mal-alignment of fracture segments involving bony irregularity or bony displacement. These evaluations were used to separate postoperative outcomes into 5 groups: excellent, good, fair, poor, and very poor. RESULTS: Immediate postoperative nasal shape was excellent in 10 cases, good in 31 cases, fair in 8 cases, and poor results in a single case. Postoperative shape at one month was excellent in 37 cases, good in 12 cases, fair in a single case. CONCLUSION: The overall shape of nasal bone after fracture reduction tended to improve with passage of time.

Acute Bone Remodeling after Reduction of Nasal Bone Fracture on Computed Tomography Imaging

BACKGROUND: A number of studies have reported complication after reduction of nasal bone fractures. Among complicated cases, some showed improvement in shape of the nose with passage of time. Therefore, we examined these changes using computed tomography (CT) images taken over intervals. METHODS: CT scans of 50 patients with new nasal bone fractures were reviewed, and the images were compared amongst preoperative, immediately postoperative, and one month scans. Changes in nasal bone shape, were evaluated based on the angle of nasal bone arch between the nasal bone and frontal process of maxilla, overall shape of arch, mal-alignment of fracture segments involving bony irregularity or bony displacement. These evaluations were used to separate postoperative outcomes into 5 groups: excellent, good, fair, poor, and very poor. RESULTS: Immediate postoperative nasal shape was excellent in 10 cases, good in 31 cases, fair in 8 cases, and poor results in a single case. Postoperative shape at one month was excellent in 37 cases, good in 12 cases, fair in a single case. CONCLUSION: The overall shape of nasal bone after fracture reduction tended to improve with passage of time.

Clinical Consideration of 137 Cases of Basal Cell Carcinoma in Face

BACKGROUND: Basal cell carcinoma (BCC) is the most common skin cancer. About 74% cases of basal cell cancer occur on the head and neck. Basal cell carcinoma on the face may have a higher degree of subclinical spread than tumors arising elsewhere. And incompletely excised BCCs become more aggressive when they recur. So the surgical removal and reconstruction of BCC located on the face are important to make perfect curing and cosmetic results. METHODS: A retrospective study was done with 128 patients (137 cancers) who were treated with BCC on the face since 1987 to 2011. General data of these cases such as the primary site of cancer, age and sex of the patients, operative methods, and recurrence rate were reviewed. RESULTS: The ratio of men to women was 1:1.4. And 86.9% of the patients with BCC were older than the age of 50 years with the mean age of 65.8 years. The distribution of facial basal cell carcinoma was on the nose, eyelids, cheek, and nasolabial fold. Surgical methods for treatment were local flap, full thickness skin graft, primary closure, and split thickness skin graft. Specifically, local flap consists of V-Y advancement flap, cheek advancement flap, limberg flap, forehead flap, nasolabial flap, rotation flap, transposition flap, bilobed flap, and island flap. Six cases recurred and all of them were treated with reoperation. CONCLUSION: The authors reviewed facial basal cell carcinoma cases in our hospital. This study might be helpful to choose appropriate operation method to manage BCC on face in Korea.