ABSTRACT
Rhinoplasty is one of the most popular surgical procedures in plastic surgeries. Good results depend not only on the surgical technique but also on individual preference and philosophy of the surgeons. This article reports on the survey of the attitude, preference, and philosophy of surgeons, and finally to elicit the evidence based consensus of current trends mainly dealing with the primary rhinoplasty. The Korean Society of Rhinoplasty Surgeons(KSRS) prepared a questionnaire composed of 20 questions asking about the primary esthetic rhinoplasty. A total of 77 out of 450 plastic surgeons attending the rhinoplasty symposium, 2009, Korea replied and the answerswere assessed. Twenty questions were about operation techniques, preference of alloplastic implant, autologous materials and trivia about the complications rates, etc. Many plastic surgeons preferred silicone to Gore-tex(R). In cases of autologous cartilage grafts, experienced plastic surgeons were more likely to use septal cartilage. But generally, ear cartilages were more frequently used when it is concomitantly used with alloplastic implants. Among silicone implants, boat-shape implant was preferred to L-shape regardless of their surgical experiences. Many Korean plastic surgeons prefer open rhinoplasty to closed rhinoplasty and routinely use boat shape silicone with auricular cartilage when they are doing simple primary rhinoplasty.
Subject(s)
Cartilage , Consensus , Ear Cartilage , Korea , Philosophy , Rhinoplasty , Ships , Silicones , Transplants , Surveys and QuestionnairesABSTRACT
Laminins, a subset of glycoproteins, are main components of the basement membrane along with fibronectin, type IV collagen, and heparan sulfate proteoglycan and influence the biologic features, such as growth and polarization, of all tissues attached on the basement membrane. Although evidence has been suggested that laminins are involved in the process of hair follicle formation in mammalian skin tissues, the significance of laminin on the physiology of hair follicles remains to be fully understood. In this study, we assessed whether the distribution of laminin is associated with the growth of hair follicles and whether all-trans retinoic acid (RA), a stimulus of hair follicle growth, affects the expression profile of laminins. To observe the distribution of laminin varied depending on the developmental stages, fetuses(at day 20 of gestation) and pups(at day 1 and 3 after birth) of Sprague- Dawley rats were used. To examine the effect of RA, 5 days-old pups were administered with RA and their skin tissues were removed post mortem 2, 4, or 7 days later. Skin specimens were sectioned and observed using the immunohistochemical staining, immunogold staining for electron microscopy, and in situ RT-PCR assays. In fetuses at day 20 of gestation and 1 and 3-days-old pups, the distribution of laminin within hair follicles was restricted in the cytoplasm of fibroblasts located in hair papilla and dermal root sheath, basement membrane, and glassy membrane. Following RA treatment for 2 and 4 days, laminin expression was increased in the basement membrane, glassy membrane, outer root sheath, and dermal root sheath in hair follicles. Following RA treatment for 2 and 4 days, the level of laminin was increased in fibroblasts and matrix cells present in hair follicles, as shown in immunogold staining. The expression of laminin at day 7 post administration with RA was decreased at the level comparable with that of untreated controls. In in situ RT-PCR assays, matrix cells in hair follicles exhibited an increase in the levels of laminin alpha1 and beta1 transcripts following RA administration. Thus, these results suggest that matrix cells play a role in the growth of hair by enhancing laminin gene expression and all-trans retinoic acid promotes this induction.
Subject(s)
Animals , Pregnancy , Rats , Basement Membrane , Collagen Type IV , Cytoplasm , Fetus , Fibroblasts , Fibronectins , Gene Expression , Glycoproteins , Hair Follicle , Hair , Heparan Sulfate Proteoglycans , Laminin , Membranes , Microscopy, Electron , Physiology , Skin , TretinoinABSTRACT
Previous anatomic concepts in cleft lip nose deformity have following characteristics: 1. Obtuse angle between medial and lateral crus in affected alar cartilage; and 2, Cleft side alar cartilage is hypoplastic. The purpose of this study was to review the anatomy of alar cartilage in cleft lip nose deformity and to find out the effects of removal of intercartilagenous soft tissue on the effects of removal of intercartilagenous soft tissue on relocation of alar cartilage. There were 97 cleft lip nose corrections from Oct. 1996 to March When the affected alar cartilage was dissected, redundant intercartilagenous fibro-fatty tissue was found. After removing this redundant soft tissue, we found that the cleft side alar cartilage was better adjusted to the normal position. In addition, the plicavestibularis was more improved. Alar cartilage suture fixation was subsequently performed. Alar cartilage suture fixation was subsequently performed. After this procedure, we found that subsequently performed. After this procedure, we found that the affected side of alar cartilage was more normally positioned than before. The summary of the author's view on affected alar cartilage is as follows: 1. An acute angle between the medial and lateral crus was noted in affected alar cartilage; 2. Redundant intercartilagenous fibro-fatty tissue was present in cleft lip nose deformity;3.The terminal portion of the lateral crus of alar cartilage makes a plica vestibularis in the cleft side; 4. The position of the medial crus of alar cartilage was lower in the cleft side with the lateral crus was lower and cephalic in the cleft side; 5. The cleft side of alar cartilage is not hypoplastic.
Subject(s)
Cartilage , Cleft Lip , Congenital Abnormalities , Nose , SuturesABSTRACT
The microform cleft lip is the mildest expression of cleft lip and nose deformity, but it has no specific definition, classification, and few methods have been reported for its correction. It is characterized by deformity of the nostril, skin striae of the upper lip, notching of peaked Cupid's bow, deformity of the vermilion, and anomaly of the upper lateral incisior and alveolar ridge on the affected region. Sixty-three microform cleft lip patients were operated on between Dec. 1993 and Sep. 1998 in our department(29 males and 34 females). The age of the patients ranged from 5 months to 30 years(Mean 9 years). We classified and treated the microform cleft lip as follows: Class I: Cleft lip nose with very slight lip deformity Class II: Minimal lip deformity without vermilion notching Class III: Mild lip deformity with slight vermilion notching. The goals in the correction of a microform cleft lip are to obtain an esthetically pleasing upper lip and nose, and to reestablish muscle continuity for improved function. To attain these goals, we used the above classification and satisfactory results were obtained by treating the microform cleft according to the classification.
Subject(s)
Humans , Male , Alveolar Process , Classification , Cleft Lip , Congenital Abnormalities , Lip , Microfilming , Nose , SkinABSTRACT
Individuals with cleft lip and palate often require orthognathic surgery to estabilish facial harmony and optimal occlusal function because cleft induced secondary deformities of maxilla and mandible have been taken for the worse as growing up. During operation many problems as like residual oronasal fistula, bony defects, soft tissue-scarring from previous surgery, and the congenital absence of the maxillary lateral incisor teeth with cleft-dental gap are encountered and interfere the operation. In this retrospective study 16 patients who were performed orthognathic surgery from the January. 1991 to the March 1997, could remind the clinically important problems of the orthognathic surgery and suggest more easy, safety, and accurate methods to solve these problems. The preperative and postoperative cephalometric skeletal and soft tissue data were compared and many problems which could encounter during operation were checked and reviewed many historical experiments and newly suggested articles, so some results can be suggested as like: 1. The sum of maxillary advancement(mean 5.14mm) and mandibular retrusion(mean 6.71mm) is about 11.85mm. Two-jaw surgery is recommended because the scar of upper lip and palate limit the maxillary advancement. 2. Upper lip tightness interfere the soft tissue movement after bone segment mobilization, release of tightness improve the soft tissue profile. 3. Soft tissue profile is most important in orthognathic surgery.4. Soft tissue response to orthognathic surgery is not different in secondary cleft deformities and simple malocclusion patient but amount of soft tissue response is not constant in many experimental study. 5. Camouflage mandibular surgery is benefit in some maxillary deformity patient.