A Report on the Questionnaire about Augmentation Rhinoplasty

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.

A Case Report of Epiphora after Epicanthoplasty

PURPOSE: The epicanthus is a specific feature in Asian. Many techniques have been described to eliminate the epicanthal fold: resection of glabellar skin, resection of medial canthal skin, V-Y advancement, V-W technique, modified Z-plasty, multiple Z-plasties, and others. The authors observed postoperative epiphora after correction of epicanthal fold by periciliary skin flap without damaging lacrimal duct. METHODS: A 19-year-old woman underwent non-incisional blepharoplasty, septorhinoplasty, and periciliary epicanthoplasty. On her history, she didn't have any symptom of epiphora preoperatively. And there was no specific complaint of epiphora during the postoperative two weeks. However epiphora got worse from one month after the surgery. She was out of this country, so the patient re-visited the clinic on the postoperative six months for this on-going symptom. On an ophthalmologic examination, patient's lacrimal duct and sac was intact but both lacrimal puncta of the patient were covered with a thin membrane. This membrane was punctuated by a 25 gauge needle and dilated with a standard dilator. RESULTS: After ophthalmologic treatment, no recurrence was observed during five weeks of follow-up periods. CONCLUSION: Both lacrimal puncta of the patient were only covered with membranes. And we could not confirm the direct relationship between periciliary epicanthoplasty and postoperative epiphora. The probable factors will be a predisposing narrowed punctum, post operative peri-punctal edema and decrease in muscular function of orbicularis oculi.

Effect of Lipoaspirate Cell Autograft on Proliferation and Collagen Synthesis of Diabetic Fibroblasts in Vitro

PURPOSE: Human lipoaspirate cells are relatively easy to obtain in large quantities without cell culture. The aim of this in vitro pilot study is to identify the effects of cell therapy using uncultured lipoaspirate cells on cell proliferation and collagen synthesis of diabetic fibroblasts, which are the major contributing factors in wound healing. METHODS: In order to get diabetic fibroblasts, dermis tissues were obtained from foot skin of diabetic patients who underwent debridements or toe amputations (n = 4). In order to isolate lipoaspirate cells, the same diabetic patients' abdominal adipose tissues were obtained by liposuction. The diabetic fibroblasts were co-cultured with or without autogenous lipoaspirate cells using porous culture plate insert. Initial numbers of the lipoaspirate cells and diabetic fibroblasts seeded were 15,000 cells/well, respectively. For cell proliferation assay, two treatment groups were included. In group I, diabetic fibroblasts were cultured with the insert having no cells, which serves as a control. In group II, the lipoaspirate cells were added in the culture plate insert. For collagen synthesis assay, one additional group (group III) was included for a reference, in which diabetic fibroblasts were not seeded in the well and only lipoaspirate cells inside the insert were incubated without diabetic fibroblasts. RESULTS: One hundred to one hundred sixty thousand lipoaspirate cells were isolated per ml of aspirated adipose tissue. After 3-day incubation, the mean cell numbers in group I and II were 17,294/well and 22,163/well. The mean collagen level in group I, II, and III were 29, 41, and 2 ng/mL, respectively. These results imply that both cell proliferation and collagen synthesis in the lipoaspirate cell treatment group were 28 and 44 percents higher than in the control group, respectively (p < 0.05). CONCLUSION: Uncultured lipoaspirate cell autografts may stimulate the wound healing activity of diabetic fibroblasts.