Correction of Sunken and/or Multiple Folded Upper Eyelid by Refined Structural Micro-Fat Graft: Technical Pearls

Structural micro-fat graft is one of the surgical techniques for facial rejuvenation, and it is reliable for correction of sunken upper eyelids especially. However, several factors may influence surgical outcomes substancially. The author introduces the modified micro-fat graft to correct sunken eyelids and multiple eyelid folds to make better results. A series of 162 patients who underwent the refined structural micro-fat graft were included in this study. The purified fat was injected into the subcutaneous and sub-orbicularis oculi muscle layer of the upper eyelids through the 19-gauge cannula with 1 ml syringe. After the operation, all patients were followed up on 2 weeks, 1 month, 3 months, 6months, and 1 year. Clinical photographs were taken every visit and the author evaluated the volume and symmetry of the eyelids and checked the satisfaction of each patient and any complications. Among the 162 patients, 156 patients were satisfied with the upper eyelid volume after primary fat graft and other 6 patients were performed secondary fat graft. Even though the volume of the fat was sufficient, 4 patients showed palpable fat nodule during the follow-up period. Modified micro-fat graft is a simple, safe, and alternative method to correct sunken eyelids and multiple eyelid folds.

A Case Repot of Chronic Unhealing Wound Related to Odontogenic Cutaneous Sinus Tract

PURPOSE: The odontogenic sinus and fistulous tracts is the most common draining sinus and fistulous tract of the head and neck region. These are often misdiagnoses by clinicions who are not familiar with cutaneous sinus, since most of patients do not have dental symptoms. Here we present two cases of odontogenic cutaneous sinus tract which have been diagnosed after excision of epidermal cyst. METHODS: Two patients who presented with an odontogenic sinus tract draining to the skin at our institusion during the two years were enrolled in this study. We reviewed all the medical records of the patients and literature about odontogenic cutaneous sinus tract. RESULTS: Odontogenic cutaneous sinus tracts of our cases were healed after treatment of periapical odontitis and extraction of the carious tooth. CONCLUSION: The cutaneous sinus tract of dental origin is well documented condition. But its diagnosis is not always easy unless the clinicians consider the possibility of its dental origin. An understanding of the pathogenesis of odontogenic cutaneous sinus tract will lead to early correct diagnosis and proper treatment without unnecessary surgery.