How to get the Best Results in Transaxillary Breast Augmentation with Anatomic form Stable Implants: Pocket Shapes, Insertion, and Maintenance

Although IMF incision is known the best way for anatomic implant, most Korean doctors and patients hesitate IMF incision. Anatomic form stable implants have some benefits such as less prominent upper pole, less wrinkles and ripples, and less rupture rate than round cohesive type I implants. However more concern is necessory for placing the anatomic implants. The Korean Academic Association of Breast Surgery(KAABS) planned to support some tips for using anatomic form stable implants through axillary incision. The KAABS gathered and analyzed the concepts of Korean plastic surgeons who have experienced transaxillary breast augmentation with anatomic form stable implants. The KAABS requested them of their concepts of 9 basic categories: entrance dissection, pocket dissection, lubricant, inserting aids, skin protector, inserting direction, suction drainage, dressing, compression garment, and their key considerations. Eight expert surgeons suggested their own cutting edge methods of transaxillary breast augmentation with the anatomic form stable implant, however each surgeon should find his or her own method. Authors and KAABS hope that these developing and incomplete concepts help beginners to find their own concepts.

Branching pattern and morphometry of the axillary nerve / 대한해부학회지

The branches of the axillary nerve and branching pattern of the posterior cord of the brachial plexus are not fully described in the anatomy textbooks. The branching pattern of the axillary nerve is needed to understand various symptoms of quadrilateral space syndrome. We studied on the branching patterns and variation of the axillary nerve and posterior cord of brachial plexus in 127 adult cadaver arms. The axillary, radial and thoracodorsal nerves arising from the posterior cord of the brachial plexus were classified into 4 types according to the position of the thoracodorsal nerve. The most common type (42.5%) was that the three nerves directly arising from the posterior cord. The thoracodorsal nerve branched from the axillary nerve in 27.6%. The posterior branches of the axillary nerve were divided into 6 types by the arising point of the nerve to teres minor muscle. The deltoid branch and lateral superior brachial cutaneous nerve were divided after branching of nerve to teres minor muscle in 50.8%. The lower subscapular nerve was branched from the axillary nerve in 70.9%. We measured the distances from the branching point of the axillary nerve to the inferior border of the subscapularis in the quadriangular space and from the coracoid process to the axillary nerve. The length and motor point of the teres minor muscle were measured. The relationship of the axillary nerve and posterior circumflex humeral artery was observed. The axillary nerve was always medial to the artery and their superoinferior relationship was variable. The clinical significance of the branching pattern of the axillary nerve was discussed.

Bilobed Sensate Radial Forearm Free Flap for Functional Reconstruction Following Hemiglossectomy

After hemiglossectomy due to tongue cancer, such factors as mobility, sensation, volume and the shape of the tongue are critical elements for successful rehabilitation. As long as there is a residual segment of mobile tongue with an intact motor nerve supply, the mobility of native tongue can be preserved by using tissue with thin, pliable and sensory potential. The residual tongue motion can be maximized by separating the reconstruction of mobile tongue from the reconstruction of the floor of mouth. Six patients who underwent significant glossectomy for squamous cell cancer were reconstructed with a bilobed design of sensate radial forearm flap. One lobe of the flap is used to restore the shape and volume of the tongue, while the other lobe is used to resurface the floor of the mouth. There were no flap failure and fistula formation. In all patients, the tongue mobility was preserved and the earliest recovery of sensation was noted 5 weeks following the surgery. The articulation was good enough for them to perform daily activities. With the bilobed design, we can maximize the mobility of the residual tongue by preventing tethering of the root of tongue to the inner table of the mandible. In this article e present our successful experiences with this method, especially in view of mobility and sensation.

Communication between the musculocutaneous and the median nerves and its clinical significance / 대한해부학회지

The purpose of this study was to investigate variations in the communicating branch between the musculocutaneous and the median nerves and to discuss their clinical significance. Seventy two arms from 36 Korean adults were used. Twenty four cases (33.4%) among 72 arms had communications between the musculocutaneous and the median nerves. In 19.5%, a communicating branch ran from the musculocutaneous to the median nerves and in 4.2% of these a communicating branch formed a loop. A branch running from the median to the musculocutaneous nerves was observed in 6.9%. There were more than two communicating branches between two nerves in 5.6%. The average angle between the musculocutaneous nerve proximal and distal to the coracobrachialis was 159+/-9degrees at adduction of the arm. The musculocutaneous nerve did not pierce the coracobrachialis muscle in 2.8%. One case (1.4%) showed partial fusion of the trunks of the musculocutaneous and median nerves. The musculocutaneous nerve ran next to the median nerve after the coracobrachialis muscle and coursed laterally in 5.6% with or without a communicating branch. In these cases, the angle of the musculocutaneous nerve was more acute. The musculocutaneous nerve entrapment is discussed with this angle.

BREAST RECONSTRUCTION WITH LATISSIMUS DORSI ISLAND FLAP IN ORIENTALS

No abstract available.