Surgical treatment of rhinophyma using an ordinary bur

Rhinophyma is a painless benign tumor of the skin of the nose. It is the most severe form of rosacea. Rhinophyma is particularly rare among Asians. It can be treated with surgical resection using various methods, including scalpel excision, dermabrasion, cryosurgery, argon laser, carbon dioxide laser, and electrocautery. However, the gold standard treatment of rhinophyma remains unknown. In the present case, we debulked a giant rhinophyma with a scalpel and contoured it using a bur. Along with a relevant literature review, we present a case of rhinophyma in an Asian patient who was treated at no additional cost using a bur widely used in general plastic surgery.

Usefulness of full-thickness skin grafting from the infraclavicular area for facial reconstruction

Background@#Full-thickness skin grafts (FTSGs) have been widely used after facial skin cancer resection, for correcting defects that are too wide to be reconstructed using a local flap or if structural deformation is expected. The preauricular, posterior auricular, supraclavicular, conchal bowl, nasolabial fold, and upper eyelid skin areas are known as the main donor sites for facial FTSG. Herein, we aimed to describe the effectiveness of using infraclavicular skin as the donor site for specific cases. @*Methods@#We performed FTSG using the infraclavicular skin as the donor site in older Asian adults following skin cancer resection. Outcomes were observed for > 6 months postoperatively. The Manchester Scar Scale was used for an objective evaluation of satisfaction following surgery and scarring. @*Results@#We analyzed the data of 17 patients. During follow-up, the donor and recipient sites of all patients healed without complications. Upon evaluation, the average Manchester Scar Scale scores for the recipient and donor sites were 7.4 points and 5.7 points, respectively. @*Conclusion@#In general, conventional donor sites, such as the preauricular, posterior auricular, and supraclavicular sites, are widely used for facial FTSG because they achieve good cosmetic results. However, the infraclavicular skin may be a useful donor for facial FTSG in cases where the duration of time spent under anesthesia must be minimized due to a patient’s advanced age or underlying health conditions, or when the recipient site is relatively thick area, such as the nose, forehead, or cheek.

Usefulness of full-thickness skin grafting from the infraclavicular area for facial reconstruction

Background@#Full-thickness skin grafts (FTSGs) have been widely used after facial skin cancer resection, for correcting defects that are too wide to be reconstructed using a local flap or if structural deformation is expected. The preauricular, posterior auricular, supraclavicular, conchal bowl, nasolabial fold, and upper eyelid skin areas are known as the main donor sites for facial FTSG. Herein, we aimed to describe the effectiveness of using infraclavicular skin as the donor site for specific cases. @*Methods@#We performed FTSG using the infraclavicular skin as the donor site in older Asian adults following skin cancer resection. Outcomes were observed for > 6 months postoperatively. The Manchester Scar Scale was used for an objective evaluation of satisfaction following surgery and scarring. @*Results@#We analyzed the data of 17 patients. During follow-up, the donor and recipient sites of all patients healed without complications. Upon evaluation, the average Manchester Scar Scale scores for the recipient and donor sites were 7.4 points and 5.7 points, respectively. @*Conclusion@#In general, conventional donor sites, such as the preauricular, posterior auricular, and supraclavicular sites, are widely used for facial FTSG because they achieve good cosmetic results. However, the infraclavicular skin may be a useful donor for facial FTSG in cases where the duration of time spent under anesthesia must be minimized due to a patient’s advanced age or underlying health conditions, or when the recipient site is relatively thick area, such as the nose, forehead, or cheek.

Dear members of the Korean Cleft Palate-Craniofacial Association

No abstract available.

Use of Acellular Allogenic Dermal Matrix in Soft Palate Reconstruction after Excision the Pleomorphic Adenoma / 대한두경부종양학회지

Recent studies have reported on the reconstruction of oral mucosal defects using acellular dermal matrix (ADM). This case report describes the reconstruction of a soft-palate mucosal defect using ADM. A 43-year-old man developed a 2.5 cm × 3 cm soft-palate mucosal defect after the removal of a lump on the soft palate andreconstructed the defect using ADM without further complications. Reconstruction of the soft palate with ADM could be more convenient than traditional methods including primary closure, skin graft, and local or free flap without complications.

Effectiveness of radiotherapy for head and neck skin cancers: a single-institution study

PURPOSE: External beam radiotherapy (EBRT) is a useful option to treat head and neck skin cancer patients who are not indicated for surgery. In this study, we evaluated the treatment outcomes of EBRT in an Asian population.MATERIALS AND METHODS: The records from 19 head and neck skin cancer patients (10 with squamous cell carcinoma and 9 with basal cell carcinoma) who were treated with definitive or adjuvant EBRT from 2009 to 2017 were retrospectively reviewed. The radiotherapy doses administered ranged from 50 to 66 Gy (median, 55 Gy) with 2.0–2.75 Gy per daily fraction (median, 2.5 Gy). The T stage at presentation was as follows: Tis (1 patient), T1 (11 patients), T2 (6 patients), and T3 (1 patient). None had regional lymph node disease or distant metastasis at presentation. The local failure-free survival (LFFS) rates, toxicity, and cosmetic results were analyzed.RESULTS: The median age was 75.5 years (range, 52.6 to 92.5 years). The median follow-up duration from the completion of radiotherapy was 44.9 months (range, 5.8 to 82.6 months). One local failure occurred in a patient with a 2.1-cm posterior neck squamous cell carcinoma at 32.5 months after radiotherapy (1/19, 5.3%). The 3-year LFFS rate was 91.7%. No patients died from skin cancer during follow-up, and no grade 3 complications occurred. The cosmetic outcomes were excellent for 16 (84.2%) and good for 3 (15.8%) of the 19 patients.CONCLUSION: EBRT offers good local control and cosmetic outcomes in patients with head and neck skin cancer, with no grade 3 complications.

Reconstruction of a scalp defect due to cochlear implant device extrusion using a temporoparietal fascia flap and a split-thickness skin graft from the scalp

Cochlear implant extrusion, which is a common complication of cochlear implants, is generally repaired by a well visualized soft-tissue flap. A 61-year-old female patient with a medical history of schizophrenia who had a skin ulcer that caused cochlear implant extrusion, but that would be a stronger statement was referred to our department for removal of the implant and reconstruction of the resultant scalp defect. Accordingly, the broad defect was covered via rotation of a temporoparietal fascia flap (TPFF) using the superficial temporal artery, with the pedicle in the preauricular region as the pivot point. Coverage of TPFF was achieved with a split-thickness skin graft using the scalp as the donor site, which led to a quick recovery after the operation and satisfactory results in terms of aesthetics. This case suggests that a TPFF might be used as a flexible flap with low donor site morbidity for reconstructing cases of cochlear implant extrusion accompanied by a large full-layer scalp defect.

Hair Control during Scalp Surgery Using a Sterile Gel Technique

It is necessary to organize and arrange the hair before performing surgery on the scalp. The hair is preserved in most cases, and the remaining hair makes it difficult to apply and maintain the drape. Moreover, hair that has not been properly sterilized can be a risk factor for infection. Accordingly, the authors of the present study benchmarked a method of hair control within the operative field using a sterile gel. Prior to surgery, the hair around the lesion can be organized and rearranged to the desired shape by using a sterile medical gel as a hairstyling product. Subsequently, chlorhexidine-isopropyl alcohol can be used for aseptic skin preparation, followed by draping for surgery. By controlling the hair using this method, hair can be prevented from falling into the operative field, thereby reducing the risk of surgical site infection.

Inverted Nipple Correction Using a Combination of the Perpendicular Suture Method and the Purse-String Suture Method

While various surgical methods are used for inverted nipple correction, an optimal technique has not been established. We describe a combination of suture methods including purse-string sutures, based on a report by Gould et al. This is a simple and safe method for inverted nipple correction.

Inverted Nipple Correction Using a Combination of the Perpendicular Suture Method and the Purse-String Suture Method

While various surgical methods are used for inverted nipple correction, an optimal technique has not been established. We describe a combination of suture methods including purse-string sutures, based on a report by Gould et al. This is a simple and safe method for inverted nipple correction.

Non-Melanocytic Skin Cancers of the Head and Neck: A Clinical Study in Jeju Province

BACKGROUND: Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. METHODS: Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015. RESULTS: In total, 190 patients (57 men) with a mean age of 75 years (range, 42–97) were assessed. Overall, 203 NMSCs were diagnosed, including 123 basal cell carcinomas and 80 squamous cell carcinomas. The tumor sites included the nose, cheeks, periorbital area, and lips (n=55, 54, 25, and 20, respectively). We identified 92 T1-stage and 60 T2-stage tumors, and 120 cases were treated with wide surgical resection and 17 cases were treated with radiation therapy at the medical center. Of the 120 cases treated surgically, 69 required reconstructive surgery using a local skin flap, 22 required full-thickness skin grafting, and 12 underwent primary closure. Basal and squamous cell carcinomas recurred in 2 and 1 cases, respectively. CONCLUSIONS: Compared to the reports from other regions, the average patient age was 10 years higher, with a marked female preponderance. While the proportion of squamous cell carcinoma was higher than in other regions, the tumor distribution and surgical management profiles were similar.

The Oral Cavity Burn by Firework Explosion

Facial injury by firework is not rare, but there are few reports on oral firework explosion injury. The authors of this article present a case of an 18-year-old male with intraoral injury from a firework explosion with literature review.

Reduction and Fixation Methods for Fractured Anterior Maxillary Sinus Wall Using Suture Tie

The anterior maxillary sinus walls are the most frequently injured sites in midfacial fractures. The maxillary sinus is a difficult surgical site for reduction and fixation due to its narrow surgical field, and has a chance of developing sinusitis when sufficient treatment is not given. In this study, the methods developed by the authors for managing such are introduced. Two small openings were made on both sides of the fracture line, then a suture knot was tied instead of wiring for reduction and fixation. Then an absorbable mesh was applied on top of the fracture site, with a suture knot for additional fixation. This method was applied on an actual patient, and it was a convenient method despite the narrow surgical field that was provided. The authors believe that using suture knots to fixate fractured segments and absorbable mesh is relatively convenient and economically efficient when it comes to the reduction and fixation of the maxillary sinus wall fracture with several fragments.

Analysis of Scientific Papers Included in the Sciences Citation Index Expanded Written by South Korean Plastic Surgeons: 2001-2010

BACKGROUND: The purpose of our study was to analyze scientific papers published by South Korean plastic surgeons in journals included in the Science Citation Index Expanded (SCIE), and to evaluate the publication and research activities of Korean plastic surgeon. METHODS: We conducted a survey of SCIE papers in the field of plastic surgery published by South Korean authors between 2001 and 2010 using Web of Science software. We further analyzed these results according to the number of publications per year, journals, institution, and type of papers. We also compared the total number of citations to published scientific papers. We analyzed the rank of South Korea among other countries in representative journals. RESULTS: Overall, 667 papers were published by South Korean authors between 2001 and 2010. The number of publications increased dramatically from 2003 (n=31) to 2010 (n=139). Subsequently, the ten most productive Korean medical colleges were identified. All published papers received 2,311 citations and the citation to paper ratio was 3.49. The rank of Korea among other countries in terms of the number of published papers remained in the top 10 during the recent 10 years. CONCLUSIONS: Publication output of Korean plastic surgeon over the last 10 years showed a remarkable growth in terms of quantity and quality. Currently, Korea is among the top six countries in representative plastic surgery journals. Korean plastic surgeons have played a central role in this progress, and it is anticipated that they will continue to do so in the future.

Reconstruction of Cheek Defect with Facial Artery Perforator Flap

PURPOSE: To reconstruct the midface, local flaps such as nasolabial flaps have been frequently used. These local flaps, however, have the shortcomings of requiring a secondary operation or limitations in the movement of the flap. Thus, new methods have been developed. This paper reports a case wherein the basal cell carcinoma on the cheek was resected and the skin and soft tissue defect was successfully treated using a facial artery perforator flap. METHODS: A 68-year-old female consulted the authors on the basal cell carcinoma that developed on her cheek. The mass was fully resected and revealed a 2.3 x 2.3 cm defective region. Using a Doppler ultrasonography, the facial artery path was traced, and using a loupe magnification, the facial artery perforator flap was elevated and the defective region was covered with the flap. RESULTS: The flap developed early venous congestion, but it disappeared without any treatment. Six months after the surgery, the patient was satisfied with the postoperative result. CONCLUSION: The facial artery perforator flap has a thin pedicle. It offers a big arc of the rotation that allows free movement and one-stage operation. These strengths make the method useful for the reconstruction of the midface among other procedures.

Multiple Osteomas in the Skull Vault: Case Report

PURPOSE: Osteoma is one of the common benign tumors of the skull vault and facial skeleton. Although most of the osteomas cause no symptoms, forehead osteomas may lead to facial disfigurement. Osteoma usually happens in solitary lesion and multiple osteomas which don't combine with syndrome are very rare. We report an experience of treatment of non-syndromic multiple osteomas in the skull. METHODS: A 54-year-old female patient visited due to the multiple palpable hard masses on her forehead in 2010. In 2002 of her first visit, masses started to appear on her forehead and she was diagnosed as the osteoma by excisional biopsy. She visited again because the mass size and number increased. In preoperative CT scanning, there were above 160 of osteomas, so surgery was planned. Enterogastroduodenoscopy and colonoscopy was conducted to rule out Gardener's syndrome, however there was no abnormality such as multiple polyposis. RESULTS: Under general anesthesia, coronal approach was conducted. There were numerous osteomas in frontal and parietal bone. The multiple osteomas were removed by burring and the patient recovered without any postoperative complications. CONCLUSION: Multiple osteomas in the skull were rarely reported, although it can accompanied with Gardener's syndrome. We report a case of non-syndromic multiple osteomas in skull vault.

Present and future of aesthetic plastic surgery in Korea

Due to Confucian ethics and socioeconomic factors, aesthetic plastic surgery came late to Korea. However, the field of aesthetic plastic surgery developed rapidly after the establishment of the Korean Society of Aesthetic Plastic Surgeons in 1985. At present, Korean aesthetic plastic surgeons have achieved world leading surgical skills and research abilities. This article review the history and current state of Korean aesthetic plastic surgery with the follow-up study of statics and numerical data. Over the period of 10 years (2001-2010), the Korean plastic surgeons contributed 607 papers to SCI & SCI(E) journals. Among them, the number of pure cosmetic surgical papers was 133 (21.9%). According to biannual survey data from the International Society of Aesthetic Plastic Surgery in 2009, the number of plastic surgeons and aesthetic procedures in Korea became the highest contrast to percentage of the population in the world. As dynamic forces of development for Korean aesthetic plastic surgery, this advocate the medical tourism, non-surgical cosmetic procedures, and adipose-derived stem cells. With developing these items, Korean plastic surgeons will create the brilliant future of the aesthetic plastic surgery in Korea.

Reconstruction of Burn Scar Contracture with Split-Thickness Skin Graft Taken from the Scalp and Alloderm(R): Case Report

A 13 year old male patient had limitation of foot motion due to burn scar contracture on right ankle area. The scar contracture was released and Alloderm(R) was applied over the raw surface. Split thickness skin was harvested from the scalp and harvested skin was applied over Alloderm(R). Epithelialization of donor site began from the post-op 5th day. Graft was well taken without any problem. There was no complications during 6 months of follow-up period.

The Correction of Osmidrosis Using the Liposuction and Subdermal Manual Shaving Through Small Midline Incision

No abstract available.

Treatment of a Giant Pigmented Nevus using an Alloderm: A Case Report

Because a giant pigmented nevus has the risk of malignant transformation to malignant malanoma, early surgical excision is recommended. There have been various types of surgical methods in a giant pigmented nevus, for example dermabrasion, staged excision, skin graft, local flap and tissue expander. The authors have used an alloderm combined with a very thin split thickness skin graft in the treatment of a giant pigmented nevus. Among the 3 patients we operated in 1999, we could not find a significant cosmetic difference compaired with the conventional split thickness skin graft. Our method with the use of an alloderm combined with a very thin split thickness skin graft would be considerable in the treatment of a giant pigmented nevus, because it shows less visible scars in donor site than conventional split thickness skin graft. Moreover, we could harvest skin graft from the same site twice or more times.