Current Methods for the Treatment of Alveolar Cleft

Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6–11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.

Contracted Nose after Silicone Implantation: A New Classification System and Treatment Algorithm

BACKGROUND: Silicone implants are frequently used in augmentation rhinoplasty in Asians. A common complication of silicone augmentation rhinoplasty is capsular contracture. This is similar to the capsular contracture after augmentation mammoplasty, but a classification for secondary contracture after augmentation rhinoplasty with silicone implants has not yet been established, and treatment algorithms by grade or severity have yet to be developed. METHODS: Photographs of 695 patients who underwent augmentation rhinoplasty with a silicone implant from May 2001 to May 2015 were analyzed. The mean observation period was 11.4 months. Of the patients, 81 were male and 614 were female, with a mean age of 35.9 years. Grades were assigned according to postoperative appearance. Grade I was a natural appearance, as if an implant had not been inserted. Grade II was an unnatural lateral margin of the implant. Clearly identifiable implant deviation was classified as grade III, and short nose deformation was grade IV. RESULTS: Grade I outcomes were found in 498 patients (71.7%), grade II outcomes in 101 (14.5%), grade III outcomes in 75 (10.8%), and grade IV outcomes in 21 patients (3.0%). Revision surgery was indicated for the 13.8% of all patients who had grade III or IV outcomes. CONCLUSIONS: It is important to clinically classify the deformations due to secondary contracture after surgery and to establish treatment algorithms to improve scientific communication among rhinoplasty surgeons. In this study, we suggest guidelines for the clinical classification of secondary capsular contracture after augmentation rhinoplasty, and also propose a treatment algorithm.

Delayed Orbital Hemorrhage around Alloplastic Implants after Blowout Fracture Reduction

Alloplastic implants have been used to repair orbital wall fractures in most cases. Orbital hemorrhage is a rare complication of these implants and has been reported rarely in Korea. The purpose of this article is to report a late complication case focusing on their etiology and management. A 20-year-old male patient underwent open reduction with Medpor (porous polyethylene) insertion for bilateral orbital floor fractures. The initial symptom occurred with proptosis in the right side as well as vertical dystopia, which had started 4 days earlier, 8 months after surgery. Any trauma history after the surgery was not present. We performed an exploration and removal of hematoma with Medpor titanium meshed alloplastic implant. A case of delayed orbital hematoma following alloplastic implant insertion was identified. It occurred within the pseudocapsule of the implant. One week after surgery, overall symptoms improved successfully, and no complications were reported during the 11-month follow-up period. Although rare, orbital hemorrhage is a potential complication of alloplastic orbital floor implants, which may present many years after surgery. As in the case presented, delayed hematoma should be included in the differential diagnosis of late proptosis or orbital dystopia.

Delayed Reduction of Facial Bone Fractures

Except for special situations, it is generally agreed that best results in the treatment of facial fractures is expected if reduction is done within the first 2 or 3 weeks after injury. We reduced facial bone fractures at 4 to 7 weeks after trauma. A 44-year-old female patient underwent open reduction for her right zygomaticomaxillary complex fracture at 7 weeks after injury. A 59-year-old female patient underwent surgery for the right mandible body and left parasymphysis fractures at 4 weeks after injury. Using traditional approaches, granulation tissue and callus were removed from the fracture sites, and malunited fracture lines were separated by a small osteotome. We reduced the displaced fractured zygoma and mandible to their normal anatomical positions and fixed them using titanium plates. No complications such as asymmetry, malunion, malocclusion, or trismus were seen. Unfavorable asymmetric facial contours were corrected, and we obtained good occlusion with favorable bony alignment. The functional and aesthetic outcomes were satisfactory. Through removal the callus and limited osteotomy, a successful approach to the previously fractured line was possible, and an exact correction with symmetry was obtained. This method can be a good option for obtaining good mobility and clinical results in treating delayed facial bone fractures.

Aesthetic Consideration of Management in Encephalocutaneous Lipomatosis: How we do it

Encephalocraniocutaneous lipomatosis (ECCL) is a rare congenital neurocutaneous syndrome that was characterized by unilateral, smooth, hairless fatty tissue nevi of the scalp, termed nevus psiloliparus, facial lesions, multiple anomalies involving the eye, and ipsilateral porencephalic cysts with cortical atrophy, cranial asymmetry, marked developmental delays, and mental retardation. A 12-month-old boy was referred to our clinic for evaluation of non-scarring alopecia on the left side with an underlying fatty mass in the left parietal scalp and left-sided multiple periocular masses. It showed a large lipomatous mass on the scalp with overlying alopecia. Multiple skin tags and defects in the left periocular area were also observed. Additional ocular anomalies included epibulbar lipodermoid, iris coloboma, and localized peripapillary hypopigmentation lesions. After complete excision, the wound was covered with a local flap. The histologic examination revealed a mass surrounded by a well-developed capsule within the dermal layer, adipose tissue and connective tissue septa extending into the reticular dermis. No recurrence was observed at follow-up. It is essential to differentiate suspected ECCL from other syndromes which present with epibulbar chorisotomas. Neuroimaging, and pathological studies may be helpful for correct diagnosis. We will correct multiple periocular lesions in preschool age and follow up developmental problems like developmental delay and mental retardation constantly.

Chronic Ulcerating Lesions due to Limited Form of Wegener's Granulomatosis on the Face: Cosmetic Consideration

Wegener's granulomatosis (WG) is a systemic disease characterized by necrotizing granulomas and vasculitis involving the upper and lower respiratory tract as well as the kidneys. Limited form of WG usually involves the head and neck, lacks renal involvement, and may not progress to generalized disease. We report the case of limited form of WG who presented not systemic symptom but several times relapsed multiple ulcerating lesions on the face, uveitis and keratoconjunctivitis. A 23 year-old female initially presented with ulcerative skin lesions on the left cheek and nose. The skin lesion had commenced as an ulcerative and nodulopapular lesion on her right cheek initially, 8 months ago. Subsequently, there was progression of the disease to her left cheek and nose. The patient was treated with oral prednisolone and oral cyclophosphamide. Two weeks later, skin lesion had started to heal, oral prednisolone tapered to 15 mg. Eight weeks later, all of skin lesions were healed well. With silicone gel sheets and Laser therapies, we gained excellent cosmetic results. In the aesthetic aspect, early recognition of rare variants of limited form of WG, facial chronic ulcerative wounds that are nonresponsive to conservative treatment, is very important as appropriate therapy can prevent facial mutilation.

Donor Site Morbidity after Sural Nerve Harvesting for Peripheral Nerve Reconstruction

PURPOSE: Although the sural nerve is the most commonly used donor for autologous nerve graft, its morbidity after harvesting is sparsely investigated. The sural nerve being a sensory nerve, complications such as sensory changes in its area and neuroma can be expected. This study was designed to evaluate the donor site morbidity after sural nerve harvesting. METHODS: Among the 13 cases, who underwent sural nerve harvesting between January 2004 and August 2009, 11 patients with proper follow up were included in the study. The collected data included harvested graft length, actual length of the grafted nerve, anesthetic and paresthetic area, presence of Tinel sign and symptomatic neuroma, and scar quality. RESULTS: In 7 patients, no anesthetic area could be detected. Of the patients with a follow up period of more than 2 years, all the patients showed no anesthetic area except two cases who had a very small area of sensory deficit (225 mm2) on the lateral heel area, and large deficit (4,500 mm2) on the lateral foot aspect. The patients with a short follow up period (1~2 m) demonstrated a large anesthetic skin area (6.760 mm2, 12,500 mm2). Only one patient had a Tinel sign. This patient also showed a subcutaneous neuroma, which was visible, but did not complain of discomfort during daily activities. One patient had a hypertrophic scar in the retromalleolar area, whereas the two other scars on the calf were invisible. CONCLUSION: After a period of 2 years the size of anesthetic skin in the lateral retromalleolar area is nearly zero. It is hypothesized that the size of sensory skin deficit may be large immediately after the operation. This area decreases over time so that after 2 years the patient does not feel any discomfort from nerve harvesting.

Clinical Experiences of Facial Asymmetries in Zygomaticomaxillary Complex Bone Fracture Patients

PURPOSE: Zygomaticomaxillary complex(ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. METHODS: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation(ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. RESULTS: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch(n=2), lateral displaced comminuted fracture of arch(n=6), comminuted arch fracture combined posterior root fracture(n=9), and communited arch and body fracture(n=12), severely contused soft tissue(n=9). After the manipulations outcomes were acceptable. CONCLUSION: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.

A Case of DiGeorge Syndrome with Metopic Synostosis

PURPOSE: We report a patient with DiGeorge syndrome who was later diagnosed as mild metopic synostosis and received anterior 2/3 calvarial remodeling. METHODS: A 16-month-old boy, who underwent palatoplasty for cleft palate at Chungnam National University Hospital when he was 12 months old of age, visited St. Mary's Hospital for known DiGeorge syndrome with craniosynostosis. He had growth retardation and was also diagnosed with hydronephrosis and thymic agenesis. His chromosomal study showed microdeletion of 22q11.2. On physical examination, there were parieto-occipital protrusion and bifrontotemporal narrowing. The facial bone computed tomography showed premature closure of metopic suture, orbital harlequin sign and decreased anterior cranial volume. The interorbital distance was decreased(17mm) and the cephalic index was 93%. RESULTS: After the correction of metopic synostosis by anterior 2/3 calvarial remodeling, the anterior cranial volume expanded with increased interorbital distance and decreased cephalic index. Fever and pancytopenia were noted at 1 month after the operation, and he was diagnosed as hemophagocytic lymphohistiocytosis by bone marrow study. He however, recovered after pediatric treatment. There was no other complication during the 12 month follow up period. CONCLUSION: This case presents with a rare combination of DiGeorge syndrome and metopic synostosis. When a child is diagnosed with DiGeorge syndrome soon after the birth, clinicians should keep in mind the possibility of an accompanying craniosynostosis. Other possible comorbidities should also be evaluated before the correction of craniosynostosis in patients as DiGeorge syndrome. In addition, postoperative management requires a thorough follow up by a multidisciplinary team of plastic surgeons, neurosurgeons, ophthalmologists and pediatricians.

Comparative Study for Compatibility of Acellular Dermis (SureDerm(TM)) and Synthetic Material(PROCEED(R)) on Abdominal Wall Defect in Rabbit Models

PURPOSE: Deficiencies of the abdominal wall can be the a result of infection, surgery, trauma, or primary herniation. For abdominal wall reconstruction, synthetic materials have been shown to provide a better long-term success rate than primary fascial repair. But, synthetic materials cannot elicit angiogenesis or produce growth factor and are therefore plagued by an inability to clear infection. As a result of the inherent drawbacks of synthetic, significant effort has been spent on the identification of new bioprosthetic materials. The aim of our study is to evaluate the effectiveness of a synthetic material(PROCEED(R)) and an ADM(SureDerm(TM)) to repair abdominal wall defects in a rabbit models. METHODS: We measured the tensile strength of the SureDerm(TM) and PROCEED(R) by a Tension meter(Instron 4482). 16 Rabbit models were assigned to this study for abdominal wall reconstruction. Abdominal defect of 8 rabbits were reconstructed by PROCEED(R) and the rest were reconstructed by SureDerm(TM). We assessed gross and histologic examinations for the reconstructed abdominal wall. RESULTS: The tensile strenth of SureDerm(TM) and Gore Tex(R) is 14.64+/-0.51 Mpa, 8.54+/-0.45 Mpa. PROCEED(R) was estimated above the limits of measurement. Inflammatory reaction of PROCEED(R) persisted for 32weeks, but SureDerm(TM) decreased after 16weeks. Vascular ingrowth into the SureDerm(TM) was seen after 32 weeks. The basement membrane of SureDerm(TM) changed into a form of pseudoperitoneum. In PROCEED(R), it seemed like pseudoepithelial lining was made from the fibrosis around the mesh. CONCLUSION: In our study, the SureDerm(TM) not only have less inflammatory reaction and presented more angiogenesis than the PROCEED(R), but also have pseudoperitoneum formation. It is expected that SureDerm(TM) is useful for abdominal wall reconstruction. However, a long-term study of its usage consequences are thought to be needed.

Modified Submental Intubation in Panfacial Bone Fracture Patients

PURPOSE: Nasotracheal or oral intubation procedure is widely used for facial bone fractures. However, during the operation intubated tube can interfere or obstruct the view of the operator. We authors used a modified submental intubation method in panfacial bone fracture patients for intact airway and the operation view. METHODS: After intravenous induction of anaesthesia, traditional orotracheal tubation was done. A horizontal incision was made 2cm from the midline, 2cm medial to and parallel with the mandible in the submental region.1 In order to approach to the floor of the oral cavity, a haemostat was pushed through the soft tissues. A chest tube front cover was applied to the intubation tube and the tube was inserted through the submental tunnel. Orotracheal tube was disconnected and pulled back through the soft tissue and secured with a suture. RESULTS: The procedure took about 30 minutes and there were no problems during the intubation. Intraoral manipulation and occlusal checks were free without any interference. Extubation was also easily done without any complications such as lung aspiration, infection, hematoma, or fistula. CONCLUSION: Submental endotracheal intubation is fast, safe, easy to use and free from the concern about the tube being pull back again. Conventional submental intubations are being held without any coverage of the tip. We authors applied the modified method to the trauma patients and obtained satisfactory results. From the above advantages, modified submental intubation can be widely available not only in fractured patients, but also in aesthetic or orthognathic surgeries.

Preoperative Evaluation of the Facial Artery Using Facial Angio Computed Tomography

PURPOSE: Previous studies of the facial artery have shown significant anatomical variability in this region. The vascular anatomy of the region is considered unreliable in predicting the ideal pedicle. Preoperative imaging has been suggested as a means of improving preoperative awareness, with Doppler ultrasound as useful tools. Multi-detector row angiographic computed tomography (angio CT) is a significant improvement, providing non- invasive operator-independent details of the vascular anatomy. This tool was used to perform an in vivo anatomical study of the facial artery, demonstrating the usefulness of facial angio CT in planning the facial reconstruction. METHODS: Eleven consecutive patients underwent facial angio CT of the facial vasculature with the anatomical details of the facial artery assessed. RESULTS: Facial angio CT could demonstrate the size and course of the facial vasculature, particularly the facial artery. CONCLUSION: The vascular anatomy of the facial artery is highly variable, and thus there is a role for preoperative imaging. Facial angio CT can demonstrate cases where there is an aberrant or non-preferred anatomy, or select the method of a facial reconstruction.

Application of Osteotomies in Aesthetic Rhinoplasty

Nasal osteotomy for aesthetic results is required in patients who have broad nasal bone. Since the procedure is difficult, many operators hesitate the surgery. From January 2007 to July 2009, we performed 77 cases of nasal osteotomy, consisting of paramedian oblique medial osteotomy or median oblique-medial osteotomy and percutaneous lateral osteotomy. Most of the patients had satisfying results, however three patients had asymmetric shape and inappropriate inward movement of nasal bone which required revision with percutaneous lateral osteotomy. Osteotomy procedure varies, depending on surgeon's preference and experience, however, each surgeon should be aware of good and weak points of those procedures and use the most suitable method. In order to achieve maximal satisfying results, preoperative analysis of patients and minimal invasive handling should be done. Based on these efforts, this method could broadly be used in the aesthetic field.

Expansion Procedures of the Nasal Envelope in Short Nose Deformity : Release of the Transverse Nasalis Sling and Division of Muscle Confluence in Nasal Hinge Area

Cartilage extension and nasal envelop expansion play a main role incorrecting short or contracted nose. Despite numerous studies for cartilage expansion, there has been no reports of nasal skin elongation methods. We hereby preport a new method for expansion of nasal envelop with a comprehensive understanding of anatomical structures. From April 2009 to September 2010, 6 patients underwent operations to correct short or contracted nose. Two separating procedures were included for nasal envelop elongation; division of muscle(Procerus, Transverse nasali, Levator labii superior alaque nasi: PTL muscles) confluence located at nasal hinge and release of transverse nasalis sling. To estimate the degree of nasal envelop extension, forced skin traction test was performed. Comprehensive research with fresh cadaver was held to study the relationship between nasal SMAS and surrounding structures. Average 3.8mm elongation was documented by forced skin traction testafter the procedure. In the fresh cadaver study, transverse nasalis sling and PTL muscle confluence were firmly attached to the supportive framework. From our clinical experience and cadaver study, we discovered that release of transverse nasalis sling and division of PTL muscle confluence are the main factors for nasal envelop expansion in short or contracted nose.

Sebaceous Carcinoma Treated with Various Flaps in Head and Facial Regions

PURPOSE: Sebaceous carcinoma is a rare malignant tumor that occurs mostly in head and neck regions. Early diagnosis and treatment are necessary because it tends to be locally aggressive and goes through distal metastasis with fast progression. This study presents reliable surgical methods for sebaceous carcinoma in head and neck regions. METHODS: Three patients were included in this study. First, a 61-year-old woman visited the hospital with a yellow-colored, slowly growing mass on the left ala. A 54-year-old woman had a brown-colored mass on her right preauricle. Last case was a 62-year-old man who had a yellow-colored mass on his scalp. CT scan and punch biopsy were done. All cases were diagnosed as sebaceous carcinoma. The lesions were resected with 10 mm safety margin and various regional flaps were used for reconstruction. RESULTS: Histological examination revealed sebaceous differentiation and local invasions. Postoperatively, all patients did not suffer from complication and no recurrence was found. CONCLUSION: We recommend early wide excision with an enough safety margin, and a regional flap as a treatment of sebaceous carcinoma.

Muscular System of Depressor Septi Nasi: Anatomical Study and Clinical Application

Hyper-activated depressor septi nasi is an important factor caused a nasal tip drooping and many studies have been carried out, however it still remains controversial. This study presents a surgical modality for its intervention, based on the anatomical study. Eleven fixed and six fresh cadavers were used for the study. We found that the depressor septi nasi was consisted of three fascicles. Medial fascicles were inserted into the dermocartilaginous ligament, and deep fibers of the medial fascicles were attached to the anterior nasal spine. After superficial fibers were interdigitated with the orbicularis oris, they were attached to the alveolar bone. Intermedial fascicles were inserted to the footplates of the medial cruses and the caudal septum. After they were interdigitated with the medial fascicle and the orbicularis oris, they were attached to the alveolar bone. From April to August 2008, five patients had surgical intervention for hyper-activated depressor septi nasi. Medial and intermedial fascicles were detached completely from the anterior nasal spine and the septum through intranasal approach. Tip droopings were improved in all cases. Specific complications were not found. We believe that surgical intervention through intranasal approach is a useful method for correction of tip drooping.

Stabilization of Unilateral Septal Extension Graft Using Pivot Locking Suture

Septal extension graft is valuable in elongating the nasal length which projects and rotates the tip. It is very effective for improving the nasal tip, therefore, it has widely been applied to correct short noses and drooping tips. In the field of Asian rhinoplasty, many operations are conducted using a septal extension graft, and variable techniques and methods have been introduced by several surgeons. However, there are difficulties in harvesting a sufficient amount of septum from Asian noses, therefore, appropriate designs and definite fixation of a graft are important factors. Furthermore, when applying the harvested septal cartilage to the L-strut, stability depends on the method and the location of the graft fixation. When the graft is unstable due to its pivot motion, the tip will be drooping, deviated and decreased in projection. We herein introduce a pivot locking suture that can firmly stabilize the septal extension graft and explain the factors related with septal stabilization. From September 2006 to February 2008, we performed unilateral septal extension graft for aesthetic purposes in 64 patients. After classic compression suture between L-strut and unilateral septal cartilage graft, pivot locking sutures were performed. Pivot locking suture fixed the meeting site of septal extension graft, and cephalic and caudal margin of L-strut using "figure of 8" suture. Then, we confirmed the stability with a vertical stability test and horizontal stability test. We could follow up with 20 patients. All patients were satisfied except 2 patients with the tip deviation. Therefore, we believe that pivot locking sutures together with classic compression sutures can overcome limitations of stability inherent with conventional methods, due to unstable septal extension graft cartilage.

A Case of Isolated Collagenoma on the Finger

PURPOSE: Collagenoma is an intradermal harmatomatous collagen proliferation among connective tissue nevi of the skin. Although there are some reports of isolated collagenomas that occurred on the sole and the palm, collagenoms at the finger has not been reported in Korea. METHODS: An 11-year-old girl presented with a growing mass on the distal interphalangeal joint of the left 5th finger. It was a skin-colored, oval and mild tender mass. There were no associated cutaneous or systemic abnormal findings. RESULTS: The nodule, at the subcutaneous level on the distal phalanx, was completely removed by excision. Grossly it was covered with normal skin, and its surface was smooth having a definite margin with a size of 1.5x1.2cm. Histopathological examination, the epidermis showed to be normal, increased thickness of collagens arranged with a whirl formation was found in the dermis. No signs of cellular component increase were observed. CONCLUSION: Isolated collagenoma can be aroused as a solitary nodule in at any place of the body. We report a rare case of a female patient with an isolated finger collagenoma.

Effects of Cross-Linking Agents on the Stability of Human Acellular Dermal Matrix

PURPOSE: Human acellular dermal matrix(ADM) is widely used in the treatment of congenital anomalies and soft tissue deficiencies. But it is rapidly degraded in the body and does not provide satisfactory results. There is a need to improve collagen fiber stability through various methods and ultimately regulate the speed of degradation. METHODS: The ADMs were added with various cross- linking agents called glutaraldehyde, dimethyl 3,3'-dithiobispropionimidate to produce cross-linked acellular dermal matrices. 1,4-butanediol diglycidyl ether solution was applied with a pH of 4.5 and 9.0, respectively. The stability of cross-linked dermal matrix was observed by measuring the shrinkage temperature and the degradation rates. The cross- and non-cross linked dermis were placed in the rat abdomen and obtained after 8, 12 and 16 weeks. RESULTS: The shrinkage temperature significantly increased and the degradation rate significantly decreased, compared to the control(p<0.05). All of cross- linked dermises were observed grossly in 16 weeks, but most of non-cross linked dermis were absorbed in 8 weeks. Histologically, the control group ADM was found to have been infiltrated with fibroblasts and most of dermal stroma were transformed into the host collagen fibers. However, infiltration of fibroblasts in the experiment was insignificant and the original collagen structure was intact. CONCLUSION: Collagen cross-linking increases the structural stability and decreases degradation of acellular dermis. Therefore, decrease in body absorption and increase in duration can be expected.

Comparison Study of Physical Properties between Two Silicone Gel Sheets

PURPOSE: Silicone gel sheet(SGS) is used for preventing and treating keloid or hypertrophic scars. Because the product is weak in tear strength and adherence, it requires several replacements, which requires high cost. As a solution for this problem, we developed a new silicone gel sheet, named as Scar Clinic, and confirmed its physical properties. METHODS: Tensile strength, elongation rate, adhesiveness, and water vapor transmission rate were experimentally compared between the most commonly used SGS product and the Scar Clinic. RESULTS: The newly developed SGS showed better results compared to the existed SGS in regards to tensile strength, elongation rate, adhesiveness, and water vapor transmission rate. CONCLUSION: The Scar Clinic showed higher durability and flexibility. It will be a useful product for treating scars clinically.