A modified method for corner mouth lift in scar-prone patients

Corner mouth lift is in increasing demand among young patients in East Asia. Although various surgical methods exist for corner mouth lift, many patients are reluctant to undergo surgery due to fears of postsurgical scarring. We present a new technique aimed at reducing postoperative scarring. The technique involves triangular excision of the corner of the mouth and incision of the commissure with transposition of a lateral vermilion flap to lift the corner of the mouth. The muscle around the corner of the mouth is dissected to release tension. The corner mouth lift was successfully performed in all patients. It can be effectively used even in patients, such as young Asian women, who are susceptible to hypertrophic scars.

Multi-modal treatment strategy for achieving an aesthetic lower face

Background@#Most women consider an oval-shaped face to be youthful and beautiful. In recent years, demand has grown for surgical procedures with a shorter downtime and fewer complications. These minimally invasive procedures include botulinum toxin type A (BoNTA) injection, filler injection, suction-assisted liposuction (SAL), laser-assisted lipolysis (LAL), thread lifting, and fat grafting. This study aims to introduce an effective method for creating an aesthetically pleasing lower face using a combination of minimally invasive procedures. @*Methods@#From March 2017 to March 2019, 94 patients simultaneously underwent LAL, SAL, and thread lifting. Ancillary procedures such as BoNTA injections, hyaluronic acid filler injections, and removal of the buccal fat pad (BFP) were selectively performed according to the patient’s condition. @*Results@#Patients rated their postoperative satisfaction as very satisfied, satisfied, dissatisfied, or very dissatisfied. Approximately 83% of all respondents were satisfied with the results, whereas the remaining respondents had complaints regarding the outcomes. The most common reasons for dissatisfaction were a longer-than-expected recovery time and undercorrection, and the most severe complaint was skin depression as a result of overcorrection. @*Conclusions@#Our method of simultaneously performing LAL, SAL, and thread lifting, while adding BoNTA, filler injections, and BFP removal as needed, was capable of producing consistent and reliable aesthetic outcomes for the lower face.

Treatment of Capsular Contracture after Breast Augmentation with Serial Fat Grafting and Implantation

BACKGROUND: Capsular contracture is the most common complication after breast augmentation using implants. In case of severe capsular contracture, surgical correction is inevitable. We introduce a treatment for severe capsular contracture with serial fat grafting before augmentation using implants. METHODS: In severe cases of capsular contracture, we removed the implants and performed partial capsulectomy. We harvested fat from the flanks or thighs using liposuction. The first fat graft was performed in the subdermal, subcutaneous, and subglandular layers of the breast. The harvested fat was frozen and stored. One month after implant removal and the first graft, a second fat graft was performed. One month later, a third fat graft was performed. Six months after implant removal, we augmented the breasts with implants. RESULTS: The cases of severe breast contracture were treated without any complications. The volume and contour of the breasts were satisfactory. CONCLUSIONS: After implant removal in cases of severe capsular contracture, breast augmentation may be needed. Serial fat grafting before augmentation using implants prevents scarring of the breast envelope and provides sufficient volume with a secure breast envelope.

A Case Report of Large Schwannoma Arising in Sciatic Nerve

PURPOSE: Schwannoma is one of common neoplasm in the central and peripheral nervous systems. However, schwannoma of sciatic nerve is rare, especially large schwannoma arising in sciatic nerve is extremely rare. This is a report of our experience with large schwannoma arising in sciatic nerve with minimal neurologic symptoms. METHODS: A 65-year-old man presented with palpable mass in middle portion of posterior thigh. No definitive neurologic deficits were detected on physical examinations. CT and sonography showed well-defined mass with large dimension. The mass was excised and confirmed histologically as a schwannoma. In postoperative period, NCS and EMG were followed. RESULTS: The patient complained of difficulty in dorsiflexion of ipsilateral ankle joint postoperatively. NCS and EMG obtained immediately and showed sciatic neuropathy. After 2 months postoperatively, NCS and EMG were followed and abnormal findings of previous NCS and EMG were not found. Dorsiflexion of ankle joint was improved to normal range of motion. CONCLUSION: We report a rare case of large schwannoma arising in sciatic nerve with no definitive neurologic symptoms.

Effectiveness of Nanocrystalline Silver(Acticoat(R) Dressing at Wound Infected by Multidrug Resistant Bacteria

PURPOSE: The emergency of multi-drug resistant stains of bacteria represents a challenge in the field of plastic surgery. Especially, MRSA(methicillin-resistant Staphylococcus aureus) and Pseudomonas aeruginosa have strong pathogenicity as well as multi-drug resistance so that they have become a lot more problematic strains. This study has been planned to reduce the bacterial burden by applying Acticoat(R)(Smith & Nephew Healthcare, Hull, England)?dressing into the chronic wounds infected by multi-drug resistant strains and to facilitate their healing. METHODS: Nanocrystalline silver dressings(Acticoat(R)) were applied to chronic wound infected by MRSA or Pseudomonas aeruginosa. Multi-drug resistant bacteria were smeared over a slide glass using sterilized cotton swabs and gram stains were performed directly before and after applying Acticoat(R) dressings at 1, 24, 48 and 72 hours. The gram-stained slides were observed using an optical microscope magnified 1000 times(x1000). The bacterial counts of the control group(0 hour) were compared to those of the experimental groups(1, 24, 48, and 72 hour). Paired T-test was used to assess a statistical significance. MRSA was cultured in two BAPs(blood agar plate) and two MacConkey plates with streak plate method. None were interventions on one culture plate, while on the other culture plate, Acticoat(R) was placed in a square shape and cultured for 72 hours at 37 degrees C, then plates were examined. Pseudomonas aeruginosa was cultured in the same manner as MRSA. RESULTS: There are the large amount of declination of bacterial counts with statistical significance after Acticoat(R) dressing. The bacteria grew in culture plate without specific intervention, but no bacteria grew in culture plate with applying of Acticoat(R) dressing. CONCLUSION: We believe that Acticoat(R) dressing could be used as an effective method of treating chronic wounds which are infected by multi-drug resistant organisms.

Case Report of Compound Odontoma Extending Into Maxillary Sinus

PURPOSE: Odontoma is a benign tumor originating from odontogenic tissue without any specific cause. Odontoma is usually found in people in their first and second decades of life. It generally exists along the dental arch of maxilla and mandible in the intraosseous location and rarely extends into maxillary sinus. The purpose of this report is to report a rare case of compound odontoma which extended into maxillary sinus. METHODS: We experienced a compound odontoma extending into maxillary sinus with swelling on upper labium in 21-year-old man. RESULTS: The excised tumor was 2.3x1x1cm sized and was confirmed as compound odontoma by the histological examination. CONCLUSION: We report this rare case of compound odontoma extending into maxillary sinus and having swelling of upper labium.