Masseter Muscle Reduction Using Radiofrequency Rhizotomy

Most Korean women prefer ovoid face to squared one and many female patients with squared face want to reduce their lower facial width. Mandibular angle ostectomy and botulinum toxin injection used to be the most common procedures performed to produce this purpose. After botulinum toxin, a series of non-invasive methods to reduce masseter muscle hypertrophy have been introduced. Radiofrequency rhizotomy was first used to treat chronic pain, such as, trigeminal neuralgia and showed good and long-lasting results. This concept of rhizotomy technique was then modified to block motor nerve conduction and used to treat motor dysfunction including painful spasticity. We tried this technique to reduce masseter hypertrophy by blocking the masseteric nerve using radiofrequency. From March 2007 to October 2007, 19 female patients underwent this masseter reduction using radiofrequency rhizotomy and follow-up period was 2 to 6 months. Most results showed reduction of masseter volume with improvement of lower facial contour and no significant complication occurred. The advantages of this method are safety, durability and cost-effectiveness and we think that this technique can be a good alternative method for treating masseter hypertrophy. But, longer follow-up periods and further studies are required to consolidate long-term results.

A New Technique for Surgical Correction of Nipple Hypertrophy in Male Patients

Nipple hypertrophy in male patients is a very rare condition but still requires surgical correction regardless of its rarity. It is important to consider two factors during surgical correction of nipple hypertrophy in male patient. First, the size of men's nipple is quite smaller than that of female's. Therefore, diameter as well as vertical height should be reduced simultaneously to achieve more satisfactory aesthetic result. Second, it is not required to preserve ductal function as long as nipple sensory is kept intact. Our new technique can reduce the diameter of the hypertrophic nipple as well as the vertical height efficiently and safely. No complication including nipple necrosis or sensory loss were found after 2 months of folllow-up.

Immediate One-Stage Breast Reconstruction Including Nipple-Areolar Complex

As surgical trend for breast cancer changes, the method for breast reconstruction is also changing. Due to improved diagnostic techniques and public awareness, more and more patients with breast cancer are diagnosed at earlier stage and the number of patients who undergo skin sparing mastectomy is also increasing. Skin sparing mastectomy has several advantages for immediate breast reconstruction over modified radical mastectomy. Its preservation of breast skin envelope and inframammary fold made it possible to provide more natural breast mound shape without any evidence of increased local recurrence of malignancy. Furthermore, in case of immediate breast reconstruction after modified radical mastectomy, procedures for nipple-areolar reconstruction was deferred for fear of postoperative deformation and vascular problem of the flap. This interval made patients less satisfied with the result and postoperative adjuvant treatment had to be sometimes postponed. To avoid these limitations, "one-stage" breast reconstruction including nipple-areolar complex was performed after skin sparing mastectomy. From December 1998 to March 2000, a total of 12 patients with breast cancer underwent skin-sparing mastectomies, which were followed by immediate reconstruction using our new technique. After long-term follow-up, no major complication including flap necrosis or asymmetry was found and all patients were satisfied with the results. With careful patient selection and adequate intra-operative flap tailoring, this new technique could offer lots of advantages to both surgeons and patients.

Immediate One-Stage Breast Reconstruction Including Nipple-Areolar Complex

As surgical trend for breast cancer changes, the method for breast reconstruction is also changing. Due to improved diagnostic techniques and public awareness, more and more patients with breast cancer are diagnosed at earlier stage and the number of patients who undergo skin sparing mastectomy is also increasing. Skin sparing mastectomy has several advantages for immediate breast reconstruction over modified radical mastectomy. Its preservation of breast skin envelope and inframammary fold made it possible to provide more natural breast mound shape without any evidence of increased local recurrence of malignancy. Furthermore, in case of immediate breast reconstruction after modified radical mastectomy, procedures for nipple-areolar reconstruction was deferred for fear of postoperative deformation and vascular problem of the flap. This interval made patients less satisfied with the result and postoperative adjuvant treatment had to be sometimes postponed. To avoid these limitations, "one-stage" breast reconstruction including nipple-areolar complex was performed after skin sparing mastectomy. From December 1998 to March 2000, a total of 12 patients with breast cancer underwent skin-sparing mastectomies, which were followed by immediate reconstruction using our new technique. After long-term follow-up, no major complication including flap necrosis or asymmetry was found and all patients were satisfied with the results. With careful patient selection and adequate intra-operative flap tailoring, this new technique could offer lots of advantages to both surgeons and patients.