Double-Fold Operation with a Partial Incision and Continuous Buried Suture

BACKGROUND: The double fold operation is one of the most common aesthetic surgeries in Korea. There are many methods to make double fold using non-incision, incision and partial incision. Patients seeking double folds prefer natural appearance, less downtime, minimal scarring technique. The most favorable method is the minimal invasive but long-lasting fold formation technique. METHODS: From October 2003 to September 2016, this procedure was applied in 7,963 patients who worried about surgical scar or preferred non-incision method with puffy eyelids. Five stab incisions including two small incisions were taken in the upper eyelid. Through the small incision lines, the pretarsal muscle and the orbital fat were removed to facilitate tissue adhesion. The double fold line was made with the continuous buried suture. The suture was tied in the fifth stab incision site and the knot was placed deeply to prevent granuloma formation. RESULTS: This method was performed in all patients. The complications were asymmetry (52 cases), fold loosening (43 cases), granuloma (12 cases), conjunctival hemorrhage (5 cases), and scar (4 cases). Especially 74% of fold loosening cases were developed in mild ptotic patients. CONCLUSIONS: This method achieves good cosmetic result, shorter operation time, less morbidity, faster recovery in puffy eyelids than the other method.

Endoscope-Assisted Trichophytic Anterior Hairline Brow Lift

BACKGROUND: The brow lift plays an essential role in upper face rejuvenation. The authors designed a new brow lift technique, the endoscope-assisted trichophytic anterior hairline brow lift. It combines the advantages of an endoscopic approach and an anterior hairline approach. This technique was applied to 13 patients with aesthetically excellent results. METHODS: A trichophytic incision line was designed within the fine hairs of the entire anterior hairline and the incision was extended to the temporal hair-bearing scalp. After the incision, most of the procedures were conducted in a similar way to the conventional endoscopic brow lift. Without direct visualization, the dissection was extended down onto the root of the nose and the forehead. An endoscope was used from 2 cm above the supraorbital notch to avoid supraorbital nerve injury. Scars were assessed with the Stony Brook Scar Evaluation Scale (SBSES) at the time the sutures were removed. The visual analogue scale (VAS) score was checked at postoperative 1-year follow-up. The surgical outcomes for brow position and subjective satisfaction were rated with the Global Aesthetic Improvement Scale (GAIS) at postoperative 1-month follow-up. The dermatome of the deep branch of the supraorbital nerve, especially around the hairline, was checked with a two-point discrimination test. RESULTS: From October 2012 through August 2015, 13 endoscope-assisted trichophytic anterior hairline brow lifts were performed. The GAIS score was 1.62 on average. The VAS score was 2.09 on average. No permanent nerve damage has been reported except for 2 cases of temporary paresthesia. These fully recovered at 1-month follow-up. CONCLUSIONS: Based on our results, we think our technique could be a safe and effective treatment option for brow ptosis patients with a high hairline.

Permanent Makeup with Micropigmentation

Beauty make up in order to stimulate the appearance and express the identity has become a commonly performed cosmetic procedure. Recently developed permanent make up is the introduction of micropigment into the dermis. The pigmenting procedure is achieved by a single or triple needle coated with pigment, moving rapidly in a reciprocating fashion. It maintains cosmetic effect about 5 years. Contrary to old fashioned tattooing, micropigmentation produces various color and gradually the color is faded. So, after several years when the pigmentation color is faded, a patient can cope with new fashion. We introduce micropigmentation method in eyebrow and eyelashes. From september 2002 to 2005, a total 132 patients(4 men and 128 women) had been treated with micropigmentation. We have had 132 cases of scanty eyebrows, 68 cases of thin eyelashes. After 24 months follow-up period, we achieved satisfactory results.

New Treatment for Osmidrosis Axillae by High Frequency Electrocoagulator and Insulated Needle

Osmidrosis axillae is a distressing problem characterized by foul odor at the axillae due to excessive apocrine sweat gland secretion. We introduce a new non-surgical method using a specially insulated needle and high frequency electrocoagulator. From September 2001 to January 2005, 52 patients were treated with this procedure for osmidrosis axillae. In authors' procedure, insulated needle which was designed to protect skin and dermal layer was inserted into the deep dermis of axilla area and apocrine sweat glands were removed by electrocoagulation. Fifty two patients were evaluated more than 6 months after surgery. Among these patients, 48 patients received secondary coagulation procedure. After second operation, all patients were satisfied with postoperation results. We conclude that our method has several advantages such as 1) short operation time, 2) no necessity of postoperative immobilization of shoulder joints, 3) no need of hospitalization, 4) minimal scarring and no bleeding, 5) prevention of skin necrosis, 6) a safer operative method for recurred cases as a secondary method.

Mazabraud's Syndrome: A case report

Mazabraud's syndrome is rare benign disease characterized by the association of intramuscular myxoma and fibrous dysplasia of bone. We present a case of multiple intramuscular myxomas of the right forearm with polyostotic fibrous dysplasia. X-rays suggested fibrous dysplasia of adjacent bones and CT scans showed two intramuscular cystic masses on the right forearm. 99mTc bone scintigraphy also showed a markedly increased uptake in the skull, both scapulas, both clavicles and both humeri. The masses were successfully removed. Fibrous dysplasia of the radius and myxoma were confirmed by pathologic study.