Cleft lip nose correction with onlay calvarial bone graft and suture suspension in Oriental patients.

To correct the secondary cleft lip nose deformity in Oriental patients, many alar cartilage mobilization and suspension techniques have been developed. However, these techniques have critical limitations. One of the limitations is the suspension vector, and another is suspension power. The suspension vector is from inferior to superior and from the deformed alar cartilage to the normal alar cartilage. Thus, the vector is not suitable for normal nasal tip projection. The suspension power is not satisfactory because Oriental people have underdeveloped, thin alar cartilages and thick skin. So, the suspended, deformed alar cartilage may relapse and pull the normal alar cartilage to the deformed side. To overcome these limitations, the authors use the cantilever calvarial bone graft for tip projection; it also serves as a strong, rigid framework for cartilage and soft-tissue suspension. Using these techniques, the authors can create normal nasal tip projection and a normal looking nasal aperture.

Prominent zygoma in Orientals: classification and treatment.

The aesthetic face for Orientals is different than for white persons. Orientals are usually mesiocephalic compared with dolichocephalic whites, and thus, reduction malarplasty of the prominent malar eminence is often sought by Orientals. A classification for each type of prominent zygoma and a method of treatment for each type are presented.

Restoration of finger extension and forearm contour utilizing a neurovascular latissimus dorsi free flap.

The use of a free neurovascular latissimus dorsi flap for restoration of wrist and finger extension and forearm contour is described in a burn patient. Wound coverage is the prime need of the extensive tissue loss in the upper limb, and a muscle or musculocutaneous flap is necessary to cover the exposed bone and muscles for infection control. Furthermore, restoration of the limb function as well as aesthetic flap donor and recipient site contour are needed. The case presented is the extremely rare patient in whom restoration of finger extension was achieved after the nearly total loss of the extensor forearm muscles.

Nostril sill augmentation in secondary cleft lip.

In most cases, after successful correction of primary cleft lip deformity, some problems remain to be solved. One of them is nostril sill depression, which should not be overlooked in cleft lip repair. However, there have been few reports on the anatomy of the depressed nostril sill and methods for augmenting the sill depression. The anatomy of the depressed nostril sill, its relationship to surrounding tissue, and the gross features of nostril sill depression in cleft lip deformity were reviewed, and a method in which a scar flap and a suture-fixation technique are used was developed for augmenting the depression. The clinical results of this method in 16 patients are presented.

Crane principle of the cross-leg fasciocutaneous flap: aesthetically pleasing technique for damaged dorsum of foot.

Crushing injuries, including electrical burns on the dorsum of the foot, result in extensive tissue loss and exposure of bone and tendon. Debridement and covering of the wound with richly vascularized tissue are necessary at an early date. Flaps for the dorsum of the foot should be thin and the donor tissue to be sacrificed should be minimal, with good aesthetic appearance of both donor and recipient sites. The "Crane principle" described by Millard [9] fulfills these criteria. Using a fasciocutaneous flap rather than a random pattern cutaneous flap may, however, increase flap survival rate without a delay procedure. It minimizes the inconvenience of strict immobilization, is resistant to infection and trauma, and reduces hospitalization. This article describes the use of the Crane principle in a cross-leg fasciocutaneous flap in 2 representative patients.