{"title":"Delivery technique for the pedicled transverse rectus abdominis myocutaneous flap","authors":"J. Lee, H. Kwon, Won Suk Lee, Sang-Ha Oh","doi":"10.14730/aaps.2021.00367","DOIUrl":"https://doi.org/10.14730/aaps.2021.00367","url":null,"abstract":"The pedicled transverse rectus abdominis myocutaneous (TRAM) flap is often used during breast reconstruction. After completely elevating the flap, a medial tunnel is created to connect the dissection area to the mastectomy defect. This tunnel should typically accommodate four of the surgeon’s fingers, although this may vary depending on flap volume. Wider tunneling facilitates flap delivery, but can damage the breast and inframammary fold. Therefore, we introduce a technique to move the flap easily and safely through a small tunnel. During breast reconstruction using a pedicled TRAM flap, a tunnel was made in the mastectomy defect along the meridian of the breast. This tunnel accommodated a width of three of the surgeon’s fingers (6 cm). After completely elevating the flap, it was inserted into a funnel with an inner surface made of polymeric vinyl and a hydrophilic coating. The flap was propelled into the mastectomy defect via the funnel. Our novel technique for pedicled TRAM flap delivery using a funnel was easy and safe, and it is deemed to be suitable for delivering a pedicled TRAM flap.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45628938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daiwon Jun, Da-Hoon Kim, M. S. Park, Y. J. Kim, J. H. Lee
{"title":"An outbreak of devastating facial stigmata caused by a single unlicensed aesthetic practitioner","authors":"Daiwon Jun, Da-Hoon Kim, M. S. Park, Y. J. Kim, J. H. Lee","doi":"10.14730/aaps.2022.00563","DOIUrl":"https://doi.org/10.14730/aaps.2022.00563","url":null,"abstract":"Background The practice of medicine by uncertified personnel is a common concern in public healthcare. Although the introduction of the Korean National Health Insurance Service has significantly reduced the number of these cases, the problem persists in the field of aesthetics. Herein, we report an outbreak of devastating facial stigmata in patients treated with illegal cosmetic procedures.Methods During 1 week in November 2021, five patients presented to Bucheon St. Mary’s Hospital for the management of identical patterns of severe facial scarring. Each patient had been treated for “skin rejuvenation” by a single unlicensed practitioner. Months of needling therapy by the practitioner, aimed at resolving the problem, only aggravated the scarring. The victims visited our hospital after the practitioner ceased to answer their calls. The patients had similar presentations with multiple prominent scars on both cheeks. Ectropion of the right lower eyelid due to scar contracture was observed in one patient.Results Five monthly treatments with intralesional triamcinolone injection and laser therapy were performed. Despite thorough management, the patients were left with improved but distinctive stigmata on their faces.Conclusions Cases of illegal aesthetic procedures are difficult to prosecute because the patients have implicitly agreed to the procedure. Therefore, active legislative measures should be adopted to prevent further victimization. Public education on the dangers of illegal aesthetic practices is also necessary.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47341422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sun Eung Kim, Y. Chun, H. Park, Y. J. Kim, Y. Cheon
{"title":"A prospective comparison of prepectoral and subpectoral methods for immediate breast reconstruction with acellular dermal matrix: the cogwheel-shaped anterior wrapping method","authors":"Sun Eung Kim, Y. Chun, H. Park, Y. J. Kim, Y. Cheon","doi":"10.14730/aaps.2022.00570","DOIUrl":"https://doi.org/10.14730/aaps.2022.00570","url":null,"abstract":"Background Prepectoral breast reconstruction has recently gained wide recognition for its advantages, such as rapid recovery and less pain. This study compared the effectiveness of and differences between the prepectoral and subpectoral breast reconstruction techniques.Methods Eighty-three patients (90 breasts) who underwent prepectoral or subpectoral breast reconstruction surgery between January 2019 and December 2020 were prospectively recruited. Patient demographics, comorbidities, oncological treatment, and intraoperative and postoperative data were evaluated to investigate the validity and stability of each surgical technique. The follow-up period was a minimum of 18 months.Results The surgical cohorts (22 prepectoral and 68 subpectoral) had comparable demographics. No significant differences in postoperative complications were observed between the two groups. The prepectoral group showed shorter operation times than the subpectoral group (mean: 97.27 and 127.63 minutes, respectively; P<0.001). Fewer days elapsed until drain removal and the total amount of drainage was less in the prepectoral group than in the subpectoral group (mean: postoperative day [POD] 8.95 and 10.06, respectively; P=0.048) and (501.72 mL and 671.19 mL, respectively; P=0.009). The numeric pain rating scale (NPRS) scores at POD 7 were significantly lower in the prepectoral group than in the subpectoral group (mean: 0.41 and 1.82, respectively; P=0.029). There were no statistically significant differences in the NPRS scores at POD 1 or the BREAST-Q questionnaire scores at 3 months.Conclusions Prepectoral breast reconstruction using acellular dermal matrix can feasibly replace the conventional subpectoral breast reconstruction technique and has the advantages of reducing operation time, length of hospitalization, and long-term postoperative pain.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41447205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comments on “Usefulness of the eyeball exposure area as an eye measurement modality through a comparison between eyes with inborn double eyelids and operated double eyelids”","authors":"K. Hwang","doi":"10.14730/aaps.2022.00507","DOIUrl":"https://doi.org/10.14730/aaps.2022.00507","url":null,"abstract":"We would like to express our appreciation of Dr. Kun Hwang for his thoughtful comments and kind discussion about the different vertical and horizontal ratios of the human cornea [1]. From the frontal view of the eye, it is known that the horizontal distance of the cornea appears slightly wider than the vertical distance. This is because the top and bottom of the anterior cornea are slightly overlapped by the sclera. The resulting difference between the horizontal and vertical diameters of the cornea is about 10%, according to relevant references. Thus, if the measurement was based on a vertical standard, as the commenter pointed out, it would be necessary to adjust the values accordingly; however, in this study, the values were measured based on the horizontal diameter. Nonetheless, in Figure 1, the drawings of the corneal diameter as the reference point were incorrectly marked with vertical distances.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48315762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Atypical rupture of a Poly Implant Prothése implant and fluid shifting: a case report","authors":"Jae Chung Min, E. Kim","doi":"10.14730/aaps.2022.00458","DOIUrl":"https://doi.org/10.14730/aaps.2022.00458","url":null,"abstract":"Women have undergone augmentation mammoplasty for decades, and if implant rupture is suspected, imaging modalities such as magnetic resonance imaging (MRI) and ultrasonography are available. The linguine sign, keyhole sign, and noose sign are all suggestive of rupture. However, earlier-generation implants with alternative filler materials demonstrate rupture signs that differ from those of today’s better-known implant materials. A 60-year-old female patient who had undergone augmentation mammoplasty 20 years ago presented with left breast swelling and pain in the lower-outer quadrant. Ultrasonography and MRI confirmed extracapsular diffuse wall enhancement with suspected, but not apparent, discontinuity in the patient’s left breast implant. Therefore, both implants were removed. It was determined that these were Poly Implant Prothése implants. The left breast implant differed from the contralateral implant in that it contained fluctuating fluid. This could be attributed to an osmotic gradient that caused the implant to swell and weakened the elastomer shell, resulting in micro rupture without a gross tear. Patients who undergo augmentation mammoplasty should have regular follow-up examinations, even if there are no symptoms. Furthermore, clinicians should be aware that some patients who have had breast augmentation mammoplasty may experience atypical symptoms and signs if the implant ruptures.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47191491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unilateral autoinflation of a saline-filled breast implant initially diagnosed as capsular contracture: a case report and review of the literature","authors":"Jangyoun Choi, Young Bin Yang, D. Oh","doi":"10.14730/aaps.2022.00437","DOIUrl":"https://doi.org/10.14730/aaps.2022.00437","url":null,"abstract":"Spontaneous inflation of saline breast implants is a rare phenomenon. In this case report, we share our experience treating a patient who complained of asymmetric breasts from what appeared to be a straightforward case of capsular contracture. Spontaneous autoinflation of the right breast implant was subsequently found to be the cause of breast asymmetry and hardness. The presentation, diagnostic challenge, management, and mechanism of this rare phenomenon are presented here.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41836880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preliminary results of alternative treatment for postmastectomy pain syndrome: stromal vascular fraction-enriched fat grafting","authors":"Kyunghyun Min, I. Yoon, E. Kim","doi":"10.14730/aaps.2022.00451","DOIUrl":"https://doi.org/10.14730/aaps.2022.00451","url":null,"abstract":"Postmastectomy pain syndrome (PMPS) is defined as chronic pain lasting more than 3 months after surgery. PMPS reduces the quality of life for patients and affects their daily life. Although the pathogenesis of PMPS has not been clearly elucidated, it is strongly suggestive of neuropathic pain caused by damage to the intercostobrachial nerve. While previous studies have used stromal vascular fraction (SVF)-enriched fat grafts in patients with neuralgia, few studies have used it for PMPS. Therefore, the present study evaluated the use of SVF-enriched fat, which includes adipose-derived stem cells with good differentiation capacity, in patients with PMPS to improve quality of life and reduce neuropathic pain. In three patients, the fat was mixed with concentrated SVF using a centrifuge and injected into the primary pain sites. After surgery, in all three cases, the subjective pain scale score decreased significantly over time.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48466830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mijung Kim, N. Lee, W. Tark, W. Lee, T. Roh, Wooyeol Baek
{"title":"Dual cortical tunneling method for endoscopic forehead lift","authors":"Mijung Kim, N. Lee, W. Tark, W. Lee, T. Roh, Wooyeol Baek","doi":"10.14730/aaps.2022.00444","DOIUrl":"https://doi.org/10.14730/aaps.2022.00444","url":null,"abstract":"Background Endoscopic forehead lift with cortical tunneling is an effective option for rejuvenation of the upper third of the face. Although it has been considered safe and reliable, with relatively consistent long-term results, relapse and weakening of adhesion have been common problems.Methods We suggest the dual-tunneling method for overcoming these limitations. A total of 100 patients aged 17 to 65 years underwent forehead lifting with cortical tunneling by the senior author from August 2016 to December 2017. The single-tunnel method was applied in one half of the patients and the dual-tunnel method in the other half. Bilateral brow positions were measured immediately following surgery and 6 months later.Results For all cases, cortical tunneling was done at the central incision and both paramedian incisions; therefore, three tunnels were used in the control group and six tunnels in the experimental group. In the single-tunnel group, relapse distances were 2.39±0.83 mm for the medial brow and 3.26±0.91 mm for the lateral brow (6 months postoperatively; n=100). The dual-tunnel group showed significantly smaller (P<0.001) relapse distances, with values of 1.69±0.46 mm and 2.17±0.59 mm for the medial and lateral brow, respectively (6 months postoperatively; n=100). The experimental group did not show an increase in complications.Conclusions The dual-tunneling method, designed to minimize the cheese-wiring effect, uses a triangular plane to avoid a focal fixation. The fixation also includes the periosteum to hold the forehead tissue in place, inducing stronger adhesion.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47589783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sunje Kim, H. Kwon, C. Ahn, Yooseok Ha, Joo-Hak Kim, H. Kyung, Sang-Ha Oh, Hojun Yang, S. Song
{"title":"Serratia marcescens infection in a patient after a fat graft: a case report","authors":"Sunje Kim, H. Kwon, C. Ahn, Yooseok Ha, Joo-Hak Kim, H. Kyung, Sang-Ha Oh, Hojun Yang, S. Song","doi":"10.14730/aaps.2021.00325","DOIUrl":"https://doi.org/10.14730/aaps.2021.00325","url":null,"abstract":"Serratia marcescens is a Gram-negative, facultatively anaerobic bacillus that has been implicated in hospital-acquired infections. Because no previous cases of delayed infections caused by S. marcescens after autologous fat injection have been reported, we introduce a case report. A 74-year-old woman underwent fat injection for aesthetic purposes and visited our hospital for left cheek swelling after this procedure. Blood tests showed a slightly elevated white blood cell count. Facial computed tomography demonstrated an abscess and emergency surgery was performed. A work-up of the necrotic tissue and drained abscess contents was conducted. Cultures showed growth of S. marcescens. Based on the culture results , a proper antibiotic was prescribed. Follow-up blood tests showed normal findings, and there was no recurrent infection or inflammation. In most acute infections after a fat graft, Staphylococcus aureus or Staphylococcus epidermidis can be suspected, while mycobacterial infections are often suspected in cases of delayed infection and chronic inflammation. However, clinicians should keep in mind that there may be infections of uncommon bacteria. When an atypical delayed infection is suspected after an autologous fat graft, it is important to perform aseptic wound culture and biopsy as soon as possible, use appropriate antibiotics, and conduct proper surgical treatment.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46359209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A rare case of a folded nasolabial flap for a full-thickness alar defect due to trigeminal trophic syndrome after herpes zoster infection","authors":"H. Ryu, D. Lee, Jun Hyuk Kim, Hwanjun Choi","doi":"10.14730/aaps.2021.00185","DOIUrl":"https://doi.org/10.14730/aaps.2021.00185","url":null,"abstract":"A 51-year-old man was referred for a skin defect with paresthesia and decreased pain in his right ala. He had a history of herpes zoster infection 3 weeks previously. Excisional biopsy and culture showed no evidence of skin malignancy or infection. He was diagnosed with trigeminal trophic syndrome (TTS) after herpes zoster infection. A two-stage folded nasolabial flap was used to reconstruct the defect. The patient was satisfied with the cosmetic outcomes of surgery, and there was no evidence of recurrence during the follow-up. TTS, a rare skin condition that presents with paresthesia, anesthesia, and facial ulceration, occurs after trigeminal nerve injury, which can be caused by herpes zoster infection in rare cases. TTS is an often-persistent condition with a high recurrence rate, causing cosmetic problems. Some surgical methods have been attempted, but our case presents the first use of a folded nasolabial flap to treat TTS. The flap was symmetric, without any nostril collapse. It is also noteworthy that the outcome was excellent with only a skin flap that did not use a bony framework. Herein, we report a rare case of TTS that occurred after herpes zoster infection and was successfully treated with a folded nasolabial flap.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45320047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}