• Archives of Plastic Surgery
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• v.37 no.2
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• pp.143-147
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• 2010

Purpose: Nostril stenosis is an uncommon deformity that develops as a consequence of smallpox, chickenpox, tuberculosis, syphilis, congenital malformations etc. There have been several studies on the surgical techniques to treat it. However, it is difficult to maintain the result for a long time. The goal of this study is to evaluate the use of Wplasty, perialar flap as an operative techniques and expansion exercise using Foley catheter as a method to keep the patency of nostril. Methods: This is a retrospective review of the senior surgeon's (Y.L.) patients who underwent W-plasty and a perialar flap. Patients treated from 2005 to 2009 were reviewed and the postoperative results were evaluated. Average patient age was 24 years, ranged from 1 to 61 years, average follow-up period was 27.5 months, ranged from 3 to 77 months. The mild deformity was released with an incision and expansion by the ballooning of a Foley catheter and corrected by W-plasty only. However, a severe deformity required an additional procedure including perialar flap transposition. During the postoperative period, the patients maintained a nasal stent and exercise using a Foley catheter to prevent recurrence. Results: Five cases of nostril stenosis in four patients were treated using this technique. One case was corrected with W-plasty only, but four cases were more severe and were corrected with W-plasty and a perialar flap. There were no perioperative complications. The patients were satisfied with the results and retained a good shape during the follow-up periods. Conclusion: Nostril stenosis can be corrected with W-plasty and a perialar flap. A perialar flap is added if W-plasty is unable to correct the deformity. A postoperative nasal stent and expansion with a Foley catheter can help in preventing recurrences.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.2
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• pp.137-144
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• 1994

Inselecting scars for treatment, attention be paid not only to the features of the defect as seen objectively but also to the element of the defect most disturbing to the patient. We revised the scar tissues with simple elliptical excision, Z-plasty, modified Z-plasty, W-plasty and hand dermabrasion in varialbe pattern of scars and got the favorable results. The success rate of scar revision usually depends on the patient's subjective judgement. We must inform our patient the limitation of scar revision and importance of postoperative care. The oral and maxillofacial surgeons must resolve the variable scars which re involved in variable operations and traumas.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.465-471
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• 2011

Purpose: Blepharoptosis is often associated with telecanthus and the presence of epicanthal fold in telecanthus is one of unique features in Asian eyelids. The purpose of this article is to define telecanthus and pseudotelecanthus, and to determine optimal surgical procedure depending on classification of telecanthus. Methods: Among 187 patients with blepharoptosis who had the advancement procedure of the Muller's musclelevator aponeurosis composite flap for ptosis, 55 patients underwent Flowers' split V-W plasty concomitantly with shortening the medial canthal tendon for correction of telecanthus from September 2003 to January 2011. Among them, 52 patients were followed up for 16 months. We newly defined telecanthus because Mustarde ratio is inaccurate to measure in certain cases and then made a definition of pseudotelecanthus. Besides, we also classified telecanthus into mild, moderate and severe types based on its severity. Results: Telecanthus is defined when the ICD (inner canthal distance) is greater than 110% of normal ICD. Pseudotelecanthus is a telecanthus like a wide skin bridge formed between the eyes because of the epicanthal fold in the normal ICD. Flowers' split V-W plasty combined with shortening medial canthal tendon was very effective in mild and moderate telecanthus with almost invisible scar and no recurrence occurring. In severe types, however, it showed high incidence (28%) of incomplete correction of telecanthus. Conclusion: New definition of telecanthus can be easily applied to any case and we think the classification of telecanthus is useful to select an appropriate operative procedure. Split V-W plasty with shortening of medial canthal tendon is a very effective procedure in mild and moderate telecanthus. Besides, it is also effective in improving the treatment outcomes of ptosis in cases of blepharoptosis associated with telecanthus.

• Archives of Craniofacial Surgery
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• v.21 no.6
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• pp.372-375
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• 2020

Congenital midline cervical cleft is a rare congenital disease. The disease is often misdiagnosed as a branchial cleft deformity, thyroglossal duct cyst, or other skin diseases. It has the following characteristics: skin defect at the midline of the anterior neck, a skin tag at the upper end of the lesion, and a blind sinus tract at the caudal aspect with or without mucoid discharge. Treatment is usually for aesthetic purposes; therefore, early surgical en bloc resection with Z-plasty or W-plasty is recommended to reduce recurrence and scar formation.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.807-812
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• 2007

Purpose: The presence of epicanthal fold and the absence of supratarsal fold are characteristics of Korean eyelids. There has been many surgical procedures to eliminate medial epicanthal fold but those procedures focus on the lengthening of horizontal palpebral fissure and the shortening of intercanthal distance so that the shape of eye had tendency to be sharp. The authors suggest that the supermedial shifting of epicanthal fold enhance the aesthetic result. Methods: From Sep 2006 to May 2007, total 17 women(mean age 22) with Type III epicanthal fold underwent epicanthoplasty using author's modified Uchida method. The design for epicanthoplasty was drawn superolaterally along epicanthal fold and split V-W plasty was done to shift the epicanthal fold superomedially. Also non-incisional double-eyelid operation was underwent. Results: The epicanthal fold was shifted in superomedially, intercanthal distance was shortened and double-eyelid was achieved. The patients were satisfied with the result and no major complication was noted. Conclusion: This method can be effective in correcting the epicanthal fold of Korean eyelid by shifting the epicanthal fold superomedially to make the shape of eye aesthetically without noticeable scar.

• Archives of Craniofacial Surgery
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• v.11 no.1
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• pp.41-44
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• 2010

Purpose: The epicanthus is a specific feature in Asian. Many techniques have been described to eliminate the epicanthal fold: resection of glabellar skin, resection of medial canthal skin, V-Y advancement, V-W technique, modified Z-plasty, multiple Z-plasties, and others. The authors observed postoperative epiphora after correction of epicanthal fold by periciliary skin flap without damaging lacrimal duct. Methods: A 19-year-old woman underwent non-incisional blepharoplasty, septorhinoplasty, and periciliary epicanthoplasty. On her history, she didn't have any symptom of epiphora preoperatively. And there was no specific complaint of epiphora during the postoperative two weeks. However epiphora got worse from one month after the surgery. She was out of this country, so the patient re-visited the clinic on the postoperative six months for this on-going symptom. On an ophthalmologic examination, patient's lacrimal duct and sac was intact but both lacrimal puncta of the patient were covered with a thin membrane. This membrane was punctuated by a 25 gauge needle and dilated with a standard dilator. Results: After ophthalmologic treatment, no recurrence was observed during five weeks of follow-up periods. Conclusion: Both lacrimal puncta of the patient were only covered with membranes. And we could not confirm the direct relationship between periciliary epicanthoplasty and postoperative epiphora. The probable factors will be a predisposing narrowed punctum, post operative peri-punctal edema and decrease in muscular function of orbicularis oculi.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.508-511
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• 2007

Purpose: Dermoid cysts are almost always caused by congenital events. The most widely accepted pathogenesis is that the cysts are dysembryogenetic lesions that arise from ectodermic elements entrapped during the midline fusion. We report a rare case of dermoid cyst, which occurred not congenitally but newly in the subcutaneous scar tissue secondary to trauma. Methods: A 26-year-old man had a deep submental laceration caused by a car accident and got a primary wound closure 16 months ago. There were 18 cm-long submental hypertrophic scar and newly developed palpable masses inside the subcutaneous layer at the center of the scar. Initial impression was an epidermal cyst or a thyroglossal duct cyst. Ultrasonographic finding showed two cystic masses inside the scars at the submental area, but impressed dermoid cysts. The cystic masses were completely removed with W-plasty and histological examination were followed. Results: The histological diagnosis was dermoid cysts which were mainly composed of keratotic squamous epithelium in their inner surface linings and numerous skin appendages such as sebaceous glands, sweat glands, and hair follicles in their cystic lumens histopathologically. During the follow-up period of 25 months, there was no recurrence of any subcutaneous mass in the site of scar. Conclusion: We report a very unusual case of dermoid cysts developed by an acquired cause, considering that the accidental inclusion of deep skin elements caused by a trauma can be a critical origin of dermoid cysts.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.1
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• pp.25-34
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• 2004

The present study was carried out to investigate the change of the palatal length after palatoplasty in congenital cleft palate. With the data from one hundred and twelve patients with cleft palate who had been treated at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital over a period of 10 years(April 1995 to April 2004). The epidemiological characteristics, the method of palate repair, the postoperative complications and the extent of palatal lengthening were investigated and analyzed statistically. Incomplete cleft palate occurs more frequently than complete cleft palate. Male were affected 2.1 times more than female in complete cleft palate, and female were affected 1.2 times more than male in incomplete cleft palate. Dorrance method and Wardill V-Y method were frequently used in repair of incomplete cleft palate. Wardill V-Y method, Furlow double opposing Z-plasty, two flap method, and Perko method were widely used in repair of complete cleft palate. The extent of palatal lengthening was greater in the incomplete cleft palate group(5.84 mm) than in the complete cleft palate group(4.71 mm), and in the Furlow double opposing Z-plasty group(5.70 mm) than in the push back palatoplasty group(5.33 mm). But no significant difference was noted. Palatal fistula and wound dehiscence were popular postoperative complications in cleft palate. These results indicate that the extent of palatal lengthening, which contributing to speech function, is a range of 3.5% to 24.0%(average 10.8%) after palatoplasty in cleft palate patients.