Extended reduction malarplasty for Asians with flat and wide face: Comparison with L-shaped osteotomy.

Background: Reduction malarplasty is effective in correcting prominent zygomatic body and arch in Asian populations, but periorbital zygomatic bony protrusion may not be sufficiently improved. In this study, we present the extended reduction malarplasty procedures to correct it simultaneously and compare the outcome with that of conventional L-shaped osteotomy.

Methods: A retrospective review of consecutive patients who received reduction malarplasty between August 2021 and September 2023 at our hospital was conducted.

The Surprising Effect of Phenformin on Cutaneous Darkening and Characterization of Its Underlying Mechanism by a Forward Chemical Genetics Approach.

Melanin in the epidermis is known to ultimately regulate human skin pigmentation. Recently, we exploited a phenotypic-based screening system composed of ex vivo human skin cultures to search for effective materials to regulate skin pigmentation. Since a previous study reported the potent inhibitory effect of metformin on melanogenesis, we evaluated several biguanide compounds.

Multidirectional cranial distraction osteogenesis technique for treating bicoronal synostosis.

Fronto-orbital advancement by distraction osteogenesis is a useful means of surgically correcting bicoronal synostosis. However, the scope for morphological revision is limited. To address this issue, we developed a multidirectional cranial distraction osteogenesis (MCDO) technique that we quantitatively assessed in patients with bicoronal synostosis.

Development of Multidirectional Cranial Distraction Osteogenesis for the Treatment of Craniosynostosis.

Background: Previously, the authors developed a new method of distraction osteogenesis for the treatment of craniosynostosis, multidirectional cranial distraction osteogenesis (MCDO). The purpose of this study is to review the authors' experience of MCDO for remodeling of the anterior cranium in the patients of craniosynostosis.

Methods: Forty-five patients with craniosynostosis underwent MCDO for anterior cranial remodeling from 2003 to 2017.

Contact Dermatitis Caused by Dermabond Advanced Use.

Background: Dermabond Advanced (DBA) has been widely used globally; however, severe contact dermatitis (CD) can be a serious adverse effect of DBA use. In this study, we investigated the characterization and incidence rate of CD after using DBA and the safe use of DBA.

Methods: One hundred consecutive patients who underwent skin closure with DBA were investigated.

Tumoral Calcinosis: A Giant Tumoral Mass in the Shoulder Joint of a Dialysis Patient.

Tumoral calcinosis is a rare condition in which a calcified mass grows around a large joint, and can occur in patients undergoing renal dialysis. Here, we report the case of a 64-year-old man with a long history of dialysis who presented with a giant, painless mass in his right shoulder joint. A near-complete surgical resection is performed without muscle function loss and with no sign of recurrence after 1 year.

Use of Multidirectional Cranial Distraction Osteogenesis for Cranial Expansion in Syndromic Craniosynostosis.

Patients with syndromic craniosynostosis often require a large amount of cranial expansion to avoid intracranial hypertension, but the surgical procedure remains controversial. A patient of severe syndromic craniosynostosis with multiple bony defects and anomalous venous drainage at the occipital region was treated by multidirectional cranial distraction osteogenesis (MCDO) at the age of 8 months. Distraction started 5 days after surgery and ceased on postoperative day 16.

Multidirectional Cranial Distraction Osteogenesis with Simplified Modifications for Treating Sagittal Synostosis.

Background: Multidirectional cranial distraction osteogenesis (MCDO) is a procedure of ours developed earlier for treating craniosynostosis. However, the numerous bone flaps led to prolonged operative time and occasional bone detachment from dura. We have since simplified the osteotomy design.

Growth curves for intracranial volume in normal Asian children fortify management of craniosynostosis.

Background: Although the charting of normal intracranial volume (ICV) is fundamental for managing craniosynostosis, Asian norms in this regard are unknown. The purpose of this study was to establish a growth curve for ICVs in a large series of normal Asian children, providing reference values to guide corrective surgery.

Methods: A total of 124 normal children (male, 63; female, 61) and 41 children diagnosed with craniosynostoses were analyzed.

Biological Properties and Therapeutic Value of Cryopreserved Fat Tissue.

Background: Fat grafting frequently requires multiple treatments and thus repeated liposuction to achieve treatment goals. The purpose of this study was to evaluate whether cryopreservation of adipose tissue may facilitate future fat grafting.

Methods: Lipoaspirates were harvested from six women and preserved using two cryopreservation methods: (1) simple cooling to -80°C (cryo-1); or (2) programmed cooling to -196°C (cryo-2).

Clinical and Quantitative Isokinetic Comparison of Abdominal Morbidity and Dynamics following DIEP versus Muscle-Sparing Free TRAM Flap Breast Reconstruction.

Background: The deep inferior epigastric perforator (DIEP) flap, which is a modification of the muscle-sparing free transverse rectus abdominis musculocutaneous (TRAM) flap, is being more frequently used in an effort to reduce postoperative abdominal morbidity. However, there is no consensus as to which of these flaps is superior. The authors aimed to compare quantitative measurements of abdominal function obtained with an isokinetic dynamometer after DIEP and muscle-sparing free TRAM flap elevation.

Free-flap surgical correction of facial deformity after anteromedial maxillectomy.

Anteromedial maxillectomy is typically performed in conjunction with low-dose radiotherapy and intraarterial chemotherapy. In doing so, the extent of surgical defects is reduced. However, nasal deviation and oral incompetence may ensue, due to cicatricial contracture of wounds, and may be distressing to these patients.

Studying the blood pressures of antegrade and retrograde internal mammary vessels: Do they really work as recipient vessels?

Background: The proximal ends of internal mammary (IM) vessels are now the most common recipient vessels for breast reconstruction. On the other hand, bilateral deep inferior epigastric artery perforator (DIEP) flaps are often needed according to the territory and the volume required for reconstruction. The usefulness of retrograde IM vessels as second recipients has recently been reported, but there are very few quantitative studies on the hydrodynamics of the retrograde IM vessels.

Reconstitution of Human Keloids in Mouse Skin.

Background: Keloids are a dermal fibroproliferative scar of unknown etiology. There is no good animal model for the study of keloids, which hinders the development and assessment of treatments for keloids.

Methods: Human keratinocytes and dermal fibroblasts were isolated from 3 human skin tissues: normal skin, white scars, and keloids.

Vertically Set Sombrero-shaped Abdominal Flap for Asian Breast Reconstruction after Skin-sparing Mastectomy.

Background: Immediate autologous breast reconstruction after skin-sparing mastectomy is an esthetically superior method, and a free abdominal flap is often used. However, in Asian patients, little redundant abdominal skin and thin subcutaneous tissue are common, necessitating the development of a more suitable flap design and setting. We devised a narrow flap, the sombrero-shaped flap (S-flap), set vertically, to reduce postoperative abdominal morbidity without sacrificing cosmetic results.

A Novel Technique That Protects the Lips during Orthognathic Surgery.

Serious lip injuries can occur during orthognathic surgery. Although an Angle Wider device, which is commonly used during orthognathic surgery, provides some lip protection, it leaves more than half of the lip exposed to surgical instruments. Here, we describe a novel technique to protect the entire upper and lower lips during orthognathic surgery using a minilaparotomy wound edge protector (Lap-Protector).

Orbitomaxillary Reconstruction Using a Combined Latissimus Dorsi Musculocutaneous and Scapular Angle Osseous Flap.

Immediate reconstruction of orbitomaxillary defects is challenging for head and neck reconstructive surgeons. The primary goals of orbitomaxillary reconstruction are to cover the skin and mucosal defects, fill the defect space, and reconstruct the natural facial contour. This report describes 2 patients who underwent extended orbitomaxillectomy and immediate reconstruction using a combined latissimus dorsi musculocutaneous and scapular angle osseous free flap (LD-SA flap).

Abdominal morbidity after single- versus double-pedicled deep inferior epigastric perforator flap use.

Background And Aim: The reduced incidence of donor site morbidity after deep inferior epigastric perforator (DIEP) flap is because the rectus muscle and its fascia are preserved. However, no study has proved that trunk flexion recovers not by the compensatory effect of the contralateral rectus muscle but by reinnervation of the ipsilateral rectus muscle. We hypothesized that if sufficient reinnervation occurs, patients who undergo single-pedicled DIEP (S-DIEP) flap or double-pedicled DIEP (D-DIEP) flap breast reconstruction would have similar levels of preoperative trunk flexion.

Mandibular Reconstruction Based on the Concept of Double Arc Reconstruction.

The natural mandible has 2 arcs, the marginal arc and the occlusal arc. The marginal arc is situated along the lower margin of the mandible and affects the contour of the lower third of the face. The occlusal arc is situated along the dental arc and affects the stability of prosthodontics.

Comparison of abdominal wall morbidity between medial and lateral row-based deep inferior epigastric perforator flap.

Introduction: Although deep inferior epigastric perforator (DIEP) flap is associated with decreased abdominal morbidity, motor nerve damage during flap elevation cannot be ignored. We compared abdominal morbidity after elevation of DIEP flap with lateral row perforators (L-DIEP) and medial row perforators (M-DIEP) to determine the perforators associated with less abdominal morbidity.

Methods: Women who underwent breast reconstruction with DIEP flaps (n = 49) were included in this study.

Shaping of the Unaffected Breast with Brava-Assisted Autologous Fat Grafting to Obtain Symmetry after Breast Reconstruction.

Background: In breast reconstruction, symmetry is a vital issue. However, when the original breast is unusually shaped or the patient desires augmentation at the time of reconstruction, obtaining symmetrical breasts becomes difficult.

Objectives: The authors performed shaping of unaffected breasts by Brava-assisted autologous fat grafting to enhance breast symmetry, and evaluated the clinical results to validate this new approach.

The oculocardiac reflex in aponeurotic blepharoptosis surgery.

The purpose of this study was to investigate the correlation between the oculocardiac reflex (OCR) and blepharoptosis surgery for safe eyelid surgery. Fifty-four consecutive patients with bilateral aponeurotic blepharoptosis were enrolled in this study. Changes in electrocardiography (ECG) monitoring were recorded during surgery.

The concept and method of closed reduction and internal fixation: a new approach for the treatment of simple zygoma fractures.

Background: The authors have developed a new minimally invasive surgical procedure for simple zygoma fractures, a closed reduction and internal fixation method, that uses a cannulated cortical screw system.

Methods: From 2007 to 2012, 42 selected patients with simple zygoma fractures without ocular problems or shear at the zygomatic frontal portion were treated with this method. The mean age of the patients was 33 years (range, 13 to 77 years).

Brava and autologous fat grafting for breast reconstruction after cancer surgery.

Background: Although autologous fat grafting is widely accepted for breast reconstruction, its indications remain limited to minor contour deformities after reconstruction and small deformities after breast-conserving surgery. The authors describe a case series of total or nearly total breast reconstructions treated with the perioperative use of a vacuum-based external tissue expander (i.e.