흉배혈관천공분지피판을 얇게 한 유리피판

노복균,김광석,김대영,이삼용,조백현 大韓成形外科學會 2001 Archives of Plastic Surgery Vol.28 No.4

자가지방이식을 이용한 턱끝성형술

노복균,황재하 대한미용성형외과학회 2011 Archives of Aesthetic Plastic Surgery Vol.17 No.2

Facial beauty depends on the form, proportion and position of its various units. The chin is the most prominent element of the lower third of the face, both in the frontal view and in profile. Whether it is advisable to perform rhinoplasty first, followed by genioplasty, or the reverse depends on the type and severity of the deformities of the nose and chin. The selection of material is a matter of the plastic surgeon's preference. Fat is an ideal tissue filler substance because it is living tissue and from the patient’'s own body. So it is nonallergenic. The procedure can be performed alone as a chin augmentation with fat grafting or in combination with rhinoplasty or other facial surgery. The technique requires minimally traumatic fat harvesting, fat preparation, and multi-level facial infiltration. Remnant fat in the initial procedure is frozen and stored at -18C and can be used successfully for minor touch-up procedures. We have performed a review of chin surgery, the multiple aesthetic analyses available and the advantages and disadvantages of the various materials. Autologous fat transfer to the chin is safe, cost effective, and can produce long term aesthetic improvement. Although there are many synthetic fillers available, autologous fat is perhaps the best option for genioplasty. This simple, fast procedure is a very good alternative for patients with some form of microgenia or when patients and surgeons are not likely to use alloplastic implants. (Archives of Aesthetic Plastic Surgery 17: 69, 2011)

코뼈 골절의 전산화 단층 촬영에 의한 분류

노복균,안호범,김대영,이삼용,조백현 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.2

The reduction of nasal bone fracture has been done by a simple procedure. The nasal bone fracture was not a serious problem and patients are usually treated as outpatients. However it is causing increased demand for medical services far cosmetic reasons. We studied the nasal bone fracture by retrospective analysis, it comprising 606 patients with nasal bone fractures in various accidents and treated of Chonnam University Hospital from March 1995 to February 1998. We reviewed and analyzed the medical records and facial bone CT scans of 606 patients. The following results were obtained. 1. The prevalent age group was in the third decade, the most common cause was traffic accidents, while nasal swelling, tenderness, nasal deviation and crepitation were examined 2. The classification of nasal bone fracture was done by facial bone CT. Class 1: Nasal tip depressed fracture(16%) Class 2: Displaced nasal bone fracture without depression(30%) Class 3: Displaces nasal bone fracture with depression(12%) Class 4: Comminuted nasal bone fracture (10%) Class 5: Simple fracture of nasal bone and frontal process of maxilla(14%) Class 6: Comminuted fracture of nasal bone and frontal process of maxilla(11%) Class 7: Nasal bone fracture without displacement(9%)

흰쥐에 삽입된 인공성형삽입물의 생체내 물리, 조직학적 변화의 비교

김성남,노복균,김의식,황재하,김광석,이삼용,조백현 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.2

Augmentation rhinoplasty is one of the most popular aesthetic procedure in Asians. Numerous alloplastic implants have been used until now, but no accurate comparative analysis about the implant materials has been reported yet.This study in animal model was designed to determine the safety and effectiveness of various implant materials in augmentation rhinoplasty. The 15 × 15×2mm sized square shaped plate of Gore-Tex, silicone rubber, and 15×15×1.5mm sized Medpor were implanted under panniculus carnosus of the abdomen wall of rat. And tissue specimens including the implant and surrounding soft tissue were obtained by en bloc excision in 6 months after implantation. The implants were estimated in weight and volume, and also the specimens were examined grossly and microscopically.The results revealed that increase of average weight 26.9%, decrease of average volume 55.4% in Gore-Tex implant, increase of each average weight and volume 62.6%, 8.7% in Medpor implant and very slight increase of both average weight and volume 4.7%, 1.1% in silicone rubber implant. Grossly, the Gore-Tex was deformed, Medpor was strongly adherent to surrounding soft tissue and the silicone rubber was well encapsulated and easily peeled off. Microscopically, silicone rubber showed foreign body reaction slightly and there were no inflammatory responses in all alloplastic implants. In our study, silicone rubber showed very proper alloplastic features for augmentation rhinoplasty due to causing no inflammatory response, no physical change, and no deformity

성형외과 영역에서 3차원 스캐너의 유용성

문성원,노복균 대한미용성형외과학회 2006 Archives of Aesthetic Plastic Surgery Vol.12 No.2

The accurate measurement is essential in evaluating the patients in the aesthetic plastic surgery. So many plastic surgeons would have increased the accuracy of photograph. But the results of the efforts are not satisfactory. Now, we can use the 3-D scanner possibly. We want to investigate the reliability of the 3-D scanner by comparing real measurements with the 3-D scanner measurements.Between Apr, 2003 and Nov, 2005, the Korean agency for technology and standards(ATS) investigates the size of 15,576 Korean by real measurements and 5,186 Korean by the 3-D scanner measurements. We selected the measurements of female aged from 20 to 24. These measurements divide into the sections of height, width, thickness, circumference, and compared in each sections. The statistical analysis was performed by STATA 9.0.If the datum points were fixed, unstable and the data was easily measured by the measuring devices such as height, the 3-D scanner measurements were almost coincident with the real measurements. The p-value was statistically not significant. Otherwise, If the datum points were unfixed and the data was measured by a measuring tape, the 3-D scanner measurements were not coincident with the real measurements. The p-value was statistically significant.According to these results, the height can be measured by the 3-D scanner instead of real measurements. But the circumference, thickness and width by the 3-D scanner is almost incompatible with that of the real measurements. The new paradigm of anthropometry is needed.

괴사성 근막염 환자의 원인 균주에 따른 경과 비교

박선형,노복균,김의식,황재하,김광석,이삼용 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.3

Purpose: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. Methods: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis.Results: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit.Conclusion: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.

상완내측 피부를 이용한 안면부의 부분층 식피술

문성원,노복균,김의식,황재하,이삼용 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.1

Purpose: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp.Methods: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak grade(Smith & Nephew). The statistical analysis was performed by SPSS 12.0.Results: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp.Conclusion: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.

부분기질절제술과 발톱주위전진피판을 이용한 재발성 내증식발톱의 교정

김의식,김성남,노복균,황재하,김광석,이삼용 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.3

복벽에 발생한 낭미충증 1례

김의식,박정준,노복균,황재하,김광석,이삼용 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.2

Human cysticercosis is an infestation with C. cellulosae, the larval stage of the tapeworm T. solium. It prevails in regions of poverty and where personal hygiene is poor. They can lodge in almost any tissue, but cysticerci are most frequently found in brain, skeletal muscle, subcutaneous tissues. We experienced a 41-year old male with 5×12cm sized movable non tender brownish hard mass at lateral abdominal wall. The laboratory study didn't show any specific symptoms except peripheral blood eosinophilia and positive parasite ELISA screen for cysticercosis. The ultrasonogram revealed multiple ill-defined mixed echoic inflamatory lesion. Excisied cyst showed multiple severe foul-odor gelatinous subcutaneous mass. Microscopic examination disclosed necrotic body with foreign body reaction, massive eosinophilia and dead parasitic organism, compatible with cysticercosis. There was no evidence of recurrence during 12 months follow-up.

이마피판술과 후이개부 전층피부이식술을 이용한 안면부 연부조직 결손 재건 후 피부 색상의 비교

조성후,유성인,노복균,김의식,황재하,김광석,이삼용 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.1

Purpose: For facial reconstruction, skin color match is crucial to achieve great aesthetic result. Forehead flap and full thickness skin graft have been used for many years to reconstruct facial defect. Their results are aesthetically valuable with remarkable resemblance and harmony of the skin color between donor and recipient sites. The purpose of this study is to evaluate and compare the aesthetic outcome of the two methods as the analysis of skin color match.Methods: From January 1995 to December 2005, ten forehead flaps and ten full thickness skin grafts were performed. The reconstructed areas of forehead flaps were five noses and five eyelids. Recipient sites of full thickness skin grafts were seven eyelids, two noses and one forehead. In order to obtain the objective validity, the skin color of flap(or graft) and the recipient sites were measured by chromameter. The skin colors were quantified according to a three-dimensional coordinate system used in chromameter, L*(brightness), a*(redness), and b*(yellowness).Results: There was no significant color difference between forehead flap site and adjacent skin in all color values. On the other hand, the L* and b* values of graft sites were significantly lower than those of the adjacent skins. The a* values of graft sites were higher than those of the adjacent skins.Conclusion: This study reveals that skin color match of forehead flap is greater than that of full thickness skin graft. As forehead flap has adequate volume and great color match, it can be useful to reconstruct deep facial defect such as nasal defect. On the other hand, full thickness skin graft can be used for superficial defect like partial eyelid defect.