회전 피판을 이용한 함몰유두의 교정

오영웅,박 철,유대현,박병윤 대한미용성형외과학회 1997 Archives of Aesthetic Plastic Surgery Vol.3 No.1

The patient with unilateral or bilateral inverted nipple has both functional and cosmetic impairments. The structural and histopathologic features of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. For these reasons, surgical correction of inverted nipple requires release of the short lactiferous ducts and providing the bulkiness under the nipple. We conbined the concept of both adding the bulkiness under the nipple and creating a tight neck at its base without sacrificing the duct system. We rotated the bilateral diamond shaped deepithelized dermal flaps around the nipple areolar complex for providing the nipple bulkiness without division of lactiferous duct and reinforced it with the purse-string suture around the dermal flap for providing the stability. This two rotational dermal flap method was applied 12 inverted nipple in 6 patients and followed up for 2 months to 24 months. We have got the satisfatory results in cosmetic and functional aspect without any complication such as sensory change, relapse, and nipple necrosis.

복직근 및 박근 근피판술을 이용한 골반 및 서혜부 연부조직 결손의 재건

이재화,정윤규,김주봉,유대현,황성관,이훈범,김석원 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Many operations for the reconstruction of the pelvic area have been studied until now. The local muscle flap is often used for the closure of these complex wound. But, these local muscle flaps may not be available for reconstruction due to the factors of infection, radiation, and surgical trauma. Since rectus abdominis muscle and gracilis muscle were introduced, their use has been steadily increased for the reconstruction of soft tissue defect of the pelvic area. Inferiorly based rectus abdominis muscle flap and the gracilis muscle flap have been adopted for well-vascularized soft tissue coverage of the defect of pelvis and groin area. These techniques were utilized in seven patients. Of these patients, rectus abdominis muscle flap was used on four patients and three patients were treated with gracilis muscle flap. Among these, chronic osteomyelitis of pelvic bone has been managed with inferiorly based rectus abdominis muscle flap in three patients. No complication has been found. The mean postoperative follow-up period was 26 months, with a range of 12 to 39 months. In conclusion, these muscles are functionally expandable , and provide adequate tissue volume with sufficient blood supply away from the zone of injury, and readily transposed into the pelvis and groin area through subcutaneous tunnel, and serve as an antibiotic delivery system that aids in the eradication of infection. These findings suggest a reconstructive option for the defect of pelvis and groin, and/or bone infection in this area.

PRS KOREA 2016: 50th Anniversary of the Korean Society of Plastic and Reconstructive Surgeons and Another Successful Congress for Plastic and Reconstructive Surgery

Lew, Dae Hyun Korean Society of Plastic and Reconstructive Surge 2017 Archives of Plastic Surgery Vol.44 No.1

유리피판술 및 Ilizarov 골 신장을 병행한 광범위한 하지결손의 재건

유대현,박병윤,김학선,양규현,윤지영,탁관철 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.5

The treatment of massive bone and soft tissue defect in the lower leg has a high complication rate of nonunion, chronic infection, and amputation without well-vascularized tissue coverage of the open fracture. Despite adequate free soft tissue coverage, massive skeletal defect may result in segmental bone defects, angulation deformity, and limb length discrepancies. In the last decade, major advances have occurred in the Ilizarov method of distraction osteogenesis in lower leg salvage as a delayed procedure or simultaneous distraction after free-tissue transfer. The authors have performed Ilizarov transport in conjunction with muscle and musculocutaneous flap coverage in nine cases of lower leg salvage. The flaps consist of rectus, gracilis, latissimus dorsi, parascapular, and serratus muscle or musculocutaneous fashioning using ipsilateral or contralateral pedicle in consideration of vessel condiation. Revision, recorticotomy and flap elevation were also used as a secondary procedure for satisfactory results. The conclusions, were as follows: 1) Multidisciplinary team approach with conjoining departments at the time of preoperative evaluation, postoperative care and rehabilitation care; 2) Muscle flap covered with split-thickness skin graft was preferred to musculocutaneous flap; 3) To reduce the total reconstructive period, simultaneous free tissue transfer with Ilizarov distraction should be considered.

내시경을 이용한 전두부 및 안면부 골막하 거상술

유대현,이은정 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.1

The subperiosteal face lift developed by Tessier is a technique for rejuvenating the face. Ramirez described ti as "The 3rd generation face lift" The constant conflict between the downward force(caused by depressor muscles & gravity) and the upward force(by elevator muscles) leads to wrinkles in the forehead, the malposition of the eyebrows & upper eyelids. With aging, facial soft tissue & bony mass undergo changes. Bony mass in especially reduced. The disturbance of balance between facial bones & soft tissue causes soft tissue redundancy. After completion of subperiosteal undermining of upper & midface, we can pull the underlying soft tissue against the facial bone and restore the tension of facial mimetic musculature. We used endoscopic technique during subperiosteal lift, especially for supraorbital nerve identification and Corrugator & Procerus avulsion. Endoscopic assistance during this superiosteal dissection avoids coronal incision and decrease postoperative morbidity. We have experienced 11 cases of subperiosteal lift, of which 9 patients received endoscopic procedure and 2 patients, the bicoronal approach. 9 cases of endoscopic face lift included 4 cases of forehead lift and 5 cases of forehead & midface lift.

폐경후 여성에서 호르몬 대체요법이 체성분과 leptin level 에 미치는 영향

조현희(Hyun Hee Jo),김진홍(Jin Hong Kim),유영옥(Young Oak Lew),정인철(In Cheul Jung),권동진(Dong Jin Kwon),김장흡(Jang Heub Kim),김은중(Eun Jung Kim),김대훈(Dae Hun Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11

N/A Objective : To compare the women who use postmenopausal hormone replacement therapy to never user for the serum leptin level and degree of obesity, then evaluate the precausing factor of postmenopausal obesity. Method : We checked the serum leptin level, blood chemistry and body composition in three groups, two groups are postmenopause groups which is HRT user (n=125) and HRT never user (n=194), and the other is premenopause groups(n=82). We used SPSS and Excel for analyzed the difference between the groups. Result : BMR is decreased after menopause, body fat ratio, abdominal fat ratio, BMI, leptin, sugar, and cholesterol level are increased after menopause. There is no difference between the postmenopausal HRT group and non-HRT group in body fat composition, abdominal fat ratio, BMI,BMR,AMC and leptin levels. Serum sugar level shows positive correlation with the leptin level in pre and postmenopausal women after exclude the effect of body fat ratio. Serum estradiol and leptin level shows positive correlation.(correlation coefficient 0.68 in postmenopausal non-HRT group and 0.735 in postmenopausal HRT group) Conclusion : Serum estradiol and sugar level have some correlation with leptin level and leptin resistance in postmenopausal women, and decreased estradiol level caused obesity through increased leptin resistance.

Use of Acellular Allogenic Dermal Matrix (MegaDerm) in Orbital Wall Reconstruction: A Comparison With Absorbable Mesh Plate and Porous Polyethylene

Kim, Jiye,Lew, Dae Hyun,Roh, Tai Suk,Lee, Won Jai by Mutaz B. Habal, MD. 2017 JOURNAL OF CRANIOFACIAL SURGERY - Vol.28 No.7

ABSTRACT: The selection of materials for orbital wall reconstruction has been a matter of debate. This study aimed to evaluate the effectiveness of an acellular allogenic dermal matrix (ADM) as an orbital wall reconstruction material and to compare the results of orbital wall reconstruction with the ADM to those of reconstruction with the more widely used absorbable mesh plate and porous polyethylene. We retrospectively reviewed the clinical charts and computed tomography images of 73 patients who underwent orbital reconstruction at 1 institution between March 2013 and February 2014. In the ADM group, the mean defect size of 29 patients was 2.89 cm. After orbital wall reconstruction with ADM, patients with preoperative enophthalmos (7 patients), limited range of eyeball movement (6 patients), and diplopia (12 patients) showed improvements. In the comparative study, the 3 groups showed no significant differences with respect to age distribution (P = 0.522), defect size (P = 0.455), and preoperative findings such as enophthalmos (P = 0.811), diplopia (P = 0.357), and limited range of eyeball movement (P = 0.795). All the preoperative symptoms improved in every group, and in the ADM group, no complication was observed during the postoperative follow-up. ADM is a biocompatible material that combines the flexibility and rigidity required to support the orbital soft tissue. Therefore, it could be an excellent alternative material for orbital wall reconstruction.

Transaxillary Subpectoral Placement of Cardiac Implantable Electronic Devices in Young Female Patients

Oh, Joo Hyun,Kim, Chae Min,Song, Seung Yong,Uhm, Jae Sun,Lew, Dae Hyun,Lee, Dong Won Korean Society of Plastic and Reconstructive Surge 2017 Archives of Plastic Surgery Vol.44 No.1

Background The current indications of cardiac implantable electronic devices (CIEDs) have expanded to include young patients with serious cardiac risk factors, but CIED placement has the disadvantage of involving unsightly scarring and bulging of the chest wall. A collaborative team of cardiologists and plastic surgeons developed a technique for the subpectoral placement of CIEDs in young female patients via a transaxillary approach. Methods From July 2012 to December 2015, subpectoral CIED placement via an axillary incision was performed in 10 young female patients, with a mean age of 25.9 years and mean body mass index of $20.1kg/m^2$. In the supine position, with the patient's shoulder abducted, an approximately 5-cm linear incision was made along one of the deepest axillary creases. The submuscular plane was identified at the lateral border of the pectoralis major, and the dissection continued over the clavipectoral fascia until the subpectoral pocket could securely receive a pulse generator. Slight upward dissection also exposed an entrance to the subclavian vein, allowing the cardiology team to gain access to the vein. One patient with dilated cardiomyopathy underwent augmentation mammoplasty and CIED insertion simultaneously. Results One case of late-onset device infection occurred. All patients were highly satisfied with the results and reported that they would recommend the procedure to others. Conclusions With superior aesthetic outcomes compared to conventional methods, the subpectoral placement of CIEDs via a transaxillary approach is an effective, single-incision method to hide operative scarring and minimize bulging of the device, and is particularly beneficial for young female or lean patients.

금속 가이드 장치를 이용한 하악각 골절제술

박병윤,유대현,김형태,박승호,김용욱 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.7

Intraoral approach for mandible angle contouring has been popularized because it can avid external scars on the face. However it is difficult to perform safe and precise as condylar fracture, asymmetry, undercorrection, and overcorrection. Among these complications, the main reason of condyle fracture and asymmetry may be caused by the wrong perception of the pathway of osteotomy. To be free form such wrong perception of the osteotomy pathway, we designed guiding instrument for osteotomy of the mandible angle and used this guiding instrument in 14 patients successfully.

Stromal vascular fraction injection to treat intractable radiation-induced rectovaginal fistula

Kim, Mijung,Lew, Dae Hyun,Roh, Tai Suk,Song, Seung Yong Korean Society of Plastic and Reconstructive Surge 2021 Archives of Plastic Surgery Vol.48 No.1

Rectovaginal fistula, which can arise after an injury to the vaginal canal or rectum, is a troublesome obstacle for patients' everyday life. In most cases, it can be covered with a local flap, but previous radiation therapy increases the recurrence rate, making it especially difficult to cure. As the application of stromal vascular fraction (SVF) obtained from enzymatically digested autologous adipose tissue has become increasingly common, several reports have advocated its effectiveness for the treatment of refractory wounds. In light of the angiogenic, regenerative characteristics of SVF, it was incorporated as a treatment option in two cases of rectovaginal fistula discussed here. As described in this report, irradiated rectovaginal fistulas in rectal cancer patients were successfully treated with SVF injection, and we suggest SVF as a feasible treatment option for cases of rectovaginal fistula that would otherwise be very difficult to cure.