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Consideration of Facelift Methods and Facial Retaining Ligaments in Asians
류민희 대한미용성형외과학회 2014 Archives of Aesthetic Plastic Surgery Vol.20 No.2
Background The demand for facelifts is rapidly increasing in Asia because of economicdevelopment as well as the aging of the population. It is difficult to obtain satisfactoryresults, because of the facial characteristics of Asians. Various approaches,such as the extended superficial musculoaponeurotic system (SMAS) facelift, the finger-assisted malar fat elevation facelift, and the high SMAS facelift, were designed toimprove facial sagging in the mid- and lower face with the development of advancedfacial surgical procedures. Methods We reviewed facelift methods and surgical anatomy from the Asian viewpoint. Results In Asians, skin is fibrous and richer in collagen, and retaining ligaments aretougher and more rigid. Facial features are flat and wide, so achieving satisfactoryfacelift results is a challenge. The release of retaining ligaments in the sub-SMASplane is the most important procedure in Asian facelifts to achieve satisfactory results. Supplementing the SMAS dissection above the upper border of the zygomaticarch and elevating the malar fat pad through the prezygomatic space achieve betterresults in Asian facelifts. Conclusions The release of retaining ligaments in the sub-SMAS plane is the most importantstep during Asian facelifts for satisfactory results. The addition of SMAS dissectionabove the upper border of the zygomatic arch and malar fat pad elevationthrough the prezygomatic space help achieve better results for Asian facelifts.
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류민희,김효헌 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.6
Purpose: The main advantages of the perforator flap are minimal donor site morbidity, preservation of any main source artery and its thin characteristics. Most perforator flaps for hand reconstruction need primary and secondary procedures such as a flap debulkiness and liposuction etc. However, flap thickness of calf area is thinner than any other perforator flaps.Methods: We performed an anatomical study and clinical application of medial sural artery perforator flap. We found that there are two or more medial sural perforators located on a straight line drawn from the mid-point of popliteal crease to the mid-point of medial malleolus. Most pathway of medial sural artery comes along with this line. It is possible to observe the first perforators almost exactly 8cm from midpoint of popliteal crease in a distal half circle drawn with a radius of 2cm.Results: We report 12 cases in 11 patients of hand reconstruction with medial sural perforator free flap from Febrary 2003 to Febrary 2006. Complete healing was possible in 11 cases. Total flap loss for venous insufficiency was in 1 patient. During the follow-up, good contour and full range of motion was observed on hand reconstruction with medial sural perforator free flap.Conclusion: In the authors' experience, this anatomical study made it possible to prepare a diagram of the exact location of the medial sural perforators. This flap can be used to achieve acceptable functional and aesthetic results for hand reconstruction because of its thin characteristics.
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류민희,김효헌,정재호 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.2
Purpose: Breast reconstruction with deep inferior epigastric perforator(DIEP) free flap is known to be the most advanced method of utilizing autologous tissue. The DIEP free flap method saves most of the rectus abdominis muscle as well as anterior rectus sheath. Therefore, the morbidity of the donor site is minimized and the risk of hernia is markedly decreased. Methods: We chose the internal mammary artery and its venae comitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels. The number and location of the perforators derived from medial or lateral branch of deep inferior epigastric artery(DIEA) in 23 DIEP flaps were identified. Ten patients underwent evaluation of their abdominal wall function preoperatively and 6 months postoperatively by using Lacote's muscle grading system.Results: Of the 23 patients, a patient with one perforator from lateral branch of DIEA experienced partial necrosis of flap. Total flap loss occurred in one patient. Mild abdominal bulging was reported in one patient 4 months postoperatively probably because of early vigorous rehabilitational therapy for her frozen shoulder. Postoperative abdominal wall function tests in 10 patients showed almost complete recovery of muscle function upto their preoperative level of upper and lower rectus abdominis and external oblique muscle function at 6 months postoperatively. All patients have been able to resume their daily activities.Conclusion: The breast reconstruction with DIEP free flap is reliable and valuable method which provide ample soft tissue from abdomen without compromising the integrity of abdominal wall. Selection of reliable perforators is important and including more than two perforators may decrease fat necrosis and partial necrosis of flap.
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REAL 분류상 B-미만성 대세포 림프종에서 조직학적 아형 분류의 임상적 의의
류민희 ( Min Hee Ryu ),김봉석 ( Bong Seog Kim ),김태원 ( Tae Won Kim ),박연희 ( Yeon Hee Park ),허주령 ( Joo Ryung Huh ),이승숙 ( Seung Sook Lee ),김철우 ( Chul Woo Kim ),류백렬 ( Baek Yeol Ryoo ),김노경 ( Noe Kyeong Kim ),이규형 대한내과학회 2003 대한내과학회지 Vol.65 No.1
Background : Diffuse large B-cell lymphoma (DLBL) category in the REAL classification includes histologically heterogeneous subtypes in Working Formulation or Kiel classification. Some investigators insist that the prognosis of B-cell immunoblastic lympho
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