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Biomedical subjects

Seok-Kwun Kim

Publications and source records attributed to Seok-Kwun Kim.

5 recordsLinked to original sources

Foreign body removal and immediate nasal reconstruction with superficial temporal fascia.

For nasal augmentation, various materials have been used for many years. The injection of foreign body has been carried on, although it is performed mostly by laymen. Because many complications arise after augmentation rhinoplasty by foreign body injection, secondary correction has been needed. These complications have included headaches, swelling, redness, palpable mass, skin discoloration, telangiectasia and fear of cancer. The authors treated 10 patients who had undergone injection of foreign body to the nose. After the foreign body was removed, we immediately reconstructed nasal deformity by silicone implant wrapping with superficial temporal fascia. This method has many advantages including easy contouring of nasal shape and fixation, absence of foreign body reaction, reduced inflammatory reaction, no or minimal concerns regarding the migration or extrusion of the implants, and nonvisible donor scar. The mean follow-up period was 8 months, and no complications occurred. The authors conclude that nasal deformity can be successfully reconstructed immediately using silicone implant wrapping with superficial temporal fascia after foreign body is removed from the nose. In the authors' experience, this procedure has improved aesthetic appearance and met patients' expectations.

Adult↗

Reduction malarplasty by 3-mm percutaneous osteotomy.

Oriental people usually have a wide midface and a prominent malar curve. The zygomatic bone forms the prominence of the cheek, and it is the most important part in determining the ideal oval shape of the face on the frontal view and the character of the oblique profile. Therefore, zygoma contouring is commonly performed. Women with a prominent zygoma have an inferiority complex associated with unattractive facial features resembling aged, melancholic, and strong characters in oriental culture. Zygoma is the highlighted area of the midface and a major determinant of midfacial shape, but harmony with the adjacent area is very important. Therefore, to obtain the optimal outcome of reduction malarplasty, various ancillary procedures must be performed simultaneously. The authors performed 30 reduction malarplasties during the past 2 years. The amount of bone to be removed was determined by the preoperative interview, physical examination, and x-rays. Intraoral incisions provided access to the zygomatic body and lateral orbital rim. After the L-shaped osteotomy, two parallel vertical and transverse osteotomies in the medial part of the zygomatic body, the midsegment was removed. The posterior portion of the zygomatic arch was approached through a stab incision in the preauricular area. A 3-mm osteotome was used. After completion of the osteotomy, the movable zygomatic complex was reduced medially and superiorly, then fixed with miniplates and screws on the zygmaticomaxillary buttress. The combined operations with reduction malarplasty were as follows: reduction of the mandibular angle in 15 cases, rhinoplasty in 14 cases, and double-fold operation in 11 cases. The follow-up period was 2 months to 2 years, and all the patients were satisfied with the results. In conclusion, this method is a very simple, easy, and safe method that reduces the operating time to 1 h and minimizes postoperative edema and swelling. Consequently, recovery time is relatively short, and no conspicuous scars in the preauricular area are left. The authors also performed many ancillary procedures, thereby obtaining optimal satisfaction with their results, including decreased facial width and superior mobilization of the prominent area. They were able to prevent postoperative cheek drooping, and to give the patients a more youthful, charming look.

Adult↗

Mulliken method of bilateral cleft lip repair: anthropometric evaluation.

BACKGROUND: Simultaneous surgical correction of bilateral cleft lip and nasal deformity is becoming more common. This is a major change from the conventional strategy of secondary nasal correction. METHODS: Thirty patients with bilateral cleft lip and nasal deformity were repaired using the Mulliken method between July of 1997 and December of 2002. This series was composed of 10 infants with bilateral complete cleft lip, 12 with bilateral incomplete cleft lip, and eight with bilateral asymmetric cleft lip, defined as complete on one side and incomplete on the other. A preoperative orthopedic appliance was employed in five infants who had severe collapse of the lateral maxillary segments. Mean age at the time of repair was 3.8 months. RESULT: Postoperative results were evaluated anthropometrically. The mean follow-up period was 3.8 years (range, 1.2 to 5.5 years). Nasal tip protrusion was low; interalar dimension was wide; columellar length was slightly short; upper cutaneous labial height was short; and vermilion-mucosal height was near normal. All anthropometric values approached controls by 5 years. CONCLUSION: Our modified Mulliken method is effective in correction of all forms of bilateral cleft lip and nasal deformity. Further evaluation is needed for possible differences in outcome based on race and age at the time of operation.

Anthropometry↗

Nasal tip plasty using various techniques in rhinoplasty.

Rhinoplasty is one of the most common aesthetic surgical procedures in Korea today. However, simple augmentation rhinoplasty results often failed to satisfy the high expectations of patients. As a result, many procedures have been developed to improve the appearance of the nasal tip and nasal projection. However, the characteristics of Korean nasal tips including the bulbous appearance (attributable to the thickness of the skin), flared nostrils, and restriction of the nasal tip attributable to an underdeveloped medical crus of the alar cartilage and a short columella have made such procedures difficult. Currently, most plastic surgeons perform rhinoplasty simultaneously with various nasal tip plasty techniques to improve the surgical results. An important part of an aesthetically pleasing result is to ensure an adequate nasal tip positioned slightly higher than the proper dorsum, with the two tip defining points in close proximity to each other, giving the nose a triangular shape from the caudal view. From June 2002 to November 2003, the authors performed rhinoplasty with simultaneous nasal tip plasty using various techniques according to the tip status of 55 patients (25 deviated noses, 9 broad noses, 15 low noses, and 6 secondary cleft lip and nose deformities). The surgery included realignment of alar cartilage by resection and suture, fibroareolar and subcutaneous tissue resection, tip graft, and columellar strut. The postoperative results over an average period of 10 months were entirely satisfactory. There were no patient complaints, nor complications resulting from the procedures. Good nasal tip projection, natural columellar appearance, and improvement of the nasolabial angle were achieved for most patients. In conclusion, rhinoplasty with simultaneous nasal tip plasty, achieved by a variety of techniques according to patients' tip status, is an effective method for improving the appearance of the nose and satisfying the desires of the patients.

Adult↗

Primary correction of unilateral cleft lip nasal deformity in Asian patients: anthropometric evaluation.

Previously it was thought that primary correction of nasal deformity in cleft lip patients would cause developmental impairment of the nose. It is now widely accepted that simultaneous correction of the cleft lip nasal deformity has no adverse effect on nasal growth. Thus, the authors tried to evaluate the results of primary correction of cleft lip in Asian patients. Of 412 cases of cleft lip, 195 cases were corrected by means of the conventional method from June of 1992 to June of 1997, and 217 cases were corrected by simultaneous rhinoplasty from July of 1997 to October of 2001. The average patient age was 3 months. Photographs and anthropometric evaluation were used to evaluate the results. Nasal tip projection, columellar length, and nasal width were measured in 60 randomized normal children, 30 randomized children treated with the conventional method, and 30 randomized children with primary nasal repair. Data were analyzed using t tests, and the level of significance was 5 percent (p < 0.05). In cases of simultaneous repair, nasal tip projection and columellar length were increased 24.8 percent and 28.8 percent, respectively. Nasal width was increased 12.3 percent in the cases of simultaneous repair and 12.6 percent in the cases without primary rhinoplasty. Simultaneous repair of cleft lip and nasal deformity in Asian patients showed that more symmetry of nostril and nasal dome projection and better correction of buckling and alar flaring were achieved. More balanced growth and development of the alar complex was achieved, and no interference with nasal growth was encountered.

Anthropometry↗