Pub Date : 2023-01-30DOI: 10.14730/aaps.2022.00598
S. Jwa, J. Won, Y. Suh, Won Jai Lee
Background Keloid treatment is challenging because of the high likelihood of recurrence and a lack of definitive treatment combinations. The treatment of bulky and recurrent keloids is particularly difficult. We investigated the administration of extralesional cryotherapy (EL) in conjunction with intralesional (IL) triamcinolone (TA) injections as adjuvant therapy after surgical excision for the management of keloids.Methods Among all patients who visited our scar laser center between January 2016 and August 2017, 54 patients who underwent IL keloid excision with EL cryotherapy and IL TA injection as adjuvant therapy were included in this retrospective study. We examined sex, site, the number of cryotherapy sessions and TA injections, symptoms after surgery, and recurrence. The Vancouver Scar Scale (VSS) was used as to quantify treatment outcomes.Results Among 54 cases of IL keloid excision, after an average of 6.26 cryotherapy sessions and IL TA injections as combined adjuvant treatment, the lesion was controlled without recurrence in 49 cases. Relapse occurred in five patients, requiring additional treatment and reoperation. For 49 patients with photographic data, the average VSS score before and after treatment improved from 10.1 to 5.0. In 17 patients in whom symptoms recurred after surgery, all symptoms were controlled and maintained with adjuvant therapy.Conclusions Initial direct surgical excision, followed by a combination of EL cryotherapy and IL TA injections, was shown to be effective in challenging cases of large and recurring keloids.
{"title":"Extralesional cryotherapy combined with intralesional triamcinolone injections after keloid excision","authors":"S. Jwa, J. Won, Y. Suh, Won Jai Lee","doi":"10.14730/aaps.2022.00598","DOIUrl":"https://doi.org/10.14730/aaps.2022.00598","url":null,"abstract":"Background Keloid treatment is challenging because of the high likelihood of recurrence and a lack of definitive treatment combinations. The treatment of bulky and recurrent keloids is particularly difficult. We investigated the administration of extralesional cryotherapy (EL) in conjunction with intralesional (IL) triamcinolone (TA) injections as adjuvant therapy after surgical excision for the management of keloids.Methods Among all patients who visited our scar laser center between January 2016 and August 2017, 54 patients who underwent IL keloid excision with EL cryotherapy and IL TA injection as adjuvant therapy were included in this retrospective study. We examined sex, site, the number of cryotherapy sessions and TA injections, symptoms after surgery, and recurrence. The Vancouver Scar Scale (VSS) was used as to quantify treatment outcomes.Results Among 54 cases of IL keloid excision, after an average of 6.26 cryotherapy sessions and IL TA injections as combined adjuvant treatment, the lesion was controlled without recurrence in 49 cases. Relapse occurred in five patients, requiring additional treatment and reoperation. For 49 patients with photographic data, the average VSS score before and after treatment improved from 10.1 to 5.0. In 17 patients in whom symptoms recurred after surgery, all symptoms were controlled and maintained with adjuvant therapy.Conclusions Initial direct surgical excision, followed by a combination of EL cryotherapy and IL TA injections, was shown to be effective in challenging cases of large and recurring keloids.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45900245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-30DOI: 10.14730/aaps.2022.00696
Hyun Wang, Jae A Jung
Hyaluronic acid soft-tissue fillers are the second most widely used injectable agents in cosmetic surgery. During the coronavirus disease 2019 (COVID-19) pandemic, a few cases of delayed hypersensitivity reactions to hyaluronic acid filler injections have been reported following COVID-19 infection or vaccination against the virus. A 61-year-old woman visited the emergency room with swelling and redness on the entire face that started on the nasolabial area. She had received hyaluronic acid filler injections in her nasolabial area 8 months previously and had completed the primary series of vaccinations and received a booster dose of the mRNA Pfizer-BioNTech COVID-19 vaccine 1 month before the swelling episode. A corticosteroid was added to the antibiotic regimen because of the nonsignificant effect of the antibiotics. The symptoms then resolved, and corticosteroid use was tapered over the course of 2 weeks. Four months later, swelling and redness recurred on both nasolabial folds and chin, but the symptoms were more localized than before. The renewed symptoms regressed with surgical drainage and corticosteroid and antibiotic treatment. This study discusses this extremely rare case of a recurrent delayed hypersensitivity reaction to a hyaluronic acid soft-tissue filler following COVID-19 vaccination.
{"title":"Recurrent delayed hypersensitivity reaction to a hyaluronic acid soft-tissue filler following COVID-19 vaccination: a case report","authors":"Hyun Wang, Jae A Jung","doi":"10.14730/aaps.2022.00696","DOIUrl":"https://doi.org/10.14730/aaps.2022.00696","url":null,"abstract":"Hyaluronic acid soft-tissue fillers are the second most widely used injectable agents in cosmetic surgery. During the coronavirus disease 2019 (COVID-19) pandemic, a few cases of delayed hypersensitivity reactions to hyaluronic acid filler injections have been reported following COVID-19 infection or vaccination against the virus. A 61-year-old woman visited the emergency room with swelling and redness on the entire face that started on the nasolabial area. She had received hyaluronic acid filler injections in her nasolabial area 8 months previously and had completed the primary series of vaccinations and received a booster dose of the mRNA Pfizer-BioNTech COVID-19 vaccine 1 month before the swelling episode. A corticosteroid was added to the antibiotic regimen because of the nonsignificant effect of the antibiotics. The symptoms then resolved, and corticosteroid use was tapered over the course of 2 weeks. Four months later, swelling and redness recurred on both nasolabial folds and chin, but the symptoms were more localized than before. The renewed symptoms regressed with surgical drainage and corticosteroid and antibiotic treatment. This study discusses this extremely rare case of a recurrent delayed hypersensitivity reaction to a hyaluronic acid soft-tissue filler following COVID-19 vaccination.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41699497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-30DOI: 10.14730/aaps.2022.00556
Woo Jung Choi, W. Song, S. Kang
An advantage of breast augmentation with injectable fillers is that the desired size can be determined and achieved under local anesthesia with a short recovery time. However, a high complication rate is a critical disadvantage. Some fillers are challenging to remove, resulting in breast deformity and scarring. Five patients who underwent surgery to manage a foreign body in the breasts in 2021 were enrolled in this study. Two had copolyamide filler injections, while the other three had polyacrylamide hydrogel filler injections. A physical examination was performed, and preoperative and intraoperative photographs were obtained. Two patients underwent subcutaneous mastectomy because most of the filler had infiltrated into the normal breast tissue. In contrast, the other patients underwent filler removal and debridement because most of the filler had remained separate from the normal breast tissue. All patients who had a subcutaneous mastectomy and one who underwent only filler removal underwent immediate breast reconstruction with cohesive gel implants. The other patients rejected immediate reconstruction, and only filler removal was performed. All patients recovered without complications. We propose an algorithm for diagnosis and treatment based on our cases, which we hope can help clinicians manage the complications of filler injections for breast augmentation.
{"title":"Complications and management of breast augmentation using two different types of fillers: a case series","authors":"Woo Jung Choi, W. Song, S. Kang","doi":"10.14730/aaps.2022.00556","DOIUrl":"https://doi.org/10.14730/aaps.2022.00556","url":null,"abstract":"An advantage of breast augmentation with injectable fillers is that the desired size can be determined and achieved under local anesthesia with a short recovery time. However, a high complication rate is a critical disadvantage. Some fillers are challenging to remove, resulting in breast deformity and scarring. Five patients who underwent surgery to manage a foreign body in the breasts in 2021 were enrolled in this study. Two had copolyamide filler injections, while the other three had polyacrylamide hydrogel filler injections. A physical examination was performed, and preoperative and intraoperative photographs were obtained. Two patients underwent subcutaneous mastectomy because most of the filler had infiltrated into the normal breast tissue. In contrast, the other patients underwent filler removal and debridement because most of the filler had remained separate from the normal breast tissue. All patients who had a subcutaneous mastectomy and one who underwent only filler removal underwent immediate breast reconstruction with cohesive gel implants. The other patients rejected immediate reconstruction, and only filler removal was performed. All patients recovered without complications. We propose an algorithm for diagnosis and treatment based on our cases, which we hope can help clinicians manage the complications of filler injections for breast augmentation.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42576484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-30DOI: 10.14730/aaps.2022.00633
Joonsuk Bae, S. Nam, H. Cha, E. Park
Background This study aimed to evaluate the efficacy and safety of a dissolving microneedle (DMN)-encapsulated niacinamide skin patch to reduce facial hyperpigmentation.Methods A split-face study was conducted between April and June 2022 in 17 patients treated with a DMN-encapsulated niacinamide skin patch, which was applied only on the right side of the face, while the left face remained free of a pigmentation-improving agent. A topical moisturizer and physical sunscreen were applied on both sides of the face for 2 weeks. We compared both sides of the face 2 weeks after applying the skin patch using an automatic skin analysis device to investigate skin pigmentation. The melasma severity scores of both sides were evaluated before and 2 weeks after application.Results A significant difference in the epidermal pigmentation score between pre-treatment and 2 weeks after treatment was noted on the right side (P<0.05), but not on the left side of the face (P>0.05). A significant difference in the melanin score between pre-treatment and 2 weeks after treatment was noted on the right side (P<0.05), but not on the left side (P>0.05) of the face. There was no significant difference in the melasma severity score on either side of the face between pre-treatment and 2 weeks after treatment (P>0.05).Conclusions The application of a DMN-encapsulated niacinamide skin patch to improve skin pigmentation may yield good outcomes and provide comfort to patients without any complications.
{"title":"A split-face study to evaluate the efficacy of a dissolving microneedle-encapsulated niacinamide skin patch for the reduction of facial hyperpigmentation","authors":"Joonsuk Bae, S. Nam, H. Cha, E. Park","doi":"10.14730/aaps.2022.00633","DOIUrl":"https://doi.org/10.14730/aaps.2022.00633","url":null,"abstract":"Background This study aimed to evaluate the efficacy and safety of a dissolving microneedle (DMN)-encapsulated niacinamide skin patch to reduce facial hyperpigmentation.Methods A split-face study was conducted between April and June 2022 in 17 patients treated with a DMN-encapsulated niacinamide skin patch, which was applied only on the right side of the face, while the left face remained free of a pigmentation-improving agent. A topical moisturizer and physical sunscreen were applied on both sides of the face for 2 weeks. We compared both sides of the face 2 weeks after applying the skin patch using an automatic skin analysis device to investigate skin pigmentation. The melasma severity scores of both sides were evaluated before and 2 weeks after application.Results A significant difference in the epidermal pigmentation score between pre-treatment and 2 weeks after treatment was noted on the right side (P<0.05), but not on the left side of the face (P>0.05). A significant difference in the melanin score between pre-treatment and 2 weeks after treatment was noted on the right side (P<0.05), but not on the left side (P>0.05) of the face. There was no significant difference in the melasma severity score on either side of the face between pre-treatment and 2 weeks after treatment (P>0.05).Conclusions The application of a DMN-encapsulated niacinamide skin patch to improve skin pigmentation may yield good outcomes and provide comfort to patients without any complications.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46266991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-30DOI: 10.14730/aaps.2022.00661
S.D. Yoon, S. Song, Young-Soo Choi
Keloid scars may cause a range of symptoms and aesthetic problems. The ear is one of the most frequent sites of keloids, and the earlobe and ear helix account for more than 80% of ear keloids. There are various surgical methods for removing keloids in the ear. Standard keloidectomy and core excision can be effective surgical methods compared to wedge resection since they preserve normal tissue surrounding the keloid. However, ears often show various types of asymmetry by default, which can be relatively difficult to detect, so wedge resection continues to be a useful surgical method for ear keloids. Here, we report four cases of keloids in the earlobe and ear helix that were successfully treated by wedge resection without a postoperative deformity or recurrence.
{"title":"Case series of keloid wedge resection in the ear: a focus on aesthetic aspects","authors":"S.D. Yoon, S. Song, Young-Soo Choi","doi":"10.14730/aaps.2022.00661","DOIUrl":"https://doi.org/10.14730/aaps.2022.00661","url":null,"abstract":"Keloid scars may cause a range of symptoms and aesthetic problems. The ear is one of the most frequent sites of keloids, and the earlobe and ear helix account for more than 80% of ear keloids. There are various surgical methods for removing keloids in the ear. Standard keloidectomy and core excision can be effective surgical methods compared to wedge resection since they preserve normal tissue surrounding the keloid. However, ears often show various types of asymmetry by default, which can be relatively difficult to detect, so wedge resection continues to be a useful surgical method for ear keloids. Here, we report four cases of keloids in the earlobe and ear helix that were successfully treated by wedge resection without a postoperative deformity or recurrence.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42172002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-30DOI: 10.14730/aaps.2022.00465
Woo Jung Choi, W. Song
We report a case of transient unilateral exotropia, a rare complication that occurred after an infraorbital local anesthetic injection, and present the possible mechanism underlying this adverse effect. A 64-year-old man underwent an excisional biopsy under local anesthesia for bilateral lower eyelid masses. He received a subcutaneous injection of a local anesthetic (a combination of 1:100,000 epinephrine and 2% lidocaine). Intraoperatively, we observed a homogeneous, fat-attenuated mass with thin fibrous septae inside the orbital septum of each eye. Following excision of the masses, the patient developed severe diplopia accompanied by exotropia, impaired adduction, and mydriasis of the right eye. The pupillary light reflex, visual acuity, and visual field test results were within normal ranges. Notably, his symptoms completely resolved 4 hours postoperatively without intervention. To our knowledge, transient unilateral exotropia following infraorbital local anesthetic injection is rare. The exotropia was attributed to diffusion of the epinephrine/lidocaine solution, which may have affected the ciliary ganglion and the medial rectus muscle. Caution is warranted during local anesthetic injections in patients who undergo periorbital surgery.
{"title":"Transient unilateral exotropia after an infraorbital local anesthetic injection: a case report","authors":"Woo Jung Choi, W. Song","doi":"10.14730/aaps.2022.00465","DOIUrl":"https://doi.org/10.14730/aaps.2022.00465","url":null,"abstract":"We report a case of transient unilateral exotropia, a rare complication that occurred after an infraorbital local anesthetic injection, and present the possible mechanism underlying this adverse effect. A 64-year-old man underwent an excisional biopsy under local anesthesia for bilateral lower eyelid masses. He received a subcutaneous injection of a local anesthetic (a combination of 1:100,000 epinephrine and 2% lidocaine). Intraoperatively, we observed a homogeneous, fat-attenuated mass with thin fibrous septae inside the orbital septum of each eye. Following excision of the masses, the patient developed severe diplopia accompanied by exotropia, impaired adduction, and mydriasis of the right eye. The pupillary light reflex, visual acuity, and visual field test results were within normal ranges. Notably, his symptoms completely resolved 4 hours postoperatively without intervention. To our knowledge, transient unilateral exotropia following infraorbital local anesthetic injection is rare. The exotropia was attributed to diffusion of the epinephrine/lidocaine solution, which may have affected the ciliary ganglion and the medial rectus muscle. Caution is warranted during local anesthetic injections in patients who undergo periorbital surgery.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49544021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-30DOI: 10.14730/aaps.2022.00535
T. Kong, Taegon Kim, Jun-Ho Lee
Background Acellular dermal matrix (ADM) is widely used for prosthetic breast reconstruction. Although many studies have investigated the efficacy and complications of ADM in prosthetic breast reconstruction, studies on drainage and seroma formation according to the size of ADM manufactured using the same process are lacking. This study analyzed drainage and seroma formation according to the size of sterile ADM.Methods From January 2011 to June 2018, the authors retrospectively reviewed the medical charts of patients who underwent direct-to-implant breast reconstruction using MegaDerm at a single institution. The ADMs used were classified as small or large groups. The two groups were compared in terms of the volume and duration time of two closed-suction drains (supramuscular and submuscular drains). Seroma and infection risk were also analyzed.Results Of 344 patients, 69 were included. Among them, 22 patients were in the small-ADM group and 47 patients were in the large-ADM group. The supramuscular drain volume (P=0.295) and time (P=0.365) were not significantly different between the two groups. However, the submuscular (P=0.001) and total drain volume (P=0.004) were higher in the large-ADM group. In addition, seroma occurred significantly more frequently in the large-ADM group (P=0.048), but there was no significant difference in minor infections (P=0.088).Conclusions The size of sterile ADM affected drainage and seroma formation, with a larger size increasing drain volume and seroma risk. This study could provide a clinical basis for the safe usage of large sterile ADM.
{"title":"Drainage and seroma formation according to the size of sterile acellular dermal matrix in direct-to-implant breast reconstruction","authors":"T. Kong, Taegon Kim, Jun-Ho Lee","doi":"10.14730/aaps.2022.00535","DOIUrl":"https://doi.org/10.14730/aaps.2022.00535","url":null,"abstract":"Background Acellular dermal matrix (ADM) is widely used for prosthetic breast reconstruction. Although many studies have investigated the efficacy and complications of ADM in prosthetic breast reconstruction, studies on drainage and seroma formation according to the size of ADM manufactured using the same process are lacking. This study analyzed drainage and seroma formation according to the size of sterile ADM.Methods From January 2011 to June 2018, the authors retrospectively reviewed the medical charts of patients who underwent direct-to-implant breast reconstruction using MegaDerm at a single institution. The ADMs used were classified as small or large groups. The two groups were compared in terms of the volume and duration time of two closed-suction drains (supramuscular and submuscular drains). Seroma and infection risk were also analyzed.Results Of 344 patients, 69 were included. Among them, 22 patients were in the small-ADM group and 47 patients were in the large-ADM group. The supramuscular drain volume (P=0.295) and time (P=0.365) were not significantly different between the two groups. However, the submuscular (P=0.001) and total drain volume (P=0.004) were higher in the large-ADM group. In addition, seroma occurred significantly more frequently in the large-ADM group (P=0.048), but there was no significant difference in minor infections (P=0.088).Conclusions The size of sterile ADM affected drainage and seroma formation, with a larger size increasing drain volume and seroma risk. This study could provide a clinical basis for the safe usage of large sterile ADM.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49614483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-30DOI: 10.14730/aaps.2022.00542
Min Young Kim, Jin Woo Kim, Hook Sun, J. Yun, Eui Han Chung
Known to be chemically inert, Aquafilling filler has been widely used in local aesthetic clinics in South Korea for breast augmentation. However, Aquafilling is only approved as a dermal filler and is not approved as an injectable filler for breast augmentation by the U.S. Food and Drug Administration or the Ministry of Food and Drug Safety. Several reports of complications following large-volume Aquafilling injections in the breast have been published. In this study, an HIV (human immunodeficiency virus)-infected transgender patient presented to the emergency room with a purulent infection of the breast and systemic fever. The patient had a history of large-volume Aquafilling injection in both breasts 3 years earlier to obtain a feminized appearance of the breasts. After using intravenous antibiotics and performing several surgical debridements over 4 weeks, the overall inflammatory response subsided. The skin defect site was covered successfully using an Integra Wound Matrix Dressing and there were no recurrent complications over 2 years of follow-up visits. Before injecting Aquafilling to augment patients’ breasts, a thorough consultation is mandatory, and doctors must notify patients that the risk of complications may be relatively high. Furthermore, any fillers including Aquafilling must not be used for unapproved purposes.
{"title":"Delayed purulent infected breast after a large-volume Aquafilling filler injection in an HIV-positive transgender patient: a case report","authors":"Min Young Kim, Jin Woo Kim, Hook Sun, J. Yun, Eui Han Chung","doi":"10.14730/aaps.2022.00542","DOIUrl":"https://doi.org/10.14730/aaps.2022.00542","url":null,"abstract":"Known to be chemically inert, Aquafilling filler has been widely used in local aesthetic clinics in South Korea for breast augmentation. However, Aquafilling is only approved as a dermal filler and is not approved as an injectable filler for breast augmentation by the U.S. Food and Drug Administration or the Ministry of Food and Drug Safety. Several reports of complications following large-volume Aquafilling injections in the breast have been published. In this study, an HIV (human immunodeficiency virus)-infected transgender patient presented to the emergency room with a purulent infection of the breast and systemic fever. The patient had a history of large-volume Aquafilling injection in both breasts 3 years earlier to obtain a feminized appearance of the breasts. After using intravenous antibiotics and performing several surgical debridements over 4 weeks, the overall inflammatory response subsided. The skin defect site was covered successfully using an Integra Wound Matrix Dressing and there were no recurrent complications over 2 years of follow-up visits. Before injecting Aquafilling to augment patients’ breasts, a thorough consultation is mandatory, and doctors must notify patients that the risk of complications may be relatively high. Furthermore, any fillers including Aquafilling must not be used for unapproved purposes.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46202027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-30DOI: 10.14730/aaps.2022.00500
O. Ilori, P. B. Olaitan, O. Ilori, A. Aderounmu
Background Following surgery or other types of trauma, scar formation occurs with wound healing because of the replacement of normal skin with fibrous tissue. The conversion of a normal scar to an abnormal scar usually occurs 6 to 8 weeks after surgery. Abnormal scars can be a source of patient dissatisfaction, especially following cosmetic surgical procedures. Therefore, supporting scars with tape after surgery is critical for reducing scar tension. The aim of this study was to determine the extent of patients’ satisfaction with their scar outcomes following microporous taping and to identify the determinants of scar satisfaction.Methods A prospective randomized controlled study was conducted to compare the scar satisfaction of postsurgical patients who underwent scar taping with microporous tape to those who did not. The scars were assessed at 6 weeks, 3 months, and 6 months after surgery using the Patient Scar Assessment Scale (PSAS). The test group had microporous tape applied to their scars and the tape was worn 24 hours a day for a period of 6 months. The data were analyzed using SPSS version 22.0. Categorical variables and mean PSAS scores were compared using the chi-square test and repeated-measures analysis of variance, respectively.Results At 6 weeks, 3 months, and 6 months the taped group had significantly lower PSAS scores and higher satisfaction scores than the control group. Scar thickness and pruritus were statistically significant determinants of patient satisfaction.Conclusions Microporous tape is an effective modality for improving scar satisfaction in postsurgical patients.
{"title":"Patients’ satisfaction with the effects of microporous tape on surgical scars: a randomized controlled study","authors":"O. Ilori, P. B. Olaitan, O. Ilori, A. Aderounmu","doi":"10.14730/aaps.2022.00500","DOIUrl":"https://doi.org/10.14730/aaps.2022.00500","url":null,"abstract":"Background Following surgery or other types of trauma, scar formation occurs with wound healing because of the replacement of normal skin with fibrous tissue. The conversion of a normal scar to an abnormal scar usually occurs 6 to 8 weeks after surgery. Abnormal scars can be a source of patient dissatisfaction, especially following cosmetic surgical procedures. Therefore, supporting scars with tape after surgery is critical for reducing scar tension. The aim of this study was to determine the extent of patients’ satisfaction with their scar outcomes following microporous taping and to identify the determinants of scar satisfaction.Methods A prospective randomized controlled study was conducted to compare the scar satisfaction of postsurgical patients who underwent scar taping with microporous tape to those who did not. The scars were assessed at 6 weeks, 3 months, and 6 months after surgery using the Patient Scar Assessment Scale (PSAS). The test group had microporous tape applied to their scars and the tape was worn 24 hours a day for a period of 6 months. The data were analyzed using SPSS version 22.0. Categorical variables and mean PSAS scores were compared using the chi-square test and repeated-measures analysis of variance, respectively.Results At 6 weeks, 3 months, and 6 months the taped group had significantly lower PSAS scores and higher satisfaction scores than the control group. Scar thickness and pruritus were statistically significant determinants of patient satisfaction.Conclusions Microporous tape is an effective modality for improving scar satisfaction in postsurgical patients.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42043049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-30DOI: 10.14730/aaps.2022.00577
Hyung Joon Seo, S. Park, Lan Sook Chang, Yeon Hwan Kim, Kyunghyun Min
Postmastectomy nipple necrosis is a factor that leads to a poor aesthetic outcome in breast reconstruction because of the unique projective structure of the nipple. We present a case of successful nipple reconstruction using a de-epithelialized rectangular flap. A 45-year-old woman was diagnosed with left breast cancer. She had a vertical scar below the nipple-areolar complex due to previous reduction mammoplasty. She underwent nipple-sparing mastectomy, breast reconstruction with a deep inferior epigastric artery perforator (DIEP) flap, and contralateral reduction. After the operation, the nipple gradually necrotized, and full-thickness nipple necrosis was observed on postoperative day 12. For nipple reconstruction, we designed a 38×23 mm rectangular flap from the DIEP flap considering the contralateral nipple diameter (12 mm), protrusion (2 mm), and ipsilateral mastectomy skin flap thickness (15 mm). The area in contact with the mastectomy skin flap was placed in the defect area after de-epithelialization. The reconstruction was successful and the nipple survived with a slight loss of projection. When unexpected nipple necrosis occurs after DIEP-based breast reconstruction, designing a de-epithelialized rectangular flap using the DIEP flap tissue is a feasible reconstructive method to consider.
{"title":"Successful reconstruction using a de-epithelialized rectangular flap on a nipple necrosis site after DIEP flap-based breast reconstruction: a case report","authors":"Hyung Joon Seo, S. Park, Lan Sook Chang, Yeon Hwan Kim, Kyunghyun Min","doi":"10.14730/aaps.2022.00577","DOIUrl":"https://doi.org/10.14730/aaps.2022.00577","url":null,"abstract":"Postmastectomy nipple necrosis is a factor that leads to a poor aesthetic outcome in breast reconstruction because of the unique projective structure of the nipple. We present a case of successful nipple reconstruction using a de-epithelialized rectangular flap. A 45-year-old woman was diagnosed with left breast cancer. She had a vertical scar below the nipple-areolar complex due to previous reduction mammoplasty. She underwent nipple-sparing mastectomy, breast reconstruction with a deep inferior epigastric artery perforator (DIEP) flap, and contralateral reduction. After the operation, the nipple gradually necrotized, and full-thickness nipple necrosis was observed on postoperative day 12. For nipple reconstruction, we designed a 38×23 mm rectangular flap from the DIEP flap considering the contralateral nipple diameter (12 mm), protrusion (2 mm), and ipsilateral mastectomy skin flap thickness (15 mm). The area in contact with the mastectomy skin flap was placed in the defect area after de-epithelialization. The reconstruction was successful and the nipple survived with a slight loss of projection. When unexpected nipple necrosis occurs after DIEP-based breast reconstruction, designing a de-epithelialized rectangular flap using the DIEP flap tissue is a feasible reconstructive method to consider.","PeriodicalId":41514,"journal":{"name":"Archives of Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47791427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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