Augmentation rhinoplasty

Augmentation rhinoplasty using a silicone implant is the most popular operation in Japan, but is not without several complications such as exposure of the implant and its deviation. We obtained good results in preventing these complications by a fixation at the hollow which is made by chiseling the frontal bone and by fibrous tissue which grows through the small holes of the implant tail.This paper was presented at the 36th Congress of the Japan Society of Aesthetic Plastic Surgery, Yokohama, Japan, May 16, 1987, and at the 9th Congress of the International Society of Aesthetic Plastic Surgery, New York, October 11–14, 1987     

The Round-Ear Incision in Full Face-Lifting

Several techniques for face-lifting have been described, all aimed at achieving a youthful appearance with a hidden scar. The authors are concerned about the conspicuous horizontal scar that travels all the way through the hairless skin behind the ears, which they consider very unpleasant and totally unnecessary. They are able to achieve a normal-appearing face with a safer technique that minimizes the visible scars such as the postauricular one, yet still has good and lasting results. In the past 9 years, 202 patients, men and women ages 38 to 86 years, have undergone surgery using the round-ear face-lifting technique, most of them with local anesthesia and sedation. The authors were able to achieve good and lasting results with a minimum of complications and to change the unaesthetic postauricular scar to a retroauricular one (with contouring of the concha) using a new design of marking the skin incisions. A new face-lifting incision is described. The procedure is suitable and safer for all patients requiring facial rejuvenation. The main advantage of this technique is the absence of visible postauricular scars. Paper presented at the 17th Congress of the International Society of Aesthetic Plastic Surgery (ISAPS), Houston, USA, 2004, and at the 18th Congress of the International Society of Aesthetic Plastic Surgery (ISAPS), Rio de Janeiro, Brazil, 2006.     

Management of cleft lip and palate in Brazil

We aimed to evaluate the treatment protocols for cleft lip and palate that are used in Brazil, to compare them with the ones proposed from elsewhere, and to discuss the official data about admission for treatment of cleft lip or palate, or both, in Brazil. We also assessed the importance of integrated action of different specialities to treat this condition. A questionnaire related to attendance protocols was developed and sent out to all Brazilian Plastic Surgery Services connected to the Brazilian Society of Plastic Surgery, and to other units involved in such treatment. We also studied the data produced by the Brazilian Department of Health about the operations done during the past five years. Many protocols were identified, but despite much controversy in many areas, a consensus was reached about the surgical techniques, the age group most suitable to be operated on, and there was total agreement about the need for multidisciplinary management. According to the State Department of Health, the number of operations done in 1995 was 9696, and this had increased to 21?022 in 1999. The state of São Paulo had done 17?636 (84%) of all procedures in 1999.     

Cleft lip repair

Summary The method is a modification of that of Millard and involves a small triangular flap on the end of the vermilion ridge. This approach provides continuity of the vermilion ridge, and promotes a natural appearance of the upper part of the philtrum on the cleft side. This surgical technique is applicable for all complete or incomplete unilateral cleft lips.Presented in part at the Second Congress of the Asian Pacific Section of the International Confederation for Plastic and Reconstructive Surgery, Tokyo, August 24, 1977     

Aesthetic camouflage of bilateral cleft lip scars: Technical revisions

We have attempted to change the two scar lines of bilateral cleft lip repair into one zigzag scar line. The prolabium is used to push up the columella and the nasal tip. The donor site of the prolabium is closed by transposition of the nasolabial flap. The postoperative scar shows one zigzag line at the center of the lip. This method has many advantages including an inconspicuous scar, repair of the short columella and flat nasal tip, repair of a wide nose, and repair of the whistling deformity.Complications of this method are maxillary retardation, long lip deformity, and keloid formation. However, these can be avoided by modifying the method.     

Aesthetic considerations of the cleft lip operation

The results of a cleft lip operation are checked from the anterior, the profile, and the caudal views and even if the deformities are minimal, for aesthetic reasons they should be repaired. Philtrum length, philtrum shape, philtrum depth, nasolabial triangular area, vermilion thickness, Cupid's bow peak, horizontal upper lip groove, vermilion border, alar size, depth of alar groove, nasal deviation, nostril shape, nasal tip, columella height, sill shape, columella width, and facial balance of the anterior, profile, and caudal views are used as aesthetic checkpoints for the results of a cleft lip operation. If deformities are found, the aesthetic plastic surgeon should repair them to achieve a more satisfactory result. In addition, augmentation rhinoplasty, augmentation mentoplasty, or other craniofacial surgery may be performed.Presented at the VIII Congress of International Society of Aesthetic Plastic Surgery, Madrid, Spain, September 15–18, 1985     

Simple Epicanthoplasty with Minimal Scar

Background Asian eyelids are characterized by the presence of an epicanthal fold and the absence of a supratarsal fold. Because many Asians desire wide, open, large eyes, elimination of the medial epicanthal fold along with double-eyelid operation frequently are performed for cosmetic improvement. Medial epicanthoplasty enhances the aesthetic result by lengthening the palpebral fissure horizontally, thus producing larger-looking, open eyes. This study describes the author’s method for correcting the medial epicanthal fold. Methods Simple epicanthoplasty with minimal scar, the author’s method, was performed to correct the epicanthal folds of 52 patients from December 2001 to August 2005 at the Catholic University of Korea Kangnam St. Mary’s Hospital. Results This technique yielded excellent results in terms of inconspicuous scar and long-lasting open medial canthal area during a 3-year follow-up period. Of the 52 patients, 2 showed a depressed scar on the lower eyelid, which was corrected satisfactorily. Conclusion Many procedures have been introduced to correct the epicanthal fold, but scarring or undercorrection remains as a dilemma for surgeons to overcome. Simple epicanthoplasty with minimal scar is a simple, easy-to-follow, and effective method that can be applied to various cases of medial epicanthal fold. Presented at the 55th Congress of the Korean Society of Plastic and Reconstructive Surgeons, in Seoul, Korea, November 13–15, 2003, and the 9th International Symposium of Facial Plastic Surgery, in Las Vegas, NV, May 1–4, 2006.     

The surgical management of upper eyelid hooding

A technique is described that aesthetically corrects brow ptosis and upper eyelid hooding in selected patients. This procedure is performed through a standard upper eyelid blepharoplasty incision and addresses the common findings of soft tissue fullness below the brow due to excessive suborbicularis fat and hypertrophied orbicularis oculi muscle.Presented at IXth Congress of the International Society of Aesthetic Plastic Surgery, New York New York October 1987Presented at 20th annual meeting of The American Society of Aesthetic Plastic Surgery, Los Angeles, California, March 1987     

Three-dimensional CT system using a personal computer

A three-dimensional CT display system using a personal computer was developed and used for diagnosis of craniofacial abnormalities. The advantages of this system are that it is inexpensive and easy to operate.Presented at the 10th Congress of the International Society of Aesthetic Plastic Surgery, Zurich, Switzerland, 11–14 September 1989     

Possible age-associated change at cellular level in cultured fibroblasts derived from scar tissue

Summary This study was performed employing cytogerontologic analysis to investigate the in vitro proliferative capacity of the fibroblasts of scar and normal dermis obtained from the same individual. Scarderived fibroblasts had a shorter in vitro lifespan, longer cell population doubling time, diminished cell numbers at confluency and lower percentages of cell able to incoporate ³H-thymidine than comparable firoblasts derived from normal dermis. These results may indicate that the growth characteristics of scar-derived fibroblasts resemble those of late-passage levels of normal dermal fibroblasts.Presented at the 25th Annual Meeting of Japan Society of Plastic and Reconstructive Surgery, Kanazawa, May 13, 1982     

Suggested nomenclature for aesthetic and reconstructive surgery of the breasts. IV: Congenital anomalies of the breast

A nomenclature for the definition, diagnosis, and surgical management of the congenital anomalies of the breast is suggested. The International Classification of Diseases (ICD) and the Current Procedural Terminology (CPT) code numbers pertaining to these anomalies have been tabulated.Presented at the 19th Annual Meeting of the American Society of Aesthetic Plastic Surgery, New Orleans, April 16, 1986     

Reduction malar plasty

Among Caucasians, augmentation malar plasty is occasionally performed, but, most often Orientals complain of the prominent zygoma and want an oval face. The procedure of the reduction malar plasty is not reported here. Instead, this article discusses the authors' method of reduction malar plasty and presents several cases.This paper was presented at the 6th Congress of the International Society of Aesthetic Plastic Surgery, Tokyo, September 29, 1981     

Two new free flaps developed from aesthetic surgery II. The inferior gluteal flap

A new vascular musculocutaneous flap from the lower buttock is described that is based on the inferior gluteal vessels and includes skin from the gluteal fold and a part of the gluteus maximus muscle. The inferior gluteal flap has been clinically used either as an island flap for sacral repair or as a free flap. The results of 6 clinical cases are presented and the features of the flap are exposed. The minimum residual deformity of the buttock contour and, even in some cases of trochanteric lipodystrophy, the cosmetic improvement of the donor site appearance are emphasized.Presented at the VIIth Congress of the International Confederation for Plastic and Reconstructive Surgery, May 21, 1979, in Rio de Janeiro, Brazil. (First prize award from the International Society of Aesthetic Plastic Surgery).     

A protocol for the treatment of hypertrophic scars and keloids

Hypertrophic scars and keloids still present problems in both white and pigmented skin. A treatment protocol is proposed: Hypertrophic scars are primarily treated with intralesional injections of corticosteroids or with compression therapy. Surgical scar revision is only secondarily indicated. Recurrent and resistant hypertrophic scars are surgically excised and postoperatively irradiated (twice with 400-cGy 7-MeV electron irradiation).Presented at the VIII Congress of the International Society of Aesthetic Plastic Surgery, Madrid, Spain, 16 September 1985     

One-stage reconstruction of a massive abdominal wall defect with multiple flaps

Summary It is difficult to repair large abdominal wall defects. Thus, such defects have been managed by many methods. In this paper, a one-stage repair of an exceptionally large defect of the abdominal wall is described: this resulted from an en bloc excision of a recurrent squamous cell carcinoma. Multiple flaps — a rectus abdominis myocutaneous flap, tensor fascia lata flap and gluteal thigh flap — were successfully used to close the defect.Presented at annual regional meeting of Japan Society of Plastic Surgery, Tokyo, December, 1989     

Correction of established capsular contractures with polyurethane implants

Twelve patients with severe and recurrent capsular contractures following breast augmentation and reconstruction were improved with polyurethane-covered implants. It still has not been established whether these implants prevent or merely delay the onset of contractures, but some of these patients have been followed for over three years and all 12 were improved.Presented at the 9th Congress of the International Society of Aesthetic Plastic Surgery, New York, October 11–16, 1987     

The retropectoral route for breast augmentation

The subpectoral approach, better called retropectoral, in breast augmentation procedures has been used in 52 patients with either hypoplastic or ptoticatrophied breasts, with excellent results. Breasts remained soft in all but 1 patient (who disregarded instructions regarding arm activity). Capsular formation was avoided and no lateral displacement when the arms were elevated has been observed. Postoperatively there is a superior bulging of the breast, but this subsides within 4 to 6 weeks and the breast assumes a normal, pleasant contour.Paper presented at the 6th Congress of the International Society of Aesthetic Plastic Surgery, Tokyo, 1981     

Combined use of two different fasciocutaneous flaps with distal and proximal pedicles in the repair of lower extremities

Reconstruction of extensive middle third defects of the lower leg has always presented problems. Seven patients with large anterior middle third crural defects were included in this study. A combination of two different flaps were used to reconstruct the defects. In all cases, the defects were reconstructed successfully.Presented at the 13th Congress of the Turkish Society for Plastic Surgery, Nevsehir, October 23–25, 1991     

Present status and future prospects for aesthetic plastic surgery

The recent developments and changes in surgical procedures such as rhytidectomy, blepharoplasty, nasoplasty, otoplasty, mammoplasty, mammary reconstruction, and abdominoplasty are briefly reviewed in this article, which is substantially reduced in its overall length from the guest lecture given by the author at the Seventh International Congress of Plastic and Reconstructive Surgery held in Rio de Janeiro in May 1979, in his role as president of the International Society of Aesthetic Plastic Surgery (ISAPS).     

A histopathological study of the percutaneous implantation of polyester fibers

A histopathological study was made on scalp biopsies at 1 day, 1 week, 2 weeks, 1 month, 2 months, 5 months, and 20 months following implantation of synthetic fibers developed as artificial hair in Japan, in order to determine the histological conditions of its fixation over an extended period. In addition, the operative technique and materials for implantation were explored.Presented at the 8th International Congress of Plastic and Reconstructive Surgery, Montreal, Canada, July 1, 1983 Address reprint requests to Sho Taniguchi, M.D., Department of Plastic and Reconstructive Surgery, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660, Japan