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KMID : 0358820090360050629
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Journal of Korean Society of Plastic and Reconstructive Surgeons
2009 Volume.36 No. 5 p.629 ~ p.636
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The Facial Tissue Expansion to Achieve the Natural Cervicomental Angle
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Lee Ki-Eung
Ko Jang-Hyu
Seo Dong-Kook
Lee Jong-Wook
Choi Jai-Koo
Jang Young-Chul
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Abstract
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Purpose: Wide scars occurring on the lower face and neck cause both functional and esthetic problems. Consequently, we can use skin grafts, pedicled flaps, free flaps, and tissue expansion for the reconstruction of this area. Compared with other reconstruction techniques, tissue expansion is advantageous in that it enables the maintenance of a color and texture similar to that of the adjacent tissue. However, the conventional method of tissue expansion has been reported to lead to an unnatural cervicomental angle and to the deformity of adjacent structures. We have therefore made efforts to prevent these problems through the use of several operative procedures. Methods: Forty-one patients with lower facial and cervical scars underwent tissue expansion. The tissue expansion was performed using a rectangular-shaped Nagosil$^{\circledR}$ 수식 이미지 tissue expansion device. On insertion of the tissue expander, the intermediate area of superficial fat layer was dissected and then the tissue expander was inserted to make a flap that was as thin as possible. In advancement of the flap, a capsule formed by the tissue expander was used for the interrupted fixed suture of the flap to the fascia of the platysma muscle of the neck. This procedure was performed multiple times and also performed between the flap and the periosteum of the mandible, such that the tension was removed during the suture of the flap margin. Finally, the patients were fitted with a Jobst$^{\circledR}$ 수식 이미지 facial garment in order to stabilize the operation site at least twelve months. Results: The most prevalent location of the scar was the cheek(15 cases), followed by the chin in 14 cases and the neck in 12 cases. The mean size of scar was 55.7${\pm}$ 수식 이미지 39.4$cm^2$ 수식 이미지. Conclusion: Using our procedures, we have experienced no significant deformities and have also achieved a more natural cervicomental angle in the patients.
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KEYWORD
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Burn scar reconstruction, Tissue expansion, Cervicofacial
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