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The article presents a case study of a 20-year-old man with a defect on the pretarsal portion of his lower eyelid. A full-thickness skin graft was taken from the retroauricular area to reconstruct the defect. It states that a bipedicled skin flap was used after excision of a divided nevus. A discussion on the difference between treatment of a nevus in the eyelid and reconstructive procedures for posttraumatic defects and malignant tumors is also provided.

Background: Although radiation-induced skin injuries are a concern in patients receiving radiation therapy, there are few effective treatments. The aim of this study was to evaluate the protective effects of extracorporeal shock wave therapy (ESWT) on irradiated fibroblasts and mouse skin., Methods: In the in vitro study of human dermal fibroblasts, the experimental group was subjected to ESWT following irradiation (20 Gy). The control groups were only irradiated or only subjected to ESWT. At 24 or 48 h post-ESWT, cell viability, cell migration, and mRNA and protein expression were measured. In the in vivo study, the experimental group (7 mice) was treated with ESWT following irradiation (45 Gy). The control group (7 mice) was only irradiated. At 8 weeks post-irradiation, dorsal skin was harvested for histopathologic examination and protein isolation., Results: In dermal fibroblasts, treatment with ESWT increased viability of irradiated cells compared with irradiated-only and untreated cells (p = 0.005). ESWT increased cell migration 24 h post-irradiation (p = 0.002), and decreased TGF-β1 protein expression 48 h post-irradiation (p = 0.024). In mice, ESWT decreased the level of radiation-related skin injury (p = 0.006). Treatment of irradiated skin with ESWT decreased TGF-β1 (p = 0.009) and phospho-Smad3 (p = 0.009) protein expression, as well as decreasing myofibroblasts (p = 0.047) and increasing vessel density (p < 0.001)., Conclusions: Our study demonstrated that ESWT alleviated radiation-induced fibrosis by downregulating TGF-β1 expression. It suggests the potential of ESWT for the treatment of radiation-induced fibrosis., (Copyright © 2024 by the American Society of Plastic Surgeons.)

Background: There are various opinions on the optimal timing for performing secondary alveolar bone grafting (SABG). This study compared dental health and 3-dimensional outcomes according to the timing of SABG surgery., Patients and Methods: A retrospective chart review was performed in patients who underwent SABG between January 1996 and October 2020. Patients were divided into early SABG (6-8 y old) and traditional SABG (9-13 y old) groups. The final dental survival of the lateral incisor and canine teeth, survival of the bone graft, and maxillary growth were analyzed using plain radiographs and computed tomography with a 3-dimensional volumetric analysis tool., Results: Thirty-six patients were divided into an early group (15 patients) and a traditional group (21 patients). Five patients had bilateral cleft lip, and 26 patients had unilateral cleft lip and palate; therefore, 36 alveolar clefts were analyzed in this study. Lateral incisor survival was significantly greater in the early group than in the traditional group (60% vs. 23.5%; P<0.05). Compared with that in the traditional group, graft success in the early group was greater (80% vs. 57.1%; P<0.05). Three-dimensional volumetric analysis revealed superior bone graft efficiency in the early group compared with the traditional group (55.2 vs. 38.5%; P<0.05). There was no significant difference in maxillary growth between the 2 groups., Conclusions: In our study, superior dental and clinical outcomes were observed in the early SABG group without any long-term complications or maxillary retrusion. Our institution cautiously indicated that SABG could be performed at an age earlier than the existing SABG performed after 9 years old., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Background: Although previous clinical studies have reported that cell-assisted lipotransfer increases the fat survival rate in facial fat transplants, most were case studies without quantitative evaluation. A multicenter randomized controlled study was performed to evaluate the safety and efficacy of the stromal vascular fraction (SVF) in facial fat grafts., Methods: Twenty-three participants were enrolled for autologous fat transfer in the face, and assigned randomly to the experimental ( n = 11) or control ( n = 12) group. Fat survival was assessed using magnetic resonance imaging at 6 and 24 weeks postoperatively. Subjective evaluations were performed by the patients and surgeons. To address safety concerns, results of an SVF culture and the postoperative complications were recorded., Results: The overall fat survival rate was significantly higher in the experimental group than in the control group (6 weeks, 74.5% ± 9.99% versus 66.55% ± 13.77%, P < 0.025; 24 weeks, 71.27% ± 10.43% versus 61.98% ± 13.46%, P < 0.012). Specifically, graft survival in the forehead was 12.82% higher in the experimental group when compared with that in the control group at 6 weeks ( P < 0.023). Furthermore, graft survival in the forehead ( P < 0.021) and cheeks ( P < 0.035) was superior in the experimental group at 24 weeks. At 24 weeks, the aesthetic scores given by the surgeons were higher in the experimental group than in the control group ( P < 0.03); however, no significant intergroup differences were noted in the patient-evaluated scores. Neither bacterial growth from SVF cultures nor postoperative complications were noted., Conclusion: SVF enrichment for autologous fat grafting can be a safe and effective technique for increasing the fat retention rate., Clinical Question/level of Evidence: Therapeutic, II., (Copyright © 2023 by the American Society of Plastic Surgeons.)

The nasal septum plays an important role in nose development. East Asians are believed to have inherent hypoplasia of the nasal septum because East Asians have smaller noses than whites do. However, there have been no studies of nasal septum differences between whites and East Asians. We compared the nasal septum and its components in Koreans and whites using computed tomographic scan data. Twenty-seven patients of white origin and 64 patients of Korean origin older than 20 years were enrolled in this study between 2008 and 2012. We evaluated a total of 9 measurement items (5 for the nasal bones and septa as well as 4 for the external nose morphology). Sex differences in whites were the same as those in Koreans. Nasal bridge length and cartilaginous nasal bridge length were significantly longer in whites than in Koreans. However, there were no significant differences in nasal height, nasal tip projection, nasal bone length, total septal area, or most components of the nasal septum between the samples. The relative proportions of the cartilaginous septum divided by the total septal area were negatively correlated with the relative proportions of the perpendicular plate in both groups. Differences in the external nasal morphology between whites and Koreans are not caused by differences in the nasal septum.