Ken-ichiro Kasai

A CASE OF SIDEBURN RECONSTRUCTION USING A TEMPOROPARIETO-OCCIPITAL ISLAND FLAP

A preliminary case is reported in which a large temporal bald scar including the sideburn was successfully reconstructed using a temporoparieto-occipital island flap in combination with a tissue expander. This flap is considered to be a kind of reverse-flow island flap of the occipital artery by means of the fine vascular connections with the temporal branch of the superficial temporal artery. This new method is potentially a good solution for sideburn reconstruction.

Partial Eyebrow Reconstruction Using Subcutaneous Pedicle Flaps to Preserve the Natural Hair Direction

Five cases of partial eyebrow reconstruction using subcutaneous pedicle flaps from the ipsilateral eyebrow are presented. Proper use of this method will enable safe one-stage transfer of the skin and the eyebrow hair, preserving the natural hair direction and properties. It will also leave minimal scars and dog-ears. This method is especially suitable for the reconstruction of moderate- to small-sized eyebrow defects.

The Preoperative Use of Extra-tissue Expander for Syndactyly

To our knowledge, this is the first report of a method of stretching the interdigital skin of syndactyly by means of a pincer. The pincer, a U-shaped metal spring plate with a sponge cushion, is applied before the operation for about two months; pressure is placed against both sides of the interdigital fusion to expand the skin and to develop hollows. Use of the pincer facilitates a syndactyly operation by allowing defect coverage with a local flap only. Four patients successfully treated by this method are reported. The method has the great advantage of not requiring skin grafts, which often have unfavorable results both functionally and cosmetically.

Eyelash reconstruction with strip composite eyebrow graft.

Eyelash hairs have certain unique properties such as parallel direction, limited length, and tapering, which makes eyelash reconstruction considerably difficult. Several methods for eyelash reconstruction have been reported. Among them, strip composite eyebrow graft is the most suitable because the properties of eyebrow hairs are very similar to those of the original eyelash hairs. A rich blood supply in the eyelid ensures a good survival of the graft. Careful selection of the donor strip harvesting site is critical for preserving a good direction of hairs. The thickness of the graft strip should be determined considering the optimal thickness of hairs being obtained. When suturing the graft strip to the recipient bed, the burying method is suitable for preventing the protrusion of the graft. A well-performed surgical procedure results in a postoperative outcome that closely resembles the natural eyelashes.

Case Report The Successful Treatment of a Divided Nevus on a Young Patient Using a Modified Kuhnt-szymanowski Procedure

A 16-year-old boy underwent excision of a congenital divided nevus on his left eyelids. The defect of the lower eyelid was repaired utilizing a modified Kuhnt-Szymanowski procedure, and the part of the nevus on the upper eyelid was removed by simple horizontal excision and suture. The symmetry of both of his eyelids was successfully preserved without ectropion or conspicuous scars. This procedure is especially effective even in a young patient when removing a lesion extending to the lower ciliary border.

Naiplasty using a distally based ulnar finger dorsum flap

A case of reconstruction of the nail fold and the release of the scar contracture proximal to the nail matrix using a distally based ulnar finger dorsum flap and skin grafting is presented. An aesthetically fine nail fold was obtained, and the deformity of the nail plate was corrected by the relase of the scar contracture.

Alternating-pattern Z-plasties in association with V-Y advancements: a new idea of multiple Z-plasties.

A new principle of arrangement in multiple Z-plasties is advocated. By placing Zs in an alternating pattern in combination with V-Y plasties, more effective and harmless elongation of skin will be possible.