Surgical Correction of the Lying Ear Deformities.

BACKGROUND: In contrast to prominent ear, lying ear can be defined when the antihelix of the ear is excessively folded, i.e., the conchoscaphal angle is much less than 90°. In such case, ears may look smaller than the face. These patients want their ears to be exposed more. In Asia, there is also a tendency to prefer large and long ears. The objective of this study was to present a surgical method for correcting lying ear deformities. METHODS: From August 2017 to June 2018, 37 patients (72 ears) underwent surgery using our surgical method for lying ear deformities. After the cartilage was exposed on the posterior auricular surface, the fibrous band present at the conchoscaphal angle was released. Two longitudinal cartilage incisions were performed along the border of the antihelix. Horizontal mattress sutures were performed on the cartilage until the conchoscaphal angle was close to 90°. Onlay cartilage grafting was performed for the most severe portion of the deformity. RESULTS: We performed reoperation for four patients due to recurrence (n = 2), under-correction (n = 1), and cartilage exposure (n = 1). Most patients obtained satisfactory aesthetic results. CONCLUSIONS: There have been few reports of the surgical method for lying ear deformities. Our surgical method can provide satisfactory clinical outcomes for correcting lying ear deformities. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effect of Low-Level Laser Therapy on Human Adipose-Derived Stem Cells: In Vitro and In Vivo Studies.

BACKGROUND: Low-level laser therapy (LLLT) continues to receive much attention in many clinical fields. Also, LLLT has been used to enhance the proliferation of various cell lines, including stem cells. This study investigated the effect of LLLT on human adipose-derived stem cells (ADSCs) through in vitro and in vivo studies. METHODS: Low-level laser irradiation of cultured ADSCs was performed using a 830 nm Ga-Al-As (gallium-aluminum-arsenide) laser. Then, proliferation of ADSCs was quantified by a cell counting kit-8. In the in vivo study, irradiated ADSCs or non-irradiated ADSCs were transplanted, and then, low-level laser irradiation of each rat was performed as per the protocol. Cell viability was quantified by immunofluorescent staining using the human mitochondria antibody. RESULTS: In the in vitro study, the laser-irradiated groups showed an increase in absorbance compared to the control group. Also, in the in vivo study, there was a significant increase in the number of human ADSCs in the laser-irradiated groups compared to the control group (p < 0.001). CONCLUSIONS: Our study showed that LLLT could enhance the proliferation and viability of ADSCs. The ADSCs enhanced by LLLT could be applied in various clinical fields. With the use of LLLT, the proliferation and viability of various cells can be enhanced, besides ADSCs. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Whitening effects of adipose-derived stem cells: a preliminary in vivo study.

UNLABELLED: Many studies have reported various growth factors secreted from adipose-derived stem cells (ADSCs). In particular, regenerative effects in skin have received much attention in the clinical fields. The in vitro whitening effects of ADSCs have been reported. A previous study demonstrated that ADSCs secrete growth factors that inhibit both melanin synthesis and tyrosinase activity. This study aimed to investigate the in vivo whitening effect of ADSCs using mouse models. In the study, ADSCs were isolated from the adipose tissue of C57BL/6 mice and cultured. The ADSCs (1 × 10(6) cells in 30 µl of Hanks' balanced salt solution [HBSS]) then were injected intradermally in the dorsal area of the right ear, and 30 µl of HBSS was injected on the left ear as a control. After 7 days, both ears were irradiated with ultraviolet B (UVB) (150 mJ/cm(2)) three times at 2-day intervals. The sections of each ear were stained with hematoxylin-eosin, Fontana-Masson, and HMB-45 (a melanocytic cell-specific monoclonal antibody). The histologic parameters evaluated included inflammation (+/-), erosion (+/-), and melanin formation (graded on a scale of 1 to 3). No significant differences in inflammation or erosion were observed by hematoxylin and eosin staining (inflammation: p = 0.388; erosion: p = 0.355). However, significantly more melanin formation was observed in the control group than in the ADSC injection group by Fontana-Masson and HMB-45 staining (Fontana-Masson: p = 0.025; HMB-45: p = 0.015). The study findings suggest that ADSCs inhibit melanin formation induced by UV exposure. Potentially, ADSCs may be used as anti-aging agents, including skin whitening. Before human clinical studies can be conducted, further study is required to determine the mechanisms underlying the whitening effects of ADSCs and the safety of ADSC use. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The skin-tightening effects of 1,444-nm Nd:YAG laser on human skin: an in vivo study.

BACKGROUND: The 1,444-nm Nd:YAG laser was developed to improve the removal of fat cells and to affect the underlying dermis with the aim of skin tightening. We conducted this study to evaluate whether this laser is effective in tightening the skin and causing histological alterations to dermal collagen fibers, fibroblasts, mucopolysaccharides, and elastin. METHODS: In a 38-year-old patient who was scheduled to undergo elective abdominoplasty, we subdermally performed laser-assisted treatment with the 1,444-nm Nd:YAG laser using different power settings over periods of 3 months and 1 month and prior to surgery. Postoperatively, we evaluated the skin-tightening effect through histopathologic examination. RESULTS: On histopathology examination, the thickness of the dermis had gradually increased following the 3-month treatment with laser irradiation. In the treatment groups on the abdomen, the collagen fibers were arranged in a more parallel pattern and became denser than those in the control group. Likewise, fibroblast proliferation and the levels of mucopolysaccharides and elastin were higher in the treatment groups than in the control group. CONCLUSIONS: The 1,444-nm Nd:YAG laser was effective in promoting the remodeling of the dermis and the regeneration of collagen fibers. As such, the 1,444-nm Nd:YAG laser could be used for skin tightening in addition to its function in lipolysis. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Safety of adipose-derived stem cells and collagenase in fat tissue preparation.

UNLABELLED: Recently, various studies using adipose-derived stem cells (ADSCs) have been performed. However, the safety of ADSCs has not been determined, and protocols for isolating ADSCs have not been established. This study evaluated the activity and toxicity of residual collagenase in isolated ADSCs and the carcinogenicity of these cells. It evaluated the current use of ADSC-related procedures in South Korea as reference data for the authors' studies. The study surveyed 100 private plastic surgical clinics, 68 plastic surgery departments at general and university hospitals, and 5 biotechnology companies by telephone. Among these, 14 institutions were surveyed using a more detailed questionnaire about ADSC-related procedures and methods of processing adipose tissue. The survey also evaluated the residual collagenase activity during five washes of the ADSC isolation procedure with furyl acryloyl-Leu-Gly-Pro-Ala (FALGPA) and ninhydrin assays. A 4-week toxicity study in non-obese diabetes/severe combined immunodeficiency (NOD/SCID) mice was performed as well as a tumorigenicity study in BALB/c-nu mice using ADSCs from the first and third washes. According to the findings, ADSC-related procedures were performed in 16 % of the private clinics and 14.7 % of the general hospitals surveyed. Among the 14 institutions, 0.1 % type 1 collagenase was used most frequently, and three washes generally were performed. After the first wash, residual collagenase activity was the same as in the blank group (saline only). No toxicity resulting from residual collagenase or tumorigenicity associated with the ADSCs was observed. The results of the current study may be beneficial for establishing safe ADSC isolation protocols and can be used as fundamental data for clinical applications involving ADSCs. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A Comparison of Smooth and Microtextured Breast Implants in Breast Augmentation: A Retrospective Study.

Background The number of cosmetic and reconstructive surgeries that use breast implants is increasing in Korea. Recently, it has been reported that breast implant-associated anaplastic large-cell lymphoma is related to textured breast implants, and interest in classification according to the texture of breast implants is increasing. However, there is currently no clear and unified classification. In particular, the definition of "microtextured" is highly varied. In this study, we retrospectively investigated and analyzed the clinical outcomes of smooth and microtextured breast implants. Methods A retrospective chart review of all patients who underwent breast augmentation surgery with smooth and microtextured silicone gel implants between January 2016 and July 2020 was performed. We retrospectively analyzed implant manufacturer, age, body mass index (BMI), smoking status, incision location, implant size, follow-up period, complications, and reoperation rate. Results A total of 266 patients underwent breast augmentation surgery, of which 181 used smooth silicone gel implants and 85 used microtextured silicone gel implants. Age, BMI, smoking status, implant size, and follow-up period were not significantly different between the two groups. Similarly, complications and reoperation rates were not significantly different between the two groups. Conclusion It is important to provide information regarding the clinical risks and benefits of breast implants to surgeons and patients through a clear and unified classification according to the texture of the breast implant.

Frontal peripheral osteomas: a retrospective study.

BACKGROUND: Osteomas are benign, slow-growing bone tumors that can be classified as central, peripheral, or extraskeletal. Central osteomas arise from the endosteum, peripheral osteomas from the periosteum, and extraskeletal osteomas within the muscle. Frontal peripheral osteomas are mainly encountered in plastic surgery. In this study, we retrospectively analyzed the clinical data of patients with frontal peripheral osteomas. METHODS: We retrospectively reviewed the medical records of patients who visited our hospital with frontal peripheral osteomas between January 2014 and June 2022. We analyzed the following variables: age, sex, tumor type (sessile or pedunculated), single or multiple, size, history of head trauma, operation, and recurrence. RESULTS: A total of 39 patients and 41 osteomas were analyzed, of which 29 osteomas (71%) were sessile and 12 osteomas (29%) were pedunculated. The size of the osteomas ranged from 4 to 30 mm, with an average size of 10 mm. The age of patients ranged from 4 to 78 years with a mean age of 52 years. There were seven men (18%) and 32 women (82%), and the man-to-woman ratio was 1:4.6. Two patients (5%) had multiple masses, with two osteomas in each, while only two patients (5%) had a history of head trauma. Twenty-nine patients (74%) underwent ostectomy by a direct approach, and none of the patients experienced recurrence. CONCLUSION: The epidemiologic data of our study will help plastic surgeons encounter frontal peripheral osteomas in the field to provide proper management for their patients.

The perilobule approach to subcondylar fractures.

Several approaches to the management of subcondylar fractures have been used, including the submandibular approach, the preauricular approach, and the retromandibular approach. Although they provide excellent access to repair fractures of body, ramus, and condyle, we have found it difficult to manage subcondylar fractures using either of these approaches. We describe a novel approach for subcondylar fractures that provides direct access to the fracture site. A total of 17 consecutive patients underwent open reduction and internal fixation of their subcondylar fractures using this technique. The incision line is located just anterior and posterior to the ear lobe, and is comprised of lower part preauricular and upper retroauricular incisions. Intraoperatively, the method applied shortened the time necessary for and simplified the procedure of reduction and osteosynthesis. The postoperative course was uneventful in most patients. Radiologic follow-up revealed correct reduction and fixation in all the cases. There were no occlusal disturbances, no trismus, no lateral deviations of the mandible, and no nerve lesions. Our findings indicate that the short perilobe approach is an easy and safe technique for displaced subcondylar fractures.

Effects of COVID-2019 on plastic surgery emergencies in Korea.

BACKGROUND: To fight the coronavirus disease 2019 (COVID-19) pandemic, many countries have implemented social distancing and lockdowns. We investigated the changes in the trauma patterns of emergency plastic surgeries in the midst of a pandemic. METHODS: A retrospective review of the medical records of all patients treated for emergency plastic surgeries was performed at our hospital in Seoul. We conducted the analysis between March 1 and June 30, 2020, and compared the data obtained with that of the same period in 2019. We also investigated changes in trauma patterns according to the social distancing level from July 2020 to February 2021. RESULTS: There was a total of 800 emergency plastic surgery patients from March to June 2020, which was less than the 981 in the corresponding period in 2019. The proportion of patients aged 7-17 years and ≥ 80 in 2020 showed a significant decrease. In 2020, patients presenting with facial trauma decreased and hand trauma, markedly laceration, increased significantly. In 2020, more injuries happened at home, whereas significantly fewer injuries happened on the streets. In 2020, slipping and sports injury decreased, whereas penetrating injury increased significantly. In the changes observed according to the social distancing level, there were significant differences in age classification, facial open wound, and the mechanism of injury. CONCLUSION: Social distancing has caused a change in emergency plastic surgeries. To ensure safe and appropriate treatment, strict epidemiologic workup and protective equipment are required.

Rhinoplasty using rib chondro-osseous graft in Asian patients.

Corrective rhinoplasty for functional and aesthetic recovery relies much on the use of grafts. This may be effectively accomplished with alloplastic materials; however, certain circumstances mandate the use of autologous grafts. Septal and auricular cartilages are inadequate for dorsal augmentation of the Asian nose. Here, we present our experiences with the correction of nasal deformities using chondro-osseous rib grafts, aiming at anatomic and functional reconstruction of the nose dorsum, especially the keystone area. The deformity was the result of trauma in 16 patients, postrhinoplastic deformities in 7, and congenital deformities in 5 patients. All the patients underwent reconstructive rhinoplasty using the sixth or seventh rib complex graft. Overall, functional and aesthetic outcome was satisfactory in all patients. Rigid bony union, good nasal projection, and symmetry were obtained. Graft exposure, displacement, warping, and significant bone absorption were not observed. The seventh or sixth rib provided not only the greatest overall available length and thickness, but also less donor-site morbidity. In conclusion, using rib bone and cartilage combination graft as a single unit allowed more predictable and reliable reconstruction of the nose deformity than did the conventional dorsal grafts.

Scar-free technique for inverted-nipple correction.

Background Inverted nipples are associated with aesthetic,functional, and psychological problems. In moderate to severe cases, triangular areolar dermal flap-based method scan effectively correct the condition. A triangular areolar dermal flap supports the nipple base as a result of a hammock-like action and fills the dead space beneath the nipple.However, these flaps leave visible scars on or deform the areola.Methods The authors describe a new technique based on the use of two triangular flaps. Compared with other techniques that use triangular flaps, the described technique does not involve areolar skin. Instead, triangular dermal flaps are elevated under the areolar skin, which overcomes the visible scarring issue. The devised technique has been used to correct 87 inverted nipples of 46 patients at our institute.Results No complications or recurrences were encountered,and resulting scars were almost invisible. All patients were satisfied with their postoperative results.Conclusion The described technique is straight forward and reliable and does not leave visible scars on areolar skin. In particular, it has been found to be especially useful for treating moderately to severely inverted nipples.

Effects of fat preparation methods on the viabilities of autologous fat grafts.

Fat grafts are commonly used in plastic surgery, but their unpredictable absorption rates are a considerable disadvantage. Furthermore, no agreement has been reached regarding the method that best enables fat graft survival. This study aimed to evaluate the effects of different preparation methods on fat graft viability. Fat tissue was harvested from the remnants of transverse rectus abdominis musculocutaneous (TRAM) flaps by syringe aspiration. Harvested fat tissue was prepared using three different methods: centrifugation, metal sieve concentration, and cotton gauze concentration. To evaluate the viabilities of fat cells, XTT assays were performed. For the study, 18 nude mice were allocated to three groups: the centrifugation, metal sieve, and cotton gauze groups (6 mice per group). Prepared fat (1 ml) was injected into the nuchal area of the mice, and 12 weeks later, grafts were dissected to determine graft survival rates and subjected to histologic analysis. No significant differences were observed in graft survival rates and histologic findings (necrosis and vascularity) between the three groups. However, histologic analysis found the metal sieve group to have significantly lower fat cell viability and more inflammation than the other two groups. The findings suggest that the closed centrifugation technique has no advantage over the open cotton gauze technique in terms of fat graft viability, and that the metal sieve concentration method is deficient as a preparation method because it can cause grafted fat degradation.

Classification of Mouth Corners in Asian Women.

BACKGROUND: There is increasing interest in mouth corner lift (MCL), as well as lip augmentation. Procedures for lip corner lifting to create smiling lips include botulinum toxin, injectable filler, and surgery. However, there is no proper system to classify mouth corners, thereby causing difficulties in patient counseling, treatment planning, and communicating with medical staff. We developed a new classification system to analyze the shape of mouth corners in Asian women. METHODS: Lip shapes were classified as types I (arched upper lip) and II (flat upper lip), each of which was further classified as subtypes a (upturned mouth corner) and b (flat or downturned mouth corner). Atypical cases were classified as type III. The anterior-posterior view of facial photographs were taken of female patients aged 20-40 years who visited HB Plastic Surgery Clinic between January 2017 and December 2018. Patients who visited for surgery other than lip plastic surgery (group A) and those who visited for MCL (group B) were compared. Changes in mouth corner type across age were examined. RESULTS: The most common type was IIb in group A and Ib in group B. IIa and IIb were more common in group A, whereas Ib was more common in group B, at a statistically significant level. With increasing age, the proportions of IIb and III tended to increase, and Ia and IIa tended to decrease. CONCLUSION: This relatively simple classification system for mouth corners might be helpful in patient counseling and communication with medical staff during plastic surgery.

Multi-modal treatment strategy for achieving an aesthetic lower face.

BACKGROUND: Most women consider an oval-shaped face to be youthful and beautiful. In recent years, demand has grown for surgical procedures with a shorter downtime and fewer complications. These minimally invasive procedures include botulinum toxin type A (BoNTA) injection, filler injection, suction-assisted liposuction (SAL), laser-assisted lipolysis (LAL), thread lifting, and fat grafting. This study aims to introduce an effective method for creating an aesthetically pleasing lower face using a combination of minimally invasive procedures. METHODS: From March 2017 to March 2019, 94 patients simultaneously underwent LAL, SAL, and thread lifting. Ancillary procedures such as BoNTA injections, hyaluronic acid filler injections, and removal of the buccal fat pad (BFP) were selectively performed according to the patient's condition. RESULTS: Patients rated their postoperative satisfaction as very satisfied, satisfied, dissatisfied, or very dissatisfied. Approximately 83% of all respondents were satisfied with the results, whereas the remaining respondents had complaints regarding the outcomes. The most common reasons for dissatisfaction were a longer-than-expected recovery time and undercorrection, and the most severe complaint was skin depression as a result of overcorrection. CONCLUSIONS: Our method of simultaneously performing LAL, SAL, and thread lifting, while adding BoNTA, filler injections, and BFP removal as needed, was capable of producing consistent and reliable aesthetic outcomes for the lower face.

A modified method for corner mouth lift in scar-prone patients.

Corner mouth lift is in increasing demand among young patients in East Asia. Although various surgical methods exist for corner mouth lift, many patients are reluctant to undergo surgery due to fears of postsurgical scarring. We present a new technique aimed at reducing postoperative scarring. The technique involves triangular excision of the corner of the mouth and incision of the commissure with transposition of a lateral vermilion flap to lift the corner of the mouth. The muscle around the corner of the mouth is dissected to release tension. The corner mouth lift was successfully performed in all patients. It can be effectively used even in patients, such as young Asian women, who are susceptible to hypertrophic scars.

Lower facial contouring surgery using a novel method: M-genioplasty.

BACKGROUND: Mandibular contouring surgery to produce a more slender and small face has become popular, especially in East Asia. Narrowing genioplasty should be simultaneously performed with mandibular angle resection to achieve satisfactory results. In Korea, T-genioplasty has been frequently performed for chin narrowing. The authors developed a new, safe, and reliable method, termed M-genioplasty, that can provide a more slender and attractive lower face. METHODS: From June 2013 to December 2017, 36 patients underwent M-genioplasty with mandibular angle resection for lower facial contouring. Horizontal and vertical osteotomies were performed obliquely. The resected bone segments were wedge-shaped. The remaining two bone segments were rotated and approximated centrally. The lateral mandible bony stepoff was trimmed off for mandibular angle resection. RESULTS: In all patients, the facial contour sufficiently improved, and most patients were satisfied with the outcome. No severe complications took place during postoperative follow-up. CONCLUSIONS: M-genioplasty can provide more mandibular angle resection and can create a more acute chin angle without bone resorption than other methods, including T-genioplasty. M-genioplasty with mandibular angle resection is a safer, more accurate, and more reliable method for lower facial contouring.

Osteomyelitis following Domestic Animal Bites to the Hand: Two Case Reports and Practical Guidelines.

Recently, the number of cases of animal bite wounds has increased significantly in concordance with an increase in the pet population around the world. The authors report two rare cases of osteomyelitis of the phalanx following cat and dog bites. On initial physical examination, signs of a severe infection were observed. Radiographs of both patients showed the presence of osteomyelitis, and in one of the patients, the diagnosis was confirmed with a bone biopsy. After use of empirical antibiotics, intravenous antibiotic therapy that matched the identified bacterium's sensitivity was initiated, and at the same time, secure dressing including debridement was performed to induce secondary healing. In addition, the patients were closely monitored with serial X-rays, and culture and blood test follow-up. One patient fully recovered without sequelae, but the other patient suffered a loss of distal interphalangeal joint motion. When dealing with bite wounds located on the hand, it is important to visit the hospital as soon as possible and receive the appropriate treatment early. Moreover, to prevent severe complications such as osteomyelitis, it is important to administer antibiotic therapy to which the cultured bacteria are sensitive, along with proper wound management and prophylactic antibiotic treatment.

Anthropometric Analysis of Facial Foramina in Korean Population: A Three-Dimensional Computed Tomographic Study.

BACKGROUND: Position of the facial foramina is important for regional block and for various maxillofacial surgical procedures. In this study, we report on anthropometry and morphology of these foramina using three-dimensional computed tomography (3D-CT) data. METHODS: A retrospective review was performed for all patients who have undergone 3D-CT scan of the facial skeleton for reasons other than fracture or deformity of the facial skeleton. Anthropometry of the supraorbital, infraorbital, and mental foramina (SOF, IOF, MF) were described in relation to facial midline, inferior orbital margin, and inferior mandibular margin (FM, IOM, IMM). This data was analyzed according to sex and age. Additionally, infraorbital and mental foramen were classified into 5 positions based on the anatomic relationships to the nearest perpendicular dentition. RESULTS: The review identified 137 patients meeting study criteria. Supraorbital foramina was more often in the shape of a foramen (62%) than that of a notch (38%). The supraorbital, infraorbital, and mental foramina were located 33.7 mm, 37.1 mm, and 33.7 mm away from the midline. The mean vertical distance between IOF and IOM was 13.4 mm. The mean distance between MF and IMM was 21.0 mm. The IOF and MF most commonly coincided with upper and lower second premolar dentition, respectively. Between the sex, the distance between MF and IMM was significantly higher for males than for female. In a correlation analysis, SOF-FM, IOF-FM and MF-FM values were significantly increased with age, but IOF-IOM values were significantly decreased with age. CONCLUSION: In the current study, we have reported anthropometric data concerning facial foramina in the Korean population, using a large-scale data analysis of three-dimensional computed tomography of facial skeletons. The correlations made respect to patient sex and age will provide help to operating surgeons when considering nerve blocks and periosteal dissections around the facial foramina.

Chondroid Syringoma on Face.

Chondroid syringoma is a rare mixed tumor of the skin which is composed of both mesenchymal and epithelial cells. Its incidence at less than 0.1% and is frequently located on the head and neck. Chondroid syringoma is easily confused with epidermal cysts. Since malignant forms of chondroid syringoma have been reported, accurate and timely diagnosis is important for proper management. We report clinical and histological features of chondroid syringoma in 5 patients treated at our institution. In most of the cases, chondroid syringoma presented as a round, firm, nodular or cystic lesion that had well marginated heterogeneity in sonography. Clinically, all of the lesions were removed by simple excision. Microscopically, all five tumors were well circumscribed and consisted of epithelial, myoepithelial, and stromal components. The epithelial component formed tubules lined by one or more rows of eosinophilic epithelial cells. The outer layer of tubules appeared to be flattened myoepithelial cells. The stroma is myxoid and contained spindle shaped myoepithelial cells. We expect that the clinical, sonographic, and histological data from our report may help clinicians who are confronted with various kinds of analogous facial lesions to decide the most proper management for their patients.

Non-melanocytic benign tumors of the face: a retrospective study.

BACKGROUND: Although plastic surgeons daily encounter various facial tumors in the field, reports limited on face are scarce. In our study, we want to provide basic epidemiologic data to help clinicians to decide the proper management for their patients. METHODS: We retrospectively reviewed the medical records of patients including age and gender, location and size of the tumor, histopathologic result, recurrence, type of anesthesia and any associated disorders who had undergone a surgical removal of their facial tumors and received the histopathologic report in the same institution between January 2009 and October 2012. RESULTS: One hundred eighty-nine patients with 203 non-melanocytic benign tumors were included. The most frequent site of tumors was the central subunit of the forehead, followed by the lateral subunit of the cheek and the auricular unit. Of 36 different histopathologic results, the epidermal cyst was most frequent, followed by lipoma, pilomatricoma and osteoma. Statistical analysis showed that males were dominant in the epidermal cyst and lipoma groups. While, females were dominant in the osteoma and pilomatricoma groups. No associations were found between lesions and other diseases. CONCLUSIONS: Our study is the at most specific and concentrated study on non-melanocytic benign tumors of the face. We expect the epidemiologic data of our study may help plastic surgeons who are confronted with so many facial lesions in the field to decide on the most proper management for their patients.