Background In August 2019, the Ministry of Food and Drug Safety and the Korean Society of Plastic and Reconstructive Surgeons confirmed the first case report of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in Korea and provided recommendations. This study was conducted to evaluate the impact of the first case report of BIA-ALCL on patients and whether the impact could be mitigated through expert recommendations.Methods A retrospective chart review was performed of patients who underwent implant-based breast reconstruction using Biocell textured breast implants at Soonchunhyang University Hospital. After the first case report of BIA-ALCL and informing the patients via text messages, the pattern of outpatient visits and the proportion and indications of outpatient office visitors who received reoperations were analyzed.Results After the first BIA-ALCL case report in Korea, 12 patients underwent reoperations due to other complications identified incidentally, while only three patients underwent prophylactic surgery. Among the patients who underwent reoperation after the Allergan issues, 76.7% received implant exchange. There was no significant difference in the proportion of reoperation types before and after the Allergan issues and the transmission of text messages (P=0.700).Conclusions Despite the major issues, outpatients were managed successfully according to our recommendations. The study found a low rate of regular outpatient visits; however, our efforts increased this rate. Therefore, methods for appropriate information delivery are needed for outpatient visits, as well as a system for regular monitoring. As experts, plastic surgeons should provide responsible leadership in this situation to relieve patients’ concerns.

Background We report the efficacy of a dual-plane approach using a Dufourmentel skin flap with a purse-string suture of the de-epithelized dermis to manage pseudoaneurysm at the vascular access site for hemodialysis.Methods A retrospective analysis was conducted of 61 patients from 2013 to 2018 with pseudoaneurysms at the arteriovenous fistula or graft who were treated with rhomboid excision, vessel repair with a purse-string suture, and a full-thickness Dufourmentel skin flap. The success rate was defined as the probability of complete wound closure and intact vascular access patency without infection or other complications.Results The success rate was 93.4% at 6 months postoperatively. Complications included newly occurring pseudoaneurysms (n=2), wound dehiscence (n=1) and bleeding (n=1). There were no complications such as stenosis or thrombosis from the procedure.Conclusions A dual-plane approach using a Dufourmentel skin flap with a purse-string suture for vessel repair was shown to be a favorable option for managing stable, small (diameter <2 cm) pseudoaneurysms without infection, rapid expansion, or patency issues of the vascular access.

Background The latissimus musculocutaneous flap (LD flap) is a useful option for breast reconstruction following mastectomy. It has the advantage of obtaining sufficient tissue padding and natural shape by using autologous tissue. However, with the emergence of the skin-sparing mastectomy technique and artificial dermis matrix, direct-to-implant (DTI) breast reconstruction has become the first choice of surgery. The purpose of this study was to compare the satisfaction levels of patients who underwent DTI and LD flap with implant using patient-reported Breast-Q results. Methods A retrospective study was performed reviewing the records of 49 women who underwent immediate breast reconstruction with DTI or LD flap with implant and responded to the BREAST-Q questionnaire after the operation. The patient-reported breast-Q results were analyzed and correlated to the demographic information and intraoperative information. Results A total of 26 patients who underwent reconstruction with LD flap with implant and 23 patients with DTI were identified and responded to the questionnaire after an average of 32.3 and 10.4 months postoperation, respectively. According to the patient response to the breast-q values, satisfaction with breast was 60.0 and 57.0 points, psychosocial well-being 61.0 and 60.0 points, and sexual well-being 41.0 and 43.0 points in the two groups. Overall, there was no significant difference in the breast-Q score between the two groups. Conclusion Patients who underwent DTI breast reconstruction seemed equally satisfied with the appearance and outcome of their breast reconstruction compared with LD flap with implant. Therefore, it appears that DTI is adequately replacing LD with implant.