The ultimate goal in treating zygomatic complex fracture is to obtain an accurate, stable reduction while minimizing external scars and functional deformity. The present authors present our experiences with a single transconjunctival incision and two-point (inferior orbital rim and frontozygomatic suture) fixation in 53 patients with zygomatic complex fracture which were not comminuted. All patients had transconjunctival approaches with lateral canthal extensions, and six out of 53 patients also had an additional small (about less than 2 cm) gingivobuccal incision to achieve an accurate reduction. There were 3 minor complications, and the overall esthetics and functional results were satisfactory with a long term follow-up. Our method has the following advantages in the reduction of zygomatic complex fracture; It leaves only an inconspicuous lateral canthal scar. In addition, it provides excellent simultaneous visualization of the inferior orbital rim and frontozygomatic suture area. Hence, two-point fixation through a single incision can be performed with a satisfactory stability.

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Alginate was a proven biocompatible biomatrice for cells but it was known not to provide a proper microenvironment needed for the proliferation of cells because of its anionic property, which caused its low affinity for cells. Water-soluble chitosan was well known as wound healing material and it also had cationic property which helped cell-to-matrix adhesion. The purpose of this study is to assess the ability of a chitosan/alginate mixed sponge as a scaffold for preadipocytes to serve as a biological implant for soft tissue augmentation. Chitosan/alginate and calcium alginate sponges were made by lyophilizing of alginate with water-soluble chitosan mixture and with calcium chloride mixture, respectively, and those were observed by SEM. Preadipocytes seeded in those sponges were cultured for 2 weeks. In vivo study was designed that chitosan/alginate sponges with and without preadipocytes were implanted subcutaneously into nude mouse. Chitosan/alginate and calcium alginate sponges which had highly porosity and 50-200㎛ pore size. In the chitosan/alginate sponge, the levels of DNA amount were significantly higher than those in calcium alginate sponge (P<0.05). In both groups, they increased progressively with time. On the in vivo study, it was observed that adipose tissue layer in the margin of chitosan/alginate sponge on the 2 weeks after implantation of nude mouse. On the 8 weeks after implantation, thick layer of adipose tissue and neovascularization were observed in the chitosan/alginate sponge. Consequently, chitosan/alginate sponge provided proper microenvironment to human preadipocyte, increased the cell proliferation and maintained the pore that offered neovascularization, so turned out to be effective form of fat transplantation for soft tissue augmentation and reconstruction.

Breast is one of the most important organ which characterize the femininity and the maternity. As growing not only in numbers of breast cancer patients but also concerns about the quality of life, breast reconstruction after mastectomy turns into hot topics in the area of plastic surgery. Historically, numerous operation techniques have been introduced for breast reconstruction using prosthesis (tissue expander and breast implant) and autologous tissues (various pedicled flaps and free flaps). The most ideal method for breast reconstruction is to make a natural soft breast with less complications and morbidities, and no single technique can be universally accepted in every cases. However, in terms of making a natural, good looking breast autologous tissue is more superior to tissue expander and breast implant in breast reconstruction. Usually a breast reconstruction is performed in 3 stages; 1 st stage is breast mound reconstruction using autologous tissue or tissue expander and implant. 2 nd stage is revision of the reconstructed breast and donor site such as abdomen (scar revision, volume adjustment using suction assisted lipectomy and excision), nipple reconstruction, and surgery of the opposite normal breast (augmentation, mastopexy, or reduction) for maximizing cosmetic results. 3 rd stage is a intradermal tattooing for nipple areolar complex. In this article, various techniques are presented with their indications, methods, advantages and disadvantages. For the choice of best modality, many factors should be considered including an extent of mastectomy, the size and shape of opposite breast, the condition of possible donor sites, postoperative adjuvant therapy (radiation, chemotherapy), patient's age, and patient's preferance.