is properly cited.Purpose. To reconstruct a zygomaticomaxillary complex (ZMC) fracture, zygomaticofrontal (ZF) suture is the most reliable site to assess anatomical alignment and to secure rigidity. It has been chosen primary site to be fixed, but approach through the lateral eyebrow incision may leave a visible scar. is study suggests altered two-point fixation of ZMC fracture without accessing the ZF suture. Methods. In the retrospective study, a total of 40 patients with ZMC fracture were divided into two groups (group 1, twopoint fixation and group 2, three-point fixation). Patient demographics and follow-up were evaluated, and degree of reduction including cortical gaps of ZF and inferior orbital (IO) area, protruding difference of zygoma, and malar difference using asymmetry index were measured through preoperative and postoperative CT. Results. Preoperatively, the means of ZF displacement, IO displacement, protruding difference of zygoma, and facial asymmetry index between the groups were not statistically different. e result was the same after the operation. However, all variables were significantly different before and after surgery within each group. Moreover, mean operation time was significantly different between groups (P value � 0.026). Conclusion. Altered two-point fixation in ZMC fracture excluding incision approaching the ZF provides surgical efficacy and similar surgical outcomes to three-point fixation but offers reduced operation time and fewer complications.

Polyacrylamide hydrogel (PAAG) is an injectable material for breast augmentation that was developed in the 1980s. It was widely used until the 2000s, but subsequently lost its popularity due to high complication rates. In this case report, we share our experience of a patient complaining of hard and asymmetric breasts who had received PAAG injections 7 years ago. Surprisingly, we found that the filler in the left breast had migrated to the left inguinal area. Although breast fillers have lost ground in recent years, we think that long-term complications of fillers, as observed in this case, will still arise in the future. Therefore, young plastic surgeons who do not have direct experience with this material should be aware of its possible complications.

Background. In microvascular anastomosis, size discrepancy is common and can increase thrombotic complications. If size differences can be predicted, then vessels of the appropriate size can be selected. This study documented the difference in diameter between the thoracodorsal (TD) vessel and deep inferior epigastric perforator (DIEP) pedicle in each patient who underwent breast reconstruction using free tissue transfer. Patients and Methods. This retrospective study included 32 anastomoses (27 breasts including five cases of supercharged anastomosis) of breast reconstruction with the free DIEP flap and TD recipient between August 2018 and June 2019. In the microscopic view, the caliber of the TD vessel, the largest branch to the serratus anterior muscle, the descending branch, the largest and the second largest branches to the latissimus dorsi muscle, and the DIEP pedicle were measured. Results. The diameter of the deep inferior epigastric artery was similar to that of the descending branch, and their anastomosing rate was 56.3%. The diameter of the deep inferior epigastric vein was similar to the branch to the serratus anterior muscle and the descending branch, and their anastomosing rates were 29.3% and 29.3%, respectively. All flaps were survived; however, in one case, a reoperation was needed to remove the hematoma, in which case fat necrosis occurred as the only complication. Conclusion. TD branches of similar size to the DIEP pedicle were prioritized in anastomosis. The descending branch and the branch to the serratus anterior muscle are expected to be good candidates as recipients in breast reconstruction with DIEP free flap. Moreover, supercharged anastomosis of DIEP pedicles can be achieved within TD branches.