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Hwang S.W.,Peninsula Medical School | Hwang S.W.,Inha Research Institute for Medical Science | Nam Y.S.,Catholic University of Korea | Hwang K.,Inha University | Han S.H.,Catholic University of Korea
Journal of Anatomy | Year: 2012

The aim of this study is to elucidate the thickness and tension of the gluteal aponeurosis (GA) as related to subfascial gluteal augmentation. Twenty buttocks from 10 Korean fresh cadavers (age range: 69-92years, five men and five women) were dissected. Five radial lines were made from the greater trochanter (GT) to the highest point of origin of the gluteus maximus muscle (GM), the posterior inferior iliac spine (PSIS), the piriformis line (P), the coccyx (Co) and the ischial tuberosity (IT). The upper four lines were intersected by three curvilinear lines that divided them by a quarter, half and three-quarters ratios, and the lowest line was divided by a third ratio and a two-thirds ratio. At the 14 intersecting points, the force needed to break the 6mm width of the GA was measured. The thickness of the GA was also measured with a digital caliper. The GA was widest at the GT-Co line (161.7±15.8mm), and it was narrowest at the GT-IT line (106.5±21.2mm). At most of the points (12 among the 14 points), the breaking strength of the GA was greater than 20Newtons (N). The breaking strength of the GA did not vary significantly according to the locations (P=0.568, anova). The breaking strength of the males (22.8±6.6N) was significantly greater than that of the females (20.3±7.5N, P=0.003, t-test). The thickness of the GA varied according to the locations (0.4±0.2mm to 0.7±0.3mm). The thickness of the GA of the upper part (GT-GM line: 0.64±0.24mm; GT-PSIS line: 0.66±0.23mm; GT-P line: 0.66±0.24mm) was significantly greater (P=0.040, 0.017, 0.018, respectively) than that of the lower part (GT-IT line: 0.49±0.18mm). The GA of the males (0.70±0.23mm) was significantly thicker than that of the females (0.53±0.21mm, P<0.001, t-test). We conclude that the GA is capable of holding gluteal implants in the proper position, as the average force to break up the 6mm width of the GA in females was greater than 20N. © 2012 The Authors. Journal of Anatomy © 2012 Anatomical Society. Source


Hwang K.,Inha University | Kim H.J.,Inha University | Kim K.Y.,Chung - Ang University | Han S.H.,Chung - Ang University | Hwang S.J.,Inha Research Institute for Medical Science
Journal of Craniofacial Surgery | Year: 2015

The aim of this study was to compare the skin tension of several fascial/subcutaneous tensile reduction sutures. Six upper limbs and 8 lower limbs of 4 fresh cadavers were used. At the deltoid area (10 cm below the palpable acromion) and lateral thigh (midpoint from the palpable greater trochanter to the lateral border of the patella), and within a 3 × 6-cm fusiform area of skin, subcutaneous tissue defects were created. At the midpoint of the defect, a no. 5 silk suture was passed through the dermis at a 5-mm margin of the defect, and the defect was approximated. The initial tension to approximate the margins was measured using a tensiometer. The tension needed to approximate skin without any tension reduction suture (S) was 6.5 ± 4.6 N (Newton). The tensions needed to approximate superficial fascia (SF) and deep fascia (DF) were 7.8 ± 3.4 N and 10.3 ± 5.1 N, respectively. The tension needed to approximate the skin after approximating the SF was 4.1 ± 3.4 N. The tension needed to approximate the skin after approximating the DF was 4.9 ± 4.0 N. The tension reduction effect of approximating the SF was 38.8 ± 16.4% (2.4 ± 1.5 N, P = 0.000 [ANOVA, Scheffé]). The tension reduction effect of approximating the DF was 25.2% ± 21.9% (1.5 ± 1.4 N, P = 0.001 [ANOVA, Scheffé]). The reason for this is thought to be that the SF is located closely to the skin unlike the DF. The results of this study might be a basis for tension reduction sutures. Copyright © 2014 by Mutaz B. Habal, MD. Source


Hwang K.,Inha University | Heo W.Y.,Inha University | Jeong J.M.,Inha University | Hwang S.W.,Peninsula Medical School | Hwang S.W.,Inha Research Institute for Medical Science
Journal of Craniofacial Surgery | Year: 2014

The aim of this study is to compare the old and ugly with the young and beautiful in Leonardo's profile drawings using soft tissue anthropometry. Thirty-one of Leonardo's profile drawings and portraits of the lateral view were collected and scanned. Among the 29, 9 young and 20 hideous old man scans had a measurable nasion-subnasale (n-sn) distance, and 49 anthropometric items (43 distances and 6 angles) were used for measurement as relative distances to the n-sn distance. The measured distances or angles did not differ significantly between the young and old in the 39 anthropometric items. However, the remaining 10 items were statistically significant. The young group had a significantly greater (P < 0.05) upper face height (n-stomion [sto]), nasolabial angle, and upper lip height (sn-sto) compared with the old group. However, the supraorbital depth (glabella-tragion), mandible height (sto-gnathion), nasal bridge height (n-pronasale), cutaneous lower lip height (labiale inferiussublabiale), ear length (superaurale-subaurale), Rickett line-upper lip distance, and facial inclination were significantly greater (P < 0.05) in the old group compared with the young group. The difference of soft tissue cephalometric results between the young and old subjects can be the index in rejuvenating surgeries. ©2014 by Mutaz B. Habal, MD. Source


Hwang K.,Inha University | Park J.Y.,Inha University | Hwang S.W.,Peninsula Medical School | Hwang S.W.,Inha Research Institute for Medical Science
Archives of Plastic Surgery | Year: 2015

The aim of this study is to consider breast imagery in art as depicted through western painting. Twenty western art paintings were collated. Most of the sample paintings were created from the mid-nineteenth century to the late twentieth century and some are from the Renaissance period. Ten anthropometric items were used to measure 15 distances between two landmarks and 3 angles between three points. The distance from the nipple to the sternal notch and to the midclavicular point was the same and they were 0.46 of the distance from the sternal notch to the umbilicus. The shape of the projection of the breast was almost an isosceles triangle and the altitude of the triangle was at a proportion of 0.45 of the bottom length and 0.16 of the distance from the sternal notch to the umbilicus. The distance between the lateral ends of the breasts was 2.14 times the facial width and the distance between nipples was 1.36 times the facial width. Proportions from works of art are more ideal and attractive than clinically measured proportions. The desirable ratios measured from historical paintings might be useful in planning breast surgeries. © 2015, The Korean Society of Plastic and Reconstructive Surgeons. Source


Sim H.B.,Baram Aesthetic Plastic Surgical Clinic | Sim H.B.,Inha University | Hwang K.,Inha University | Huan F.,Inha University | And 6 more authors.
Aesthetic Plastic Surgery | Year: 2013

Background This study aimed to elucidate the anatomy of the abdominal head of the pectoralis major (AHPM) in relation to transaxillary breast augmentation (TBA). Methods In 20 hemithoraxes of fresh Korean cadavers, the width, thickness, and location of the origin of the AHPM were measured in relation to the seventh rib-costal cartilage junction. A force gauge was used to measure the force needed to detach the AHPM from its origin. In another four breasts, an implant pocket was made first, followed by observation of the AHPM. In 92 patients who underwent surgery, the AHPM was observed at its origin during performance of endoscopic TBA. Results The AHPM was observed in 23 (96 %) of 24 hemithoraxes dissected. The AHPM was observed in 170 (92.4 %) of 184 breasts subjected to surgery. The AHPM originated from the rectus fascia at the sixth (60 %) and seventh (35 %) costochondral junctions. The width of the AHPM was 23.5 ± 5.2 mm at its origin, 15.2 ± 3.9 mm at midbelly, and 7.3 ± 4.3 mm at insertion. The thickness of the AHPM at its origin was 1.6 ± 0.5 mm. The force needed to detach AHPM from its origin was 23.5 ± 12.0 N. In two cadavers of mock surgery, the AHPM could limit the boundary of the implant pocket after division of the costal origins. After division of the AHPM, the free inferior space was obtained. Conclusion In submuscular or dual-plane breast augmentation, the AHPM should be cut to place the implant in the correct desired position. Level of Evidence III 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. © Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013. Source

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