Background: Soft-tissue reconstruction following vulvar cancer resection is a difficult challenge because of the functional, locational, and cosmetic importance of this region. Although numerous flaps have been designed for vulvar reconstruction, each has its disadvantages. Methods: The authors introduce the gluteal fold fasciocutaneous V-Y advancement flap for vulvovaginoperineal reconstruction after vulva cancer resection. This flap is supplied by underlying fascial plexus derived from perforators of the internal pudendal artery and musculocutaneous perforators of underlying muscle. The sensory supply of this flap comes from the posterior cutaneous nerve of the thigh and the pudendal nerve. An axis of V-shaped triangular flap is aligned to the gluteal fold. A total of 17 flaps were performed in nine patients. Results: All flaps survived completely, with no complications except for small perineal wound disruption in three patients. Conclusions: This flap is thin, reliable, sensate, easy to perform, and has matched local skin quality and concealed donor-site scar on the gluteal fold. In addition, it can cover large vulvovaginal defects because it can be advanced farther as a result of the character of the gluteal fold area. In our experience, the gluteal fold fasciocutaneous V-Y advancement flap has proven very useful for vulvar reconstruction, especially at the point of donor-site scar, flap thickness, and degree of flap advancement.

Dermal injectables are the most popular material for facial enhancement, including volumizing and wrinkle correction. However, although hyaluronic acid is the most common component of dermal injectables, the character of hyaluronic acid products is quite variable. These materials can be described in terms of their viscoelastic properties using four parameters. In this article, the author would like to describe these properties in detail. Although many physicians consider this material to be convoluted, thoroughly understanding the characteristics of various injectables enables us to tailor procedures accordingly and to enhance the final results.

To date, extensive studies have been conducted to assess diverse types of sutures. But there is a paucity of data regarding biomechanical properties of commonly used suture materials. In the current experiment, we compared biomechanical properties and biocompatibility, such as tensile strength and elongation, the degree of bovine serum albumin (BSA) release, in vitro cytotoxicity and ex vivo frictional properties, between a non-absorbable elastic thread (NAT; HansBiomed Co. Ltd., Seoul, Korea) (NAT-R: NAT with a rough surface, NAT-S: NAT with a smooth surface) and the Elasticum^® (Korpo SRL, Genova, Italy). The degree of tensile strength and elongation of Si threads was significantly higher in both the NAT-R and -S as compared with the Elasticum^® (p < 0.05). Moreover, the degree of tensile strength and elongation of PET threads was significantly lower in both NAT-R and -S as compared with the Elasticum^® (p < 0.05). Furthermore, the degree of tensile strength and elongation of braided Si/PET threads was significantly lower in NAT-S as compared with NAT-R and Elasticum^® (p < 0.05). The degree of BSA release was significantly higher in the NAT-R as compared with Elasticum^® and NAT-S throughout a 2-h period in the descending order (p < 0.05). The degree of cell viability was significantly higher in both NAT-R and -S as compared with Elasticum^® (p < 0.05). The degree of coefficient of friction as well as the frictional force and strength was significantly higher in NAT-R as compared with NAT-S and Elasticum^® (p < 0.05). NAT had a higher degree of biomechanical properties and biocompatibility as compared with Elasticum^®. But further experimental and clinical studies are warranted to compare the efficacy, safety, and potential role as a carrier for drug delivery between NAT and Elasticum^®.

Short-term safety of facial rejuvenation using an absorbable polydioxanone monofilament thread in patients with mild

Background: Botulinum neurotoxin type A (BoNTA) is widely used in aesthetic facial rejuvenation medicine. The exponential growth in using BoNTA for cosmetic purposes in Korea necessitates an update to the existing practice guidelines, building upon the consensus established by Korean experts in 2013. Aims: This work aims to provide an updated Korean consensus guideline for the safe and effective use of a novel BoNTA product (NEWLUX) for facial expression muscles. Methods: A panel of ten Korean experts in dermatology, plastic surgery, aesthetic medicine, and clinical anatomy convened in February 2024. They reviewed prior guidelines, including the 2013 Korean consensus, and shared their expertise on dosage, injection techniques, and potential complications associated with the use of the novel BoNTA product for facial expression muscles. The recommendations aimed to guide the best practices of the average aesthetic healthcare professional. Results: The panel reached a consensus on various aspects of using the BoNTA product, including recommended injection sites, dosages, and techniques for different aesthetic conditions caused by facial expression muscles. The resulting guideline emphasizes safety and efficacy, with recommendations based on the collective experience of the expert panel. Conclusion: This updated consensus guideline provides practical recommendations from Korean experts on the use of the novel BoNTA product for facial expression muscles. The guidelines will ensure safe and effective treatments while reflecting the latest advancements in the field.