Background: Eyelid reconstruction is particularly challenging because of the delicate anatomy and its critical functional and aesthetic roles. Although various methods have been described for anterior and posterior lamellar repairs, no standardized approach has been established. We developed a single-stage technique integrating reconstruction of both lamellae. Methods: This retrospective case series included seven consecutive patients who underwent full-thickness eyelid reconstruction between 2012 and 2024. Patients were included if they had full-thickness defects requiring reconstruction of both lamellae, underwent reconstruction using a nasal septal chondromucosal graft combined with a large local flap, and had at least 12 months of follow-up. The posterior lamella was reconstructed using nasal septal chondromucosal grafts, and the anterior lamella using large local flaps. Donor sites were managed using various methods. Results: All patients (7/7) achieved complete graft survival without partial or total graft loss. All patients achieved complete eyelid closure without lagophthalmos, and no cases of ectropion, corneal complications, or graft failure were observed. Buccal mucosal grafting demonstrated the most favorable donor-site outcomes, with uneventful healing and no septal perforation or airway-related complications. Conclusions: This single-stage approach combining chondromucosal grafts and local flaps is a feasible and reproducible option for selected patients, providing reliable structural support and satisfactory functional outcomes.

Background: The insertion of implants and tip plasties have been performed in Asian patients for an attractive and higher nasal profile, which can result in diverse tip deformations such as notching, pinching, alar retraction, incompetent external valve, deviated tip, cephalic rotation, and lateral crus malposition because of inappropriate manipulation of the lower lateral cartilage and/or silicone capsular contracture. This study aimed to investigate the effectiveness and utility of applying a lateral crural strut graft (LCSG) as a consistent and appropriate surgical method to correct various nasal tip deformities that occur as complications following rhinoplasty in Asian patients. Methods: The authors prospectively studied 37 patients with a minimum follow-up of 12 months among 53 patients who underwent secondary rhinoplasty, including LCSG, between January of 2016 and December of 2020. The results were assessed using the Rhinoplasty Outcome Evaluation scale preoperatively and more than 12 months postoperatively. Results: Two cases of asymmetric nostril and tip, 1 visible LCSG (bulging) and 1 external SS score, was 30.41 preoperatively and 75.90 postoperatively ( P < 0.001). All subgroups of tip deformities exhibited increased Rhinoplasty Outcome Evaluation scores after the surgery, with the subgroup demonstrating the highest change being “lateral crural deformities,” and the lowest change being “tip deviation” ( P < 0.005). Conclusion: In Asian patients, LCSG using autogenous cartilage would be a useful and versatile option for various types of nasal tip deformities in secondary rhinoplasty, which can effectively improve tip appearance, symmetry, and external valve function, and can also lengthen the contracted nose.

Background and Objectives: While many factors are known to influence adverse outcomes after head and neck cancer ablation with free flap reconstruction, two low-cost inflammatory–nutritional indices—the Controlling Nutritional Status (CONUT) score and the Systemic Immune-Inflammation Index (SII)—are not widely used. This pilot study evaluated their accuracy for predicting surgical complications, including flap-site leakage, and explored data-driven cutoff values. Materials and Methods: We retrospectively analyzed 115 consecutive patients undergoing free-flap reconstruction. Data from medical records were obtained. Preoperative CONUT and SII were computed, receiver-operating characteristic (ROC) curves derived optimal thresholds, and associations with outcomes were tested using univariable analyses and multivariable logistic regression adjusted for age, defect area, previous radiotherapy, and flap size. Classification metrics were calculated. Results: SII (continuous) remained independently associated with leakage (adjusted OR ≈ 22 per log-unit increase, p ≈ 0.001), and CONUT (continuous) with surgical complications (adjusted OR 1.39 per point, p = 0.009). ROC analyses showed AUCs of 0.740 (95% CI 0.622–0.858; p < 0.001) for log(SII) and 0.685 (0.553–0.816; p = 0.006) for CONUT for overall surgical complications, and 0.780 (0.686–0.874; p < 0.001) for log(SII) and 0.688 (0.569–0.806; p = 0.002) for CONUT for leakage, without significant difference in both indices. Cutoff values for both dependent variables were 2.875 (log(SII) (≈SII 750–760) and ≥4 (CONUT). Conclusions: Preoperative SII and CONUT demonstrated moderate predictive performance, with notably high negative predictive values. Both indices showed no significant differences in discriminating risk, and, although the result is largely exploratory, given their high negative predictive values, they may be useful for excluding anastomotic leakage and overall postoperative complications after head and neck free-flap reconstruction.

Background: Patients who undergo pelvic lymphadenectomy for gynecologic or genitourinary cancers have an increased risk of developing lower extremity lymphedema. Although total lymphadenectomy is performed, bilateral lower extremity lymphedema is rare. A state-of-the-art radiologic technique, single-photon emission computed tomography (SPECT) with radioisotope injection, was used to establish lymph flow physiology and identify retrograde lymphatic flow in patients with lower extremity lymphedema after lymphadenectomy. Methods: Data from patients who underwent treatment for lower extremity lymphedema were collected from January 2017 to December 2018. These patients had gynecological or genitourinary cancers and had undergone pelvic lymphadenectomy. Among them, 10 were evaluated for reverse lymph flow using SPECT. The radioisotope was injected solely into the subdermal area of the healthy foot, not the affected foot, in contrast to other studies. Four hours later, SPECT images were obtained and analyzed. The radiologic results were correlated with clinical observations. Results: Most patients had undergone surgery for gynecological cancers. The mean disease duration was 9.4 ± 8.1 years. Retention in the pelvis and hip was confirmed in seven out of ten patients; six patients showed reverse lymphatic flow in the affected limb. Conclusions: SPECT-CT imaging after tracer injection into the unaffected limb revealed retrograde lymphatic flow toward the clinically affected side in a substantial proportion of patients with unilateral lower-extremity lymphedema.