포켓성형외과 임상 매뉴얼

PART 01 Medical and Surgical Emergency…………1
SECTION 1 화상(Burn)……3
A. Introduction……………3
B. Classification……4
C. Management according to cause of burn………………5
D. Treatment………………6
E. Complication…………0

SECTION 2 수부손상(Hand Injuries)…………2
A. Compartment syndrome…………2
B. Amputation and replantation ……………………6
C. Infection……………………5
D. Nailbed injuries……………………5
E. Finger tip injuries……………………7
F. Phanlangeal and metacarpal fracture……0
G. Carpal bone fracture…………4
H. Flexor tendon injuries……7
I. Extensor tendon injuries……1

SECTION 3 얼굴외상(Facial Trauma)…………3
A. Facial soft tissue trauma…………3
B. Facial bone fractures…………6
C. Mandible fractures………………0

PART02 Basic Fundamentals in Plastic Surgery………………5

SECTION 1 성형외과의 정의 및 역사(Definition and History of Plastic Surgery)………………7
A. Definition and history of plastic surgery………………7

SECTION 2 임상사진술(Photography)…………4
A. Introduction…………4

SECTION 3 창상치유(Wound Healing)……8
A. Wound care…………8

SECTION 4 피부 절제 및 봉합
(Excision of Skin Lesion and Suture of Skin Wounds)……………………7
A. 흉터형성에 영향을 주는 요소 ……7
B. 수술기구……………………0
C. 국소마취(Local anesthesia) ……1
D. 지혈(Hemostsis)……………………1
E. 절제(Excision)…………2
F. 봉합(Suture of skin wounds) ……………………5
G. 봉합방법(Suture methods) ……7
H. 바늘형태(Needle configurations) …………8
I. 술후 처치(Postoperative care) ……………………9
J. 봉합선(Suture mark, Railroad track) ……100

SECTION 5 성형수술에서의 마취(Anesthesia in Plastic Surgery)……102
A. General anesthesia…………102
B. 정맥(Intravenous) 마취 …………103
C. Local anesthesia ………………105
D. 기타 마취방법 ……107

SECTION 6 피부이식술(Skin Graft)…………108
A. Anatomical structure and properties of skin …………108
B. Type……109
C. Skin graft …………111
D. Charateristics of transplanted skin ……114
E. Specific skin graft …………115

SECTION 7 피판(Flap)……………………116
A. Definition of skin flaps …………116
B. Classification of skin flaps ……………………116
C. Uses of skin flaps …………127

SECTION 8 Z-Plasty, W-Plasty………………129
A. Z-Plasty………………129
B. W-Plasty………………134

SECTION 9 조직확장술(Tissue Expansion)……………………138
A. Definition and use…………138
B. Indication and contraindication of tissue expansion………………139
C. Clinical application in body part…………140
D. Complication……142

SECTION 10 조직 이식 및 삽입물(Tissue Implantation and Insertion)………………143
A. Classification……………………143
B. 자가이식………………143
C. 동종이식 및 이종이식…………144

SECTION 11 미세 수술(Microsurgery)……145
A. Equipments and tools of microsurgery………………145
B. Indication and contraindication of free flap……148
C. Technique of micro-surgery………………149
D. Post - operative observation………………150
E. Failure of flap……………………151

SECTION 12 성형외과에서의 레이저 이용
(Application of Laser in Plastic Surgery)……………………152
A. Laser equipment and physical charactor…………152
B. Directions for laser treatment…………153
C. Effect of laser for tissue……154
D. Application of laser in plastic surgery………………155

PART03 Skin and Soft Tissue……159

SECTION 1 피부의 구조와 기능(Structure and Function of Skin)……161
A. Skin function……161
B. Anatomy………………161
C. Aging skin…………162

SECTION 2 피부양성종양(Skin Benign Tumor)…………164
A. 선천성색소성모반………………164

SECTION 3 피부악성종양(Skin Malignant Tumor)…………166
A. 기저세포암(BCC : Basal cell carcinoma)………………166
B. 편평세포암(SCC : Squamous cell carcinoma)……167
C. 악성흑색종(Melanoma)…………170

SECTION 4 혈관종과 혈관기형(Hemangioma and Vascular Anomalies)…………175
A. Hemangioma……176
B. Vascular malformation…………177
C. Arteriovenous malformation………………177

SECTION 5 액취증수술(Osmidrosis Operation)…………178
A. 정의……178
B. 해부, 생리, 조직병리…………179
C. 액취증의 발생……180
D. 진단……181
E. 치료……182

PART04 Facial Plastic Surgery…………187

SECTION 1 두개안면기형(Craniofacial Deformity)…………189
A. 두개골유합(정상 두개골 봉합선과 천문 문합)…………189
B. 두개안면 기형의 종류…………190
C. 두개안면 기형의 치료 원칙…………………………194
D. Postoperative care…………195
E. Complications……………………195

SECTION 2 구순열(Cleft Lip)……196
A. Anatomy………………196
B. Classification……198
C. 치료 ……198

SECTION 3 구개열(Cleft Palate)………………203
A. Anatomy………………203
B. Surgical treatment…………204
C. Postoperative care…………205
D. Complication……205

SECTION 4 구개인두 부전증(Velopharyngeal Incompetence)…………206
A. Definition…………206
B. Assessment……206
C. Surgical treatment…………206

SECTION 5 모발이식 및 두피 재건술
(Hair Transplantation and Scalp Reconstruction)…………210
A. Anatomy………………210
B. Hair biomechanics…………211
C. Hair transplantation……212

SECTION 6 얼굴재건술(Facial Reconstruction)…………218
A. Eyelid reconstruction (written by D. H. Park MD PhD)…………218
B. Nasal reconstruction……219
C. Cheek reconstruction……223
D. Ear reconstruction…………226
E. Lip reconstruction…………232

SECTION 7 하악재건술(Mandibular Reconstruction)……………………235
A. Considerations in mandibular reconstruction…………235
B. 하악결손의 분류……………………236
C. Mandible reconstruction에 쓰이는 피판……………………236

SECTION 8 하인두 및 식도 재건
(Hypopharyngeal and Esophageal Reconstruction)……238
A. Pharyngeal anatomy……238
B. General reconstruction principles…………239
C. Advantages and disadvantages of commonly used free flaps…………240

SECTION 9 안면마비재건술(Facial Reanimation)…………242
A. Anatomy …………242
B. Etiology ………………244
C. Treatement…………245
D. Reconstruction of facial paralysis ……246

PART05 Breast Surgery ……………………251

SECTION 1 유방의 해부와 발생(Breast Anatomy and Development)………………253
A. 유방의 구조…………253
B. 유방의 혈액공급……………………254
C. 유방의 신경지배……………………254
D. 유방과 주변근육과의 위치관계……………………255

SECTION 2 유방확대술(Breast Augmentation) …………256
A. Patient evaluation…………256
B. Implant choice……………………258
C. Incision choice ……………………261
D. Pocket plane and dissection ………………262
E. Inframammary fold와 implant size와의 관계 ……264
F. Technical point ……………………264
G. Postoperative care …………265
H. Complications and consent ………………265

SECTION 3 유방고정술(Mastopexy)……268
A. Terminology ……268
B. Classification ……………………268
C. Mastopexy techniques …………269
D. Postoperative care …………272
E. Complications ……………………272
F. Special considerations…………273

SECTION 4 유방축소술(Breast Reduction)……………………274
A. Aesthetics(예쁜 유방의 표준치)………………274
B. Indication for surgery …………274
C. Surgical options ………………275
D. Complication ……………………277
E. Cancer detection ………………277

SECTION 5 여성형유방(Gynecomastia) …………278
A. Definition …………278
B. Epidemiology ……………………278
C. Etiologic factor and classification ……278
D. Risk of malignant transformation ……279
E. Preoperative examination ……………………279
F. Staging ………………280
G. Management ……………………280
H. Surgical options ………………281
I. Result and complications ……281

SECTION 6 유방재건(Breast Reconstruction)………………282
A. Timing ……………………282
B. Considerations ……………………283
C. Implants and tissue expanders …………283
D. Latissimus dorsi flap ……284
E. Pedicled transverse rectus abdominis muscle (TRAM) flap ………………286
F. Free TRAM flap……………………287
G. Perforator flaps ………………288
H. Alternate flaps ………………290
I. Nipple - areola reconstruction …………290

PART06 Body and Lower Extremity……………………293

SECTION 1 흉벽재건(Chest Wall Reconstructoin)…………295
A. Chest wounds……………………295
B. Reconstruction of pleural cavity…………295
C. Reconstruction of thoracic skeleton……………………296
D. Chest wall deformities…………296

SECTION 2 복벽재건(Abdominal Wall Reconstruction)………………299
A. Anatomy………………299
B. Goal of reconstruction of abdominal wall defects……………………300
C. Reconstruction options of abdominal wall defects………………300

SECTION 3 비뇨생식기재건(Genitourinary Reconstruction)……301
A. Congenital vaginal defects……………………301
B. Congenital penile/scrotal defects…………302
C. Acquired vaginal/vulvar defects…………304
D. Acquired penile/scrotal defects…………306
E. Urologic defects………………307
F. Transgender surgery……307

SECTION 4 욕창(Pressure Sores)…………308
A. Etiologic factors………………308
B. Classification……311
C. Patient evaluation…………312
D. Medical management……312
E. Surgical management…………312
F. Reconstruction by anatomic site…………313

SECTION 5 하지재건(Lower Extremity Reconstruction)………………314
A. Reconstruction goal……314
B. Reconstruction by location (local flap)………………314
C. Soft tissue reconstruction……………………315
D. Tissue expansion in the lower extremity…………316
E. Treatment approach……316
F. Special considerations…………317

PART07 Hand Surgery……319

SECTION 1 손의 표면 해부(Hand Surface Anatomy)……321
A. 손의 표시선과 심부 조직의 관계………………321
B. 선천성 이상…………334
C. 건손상……………………336
D. 절단 손상………………337

PART08 Aesthetic Surgery …………339

SECTION 1 눈성형(Oculoplasty)………………341
A. Anatomy …………341
B. Preoperative assessment ……………………342
C. Double fold operatoin …………344
D. Upper blepharoplasty …………348
E. Lower blepharoplasty …………350
F. Blepharoptosis ……………………355

SECTION 2 코성형(Rhinoplasty) ………………359
A. Anatomy …………359
B. Nasofacial analysis ……362
C. Endonasl (Closed) Vs External (Open) approach……362
D. Nasal tip surgery………………363
E. Nasal dorsum……365
F. Septum and turbinates…………366
G. Nasal alae and columella……367
H. Deviated nose……………………369
I. Nose with lower height of dorsum…………370
J. Short nose…………371

SECTION 3 안면윤곽성형(Facial Contouring Surgery)……………………373

SECTION 4 악교정수술(Orthognathic Surgery)…………374
A. Le fort I osteotomy…………374
B. SSRO (Sagittal Split Ramus Osteotomy)…………375
C. VRO (Vertical Ramus Osteotomy)…………375
D. ASO (Anterior Segmental Osteotomy)………………375

SECTION 5 얼굴거상술(Face Lift)………………377
A. Face lift………………377
B. Brow lift………………382
C. Neck lift………………386

SECTION 6 보톡스, 필러, 자가 지방이식, 레이저, 필링
(Botox, Filler, Fat Grafting, Laser, Chemical Peel)…………387
A. Botox……………………387
B. Filler……390
C. Fat grafting(자가 지방이식)……391
D. Laser……392
E. Chemical peels……………………395

SECTION 7 지방흡입술(Liposuction)……398
A. Anatomy………………398
B. Preoperative evaluation……400
C. Perioperative considerations………………400
D. Marking………………401
E. Incisions………………401
F. Ultrasound-assisted liposuction…………402
G. Wetting solutions…………402
H. Fluid resuscitation…………403
I. Liposuction stages…………403
J. Drain……404
K. Postoperative care…………404
L. Healing course……………………404
M. Complication……405

SECTION 8 복부성형술(Abdominoplasty)……………………406
A. Anatomy………………406
B. Preoperative evaluation……407
C. Procedure selection……408
D. Traditional abdominoplasty……………………409
E. Miniabdominoplasty……410