확장성(더블루멘) 보형물을 이용한 유방확대술

심형보,남상재,윤상엽 대한성형외과학회 2005 Archives of Plastic Surgery Vol.32 No.4

Ideal results of augmentation mammaplasty consist of symmetry, natural shape, soft feeling and inconspicuous scar. In addition, patient's preferences about size and shape should be included. Static implants could not perfectly satisfy patients' desires for size and shape, but expandable implants enable to change the volume after the operation. From September 2001 to September 2004, 76 patients(150 breasts) underwent breast augmentation using permanent expandable implant. The procedure was unilateral in 2 women and bilateral in 74 women. Age ranged from 19 to 50 years(mean, 29 years). Fifty nine patients underwent simple augmentation mammaplasty, 7 patients were corrected of their severe asymmetry, 2 patients with the congenital breast deformity underwent mammaplasty using this, and 2 patients who had undergone unilateral mastectomy were reconstructed of their breasts using expandable implant. There were no definite complications such as capsular contracture, implant rupture, asymmetry. And there reported little dissatisfaction about the size. The permanent expandable implants might be good alternatives in cases of ordinary breast augmentation as well as tissue deficient patients, asymmetry, congenital anomaly, and breast reconstruction.

Transaxillary Endoscopic Breast Augmentation

심형보 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.5

The axillary technique is the most popular approach to breast augmentation among Koreanwomen. Transaxillary breast augmentation is now conducted with sharp electrocauterydissection under direct endoscopic vision throughout the entire process. The aims of thismethod are clear: both a bloodless pocket and a sharp non-traumatic dissection. Roundtextured or anatomical cohesive gel implants have been used to make predictable welldefinedinframammary creases because textured surface implants demonstrated a betterstability attributable to tissue adherence compared with smooth surface implants. The axillaryendoscopic technique has greatly evolved, and now the surgical results are comparable tothose with the inframammary approach. The author feels that this technique is an excellentchoice for young patients with an indistinct or absent inframammary fold, who do not wanta scar in the aesthetic unit of their chest.

설계.엔지니어링 분야의 정보화와 기업성과의 상관관계 분석

심형보,윤수원,김경래,정영수,김예상,진상윤,Shim, Hyung-Bo,Yoon, Su-Won,Kim, Kyung-Rai,Jung, Young-Soo,Kim, Yea-Sang,Chin, Sang-Yoon 한국건설관리학회 2007 건설관리 : 한국건설관리학회 학회지 Vol.8 No.1

설계 엔지니어링 분야는 다양한 건축주 및 사용자의 요구와 관련 분야에 대한 기술적인 문제들의 증가로 인해 과거보다 더 많은 분야 전문가 간의 정보소통 과정을 필요로 하는 등 정보화의 중요성이 부각되고 있다. 하지만 현실에서는 그 필요성만 인식되고 있을 뿐, 효과에 대한 검증 및 추진을 위한 동기 부여가 되지 못함으로서 정보화에 대한 투자 및 전문 인력확보가 이루어지지 못하고 있다. 그러므로 본 연구의 목적은 설계 엔지니어링 분야를 대상으로 기업의 정보화와 기업 성과의 관련성을 규명하여 기업의 정보화 전략 수립의 근거로 활용할 수 있는 평가 체계를 제안하고, 이를 중심으로 현재 설계 엔지니어링 분야의 기업 성과와 정보화 현황 및 상관관계를 규명함으로써 향후 설계 엔지니어링 분야의 정보화 추진에 활용 가능한 분석 자료를 제공하는 것이다. The importance of informatization of architectural/engineering firms has been addressed since technical problems caused by owner and users$^{\circ}{\O}s$ needs and requirements increased. However, the investment and the human resource support have not been enough, and the effectiveness and efficiency of jnformatization has not been verified and validated, either. Therefore, the objective of this paper is to analyze the effectiveness and efficiency of informatization based on the corporation performance through considering the present status of corporation performance and jnformatization of architectural/engineering firms and analyzing the correlations between them. In addition, this study proposed the performance measurement framework to evaluate the performance and jnformatization level on architectural/engineering firms based on the previous studies.

구형구축의 치료: 유륜절개 이중평면 전환술

심형보,위형곤 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.1

Purpose: The capsular contracture has been the most common complication of augmentation with breast implant, a side effect quite difficult to treat. The latest trends in the correction of capsular contracture include total capsulectomy or conversion of implant pocket. In this study, in an attempt to correct capsular contracture, the authors performed reoperation which involved capsulectomy through peri-areolar approach and dual- plane conversion. The authors hereby report the clinical results of such correction of capsular contracture and examine the efficacy. Methods: The authors selected 46 patients who were admitted to the clinic from January 2004 to January 2007 (37 months), and performed dual-plane conversion through solely peri-areolar approach. Two types of operation were done: dual-plane conversion from subglandular plane or from submuscular plane.Results: The average follow-up time after conversion to the dual-plane position was 10 months. During the follow-up period, 83.1% of patients recovered from capsular contracture and were Baker class I, and in 10.9% the condition had relapsed into Baker class II or III contracture.Conclusion: This study has proven the effectiveness of the dual-plane conversion operation for correcting established capsular contracture after previous augmentation mammaplasty. In this study, all cases of dual-plane conversion operation was performed through peri-areolar approach, which can prevent the occurrence of visible scar on inframammary fold.

Multi-agent system의 Consensus에 대해 알아보자

심형보 제어로봇시스템학회 2019 제어로봇시스템학회지 Vol.25 No.4

내시경을 이용한 겨드랑절개 이중평면 유방확대술

심형보,위형곤,홍윤기 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.5

Purpose: The transaxillary approach for breast augmentation has been advocated for patients and surgeons for several decades. However, this blind technique had many disadvantages including, traumatic dissection, difficult hemostasis, displacement of implants, and ill-defined asymmetrical location of inframammary crease. In the present study, the precise endoscopic electrocautery dissection was applied to eliminate the limits of blunt dissection throughout the procedures. Methods: From December 2006 to December 2007, a total of 103 patients with an average age of 29.5 years underwent endoscopic assisted transaxillary dual plane augmentation mammoplasty. The mean implant size was 243 cc with the range between 150 and 350cc. Through a 4cm axillary incision, electrocautery dissection for submuscular pockets was carried out under the endoscopic control. The costal origin of pectoralis muscle was completely divided to expose subcutaneous tissue and to make type I dual plane. Results: Using the endoscopic dissection, we achieved good aesthetic results including a short recovery period, less morbidity, and symmetrical well-defined inframammary crease. Type I dual plane procedure could support the consistent inframammary fold shape and be applied to most patients without breast ptosis. Minor complications did not occur, however, four major complications of capsular contracture occurred. Received April 27, 2008 Revised May 19, 2008 Accepted May 30, 2008 Address Correspondence: Hyung Bo Sim, M.D., Baram Clinic BBC, Gaonix B/D 2F, 575 Shinsa-dong, Gangnam- gu, Seoul 135-891,Korea.Tel:02)511-8758/Fax:02)540- 8759/E-mail: 123sim@hanafos.com * 본 논문은 2008년 제9차 한-일 성형외과 학술대회에서 구연되었음. Conclusion: In contrast to the era of the blind techniques, endoscopic assisted transaxillary dual plane breast augmentation can now be performed effectively and reproducibly. With Its advantage, the axillary application of endoscopy for augmentation mammaplasty is useful to achieve the optimal cosmetic outcomes.

다양한 술식을 이용한 여성형 유방증의 치료: 초음파 지방흡입술과 풀아웃법 또는 유륜절개를 통한 절제술

심형보,윤상엽 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.2

Purpose: Gynecomastia is an abnormal increase in the volume of the male breast. Patients affected by gynecomastia with significant glandular enlargement may respond to suction alone and/or sharp dissection and excision. The purpose of this report is to introduce the indications and results of authors' two techniques.Methods: The diameter of parenchyme was determined by a pinch test after liposuction. For the parenchymal diameter less than 4cm, ultrasound-assisted liposuction was performed, in conjunction with the "pull- out technique" to effectively remove the fibrofatty tissue of the male breast through a single 5-7mm incision. For the parenchymal diameter more than 4cm, ultrasound-assisted liposuction and excision were applied through 2.5cm periareolar approach. Results: A total of 94 patients (185 breasts) underwent the operation from October 2000 to October 2003 and mean follow-up period was 12 months. The volume of aspirates ranged from 50 to 450 cc per breast. There were no major complications such as skin flap necrosis. Five reoperations were performed for 1 hypertrophic scar, 2 under-resected and 2 hematoma cases. The patient's satisfaction was high and most of them were pleased with the shape of the breasts and scars.Conclusion: These procedures can minimize scars and reduce the incidence of contour problem such as saucer deformity, and provides consistent results. Patients can return to full activities in 48 hours. It can be offered as an option for the treatment of gynecomastia.

유관 부분절단과 유방 실질 V-Y 전진피판을 이용한 함몰유두의 교정

심형보,홍윤기 대한미용성형외과학회 2009 Archives of Aesthetic Plastic Surgery Vol.15 No.1

The pathophysiology of the inverted nipple is characterized by less connective tissue beneath the nipple, dense fibrous tissue at nipple-areola junction and shortened fewer functional lactiferous ducts. For grade I and II nipple inversion, the dissection of dense fibrous tissue at nipple-areola junction is sometimes not enough to completely bring out the nipple and also the recurrence rate is high. These findings suggest that the shortened hypoplastic ducts might play a considerable role in grade I and II nipple inversion. The purpose of this study was to prove the effectiveness of partial ductal division and V-Y advancement of glandular tissue to correct the inverted nipple. Through a 3mm slit incision around the nipple base, partial division of lactiferous ducts was performed and V-Y advancement of parenchyma was followed. The extent of ductal division was limited only to the central portion until the nipple protrusion persisted without any support. A deep purse-string with a 4-0 permanent suture reinforced the advancement of glandular tissue to add bulk beneath the nipple, and a superficial purse-string was applied at the subcutaneous layer to avoid instability of the nipple. 168 female patients(309 nipples) underwent this procedure from April 2000 to June 2008. 37 nipples were grade I and 272 nipples were grade II. No major complication occurred. Overall recurrence rate was 4.2%(13/309). Among 17 women who had breast-fed after correction of inverted nipples, 2 women failed to breast- feed. This safe and simple technique can correct almost all pathologic factors of nipple inversion, and it can also be easily applied to reoperation cases.

함몰유두의 치료방침

심형보 大韓成形外科學會誌 2000 Archives of Plastic Surgery Vol.27 No.1

A number of techniques have been introduced for the correction of inverted nipples, many of which are time-consuming, involve extensive incision and dissection around the nipple, or result in undesirable outcomes. Only two surgical methods were performed depending upon the patient's demand for nursing. When a patient desired breast-feeding the modified Teimourian method with pursestring was executed to preserve lactiferous ducts while the modified Hartampf method with purse-string severing the ducts was performed on a patient who did not want breast-feeding. These two methods were both simple and non-invasive. The reinversion rates were compared and analyzed for 73 nipples followed up for between 3 months and 2 years. Eversion was maintained in 89% of nipples. Invaginated nipples showed an increased tendency to reinvert postoperatively compared to umbilicated types(13.6% vs 6.9%). The duct-preserving method also tended to reinvert 3 times more than the duct-dividing method(14.3% vs. 4.2%).

유륜둘레 절개식 유방축소수술

심형보 대한미용성형외과학회 1996 Archives of Aesthetic Plastic Surgery Vol.2 No.1

Breast reduction surgery has been used for the purpose of obtaining a natural cone shape for the breast, minimizing scars, and maintaining breast physiology. An important factor influencing the selection of the type of procedure was the ease of predicting the eventual size of the breast mound and the final location of the nipple-areolar complex. Several variations of the Round Block periareolar mammaplasty (Benelli) were described, but not enough to solve the problems of mound flattening and early ptosis. The thesis is set forth that: (1) use a circumareolar incision to minimize the scar, (2) adopt the central breast pedicle to preserve the physiology and make significant resection, and (3) introduce the self-implant concept to produce conical shape and prevent early ptosis, also predict the eventual size of breast easily. A personal series of 44 consecutive cases (88 breasts) operated on from 1994 through 1996 is reviewed. The amount excised ranged from 150 g - 1200 g per breast (mean 423 g). The majority of patients were pleased with their breast size, shape and especially scars. There were few complications; one skin flap necrosis (1/88), one partial nipple-areolar necrosis (1/88) and 12 sensory disturbances of nipple-areolar complex (12/88). This series proves that sircumareolar reduction mammaplasty with self-implant technique can be used safely in significant resections for breast hypertrophy, respecting both aesthetic and functional aspects.