Introduction: Plastic and reconstructive surgery (keiseigeka in Japanese) is relatively unknown in Japan; thus, it is important to raise awareness of this medical field. To analyze the current understanding of plastic and reconstructive surgery in Japan and consider measures to improve it, we evaluated the awareness of this field in two different hospitals in Japan.
 Methods: A questionnaire survey was conducted to investigate knowledge of plastic and reconstructive surgery at Toranomon Hospital (Tokyo) and Hamanomachi Hospital (Fukuoka). We recruited patients visiting the hospital for the first time. We analyzed the difference between the two hospitals.
 Result: Treatment by plastic and reconstructive surgery was still poorly understood in both hospitals. Many patients answered that they would visit the plastic and reconstructive surgery department for facial injuries, keloid scars, and limb anomalies. However, few patients answered that they would visit it for burns, skin tumors, and nevi.
 Discussion: On the basis of the results obtained in this study, plastic surgeons should promote educational activities about plastic and reconstructive surgery throughout Japan. We discuss some approaches to increasing the recognition of the roles of plastic surgeons in Japan.

 Surgical treatment of mandibular arteriovenous malformations carries a risk of massive intraoperative bleeding. A 16-year-old girl with CHARGE syndrome and a history of anaphylactic shock due to contrast medium was referred to our department for a right mandibular arteriovenous malformation. Surgery was planned after completion of growth; therefore, she was being followed up on an outpatient basis. After falling and bruising the mandibular area, she had intermittent massive bleeding while sleeping. We performed surgical resection and reconstruction earlier than planned. Massive intraoperative bleeding was avoided by securing and temporarily clamping the bilateral external carotid arteries before approaching the lesion. Our findings suggest that this technique was less invasive, simpler, and more reliable in controlling bleeding.

 Aneurysmal fibrous histiocytoma (AFH) is a variant of dermatofibroma that grows rapidly and is associated with bleeding. We report a case of AFH associated with severe anemia. A 34-year-old woman with a bleeding tumor on the right lateral thigh underwent resection of the tumor involving the deep fascia, followed by blood transfusion. The defect was subsequently repaired uneventfully using skin grafting. The patient showed no recurrence. We diagnosed the patient with AFH based on postoperative histopathological evaluation findings. AFH is often indistinguishable from other diseases and is therefore diagnostically challenging. Local recurrence may occur despite the benign nature of the tumor; therefore, careful postoperative follow-up is important.

 Currently, silicone implants are widely used for cosmetic rhinoplasty; however, previously, other materials, including ivory obtained from elephant tusks, were used for nasal corrective surgery. We describe a patient without any history of trauma in whom a nasal ivory graft implanted 53 years prior to presentation penetrated the frontal sinus and entered the intracranial space. The ivory was stuck but not fused to the surrounding bone. We extracted the foreign body without cerebrospinal fluid leakage after gently crushing the frontal bone immediately around the implant. Postoperative computed tomography performed 8 months later revealed spontaneous ossification with closure of the defect in the frontal bone.

 Dermatofibrosarcoma protuberans (DFSP) is an intermediate-grade malignancy classified as a fibrohistiocytic tumor. The first choice of treatment for DFSP is complete surgical resection of the tumor. Herein, we report a case of DFSP in the forehead area that was completely resected and reconstructed with good cosmetic results. The patient was a 54-year-old man who underwent a partial excisional biopsy, which led to the diagnosis of DFSP. After a wide local excision, including the periosteum, and confirmation of negative margins, reconstruction with a forehead flap was performed in two phases. Because the excision also resulted in the loss of part of the eyebrow, reconstruction of the eyebrow was also performed at the same time, including the hairline at the tip of the forehead flap. The forehead flap is easy to raise and can be used to repair a variety of tissue defects through the design of the flap.

 We report a case of forearm compartment syndrome that developed during the course of a severe coronavirus disease 2019 (COVID-19) infection. Severe cases of COVID-19 are known to cause disseminated intravascular coagulation syndrome (DIC), which often presents in a thrombotic, fibrinolytic-suppressed form. However, cases of hyperfibrinolysis DIC with bleeding tendency have been reported following infection with COVID-19. In the present case, the patient had suspected hyperfibrinolysis DIC. We speculated that uncontrolled bleeding led to the development of compartment syndrome.

 A 78-year-old man developed a 22×19 cm oval skin and soft tissue defect centered on the right greater trochanter after extensive excision for right femur myxofibrosarcoma. A 25×9 cm rectus abdominis myocutaneous flap was obtained from the right abdomen and transported to the femur, and the deficient area was reconstructed by creating a rhomboid skin flap on the buttock. The flap was fully engrafted. On follow-up, the patient was progressing without limitation of the lower extremity range of motion.
 In reconstructing the greater trochanteric area, a tensor fascia lata musculocutaneous flap is often used for pressure ulcers; however, there are few reports of rectus abdominis myocutaneous flap. We report this case with a literature review.