Introduction: Cosmetic results are normally the main concern in postoperative evaluation of breast reconstruction. However, it is also important to assess postoperative well-being, including recovery of breast perception and positive acceptance of the reconstructed breast as a part of the body without discomfort.
 Method: We included patients who had undergone total mastectomy followed by breast reconstruction using silicone implants or autologous tissue. Questionnaire surveys using BREAST-Q were conducted to assess postoperative breast perception and recognition, and acceptance of the reconstructed breast. Surveys were performed at one and four years after surgery.
 Results: Patients with reconstruction using autologous tissue had significantly higher satisfaction than those who had undergone reconstruction with silicone implants. Satisfaction significantly decreased over time after reconstruction surgery with silicone implants.
 Discussion: Our findings may be useful to assist patients in selecting their best option for breast reconstruction.
 Conclusion: Recovery of breast perception and positive acceptance of the reconstructed breast may be improved by breast reconstruction using autologous tissue instead of silicone breast implants.

 Background: Preoperative autologous blood donation is traditionally recommended for bimaxillary osteotomy to reduce the need for allogeneic blood transfusions. However, based on recent studies, autologous blood transfusion may no longer be necessary because of decreased blood loss during surgery. This retrospective study aimed to evaluate the impact of autologous blood transfusion on bimaxillary osteotomy and reexamine the necessity of this practice.
 Methods: This retrospective study analyzed 24 consecutive patients who underwent bimaxillary osteotomy at our institution. Patients were divided into either an autologous blood donation group or a no-blood donation group (12 patients were assigned to each group). We compared background, and intraoperative and postoperative factors.
 Results: No patients required allogeneic blood transfusion. Intraoperative blood loss, total intraoperative fluid volume, and in/out balance were significantly higher in the autologous blood donation group, whereas postoperative hemoglobin levels and changes in hemoglobin levels did not significantly differ between the groups. Preoperative use of iron tablets and erythropoietin was effective in managing anemic patients.
 Conclusion: Our findings suggest that the discontinuation of autologous blood transfusion in bimaxillary osteotomy is safe and does not impact postoperative hemoglobin levels. For anemic patients, use of iron tablets and erythropoietin may be a sufficient alternative. Further studies are needed to confirm our findings.

 We experienced a case of cutaneous nocardiosis in a 75-year-old, healthy male patient. About a month before his first visit to our hospital, the patient fell and was injured. He had a bruise on his left forehead and was treated at a nearby hospital, but it did not improve. He underwent abscess culture due to his atypical course, and a cutaneous Nocardia infection was suspected. In cases of suspected cutaneous nocardiosis, it is necessary to ask questions about the patient's history of outdoor trauma, perform relatively long-term wound culturing, identify the causative Nocardia species, carry out drug-susceptibility testing, and rule out systemic nocardiosis. Sulfamethoxazole/trimethoprim combination drug therapy is the first-choice treatment, but side effects may occur, as was seen in our patient. Special attention is required in such cases because long-term treatment is required.

 A 49-year-old female underwent breast reconstruction with a silicone breast implant (SBI) for left breast cancer. During the postoperative course, she was diagnosed as psoriasis vulgaris and received human monoclonal antibody (brodalumab) treatment. She was also diagnosed with SBI rupture twice. She received replacement of the SBI for the first rupture and replacement by free rectus abdominis myocutaneous flap for the second rupture. Although she had been taking human monoclonal antibody for more than 1 year, after replacement by autologous tissue, she did not require further antibody treatment because psoriasis vulgaris was resolved. The increased severity of psoriasis vulgaris coincided with the time the implants were inserted. Therefore, an association was suspected between psoriasis vulgaris and SBI rupture. When autoimmune-mediated disease develops or worsens after SBI reconstruction, the SBI is a possible cause.

 Trichoblastoma, a benign cutaneous adnexal tumor formed by follicular germinative cells, is frequently confused with basal cell carcinoma (BCC). Herein, we present a case of a 58-year-old male with a subcutaneous nodule measuring 5 cm in the mid-thoracic region, which had been present for 18 years. The patient was diagnosed with BCC with neurodifferentiation based on earlier biopsy and total resection. Following consultation, sweat-gland carcinoma with neuroendocrine differentiation was suspected; however, immunostaining revealed that the patient had trichoblastoma. We report each disease and discuss it with a literature review.

 Sebaceous carcinoma of the eyelids is a malignant tumor that originates in the meibomian gland. In Japan, the nodular type is most common, whereas the diffuse type, which diffusely extends to the eyelid, is rare. In our department, pathological examination of an extended tumor resection revealed a case of poorly differentiated sebaceous carcinoma with pagetoid spread (intraepithelial invasion of the tumor cells), which is commonly observed in the diffuse type, in addition to the nodular type. Preserving the eyeball was difficult because of extensive invasion of the sebaceous carcinoma to the eyelid conjunctiva and its adjacent eyeball; therefore, the orbital content was removed surgically. The postoperative margins were negative, and the patient had no recurrence. We report this case and have conducted a review of the literature because this is an unusual histopathological finding in a Japanese patient.

 Bevacizumab is the first anti-vascular endothelial growth factor antibody approved for the treatment of solid tumors, and its indications have been expanding in recent years due to its excellent antitumor effects. However, because bevacizumab has a mechanism of action different from conventional anti-cancer drugs, adverse events associated with its use are distinctive, including wound healing complications.
 A 74-year-old female with hepatocellular carcinoma, diabetes mellitus, and hepatitis C visited our hospital due to worsening of a wound on the right lower leg after initiation of bevacizumab plus atezolizumab combination therapy. An ulcer with black necrosis on the front of the right lower leg and edema of the entire right lower leg were observed. Chemotherapy was discontinued because a wound healing complication due to bevacizumab was suspected. Thirty-five days after the final dose of bevacizumab, the patient underwent debridement and split-thickness skin graft surgery. The wound completely healed 3 months thereafter with conservative treatment.