Introduction: Strangulated ears are classified as constricted ear types IIA and IIB in the Tanzer classification. At our institution, we perform auriculoplasty for type IIA and IIB cases using a local flap and chondroplasty without cartilage grafting. This report outlines our diagnostic approach, surgical techniques, and current challenges.
 Methods: The surgeries included a large Z-plasty for cryptotia with insufficient skin above the auricle and a bent auricle, and chondroplasty with a double banner flap and antihelix formation for a standing ear. No autologous rib cartilage or auricular grafting was performed.
 Results: Of 29 auricles in 26 patients, 16 auricles in 14 patients were followed up for more than 5 years after surgery. Of these, seven cases (nine auricles) required reoperation due to postoperative deformity and retroversion, all of which were type IIB cases. Most had retroversion or deformity.
 Conclusion: The treatment concept for constricted ears varies for the treatment of mild to severe cases. Depending on the situation, cartilage grafting or surgery, similar to that performed for microtia, should be considered.

 With the incorporation of national universities, medical treatment revenue must be carefully managed while maintaining high standards of medical education and research. "Revenue and expenditure evaluation of individual medical departments" serves as a key indicator for hospital management and individual departments to discuss management strategies. However, reconstructive surgery has been difficult to evaluate financially, as most procedures involve collaboration with other surgical departments. We retrospectively investigated the number of multi-department collaborative surgeries involving reconstructive surgery over a three-year period at our facility. Collaborations with the otolaryngology and gastrointestinal surgery departments mainly consisted of long-duration surgeries requiring free flaps with microvascular anastomosis. As a result, most of these surgeries were completed after 9 p.m. However, surgical fees were recorded as expenditures of the primary department and did not reflect the contributions of the reconstructive surgery team. If surgical contributions are not properly evaluated, staffing reductions may occur due to work style reform policies, leading to a worse work environment. To address this issue, we propose implementing a method to accurately document surgical fees for each department, ensuring that achievements and contributions are properly recognized.

 Polydactyly of the thumb is the most common congenital hand anomaly in Asian countries, including Japan. Most cases that undergo surgical excision involve the radial thumb. Excision of the ulnar thumb is rare. We report a case of a 1 year and 5 month old boy with polydactyly who underwent resection of the ulnar thumb. Eight months postoperatively, there was no scar contracture on the palmar aspect of the IP joint, and the fingertip had a good form, without contracture of the nail cage or nail edge. He was able to pinch relatively large objects, and no impairment of thumb adduction was observed. However, due to gradual narrowing of the first web space, we performed a revision procedure using five-flap plasty. Six months after the revision surgery, the outcome remains satisfactory despite some residual narrowing of the first web. This case highlights the importance of long-term postoperative follow-up for such cases.

 Decubitus ulcers with extensive subcutaneous pocket formation require surgical intervention. Muscle and musculocutaneous flaps are ideal for decubitus coverage and dead space augmentation; however, recurrent ulceration is often unavoidable. Repeated recurrences eventually limit surgical options. Herein, we propose a local dermal fat flap as a valuable alternative for managing such cases.
 Between 2020 and 2023, five patients (aged 19-80 years) with decubitus ulcers around the pelvis were treated using a local dermal fat flap. This technique involved epidermal denudation and augmentation of the dead space, with coverage provided by the residual subcutaneous tissue. During the follow-up period, no serious complications were observed in all cases.
 Local dermal fat flaps are simpler and less invasive than conventional muscle and musculocutaneous flaps. They can be an alternative treatment for small- to moderate-sized decubitus ulcers that require coverage and augmentation.

 Silicone lymphadenopathy is a relatively rare condition that is associated with the insertion of silicone breast implants (SBIs) during breast reconstruction. Silicone particles leached from SBIs can be transported to adjacent lymph nodes via macrophage phagocytosis, triggering a chronic inflammatory response through a foreign body reaction. Herein, we report a patient who underwent breast reconstruction with SBI and was incidentally found to have painless lymphadenopathy in the axilla during chest CT, eight years postoperatively. CT showed no rupture of the SBI. Lymph node biopsy was performed that established a definitive diagnosis of silicone lymphadenopathy. A wait-and-see approach was taken, without surgical intervention. Two years after the lymph node biopsy, the patient was doing well, without any lymphadenopathy recurrence.

 There are a wide range of treatments for conjunctival papillomas; however, no standard treatment has yet been established. Recurrence after treatment has been reported in many cases. Conjunctival papillomas are relatively rare ophthalmic diseases and reports in the field of plastic surgery are limited. Surgical treatment is the first choice when tumor growth causes functional impairment and morphological abnormalities for which plastic surgical intervention may be necessary. In the present study, we experienced a case of marked lower eyelid ectropion due to conjunctival papilloma, which was treated with cryotherapy and resection of the tumor followed by additional cryotherapy of the surrounding tissue, with no recurrence and good cosmetic results, based on a report by Theotoka et al. The results are reported with a discussion of the literature.