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Abstract

Sir: We would like to thank Dr. Hwang et al. for their comments regarding our article “Outcomes of Surgical Excision with Pressure Therapy Using Magnets and Identification of Risk Factors for Recurrent Keloids.”1 Characteristics of magnets that we have used are the same as we described previously.2 We totally agree with Hwang et al. that the force varies according to the distance between the two magnets. Therefore, the pressure we applied was not constant. Actually, we do not measure all the cases because the result is relatively similar, considering the thickness of auricular skin. The force between two magnets was measured by the compression test using the AFG AXIS portable machine with its stand. Parameters were set for newtons (N) to mark the force and a compression distance of 5 mm, which is the average thickness of the ear lobule. One magnet was fixed on the basement of the stand and the other was tied on top of a flat attachment of the device. The magnetic force naturally arises between two magnets, and the distal panel on the device displayed the peak force. However, the condition of the environment in the vicinity of the area being measured was largely influenced by the data because the magnet drew other metals placed around the table and the force between two magnets was decreased. Based on the experiment and our clinical experience, the steady force between the magnets was hardly maintained (35 mmHg). In addition, we introduce our novel dressing of magnets and hydrocolloid materials, which appear to be effective in reducing earlobe keloid recurrence (Fig. 1).3 This novel dressing method resulted in reduced acute wound issues and significantly decreased recurrence rates. We thank Dr. Hwang et al. for insightful commentary. We hope that they will be able to apply our magnet successfully in their clinical practice.Fig. 1: Early postoperative hydrocolloid dressing combined with magnets. (Reprinted with permission from Park TH, Chang CH. Early postoperative magnet application combined with hydrocolloid dressing for the treatment of earlobe keloids. Aesthetic Plast Surg. 2013;37:439–444.)DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication. Tae Hwan Park, M.D. Health Service Center Duckjuk Ongjin-gun, Incheon, Republic of Korea, and Keloid Research Foundation New York, N.Y. Ji Hae Park, M.D. Department of Plastic and Reconstructive Surgery Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul, Republic of Korea Michael H. Tirgan, M.D. Keloid Research Foundation New York, N.Y. Choong Hyun Chang, M.D., Ph.D. Department of Plastic and Reconstructive Surgery Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul, Republic of Korea