Correction of hemifacial atrophy by use of a chest dermal-fat flap with the platysma pedicle / 中华整形外科杂志

<p><b>OBJECTIVE</b>To present a new dermal-fat flap for the correction of hemifacial atrophy.</p><p><b>METHODS</b>An upper chest dermal-fat flap was created with its upper margin 1 cm cranial to the clavicle. The platysma pedicle of the dermal-fat flap, 5 cm in width, was dissected subcutaneously through a skin incision caudal to the mandibular margin. The platysma pedicle was turned over at the mandibular margin so that the dermal-fat-flap could be transposed fitly to the atrophic face.</p><p><b>RESULTS</b>Eight cases were treated by this technique. Good results were achieved.</p><p><b>CONCLUSION</b>This flap is suitable for the correction of hemifacial atrophy for its good blood circulation and a large amount of tissue.</p>

A study on the survival mechanism of the reverse-flow axial skin flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the survival mechanisms of the reverse-flow flap.</p><p><b>METHODS</b>A skin flap measuring 8.0 cm x 2.5 cm based on the left deep circumflex iliac vessel (DCIV) was designed and elevated on the rat's dorsum with 4.0 cm of it's length crossing the midline. The flap was served as the reverse-flow flap model. The survival area, the dynamic microcirculation including flow direction, microvessel number, caliber, pressure and vasculature were assessed respectively at 6 hour, 24 hour, 48 hour, 72 hour, 7 day and 14 day after operation.</p><p><b>RESULTS</b>The average gradient of perfusion pressure was 0 kPa before operation and was 4.9 KPa postoperatively between the proximal and the distal site of the flap. By anastomosis of bilateral DCIV, the blood flow run in a reversed pattern in the region distal to the midline. No venous valves were observed. Distal congestion developed in 20% of the flaps within 72 h. After that, the number and caliber of venous anastomosis increased with pressure dropping in the midline region. The axial vessels extended its branches progressively along the dilated anastomotic rami. As a result, the vasculature of the flap became similar to that of the conventional axial flap by the 14th day. With these changes, flap congestion was alleviated gradually and subsided within 7 days. All the flaps survived completely.</p><p><b>CONCLUSIONS</b>Anastomosis connecting the two axial vessels is the circulation route of the reverse-flow flap. By the gradient pressure between the proximal and distal region, blood is driven reversely. Within 72 h, the distal part is susceptible to congestion. In this period, increasing number and caliber and decreasing pressure of anastomosis is important mechanism to support the circulation. After that, the new vasculature similar to the conventional axial flap provides the flap with reliable and permanent blood supply.</p>

Anatomical reconstructiion of orbicularis oris muscle in the repair of cleft lip / 实用口腔医学杂志

objective: To design a new technique which might be used to reconstruct the orbicularis oris muscle effectively. Methods: The superficial and deep layers of orbicularis oris muscle on the lateral side of the cleft were dissected and sutured to the correspondent layers on the medial side respectively. A small muscle flap from the medial nasal labial bundle below the columella was rotated laterally and sutured with the nasal bundle on the lateral side in 10 cases of cleft lip. Results: Satisfactory results were obtained in all the cases. The postoperative scar was minimal. The lip appearance was satisfactory at rest as well as in motion. Conclusion: This technique is effective in reconstruction the orbicularis oris muscle of cleft lip.

Periareolar mammaplasty and liposuction for breast reduction / 中华医学美学美容杂志

Objective To evaluate a new technique for breast reduction. Methods The subcutaneous fat of the breasts was removed by liposuction. Two circular incisions, an inner circle that represents the new areola perimeter and the outer circle that defines the outside extent of the skin de epithelized, were designed. The de epithelized skin worked as a dermal cloak to position the nipple and cover the remaining glandular tissue with supporting. Results This technique was used in 9 cases. All the breasts kept a satisfactory shape. The areola and scar tended to widen within 3 months. Conclusion This technique is easy to perform, and effective for breast reduction.