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Objective To measure the change of facial volume maintenance rate after autologous fat grafted for repaired progressive facial hemiatrophy by using three-dimensional digital technology.Methods 3D scanner was used to acquire facial data in 10 patients with progressive facial hemiatrophy before operation;Mimics 17.0 software was used to reconstruce patients' facial 3D model and to calculate the volume of facial tissue defect;autologous fat was grafted to repair facial deformity.The facial volume maintenance rate was calculated in all the patients 3 months and 6 months after operation.Results We had performed facial 3D data acquisition and facial repaired with autologus fat grafted in 10 patients;patients' facial morphology was improved.The mean facial volume maintenance rate was (35.80±3.44)％ in 3 months and (27.82±3.80)％ 6 months after surgery.Conclusions The mean facial volume maintenance rate in postoperative 3 months is inferior to that in 6 months in single autologous fat grafted for repairing progressive facial hemiatrophy.
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Objective@#To present a new method for correction of prominent malar complex via intraoral approach by double support technique osteotomy which can provide a stable support.@*Methods@#According to the anatomical characteristics of malar complex and relevant masseter muscle, we designed a malar reduction technique including anterior and posterior support. The reduction procedure entailed an L-shaped osteotomy ofthemalarbody and oblique osteotomy of malar arch. On the basis of prominence degree, bone fragment was moved inward and upward to form double support, which could reduce malar and zygomatic arch effectively.@*Results@#A total of 76 patients subjected to double support technique for malar reduction between January 2015 and January 2017 were retrospectively reviewed.The follow-up period ranged from 10 to 12 months. All patients were satisfied with aesthetic outcomes without major complications, such as facial nerve damage or bone ununion.@*Conclusions@#Double support technique is an effective method to correct malar prominence andreduce the zygomatic complex which can prevent saggy cheek and bony malunion.
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Objective To discuss the correlation between initial malar reduction procedures and the method of revision procedures and the personalized treatment strategies for the second deformity of postoperative prominent malar complex.Methods From January 2003 to December 2017,27 patients underwent personalized revision surgery of malar reduction according to the different second deformity of malar complex.The surgical technique included the double support malar reduction technique,orthotopic malar osteotomy technique,malar bone grinding surgery,and autogenous bone transplantation.Results A total of 27 patients subjected to revision surgery for malar reduction between November 2006 and December 2017 were retrospectively reviewed.22 patients were satisfied with aesthetic outcomes after the first revision procedure,while 5 patients were satisfied after 2 or 3 procedures follow-up for 10 to 12 months.Conclusions The incidence of complications after malar reduction is related to the first surgical method.According to the unsatisfactory results,it can be repaired individually to obtain a better clinical repair effect.
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Objective To find a method to repair nasal deformity of Tessier 3 cleft.Methods Five Tessier 3 cleft patients were treated from June 2010 to June 2015 in our department.Nasolabial groove flap or nasolabial groove flap accompanied by offside ala nasi groove flap were performed to correct the nasal deformity according to the defect of the ala.Results Two cases were treated with simple nasolabial groove glap,and 3 cases were treated with nasolabial groove flap accompanied by offside ala nasi groove flap.All the flaps survived with incisions of donor sites healed primarily.The color,texture and thickness of the flaps were similar to those of recipient sites after 1 year follow up.The scar in donor site was concealed and not obvious.The results showed good healing and good appearance,and the symmetry between the nostrils also seemed to be acceptable.Conclusions Nasolabial groove flap and nasolabial groove flap accompanied by offside ala nasi groove flap are good methods to correct nasal deformity of Tessier 3 cleft.The offside ala can be reduced at the same time and the symmetry between the nostrils can be achieved more easily.The operation is easily performed,the scar is acceptable and the results are good.
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BACKGROUND: There are currently many cryopreservation methods for the aminotic membrane, which have varying effects on the ultrastructure and biological activity of amniotic membrane, but on no one is effective. OBJECTIVE: To compare the effects of different cryopreservation methods on the ultrastructure and viability of aminotic membrane and to seek the ideal cryopreservation method. METHODS: Aminotic membrane separated from the fresh placenta was preserved respectively with deep-frozen cryopreservation and vitrification, and everyway was run for 3 and 6 months. Fresh aminotic membrane was used as control. The ultrastructure of aminotic membrane was observed by transmission electron microscopy, and the viability of aminotic membrane was assessed by microcomputer analysis system for biological oxygen consumption, and immunohistochemical staining combined with image analysis system was used for lactate dehydrogenase activity. RESULTS AND CONCLUSION:After 3 and 6 months of crypreservation, the damage to the ultrastructure of aminotic membrane by vitreous cryopreservation was slighter than that of amniotic membrane cryopreserved at-80℃. Compared with the fresh aminotic membrane, the gray value of lactate dehydrogenase and partial pressure of oxygen were significantly decreased in the cryopreserved aminotic membrane by deep-frozen cryopreservation at 3 and 6 months (P < 0.05) and by vitreous cryopreservation at 6 months (P < 0.05), but there was no statisticaly significant difference in the change rate of oxygen partial pressure and the gray value of lactate dehydrogenase between the fresh aminotic membrane and the cryopreserved aminotic membrane by vitreous cryopreservation at 3 months. The present study led to the conclusion that vitreous cryopreservation protocol alows to not only maintain the integrity of AM, but also to preserve the viability of the cels. So the vitreous cryopreservation is superior to the deep-frozen cryopreservation for cryopreservation of aminotic membrane.
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Objective To investigate the expression of the cyclin D1 in pubertal mammary hypertrophy and micromastia. Methods The expression of cyclin D1 was detected by SP immunohisto-chemistry in 18 cases of pubertal mammary hypertrophy and 12 cases of micromastia. Results The expression rate of cyclin D1 within breast tissue was 83. 33 % and 16. 67 % in pubertal mammary hypertrophy and micromastia, respectively. There was significant difference between the two groups (P<0. 01). Conclusion The expression level of the cyclin D1 within breast tissue in pubertal mammary hypertrophy is higher than that in micromastia.
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BACKGROUND: Enophthalmos deformity is the most common complication caused by orbital blow-out fractures, and others are diplopia and worsening of visual acuity. Since the therapeutic result of orbital blow-out is not satisfactory and many complications exist after operation, it is still a dispute to select implantation materials and therapeutic regimens.OBJECTIVE: To observe the therapeutic effect and assess the improvement of visual function by surgical reconstruction with porous high-density polyethylene (Medpor) for the correction of enophthalmos deformity caused by orbital blow-out fractures.DESIGN: A pre-and postoperative controlled study.SETTING: Beauty Center for Trauma Repair,Plastic Surgery Hospital,Peking Union Medical College, Chinese Academy of Medical Science .PARTICIPANTS: Totally 56 patients with orbital blow-out fractures who had enophthalmos deformity caused by fists or traffic accidents, treated at Beauty Center for Trauma Repair,Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, were selected in this study from December 1996 to March 2004. Final diagnosis were made with case history, X-ray film, two-demensional and three-dimensional CT before operation. 24 cases were accompanied with other areas fractures such as zygoma and nasal bone, 34 cases with diplopia, 35 cases with visual acuity worsening after injured.METHODS: ①Material implantation: Exposure of the orbital floor, inferior and medial walls could be performed through a 2 mm inferior subciliary incision of 3 cm long. To approach the orbital rim via a dissection plane anterior to the orbital septum, sub-periosteal dissection was then performed over the orbital rim, and along the orbital floor to the orbital apex. Mobilized the soft tissue from the bone throughout the entire area of fractures and re-position it to its proper position. Took Medpor (Type 6331) sheets as the implantation materials, trimmed Medpor sheets according to the radian and anatomic form, and 2 mm larger than the defect rim was needed.If other operations were needed during the operation, they could be done.Mannitol and dexamethasone should be used just postoperatively to decrease edema of the orbital contents and reduce inner orbital excessive pressure. ②Functional evaluation standard: Diplopia: completely disappear meant recovered, less diplopia residual meant improvement, no improvement meant inefficacy. Enophthalmos: marked improvement meant the degree of enophthalmos stabilizated at below 2 mm, less improvement meant stabilizated at above 2 mm.MAIN OUTCOME MEASURES: ①Improvement of enophthalmos; ②Improvement of diplopia ; ③Improvement of visual acuity.RESULTS: ①All 56 cases of enophthalmos deformities caused by orbital blow-out fractures improved greatly. ② Of all the 34 patients with diplopia, 27 recovered. ③ 9 patients' visual acuity of 35 improved with different degrees. No diplopia or visual acuity worsening occurred. With a follow-up ranging from 2 months to 5 years, the degree of enophthalmos stabilizated at below 2 mm, and no relapse and other complications occurred.CONCLUTION: Medpor has such advantages as better histocompatibility,fewer complications and better visual function improvement, so it is the preferred implantation material for correcting enophthalmos deformity caused by orbital blow-out fractures.