Ear reconstruction after rupture of postauricular expanded flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To summarize the principles of ear reconstruction after rupture of postauricular expanded flap.</p><p><b>METHODS</b>The rupture of the postauricular expanded flap was graded as I-IV degree. For flap rupture of I and II degree, the ear reconstruction was performed immediately with autogenous cartilage framework. For flap rupture of III degree, topical and systemic treatment should be done to relieve the redness and swelling. Then the ear reconstruction was performed. For flap rupture of IV degree, the expanded postauricular flap was smoothened. Ear reconstruction was performed 3 months later.</p><p><b>RESULTS</b>There were 67 cases with flap rupture, including 43 cases as I and II degree, 17 cases as III degree and 7 cases as IV degree. Ear reconstruction with autogenous cartilage framework was performed in 43 cases, with Medpor framework in 17 cases. Flap smoothing and secondary ear reconstruction with autogenous cartilage framework was performed in 7 cases. The results were satisfactory with complications in 4 cases (7%), which resolved after treatment. Primary healing was achieved in all the patients.</p><p><b>CONCLUSIONS</b>Good result could be achieved in ear reconstruction, even after flap rupture. Proper treatment should be adopted according to the rupture degree.</p>

Design and application of the expanded transposition flaps in the treatment of cheek skin defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the design and application of the expanded transposition skin flap in the treatment of cheek skin defects.</p><p><b>METHODS</b>The expanded transposition flaps were divided into three types: the regular expanded transposition flap (ERT flap), the expanded transposition-advancement-transposition flap (TAT flap) and the expanded rotation-advancement-transposition flap (RAT flap). 135 cases of cheek skin defects resulted from hemangioma, scar and naevi were treated with these three types of flaps. Delay surgery was needed when the ratio of length to width was bigger than 2 : 1.</p><p><b>RESULTS</b>There were 139 expanded transposition flaps, including 17 ERT flaps, 69 TAT flaps, 53 RAT flaps. Blood supply disturbance was happened at the end of the flaps in 6 cases, including 2 ERT flaps and 4 other flaps. Other flaps had no complication. The results were satisfactory.</p><p><b>CONCLUSIONS</b>The expanded transposition skin flap is a reliable method to repair the cheek skin defect. The preoperative flap design is very important for successful reconstruction.</p>

Clinical application of three methods for total ear reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the indication and results of three methods for total ear reconstruction.</p><p><b>METHODS</b>960 cases of total ear defect were treated with skin expansion and autogenous rib cartilage framework (n = 786), or skin expansion and Medpor framework (n = 150), or ear prosthesis (n = 24). The indication and results of the three methods were analysed.</p><p><b>RESULTS</b>Good cosmetic results were achieved with all three methods. Autogenous rib cartilage framework was suitable for patients under 30 years old with unaffected skin at mastoid region. Medpor framework was good for grown-up, especially over 30 years old, or with mild infection at mastoid region. Patients with severe skin injury at mastoid region or unwilling to accept surgery should choose ear prosthesis.</p><p><b>CONCLUSIONS</b>Satisfactory results can be achieved with suitable methods for total ear reconstruction.</p>

The design and transposition principles of expanded flap for treatment of cheek skin-soft tissue defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore an ideal method for repairing the skin-soft tissue defects according to the different anatomical units of cheek, and find reasonable design principles to transfer the expanded flaps.</p><p><b>METHODS</b>According to the location of the defect, we placed 1-3 appropriate expanders nearby, when the flap expanded enough we adopted advanced skin flaps, rotation-advanced skin flaps or transposition skin flaps to repair the defect. In this group of 269 cases, the defects were secondary to hemangioma, various scars, nevus or nevus excision.</p><p><b>RESULTS</b>In all 269 cheek defects, 305 expanded flaps were developed which included 145 rotation-advanced flaps, 121 advanced skin flaps and 39 transposition skin flaps. 52 of them generated complications, including blood circulation disorder of the distal part of flaps, hematoma, infection, injection, lower eyelid ectropion, expander extrusion and capsule contracture. Mostly, these complications didn't affect the final results.</p><p><b>CONCLUSIONS</b>The principles presented in this article are the guidelines to treat the skin-soft tissue defect of check with tissue expansion. The satisfied results come from the reasonable flap designs.</p>

Correct conglutination deformities of the upper eyelid after double eyelid operation by relieving infraorbicularis oculi fat flap and infilling / 中华整形外科杂志

<p><b>OBJECTIVE</b>Adhesive or too highly located folds upper eyelid and even blepharoptosis are common complications of double eyelid operation. To correct such deformities.</p><p><b>METHOD</b>We shifted down the double eyelid line, removed adhesion thoroughly, relieved orbital fat and restarted the volume with infraorbicularis oculi fat flap.</p><p><b>RESULT</b>We had treated 32 case in past two years. The results were satisfying.</p><p><b>CONCLUSION</b>The method are acted easy and gained fine result, so behaving to extend application.</p>

A new method for medial canthoplasty combined double eyelid formation / 中华整形外科杂志

<p><b>OBJECTIVE</b>In order to explore a new method to perform the medial canthoplasty applied with upper eyelid fold formation in a single procedure.</p><p><b>METHODS</b>According to the principles to correct the deformity of the medial canthus, a new method was designed to fetch up the skin defect of the medial side of upper eyelid, minimize the skin scarring around the medial canthus, and form upper eyelid fold.</p><p><b>RESULTS</b>The 86 cases, which mild or moderate epicanthus without upper eyelid fold, were treated with this technique and long-term follow-ups above 6 months were made. The 67 cases were given the follow-ups. The appearances of upper eyelid fold and medial canthus were evaluated. The appearances of eyelid fold were paralleled type. The epicanthus was corrected completely or in major.</p><p><b>CONCLUSIONS</b>This new canthoplastic method with upper eyelid fold formation may be suitable to all the medial epicanthus except inverse epicanthus. All of the patients were satisfied with the final results.</p>

Facial anatomic study and application in rhytidectomy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To find a procedure for facial rejuvenation which is simple, safe with lasting aesthetic results based on facial anatomic study.</p><p><b>METHODS</b>Anatomy study was performed on 12 sides from 6 head specimens. Observe the range and thickness of fat lateral to the nasolabial grooves. Observed the location of the skin retaining ligaments and reappraised their functions combining with clinical observations.</p><p><b>RESULTS</b>Skin and subcutis and SMAS (including mimic muscles) become slackening with aging, but the loosening degrees are different, especially in the region lateral to the nasolabial groove. So they should be handled respectively. The fat lateral to the nasolabial groove is thick and is mobile with aging . So the subcutaneous detachment need not beyond the anterior border of the masseter. In the past two years, we performed rhytidectomy on 100 patients by limited subcutaneous detachment and SMAS double-plication. Satisfactory results were obtained. There are no serious complications observed.</p><p><b>CONCLUSIONS</b>Rhytidectomy by limited subcutaneous detachment and SMAS double-plication is a simple and safe procedure with lasting aesthetic results.</p>