Microsurgical tissue transfer for the reconstruction of hemifacial atrophy (Parry-Romberg syndrome) / 中华整形外科杂志

<p><b>OBJECTIVE</b>To reconstruct the soft tissue defect of the hemifacial with free anterolateral thigh fascioadipose flaps or scapular dermal-adiposal flap.</p><p><b>METHODS</b>The free anterolateral thigh fascioadipose flaps based on the perforators of lateral circumflex femoral artery or scapular dermal-adiposal flap based on the circumflex scapular artery has been designed and reconstructed hemifacial atrophy with the donor artery and vein anastomosed to the facial artery and vein.</p><p><b>RESULTS</b>Anterolateral thigh fascioadipose flaps were performed in 7 patients. Scapular dermal-adiposal flap was applied in 1 patient. All the flaps survived well and aesthetic appearance of reconstructed face achieved good result.</p><p><b>CONCLUSIONS</b>The microsurgical tissue transfer, especially the free anterolateral thigh fascioadipose flap is a good and reliable choice for hemifacial reconstruction.</p>

Analysis of Millard II technique for correcting secondary deformities of unilateral cleft lip / 中华整形外科杂志

<p><b>OBJECTIVE</b>To analyze the Millard II technique for correcting secondary deformities of unilateral cleft lip.</p><p><b>METHODS</b>The Millard II technique was used to correct secondary deformities of unilateral cleft lip in 42 patients from March of 2003 to September of 2004. Dissection was made between the alar cartilage and skin, and the alar cartilage was suspended.</p><p><b>RESULTS</b>The postoperative follow-ups with 3 approximately 6 months revealed good results of the symmetrical nostrils and philtrums, prolonged columella nasi, good-shaped cupid's bow, and invisible scar.</p><p><b>CONCLUSIONS</b>The Millard II technique could be an ideal method to correct secondary deformities of unilateral cleft lip. Releasing and suspending alar cartilage spontaneously at the same time can correct nasal deformity adequately.</p>

The periareolar approach management of postoperative complications of breast augmentation by injected polyacrylamide hydrogel / 中华整形外科杂志

<p><b>OBJECTIVE</b>To analysis various complications of 30 patients of breast augmentation by injected polyacrylamide hydrogel and discuss the treatment through periareolar incision.</p><p><b>METHODS</b>All patients were classified according to the different complications. Open suction technique and partial mastectomies via periareolar incisions were performed in all patients, Only one patient had immediately breast reconstruction with prosthesis, five patients received secondarily breast prostheses implantation via a axillary incision.</p><p><b>RESULT</b>All the symptoms were relieved after remove of polyacrylamide hydrogel.</p><p><b>CONCLUSIONS</b>Polyacrylamide hydrogel should be prohibited for injected breast augmentation at present. A double-blinded randomized clinical study, controlled animal experiments and a large sample questionnaire survey for complications are necessary. The periareolar approach is valuable technique and can remove polyacrylamide hydrogel as completely as possible.</p>

Twice delaying of the expanded flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce a new method for enlarging the survival area of an expanded flap.</p><p><b>METHODS</b>After the skin expander was inflated with enough injection, the first delaying was performed. In the operation, two incisions were made in the skin and subcutaneous tissue superficial to the expander capsule on both sides of the long axis of the expanded flap. After 10 to 14 days, the second delaying followed, in which one pedicle was divided to form a unilateral-pedicled, super-long random flap. When the flap was transferred to the recipient Since 2000,this technique has been used in 16 patients. All the area, the door site was closed directly.</p><p><b>RESULTS</b>flaps survived completely.</p><p><b>CONCLUSIONS</b>The technique of twice delaying can enlarge the survival area of the expanded skin flap.</p>

Preventive effect of chitosan on capsular contracture after implantation of silicone gel-filled mammary implants in rats / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the preventive effect of chitosan on capsular contracture after implantation of silicone gel-filled mammary implants in rats.</p><p><b>METHODS</b>18 SD female rats were divided into three groups randomly. Small silicone gel-filled mammary implants were implanted under each side of latissimus dorsi muscle. Chitosan was injected into left cavities as experimental sides, and nothing was injected into right cavities as control sides. 4, 8 and 12 weeks postoperation, specimens were dissected and observed using light microscope, and area density of collagen both type I and type III were also detected.</p><p><b>RESULTS</b>Fibrous capsules around implants consist of two layers: dense layer and loose layer. 4 weeks postoperation, total thickness of the experimental sides was less than that of the control sides (P < 0.01). Area density of collagen either type I or type III of the experimental sides was lower than that of the control sides (P < 0.01). Both 8 and 12 weeks postoperation, total thickness of the experimental sides was less than that of the control sides (P < 0.05). Area density of collagen type I of the experimental sides was lower than that of the control sides (P < 0.05). Area density of collagen type III was of no statistical difference between the experimental sides and the control sides (P > 0.05).</p><p><b>CONCLUSIONS</b>Chitosan can remarkably prevent capsule contracture during the early period after implantation of silicone gel-filled mammary implants.</p>

A new technique of upper-middle face rhytidectomy without destroying the configuration of sideburn / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce a safe, effective and lasting rhytidectomy technique without destroying the configuration of sideburn.</p><p><b>METHODS</b>The operation is performed through the coronal incision, the temporal incision that is paralleled to the nasolabial sulcus, and the preauricular incision in the sideburn. Multi-layer dissection of facial tissue is made.</p><p><b>RESULTS</b>46 patients with aging face have been treated using this technique since 2002. All patients obtained good curative effects without any severe complications.</p><p><b>CONCLUSIONS</b>This operation technique may maintain the natural configuration of the preauricular area and sideburn, result obscure incision scar and avoid harming important nerves or vessels. Multi-layer dissection accords with anatomical principles and produces a lasting curative effect.</p>

Clinical application of the fibrous capsule to prevent muscle tendon adhesion / 中华整形外科杂志

<p><b>OBJECTIVE</b>To observe the effect of fibrous capsule to prevent the flexor tendon adhesion.</p><p><b>METHODS</b>Six bum patients with 33 digits were treated with the fibrous capsule of the expanded flaps which was used to wrap the exposed flexor tendon in zone III in order to prevent the flexor tendon adhesion.</p><p><b>RESULTS</b>From 1999-2001 ,all of the patients were followed up to 1-3 years. The functions, assessed with the TAM method, were excellent in 18 digits, fair in three and poor in one. The excellent and good rate was 87.88%.</p><p><b>CONCLUSION</b>The fibrous capsule could be used to prevent or reduce the tendon adhesion.</p>

The neuro-vascular anatomical study of breast and it's signification in reduction mammaplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>to investigate the pattern of the blood supply and the nerve distribution of breast, in order to find a way for short-scar reduction mammaplasty.</p><p><b>METHODS</b>Twelve adult women cadavers were investigated for the vascularture of the anterior thorax and the nerve distribution of the breasts by using the blood vessel casting, specimen transparency technique and the autopsy. Based on the anatomical study, a modified double-circle reduction mammaplasty technique was designed to treat 28 patients with hypertrophical breasts.</p><p><b>RESULTS</b>There existed two- or three-layers vasculature in the anterior thorax. The extensive vertical vascular anastomoses were found among the three layers. The cutaneous perforators, penetrated out of the pectoralis major muscle, were formed a dense vessel network in the retromammary space. The vertical vessels thereafter emerged from the network, passed through gland and linked to the subcutaneous vessels. These vertical vessels were smaller and denser above the fourth intercostal space, but they were larger and sparser below the fourth intercostal space. The innervation of the nipple-areola mainly came from the lateral deep branches of the 4th intercostal nerve. It appeared S-shape running into the dropped breasts. The 28 patients were successfully treated with the modified technique, except one case with the loss of the nipple-areola sense.</p><p><b>CONCLUSION</b>The modified double-circle reduction mammaplasty could maximally fulfill the blood supply to the remained gland and the innervations to the nipple-areola, by keeping the advantages of the traditional technique such as invisible scar, good projection and the long lasting results. It could also be a safe and reliable technique.</p>