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Objective To conclude the experience of restoration of fat compartments volume intreatment of facial volume lost aging.Methods From May 2015 to May 2018,126 patients with facialvolume lost aging,aged from 34 to 52 years (mean age 42.6 years),were corrected by restoring fatcompartments volume using different sized autologous fat granule grafting technique.Patients' satis-faction was rated using Visual Analogue Scale (VAS) ranging from 1 (most unsatisfactory) to 10(most satisfactory).Results 126 patients with volume lost aging face were followed up from 3months to 2.5 years,the sculpted appearance became more fullness,the laxity,wrinkles and textureof skin were improved obviously,the patients' VAS score was (8.2±1.4).Conclusions Restorationof fat compartments by using different sized autologous fat granule grafting can augment the facicalfullness,reshape the facial contour and improve the aging skin.Therefore it proves to be a safe,multi-effecive and satisfying technique in the treatment of facial volume lost aging.
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Objective To observe the clinical effects of external tissue expansion assisted lipotransfer for temple depression augmentation.Methods A total of 18 cases of temple depression wore the a vacuum-based cupping cup device for recipient-site preconditioning for 1-3 months before fat injection.Results Temple soft tissue can pinched easily after expansion,fat injection ranged from 12-16ml per site,the temple depression were augmented and the sculpted appearance were improved obviously after 1to 12 months follow-up,there were no complications such as nodules,masses,alopecia or cysts occurred.Patient satisfaction was assessed and the VAS score was (7.8.± 1.4).Conclusions The addition of temple region expansion before fat injection can improve the skin compliance,increase the recipient-site volume,enhance fat graft placement and higher graft survival rates,demonstrating a high safety and efficacy procedure.
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Objective To investigate the application of auricular cartilage in nasal plastic surgery and its clinical effects of the different tip graft and reconstructed domal graft (RDG).Methods From October 2009 to May 2015,the surgical procedure was performed on 286 patients,through the application of cymba and conchae cartilages into various tip graft and RDG in nasal tip plasty.Results A total of 286 patients were followed up post-operatively for 3 months to 5 years,245 patients (85.7％ achieved expected stability tip,the tip down to 1-2 mm after one year.Tip skin thinning was observed in 10 patients after one year,nasal tip down occurred in 89 patients;the columella skew and asymmetric nostrils occurred in 31 patients.Conclusions The ear cartilage can be made into various tip graft for rhinoplasty,with satisfactory clinical outcomes.
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<p><b>OBJECTIVE</b>To investigate the technique for unilateral cleft lip nasal deformities.</p><p><b>METHODS</b>Through the traditional columella margin incision, the alar cartilage and the lateral nasal cartilage were exposed. After the mucosa between the two cartilages was divided, a mucosa-cartilage flap was developed and anchored, moving the lateral crus upwardly and medially, correcting the nasal deformity.</p><p><b>RESULTS</b>52 cases of primary nasal deformities and 18 cases of secondary nasal deformities were corrected with this technique. Satisfactory results were achieved.</p><p><b>CONCLUSION</b>This technique is recommendable, which is more likely to restore the physiological characters of the nose than the conventional technique.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Humans , Infant , Cleft Lip , General Surgery , Rhinoplasty , MethodsABSTRACT
<p><b>OBJECTIVE</b>To present the operation for nose defect reconstruction using a retroauricular free flap and the auricle cartilage.</p><p><b>METHODS</b>Based on the anatomy and blood supply of the retroauricular region, a flap was designed and harvested with the posterior auricular vessels as its pedicle. The flap was used to repair nose defects in five patients. Of them, three had unilateral subtotal alinasal defects, one had nasal apex defect, and one had defects on nasal apex and bilateral ala. The size of the defect ranged from 2.5 cm x 1.5 cm to 3.0 cm x 4.0 cm. The flap varied between 3.0 cm x 2.0 cm and 4.5 cm x 3.5 cm. In 4 cases, the auricular cartilage of 2.0 cm x 1.5 cm to 1.5 cm x 1.0 cm was taken along with the flap. The posterior auricular vessels were anastomosed with the facial vessels. The donor site was covered with full-thickness skin graft.</p><p><b>RESULTS</b>Postoperatively, the blood supply to the flaps was fairly good in 3 cases, while there was various venous stasis in 2 cases during the first 4 days. However, the postoperative results of the 5 cases were satisfactory.</p><p><b>CONCLUSIONS</b>The retroauricular free flap is a good choice for partial nose reconstruction, which had the merits of well-hidden donor site, good color match, and one-stage operation.</p>
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Humans , Nose , Congenital Abnormalities , General Surgery , Skin Transplantation , Surgical FlapsABSTRACT
<p><b>OBJECTIVE</b>To develop and evaluate the computer-aided system in measurement of expanded skin and preoperative planning.</p><p><b>METHODS</b>Stereophotogrammetric technique was used to gain the 3D image-pairs, from which the contours of the expanded sites were restored. The 3D surface data were provided to the specially developed "computer-aided tissue expansion 3D profilometry and surgery planning system", to calculate the expansion area and help the preoperative design.</p><p><b>RESULTS</b>The system has been applied clinically in 16 tissue expansion sites of 11 patients with fairly good results since March 1999. Compared with the traditional method, this system is accurate, repeatable and feasible.</p><p><b>CONCLUSION</b>This technique is useful and promising for improving the operation of tissue expansion.</p>
Subject(s)
Adult , Humans , Male , Dermatologic Surgical Procedures , Imaging, Three-Dimensional , Methods , Skin , Wounds and Injuries , Surgical Flaps , Tissue Expansion , Tissue Expansion DevicesABSTRACT
<p><b>OBJECTIVE</b>To summarize and present the experiences and results of the expanded distant skin flaps used in plastic and reconstructive operations.</p><p><b>METHODS</b>102 patients who had undergone expanded distant skin flap transfer were reviewed and followed up.</p><p><b>RESULTS</b>Good results were obtained. Especially when there was no sufficient normal skin close to the lesion or defect, the distant skin flaps were employed. The expanded distant skin flap can be directly transferred as a pedicle skin flap or an island skin flap. It can be indirectly transferred with an intermediary carrier or as a free skin flap.</p><p><b>CONCLUSION</b>The expanded distant skin flaps have many advantages, indications, worthy of recommendation.</p>
Subject(s)
Humans , Skin Transplantation , Methods , Surgery, Plastic , Methods , Surgical FlapsABSTRACT
Objective To study the fibrous capsule structure and its change after expansion.Methods Twelve minipigs were chosen for establishing the animal models of conventional intermittent tissue expansion (CITE) and continuous pressure tissue expansion (CPTE). The capsule samples were taken for measurement and histological examination.Results The thickness and the contraction rates of capsules in CPTE group were significantly less than those of CITE group. The capsule consisted of four layers, in which a large amount of collagen and elastic fibers existed and some small arteries, veins and capillaries were well developed. After expanded flaps were transplanted, capsules contained in flaps were partially degenerated except elastic fiber layer and fibrolaminar layer, but capsules on the wound bed almost all degenerated. Conclusion The results suggest that capsules have contractive and blood supply abilities. Capsulectomy is able to decrease flap contraction. Large expanded flaps are better to have the capsule reserved. No efforts shall be done to the capsules on wound beds.
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objective: To improve the repair technique of secondary nasal deformity following surgical treatment in the patients with bilateral cleft lip. Methods: 12 cases were treated with the operation technique: bilateral vermilion flaps were inserted into prolabial for the enlongation of upper lip and "V Y incision suture" principle was employed to repaire the nasal deformity. Results: Satisfactory results were achieved in all the 12 cases. Conclusion: The technique is feasible in the reconstruction of Cupid's bow, philtrum and correction of nasal and labia deformities.
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Objective To investigate the cell dynamic changes of conventional intermittent tissue expansion (CITE) and continuous pressure controlled tissue expansion (CPTE). Methods Domestic pigs were chosen for CITE and CPTE models. Immunohistochemical technique was used to detect proliferative cells, DNA fragments in situ labeling for apoptotic cells, and H E stain for total fibroblast counting. Results Proliferative index of basal cell increased during expansion. The peak value of 78.5% reached at the ninth day in the CITE group versus 84.2 % at fourth day in the CPTE group. Proliferation index in both groups decreased after expansion. Fibroblast proliferation, apoptosis and total fibroblast density increased slowly in both groups during and after expansion. At the sixth day, total fibroblast densities in CITE group (38.1 cells/H) and in CPTE group (40.9 cells/H) were significantly increased, compared with 34.93 cells/H in the normal skin. There were obvious proliferation and apoptosis phenomena in epidermal cells and skin adnexa. Conclusion Tissue expansion has both effects of proliferation and apoptosis on cell dynamics. Continuous tissue expansion can induce tissues growing much effectively.
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Because of massive defects requiring repair, a flap with blood supply of extraterritorial blood vessels is often needed clinically, which is a little bigger than that with blood supply of axial blood vessels. In order to provide theoretical evidence for the survival of such a flap, we designed a 11cm ? 15 cm flap involving the thoracodorsalic and the lateral thoracic arteries on a rat's lateral thorax and abdomen. The flap was stained by methylene blue and filled with emulsion. The diameters of the anastomotic branches within the flap were measured at different times. The volumes of blood flow on different points of the flap were observed quantitatively by means of ECT scanning. The vitality of the flap was also observed.Our experiment proved that anastomotic branches between blood vessels are the anatomic bases for extra-territorial flap. Blood flows from one blood vessel supplying zone to another through the anastomotic branches between the blood vessels. After the flap formed, The diameters of its anastomotic branches would grow larger.Since 1988, we have designed 33 extra-territorial flaps on cervicothorac area. The flaps have survived well. Our present experiment provided the flap with theoretical evidence that an extraterritorial flap can be devised provided that there is abundant anastomosis between the two axial blood vessels.