The Effects of Timing of Postoperative Radiotherapy on Hypertrophic Scar in a Rabbit Model.

BACKGROUND Hypertrophic scar is associated with excessive proliferation of fibroblasts, the accumulation of collagen fibers, and angiogenesis associated with chronic inflammation. Scar resection, combined with radiotherapy, is widely used in clinical practice, but timing remains controversial. This study aimed to investigate the association between the timing of postoperative radiotherapy and the effects on hypertrophic scar in a rabbit model. MATERIAL AND METHODS Forty New Zealand white rabbits, 8-12 months old, weighing 1.8-2.3 kg were used in the model of hypertrophic scar and underwent surgical resection with or without postoperative radiotherapy. The study groups included: Group 1, the non-resection group; Group 2, the resection and non-radiotherapy group; Group 3, the immediate postoperative radiotherapy group; Group 4, the 12-hour postoperative radiotherapy group; Group 5, the 24-hour postoperative radiotherapy group; Group 6, the 48-hour postoperative radiotherapy group; Group 7, the 72-hour postoperative radiotherapy group; and Group 8, the 120-hour postoperative radiotherapy group. The rabbit ear skin was observed after treatment, and the hypertrophic scar index (HI), fibroblast numerical area density (NA), and collagen fiber area density (AA) were determined. RESULTS The HI, NA, and AA were significantly lower after 48 hours of postoperative radiotherapy (P<0.05), with the effects occurring mainly within 24 hours. There was no difference in HI, NA, and AA between the radiotherapy and non-radiotherapy groups within 24 hours after surgery. CONCLUSIONS In a rabbit model of hypertrophic scar, surgical resection combined with radiotherapy resulted in an optimal effect within 24 hours after surgery.

Surgical Treatment Strategy for Severe Rhinophyma With Bilateral Pedicled Nasolabial Flaps.

BACKGROUND: Rhinophyma is a rare disease characterized by chronic inflammation and hypertrophy of sebaceous glands, blood vessels, and fibrous tissue, associated with end-stage severe acne rosacea. There are multiple approaches to treatment and repair, including dermal shaving, secondary intention healing, free skin graft, and skin flaps. However, these methods have various disadvantages, such as prolonged healing, obvious scarring, and skin texture mismatch. Therefore, the authors adopted surgical excision with bilateral pedicled nasolabial flaps, which have better color, texture, thickness, and symmetry. METHODS: The authors present a case of severe nasal tip rhinophyma successfully treated by excision and repair with bilateral pedicled nasolabial flaps. This procedure combines deep excision of the focal lesion and coverage with bilateral nasolabial flaps. RESULTS: The bilateral pedicled nasolabial flaps were used for severe rhinophyma in a patient. After the operation, the flaps survived uneventfully in this study. Both functional and aesthetic results were satisfactory at 3 months. CONCLUSION: The authors offer an effective method for surgical treatment of rhinophyma. Excision of hypertrophic nasal tissue is an acknowledged effective treatment for patients with severe rhinophyma. After excision, reconstruction with nasolabial flaps results in satisfactory outcomes both functionally and aesthetically. Therefore, this approach should be considered an appropriate alternative in cases of severe rhinophyma.

Anthropometric labial analysis of Han Chinese young adults.

BACKGROUND: Facial features vary in size and proportions between different races. This study aimed to measure the anthropometric variables of the labial region in Han Chinese young adults. MATERIALS AND METHODS: A total of 900 college students (475 male and 425 female) of Chinese Han ethnicity from the northern China were included. Measurements of the labial region included 14 linear items and seven proportions. RESULTS: All the linear measurements of the males were significantly higher than those of the females (all P < 0.001). Significant gender differences were found in the philtrum morphology, philtrum width, upper vermilion-cutaneous lip, lower vermilion-cutaneous lip, and vermilion. There are significant differences in the anthropometric variables of the labial region between male and female Han Chinese young adults. CONCLUSIONS: These data may be used as a reference standard for labial reconstructive and aesthetic surgery.

High temperature requirement factor A1 (HTRA1) regulates the activation of latent TGF-ß1 in keloid fibroblasts.

Scar treatments are considered a major issue in the plastic surgery field. Activation of the transforming growth factor-ß (TGF-ß)-mediated signaling pathway plays a key role in the scar pathogeneses, and high temperature requirement factor A1 (HTRA1) inhibits TGF-ß1 activation in tumor cells. Our study aims to investigate the role of HTRA1 in the pathogenesis of scars. The mRNA levels of HTRA1 was evaluated by real time PCR, HTRA1 protein expression was determined using western blot and immunohistochemistry, and a luciferase assay was applied to measure dynamic changes of TGF-ß1 activity. We found that the expression of HTRA1 was significantly elevated in keloid tissues, compared to normal skin, and TGF-ß1 mRNA levels slightly increase in the keloid tissue. Furthermore, active TGF-ß1 protein levels and Smad2 phosphorylation significantly increased in the keloid tissue. Treatment with the latent TGF-ß1 or recombinant human HTRA1 (rhHTRA1), alone or in combination, increased Smad2 phosphorylation levels in keloid fibroblasts and active TGF-ß1 contents of associated supernatants. Our results suggest that HTRA1 is involved in the pathogenesis of scars through regulating activation of latent TGF-ß1 in keloid fibroblasts, and our study reveals that HTRA1 is a novel target that regulates scar formation.

Anthropometric nasal analysis of Han Chinese young adults.

BACKGROUND: There are varying degrees of racial differences in the size, shape, proportions of the facial structures. METHODS: A total of 900 Han Chinese young adults (501 females and 399 males) were included in the analysis. Measurements taken of the soft tissue of the external nose included 12 items of linear distance and 5 angles. Six proportion indices of the soft tissue of the external nose were determined. RESULTS: In the 12 parameters of linear measurement, females were found to have significantly smaller nasal base width, nasal ala length, nasal ala thickness, columella height, columella width, and nasal tip width in comparison to males (all, P < 0.01). In the five angular measurements, females were found to have a smaller nasal tip angle and nasolabial angle (both, P < 0.05) and a larger nostril tilt angle, nasofrontal angle, and nasal tip angle (all, P < 0.001). Nasal depth-nasal width and columella height-nasal depth were both significantly less in males than females (53.25 ± 8.2 vs. 54.56 ± 9.7 and 51.61 ± 11.92 vs. 53.37 ± 12.56, respectively); whereas nasal ala length-nasal height was significantly less in females than in males (29.41 ± 8.95 vs. 30.9 ± 7.02). CONCLUSION: Significant differences are present in nasal indices of males and females of Han Chinese ancestry. These data may serve as a reference standard for nasal reconstructive and aesthetic surgery.