Pyramidal multiple-theory (multi-type, multi-method and multi-layer) for facial fat grafting.

BACKGROUND: Age-related changes to the face pertinent anatomy and important aspects of autologous fat grafting have been widely applied in facial rejuvenation. Various types of autologous fat products (Macrofat, Microfat, SEFF, nanofat, and SVF-gel) with different properties and applicabilities have been introduced and available for surgeons. METHODS: Key differences between common techniques for fat processing and infiltration. Develop a plan for patients based on site-specific facial anatomical zones, we suggested a pyramidal multiple-theory (multi-type, multi-method and multi-layer) for facial fat grafting. Based on the complicated mechanism of the face decrepitude in different layers of facial soft tissue, autologous fat products with various particle sizes and components into different layers. RESULTS: Fifty-eight patients underwent this facial fat grafting strategy from June 2020 to Jan 2022. All achieved cosmetic improvements, with higher patients' satisfaction, and minor complications. Our facial fat grafting strategy takes advantage of different fat products and is able to address the physiological tissue changes during aging, more properly and targetedly, than the traditional facial fat grafting. CONCLUSIONS: Fat grafting to the face aids in volume restoration and rejuvenation, thereby addressing soft-tissue atrophy associated with the aging face, acquired conditions, or congenital malformations. The technique described as "lipo-tumescence" has been successfully used in the breast and other regions of the body that have radiation damage and is discussed in this article specifically for the face and neck.

The Effect of Perichondrium on Biological and Biomechanical Properties of Molded Diced Cartilage Grafts.

BACKGROUND: Diced cartilage is a significant alternative approach to cartilage grafting. However, the viability and biomechanical properties of diced cartilage grafts remain to be improved, and the role of perichondrium is largely neglected. This study aimed to evaluate the histological and biomechanical effects of perichondrium on custom-shaped diced cartilage grafts constructed via a high-density porous polyethylene mold. METHODS: Seven New Zealand rabbits were used. Unilateral auricular cartilage was harvested and divided into 2 parts, with or without perichondrium, diced into 1 × 1 × 0.5 mm cubical pieces, and filled into high-density porous polyethylene molds. Three grafts with the perichondrium removed and 3 with the perichondrium preserved were implanted subcutaneously at the dorsum. The grafts underwent biomechanical and histological tests 4, 8, and 12 weeks after the implantation. RESULTS: The diced cartilage merged into integrated blocks without observable resorption in both groups at each time point. Additionally, the retention rate of weight was higher in the perichondrium-preserved group (P < 0.05). We observed regenerated cartilage that stained positively for type II collagen and glial fibrillary acidic protein (GFAP). A greater area of regenerated cartilage and higher scores of GFAP staining were observed in the perichondrium-preserved group (P < 0.05). The yield stress and modulus of elasticity were also higher in the perichondrium-preserved grafts from week 8 after implantation (P < 0.05). CONCLUSIONS: Diced cartilage grafts with a custom shape can be constructed using a high-density porous polyethylene mold. The preservation of perichondrium can improve graft viability and biomechanical properties. LEVEL OF EVIDENCE: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.

Synergistic effects of adipose-derived stem cells combined with decellularized myocardial matrix on the treatment of myocardial infarction in rats.

AIMS: The aims of the study are to investigate whether the combination of adipose-derived stem cells (ADSCs) with decellularized extracellular matrix (dECM) of myocardium can exert synergistic therapeutic effects on acute MI and the underlying mechanism. MAIN METHODS: Myocardial dECM from fresh porcine myocardium was prepared in an injectable gel, ADSCs were seeded into the myocardial dECM gels, and then the mixture was injected into the myocardium of the infarct border zone after acute MI, which was induced by ligating the left anterior descending coronary artery in male SD rats, to assess the therapeutic potential. The degree of fibrosis was detected by Masson's trichrome. The evaluation of cardiac function was performed by Electrocardiography. KEY FINDINGS: Myocardial dECM (2.0%) had a suitable aperture and arrangement for cell growth, and also exhibited suitable biomechanical properties. Four-weeks after treatment in vivo, the combination of ADSCs and myocardial dECM could obviously increase angiogenesis, reduce the degree of fibrosis, and decrease infarct size. Furthermore, the combination treatment exerted significant functional improvement. Compared with ADSCs or dECM group alone, the left ventricular ejection fraction (LVEF) in the combination group was 13.4% and 21.8% elevated, respectively. SIGNIFICANCE: The combination of ADSCs and myocardial dECM has synergistic effects on cardiac repair in acute MI.

Treatment of Xanthelasma Palpebrarum With Intralesional Pingyangmycin.

BACKGROUND: Xanthelasma palpebrarum (xanthelasma) is the most common type of cutaneous xanthoma, and many patients tend to seek medical treatments for cosmetic reasons. Many methods treating xanthelasma have been proposed, but none of these options can be regarded as a perfect solution. OBJECTIVE: To study and evaluate the intralesional injection treatment of xanthelasma with pingyangmycin, which has been widely used as a broad-spectrum antitumor antibiotic. MATERIALS AND METHODS: 21 lesions in 12 patients were treated by intralesional pingyangmycin. Photographs were taken before and after each treatment session. Patients were followed up for 7 to 36 months. RESULTS: All patients except one received satisfactory results after up to 2 sessions. Only 1 patient had a local recurrence 1 year after the treatment. No severe complications such as infection, atrophy, ulceration, or scar were noticed. CONCLUSION: Intralesional pingyangmycin is a cheap, effective, and safe treatment for xanthelasma, which has been well accepted by patients.