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Objective:To explore and observe voice effect of the resection of the vocal fold sulcus, suture of the vocal fold mucosa, and fat granule packing under the support laryngoscope. Methods:A total of 25 patients with vocal fold sulcus underwent vocal fold sulcus resection under a support laryngoscope. After the vocal fold sulcus was removed, the mucosa on both sides of the vocal fold sulcus was sutured into a pouch. Next the fat granules removed from the abdomen were stuffed into the pouch until the vocal folds were full, and the mucosa was repaired, and then the pouched mucosa was sutured. After the operation, the patients were silent for 2 weeks and followed up at 3, 6, and 12 months postoperatively to observe the state of the vocal fold mucosa and the voice effect of the vocal fold under the stroboscopic laryngoscopy. The main outcome measures were the mucosal movement, fundamental frequency ï¼F0ï¼, fundamental frequency perturbation ï¼Jitterï¼, amplitude perturbation ï¼Shimmerï¼, normalized noise energy ï¼NNEï¼, harmony/noise ï¼H/Nï¼ and maximum phonation time ï¼MPTï¼. Results: Among the 25 patients, 23 patients had good vocal fold closure and smooth mucosa. Under the stroboscopic laryngoscope, the mucosal movement was good and smooth, and the F0, Jitter, Shimmer, NNE, H/N, MPT were significantly improved, and the voice quality was significantly improved. The other 2 patients had fat particles spillover in the vocal fold. The voice function recovered well after the second treatment. Conclusion:Resection of vocal fold sulcus, suture of vocal fold mucosa, and fat granule packing under support laryngoscope are very effective for the treatment of vocal fold sulcus. Indispensably, the operation is done properly, and the patient silence the voice according to the doctor's advice, thus the voice quality will be satisfactory after the operation. .
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Laryngeal Muscles , Vocal Cords , Humans , Laryngeal Mucosa , Sutures , Treatment Outcome , Vocal Cords/surgery , Voice QualityABSTRACT
OBJECTIVES: In this study, we analyzed the effect and prognosis of combinative implantation of autologous-fat granule and prosthesis for breast reconstruction after radical mastectomy. METHODS: 73 cases of breast cancer patients hospitalized from March 2015 to March 2017 were chosen and separated into observation group (n=41) and control group (n=32) on the basis of the surgical methods. Both the two groups underwent modified radical mastectomy. In addition, the control group received prosthesis implantation for breast reconstruction, and the observation group was implanted with combination of prosthesis and autologous-fat granule transplantation. Thereafter, the surgical indexes, postoperative complications, aesthetic effects of breast reconstruction and prognosis of the two groups of patients were evaluated. RESULTS: The surgical duration of the observation group was obviously longer than that of the control group (P<0.05), while the two groups had insignificant difference in postoperative drainage duration and postoperative hospital stay (P>0.05). FACT-B score of both groups of patients one year after surgery was dramatically higher than that before surgery (P<0.05), and patients in observation group had remarkably higher scores than those in control group (P<0.05). The incidence of postoperative complications in observation group was substantially lower than that in control group (P<0.05). In addition, the aesthetic evaluation of the observation-group patients postoperatively was notably higher than that in control group (P<0.05), and there was no statistically significant difference in progression-free survival between the two groups (P>0.05). CONCLUSION: The combinative implantation of both prosthesis and autologous-fat granule for breast reconstruction after radical mastectomy is simple in operation procedure, and has better aesthetic outcome and safety. It satisfies the aesthetic demand of patients while having lesions resection, and does not affect the surgical effect of modified radical mastectomy, which is worthy of clinical promotion.
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Objective To analyze the clinical efficacy of PRF-mixed autogenous fat granules transplantation for facial contour modification,and to discuss the methodology for improving fat preservation rate after facial fat transplantation.Methods 60 cases were divided randomly into two groups with 30 cases each:mixed treatment group of PRF and autologous fat granules (mixed group),and simple autologous fat granules transplantation group (control group).According to the different defect parts of facial contour,the mixture of proper amount of autologous fat granules and PRF harvested from venous blood via once centrifugation separation autologous transplanted to the cases in mixed group,PRF not added to the cases in control group,then the recent and long-term effect,complications,safety,and patient satisfaction were observed.Results The facial shape was stable 6 months after operation,the face of all cases was more full,and facial proportion was more harmonious than before operation.12 months of follow-up study was performed in all 60 cases,there was no fat embolism,infection,necrosis and other complications.The satisfaction rate was 96.7％ in mixed group and 80％ in control group after primary operation respectively.There were significant differences between the two groups.Conclusions Autologous transplantation of fat granule mixed with PRF has important application value in facial contour modification and facial rejuvenation.It is easy to be operated,and can achieve high fat preservation rate,stable long term effect and no obvious complication;the cases performed sufficient amount mixture of transplantation can get ideal cosmetic effect.
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Objective To explore the effect of divided injection of fat grafting and to provide a new sight for the strategy of clinical particle fat transplantation.Methods Adipose tissue was aspirated from the healthy female abdomen by liposuction.In the control group,0.5 ml of adipose tissue was subcutaneously injected into the nude mice.The experimental group was injected with 0.25 ml first,followed by 0.25 ml injection of adipose tissue on the 7th,14th and 30th days.To assess graft retention rate and effectiveness we measured the wet weight and observed the pathological sections with HE or perilipin immunofluorescence.Results The wet weight of the tissue between the experimental group and the control group had no statistical difference,the experimental group had less necrosis and empty tissue than the control group.The proportion of perilipin positive staining tissue in 7 day group had statistical difference from that of the control group.Conclusions The strategy of preinjection of part of the adipose tissue and then supplement of the residual tissue after 7 days may increase the proportion of active adipose tissue in the graft.
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Objective@#To observe the anatomical layers and important vascular structures in the main periorbital regions of the human body, and to provide some anatomical basis for clinical periorbital fat injection.@*Methods@#During January 2018 to December 2018, 12 (24 sides) cadavers (6 males and 6 females, 47.5±11.7 years old) were selected. Their orbital tissues were dissected routinely and microdissected. The important blood vessels and tissues around the orbit were measured by electronic vernier caliper. The related matters needing attention in fat injection filling were analyzed according to references.@*Results@#The main structural areas around the orbit included eyelid, eyebrow and lacrimal groove deformities. The thickness of eyelid skin was (0.09±0.03) mm. The thickness of eyebrow skin was (3.45±0.38) mm. Vascular (diameter ranged from 1 mm to 3 mm) distribution was abundant in this area. The inner diameter of dorsal nasal artery, supraorbital artery and trochlear artery were (0.73±0.42) mm, (0.88±0.37) mm and (0.71±0.51) mm respectively. Facial artery, maxillary artery and superficial temporal artery with internal diameters of (2.96±0.88) mm, (1.92±0.33) mm and (1.35±0.15) mm, respectively.@*Conclusions@#The entrance of upper eyelid injection is usually in the eyebrow tail or middle eyebrow, and fat is injected into the deep surface of orbicularis oculi muscle. The injection range is limited to the medial 2/3 of upper eyelid, the medial 1/3 of lower eyebrow and the lateral part of eyebrow. It is suggested that single layer microinjection of fat (0.5 ml to 1.5 ml) could be used. Lower eyelid fat transplantation is mainly used to correct deformities at the eyelid-cheek junction. The aim is to reduce the V-shaped deformity at the eyelid-cheek junction by increasing the fullness. Injection can be made by blunt needle into the inner, outer and middle part of the deformity. Fat can be injected into SOOF layer or periosteum in the palpebral and cheek sulcus area. The injection volume is 0.5-1.0 ml.
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To introduce the diagnosis and treatment, as well as the result of a patient with fat embolism at cerebral and ophthalmic artery, following fronto-temporal autologous fat transplantation. The patient, a 39-year-old woman, who received fronto-temporal autologous fat transplantation in other hospital in May 2018. Hemiplegia and right eye blindness happened right after autologous fat transplantation. The patient was transferred to the 940th Hospital of PLA Joint Service Support Force 5 hours after operation, but the function of the limbs and the right eye were not well restored after intensive treatment. Fat embolism is the most serious complication in fat transplantation. Once it occurs, the prognosis is poor. Therefore, the process of autologous fat transplantation should be standard to prevent related complications.
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Objective@#To investigate the possibility of adipose tissue mesenchymal stem cell-derived microvesicles (ADSC-MVs) to improve the retention volume of fat transplantation.@*Methods@#Human adipose tissue was obtained from 5 healthy female patients aged from 20 to 30 years, who came to the hospital for abdominal liposuction. Adipose tissue mesenchymal stem cells (ADSCs) were acquired by collagenase enzymatic hydrolysis. ADSC-MVs were isolated from the supernatant of cultured ADSCs through ultra-centrifugation, and characterized by transmission electron microscope and PKH26 staining. Sixteen BALB/c-nu nude mice were randomly divided into 2 groups (n=8, mice/group) by random number table method. In EV group, the mice were subcutaneously injected 0.35 ml human fat, with 7 μg ADSC-EVs (final concentration is 20 μg/ml), while 0.35 ml human fat were in blank group. The mice were sacrificed and the grafts were harvested at 1 month and 3 months after transplantation. Weight and volume of transplanted fat were tested. Morphology of adipocytes, fibrosis and necrosis of fat tissue were confirmed by HE staining. Blood vessel density were accessed by CD31 staining.SPSS 13.0 was used for statistical analysis and Student-t test was applied to compare the data from two groups.@*Results@#One month after fat transplantation, the volume of fat grafts in blank group was lower than that in MV group. Besides, lipoliquefaction can be observed in fat grafts of blank group. Fat grafts in MV group had a higher volume and littler necrosis and lipolique faction. Three months after grafting, the volume of fat grafts in blank group [(0.057±0.009) ml] was significantly lower than that in MV group [(0.103±0.015) ml], t=8.117, P<0.001. MV group had an increased number of vessels (29.6±4.0/field) compared with grafts from the Blank group (23.0±2.4/field), t=2.825, P=0.022. Histological analysis revealed that the fat grafts in MV group consisted less fat necrosis and fibrosis than control group.@*Conclusions@#ADSC-MVs can improve the retention volume of fat transplantation.
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Objective@#To investigate the clinical effect of subcutaneous injection of nanofat combined with autologous fat into tear trough deformity to improve the mixed dark circle at lower eyelid, and the feasibility of using L*a*b* value to objectively evaluate the improvement of skin color at the lower eyelid with dark circle.@*Methods@#A total of 14 patients with the mixed dark circle at lower eyelid, admitted by Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from November 2017 to August 2018 were selected. They were all female, aged between 21 and 46 years old. Thigh or abdomen was selected as the fat donor area. Autologous fat was filled into the tear trough deformity. The prepared nanofat was injected into the subcutaneous layer of the lower eyelid with dark circle. Photoes were taken under the same condition and same room temperature for patients before operation and 6 months after operation. Photoshop, CS7 exposure correction, as well as 64 Image J software measurement were adopted to evaluate the skin L* a* b* value at dark circle of lower eyelid. SPSS 20.0 rows of data statistical analysis was applied with paired t test(P<0.05).@*Results@#All patients were followed up for 6 months after the operation, and a satisfactory effect was achieved after one injection, with an overall satisfaction rate of 78.6% (11/14). The color and skin fine wrinkles at the dark circle of the lower eyelid were improved in 14 patients, and the contour of the injection area was smooth without obvious complications. 6 months after the operation, the L* value of the skin at the lower eyelid with dark circle was 55.13±5.56, which was 7.74±2.39 higher than the preoperative value of 48.23±5.63, showing significant difference(t=12.089, P=0.00). Six months after surgery, the a* value was 14.68±2.84, which decreased by 0.11±0.60 compared with 14.79±3.04 before surgery, showing no statistically difference(t=-0.71, P=0.49). Six months after surgery, the b* value was 19.77±3.45, which increased by 0.27±1.03 compared with 19.50±3.45 before surgery, showing no statistical difference (t=0.98, P=0.35).@*Conclusions@#Subcutaneous injection of nanofat combined with autologous fat injection for tear trough deformity is effective in the treatment of lower eyelid with mixed dark circle. The L*a*b* value can objectively evaluate the improvement of skin color at the lower eyelid with dark circle.
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Objective@#Report the experience of autologous fat grafting forfacial contouring and rejuvenation patients.@*Methods@#Retrospective analysis the treatment of 450 facial contouring and rejuvenation patients with global optimization autologous fat grafting in Plastic Surgery Hospital of Chinese Academy of Medical Sciences from January 2011 to December 2017. Using low negative pressure liposuction technical and blunt cannula (diameter 2.5 mm and 2.0 mm), different fat particle was harvested and concentrated by a cotton pad. The one-hole blunt cannula was used for fat grafting with multi tunnel and multi-point and two layer(deep and superficial)injection ways, regularly following up and taking picture for imaging evaluation.@*Results@#All patients were successfully performed with fat grafting. Grafted fat volume was 15-65 ml. There were 132 cases of local skin bruising after operation, which gradually subsided about 2 weeks, no severe complications occurred. 450 patients were followed up for 6-12 months. Facial contour and skin texture were improved without subcutaneous nodules and irregularity. The outcome of all patients were satisfactory. Of a total of 450 patients, 319 (70.89%) were evaluated as very good result, 94 (20.89%) as good result, and 37(8.22%) asregular result.@*Conclusions@#Optimization autologous fat grafting can improve the facial contouring and rejuvenation with little complications and satisfactory results.
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Objective@#To study the morphological characteristics and important anatomical structures of each soft tissue layer of gluteal region, and discuss the recommended levels and safe areas for liposculpture in this region.@*Methods@#Twenty-eight specimens of unilateral buttocks from 14 adult cadavers, including 16 specimens of unilateral buttocks from 8 fresh cadavers and 12 specimens from 6 formaldehyde fixed cadavers were dissected. Among the cadavers, there were 2 males with an average age of 49 years, and 12 females from 23 to 72 years old, median age 46 years. Through anatomy study of soft tissue layers of gluteal region, the morphological features of each layer were observed and documented, and the characteristics of fascia system and adipose tissue, as well as the relationship between the blood vessels and nerves with corresponding layers.@*Results@#The layers of the gluteal region that range from superficial to deep are skin, subcutaneous fat, superficial fascia system, deep fascia system, muscle and fascia compartments. Subcutaneous fat is distributed in superficial and deep layers; the superficial fascia system is well developed and dense with a layered structure; the deep fascia is thin with the characteristic of epimysium. There is a danger zone for deep fat graft in the gluteal region, with its apex at the first sacral vertebra, and its base goes along the gluteal fold, compromising the thighs′ medial two-thirds. Nearly all important blood vessels and nerves of gluteal region are located in deep layer of this danger zone.@*Conclusions@#Based on the characteristics of buttocks of Chinese people, liposuction is mainly performed in the iliolumbar region and posterolateral thigh, which can significantly increase the relative height and fullness of buttocks. For full buttocks, deep fat can be sucked appropriately, which should be longitudinal and gentle to reduce the damage to the superficial fascial system. There is a high risk for fat graft in the buttock. It is recommended to use a blunt needle with an inner diameter of more than 3 mm parallel to the fiber orientation of gluteus maximus for uniform fan-shaped injection with needle withdrawal. Satisfactory result can be obtained by injecting most fat into the subcutaneous adipose layer. Deep injection of grafts into dangerzoneis forbidden.
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Objective@#To summarize the clinical effects of meticulous fat transplantation with fat grafts in the treatment of sunken upper eyelid.@*Methods@#From September 2016 to January 2019, 58 patients with sunken upper eyelid were treated in the 940th Hospital of the Joint Logistic Support Force of PLA. There were 2 males and 56 females, aged from 20 to 63 years. Among them, 14 cases were congenital, 30 cases were senile, 8 cases were postoperative, and 6 cases were traumatic. The prepared autologous granule fat was extracted with a 1 ml syringe, which matched with a 1.0 mm diameter needle. The 1 ml syringe was packed into the card slot of a fat graft booster, and the needle was inserted into the orbital fat zone of a depressed upper eyelid to homogenously inject the granule fat. For patients with iatrogenic and traumatic upper eyelid depression, the adhesion was released by small needle knife before injection. For those with aging skin, subcutaneous injection of nano-fat was applied.@*Results@#The amount of granule fat transplantation was 0.5 ml to 3.6 ml, with an average of 1.5 ml. The amount of nano-fat injection was 0.5 ml to 1.0 ml, with an average of 0.7 ml. All patients were followed up for 1 month to 2 years. Except 2 patients with severe traumatic upper eyelid depression, the other patients were satisfied with their full and natural upper eyelids after treatments.@*Conclusions@#When the upper eyelid depression was treated with granule fat transplantation by the booster, the small needle knife peeling technique and nano fat transplantation can be combined to correct different types of congenital, aging and surgical derived sunken upper eyelid and traumatic sunken upper eyelid from mild to severe cases. At the same time, the skin of the upper eyelid can be rejuvenated as well.
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Objective To observe the fat particles survival situations in autologous transplantation under different conditions of low temperature.Methods Three sample groups of adult Wistar rats were injected with fresh autologous fat particles,which were stored under 80 ℃ for two months and under-196 ℃ for two months respectively,and the volume,parallel histological detection,glucose transport measurement,MTT experiments and other data were compared and analyzed one month and two months after the transplantation.Results One month after transplantation,graft survival rate was higher in Group injected fresh autologous fat particles than that of Group injected autologous fat particles stored under-80 ℃ and Group injected autologous fat particles stored under -196 ℃ (P＜0.05);Two months after transplantation,the differences among three groups had no statistical significance.Before the transplantation,the activity of autologous fat particles stored in -80 ℃ and-196 ℃ were 68.7％ and 62.5％ of fresh autologous fat particles,respectively,two months after cryopreservation.One month after the transplantation,we found that the activities of autologous fat particles were higher in fresh group than that of-196 ℃ and-80 ℃,There was no significant difference between the groups stored in-196 ℃ and-80 ℃.Two months after the transplantation,the activities of autologous fat particles were higher in fresh group than that of-196 ℃ and -80 ℃.Before transplantation,the particles of fat histology showed no significant difference among three groups.One month after transplantation,fat vacuoles and distinct inflammatory infiltration were observed in all three groups,with the group stored in-80 ℃ as the most serious affected.Two months after transplantation,fresh fat particles and Group stored in-196 ℃ showed large quantity of tightly packed intact fat cells,scattered around the central area in fat vacuoles,while Group stored in -80 ℃ still had a large quantity of fat vacuoles,but the fat vacuoles were obviously fused.Conclusions The fat stored at-80 ℃ and-196 ℃ could meet the needs of clinical use in the short time.The fat stored at-196 ℃ shows the best activity.The fat particles stored at-196 ℃ could be used to establish better blood circulation.The heaviest inflammatory reaction occurs in the graft zone one month after fat transplantation and the decrease of transplanted particle activity is the most obvious.
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Objective To investigate a creative breast augmentation of autologus fat in combination with implant in reconstruction of normal breast and prevention of implant related contracture.Methods The autologous fat was harvested and purified for use.A 3.0 to 4.0 cm long incision was made in the axillary crease.The implant placement cavity was created underlying the pectoralis major after subcutaneous blunt dissection through the incision.The properly selected silicone breast implant of certain type and volume was inserted into the previously created cavity through the subcutaneous tunnel.The autologous fat was transplanted overlying the pectoralis major in multiple planes and the fat was located over the implant in an umbrella form.Results A total of 12 cases obtained obvious breast increase,reconstruction of breast,fullness of breast and softness of breast without obvious contracture after the autologous fat in combination with implant in reconstruction of normal breast.The result was satisfactory during a follow-up between 6 months and 3 years.Conclusions The transplanted fat overlying the silicone implant can augment the breast,increase breast,promote regeneration of breast,reduce or resist immune response of silicone breast implant,and then prevent breast implant related contracture.The newly built breast is soft and natural.The procedure is safe and effective.
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Objective@#To construct a novel carrier with core-shell structure-inner core of pFGF2-EGFP-loaded TACS coated by hydroxybutyl chitosan (HBC), and to explore its effects on granular fat graft survival.@*Methods@#The core-structured particles (TACS-pFGF2-EGFP) and core-shell-structured particles (HBC@ TACS-pFGF2-EGFP) were prepared to explore the release pattern of pFGF2-EGFP of these particles. The expression of FGF2 protein was detected by Western-Blot in 293T cells transfected with the sustained - release microspheres in vitro. Cell proliferation assay demonstrated that 10μg/ml pFGF2 plasmid could promote 293T cells growth. Eighteen New Zealand white rabbits were used for adipose tissue transplantation experiment. Rabbit left ear was treated as experimental group, 2 ml fat granules and HBC@TACS-pFGF2-EGFP were implanted; rabbit right ear was used as control group, 2 ml fat granules and HBC@TACS-empty plasmids were transplanted. The specimens were harvested at 4, 8, 12 weeks separately after fat transplantation. Gross view, HE staining, and immunohistochemical staining were performed to observe graft survival, biological characteristics, and neovascular density.@*Results@#HBC@TACS-pFGF2-EGFP particles could sustained release Pfgf2 gene in vitro, and successfully express FGF2 protein after transfecting 293T cells. At different time points after transplantation, the volume of adipose tissues was gradually reduced with time. The fat volume and survival rate of adipose tissues in the experimental group were significantly higher than that in the control group (P<0.05). HE staining showed that the arrangement of new adipocytes in the experimental group was more regular than that in the control group. Immunohistochemistry staining showed that the micro vessel density and FGF2 protein expression level in the adipose tissue of the experimental group were higher than those in the control group (P< 0.05).@*Conclusions@#HBC@TACS-pFGF2-EGFP particles with sustained release of FGF2 can improve the survival of granule fat transplantation.
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Objective@#To treat the depressed scars by injecting nanofat and investigate its therapeutic effect.@*Methods@#Autologous fat was harvested from abdomen or thigh using low-pressure suction. The lipoaspirate was mechanically emulsified after rinsing. Emulsification of the fat was achieved by shifting the fat between two 5 ml syringes connected to each other by a three direct connector. After this emulsification process, the fatty liquid was again filtered over the sterile nylon cloth. Nanofat was injected into the dermis of depressed scars using a 26-gauge needle and the injection volume was 1-2 ml/cm2. After three months, another injection would be performed if the depressed scar remained obvious.@*Results@#From January 2016 to October 2017, eighteen patients and thirty-three depressed scars were treated. There was a temporary erythema of the injected area that lasted two to three weeks. The clinical result gradually improved over time and were maximal from three months postoperatively for most cases. Three months after nanofat injecting, the cavity of scars was significantly decreased; The color of scars were significantly improved and more close to the adjacent skin; The stiffness of scars was also obvious decreased. The follow-up ranged 4 months to 18 months and the average was 11.0±4.6 months. Seventeen patients were satisfied with the result, one patients was not satisfied and the satisfaction rate was 94%. No infections, fat cysts, granulomas, or other unwanted side effects were observed.@*Conclusions@#Nanofat injecting is a definite and effective treatment for depressed scars with fewer complications.
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Objective To discuss the clinical effect of facial contour remodeling using transplantation of the autologous granular fat grafting combined with botulinum toxin A injection.Methods Negative-pressure liposuction was carried out in the inner thigh or abdomen using liposuction needle connected with an injector,to let stand for layered,discharge lower layer water,rinse,extract the fat particles into a 2 ml syringe,inject into facial depression area with multipoint,multiple-tunnel,and multilayer manner,over injection of about 20％-30％ every time.89 patients received the injection;some accepted two injections;13 cases were injected in temple (14.6％),and 16 in forehead (17.98％).30 of them received subcutaneous injection of botulinum toxin A,each side dose was less than 20 U.Results Patients had been followed up for 3-36 months,and obvious improvements were observed in facial contour in the frontal and temporal region as well as the skin texture;the survival rate of fat granule reached to 60％-80％.No hematoma,nodes and infection been observed.Patients combined with botulinum toxin A injection had more ideal facial contour and more satisfaction.Conclusions Autologous fat granules transplantation in the face has stable clinical effect,and combining with botulinum toxin A injection can improve facial contour.It is a safe,ideal treatment in facial rejuvenation and facial contour remodeling and it therefore can be widely recommended in clinical treatment.
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Objective To evaluate the effect of facial enhanced fat injection technique in facial remodeling.Methods 36 patients with facial facial reconstruction surgery from February 2011 to October 2014 in our hospital were involved in this study.The clinical data of patients with sagging facial aging and type A botulinum toxin injection combined with autologous fat granule injection enhanced facial surgery were evaluated.After postoperative follow-up of 3 months to 2 years,the effects of combined surgery of facial reconstruction were analyzed.Results In the 36 patients three months after operation a significant rate was 97.22％;at six months significant rate was 91.67％;at 12 month efficacy rate was 80.56％;at 18 months curative effect rate was 55.56％;at 24 months effective rate was 41.67％.Conclusions The use of botulinum toxin type A injection combined with autologous fat granule injection face lifting technique for facial reconstruction of aging patients with severe,is simple operation,obvious curative effect and less complications,which is an ideal treatment method that can be extended in clinical application.
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BACKGROUND: The purpose of this study was to preliminarily assess a constant pressure and quantity fat granule injection device for minimal invasive properties in clinic. METHODS: A retrospective controlled study was carried out, from October 2013 to January 2015, on 76 female healthy patients aged between 26 and 53 years at the General Hospital of Lanzhou Military Command, China. To achieve small volume, high thrust, and precision requirements of facial fat grafting, an integrated handheld controller and motor design was adopted, reducing the volume and weight of the fat transplantation injection device. The 76 patients underwent 90 procedures each side of the face; each patient was treated with the aforementioned device on the face's left side, while a conventional hand-push injection device was used on the right side as control. The outcome was assessed on pre- and postoperative images, with 6-24 months follow-up. RESULTS: The current device consistently allowed deposition of fat threads at about 55 µL/cm after cannula withdrawal; the volume of fat injected could be precisely adjusted to 0.04 mL/s. This device had the advantages of small-volume injection and convenient operation. The patients exhibited a good, stable shape and a smooth contour line in both sides. The long term satisfaction was higher for the left side than for the right one. Nodules and unevenness occurred only on the right side. Ecchymosis occurred significantly less frequent on the left side than the right one. Intraoperative pain was significantly lower for the left side than the right one. CONCLUSIONS: This device offered superior control compared with the conventional one and constitutes a promising tool for surgeons practicing lipotransfer.
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Objective To discuss the clinical application of different particle size of grain fat sieved by the homogenizing fat extractor.Methods A lot of 68 patients in this group were women,and the average age was 28 years.With the aid of tumescent technique,anterior and lateral thigh fat granules were extracted using liposuction needle;after the homogenizing fat extractor and sieve purification,fat particles were obtained with uniform particle size and no fibrous tissue for different sizes of 2.00 mm,0.90 mm,0.50 mm and 0.28 mm,respectively.After choosing corresponding diameter of fat transplantation needle and appropriate injection level according to fat particle size,the multiple spot and multiple track tunnels,multi-level injection for the facial soft tissue deficiency or cavity were then carried out.With long-term postoperative follow-up,evaluation of different grades were given for the complication,fat survival rate and satisfaction.Results The results were followed up for 3-12 months postoperatively;as responding,the facial appearance of graft field deformity or deficiency was significantly improved and the skin of the recipient area was soft;wrinkles was relieved,and so that they appeared young plump well-pleasing appearance.And there were no complications,such as infection,hematoma,fat liquefaction,pigmentation,induration and so on.Satisfactory results were obtained.Conclusions The treatment of facial soft tissue deficiency or deficiency,by choosing corresponding diameter of fat transplantation needle and appropriate injection level according to the differences of fat particle size sieved by the homogenizing fat extractor,can acheive a high fat survival rate,and stable long-term effect.Thus,this safe and ideal method for rejuvenation of facial treatment is worth promoting.
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Objective To compare the efficacy between autologous fat and hyaluronic acid in filling nasolabial grooves.Methods Sixty patients who wanted improvement of nasolabial grooves were involved in the study.They were randomly and equally classified into two groups:autologous fat injection group and hyaluronic acid injection group.Photographs were taken before,half a year,and one year after injection.The nasolabial grooves were also graded before,half a year,and one year after injection.The grade improvement was obtained after postoperative grade minus preoperative grade.If the grade improvement was more than 1 grade,the treatment was regarded as effective to evaluate the outcome between the two methods.Results The results of the two groups were tested by SPSS 13.0 software.The effects of the two methods were not significantly different after half a year of filling (P＞0.05).The difference was significant one year after filling (P＜0.05).In autologous fat injection,the patients had a long and magnificant swelling and redness around the nasolabial grooves;on the contrary,the patients who underwent hyaluronic acid had slight and short-time local reaction like swelling and redness.No other serious complications were found in both the groups.Conclusions The effects of the autologous fat and the hyaluronic acid are equal after half a year of filling.The autologous fat has a longer effect in one year.Both methods are safe and effective.Surgeons can select the method accordingly.
