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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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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@#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 investigate two techniques and outcome in repairing facial concave deficits.Methods Eleven patients with facial concave deformity were included in this study:nine were treated with autologous fat granule injection,1,3 and 5 patients were given fat granules injection fourth,twice and once,respectivly.The other 2 patients were repaired with homolateral temporal fascia flap.Results The implantation by using autologous fat granules in all 9 patients showed excellent results.Homolateral temporal fascia flaps were used in 2 cases,one of which was formed hematoma after operation and scavenged thereafter.All the patients had satisfactory results.Conclusion Both approaches well rehabilitate patients' facial contour,and thus are capable of repairing moderate or minimal facial concave deficit and worth recommendation.
