Clinical Efficacy Analysis of Augmentation Mammoplasty with Cell-Assisted Autologous Fat Transplantation.

OBJECTIVE: To analyze the clinical efficacy of augmentation mammoplasty with cell-assisted autologous fat transplantation. METHODS: Thirty-four cases of micromastia patients in our hospital were randomly divided into control group (n = 17) and observation group (n = 17). Breast augmentation with autologous fat transplantation alone and cell-assisted autologous fat transplantation were performed, respectively, compare and observe the therapeutic effect. RESULTS: Compared with the control group, the effective rate of breast augmentation was higher in the observation group. After six months of treatment, the increase value of chest circumference (CC), Sternal notch-nipple distance (SN-N),distance between nipple and inframammary fold (N-MF) was higher in the observation group, and the uplift value was higher after six months surgery, with statistical significance (p < 0.05). MRI showed higher postoperative fat retention rate, QLQ-30 Quality of life scores showed no significant difference (p > 0.05). LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Severe Vascular Complications Caused by Facial Autologous Fat Grafting: A Critical Review.

BACKGROUND: Vascular embolism is the most severe complication after autologous fat grafting. With a worldwide increase in fat grafting, there has been a rise in severe vascular complications, such as ophthalmic artery embolism, cerebral artery embolism, and even death. This article aims to review the role of fat in causing severe vascular complications and the association between fat grafting and severe vascular complications. METHODS: A critical review was conducted by appraising the cases of severe vascular complications associated with facial fat grafting reported globally. Repeated cases that were reported in multiple publications were further screened. RESULTS: The final search yielded 50 publications in English that met the inclusion criteria for review. A total of 113 cases of fat-induced severe vascular complications in the literature were identified. The number of cases reported yearly has increased over time, with even more significant increases since 2010. The glabella and temple are the most common sites of severe vascular complications described in the literature. In addition, only one case of ophthalmic artery embolism and one case of cerebral artery embolism have been treated successfully. CONCLUSIONS: Given the increase in reported cases of severe vascular complications, both doctors and patients should pay careful attention to the risks of facial fat grafting. Because of the unclear mechanism of vascular embolism and the lack of guidelines for prevention and treatment, the effective cure rate is unsatisfactory. We propose that preventing vascular embolism is a priority in fat grafting and that timely, multidisciplinary treatment should be performed when severe vascular complications occur. It is necessary in future studies to explore the mechanisms of vascular embolism and effective treatment strategies to promote the development of fat grafting.

Closed Rhinoplasty with a Mushroom-Shaped Costal Cartilage Graft in East Asian Patients.

BACKGROUND: The most challenging part of rhinoplasty is nasal tip management. For East Asian patients with a bulbous under projected nasal tip with thick skin, autologous cartilage is considered the gold-standard graft material to provide strong support to the nasal tip and effectively increase tip projection. The present study aimed to evaluate the outcomes of closed rhinoplasty with a mushroom-shaped costal cartilage graft in East Asian patients. METHODS: From February 2018 to May 2019, 52 patients underwent rhinoplasty with a mushroom-shaped costal cartilage graft in our institution. Rhinoplasty was performed through a bilateral endonasal incision. Postoperatively, all patients were photographed and asked to complete a satisfaction survey online or by telephone. RESULTS: The mean follow-up period was 15.8 months (range 12-21 months). Twenty-four of 52 patients agreed to participate in this study. Postoperatively, the mean nasofrontal angle was 137.7 ± 3.7°, mean nasolabial angle was 94.1 ± 6.2°, mean nasal tip angle was 79.4 ± 5.2°, and mean columellar/lobular angle was 44.7 ± 2.4°. The mean tip projection/nasal length index was 0.53 ± 0.07, and the mean columellar/lobular length index was 1.21 ± 0.22. There were no prolonged functional complications. Most patients (23/24; 95.8%) were satisfied with the aesthetic results. CONCLUSION: The present results suggest that the mushroom-shaped costal cartilage graft in closed rhinoplasty is a good choice for the correction of a bulbous under projected nasal tip. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

[Research progress in thin flap and flap thinning technique].

OBJECTIVE: To review the historical origin and development of thin flap and flap thinning technique. METHODS: A wide range of domestic and foreign literatures on thin flaps and flap thinning technique were reviewed. The background, definition, methods, problems, challenges, and future development of thin flap and flap thinning technique were summarized and analysed. RESULTS: Thin flap and flap thinning technique play an important role in the development of flap surgery, leading flap surgery towards a more rational and refined direction. CONCLUSION: Thin flap and flap thinning technique are still hot topics in the future. With the development of thin flap and flap thinning technique, clinicians will have more "free" choices.