Cross Vertical Mattress Suturing with Basilar Tightening During the Correction of Inverted Nipple in 30 Cases.

OBJECTIVE: To investigate the efficacy of cross vertical mattress suturing with basilar tightening during the correction of inverted nipple. METHODS: Thirty patients with inverted nipples underwent cross vertical mattress suturing with basilar tightening. The postoperative results were recorded. RESULTS: All the patients were followed up for 6 months to 2 years. The results of 28 cases were satisfactory, and there was no recurrence. Two patients relapsed, and a mild depression was formed. They were satisfied with the results after the second correction. CONCLUSION: The method of cross vertical mattress suturing with basilar tightening has been applied to treat inverted nipple, with minimal trauma, which provides a reliable guarantee for a long-term effect. It is worthy to be widely used in clinical practice. 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 .

[Correcting tear trough by transconjunctival fat reposition :the clinical analysis of 30 cases].

Objective: To evaluate the clinical effect and experience of correcting tear trough by transconjunctival fat reposition. Methods: The study was performed in 60 patients with lower eyelid fat prolapse and tear trough deformity, in whom eyelid skin tightening was deemed unnecessary. All patients were divided into observation group and control group according to their desire. The observation group received the orbital fat release through the conjunctiva. The control group corrected eyelid bag without releasing orbital fat. The control group received filler treatment 2 months after operation. Postoperative complications were recorded, and the degree of outcome satisfaction was obtained at the 6-month postoperative follow-up. Results: Of the 30 patients in the observation group, excellent result was achieved in 25 cases, basically satisfactory in 2 cases, unsatisfactory in 3 cases. Of the 30 patients in the control group, excellent result was achieved in 16 cases, basically satisfactory in 8 cases, unsatisfactory in 6 cases. Conclusions: Transconjunctival fat repositioning is a better procedure for patients with lower eyelid fat prolapse, tear trough deformity and eyelid skin tightening.

Application of split gluteus maximus muscle--adipofascial turnover flap and subcutaneous tension-reducing suture technique in repair of decubitus ulcers.

The purpose of this study was to study the clinical effect of split gluteus maximus muscle-adipofascial turnover flap and tension-reducing suture in the treatment of decubitus ulcers. Thirty-one cases of sacrococcygeal decubitus ulcers were repaired by split gluteus maximus muscle-adipofascial turnover flap. The surface of flaps ranged from 5×6 cm to 7×8 cm. The skin was then closed, primarily using subcutaneous tension-reducing suture. Eighty-eight percent of the flaps (27 of 31) healed primarily. The split gluteus maximus muscle-adipofascial turnover flap and tension-reducing suture technique was found to be a highly efficient method of repairing decubitus ulcers with a relatively low ratio of recurrence.

[A new procedure to correct the crow's feet by covering the orbicularis oculi muscles with the superficial temporal fascia flap in rhytidectomy].

OBJECTIVE: To explore an ideal procedure with more lasting aesthetic results by covering the orbicularis oculi muscles with the superficial temporal fascia flap in rhytidectomy, which can help to correct the crow's feet successfully. METHODS: During rhytidectomy, dissection was performed subcutaneously and also under pericranium and superficial temporal fascia at temporal area. Then the superficial temporal fascia flap was formed by cutting between pericranium and superficial temporal fascia. The fascia flap was reversed to cover the lateral orbicularis oculi muscle with fixation. RESULTS: From May 2004 to May 2010, 18 cases were treated with a follow-up period of 6-12 months. The crow's feet was corrected better with long lasting results, compared with conventional rhytidectomy. No complication happened. CONCLUSIONS: The crow's feet can be corrected markedly with long lasting results by covering the orbicularis oculi muscles with the superficial temporal fascia flap in rhytidectomy.

[En block frontal-temple silicone for humping the forehead and temple].

OBJECTIVE: To explore the reliability of humping the forehead and temple by en block frontal temporal silicone . METHODS: Make wax mold by piling up wax slices layer by layer according to the rang of depressing of the forehead and temple, the section being humped and the hight need to be projected. Order the silicone block according to the dimension of the wax mold. Make the implant from the silicon block. Under local anaesthesia dissection under the superficial temporal fascia and galea through forehead and two temporal incisions. Implant the silicon through the middle incision. RESULTS: Total 18 cases in this group were followed up for 3-12 months. Wound healed primarily without infection. I case with early blood effusion cured after aspiration. l case with later clear effusion cured after aspiration ad injection of prednisone in to the capsular. The frontal temporal contours were satisfactory . No outline of the implant was seen. CONCLUSION: It is safety and satisfied to hump the forehead and temple by en block frontal temporal silicone.

The extra-long artery-pedicled back fascia skin flap for treatment of cervical contractive scar.

Severe cervical scar contractive after burn is best repaired with a flap for the neck maximal function restoration. The trapezius myocutaneous flap is a common one to be used for this purpose. However, the traditional technique is usually not appreciated to transfer the flap to the opposite side of the neck in one stage. The delayed procedures are usually needed. In this paper, an extra-long back fascia flap pedicled with descending branch of transverse cervical artery was developed to restore the whole cervical contractive scar after burn in only one operation. With our experience of 25 patients, the flap was usually formed as large as 10-14 cm wide (18-20 cm in expanded cases) and 35-45 cm long, as twice long as that formed by the traditional technique, and easily reaching the opposite side of the neck. Finally, the flaps were successfully transferred to repair the full neck in only one-stage procedure after the cervical scars were excised, except for two cases with partial necrosis in the flap tip. But the wounds were closed with further advancing the flap in secondary operation. In the end all of the patients were completely repaired. The result indicates that the extra-long back fascia flap pedicled with descending branch of transverse cervical artery could be formed long enough to reach the opposite side of the neck and safely transferred to neck in one stage.

[Correct conglutination deformities of the upper eyelid after double eyelid operation by relieving infraorbicularis oculi fat flap and infilling].

OBJECTIVE: Adhesive or too highly located folds upper eyelid and even blepharoptosis are common complications of double eyelid operation. To correct such deformities. METHOD: We shifted down the double eyelid line, removed adhesion thoroughly, relieved orbital fat and restarted the volume with infraorbicularis oculi fat flap. RESULT: We had treated 32 case in past two years. The results were satisfying. CONCLUSION: The method are acted easy and gained fine result, so behaving to extend application.

[A preliminary approach of covering corrugator with rectangle periosteous flap in rhytidectomy].

OBJECTIVE: To evaluate the aesthetic outcome after application of rectangle periosteous flap to cover corrugator. METHODS: On the basis of regular rhytidectomy, a inter-eyebrow periosteous flap is applied to cover the fascia flap of corrugator by means of turnover. This manipulation helps to separate the skin from the muscle and prevent the re-adherence between the skin and muscle. RESULTS: The approach was applied on 15 cases. The follow-up ranged from 6 months to 1 year. The results were satisfactory. CONCLUSIONS: The method is effective in elimination of inter-eyebrow crease.

[Facial anatomic study and application in rhytidectomy].

OBJECTIVE: To find a procedure for facial rejuvenation which is simple, safe with lasting aesthetic results based on facial anatomic study. METHODS: Anatomy study was performed on 12 sides from 6 head specimens. Observe the range and thickness of fat lateral to the nasolabial grooves. Observed the location of the skin retaining ligaments and reappraised their functions combining with clinical observations. RESULTS: Skin and subcutis and SMAS (including mimic muscles) become slackening with aging, but the loosening degrees are different, especially in the region lateral to the nasolabial groove. So they should be handled respectively. The fat lateral to the nasolabial groove is thick and is mobile with aging . So the subcutaneous detachment need not beyond the anterior border of the masseter. In the past two years, we performed rhytidectomy on 100 patients by limited subcutaneous detachment and SMAS double-plication. Satisfactory results were obtained. There are no serious complications observed. CONCLUSIONS: Rhytidectomy by limited subcutaneous detachment and SMAS double-plication is a simple and safe procedure with lasting aesthetic results.

[Aesthetic correct depressed nose and prolong nasal columella using nasal columella base flaps, bilateral labial mucosa flaps, and the silicone imitation].

OBJECTIVE: Using simple method to reform depressed middle part of the face and to prolong nasal columella. METHODS: Fill silicone into the subcutaneous cavity of the nase and maxillary attended by using nasal columella base and bilateral labial mucosa flaps. RESULTS: Obtain a satisfactory result to reform depressed nose,nasal columella and maxilla. CONCLUSIONS: It is a propagable economic way to resolve a complex deformation using this simple method, and get a satisfactory result.