Effect analysis of intradermal hyaluronic acid injection to treat enlarged facial pores.

OBJECTIVE: To investigate the clinical application and efficacy of intradermal injection of low molecular weight hyaluronic acid (LMW-HA) for treating enlarged facial pores. METHODS: From January 2015 to May 2016, 42 subjects who sought aesthetic treatment underwent intradermal injection of LMW-HA to improve enlarged facial pores. For each treatment, 2.5 mL (25 mg) of LMW-HA was injected into the skin of the full face. The treatment was repeated 2-5 times with an interval of 1 to 1.5 months between consecutive treatments. The postoperative follow-up period was 1 to 6 months. Statistical analysis was used to compare the degree of enlargement of facial pores before and after injection. The clinical efficacy and adverse effects were recorded. RESULTS: The enlarged facial pores before and after treatment were categorized and subjected to the Wilcoxon matched-pairs signed-rank test. The difference was statistically significant (P<.01). The improvement rate was 40.03±18.41%. No infection, nodules, or pigmentation was reported at the injection sites in the subjects who sought aesthetic treatment. The overall satisfaction rate was 92.8%. CONCLUSION: Intradermal injection of LMW-HA can significantly improve skin texture, reduce pore size, and enhance skin radiance. The injection technique was simple, safe, and effective and could easily be extended to clinical practice.

Clinical Application of Earlobe Augmentation with Hyaluronic Acid Filler in the Chinese Population.

BACKGROUND: Larger earlobes, which are a symbol of "richness" in traditional Chinese culture, are favored by Chinese patients. The objective of this paper is to investigate the application of earlobe augmentation with hyaluronic acid (HA) filler injection and its clinical effects in the Chinese population. METHODS: A total of 19 patients (38 ears) who received earlobe augmentation with HA filler injections between March 2013 and March 2015 were included. The clinical effects, duration, and complications of these cases were investigated. RESULTS: All patients who received earlobe HA injections showed immediate postoperative effects with obvious morphological improvement of their earlobes. The volume of HA filler injected into each ear was 0.3-0.5 ml. The duration of the effect was 6-9 months. Two of the 19 cases (3 ears) demonstrated mild bruising at the injection site, but the bruising completely disappeared within 7 days after the injection. No vascular embolism, infection, nodule, or granuloma complications were observed in the studied group. CONCLUSION: The application of earlobe augmentation with HA filler injection is a safe, effective, simple procedure for earlobe shaping. It has an easy clinical application with good clinical prospects. LEVEL OF EVIDENCE V: 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 .

Application of Local Injection of Botulinum Toxin A in Cosmetic Patients with Congenital Drooping Mouth Corner.

OBJECTIVE: This study aimed to investigate the clinical application and efficacy of local injection of botulinum toxin A (BTX-A) at the depressor anguli oris in patients with congenital drooping mouth corner. METHODS: From September 2013 to March 2015, 36 cosmetic patients received local injections of botulinum toxin A at the depressor anguli oris, with 1-3 injection sites in the moving region of the depressor anguli oris on each side. At each injection site, 2-4 U of BTX-A was injected, and the total dose for any unilateral treatment did not exceed 8 U. The change in the degree of drooping of the mouth corner before and after the injection was analyzed using statistical methods. The clinical efficacy, preservation time, and adverse reactions were observed. RESULTS: The degree of drooping of the mouth corners of the cosmetic patients before the treatment was compared with that at 1 month after using a paired t test, and the difference was statistically significant, with P < 0.01. The treatment results were satisfactory, and the effect was preserved for 6-9 months. None of the 36 cosmetic patients had any complications of bruising, infection, dysfunction in opening and closing the mouth, smile asymmetry, drooling, or dysarthria after the injection. CONCLUSIONS: The local injection of BTX-A at the depressor anguli oris can effectively lift a drooping mouth corner, thereby improving the depressed, stern, and aged appearance of the face. The performance of this treatment is simple, safe, and easy to perform in clinical applications. LEVEL OF EVIDENCE V: 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 .

[The relationship between abdominal fat volume and obstructive sleep apnea hypopnea syndrome in obesity people].

OBJECTIVE: To explore the relationship between abdominal fat volume and obstructive sleep apnea hypopnea syndrome in obesity people. METHODS: From July 2009 to July 2010, 50 patients with BMI > 25 were prospectively selected for study from the patients who complained of snoring in the Respiratory department. The patients were divided into OSAHS group and non-OSAHS group according to the result of sleep apnea monitoring. All the patients also received full abdominal CT and the whole abdominal fat volume was measured by 3-D CT reconstruction system. SPSS 13.0 was used for statistical analysis. RESULTS: The whole abdominal fat volume in the two groups was analyzed by T- test, which was significantly different between the two groups (P < 0.01). It showed that there was a statistical relationship between OSAHS and abdominal fat in obesity people. CONCLUSION: In obesity people, OSAHS has a close relationship with abdominal fat volume. The abdominal fat volume is markedly higher in OSAHS patients than that in non-OSAHS people.

[Middle & distal circum peeling with bleeding control technique for redundant prepuce].

OBJECTIVE: To investigate the middle and distal circum peeling with bleeding control technique for redundant prepuce. METHODS: The middle and distal part of prepuce was circum peeled with bleeding control and electrical scalpel. More preputial inner plate was reserved. RESULTS: From January 2004 to July 2008, 51 patients with redundant prepuce were treated with this procedure. The average blood loss was 1 to approximately 2 ml with minimal edema. The proportion of inner and outer plates was suitable. CONCLUSIONS: This technique has the advantages of minimal blood loss and slight edema. The cosmetic result is also satisfactory.

[The long-term contrastive result of neo-urethra reconstructed with different kinds of tissue].

OBJECTIVE: To observe the long-term apparent and structural change of the neo-urethra inner wall reconstructed with different kinds of tissue. To compare the difference between normal and reconstructed urethra for urethra reconstruction with more appropriate materials. METHODS: The neo-urethra inner wall was observed during operation, through urography and urethroscope. The tissue section of neo-urethra inner wall was observed through light microscope and electron microscope. RESULTS: With unchanged structure, the appearance of neo-urethra reconstructed with skin or mucosa could be close to normal urethra after a long time. Neo-urethra made of buccal mucosa possesses some of the most important basic structures for normal urethral microenvironment to form. The structure of neo-urethra made of bladder could be close to normal urethra after a long time. CONCLUSIONS: Buccal and bladder mucosa may be a better material than skin for urethra reconstruction.

[Mutation analysis of SRD5A2 gene in patients with hypospadias].

OBJECTIVE: To explore possible molecular mechanism of hypospadias and relationship of the mutation of SRD5A2 gene to hypospadias. METHODS: 96 blood samples from the patients with hypospadias were obtained and DNA was extracted from blood leukocytes. Polymerase chain reaction and direct sequencing were performed to analyze the coding regions of SRD5A2 gene. RESULTS: 8 mutations were detected from 14 cases, including 5 missense mutations, 1 synonymous mutation, 1 nonsense mutation and 1 frameshift mutation. The mutations are in 1st, 4th and 5th exon. Gln6stop, His232His, Phe234Leu and frameshift mutations are novel. CONCLUSIONS: Exon 4 is a hot spot region of mutation within SRD5A2 gene, and about 10 percent of hypospadiac patients complicated with SRD5A2 dysfunction or deficiency.

[The reverse buccinator musculomucosal flap for the treatment of inverted papilloma of the nose].

OBJECTIVE: This paper presents the experience in using the reverse buccinator musculomucosal flap for repairing the defect following excising inverted papilloma of the nose. METHODS: After the inverted papilloma of the nose was excised through an endonasal approach, the reverse buccinator musculomucosal flap supplied by the retrograde blood flow of the anterior buccal artery was harvested and sutured to the defect through the ora-nasal tunnel. The procedure was performed on three patients. RESULTS: The postoperative course was uneventful. All the flaps survived completely. CONCLUSIONS: The technique provides the solution to prevent nasal stricture from cicatricial contracture after excising inverted papilloma. In the operation, excising the inverted papilloma and repairing the defect was performed simultaneously, saving another operation for the secondary deformity. The technique is also applicable to the treatment of existing cicatricial stricture of the nose.

[The inherent liability to infection of various tissue for urethra reconstruction].

OBJECTIVE: Observing the long-term results of reconstructed urethra to reduce the postop infection rate of hypospadias. To explore the standard of selecting tissue for urethra reconstruction by comparing the different inherent liability to infection in use of different kinds of tissue for urethra reconstruction. METHODS: Neo-urethra inner wall and normal urethra were observed through urography and urethroscope. The tissue section of neo-urethra, normal urethra and tissue for urethra reconstruction were observed through light microscope, scanning electron microscope and transmission electron microscope. RESULTS: The structure and liability to infection of neo-urethra made of bladder mucosa, buccal mucosa or skin never changed after long time. Metaplasia never took place in neo-urethra. CONCLUSIONS: The structure and liability to infection of neo-urethra were the same as those of the congeneric tissue. Bladder or buccal mucosa is the best tissue for urethra reconstruction considering urethra microenvironment. Neo-urethra made of skin is more liable to infection by nature. The best opportunity of hypospadias operation should be before puberty.

[Bacteriology study of hypospadias].

OBJECTIVE: This clinical study was to explore why the neo-urethra is liable to be infected after hypospadias operation, find the source and the common floras of infection, and accordingly, improve the peroperation procedures so as to reduce postoperative infection rate. METHODS: The pathogenic floras were examined and analyzed by germiculture and karyotype analysis. RESULTS: The bacteria in the neo-urethra mostly came from the orifice and the reconstruction material of the urethra. The most common floras that caused infection were gram-positive coccus. The most sensitive antibiotics for hypospadias infection were demethylvancomycin. CONCLUSION: The postoperative infection of hypospadias is incisional, not the urinary system infection. Because the microenvironment of the neo-urethra is more suitable for infection than that of the skin or mucosa, the reconstructed urethra is likely to be infected.

[Using scar tissue flap to repair secondary nasal deformities of unilateral cleft lip].

OBJECTIVE: To introduce the clinical application of the upper lip scar tissue flap in correcting secondary nasal deformities of unilateral cleft lip. METHODS: Two types of the upper lip scar tissue flap were developed in correcting nasal deformities with Millard's technique. RESULTS: The procedure was performed on 51 patients. All the scar tissue flaps survived completely. The deformities were better corrected than before. CONCLUSION: The scar tissue flap has adequate blood supply. This procedure is routinely combined with other commonly used techniques to correct secondary deformities of cleft lip. It is particularly applicable for repairing the nasal deformity when usable tissue is not enough.

[Autologous buccal mucosal graft for urethral reconstruction].

OBJECTIVE: To search for a new method for urethra reconstruction using autologous buccal mucosal graft while lacking of local skin. METHODS: Since 1998, a total of 25 patients with complex hypospadias have been treated using buccal mucosal grafts for urethral reconstruction. The reconstructed urethra was anastomosed with the meatus half year later. RESULTS: All the reconstructed urethra survived without contracture or stricture except one infection, which healed with no adverse consequence. CONCLUSION: The key points for operation success is rich capillary network, thick epidermis and thin lamina propria of the buccal mucosa. Buccal mucosa is an excellent tissue for urethral reconstruction.