ABSTRACT
Objective:To investigate the feasibility and availability of one-stage treatment for congenital lacrimal fistula combined with blepharoplasty and epicanthoplasty.Methods:From November 2014 to March 2021, 6 female patients with congenital lacrimal fistula and epicanthus were treated in the 2nd Department of Maxillofacial Plastic Surgery Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, aged 12-32 years (mean 24 years), including 5 unilateral lacrimal fistula and 1 bilateral.Results:During 3 to 40 months (mean 18 months) of follow-up, the ocular appearances were improved notably and the fistulas were removed completely. There was no secondary infection or cyst occurred, and no ectropion, traction or other deformities. The position of canthus was normal and the shape of canthus was good. The scars in the operation area were inconspicuous.Conclusions:Fistulectomy combined with blepharoplasty and epicanthoplasty can excise congenital lacrimal fistula effectively while improving the ocular appearance by this procedure.
ABSTRACT
Objective@#To investigate the association between ABO blood-group system and congenital microtia.@*Methods@#Patients with congenital microtia treated in the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from January 1, 2017 to February 28, 2019 were collected as the case group. Non-malformed patients admitted to the same hospital from January 1, 2017 to February 28, 2019 were collected as the control group. ABO blood group was determined by tube agglutination test. The distribution of ABO blood group in both group was counted and Chi-square test was used for statistical analysis with a significance level α=0.05. Then spilt chi-square test was applied to compare the difference between blood groups using Bonferroni correction for multiple comparisons (significance level α′=0.008 3) if a statistically significant difference was found in chi-square test. Odds ratio (OR) and its 95% confidence intervals (CI) were calculated to compare the association between ABO blood group and risk of microtia by using Woolf’s method . All statistical analysis was performed with SPSS version 25.0.@*Results@#2 317 patients with congenital microtia (case group) and 5 411 patients without malformation (control group) were included in this study. The distribution of ABO blood types in congenital microtia group was 29.39% (681/2 317) for type A, 31.89% (739/2 317) for type B, 9.75% (226/2 317) for type AB, and 28.97% (671/2 317) for type O. The distribution of blood group was B>A>O>AB. While, the distribution of blood groups in the control group was O>B>A>AB, which was statistically different from the congenital microtia group (χ2=8.387, P=0.039). The incidence of congenital microtia differed significantly between A blood group and O blood group (χ2=7.448, P=0.006). The risk of congenital microtia was significantly lower in blood group O (OR=0.863, 95% CI: 0.776-0.960, P=0.007) and relatively higher in blood group A (OR=1.110, 95% CI: 0.997-1.236).@*Conclusions@#In the population managed in the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences, ABO blood group is correlated with the occurrence of congenital microtia. O blood group is a potential protective factor. While A blood group is susceptible to congenital microtia.
ABSTRACT
Birth defects is one of the most important problems of human society. External birth defect is one of the major research fields of plastic surgery. This kind of disorders damages the body image of patients in mild or severe way, affects severely the social confidence of the patients themselves and their families. we summarized the research progress of the common external birth defects (the incidence top 10) from the aspects of pathogenesis, prevention, treatments and so on, in order to provide reference materials to the prevention and treatment of them.
ABSTRACT
Objective@#To investigate the clinical efficacy and safety profile of hyaluronic acid dermal filler(Restylane®) in treating nasolabial folds in Chinese population.@*Methods@#103 subjects in this study were recruited from five Chinese clinical trial centers between July 2014 and December 2015. Subjects were treated with hyaluronic acid dermal filler in correcting nasolabial folds and an optional re-treatment was performed after 12 months according to the subjects′wishes. The improved of nasolabial folds was evaluated by the change of severity (wrinkle severity rating scale, WSRS) and aesthetic improvement (global aesthetic improvement scale, GAIS). Satisfaction of subjects on treatment was evaluated using subject satisfaction questionnaires (SSQ). Safety indicators such as pain, skin and soft tissue presentation at the injection site were continuously evaluated throughout the whole treatment process.@*Results@#Significant improvement in scores of WSRS and GAIS of all subjects was observed after treatment. Nine months after treatment, the scores of WSRS in 80 subjects (77.7%) and GAIS in 96 subjects (93.2%) were still improved. The 68 subjects (95.8%) received re-treatment after 12 months gained further improvement in nasolabial folds. Most adverse events were mild or moderate (transient/reversible local manifestations) and all resolved before study end, no severe adverse event related to products observed.@*Conclusions@#Hyaluronic acid dermal filler is effective and safe in treatment of nasolabial folds in Chinese population and the effect can last up to 12 months.
ABSTRACT
Objective@#To describe an extended whole upper limb liposuction technique and evaluate its clinical effect.@*Methods@#34 patients who underwent upper limb liposuction from February 2018 to February 2019 were selected and the clinical data were retrospectively summarized. Patients were treated with upper arm ring/upper arm ring + forearm 1/3 rings/whole arm ring aspiration combined with accessory mammary gland, armpit, scapula and other adjacent aesthetic parts of extended liposuction. The preoperative and postoperative maximum circumference, thickness of the anterior and posterior subcutaneous tissue and skin laxity were measured and compared. analysis of complications, and evaluation of patients′ satisfaction through satisfaction questionnaire.@*Results@#The arm shape of all patients was significantly improved, the maximum circumference of the arm was reduced (16.2±4.0)%, the distance of the upper arm was reduced (29.5±8.9)%, the thickness of the posterior subcutaneous tissue was reduced (56.6 ±6.2)%, and the thickness of the anterior subcutaneous tissue was reduced (44.7±9.6)%. There were three cases of mild anemia after operation, and no other serious complications occurred. Patient satisfaction was very high.@*Conclusions@#This is an innovative arm liposuction technique with hidden incision. The effect of improvement is remarkable. The patient′s satisfaction is high.
ABSTRACT
Objective@#To describe the general and histological features of the full-length superficial fascia of the circumferential upper limb.@*Methods@#Fresh frozen arm specimens were dissected, and then MRI imaging in vivo, enhanced CT angiography and HE histological staining were used to describe the characteristics of the full-length superficial fascia of the circumferential arm and its relationship with important blood vessels.@*Results@#The four typical structures of the superficial fascia of the arm were divided into subcutaneous superficial fat, membrane-like substance, deep fat and deep fascia from superficial to deep. The thickness and stratification, fusion degree and histological characteristics of the superficial fascia of these four layers were obviously different in different levels and regions of the arm. MRI confirmed that the total thickness of superficial fascia gradually decreased from shoulder to wrist. Venography showed that the cephalic vein ran below the second layer of superficial fascia and above the deep fascia. The basilic vein originated from the dorsal vein network of the hand and always lied below the second layer of membranous material until the basilic vein penetrates below the deep fascia of the upper arm.@*Conclusions@#The deep understanding of the circumferential full-length of superficial fascia structure of the upper limb provides an important theoretical basis for improving the surgical safety and fine operation for the Dynamic Arm Circumferential Liposuction.
ABSTRACT
Peripheral nerve injury is a relatively common sequela of trauma. Nerve regeneration and target re-innervation are complex processes, and remain clinical challenges. For a long period of time, the placement of an autologous nerve graft is the gold standard. However, autologous nerve grafts are limited in supply due to its potentially associated with donor site morbidities. Therefore, researchers keep seeking the ideal alternatives for neural repair. The clinical application of artificial nerve regeneration conduit has made incremental advancement. Specifically, compound conduits are gaining more and more attention, which are reported to have comparable effect to autologous nerve graft. The purpose of this paper is to review the progress of construction and application of compound nerve conduits in peripheral nerve repair.
ABSTRACT
Platelet-rich fibrin(PRF) was first reported in 2001 by Choukroun. PRF is rich in growth factors, which can promote collagen deposition, angiogenesis, and reduce the incidence of postoperative pain, inflammatory reaction and infection. It is often used in stomatology and other wound repair. Recently, some researchers try to use PRF in fat grafting. The aim of this review is to summarize PRF and its application in fat grafting.
ABSTRACT
In October 2017, a female patient, 3 years and 5 months of age, with Crouzon syndrome, associated with multiple craniosynostoses was admitted to Plastic Surgery Hospital. Combined intracranial and extracranial approaches of fronto-orbital advancement and cranial suture release were performed to treat plagiocephaly and scaphocephaly. The patient′s families were investigated. Corresponding mutations were detected by DNA sequencing. Therapeutic effect was satisfactory. The mutation was inherited for 5 generations. Genomic sequencing results showed that the exons of fibroblast growth factor receptor 2 gene in the child was mutated, which excessively activated downstream signals and caused craniosynostosis.
ABSTRACT
Roberts syndrome (RBS, OMIM 268300) is a rare autosomal recessive disease, characterized by retardation before and after birth, cranial and maxillofacial deformities, limb anomalies and mental retardation, etc. Mutations in the establishment of cohesion 1 homolog 2(ESCO2) gene on the chromosome of 8p21.1 have been found to be causative for RBS.Here we systematically review this rare disease and summarize the pathogenic mechanisms and process in its treatment.
ABSTRACT
Objective@#To evaluate the clinical outcomes of a series of patients who have undergone reconstruction of craniofacial defects after resection of intracranial tumors or craniofacial trauma with free composite anterolateral thigh flaps.@*Methods@#Retrospective analyses the clinical cases from September 2007 to September 2016. Data included flap survival rate, complication, satisfaction survey was reviewed to evaluate the efficacy and safety of this surgical strategy.@*Results@#Totally 10 free anterolateral thigh flaps including 3 cases of fasciocutaneous flaps, 2 case of adipofascial flaps, 4 cases of myocutaneous flaps, 1 case of chimeric flap, were adopted to reconstruct craniofacial defects. Follow-up ranged from 3 to 17 months (average, 12 months). All flaps were transferred successfully. There were no cranial spinal fluid(CSF) leaks, intracranial infections or donor site complications. All patients were satisfied.@*Conclusions@#Because of its abundance of tissue, matched vessels to recipient site, versatility of muscular flaps to fill irregularly intracranial defects, reliable blood supply, feasibility of simultaneous fascia lata harvesting, free composite anterolateral thigh flap is the reconstructive method of choice for craniofacial defects reconstruction after resection of intracranial tumors or craniofacial trauma. The use of ALT flap was reliable in the decrease of CSF leak and infection rate and dependable according to long time follow-up.
ABSTRACT
Objective@#The purpose of this study was to explore the surgery-first approach in sequential combined orthodontic-orthognathic treatment to shorten total treatment duration and improve the clinical outcome.@*Methods@#This study included 185 patients with Angle classⅢ malocclusion. The patients were divided into 3 different types according to cephalometry analyses and facial features. ①Type Ⅰ: mandibular prognathism or asymmetry mandibular prognathism; ②Type Ⅱ: mandibular prognathism and maxillary retrusion; ③ Type Ⅲ: mild Angle′s Class Ⅲ malocclusion, cross bite in anterior teeth, or normal overlap and overbite relation with midfacial hypoplasia. All of patients received surgery first approach therapy. The surgical procedures were chosen according to different malformation types. Type Ⅰ was treated with the sagittal split ramus osteotomy (SSRO). Type Ⅱ was treated by Le Fort Ⅰmaxillary osteotomy combined with SSRO. Type Ⅲ underwent anterior subapical osteotomy combined pyriform aperture augmentation with biomaterials as well as maxillary anterior orthodontics. All patients received postoperative rapid orthodontic treatment for 6-12 month after 2 weeks of operation. Using the straight arch wire techniques and the class Ⅲ intermaxillary traction, we removed the overcrowding upper and lower teeth, the compensatory axial tilt of teeth, and the deviation of the dental arch and maintained the neutral relationship of the molar. The mandible Hawley retaining devices were used during the maintaining stage.@*Results@#The cases in study acquired satisfactory clinical outcome, which included the shortened overall treatment duration, the significantly improved facial features, the corrected occlusion relationship, and the restored function of mastication and temporomandibular joint. There were some complications as follows: intraoperative fracture (6 cases, 3.24%), the inferior alveolar nerve bundle injury (2 cases, 1.1%), and temporary open-bite that diminished by inter-maxillary elastic distraction one month after operation (19 cases, 10%). All cases in this study accepted postoperative orthodontic treatment. Follow-up time ranged from 6 months to 5 years. The cephalometric analysis results of 126 cases who had complete image data and over 6 months of follow-up showed that hard and soft tissue indexes were restored to normal range after combined orthognathic-orthodontic treatment. The stability of the maxillary and occlusive relationship of SFA(surgery-first approach) was similar to that of the COS(conventional orthodontics-first system) [relapse ratio=(T2-T1)/(T1-T0)×100%]. Over six months of follow-up , SNB and ANB showed that the average relapse ratio were 22% and 19.8%, whereas the relapse angle are less than 2°.@*Conclusions@#The Surgery-first approach could be used to treat most patients with Angle skeletal Class Ⅲ malocclusion, but the indications and the surgical procedures should be noticed and chosen.
ABSTRACT
Objective@#To explore the application of the 3D precise digital technology in restoring structural defects of the orbital region.@*Methods@#Structural defects of the orbital region concerning on osseous structure and soft tissue were restored in one stage or stages using EH composite artificial bone prosthesis with complex three-dimensional structure. The fabrication of EH composite artificial bone prosthesis was based on CT scanning and 3D reconstruction of the skull with computer aided data analysis and design. The appearance, degree of satisfaction and the complications were evaluated in postoperative regular follow-up.@*Results@#Five cases of structural defects in the orbital regions presenting bone defect and soft tissue abnormality, received treatments in the department from January 2016 to September 2017. The cases consist of one patient with dysplasia following surgical treatment, three with post-traumatic and one with Treacher-Collins syndrome. With the application of individualized EH composite artificial bone fabricated by aforementioned method, all the repair materials presented the ideal three-dimensional structure and coincided well with the defects, and soft tissue restoration of 2 cases was performed in one stage or by stages. Appearance and symmetry of the 5 cases was significantly improved, without complications of infection, rejection, exposure or graft tissue necrosis. All the patients were satisfied with the results.@*Conclusions@#In consideration of the capacity to fabricate accurate individualized repair materials, the three-dimensional digital technology plays an important role in the treatment of structural defects in the orbital region, especially the reconstruction of the bony contour. The simple orbital deformities can be treated with the repair materials and correction of soft tissue. For special orbital deformities, attention should be paid to bone structure repair, eye socket reconstruction and filling of orbital contents sequentially.
ABSTRACT
With the rapid development of digital technology, digital medicine has seen an upsurge in the 21st century, thus entering the era of precision and digital medicine. This article mainly introduces the application of digital technologies in plastic and reconstructive surgery, such as three-dimensional scan imaging, surgical navigation, microsurgical navigation, 3D printing, etc. In the era of big data, digital technologies have been widely applied in the preoperative design, navigation during surgery and post-operative evaluation of plastic surgery. Naturally the digital teams and societies of plastic surgery have come into being. Additionally this article puts forward the new prospects for more extensive applications of digital technologies such as surgical robots, 3D printing of prosthetic implants, and virtual reality. We believe that when the professionals who master artificial intelligence algorithms collaborate with the experts who have deep insight into medicine, the digital technologies can be applied better to the field of cosmetic surgery. This is our main task at present and the final goal.
ABSTRACT
Objective@#To perform a comparative study of different fat-processing techniques to explore which technique could obtain higher fat content.@*Methods@#Lipoaspirates was purified with three groups of fat-processing techniques (sedimentation, centrifugation, and cotton pad filtering). Isometric purified fat tissue was centrifuged at 5 000 g for 5 minutes to quantify the oil, aqueous, and fat content from them. HE staining was applied to evaluate the effect of different fat-processing techniques on the integrity of adipocyte.@*Results@#The fat content, aqueous content, and oil content of three groups was respectively 86.0%, 9.6% and 4.4% for the cotton pad filtering group; 74.4%, 14.8% and 10.8% for the centrifugation group; 62.0%, 28.4% and 9.6% for the sedimentation group. In the HE histologic findings, no significant difference was observed in the integrity of adipocyte of three groups (P>0.05).@*Conclusions@#In comparison with the sedimentation group and the centrifugation group, more fat content, less oil content and aqueous content was observed in the cotton pad filtering group. The cotton pad filtering technique was helpful in postoperative volume retention.
ABSTRACT
Objective@#The study presents a new method to prefabricate the nasoalveolar molding appliances for preoperative cleft lip and palate by using three-dimensional technology.@*Methods@#A long term retrospective study of 40 cases of infants with unilateral cleft lip and palate who underwent the preoperative 3D models of alveolar bone acquisition, computer aided design for the rapid prototyping process, gypsum powder printing maxillary three-dimensional entity model and install the appliance for 3-4 months (or alveolar cleft<2 mm). Simultaneously, primary rhinoplasty can be done during cleft lip repair. All patients had clinic visits three times each month.@*Results@#Deformities of infants who underwent this treatment, were significantly improved. The alveolar cleft was significantly reduced (P<0.01), while bilateral alveolar tissue volume was significantly increased (P<0.01). Alveolar bone morphology was more symmetrical than before.@*Conclusions@#The digital design and manufacture system of appliances for preoperative cleft lip and palate can be successfully applied to the preoperative orthodontic treatment. The sequence treatment of cleft lip and palate becomes better improved. It can shorten the time duration and the numbers of clinic visit on the basis of ensuring the accuracy of preoperative orthodontic effect.
ABSTRACT
Clinical application of imaging technology (e.g., CT, MRI and DSA) in craniomaxillofacial surgery, genetic detection and analysis, three-dimensional visualization of panoramic anatomy, rapid and accurate molding of craniofacial skeletal models, precise designing and manufacturing technology, intraoperative real-time navigation system, and the remote consultation system aided by information network technology effectively improve the diagnosis and treatment of craniomaxillofacial malformation.Application of rigid internal fixation improves the stability and accuracy of the fracture treatmentand osteotomy. With the research and application of distraction osteogenesis(DO) in craniomaxillofacial surgery, DO in Le Fort III osteotomy and treatment on hemifacialmicrosomiareduce postoperative recurrence significantly. The combination of craniomaxillofacial surgery and advanced technology of related medical and engineering disciplines has promoted the development of craniomaxillofacial surgery.
ABSTRACT
Objective To investigate clinical characteristics and treatment of upper eyelid lipogranuloma cases that developed after facial autologous fat injection.Methods This retrospective study involved 8 patients who presented with upper eyelids symptoms (final diagnosis of lipogranulo ma) and had history of facial autologous fat injection.The collected data included information on patient sex,age,clinical presentation,laboratory findings,treatment and outcome.Results All 8 cases were managed by exploration and surgical removal through double eyelid surgery.All patients showed complete resolution over 1-12 months follow up period.Conclusions Lipogranuloma can develop in the upper eyelid after autologous fat injection into the face.and surgical removal can yield satisfactory outcomes in cases of repeated failure of conservative therapies.
ABSTRACT
Objective@#To identify the special biomarkers and the differentially expressed proteins in keloid tissue and to explore the pathogenesis characteristics of familial keloid by comparing the protein expression differences among familial keloid(FK), sporadic keloid(SK), hypertrophy scar (HS), normal scar (NS).@*Methods@#The tissue specimens of FK, SK, HS and NS(6 specimens in each group), were digested, taged and analysed using quantitative proteomic isobaric tags for relative and absolute quantitation (iTRAQ) labeling technology. A difference greater than 1.2 folds and P<0.05 were selection criteria for differencial expression proteins. Then bioinformatics analysis was applied.The expressions of 2 differential proteins were validated using Western Blot analysis.@*Results@#A total of 2 450 differentially expressed proteins were identified. Compared with NS, 250 up-regulated and 281 down-regulated proteins were identified in FK; 281 up-regulated and 232 down-regulated proteins were identified in SK; 199 up-regulated and 233 down-regulated proteins were identified in HS.Compared with SK, 64 up-regulated and 164 down-regulated proteins were identified in FK; 79 up-regulated and 169 down-regulated proteins were identified in HS.Compared with HS, 124 up-regulated and 115 down-regulated proteins were identified in FK.These different proteins were concentrated in several vital signal pathways such as the extracellular matrix protein, cell adhesion and biological metabolism pathways. The variation trend of 2 differentially expressed proteins (P3H1 and RCN-3) were validated by Western Blot.@*Conclusions@#Proteomic analysis can identify the proteins with variance of keloid, hypertrophy scar and normal skin. Further investigations of these differential proteins may reveal the pathogenesis of keloid and provide new treatments for it.
ABSTRACT
Objective To investigate the plastic surgery of facial soft tissue for improvement of facial contour. Methods Botulinum toxin type A was injected into hypertrophied masseter to make it atrophy and attenuation; meanwhile, buccal fat lining was partly resected by intra-oral approach. Buc-cal liposuction was performed if necessary. Results 36 cases got satisfactory face thinning results af-ter treatment. The facial contour of all patients was markedly improved. Following up for 6 - 12 months showed that the effect was stable. Conclusion Plastic repair of facial soft tissue for improve-ment of facial contour is a simple approach, with mild injury, quick recovery, safe and effective.