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Objective:To observe the lipogenic or osteogenic differentiation of decellularized adipose matrix (DAM) in the periosteal microenvironment.Methods:From June 2020 to December 2020, adipose tissue obtained by human liposuction was prepared as DAM at the National Institute of Plastic Surgery. Six male SD rats of 4 to 6 weeks were selected and implanted into the subperiosteum of the rat parietal bone according to the same initial volume. After 12 weeks, adipogenesis and osteogenic differentiation of DAM were observed by gross specimens, histological staining, and immunofluorescence staining. Label-free quantitative protein mass spectrometry was used for detection of osteogenic-associated proteins in DAM.Results:Vascularization around the DAM was evident. Adipogenesis and angiogenesis were observed in DAM by H&E and Masson staining, while OCN immunofluorescence staining confirmed osteogenic differentiation of DAM. The osteogenic differentiation related proteins were screened by mass spectrometry.Conclusions:In the microenvironment of periosteum, DAM mainly differentiates towards adipose tissue, but a few of them havs the potential to differentiate towards osteogenesis, which might be related to some of the osteogenesis-related proteins contained in DAM.
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Objective:To explore whether botulinum toxin A (BTX-A) can improve the retention rate of fat transplantation in fat breast augmentation.Methods:Each patient was divided into control side and experimental side according to the random number table in 14 patients studied. The experimental group received autologous fat and BTX-A combined transplantation on both sides of the breast, while the control side only received autologous fat transplantation. The fat was added with the same volume of normal saline as BTX-A in the control group. All patients were followed up and the effects of BTX-A were evaluated objectively via the comparison of the remained bilateral fat graft volumes that were obtained through a digital three-dimensional reconstructions technique. Moreover, the improvement of each breast appearance and complication were assessed by the physician and patients who were blinded to the recipient treatment assignment.Results:The outcome of the fat breast augmentation was evident for both groups at the follow-up with no evidence of fat embolism, vascular/nervous injury, infection and prolonged bruising. In one of the 14 patients (control group), fat liquefaction necrosis occurred in one side of the breast; after active treatment, it returned to normal, and three patients had different degrees of mass. The analysis on the three-dimensional reconstruction data and the assessments from both the physicians and patients showed significant differences in the fat graft retention volume between the BTX-A group (51.10±20.56)% and the control group (33.06±14.77)%. Nevertheless, there was no significant difference in the incidence of complications between the two sides.Conclusions:Autogenous fat breast augmentation is safe and effective. This study result has shown that BTX-A can significantly improve the retention rate of fat transplantation but cannot reduce the incidence of complications.
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Objective To explore the significance of preoperative MRI in the detection of gynecomastia before surgery.Methods From November 2016 to August 2018,we used preoperative MRI to determine surgical options to treat 38 cases of adolescent and post-adolescent patients with gynecomastia.After operation we followed up the patients for 6 months to 1 year.Results The breast had good shape,smooth chest wall,natural contour,and no complications such as hematoma,nipple and areola sensory disturbance.No surgical traces remained in the chest and no recurrence occurred during the follow-up.All patients were satisfied with the surgical effect and chest wall shape.Conclusions Preoperative MRI can clearly show the type of breast development,the proportion of fat and breast tissue,to guide the clinical personalized design of surgical procedures.It can be used as a routine pre operative examination for gynecomastia.
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Objective To evaluate the clinical effect of nanofat on superficial rhytides of face and neck and dark lower eyelids.Methods From September 2014 to January 2017,a total of 86 cases were collected in our hospital for voluntary nanofat transplantation on superficial rhytides and dark lower eyelids.This was a retrospective study,which included 18 cases of eye wrinkles,14 cases of forehead wrinkles,neck wrinkles in 14 cases,and 22 cases of dark lower eyelids.First of all,we harvested mircofat through liposuction,and then transformed mircofat to nanofat.At last,nanofat was grafted into intradermal layer of the skin with sharp needles.We took the standard photographs of the patients.After six months follow-up,doctors and patients evaluated the short term and long-term postoperative effect.Results No serious complications occurred in all patients.Postoperative evaluation of facial and neck superficial wrinkles showed that the satisfactory rate of doctors and patients after one month,was 85.9％and 84.3％,and after 6 months 87.5％ and 84.3％,respectively.Postoperative evaluation of dark lower eyelids showed that the satisfactory rate of doctors and patients after one month was 45.5％ and 36.4％,and after 6 months 81.8％ and 86.4％,respectively.Conclusions Nanofat can rectify the superficial rhytides of face and neck and dark lower eyelids in some patients.However,for some patients the effect is not satisfied.
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Objective@#This study aims to explore the potential related gene and mechanism of mesenchymal stem cells (MSCs)-derived extracellular matrix (ECM) promoting the proliferation and differentiation of adipose-derived stem cell (ADSCs), through regulating extracellular microenvironment.@*Methods@#Twelve transcriptomes were analysed using Gene Expression Omnibus (GEO) database, and divided into four groups: (1) ADSCs cultured in Tissue Culture Polystyrene (TCPS) medium with normal human dermal fibroblasts (NHDF)-derived ECM, (2) ADSCs cultured in TCPS medium with bone marrow mesenchymal stem cells (BMSCs)-derived ECM.(3) ADSCs cultured in TCPS medium with ADSCs-derived ECM.(4) ADSCs cultured in TCPS medium as the control group. Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Ontology (GO), and Gene Set Enrichment Analysis (GSEA). Software R, Perl and Cytoscape software were used for differential expression analysis and data visualization.@*Results@#Each MSC produced specific extracellular matrix. However, the ADSCs cultured with additive ECM expressed partially different genes and proteins, e. g. The collagen family genes. Furthermore, 3 important molecules: COL4A1, COL11A1, COL15A1 were detected by constructing the interaction relationship between the shared genes and the functional groups. They may affect the proliferation and differentiation of ADSCs by changing microenvironment. The low expression of above molecules, may be related to biological processes and signaling pathways, such as cell repair, nucleotide metabolism, DNA replication, cell cycle, etc.@*Conclusions@#The gene expression of collagen encoding were down-regulated, when ADSCs cultured in the medium with additive ECM derived by MSCs. This may significantly affect the proliferation and differentiation of ADSCs through various pathways.
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Objective@#To explore the nipple-areola complex blood supply mode in hypertrophic breasts, and to obtain the pertinent knowledge of vascular anatomy for breast reduction surgery as well as the analysis of similarities and differences between hypertrophic and normal breasts. Comparing the blood supply of nipples-areola complex between these two groups for analyzing their similarities and differences.@*Methods@#Three dimensional reconstruction of the arteries in breast were performed in 50 patients between September 2015 and August 2017 with breast hypertrophy by computed tomographic angiography (CT angiography). The distribution pattern and the source direction of each main blood vessel was observed, counted and analyzed. Then, the data of breast hypertrophy patients were compared with the previous data about nipple-areola blood supply in normal population (the definition of main vessel: entering the breast gland or reaching the nipple-areola surrounding area, and diameter larger than 1 mm). Statistical description was taken for comparison.@*Results@#135 main vessels were observed in 100 breasts (50 patients). They mainly originate from the internal thoracic artery (69, 51.1%), lateral thoracic artery (37, 27.4%) and thoracoacromial artery(16, 11.9%), as well as a small amount from the brachial artery (7, 5.2%) and axillary artery(6, 4.4%). No main supply vessels from the posterior intercostal artery have been found. The patterns of breast blood supply varied among individuals, and high asymmetry ratio in the same individual was also observed. The internal superior (left: 30.7%, right: 34.2%) and superior lateral quadrant (Left: 29.2%, Right: 20%) of the breast was the most likely area for the main vessel to pass, followed by the breast lateral (Left: 16.9%, Right: 18.5%), lower inner (Left: 4.6%, Right: 5.7%), central (Left: 4.6%, Right: 4.2%), and superior (Left: 1.5%, Right: 2.8%). Differences existed in main vessels between normal breasts and hypertrophic breasts, either for source arteries or the distribution of breast. There was no main blood supply from the intercostal arteries or across the outer inferior quadrant.@*Conclusions@#The blood supply of the nipple-areola is not completely consistent between the hypertrophic breast and the normal size breast, and the blood supply pattern of the hypertrophic breasts is complex and diverse. CT angiography might be used before breast reduction surgery for clarifying the direction of the main vessels, so as to preserve more blood supply for nipple-areola, and to prevent nipple-areola necrosis.
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Objective To investigate the feasibility and clinical effect of transaxillary dual-plane breast augmentation under endoscope combined with autologous fat transplantation.Methods From January 2015 to December 2015,88 patients who accepted augmentation mammoplasty were divided into control group (from January to June) and observation group (from July to December).Patients in control group only accepted transaxillary dual-plane breast augmentation and transaxillary dual-plane breast augmentation combined with autologous fat transplantation was used for patients in observation group.Patients' basic information,surgery-related indicators,recovery situations,complications and patients' satisfactory data were collected.34 patients in control group and 38 patients in observation group were followed up.Results For surgery-related indicators and recovery situations,statistically significant difference was not found in the blood lost,duration of drainage tube and postoperative stay (P＞0.05),but was found in operation time (P＜0.05).And there was no significant difference in terms of surgical effects between two groups (P＞0.05).There were no complications such as hematoma,infection,capsular contracture in two groups.25 patients in observation group were performed B ultrasonic examination 6 months after operation.Multiple cysts were found at the cleavage in only 1 patient and were cured by suction.And the rest B ultrasonic results were negative for pathologic findings such as calcifications,cysts and masses.Conclusions Autologous fat transplantation is useful in minimizing the unaesthetic appearance of the cleavage and the bad feeling of the inframammary fold and thus a proper solution for the patient's breasts with thin soft tissue.
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Objective To study the method and effect of superomedial pedicled mammaplasty based on Würinger's horizontal septum.Methods During August 2014 to August 2015,25 cases of cromastia were treated with septum-based mammaplasties with a superomedial pedicled and vertical incision.Based on the preoperation design,the superomedial pedicle was deepithelialized with preservation of the dermis and the subdermal plexus.The pedicle was dissected as described,the excess tissue was removed with the prepectoral fascia preserved.After remodeling the shape of mammary gland,the incision was sutured.Results There was no hematoma,no fat liquefaction and no partial or complete NAC necrosis.The pre and postoperative NAC sensibilities were comparable in all the patients.The patients were followed up for 6 to 12 months,and all the patients were satisfied with the therapeutic effect and expressed acceptance to the scar.Conclusions The breast reduction based on wellvascularized septum and superomedial pedicle is safe with minor scar,even in large breasts.This technique demonstrates ease of pedicle shaping and breast remodeling.The satisfied effect could be obtained for patients with severe ptosis of breasts just after operations and in future.
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Objective To study the effect of autogeneic platelet-rich fibrin (PRF) on proliferation and adipogenic differentiation of human adipose-derived stem cells (ADSCs) in vitro.Methods ADSCs were isolated from adipose tissue obtained from donors undergoing liposuction and were cultured,and underwent identification.ADSCs at passage 3 were divided into three groups:test groups were cultured with 1PRFM and 2PRFM,and control group was cultured without PRF membrane.Then the growth of the cells was observed by inverted microscope.MTT method was used to observe cell proliferation activity at days 1,2,3,4,5,6 and 7 after culture.Adipogenic differentiation of ADSCs was observed and quantified by oil red O staining at days 3,5,7,9,11 and 14.Results Cell proliferation and adipogenic differentiation would be increased with the PRFM,There were significant differences among three groups.Conclusions PRF could significantly promote proliferation and adipogenic differentiation of ADSCs.