Cross-linked Sodium Hyaluronate Gel with PLLA-b-PEG Microsphere for Facial Contouring in Chinese: A Retrospective Study.

BACKGROUND: In Asia, the demand for cosmetic facial treatments has surged due to technological advancements, increased social acceptability, and affordability. Poly-L-lactic acid (PLLA) fillers, known for their biocompatibility and biodegradability, have emerged as a popular choice for facial contouring, yet studies specifically addressing their use in Asian populations are scarce. METHODS: This retrospective study examined 30 Chinese patients who underwent facial contouring with PLLA fillers, focusing on product composition, injection techniques, and safety measures. A comprehensive clinical evaluation was performed, including the Global Aesthetic Improvement Scale (GAIS) and Global Impression of Change Scale (GICS) for effectiveness and patient satisfaction, respectively. RESULTS: No significant difference in GAIS scores was observed between injectors and blinded evaluators over a 12-month period, indicating consistent effectiveness. Patient satisfaction remained high, with GICS scores reflecting positive outcomes. The safety profile was favorable, with no serious adverse events reported. The study highlighted the importance of anatomical knowledge to avoid complications, particularly in areas prone to blindness. CONCLUSIONS: PLLA fillers offer a safe, effective option for facial contour correction in the Asian population, achieving high patient satisfaction and maintaining results over time. The study underscores the need for tailored approaches in cosmetic procedures for Asians, considering their unique facial structures and aesthetic goals. Further research with larger, multicenter cohorts is recommended to validate these findings and explore long-term effects. LEVEL OF EVIDENCE III: 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 Reverse Dual Plane: A Novel Technique for Endoscopic Transaxillary Breast Augmentation.

Background: Quite a few Asian patients prefer axillary incision for breast augmentation. However, this surgery needs improvement. Objectives: To introduce a reverse dual-plane technique through a transaxillary approach and compare it with a transaxillary dual-plane approach. Methods: Eighty-two patients were divided into Group A (n = 40) and Group B (n = 42). Axillary incision and endoscope were utilized in the 2 groups. Tebbetts' dual plane was performed in Group A patients. Patients in Group B underwent our reverse dual-plane technique, in which the upper 70% was subfascial and the lower 30% was subpectoral, with the fascia of the external oblique and anterior serratus being elevated together with the pectoral muscle. The Numeric Pain Rating Scale (NPRS) scores were recorded daily for 7 days. Breast shape and softness, in both sitting and supine positions, were assessed by the patients, and complications were compared. Results: The NPRS scores of Group B patients were significantly lower than those of Group A patients (P < .01). The satisfaction rate of shape and softness in the seated position was not significantly different (P > .05). However, in the supine position, only 20 patients (50.0%) in Group A and 32 patients (76.2%) in Group B were satisfied with their breast softness (P < .01), and the breasts of the others became stiffer. Breast animation deformity (BAD) occurred in 2 patients in Group A and in no patient in Group B (P < .01). Other complications were not significantly different. Conclusions: Compared with Tebbetts' dual plane, this procedure significantly reduced pain, improved breast softness, and eliminated BAD, without increasing complications.

AMF siRNA treatment of keloid through inhibition signaling pathway of RhoA/ROCK1.

A keloid (KD) is a benign dermal fibrotic tumor. Treatment of KDs is challenging and the recurrence rate is high; thus, there is an unmet need to explore new target sites and new treatment methods. As a tumor-associated cytokine, autocrine motility factor (AMF) can effectively stimulate the random and directional movement of cells. We first found that AMF was overexpressed in keloid fibroblasts (KFs) and the proliferation and migration of KFs were promoted by AMF stimulation. After treatment with Y-27632, RhoA kinase inhibitor, the proliferation and migration capacity of KFs declined significantly, and type I collagen protein, active RhoA and ROCK1 also were downregulated. In addition, a KD transplantation model was established under the skin of nude mice, with KD intramural injection AMF siRNA, we found that the weight of the KD was smaller than in the control group (P < 0.05), KD tissue sections stained by HE and Masson showed that fibers became loose and the blood vessels were visibly reduced. In conclusion, AMF siRNA is expected to be a novel strategy to treat KD by inhibiting signaling pathway of RhoA/ROCK1.

[Myocutaneous platysma flap containing external jugular vein for the oral reconstruction after cancer excision].

OBJECTIVE: To improve the blood circulation of myocutaneous platysma flap and its survival rate. METHODS: There were seventeen oral cancer patients in this group. After the tumor excision, the oral defect was reconstructed with myocutaneous platysma flap which had submandibular pedicle and contained external jugular vein. RESULTS: There was no any circulation compromise in this group. The survival rate of the flap was 100% . Two cases encountered oral-facial fistula but were cured by dressing change. CONCLUSIONS: Preserving and containing the external jugular vein in the flap is helpful for improving the blood circulation of the myocutaneous platysma flap and making its survival rate higher.

[Primary clinical study on using end-to-end neurorrhaphy following rapid nerve expansion to repair facial nerve defect].

OBJECTIVE: To evaluate the clinical effect of end-to-end neurorrhaphy following rapid expansion of the nerve in repairing facial nerve defect. METHODS: From August 2000 to February 2005, 9 patients suffering from facial nerve defect were treated by the surgical method. The defect was caused by traffic injury(4 cases) , by cutting injury (2 cases) and falling wound (1 case). Seven cases showed prominent facial paralysis. The other 2 cases were invaded by parotid carcinoma, without remarkable paralysis. One case had unibranch defect, and the other 8 cases had multibranch defect. The nerve gap ranged from 1.5 cm to 3.0 cm. After both the proximal and the distal segment had been dissected, the nerve was elongated by the expander designed and manufactured. The expansion was done at a speed of 2.0 cm/30 min, and it lasted until the end-to-end neurorrhaphy can be done easily. The treatment result was evaluated according to Baker's classification and House-Brackmann's grading system. RESULTS: Nine patients were followed up 6-18 months. In 5 cases achieving good result, both dynamic look and static look of face were symmetric, the EMG peak value of mimetic muscle was 82%-95% of normal side. In 3 cases achieving fair result, the dynamic look and static look of face were basically symmetric, and the EMG peak value of mimetic muscle was 60%-90% of normal side. In 1 case achieving poor result, the function of mimetic muscle was improved slightly, and the EMG peak value of mimetic muscle was 55% of normal side. CONCLUSION: The satisfactory result can be obtained by end-to-end neurorrhaphy following rapid expansion of the nerve in condition that nerve defect is less than 3.0 cm.

[A study on the survival mechanism of the reverse-flow axial skin flap].

OBJECTIVE: To investigate the survival mechanisms of the reverse-flow flap. METHODS: A skin flap measuring 8.0 cm x 2.5 cm based on the left deep circumflex iliac vessel (DCIV) was designed and elevated on the rat's dorsum with 4.0 cm of it's length crossing the midline. The flap was served as the reverse-flow flap model. The survival area, the dynamic microcirculation including flow direction, microvessel number, caliber, pressure and vasculature were assessed respectively at 6 hour, 24 hour, 48 hour, 72 hour, 7 day and 14 day after operation. RESULTS: The average gradient of perfusion pressure was 0 kPa before operation and was 4.9 KPa postoperatively between the proximal and the distal site of the flap. By anastomosis of bilateral DCIV, the blood flow run in a reversed pattern in the region distal to the midline. No venous valves were observed. Distal congestion developed in 20% of the flaps within 72 h. After that, the number and caliber of venous anastomosis increased with pressure dropping in the midline region. The axial vessels extended its branches progressively along the dilated anastomotic rami. As a result, the vasculature of the flap became similar to that of the conventional axial flap by the 14th day. With these changes, flap congestion was alleviated gradually and subsided within 7 days. All the flaps survived completely. CONCLUSIONS: Anastomosis connecting the two axial vessels is the circulation route of the reverse-flow flap. By the gradient pressure between the proximal and distal region, blood is driven reversely. Within 72 h, the distal part is susceptible to congestion. In this period, increasing number and caliber and decreasing pressure of anastomosis is important mechanism to support the circulation. After that, the new vasculature similar to the conventional axial flap provides the flap with reliable and permanent blood supply.