Analysis of age-related changes in midfacial fat compartments in Asian women using computed tomography.

BACKGROUND: Volume restoration is no more a fresh theory for midfacial rejuvenation. However, lack of knowledge regarding the natural ageing process of fat compartments often leads to an insufficient or excessive clinical result. The aim of this study is to reveal the age-related changes in midfacial fat compartments and the correlation between midfacial grooves and the related fat compartments. METHODS: This study included 60 Asian females in defined age-based categories. The thickness of the infraorbital fat compartment, the nasolabial fat compartment, and the cheek fat compartments were measured using computed tomography (CT) images. Analysis of correlations between midfacial grooves and the related fat compartments was performed using the SPSS software. RESULTS: A tendency of thickening in the infraorbital fat and nasolabial fat compartments with age was observed. The superficial layer of cheek fat compartments was found to be thinner, and a similar tendency was observed in the medial part of deep medial cheek fat. However, it was thicker in the lateral part of deep medial cheek fat. There was a negative correlation between the fat thickness of deep medial cheek fat and both the severity of tear trough deformity and the nasolabial fold. A positive correlation between the lower third of the nasolabial fat compartment and the severity of the nasolabial fold was found as well. CONCLUSION: Different midfacial fat compartments tended to undergo selective hypertrophy or atrophy with ageing. The findings of this study suggested that augmentation of the deflated fat compartment and liposuction of the hypertrophic fat compartment can provide a more natural effect in facial rejuvenation.

Determinants of crease width in inherent double eyelid of Asian young women.

BACKGROUND: The creation of a superior palpebral crease has been the most popular plastic surgery procedure in Asians for several decades. The most important criterion for judging the success of this procedure is the achievement of the desired size and shape of this crease or the perfect crease width. However, the determinants of crease width remain unclear, which may account for the high rate of unsatisfactory results. METHODS: Standard images were used to study the anatomic parameters, including crease width, crease height, and upper eyelid movement distance (ULMD) at the midpupillary axis, of the inherent double eyelid crease in 32 Chinese women aged 19-26 years. The thickness of the eyelid tissue at 5, 7.5, 10, and 15 mm from the lid margin was measured in the oblique sagittal direction by magnetic resonance imaging (MRI) at the central axis of the optic nerve. Multiple linear regression was used to analyze the relationship between crease width and crease height, ULMD, and eyelid thickness. RESULTS: Multiple linear regression revealed that crease height, crease thickness, and ULMD were significantly associated with crease width (partial regression coefficients: 0.67, -0.33, and -0.29 respectively). The determination coefficient R2 was 0.667 in the regression model, and the result of analysis of variance (ANOVA) showed that the regression model was significant (F = 16.04, p = 0.000). CONCLUSIONS: In performing upper blepharoplasty, it is important to consider eyelid thickness and movement distance of the upper eyelid margin rather than relying on crease height alone. Attention to these factors will help to achieve the desired size and shape of the crease.

Stromal cell-derived factor 1 promoted migration of adipose-derived stem cells to the wounded area in traumatic rats.

BACKGROUND: Adipose-derived stem cells (ADSCs) were effective in treating wound. Stromal cell-derived factor-1 (SDF-1), a chemokine usually called CXCL12, is well known for its chemotaxis in induction of cell migration. However, little is known about the SDF-1responsible for the complex migration of ADSCs from residence to injured sites. OBJECTIVE: Herein, we firstly showed SDF-1 is a major regulator involved in migration of ADSCs during wound repair in vivo. METHODS: Trauma in rats was induced by surgical operation. The levels of SDF-1 in wounded tissue were assayed by ELISA. ADSCs were labeled with Green Fluorescent Protein (GFP), and then were transferred to injured rats by intracarotid injection. The plasma levels of ADSCs during wound healing were detected by flow cytometry, and ADSCs in injured tissue were evaluated by bioluminescence imaging in vivo and laser confocal microscopy (LCM), respectively. RESULTS: ADSCs were successfully labeled with GFP. SDF-1 level reached to the peak value on 24 h after injury and then decreased continuously. Additionally, levels of plasma ADSCs in SDF-1 treated rats reached to the peak value (12%) at d21 after medicine delivery, while those of normal and injured rats showed the peak values of 6.28% and 9.84% at d7 and d21, respectively. Finally, the results of LCM indicated treatment of ectogenic SDF-1 obviously enhanced GFP-ADSCs distribution in wounded tissues. CONCLUSION: Our results indicated that SDF-1 treatment obviously promoted the migration and directed distribution of ADSCs in traumatic tissue.

[Effect of botulinum toxin type A injection into the masseter muscle on mandibular development in rats].

OBJECTIVE: To investigate the effect of Botulinum toxin type A (Botox) injection into the masseter muscle on mandibular development in rats. METHODS: 12 28-day-old Wistar rats were divided into two groups as Botox group (n= 6) and control group (n = 6) which received anesthesia only. In Botox group, Botox was injected into the right masseter muscle, while only sterile saline into the left muscle. When the rats were 75-day-old, CT scan and 3D reconstruction were performed for cephalometry. The masseter muscles at both sides were weighed. Histologic study of masseter muscle and mandible was also performed. RESULTS: The weight of right masseter muscle was (0.4575 +/- 0.0940) g in Botox group, and (0.8899 +/- 0.1030) g in control group (< 0.05). The mandibular height II and III was (10.8 +/- 0.8) mm and (9.5 +/- 0.6) mm in Botox group and (12.5 +/- 0.6) mm and (10.7 +/- 0.4) mm in control group, respectively (P < 0.05). The intergonial distance was (11.6 +/- 0.6) mm and (12.4 +/- 0. 6) mm in Botox and control group, respectively (P > 0.05). CONCLUSIONS: When the rats receive Botox injection into the masseter muscle at young age, the grown-up rats have a decreased mandibular height, but the mandibular length and intergonial distance are not affected.

[Modified technique for correction of the orbital hypertelorism].

OBJECTIVE: To explore the possibility of para-orbital soft-tissue expansion, before orbital osteotomy and medial translocation procedures with a combined intracranial-extracranial approach. METHODS: Tissue expansion in the region of the zygomatic and temporal has been undergone for 3 weeks before the traditional intracranial-extracranial approach for orbital osteotomy and medial translocation in two patients. The healing between the orbital bone was studied with measurement of interorbital distance and three-dimensional CT. RESULTS: The inter-orbital distance of the two patients decreased from 4.4 cm and 3.2 cm to 2.0 cm and 1.4 cm. The intercanthal distance decreased from 6.7 cm and 4.8 cm to 5.0 cm and 3.8 cm. CONCLUSIONS: The para-orbital soft-tissue expansion technique may be an effective technique for the stability of the corrected interorbital distance in orbital hypertelorism.

Complications of breast augmentation with injected hydrophilic polyacrylamide gel.

Since 1997, the hydrophilic polyacrylamide gel (PAAG), an injectable alloplastic biomaterial, imported from the Ukraine has been used for augmentation mammaplasty in China. There were twelve patients with various complications visiting our hospitals after breast augmentation with injected hydrophilic polyacrylamide gel by other clinics, even though such procedures are not performed in our clinical practices. The complications included four cases of PAAG-induced multiple induration and lumps, and one with lactation, three cases of hematoma, two cases of inflammation (infection), and persistent mastodymia, unsatisfactory contour results and abnormal skin sensations in each case. All patients have been treated by removing the injected gel and giving antibiotics. Other procedures included replacement by silicon breast prostheses, mammotomy, and segmental mastectomy. We suggest that the injectable hydrophilic polyacrylamide gel be contraindications for breast augmentation in any young female who is not married, or without a child, with a tendency to hemorrhage, and with little mammary tissue. Some considerations to prevent and manage these complications are discussed.