Aesthetic Preferences for Beautiful Buttocks in Female: A Study on the Chinese Population.

BACKGROUND: Many theories referring to the conception of a beautiful buttock have been put forward, but little has been proved, especially in the Asian group. OBJECTIVE: To analyse the aesthetic preference for aesthetically pleasing characteristics in the Chinese population. METHODS: In the survey, we computerized the buttock image of a Chinese female through the Photoshop software (Adobe Photoshop CS5; Adobe Systems, Inc., San Jose, Calif), and buttocks with and without four features were attained. An online questionnaire was made to rank the most aesthetic buttocks. The data for the various demographic groups were compared using the Pearson Chi-square test. A value of p < 0.05 was used for statistical significance. RESULTS: In total, 2348 responses were collected. Over half of the respondents prefer without supragluteal fossettes (56.9%), V-shaped crease (60.4%) and lateral depression (90.1%). The most attractive infragluteal fold option was short type (34.9%), followed by median infragluteal fold (32.7%) and long infragluteal fold (32.4%). Supragluteal fossettes, median or long infragluteal fold and V-shaped crease were more preferred among young people. CONCLUSION: Supragluteal fossettes, V-shaped crease and lateral depressions were not preferred in over half of the respondents. The aesthetic preference was influenced by the gender and age. The plastic surgeons should consider the variabilities above when establishing aesthetic aim for beautiful buttocks in gluteoplasty. 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.

Influence of the 4G/5G polymorphism of plasminogen activator inhibitor-1 gene in acute unprovoked deep vein thrombosis and residual vein thrombosis.

BACKGROUND: Plasminogen activator inhibitor-1 (PAI-1) is an important inhibitor of plasminogen activator, but the role of the PAI-1 4G/5G polymorphism in deep vein thrombosis (DVT) has been contradictory. In this study, we investigated the distribution of the PAI-1 4G/5G genotype in Chinese patients with DVT compared with healthy controls and the association between the PAI-1 4G/5G genotype and the persistence of residual venous occlusion (RVO) after different treatments. METHODS: The PAI-1 4G/5G genotype was determined by fluorescence in situ hybridization in 108 patients with unprovoked DVT and 108 healthy controls. The patients with DVT were treated with catheter-based therapy or anticoagulation only. RVO was assessed by duplex sonography during the follow-up. RESULTS: Thirty-two patients (29.6%) were homozygous for 4G (4G/4G), 62 patients (57.4%) were heterozygous for 4G/5G, and 14 patients (13%) were homozygous for 5G (5G/5G). No significant difference in genotype frequency was found between patients with DVT and controls. A total of 86 patients completed follow-up of ultrasound examination with a mean follow-up of 13.4 ±7.2 months. The results of patients with RVO were significantly different between homozygous 4G carriers (76.9%), heterozygous 4G/5G (58.3%), and homozygous carriers of 5G (33.3%) (P <.05) at the end of follow-up. Catheter-based therapy showed a better result in patients who were noncarriers of 4G (P = .045). CONCLUSIONS: The PAI-1 4G/5G genotype was not a relevant predictor for DVT in Chinese patients, but is a risk factor for persistent RVO after idiopathic DVT.

Bioinspired Impact-Resistant and Self-Monitoring Nanofibrous Composites.

Lightweight and impact-resistant materials with self-monitoring capability are highly desired for protective applications, but are challenging to be artificially fabricated. Herein, a scalable-manufactured aramid nanofiber (ANF)-based composite combining these key properties is presented. Inspired by the strengthening and toughening mechanisms relying on recoverable interfaces commonly existing in biological composites, mechanically weak but dense hydrogen bonds are introduced into the ANF interfaces to achieve simultaneously enhanced tensile strength (300 MPa), toughness (55 MJ m-3 ), and impact resistance of the nanofibrous composite. The achieved mechanical property combination displays attractive advantages compared with that of most of previously reported nanocomposites. Additionally, the nanofibrous composite is designed with a capability for real-time self-monitoring of its structural safety during both quasi-static tensile and dynamic impact processes, based on the strain/damage-induced resistance variations of a conductive nanowire network inside it. These comprehensive properties enable the present nanofibrous composite with promising potential for protective applications.

Outcome Comparison of Endovascular and Open Surgery for the Treatment of Acute Superior Mesenteric Artery Embolism: A Retrospective Study.

Background: Few centers have adopted endovascular revascularization for the treatment of superior mesenteric artery embolism (SMAE). We sought to evaluate the efficacy of endovascular therapy for the treatment of SMAE and identify post-treatment prognostic factors. Methods: The clinical data of 41 patients with acute SMA embolism between 2013 and 2021 were retrospectively reviewed. Patients with mesenteric artery thrombosis, mesenteric venous thrombosis, and who had only conservative treatment were excluded. Results: Forty-one consecutive patients were identified with SMAE (median age, [range] 35-86 years). Endovascular therapy was initiated in 14 patients with no clinical evidence of bowel necrosis, with mainly mechanical thrombectomy, and technical success was achieved in 93%. Endovascular therapy had advantages in duration surgery time, blood loss, bowel rest time, ICU time, and ventilator use. There was no difference in bowel necrosis, length of necrotic bowel resected, or in-hospital mortality between the two groups. An initial white blood cell (WBC) count >15 × 103/dl and neutrophil count >13 × 103/dl were associated with an increased risk of bowel necrosis, and an initial WBC count, renal function, American Society of Anesthesiologists (ASA >3) and necrotic bowel >2 m were associated with increased mortality. Conclusions: Endovascular treatment has altered the management of SMAE, and it may be adopted in selected patients who are not at risk for bowel necrosis. Avoidance of bowel necrosis patients and close monitoring for bowel necrosis are important.

Idiopathic ovarian vein thrombosis causing pulmonary embolism: case report and literature review.

Ovarian vein thrombosis (OVT) is a rare medical disorder, which is most often found in the immediate postpartum period. OVT is rarely considered idiopathic. We report a case of idiopathic OVT with pulmonary embolism in a 33-year-old woman who presented with abdominal pain. Computed tomography and postoperative pathology confirmed the diagnosis of idiopathic OVT. To date, only 12 cases of idiopathic OVT have been reported. In this case report, we present a summary of these cases and a review of literature regarding management of idiopathic OVT.

[Application of dual-pedicle abdominal flap for unilateral breast reconstruction].

Objective: To explore the effectiveness of dual-pedicle abdominal flap for unilateral breast reconstruction. Methods: Between March 2014 and March 2018, a clinical data of 19 female patients underwent dual-pedicle abdominal flap reconstruction because of unilateral mastectomy defect was reviewed retrospectively. The median age was 45 years (range, 32-51 years), including 3 immediate breast reconstruction and 16 delayed breast reconstruction, and left side in 7 cases and right side in 12 cases. Unilateral breast reconstruction were performed for 8 patients with unilateral pedicle transverse rectus abdominis musculocutaneous (TRAM) flap and contralateral free TRAM flap, for 3 patients with pedicle TRAM flap and contralateral deep inferior epigastric perforator (DIEP) flap, for 7 patients with bilateral DIEP flaps, for 1 patient with free muscle-sparing TRAM flap and contralateral DIEP flap. The size of abdominal flap ranged from 24 cm×7 cm to 43 cm×13 cm. The donor sites were closed directly. Results: Vascular crisis ocuurred in 1 flap and relieved after surgical exploration. The other flaps survived. Poor wound healing in abdominal incision occurred in 1 patient and was successfully treated with debridement. The other donor sites healed without any other complication. The patients were followed up with a median period of 12 months (range, 4-42 months). Four patients received reparative operation of their reconstructive breast, and 2 patients received mamopexy of the contralateral breast due to mastoptosis. The abdominal BREAST-Q score was 84.1±11.7, chest score was 86.5±8.9, and breast score was 67.6±16.4 at last follow-up. Conclusion: The dual-pedicle abdominal flap for unilateral breast reconstruction provides adequate soft tissue volume and good blood supply. It is a reliable and effective breast reconstructive method for patients who need large tissue volume to make symmetric with the contralateral breast, or slim patients with few tissue in the donor site, or patients with scars in the donor site, especially vertical abdominal scars.

Pacman flap for oncologic reconstruction of soft-tissue defects after tumor resection: A retrospective case series.

INTRODUCTION: The Pacman flap is a novel modality for repairing round soft-tissue defects after tumor resection. This modality provides a robust blood supply without microsurgical tissue rearrangement. This article reviews the authors' experience with Pacman flap for reconstruction of round soft-tissue defects. The safety and effectiveness of the Pacman flap are investigated. METHODS: Here, we describe a method for oncologic reconstruction of round soft-tissue defects with a Pacman flap after tumor resection. Fourteen consecutive patients (6 males and 8 females, median age of 60 years, range, 18-87 years) who received Pacman flaps for oncologic reconstruction during the period from April 2015 to April 2017 were included in the present study. RESULTS: In total, 15 Pacman flaps (including 1 bilateral Pacman flap) were created to provide coverage after resection of a tumor from the face (n = 11), chest (n = 1), or extremities (n = 2). One patient had twice previously undergone tumor resection. Median defect size was 25.5 × 25 mm (range, 9 × 9-100 × 90 mm). Median flap size was 35 × 27 mm (range, 12 × 10-120 × 110 mm). Median duration of follow-up was 10 months (range, 6-22 months). No local or distal tumor was observed during the follow-up period. All flaps survived without partial or complete necrosis, infection, or other complications. All patients were satisfied with their aesthetic outcomes. A hematoma formed in 1 patient and was successfully treated with debridement. CONCLUSIONS: The Pacman flap enables the surgeon to achieve tension-free round defect closure after tumor resection, with good functional and aesthetic outcomes. This modality is a reliable and effective reconstructive surgical technique for oncologic reconstruction of round soft-tissue defects.

A Systematic Review and Meta-analysis of Free-style Flaps: Risk Analysis of Complications.

BACKGROUND: Free-style flaps allow surgeons to overcome anatomical variations and raise perforator flaps wherever a pulsatile signal can be detected. We performed a systematic review and meta-analysis to identify the risk factors for complications and indications for free-style flaps in soft-tissue defect reconstructions. METHODS: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The databases of MEDLINE, PubMed, ScienceDirect, and Cochrane Library were searched from January 1991 to January 2017 for original articles describing free-style flaps in soft-tissue defect reconstruction. RESULTS: A total of 17 articles met the inclusion criteria, representing 453 free-style flaps. The percentage of free-style flaps conducted after primary oncologic resection was 54.4% (246/453). Free-style flaps were mostly used in the head and neck region (35.5%), and most of them were designed as pedicled perforator flaps (96.7%). Complete flap survival was accomplished in 91.8% of the free-style flaps. Complications were found in 13.5% of cases, and 2 risk factors were identified: extremity defects (risk ratio, 2.39; P = 0.006) and single perforator flaps (risk ratio, 4.93; P = 0.002). No significant differences were found among the criteria including patients aged greater than 60 years, female gender, chronic etiology, flap size over 100 cm2, flap rotation, or perforator skeletonization. CONCLUSIONS: Free-style flaps are both reliable and advanced forms of perforator flaps for use in soft-tissue defect reconstructions. Defects located on the extremities and flaps with single perforators are risk factors for flap failure and complications.

Character of Gluteal Region Morphology in Young Chinese Females.

BACKGROUND: The female gluteal morphology is an important secondary sexual characteristic and helps accentuate and define the female body shape. Despite the increasing prevalence of gluteal augmentations in our country, little data exist regarding the morphology of the gluteal region in young Chinese females. This study analyzed a convenience sample of Chinese females and their gluteal region. METHODS: Data, measurements, and photos of the following parameters were taken: age, weight, height, and body mass index (BMI). Morphology was classified into four types: A shape, V shape, round shape, and square shape. Aesthetic characteristics of each buttock were recorded. Height, weight, BMI, and gluteal projection ratio differences in different shape groups were analyzed. RESULTS: The study sample consisted of 103 women, with ages from 23 to 27 years. The V-shaped buttock was not found in this sample. The A shape, square shape, and round shape occupied 55.3%, 38.8%, and 5.8% accordingly. Short infragluteal fold, supragluteal fossettes, lateral depression, and V-shaped crease appeared in 42.7%, 14.6%, 11.7%, and 2.9% of samples, respectively. Of the 103 samples, 39 (37.9%) fulfilled the aesthetic gluteal projection(ratio ≥ 2). The average BMI was statistically significant between each gluteal shape (P = 0.009). Height, weight, and gluteal projection ratio showed no significant difference with the buttock shapes. CONCLUSIONS: We are the first to describe gluteal morphology in young Chinese woman using gluteal anthropometrics. The findings of the study may provide a guideline for plastic surgeons who perform gluteal augmentation in Asian patients.