Objective To investigate the clinical effect of type A botulinum toxin and nipple retractor in correcting severe inverted nipples.Methods All the patients with bilateral severe inverted nipples that sought consulting in the Plastic and Reconstructive Surgery Center of Peking Union Medical College Hospital were included in this study and the patients were randomized into different treatment group with nipple retractor only or BTX-A (Lanzhou,China) combined with nipple retractor.In the combined therapy group,50 u BTX-A was injected into the bottom of each nipple.2 weeks later,nipple retractor was placed and kept wearing for 6 months.For the retractor only group,no BTX-A was used.All the patients were followed up at 1 month,3 months and 6 months after the operation.Nipple projection was measured according to the profile view of pre-and post-operation.Effectiveness and complication rate were compared between the two groups.Results 20 patients were included in this study.Average nipple projection in the combined therapy group was (1.12±0.13) cm,(0.95± 0.10) cm and (0.73±0.11) cm (3 months,6 months and 12 months post-operation,respectively),which had a significant difference from that of the retractor group [(0.81±0.10) cm,(0.72±0.12) cm and (0.53±0.10) cm].Total complication rate of combined group was also lower than that of retractor group.The complications of the combined therapy group included hypopigmentation (1 case),without skin ulcer or wire dislocation.However in the retractor group,complications included skin ulcer (2 cases),hypopigmentation (1 case) and dislocation (1 case).No severe complications such as nipple necrosis happened in both groups.Conclusions BTX-A combined with nipple retractor is an effective method in correcting severe inverted nipple with low complication rate.

To explore the ideal pretarsal shows and morphological characteristics of double eyelids in Chinese populations through a morphometric analysis.

To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control.

Objective: The purpose of this study is to systematically review the literature about surgical management of lymphedema, to provide recomendations for the surgical treatment plan of the disease. Methods: Cochrane Library and EMBASE databases were searched from January 1st, 2007 to October 1st, 2017 for the literature related to the surgical treatment of lymphedema. Data were extracted from clinical studies matching our inclusion criteria. Meta-analysis was performed with R 3.4.2. Results: 71 studies were included, out of which 4 studies described were excision, 9 were liposuction, 33 were lymphvenous anastomosis(LVA), 23 were vascularized lymph node transfer(VLNT) and 5 were combined therapy. The excess volume reduction were averaged 96.86%(95%CI: 87.38%—106.33%, I²=0%)for liposuction, 34.64%(95%CI: 19.80%—49.47%, I²=72%)for LVA, 36.85%(95%CI: 12.40%—61.30%, I²=81%) for VLNT. Conclusions With further understanding of the pathophysiology of lymphedema and development of radiologic and surgical technique, surgical treatment has the potential to play an important role in lymphedema complex management.

Objective: To introduce the experience in skin defect reconstruction with keystone design perforator flap. Methods: From January 2012 to December 2012, 26 patients with different types of skin defect were repaired with keystone design perforator flaps, including 21 classic keystone design perforator flaps, 3 short incision keystone design perforator flaps, and 2 Omega variant keystone design perforator flaps. Results: One patient suffered partial flap loss and healed secondarily. All other patients recovered smoothly without complications. Conclusions Keystone design perforator flap offers a versatile technique for skin defect reconstruction except for scalp.

Objective: To report a case who had cerebral hemorrhage after facial injection with hyaluronic acid and to present the literature review about cerebrovascular infarction after cosmetic facial injection. Methods: Articles were collected from domestic and overseas database, with the key word of "filler injection, autologous fat, hyaluronic acid, stroke, cerebrovascular disease, cerebral embolism" from 1990 January to 2016 July. Information about researchers, patients, injection, complication, therapy and prognosis was collected. Results: The analysis shows cases are mostly reported by South Korea among the 18 articles in total (20 cases). 81% of injection material is autologous fat and the rest is hyaluronic acid.Glabella is mostly injected(n=9). Symptoms of cerebrovascular infarction are paralysis(n=15), disturbance of consciousness(n=7) and aphasia(n=5), whose onset were mostly within the operation(47%, n=8). 81% cases were combined with blindness. Infarction positions mostly were middle cerebral artery(n=14), anterior cerebral artery(n=6), frontal lobe(n=6)and parietal lobe(n=5). Meanwhile, there were three cases combined with cerebral hemorrhage including the case we reported in this article. Blind patients had poor prognosis while the other neurologic symptoms mostly could be improved. Conclusions Cerebrovascular infarction is a rarely severe complication of cosmetic facial injection, which we should pay close attention to.

Improvement of the jawline contour is a key focus in lower face and neck rejuvenation treatments. Achieving a well-defined, smooth jawline is a shared goal for both patients and plastic surgeons. This article reviews recent research on age-related changes of the jawline and evaluation method, offering valuable references for jawline rejuvenation treatments.The jawline's unique anatomical position, coupled with age-related changes, involves dynamic alterations in bone, soft tissue, and skin across multiple layers, making rejuvenation of this area a complex and challenging task. In recent years, advances in imaging technologies such as two-dimensional photography, three-dimensional stereophotogrammetry, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and micro-CT have expanded the understanding of jawline anatomy and provided precise tools for analysis and evaluation.

Improvement of the jawline contour is a key focus in lower face and neck rejuvenation treatments. Achieving a well-defined, smooth jawline is a shared goal for both patients and plastic surgeons. This article reviews recent research on age-related changes of the jawline and evaluation method, offering valuable references for jawline rejuvenation treatments.The jawline's unique anatomical position, coupled with age-related changes, involves dynamic alterations in bone, soft tissue, and skin across multiple layers, making rejuvenation of this area a complex and challenging task. In recent years, advances in imaging technologies such as two-dimensional photography, three-dimensional stereophotogrammetry, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and micro-CT have expanded the understanding of jawline anatomy and provided precise tools for analysis and evaluation.

BACKGROUND: Due to adipose-derived stem cells (ASCs) being easy to obtain, their rapid proliferation rate, and their multidirectional differentiation capabilities, they have been widely used in the field of regenerative medicine. With the progress of decellularized adipose tissue (DAT) and adipose tissue engineering research, the role of DAT in promoting angiogenesis has gradually been emphasized. METHODS: We examined the biological characteristics and biosafety of DAT and evaluated the stem cell maintenance ability and promotion of growth factor secretion through conducting in vitro and in vivo studies. RESULTS: The tested ASCs showed high rat:es of proliferation and adhered well to DAT. The expression levels of essential genes for cell stem maintenance, including OCT4, SOX2, and Nanog were low at 2–24 h and much higher at 48 and 96 h. The Adipogenic expression level of markers for ASCs proliferation including PPARγ, C/EPBα, and LPL increased from 2 to 96 h. Co-culture of ASCs and DAT increased the secretion of local growth factors, such as VEGF, PDGF-bb, bFGF, HGF, EGF, and FDGF-bb, and secretion gradually increased from 0 to 48 h. A model of full-thickness skin defects on the back of nude mice was established, and the co-culture of ASCs and DAT showed the best in vivo treatment effect. CONCLUSION The application of DAT promotes wound healing, and DAT combined with ASCs may be a promising material in adipose tissue engineering and regenerative medicine.

BACKGROUND: Due to adipose-derived stem cells (ASCs) being easy to obtain, their rapid proliferation rate, and their multidirectional differentiation capabilities, they have been widely used in the field of regenerative medicine. With the progress of decellularized adipose tissue (DAT) and adipose tissue engineering research, the role of DAT in promoting angiogenesis has gradually been emphasized. METHODS: We examined the biological characteristics and biosafety of DAT and evaluated the stem cell maintenance ability and promotion of growth factor secretion through conducting in vitro and in vivo studies. RESULTS: The tested ASCs showed high rat:es of proliferation and adhered well to DAT. The expression levels of essential genes for cell stem maintenance, including OCT4, SOX2, and Nanog were low at 2–24 h and much higher at 48 and 96 h. The Adipogenic expression level of markers for ASCs proliferation including PPARγ, C/EPBα, and LPL increased from 2 to 96 h. Co-culture of ASCs and DAT increased the secretion of local growth factors, such as VEGF, PDGF-bb, bFGF, HGF, EGF, and FDGF-bb, and secretion gradually increased from 0 to 48 h. A model of full-thickness skin defects on the back of nude mice was established, and the co-culture of ASCs and DAT showed the best in vivo treatment effect. CONCLUSION The application of DAT promotes wound healing, and DAT combined with ASCs may be a promising material in adipose tissue engineering and regenerative medicine.