Objective To explore a new method of nasal tip plasty and its clinical effect,which is much accorded with biomechanical properties of the human body.Methods From June 2010 to March 2016,a total of 33 cases of nasal tip surgery,6 males and 27 females,were performed.Ages ranged from 22 to 46 years in this group.Ear cartilage was trimmed into two strips and sutured them together in a M shape.When located to the original position of the nasal alar cartilage,theM shaped cartilage could be used in nasal tip;when fixing part of it on the nasal septum or lengthened nasal septal cartilage,the M shaped cartilage could be used in cosmetic surgery of nasal tip lengthening.Results The follow-up period was from one month to 60 months,with average 14 months.29 patients (87.9 ％) were satisfied with the efficacy and 2 patients were suffered from infection (6.1 ％).Conclusions When the M-shaped cartilage is fixed with lengthened nasal septum,it can lengthen the nasal tip much more and the contouring and texture of nasal tip are better than that of using a shield or a cap cartilage graft.

Severe muscle injury is still a challenging clinical problem. Exosomes derived from adipose stem cells (ASC-exos) may be a potential therapeutic tool, but their mechanism is not completely clear. This review aims to elaborate the possible mechanism of ASC-exos in muscle regeneration from the perspective of signal pathways and provide guidance for further study. Literature cited in this review was acquired through PubMed using keywords or medical subject headings, including adipose stem cells, exosomes, muscle regeneration, myogenic differentiation, myogenesis, wingless/integrated (Wnt), mitogen-activated protein kinases, phosphatidylinositol-4,5-bisphosphate 3-kinase/protein kinase B (PI3K/Akt), Janus kinase/signal transducers and activators of transcription, and their combinations. We obtained the related signal pathways from proteomics analysis of ASC-exos in the literature, and identified that ASC-exos make different contributions to multiple stages of skeletal muscle regeneration by those signal pathways.

Objective To evaluate the applied value of septal cartilage combined with perpendicular plate of ethmoid bone graft in short nose plasty in Chinese people with insufficient septal cartilage.Methods From February 2015 to March 2017,thirty-five women with short noses underwent septal extension grafting in our institute.We used perpendicular plate of ethmoid bone to enhance the L-strut structure.An L-strut,comprising 0.6 cm segments of the caudal and dorsal cartilaginous septum,was left altered to harvest more cartilages for septal extension.The harvested septal cartilage was grafted on one side of the caudal septum.Then the alar cartilage was fixed at the end of the septal cartilage graft.Nasal lengths and nasolabial angles were measured pre-and postoperatively.Results The average nasal lengthening was (3.37±1.87) mm (P＜0.001).There was no infection,cerebral spinal fluid leakage,hemorrhage and other complications postoperatively.The average follow-up was 10 months (6 months to 2 years).After operation,33 patients were satisfied with the nasal contour,1 patient complained of high tip projection whereas one patient complained of low tip projection,and the dissatisfactions were corrected by revision surgeries.Conclusions Combining the septal cartilage with perpendicular plate of ethmoid bone graft presents an adequate nose lengthening and a decreased nostril show,even in patients with very little septal cartilage.With minimum complications,this novel technique provides promising clinical outcomes and high patient satisfaction.

The contracted nose is a unique entity that follows rhinoplasty in the Asian patient, which is mainly related to infection, graft implant, multiple invasive nasal repair operations, patients’ own inflammatory reaction and basic conditions, and is a complication that seriously affects the nasal aesthetics and functional characteristics of patients. Comprehensive understanding of the causes, mechanisms and repair method of contracture nose is helpful for its prevention and treatment. In view of the causes and mechanisms of capsular contracture, this paper reviews the research progress in improving the aesthetic and functional characteristics of patients from the three levels of nasal mucosa, cartilage scaffold and skin, as well as the adjuvant treatment of skin contracture release.

The contracted nose is a unique entity that follows rhinoplasty in the Asian patient, which is mainly related to infection, graft implant, multiple invasive nasal repair operations, patients’ own inflammatory reaction and basic conditions, and is a complication that seriously affects the nasal aesthetics and functional characteristics of patients. Comprehensive understanding of the causes, mechanisms and repair method of contracture nose is helpful for its prevention and treatment. In view of the causes and mechanisms of capsular contracture, this paper reviews the research progress in improving the aesthetic and functional characteristics of patients from the three levels of nasal mucosa, cartilage scaffold and skin, as well as the adjuvant treatment of skin contracture release.

Objective:To evaluate the improvement of nasal appearance, symptoms and psychological burden in patients with secondary cleft rhinoplasty by using retrospective research methods, through preoperative and postoperative questionnaires.Methods:Twenty-three cleft lip patients that underwent surgery in our unit since April 2016 were enrolled in this study. The self-designed questionnaire was used to explore the changes of patients before and after the operation. The questionnaire star was utilized to collect the data, and after the data was sorted and summarized, SPSS 20.0 was used for analysis and statistics.Results:The average follow-up time was 28.9 months. The total score of ROE satisfaction before surgery was 46.74 points, while after surgery it reached 63.04 points ( t=4.10, P<0.01); the self-scores of nasal shape were significantly improved after surgery; but there was no significant change in the ventilation function in the VAS scale before and after the operation; the nasal symptoms and psychological status in the SNOT-22 questionnaire, such as, nasal congestion, embarrassment, depression, restlessness and irritability, were significantly improved ( P<0.05). Conclusions:Our semi-autonomous designed questionnaire can be used to effectively evaluate the satisfaction, nasal shape, and symptoms of patients with nasal deformity secondary to cleft lip. Data analysis shows that our secondary cleft lip rhinoplasty for cleft lip and palate can improve patients′ satisfaction after the repair, as well as nose shape and function, at the same time the psychological burden caused by it.

Objective:To establish a three-dimensional finite element model of the nose, simulate and analyze the deformation of nasal tissue caused by different focal points, traction directions, and modes, provide the theoretical basis for the effectiveness of physical traction therapy, and guide the clinical selection of more efficient physical traction therapy methods.Methods:A finite element model of the nose was established by ANSYS Workbench 19.2 software based on image data obtained from CT scans of a 29-year-old male volunteer with normal nasal appearance in Peking University Third Hospital. Two focal points, the nasal tip, and the nasal columella, were selected, and three force directions, parallel to the forward, forward and down 30°, forward and down 60°, were applied. The deformation caused by different traction conditions on the skin, lining, and soft bone parts, as well as the four anatomical landmarks of the nasal tip, nasal root, the midpoint of the nasal columella, and the nasal base, were compared. The deformation produced by 10 minutes of continuous pulling and 10 times 1-minute pulse pulling were compared under the same pulling conditions. The deformations generated by two types of pulling modes within a 24-hour cycle: a single 1-hour cycle and 6 intermittent 10-minute cycles, were compared.Results:All traction conditions resulted in deformation of the nasal model, with the maximum deformation of the nasal tissue obtained by pulling forward and downward at 60° (4.632 9 mm) which was greater than other traction conditions (0.825 0-3.105 0 mm). The maximum deformation value was located near the nasion of the model’s skin layer. The deformation obtained by 10 minutes of continuous pulling (0.176 6 mm) was slightly greater than that obtained by 10 times of 1-minute pulse pulling (0.176 5 mm). Within 24 hours, the final deformation of multiple intermittent pulling modes (0.019 0 mm) was greater than that of a single pulling mode (0.004 3 mm).Conclusion:Physical traction can effectively deform the skin and soft tissue of the nose, and the most efficient operation is to continuously pinch the tip of the nose for a short period and apply tension parallel to the back of the nose downwards, repeating every a few hours.

Objective:To establish a three-dimensional finite element model of the nose, simulate and analyze the deformation of nasal tissue caused by different focal points, traction directions, and modes, provide the theoretical basis for the effectiveness of physical traction therapy, and guide the clinical selection of more efficient physical traction therapy methods.Methods:A finite element model of the nose was established by ANSYS Workbench 19.2 software based on image data obtained from CT scans of a 29-year-old male volunteer with normal nasal appearance in Peking University Third Hospital. Two focal points, the nasal tip, and the nasal columella, were selected, and three force directions, parallel to the forward, forward and down 30°, forward and down 60°, were applied. The deformation caused by different traction conditions on the skin, lining, and soft bone parts, as well as the four anatomical landmarks of the nasal tip, nasal root, the midpoint of the nasal columella, and the nasal base, were compared. The deformation produced by 10 minutes of continuous pulling and 10 times 1-minute pulse pulling were compared under the same pulling conditions. The deformations generated by two types of pulling modes within a 24-hour cycle: a single 1-hour cycle and 6 intermittent 10-minute cycles, were compared.Results:All traction conditions resulted in deformation of the nasal model, with the maximum deformation of the nasal tissue obtained by pulling forward and downward at 60° (4.632 9 mm) which was greater than other traction conditions (0.825 0-3.105 0 mm). The maximum deformation value was located near the nasion of the model’s skin layer. The deformation obtained by 10 minutes of continuous pulling (0.176 6 mm) was slightly greater than that obtained by 10 times of 1-minute pulse pulling (0.176 5 mm). Within 24 hours, the final deformation of multiple intermittent pulling modes (0.019 0 mm) was greater than that of a single pulling mode (0.004 3 mm).Conclusion:Physical traction can effectively deform the skin and soft tissue of the nose, and the most efficient operation is to continuously pinch the tip of the nose for a short period and apply tension parallel to the back of the nose downwards, repeating every a few hours.

Adipocytes ; Adipose Tissue ; Exosomes ; Stem Cells ; Wound Healing

In the field of plastic and reconstructive surgery, the loss of organs or tissues caused by diseases or injuries has resulted in challenges, such as donor shortage and immunosuppression. In recent years, with the development of regenerative medicine, the decellularization-recellularization strategy seems to be a promising and attractive method to resolve these difficulties. The decellularized extracellular matrix contains no cells and genetic materials, while retaining the complex ultrastructure, and it can be used as a scaffold for cell seeding and subsequent transplantation, thereby promoting the regeneration of diseased or damaged tissues and organs. This review provided an overview of decellularization-recellularization technique, and mainly concentrated on the application of decellularization-recellularization technique in the field of plastic and reconstructive surgery, including the remodeling of skin, nose, ears, face, and limbs. Finally, we proposed the challenges in and the direction of future development of decellularization-recellularization technique in plastic surgery.
Tissue Engineering/methods* ; Tissue Scaffolds/chemistry* ; Surgery, Plastic ; Regenerative Medicine/methods* ; Extracellular Matrix