Objective To find a procedure for facial rejuvenation w hi ch is simple, safe with lasting aesthetic results and to make it popularized eas ily. Method We performed complete face lifting first by extens ive subcutaneous detatchment. Secondly we plicated the superficial musclo-apon eurofic system (SMAS), including the superficial temporal fascia and the SMAS su perior to the parotid fascia, 1 cm anterior to the incision line by No.1 silk su tures. The distance of plication was about 1-2 cm. Interval of suture was 1 cm. After dissection under the platysma for 1-2 cm, we pulled the posterior edge of platysma postlaterally, and sutured it to the sternocleiodomasoid fascia. The n we suspended the obiculoris oculi and the SMAS lateral to the nasoalar and com issura oris by 4-0 absorbable surtures. If necessary, we plicated the platysma near the anterior border of the detachment. Results We performe d rhytidectomy on 48 patients by extesive subcutaneous detachment and multiple S MAS suspension in the past two years. The results were satisfactory after 3-16 months follow -up. There were no serious complications (including injury of fa cial nerve and skin necrosis and severe bleeding which needed another operation to clean up the hematoma). The aesthetic results were lasting. Complications in cluded temporal hair loss in 3 cases, in which one patient accepted hair transpl antation, and in another two patients alopecia zone were incised and sutured pri marily. Two cases had scar hyperplasia behind the ear, who required revision. Tw o cases had temporary asymmetry which were given no treatment and recovered 3 mo nths after operation. Conclusion This procedure overcomes the s hortcoming caused by simple subcutaneous rhytidectomy, in which improvement is t emporary. The SMAS is well perserved to avoid the facial nerve injury, the most severe complication of rhytidectomy. Therefore, rhytidectomy by extensive subcu taneous detachment and multiple SMAS suspension is a simple and safe procedure w ith lasting aesthetic results.

A new definition of metabolic dysfunction-associated fatty liver disease (MAFLD) has recently been proposed. We aim to examine the associations of MAFLD, particularly its discordance from non-alcoholic fatty liver disease (NAFLD), with the progression of elevated brachial-ankle pulse wave velocity (baPWV) and albuminuria in a community-based study sample in Shanghai, China. After 4.3 years of follow-up, 778 participants developed elevated baPWV and 499 developed albuminuria. In comparison with the non-MAFLD group, the multivariable adjusted odds ratio (OR) of MAFLD group for new-onset elevated baPWV was 1.25 (95% confidence interval (CI) 1.01-1.55) and 1.35 (95% CI 1.07-1.70) for albuminuria. Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria (OR 1.77; 95% CI 1.07-2.94). Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria. In conclusion, MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index, waist circumference, and hip circumference. Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria, supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.
Humans ; Pulse Wave Analysis ; Albuminuria ; Ankle Brachial Index ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Vascular Stiffness ; Prospective Studies ; Risk Factors ; China/epidemiology*