Objective: To observe the safety and efficiency of face-lift combined with fat grafting in facial rejuvenation. Methods: We performed a retrospective study, which included 23 patients. SMAS suspension and multi-site suspension were combined to correct the nasolabial fold, mid-cheek aging and malar mounds. Structural fat grafting was performed to treat the volume loss in mid-face. Results: All patients demonstrated a significant improvement in midfacial appearance. No infection or nerve injury were found in this study. Only three patients did not get primary healing in temple region, which led to temporal hair loss from secondary healing. Conclusions This study demonstrates that fat grafting and multiple layers face-lift are efficient method for facial rejuvenation. These approaches appear to be very promising for facial anti-aging techniques.

Objective:To observe the clinical effect, postoperative satisfaction and complications of liposuction combined with low-energy bipolar radiofrequency BodyTite in arm with dermatolysis.Methods:From June 2013 to December 2019, 66 female patients were included. Firstly, liposuction treatment was performed in the designed operation area, and then radio-frequency skin tightening treatment was performed with BodyTite equipment. All patients were followed up for 6 months.Results:All the 66 patients had completed the operation successfully; their age ranged from 22-53 (28.3±6.9) years. The average body mass index was (23.8±3.4) kg/m 2, the average liposuction volume of unilateral upper arm was (288.6±95.6) ml, the average radiofrequency energy of unilateral upper arm was (4.2±1.1) kJ and the average operation time was (75.1±18.7) min 6 months after operation. A total of 42 cases were followed up. By self-evaluation satisfactory rate of patients was 92.8%, and the satisfactory rate of third-party independent plastic surgeons was 88.1%. There were no hematoma, seroma or infection except one case of skin blister. There was no serious complication requiring further surgical intervention. Conclusions:Bipolar radiofrequency BodyTite is a safe and effective method for the treatment of fat accumulation of upper arm with flabby skin.

Objective: To observe the outcome of breast reconstruction with autologous fat grafting in the patients following treatment for breast cancer. Methods: The clinical data of 22 patients after breast cancer modified radical mastectomy with fat grafting for breast reconstruction from January 2012 to March 2015 at Department of Body Contouring and Liposuction Center of Plastic Surgery, Hospital of Peking Union Medical College were analyzed retrospectively. The age of 22 patients (all female) was 28 to 54 years. Fifteen patients were performed breast modified radical mastectomy 5 to 16 year ago without radiotherapy, 7 patients were performed breast modified radical mastectomy following regular radiotherapy 2 years ago. Low negative pressure liposuction technical was applied to harvest fat tissue for 400 to 800 ml which was filtrated and purified by cotton pad method in low temperature environment. Fat grafting was performed with multi-level and multi-tunnel and in multi-point injection ways. All patients were followed up by regular imaging evaluation with MRI or ultrasonography after operation every 3 months. Results: All breast reconstruction were successfully performed in 22 patients, no severe complications occurred. Among 15 patients without radiotherapy, 12 patients were performed with autologous fat grafting for breast reconstruction, 3 patients with prosthetic implantation for breast augmentation after autologous fat grafting. Among 7 patients with radiotherapy, 6 patients were performed with autologous fat grafting for breast reconstruction, 1 patient with prosthetic implantation for breast augmentation after autologous fat grafting. The volume of fat grafting was 104 to 380 ml. It took 2.5 hours to finish the operation including 1.0 to 1.5 hours for liposuction and 40 minutes for fat grafting. Next fat grafting were performed after 3 months. The fat of the breast were survived well detecting by MRI, only 1 patient had a cystic nodule which had been resected during nipple reconstruction. Ultrasonography screened several cystic nodules with the major axis of 0.1 to 0.2 cm in the breast, which couldn′t be found by palpating in 18 patients. The patients were followed up for 18 to 36 months, the outcome were satisfactory. Conclusion Autologous fat grafting for breast reconstruction simplifies the operation program with satisfied results and avoids the complications of breast reconstruction with skin flap.

Objective:To report our clinical experience in simultaneous implant exchange with fat (SIEF) for breast augmentation and reshaping.Methods:The medical records of 26 patients who received SIEF in our department from January 2013 to June 2019 were reviewed. All patients were female, aged (35.2±8.3) years. The prosthesis was removed through axillary approach, inframammary approach or radial incision at the junction of lateral breast and chest wall. Capsulectomy was not performed after implant removal. Fat was harvested using a blunt liposuction cannulas with the diameter of 2.5 mm and 3 side holes, with a negative pressure of -60 kPa. After washing with 4 degree physiological saline, the fat was processed with the cotton pad filtering technique, then a diameter 2.5 mm, 1-hole blunt cannula was used to place the fat. The evaluation of postoperative improvements included breast size, incidence of complications. Patient satisfaction and physician satisfaction were assessed by two independent surgeons (the full score ranged from 4 to 20).Results:All patients completed the study. The volume of implants in the left breast was (216.2±54.6) ml and that in the right breast was (217.9±53.1) ml. Grafted fat volume for the left breast was (256.8±55.8) ml each time and that for the right breast was (258.1±55.7) ml. The mean follow-up time was (13.5±5.7) months. Small nonpalpable nodules were detected in two patients (7.7%) by ultrasound. No other complications were documented during the study period. The average chest circumference was decreased by (1.1±0.8) cm which was less than one cup according to Chinese Industrial Standards. Patient satisfaction and physician satisfaction were (16.8±2.0) and (16.4±1.6), respectively.Conclusions:SIEF is an effective and safe method to restore breast volume after implant removal.

Autologous fat grafting has been proved to be effective for both total and adjunctive breast reconstruction, but oncologic safety for breast reconstruction after breast cancer surgery has always been a focus of attention. This review revisted the relevant studies and discussed the risk of breast cancer recurrence after autologous fat grafting on the conditions of different types of breast cancer surgery, timing of autologous fat grafting, pathological classification and various medical treatment. It turned out that autologous fat grafting does not increase the recurrence of breast cancer.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

Objective:To compare the clinical effects of the two design schemes of heart-shaped incision and "Mercedes-Benz incision" (three-leaf method) in umbilicoplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent umbilicoplasty during abdominoplasty admitted to the Body Contouring & Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from November 2019 to September 2022. During the umbilicalplasty operation, different patients were treated with either a heart-shaped incision or a "Mercedes-Benz incision" three-flap method. The umbilical cord for infection, hematoma and other complications were observed after surgery; a 5-point Likert scale was used to evaluate the aesthetic effect of the new umbilicus 6 months after surgery(3-15 points, the higher the score, the better the aesthetic effect); the Vancouver scar scale (VSS) was used to score the scar condition 6 months after surgery (0-18 points, the higher the score, the better the scar condition). Postoperatively, patients were surveyed on umbilical shape satisfaction, which was divided into three levels: dissatisfied, relatively satisfied, and very satisfied. Normally distributed measurement data were expressed as Mean±SD, and independent samples t-test was used for comparison between two groups. P<0.05 was considered as a statistically significant difference. Results:A total of 35 patients were enrolled, all of whom were female. Among them, 19 cases underwent heart-shaped incision, and 16 cases underwent umbilicoplasty using "Mercedes-Benz incision". The ages of the two groups were (32.3±2.7) years old and (33.7±2.3) years old respectively. At the 6-month follow-up after surgery, the total aesthetic effect score of the umbilical cord in the heart-shaped incision group was higher than that in the "Mercedes-Benz incision" group [(13.3±0.7) points vs. (12.7±0.5) points, P<0.05]. The VSS score of the heart-shaped incision group was lower than that of the "Mercedes-Benz incision" group [(2.6±0.8) points vs. (3.4±0.9) points, P<0.05]. The results of the satisfaction survey after umbilicoplasty showed that in the heart-shaped incision group, 3 cases were relatively satisfied and 16 cases were very satisfied; in the "Mercedes-Benz incision" group, 2 cases were relatively satisfied and 14 cases were very satisfied. Conclusion:Compared with the classic "Mercedes-Benz incision", the heart-shaped incision design can obtain a better-shaped, more natural new umbilicus and a more invisible scar after umbilicoplasty.

June 5, 2019, a 36-year-old female was diagnosed with septic shock caused by Streptococcus dysgalactiae infection eight hours after liposuction and fat grafting in Plastic Surgery Hospital, Chinese Academy of Medical Sciences. As the symptoms were identified early, the patient received immediate treatment and was transferred to Peking Union Medical College Hospital. After multi-disciplinary coordination of departments of emergency, plastic surgery, and ICU, the septic status was finally resolved and the patient was discharged after a 103-day hospital stay. The authors reviewed the course of the treatment in detail and our experience in dealing with the special kind of toxic septic shock.