Objective To seek the method for the correction of inadequate nasotip projection with the expanded polytetrafluoroethylene(ePTFE) implants to reduce the complications caused by the traditional method.Methods The enhanced ePTFE implants were used to correct the deformity of the inadequate nasotip projection by the nasal median incision of butterfly-shape together with lateral incision of marginal nosewing.Results This rhinoplasty was correcred in 536 cases of saddle nose with the correction of the inadequate nasotip projection.All the cases were followed up for 3 months to 6 years.533 cases(99.4 %) got satisfactory results and 3 cases(0.6 %) failed with wound infection,in which the implants were taken out and replaced after 3 months,and all the three cases got satisfactory results.Conclusion It is an effective new method for the correction of the inadequate nasotip projection.

Objective To explore the methodology of choosing the volume and shape of the mammary implant.Methods The changes of the volume and shape were analyzed in 502 cases of breast augmentation,to find out how to select the volume and shape of the mammary implant.Results The thoracic width H was the most important factor of choosing width of the implant; the SN was the important factor of choosing the height of the anatomic implant; After setting the diameter and height of the implant,a bigger breast could be achieved by increasing the projection of implants.For those very thin females with flat chest, anatomic implants were the better choice. Conclusions Thoracic width,breast volume and other data are the most important factors in choosing the mammary implant.Round and anatomic mammary implants have their specific indications.

Objective To evaluate the the brow position and shape in young Chinese women using a photography measurement.Methods A total of 100 Chinese women aged 20 to 30 years were photographed to determine the distance between brow and eye.Measurements were made from a horizontal plane through the lateral canthus of right eye to three vertical points on the upper brow margin at the medial canthus,lateral limbus of the iris,and lateral canthus.Results The distance between brow and eye in young Chinese women was 2.12,2.52 and 2.46 cm at medial canthus,lateral limbus of the iris and lateral canthus,respectively.The distances were higher between the brows and eyes at lateral limbus of the iris and lateral canthus than that at medial canthus (P＜0.05).Conclusions The measurement used in this study is a simple and practical quantitative method.The results can be used to guide the surgical choice and help to evaluate the surgical techniques.

Objective To explore the clinical significance of injecting the tumescent fluid into the separated space in breast augmentation by transaxillary incision under gerenal anesthesia. Methods In 203 cases of breast augmentations by transaxillary incision, some tumescent fluid was injected into the incision and submuscular or subgland space, and then separated under general anethesia. By comparison of the 210 cases without tumescent fluid, the advantages and the clinical significances of this approach were discussed. Results There were less bleeding, early allevation of pain after operation and decreased incidence of local congestion and swelling in patients with tumescent fluid. Conclusion The tumescent fluid could reduce bleeding, early pain after operation and local congestion and swelling in the breast augmentation under general anesthesia.

Objective To introduce the advantages of the endoscopic assistance in primary and secondary face-lift in the frontal and temporal areas.Methods 67 cases were involved in the study,22 of them were secondary facelift cases.The follow-up period ranged from 1 month to 2 years.The patients and doctors satisfactory rate were recorded and the complications were also reported.Results All 67 cases had complete recovery without serious complications.The patient's satisfactory rate was 85％ (57/67),and the doctor's satisfactory rate was 89％ (60/67).Some early minor complications included dimpling at the suture site,asymmetry,overcorrection,transitory paralysis,late edema,scar and fall-off of hair among 80％ or so of patients.4 cases experienced hematoma on the frontal areas.The hematoma disappeared after early aspiration and later fomentation.2 cases had wound ulceration in the temporal 3 months after operation.The anchoring materials were removed and the ulceration tissues were excised 6 months after operation.The wound healed completely.2 patients experienced skin necrosis and depression due to careless electric cauterization on the frontal area.The depression gradually became smooth and inconspicuous after 6 months.All these complications were resolved and became negligible about 6 months after operation.Conclusions Endoscopic assistance is valuable in primary and secondary face-lift in the frontal and temporal areas.It is reliable and worthwhile to introduce the technique for patients aged less than 50-year-old.

Objective To evaluate the effect of double L-shape osteotomy combined bony Z-plasty for prominent malar complex.Methods Thirty-two patients with prominent malar complex were treated with double L shape osteotomy combined bony Z plasty for prominent malar complex.Width of lower face was observed during follow-up phase.Questionnaires were used to assess the patents' level of satisfaction at 6 months after operation.Results All wounds got primary intention healing and no severe complication in perioperative period.Postoperative appearance of all 32 cases showed that the width of middle face was efficiently reduced.All patients expressed high levels of satisfaction 6 months after operation.Conclusions Double L-shape osteotomy combined bony Z-plasty for prominent malar complex is an effective and safe method for the treatment of prominent malar complex.

Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage,and to observe the outcome and summarize the possible complications.Methods A 6-7 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes.A lancet shaped piece was used for dorsal augmentation,several cartilage bars for collumellar elevation and nasal tip elongation.Comprehensive structural rhinoplasty was then done with open rhinoplasty incision.Results 52 patients were treated with this method and satisfying aesthetic contouring of the nasal tip and dorsum was achieved.Among these patients,no such complications as implant extrution or dislocation,cartilage distortion,pneumothorax,hemothorax,infection or hemotoma were observed.The scar on the donor site was not obvius.Conclusions Costal cartilage can meet the demands of patients who consider prosthesis as an unacceptable option.For secondary revision rhinoplasties,costal cartilage provides sufficient materials to ensure a promising outcome with lower risk of infection and other complications.

Objective To introduce the technical key points and clinical efficacy of dual plane breast augmentation under endoscope through a transaxillary incision.Methods By analyzing the 89 surgical cases,we have summarized the key points of the pre-operative design,surgical skills and postoperative management.Results All patients had no uncontrolled bleeding during operation and loss of nipple and areola sensation.71 patients got 6-12 months follow-up,showing that only one case presented with unilateral capsular contraction,and the others had satisfied results.Conclusions Blunt dissection can reduce the risks of uncontrolled bleeding on the inner side of the pocket and the damage of the nerves on the lateral side of the dissecting pocket.The lower inner part,lower part and lower lateral part are the areas that could be sharply dissected by electrocautery under endoscope to achieve the dual plane Ⅰ.The drainage and bandage are necessary after the operation.

Objectives To explore a comprehensive approach for the functional and aesthetic correction of septal deviation. Methods From Jan. 2007 to Dec. 2009, 48 patients with deviation of the frontier and ceiling border of the septal cartilage, 6 males, 42 females, average age of 26.5 years, were surgically treated with a comprehensive use of several techniques, such as septoplasty, reconstruction of septal support, precise osteotomies and nasal tip plasty. Results Functional improvement achieved in all the patients, contour satisfaction achieved in 91.7 % patients; 30 patients were very satisfied, and 14 satisfied with the outcome. Conclusions With the thorough understanding of surgical anatomy of the nose and the use of comprehensive surgical approach, satisfactory outcomes can be achieved both functionally and aesthetically in patients with septal deviation.

Objective To employ autologous septal cartilage grafting as a new method of elongating the nose and adjusting the nasolabial angle in order to correct the deformities of short nose and bulbous tip.Methods A set of techniques,including,yet not limited to,releasing and sculpturing of the alar cartilages,harvesting of septal cartilages and carving them into L shape and cap-like shape for transplant,moulding the soft tissue envelop with buried through and through sutures etc.were used to lengthen the nose and modify the tip.Results From 2004 to now,the new technique had been applied to 345 patients with short nose and bulbous tip.Follow-up ranged from 6- 48 months,satisfactory outcomes were obtained.Conclusions The new technique adopted by the author in which autologous septal cartilages are settled to the anterior angle of the nasal septum and between the domes of alar cartilages has been proved to be a viable and reliable way to lengthen the nose.Further advantages of this technique include the easiness of harvesting grafts,minimal injury,rare complications of infection and rejection etc.