1.The application of facial liposuction and fat grafting in the remodeling of facial contour.
Huicai WEN ; Li MA ; Ynnpeng SUI ; Xueping JIAN
Chinese Journal of Plastic Surgery 2015;31(2):89-92
OBJECTIVETo investigate the application of facial liposuction and fat grafting in the remodeling of facial contour.
METHODSFrom Nov. 2008 to Mar. 2014, 49 cases received facial liposuction and fat grafting to improve facial contours. Subcutaneous facial liposuction with tumescent technique and chin fat grafting were performed in all the cases, buccal fat pad excision of fat in 7 cases, the masseter injection of botulinum toxin type A in 9 cases, temporal fat grafting in 25 cases, forehead fat grafting in 15 cases.
RESULTSMarked improvement was achieved in all the patients with stable results during the follow-up period of 6 - 24 months. Complications, such as asymmetric, unsmooth and sagging were retreated with acceptance results.
CONCLUSIONCombination application of liposuction and fat grafting can effectively and easily improve the facial contour with low risk.
Adipose Tissue ; transplantation ; Botulinum Toxins, Type A ; administration & dosage ; Chin ; Face ; surgery ; Forehead ; Humans ; Injections, Intramuscular ; Lipectomy ; adverse effects ; methods ; Masseter Muscle ; Neuromuscular Agents ; administration & dosage
2.Topical application of leptin promotes burn wound healing in rats.
Huicai WEN ; Guohui WU ; Wen CHEN ; Honghua YANG ; Jianhua FU
Journal of Southern Medical University 2012;32(5):703-706
OBJECTIVETo investigate the effect of topical application of leptin in promoting burn wound healing in rats.
METHODSFour parallel second-degree burn wounds induced on the back of 18 Wistar rats were divided into leptin treatment group (treated with topical application of 400 ng/ml leptin dissolved in PBS) and control group (treated with PBS). The time of wound healing was recorded, and the wound area that was not healed was measured at 3, 7, 11, 15, and 19 days after burns. The tissue at the peripheries of the wound was sampled at 7, 14 and 21 days after burns for pathological examination with HE staining and immunohistochemistry for proliferating cell nuclear antigen (PCNA) to evaluate the proliferation of keratinocytes.
RESULTSCompared with the control group, leptin-treated wounds showed a shorter time (by 2-3 days) of wound healing, and significant differences were found between the two groups in healing at 7, 11, 15, and 19 days after burns. HE staining and immunohistochemistry revealed a faster rate of epidermis growth and a greater thickness of the cuticular layer in leptin-treated wounds at 7, 14 and 21 days after burns. PCNA positivity in the keratinocytes was stronger in leptin-treated wounds than in the control wounds at 7 and 14 days, but no such distinct difference was noted at 21 days between the two groups.
CONCLUSIONTopical application of leptin can promote re-epithelization in burn wounds to shorten the wound healing time of burns.
Administration, Cutaneous ; Animals ; Burns ; drug therapy ; Leptin ; administration & dosage ; therapeutic use ; Male ; Rats ; Rats, Wistar ; Wound Healing
3. Refined Converse otoplasty with Ω shape for prominent ears
Jinjun HUANG ; Huicai WEN ; Yingjie LU
Chinese Journal of Plastic Surgery 2018;34(4):286-288
Objective:
To investigate the feasibility and efficiency of refined Converse otoplasty with Ω shape for correcting prominent ears.
Methods:
Refined Converse otoplasty with Ω shape was performed in 8 cases(3 cases of bilateral deformities)of prominent ears during January 2014 to September 2016. The postauricular fascial-perichondrial complex tissues were elevated through postauricular incision based on Converse otoplasty. The new antihelix was reformed by parallel mattress sutures though postauricular parallel cartilaginous incisions. The Ω shape appeared on the transverse section of the auricular cartilage after fascial-perichondrial sutures.
Results:
Postoperative 6 month to one year follow-up presented satisfactory results in all 8 cases. The appropriate location and contour of the recreated antihelix was achieved. The included angle between fossae helicis and concha was decreased. The auricles were symmetric in both unilateral and bilateral patients of prominent ears. The scars were inconspicuous. Hematoma, infection, suture extrusion and secondary deformities were not seen in our series.
Conclusions
Natural and clear contour of the recreated antihelix was achieved by refined Converse otoplasty with Ω shape. Reoccurrence was not seen and complications were rare.
4. Clinical efficacy of combined nano-fat and structural fat transplantation for periocular rejuvenation
Cong LI ; Guizhen XU ; Jun WAN ; Yanping LIU ; Huicai WEN
Chinese Journal of Plastic Surgery 2018;34(4):291-295
Objective:
To investigate the clinical efficacy of combined nano-fat and structural fat transplantation for periocular rejuvenation, such as fine wrinkle, darkness and volume loss.
Methods:
Structural fat was harvested by Coleman′s structural fat grafting technique from thigh and was grafted at different layers for depression correction. Nano-fat was harvested by Tonnard′s nano-fat technology from thigh and was injected smoothly intradermally and subcutaneously for correction of fine wrinkle and darkness.
Results:
The patients were followed up for 3—12 months, 6 months in average. Satisfactory result was achieved in 42 cases after only one operation. No complication happened. 2 cases was unsatisfied due to upper eyelid fullness. 4 cases didn′t get improvement in periocular darkness.
Conclusions
Combined nano-fat and structural fat transplantation are effective for periocular rejuvenation, including depression deformity and skin darkness.
5.The research progress in the causes diagnosis and treatment of dark circles
Jiaqi WU ; Guizhen XU ; Huicai WEN
Chinese Journal of Plastic Surgery 2024;40(7):806-810
Dark circles refer to a cosmetic issue characterized by relatively darker skin color between the brow arch and the cheekbones. It has a high incidence rate and significantly affects patients’ quality of life and mental health. This article provides an overview of the periocular anatomical structures and the clinical classification of dark circles. It delves into the pathogenesis and etiologies of structural, pigmented, and vascular dark circles, summarizing and differentiating the clinical manifestations of these three types. This article also discusses selection of the appropriate diagnostic and therapeutic approaches based on the etiology and types, offering valuable insights for clinical practice.
6.The research progress in the causes diagnosis and treatment of dark circles
Jiaqi WU ; Guizhen XU ; Huicai WEN
Chinese Journal of Plastic Surgery 2024;40(7):806-810
Dark circles refer to a cosmetic issue characterized by relatively darker skin color between the brow arch and the cheekbones. It has a high incidence rate and significantly affects patients’ quality of life and mental health. This article provides an overview of the periocular anatomical structures and the clinical classification of dark circles. It delves into the pathogenesis and etiologies of structural, pigmented, and vascular dark circles, summarizing and differentiating the clinical manifestations of these three types. This article also discusses selection of the appropriate diagnostic and therapeutic approaches based on the etiology and types, offering valuable insights for clinical practice.
7.Research advances on platelet-rich blood products combined with biological materials in wound repair
Lubing LIU ; Huicai WEN ; Jinjun HUANG ; Guizhen XU ; Huaiwei LIAO
Chinese Journal of Burns 2021;37(4):395-400
The efficient management of wounds is the focus of current research. In addition to conventional wound management and necessary surgery, the role of pro-healing drugs in wound treatment has gradually been emphasized. Platelet-rich blood products that is rich in a variety of biologically active molecules are considered as a low-cost and safe therapy in promoting tissue healing, and have great development prospects in the field of regenerative medicine. However, due to the lack of standard preparation and management and the unstable activities of the biomolecules in them, the therapeutic effects of platelet-rich blood products are uneven. In order to solve these problems, researches related to the protection and delivery of biologically active molecules in platelet-rich blood products by biomaterials have gradually increased in recent years, which is also one of the latest trends in wound treatment research. This article first briefly introduces the types of platelet-rich blood products, then outlines the latest research progress achieved by their combination with biomaterials, and finally summarizes the research progress and future research directions of the combination approach in wound treatment.
8.Comparison of clinical efficacy between autologous fat injection and orbital septum fat reset for infraorbital margin depression in young people
Lubing LIU ; Jinjun HUANG ; Huaiwei LIAO ; Jun WAN ; Cong LI ; Na HUANG ; Ye HUANG ; Huicai WEN
Chinese Journal of Medical Aesthetics and Cosmetology 2021;27(5):374-378
Objective:To compare the clinical efficacy of autologous fat injection and conjunctival pedicled orbital septal fat grafting for infraorbital margin depression in young people.Methods:Fourty young patients with lower eyelid pouch and infraorbital margin depression with age of 20 to 40 years and average age of 30.6 yaers in the First Affiliated Hospital of Nanchang University from September 2017 to September 2019 were enrolled. According to the surgical method, all patients were divided into 2 groups with 20 cases each. Group 1 underwent transconjunctival orbital septum fat reset. Group 2 underwent various autologous fat injection after proper amount of orbital septal fat being removed, including structural fat, fine-particle fat and nano-fat, performed in different parts and layers. The tear trough rating scale (TTRS) scores and patients' satisfaction at 1 year after operation between 2 groups were compared.Results:Compared with the preoperative TTRS scores, the differences in scores at 6 months and 1 year after surgery were statistically significant ( P<0.01). The scores between two groups were compared at 6 months and 1 year respectively after the operation, and the difference were both statistically significant ( P<0.01). 6 months after the operation, the TTRS scores including four items were carefully compared between the two groups. It showed that the reduction of tear groove depth ( P<0.05), pigmentation ( P<0.01) and wrinkle ( P<0.01) in group 2 were more obvious than those in group 1. The percentage of satisfaction in group 2 (95%) was higher than that in the group 1 (70%), and the difference was statistically significant ( P<0.01). Conclusions:For infraorbital margin depression of young people, after proper amount of orbital septal fat being removed, various free fats graft injection into different parts and layers could obtain better treatment results, reducing not only the depth of the tear groove, but also periorbital pigmentation and fine wrinkles.
9.A clinical comparative study of two kinds of epicanthoplasty combined with double eyelid surgery in the construction of inner and outer type double eyelids
Zheng HUANG ; Na ZHAN ; Huicai WEN ; Guoyu ZHENG ; Chenwen WU
Chinese Journal of Plastic Surgery 2024;40(7):716-722
Objective:To investigate the outcome of epicanthoplasty combined with double eyelidplasty in different aesthetic forms of double eyelids (inner type and outer type) using Z-epicanthoplasty and inverted L method.Methods:The clinical data of patients with single eyelids and epicanthus were retrospectively analyzed from November 2021 to October 2022 in Gaoxin Hospital of the First Affiliated Hospital of Nanchang University. Patients were divided into inner type group and outer type group based on their aesthetic requirements for inner double eyelids. Both groups underwent Z-epicanthoplasty or inverted L method for epicanthus correction. Postoperative follow-up was conducted to observe the incision healing, complications, and postoperative effects of the two groups. The correction effects [ineffective, effective, and markedly effective, with the effective rate calculated as (the number of markedly effective cases + the number of effective cases)/total number of cases × 100%], scar scores, and patient satisfaction scores were collected for more than 12 months after surgery. Independent sample t-test was used for the scar scores and patient satisfaction scores, and chi-square test was used for the epicanthus correction effects. P<0.05 indicated a statistically significant difference. Results:A total of 76 patients were included. Among them, 41 patients in the inner type group (4 males and 37 females, with an average age of 22.3 years, ranging from 18 to 28 years) underwent 19 cases of Z-epicanthoplasty and 22 cases of inverted L method; 35 patients in the outer type group (3 males and 32 females, with an average age of 24.2 years, ranging from 19 to 30 years) underwent 20 cases of Z-epicanthoplasty and 15 cases of inverted L method. After 12 to 16 months of follow-up, with an average of 14 months, all incisions in both groups healed in the first stage, with no significant scar hyperplasia or other complications. Most of the double eyelid shapes are natural after the surgery, and the correction of epicanthus is obvious. Comparison of the treatment efficacy between Z-epicanthoplasty and inverted L method showed no significant difference [94.87% (37/39) vs. 94.59% (35/37), P>0.05]. In the inner type group, the postoperative scar score of the inverted L method was lower than that of the Z-epicanthoplasty [(6.81±0.66) vs. (7.31±0.88)], and the satisfaction score was better than that of the Z-epicanthoplasty [(0.86±0.63) vs. (1.73±0.65)], with statistically significant differences (both P<0.05). In the outer type group, the scar score of the inverted L method was higher than that of the Z-epicanthoplasty [(7.66±0.89) vs. (7.00±0.64)], and the satisfaction score was worse than that of the Z-epicanthoplasty [(1.80±0.86) vs. (1.00±0.56)], with statistically significant differences (both P<0.05). Conclusion:For patients requiring inner type aesthetic form of medial double eyelids, inverted L method can achieve less postoperative scars and higher postoperative satisfaction compared with Z-epicanthoplasty. For patients requiring "outer type" aesthetic form, Z-epicanthoplasty can achieve less postoperative scars and higher postoperative satisfaction compared with inverted L method.
10.Evaluation of static symmetry in patients with facial paralysis after masseteric-to-facial nerve transfer combined with fascia lata graft
Yulu ZHOU ; Hao MA ; Huicai WEN ; Wei WANG
Chinese Journal of Plastic Surgery 2022;38(9):1013-1021
Objective:To evaluate the static symmetry in patients with early facial paralysis after masseteric-to-facial nerve transfer combined with fascia lata graft.Methods:Clinical data of paralyzed patients who treated with masseteric-to-facial nerve transfer combined with fascia lata graft in Shanghai Jiao Tong University School of Medicine Affiliated Ninth People’s Hospital from January 2016 to December 2018 were retrospectively analyzed. Patients were divided into two groups according to the degree of preoperative oral commissure dropping: slight asymmetry (Scale Ⅱ, Group A) and severe asymmetry (Scale Ⅲ, Group B). Facial muscle contraction was evaluated by Terzis Facial Grading System to evaluate smile function, which was divided into Score Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ. The higher the score, the better the facial muscle contraction and the better the dynamic symmetry during preoperatively and one year postoperatively. The static symmetry of oral commissure was evaluated by Symmetry Scale of Oral Commissure to evaluate symmetry at rest, which was divided into Scale Ⅰ, Ⅱ, Ⅲ and Ⅳ, the higher the scale, the worse the static symmetry. Face-gram software was adopted to measure bilateral vertical differences(D 1) or horizontal differences(D 2) in the oral commissure position of the patients with facial paralysis for evaluating the postoperative static symmetry objectively. Statistical analyses were performed with SPSS version 26.0. Numeration data were analyzed by chi-square test. Intragroup quantitative data was analyzed by paired t-test and intergroup quantitative data was analyzed by two-sample t-test. The significance level was set at 0.05. Results:A total of 58 patients were included, including 30 patients in group A [male 12, female 18, age (43.5 ±8.1) years], and 28 patients in group B[male 12, female 16, age (40.6 ±9.6) years]. There was no significant difference in sex, age at surgery, paralyzed side and denervation time between groups ( P>0.05). The patients were scored Ⅰ on Terzis’ smile functional evaluation scale preoperatively. The score of smile function in postoperative percentage in all patients was improved to Score Ⅲ (Group A, 9/30, 30.0%; Group B, 10/28, 35.7%) or Score Ⅳ (Group A, 21/30, 70.0%; Group B, 18/28, 64.3%), according to the Terzis Facial Grading System. There was no significant difference in the improvement of smile function between groups ( P>0.05). In Group A, 73.3% patients had postoperative improvement in static symmetry (Scale Ⅱ to Scale Ⅰ, 22/30) and 26.7% patients were still Scale Ⅱ according to Symmetry Scale of Oral Commissure to evaluate symmetry at rest. In Group B, 39.3% of patients achieved static symmetry effect (Scale Ⅲ to Scale Ⅰ, 11/28), 42.9% patients had postoperative improvement (Scale Ⅲ to Scale Ⅱ, 12/28) and 17.8%(5/28) of them were still Scale Ⅲ. The proportion of achieving static symmetry effect (Scale Ⅰ) in Group A was higher than that in Group B ( P<0.01). D 1 values of one-year postoperation were smaller than that of preoperation [Group A: (5.27 ±0.74) mm vs. (2.24 ±0.57) mm; Group B: (8.22 ±1.37) mm vs. (4.42 ±0.95) mm, P<0.01]. Similarly, D 2 values of one-year postoperation were smaller than that of preoperation [Group A: (6.11 ±1.18) mm vs. (2.98±1.13) mm; Group B: (8.84 ±2.16) mm vs. (5.24 ±1.85) mm, P<0.01]. There were significant differences between groups in preoperative comparison and one-year postoperative comparison( P<0.01). Conclusions:Masseteric-to-facial nerve transfer combined with fascia lata graft achieved dynamic and static symmetry in patients with different levels of asymmetry. The postoperative static symmetry effect at rest may be influenced by the different levels of oral commissure asymmetry preoperatively.