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

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

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.

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.

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.

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.

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.

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.

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.

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.