OBJECTIVETo improve a better method to achieve the upper arm's circumferential harmony by using adjacent aesthetic unit combined upper arm liposuction.

METHODSLiposuction of upper arm, axilla and part of the scapula area was performed on 88 cases at one stage from January 2007 to March 2013.

RESULTSAll the cases achieve satisfactory results. The circumferential curve is smooth and elegant. No severe complication happened.

CONCLUSIONSThis method proved to be safe and effective and can be accomplished in one stage.

Adult ; Arm ; anatomy & histology ; surgery ; Axilla ; Esthetics ; Female ; Humans ; Lipectomy ; methods

OBJECTIVETo investigate the effect of the anticoagulants on PRP quality, so as to clarify the appropriate anticoagulant used in PRP production.

METHODSThe microstructure change of platelets collected via heparin, citrate, acid citrate dextrose (ACD) and citrate-theophylline-adenosine-dipyridamole ( CTAD) was observed by TEM following time course. The extent of spontaneous activation of platelets in four groups was detected by measuring sP-selectin in plasma. The TGF-β1 release amount of activated PRP of four groups was measured.

RESULTSCTAD is superior to other anticoagulants in maintaining the integrity of platelet structures for a long time and preventing platelet spontaneous activation. ACD slightly surpassed heparin and citrate in above two aspects. ACD-PRP and CTAD-PRP released significantly more TGF-β1 compared with heparin and citrate.

CONCLUSIONSThe PRP quality and biological effects were strongly associated with the type of Anticoagulants. ACD and CTAD are optimal anticoagulants in PRP production for they can maintain platelet viability at a high level.

Adenosine ; pharmacology ; Anticoagulants ; pharmacology ; Blood Platelets ; drug effects ; physiology ; Citrates ; pharmacology ; Citric Acid ; pharmacology ; Dipyridamole ; pharmacology ; Drug Combinations ; Glucose ; analogs & derivatives ; pharmacology ; Heparin ; pharmacology ; Platelet Activation ; drug effects ; Platelet-Rich Plasma ; Theophylline ; pharmacology ; Transforming Growth Factor beta1 ; metabolism

Objective To explore the methodology of the preventing the absorption after autog-enous fat granule mammaplasty, and the main point of the operative methods.. Methods The clinical data were reviewed in 30 cases of patients with liposuction combined with fat-grafting injection for breast mammaplasty in the past four years. The tumescent technique was used in liposuction and the volume of fat tissue aspirated was between 500 ml and 3250 ml. Using appropriate way we prepared pure fat granules and then evenly injected into the layer beneath the pectoralis major muscle, submam-mary layer and subcutaneous layer of the breast, respectively. Results The effect of the method was satisfying because sucking area was significantly decreased. From six months to 10 months follow-up, grafts showed no obvious absorption. The breast looked symmetry. Conclusion Fat grafting injection is a practicable method for breast mammaplasty. The key point is to use appropriate way to get pure fat granule and to prevent infection. It deserves to be recommended.

OBJECTIVETo explain a method for lower face and anterior neck reconstruction.

METHODSTissue expanders were implanted subcutaneously beside the defect. When the skin was properly expanded, the bipedicled expanded skin flap was created and transferred to the lower face and the anterior neck. If the defect can not be repaired by one stage, the expanded skin was re-expanded for the rest.

RESULTS11 patients have been treated with this method since 1990. All flaps survived and all the defects have been successfully repaired with satisfactory results.

CONCLUSIONThe bipedicled expanded flap, which provided good blood supply, improved the survival rate of the flap and reduced the incision scar on the face, is an effective surgical procedure.

Adolescent ; Adult ; Child ; Face ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neck ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Time Factors ; Treatment Outcome

OBJECTIVETo evaluate the effect of external use of papaverine cream on enhancement of tissue expansion.

METHODS8 mini pigs were randomly divided into 4 groups. During inflation, papaverine was given externally in group A, through a delivery system in group B, though intramuscular injection in group C. Papaverine was not given in group D. The time of inflation, the expansion rate, the surviving length of expanded flaps and the papaverine concentration in the fibrous capsule in each group were examined. Histologic and electroscope examinations of the expanded tissue were made.

RESULTSThe average inflation time was 28.9 +/- 4.5 days in group A, 34.0 +/- 2.6 days in group B, 37.6 +/- 4.8 days in group C and 38.5 +/- 3.5 days in group D. There was significant difference between each group(P < 0.05). The average surviving length of expanded flaps in group A was 13.67 +/- 1.28 cm, 11.07 +/- 0.88 cm in group B, 10.79 +/- 0.49 cm in group C, and 9.49 +/- 0.77 cm in group D. There was significant difference between each group (P < 0.01). Histologic examinations of the expanded tissue suggested that there were no significant differences in thickness of epidermis, derma and fibrous capsule among the four groups. Electroscope examinations of the myofibroblast in fibrous capsule showed that there were smaller nuclei, fewer microfilaments and fewer mitochondrias and rougher endoplastic reticulume in group A than those in other groups. The concentration of papaverine in fibrous capsule of group A was 3.5 +/- 1.2 micrograms/g. Papaverine was detected neither in the skin of other groups nor in the blood of all groups.

CONCLUSIONS1. Papaverine cream can permeate through skin and maintain high concentration and continuous effect in local tissue. 2. External use of papaverine cream can inhabit the function of myofibroblast in fibrous capsule, increase inflation rate, accelerate expansion process, and improve microcirculation of the expanded skin with a result of prolongation of surviving length of expanded flaps. 3. The technique of enhancing tissue expansion with external use of papaverine has the advantages of convenient delivery, cheapness, no more injury and infection, and no side effects etc. It is a safe, effective, simple, and reliable method for accelerating tissue expansion.

Animals ; Papaverine ; administration & dosage ; pharmacokinetics ; Skin ; drug effects ; Surgical Flaps ; Swine ; Swine, Miniature ; Time Factors ; Tissue Expansion ; Vasodilator Agents ; administration & dosage

Objective: To describe an extended whole upper limb liposuction technique and evaluate its clinical effect. Methods: 34 patients who underwent upper limb liposuction from February 2018 to February 2019 were selected and the clinical data were retrospectively summarized. Patients were treated with upper arm ring/upper arm ring + forearm 1/3 rings/whole arm ring aspiration combined with accessory mammary gland, armpit, scapula and other adjacent aesthetic parts of extended liposuction. The preoperative and postoperative maximum circumference, thickness of the anterior and posterior subcutaneous tissue and skin laxity were measured and compared. analysis of complications, and evaluation of patients′ satisfaction through satisfaction questionnaire. Results: The arm shape of all patients was significantly improved, the maximum circumference of the arm was reduced (16.2±4.0)%, the distance of the upper arm was reduced (29.5±8.9)%, the thickness of the posterior subcutaneous tissue was reduced (56.6 ±6.2)%, and the thickness of the anterior subcutaneous tissue was reduced (44.7±9.6)%. There were three cases of mild anemia after operation, and no other serious complications occurred. Patient satisfaction was very high. Conclusions This is an innovative arm liposuction technique with hidden incision. The effect of improvement is remarkable. The patient′s satisfaction is high.

Objective To investigate the total facial autologous fat transplantation based on the facial aesthetic unit for facial contour improvement .Methods From June 2015 to October 2016, 50 cases underwent total facial autologous fat injection based on the facial contour characteristic .Among them , 9 cases underwent masseter intramuscular injection with botulinum toxin type A , 4 cases underwent nasal augmentation simultaneously . Results The facial contour and proportion were improved in all the patients.All the patients were followed up for 3-12 months with stableresult with satisfactory rate of 76％(38/50).No facial asymmetry and unsmooth happened .The fat absorption rate was 30％ to 50％. Secondary fat transplantation was performed in 4 cases for further improvement .Conclusions Autologous fat transplantation is a less invasivemethod with great improvement in facial contour based on combined aesthetic unit design .

Objective To investigate the total facial autologous fat transplantation based on the facial aesthetic unit for facial contour improvement .Methods From June 2015 to October 2016, 50 cases underwent total facial autologous fat injection based on the facial contour characteristic .Among them , 9 cases underwent masseter intramuscular injection with botulinum toxin type A , 4 cases underwent nasal augmentation simultaneously . Results The facial contour and proportion were improved in all the patients.All the patients were followed up for 3-12 months with stableresult with satisfactory rate of 76％(38/50).No facial asymmetry and unsmooth happened .The fat absorption rate was 30％ to 50％. Secondary fat transplantation was performed in 4 cases for further improvement .Conclusions Autologous fat transplantation is a less invasivemethod with great improvement in facial contour based on combined aesthetic unit design .

Objective:To investigate the quantification assessment of segmental volume after thigh liposuction utilizing three-dimensional(3D) scanning technology.Methods:This retrospective study was performed with the analysis of 3D scanning images of patients who had undergone bilateral thigh liposuction in Body Contouring & Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2018 to September 2022. Preoperative and postoperative 3D scanning were performed to build visual 3D models of bilateral thighs. From top to the bottom, bilateral thighs were segmented into seven sections with a space of 5 cm in acquired 3D model. Certain measurements and calculation of preoperative and postoperative volume and volume change rate of the overall thigh and each segment were conducted, to validate the efficiency of liposuction (EOL). Additionally, EOL of each thigh segment was computed and the symmetry of bilateral thighs was analyzed before and after surgery. The volume differences were computed using the paired Wilcoxon rank-sum test, and intraclass correlation coefficient (ICC) was exerted to assess the symmetry of bilateral thighs before and after surgery.Results:A total of 36 female patients were included in the study, with an age range of 18 to 49 years and a mean age of (28.6±7.6) years. Follow-up duration ranged from 23 to 1 133 days postoperatively, with a mean follow-up period of 274.7 days. The results of 3D scanning measurements indicated significant changes ( P<0.01) in both the overall volume of the thigh and the volumes of each segment before and after surgery. The highest volume change rate and EOL were observed in the uppermost segment, and the volumetric change rate and EOL exhibited a descending trend across the segments of the thigh from the uppermost to the lowermost segments. The ICC of the volume of each segment consistently surpassed 0.950 whether preoperatively or postoperatively, indicating a high level of symmetry between the bilateral thighs, and the ICC of overall volume showed a notable increase from 0.992 preoperatively to 0.997 postoperatively. Conclusion:3D scanning technology can be exerted to quantify the volume changes before and after thigh liposuction. This study provided quantitative and objective evidence to confirm the efficacy of thigh liposuction procedure, elucidating that the most significant liposuction effects observed in the uppermost segment of the thigh. Moreover, postoperative assessments reveal a further enhancement in bilateral thigh symmetry.

Objective:To evaluate the effect of continuous pump ropivacaine in rectus sheath in the postoperative analgesia after abdominoplasty.Methods:Patients with abdominoplasty who were admitted to the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from August 2020 to December 2021 were retrospectively analyzed. They were divided into 2 groups: the control group received patient-controlled intravenous analgesia (PCIA) after the operation, sufentanil 100 μg + normal saline diluted to 100 ml, the rate was 2 ml/h, lasted for 48 h, locking time 15 min, Bolus: 0.5 ml; the study group underwent postoperative rectus abdominis intrathecal intubation and continuously infused 0.262 5% ropivacaine saline mixture 100 ml, the rate was 2 ml/h, lasted for 48 h, the locking time is 15 min, Bolus: 0.5 ml. The method of catheter placement in the study group: a catheter was placed unilaterally in the anterior sheath of the rectus abdominis under direct vision, and an incision was made 2 cm below the umbilical plane. The other end is pierced from the umbilicus and connected to the analgesic pump. The visual analogue scale (VAS) for pain and the number of analgesic pump boluses at 24 h and 48 h after operation, the occurrence of postoperative adverse drug reactions and the patient satisfaction at 1 month after operation were collected. The normally distributed measurement data were expressed as Mean±SD, and the comparison between the two groups was analyzed by t-test; the count data was expressed by the frequency (percentage), and the Fisher’s test was used for analysis. Results:A total of 56 patients were included, including 9 males and 47 females, ranging in age from 27 to 53 years old, with ASA graded from 1 to 2, body mass index (BMI) ranged from 26 to 33 kg/m 2. Their rectus abdominis separation ranged from 3 to 7 cm. Compared with the control group, the pain VAS score of the study group at 48 hours after the operation was lower (3.9±1.5 vs. 5.2±1.4, P<0.05), and the number of analgesic boluses was reduced (2.9±0.3 vs. 3.9±0.4, P<0.05), the incidence of adverse reactions such as nausea, vomiting decreased( P<0.05). The satisfaction rate 1 month after operation in the study group was significantly higher than that in the control group [100.0% (30/30) vs. 42.3% (11/26), P<0.05]. Conclusions:Continuous infusion of ropivacaine through anterior rectus intrathecal cannula can effectively relieve abdominal pain after total abdominoplasty, reduce adverse reactions caused by postoperative analgesics, improve patient comfort during hospitalization, and improve overall surgical satisfaction.