Objective:To explore the method and experience of augmentation mammoplasty with autologous fat transplantation assisted by external expander.Methods:From January 2013 to December 2020, 352 female patients (698 breasts, 346 bilateral and 6 unilateral), aged from 18 to 55 years, with an average age of 41.5 years, were admitted to the Department of Cosmetic Surgery, Beijing Jingmei Medical Cosmetology Clinic. From 1-28 days before surgery, autologous fat transplantation was performed after wearing the dilator, and postoperative wearing of the dilator lasted from 1 to 24 months, with an average of 3.5 months.Results:The volume of fat transplantation per breast ranged from 150 ml to 460 ml, with an average of 320 ml. No obvious postoperative complications such as fat liquefaction, infection, intramammary induration and fat embolism were observed, and the postoperative appearance was lasting. The postoperative follow-up was conducted from 6 months to 7 years, and patient postoperative satisfaction rate reached 84.9% and doctors＇ satisfaction after surgery reached 82.1%.Conclusions:Augmentation mammoplasty with autologous fat transplantation assisted by external expander can effectively improve the appearance of breast morphology and contour defects and increase the survival rate of fat transplantation, which is worthy of clinical application.

Objective:To investigate the effect and reasonable strategy of shuffling fat in the treatment of eyelid stick-bone scar cicatricial depression and atrophy.Methods:A retrospective analysis consisted of patients admitted in Plastic Surgery Hospital, CAMS from March 2017 to May 2019, and the inclusion criteria was depressive and atrophic deformities caused by eyelid stick-bone scar. By performing subcutaneous liposuction on the abdomen, the harvested fat was further mechanically refined into shuffling fat. Single serialized shuffling fat injection with a 3-month interval was performed in the orbital region. Approximately 3 months after fat transplantation, symptomatic treatment was performed due to complications of upper eyelid ptosis or ectopic, and fat injection combined with the orbicularis oculi muscle flap was carried out to repair the lower eyelid atrophic deformity. Follow up regularly after the operation to observe the occurrence of complications. Six months after the end of treatment, the patient and observer scar assessment scale (POSAS) was used to assess scars, and the doctor-patient comprehensive score was used to assess patient satisfaction.Results:A total of 6 patients with stick-bone scar in the eyelid area were enrolled including 4 males and 2 females, aged 24-53 years old, with an average of 37 years old. The causes of defects included 4 cases of trauma, 2 cases after maxillary osteomyelitis treatment. Duration of disease ranged 1.5-50.0 years, average 14.2 years. Scars were located in the regions of upper eyelid in 4 cases and lower eyelid in 2 cases. Area of depressed region ranged 0.5 cm×2.0 cm-1.5 cm×3.0 cm. After mechanical refinement, the fat texture was more delicate and even. Injection of shuffling fat with the single volume of 0.6 to 1.3 ml was performed 3 to 4 times (average 3.25 times) on the upper eyelid and average 2 times on the lower eyelid, respectively. During the post-operative 6 months, the appearance of all patients was significantly improved, the volume of soft tissues of the eyelid was significantly increased, the pliability and elasticity of the scar tissue was ameliorated, and no complications occurred. The scores of patient scar assessment scale (PSAS) and observer scar assessment scale (OSAS) were (7.0±1.0) and (6.7±1.1), respectively, and the doctor-patient comprehensive score was 4-5 (average 4.5).Conclusions:For upper eyelid, shuffling fat injection has a good therapeutic effect on depressive and atrophic deformity caused by the stick-bone scar by increasing the tissue volume; for lower eyelid, it is necessary to combine the orbicularis oculi myocutaneous flap on the basis of shuffling fat transplantation to further increase the support structure for better appearance.

Neck rejuvenation is warmly concerned day by day. The aesthetic of neck rejuvenation surgery include restoring or creating a clear jawline, ideal cervico-mentalangle, smooth and tight skin and a healthy redistribution of soft tissue volume. Based on the fine anatomy of the neck, this paper analyzes the appearance and pathological features of neck agingand discusses the treatment options for neck rejuvenation, such as injection, photoelectric treatment and surgical treatment.Among them, the surgical treatment includes embedding suspensions, liposuction and chin augmentation, anterior cervical plasty and platysma myoplasty, combined with deep cervical structure treatment for cervical rejuvenation.

Objective:To investigate the effect and reasonable strategy of shuffling fat in the treatment of eyelid stick-bone scar cicatricial depression and atrophy.Methods:A retrospective analysis consisted of patients admitted in Plastic Surgery Hospital, CAMS from March 2017 to May 2019, and the inclusion criteria was depressive and atrophic deformities caused by eyelid stick-bone scar. By performing subcutaneous liposuction on the abdomen, the harvested fat was further mechanically refined into shuffling fat. Single serialized shuffling fat injection with a 3-month interval was performed in the orbital region. Approximately 3 months after fat transplantation, symptomatic treatment was performed due to complications of upper eyelid ptosis or ectopic, and fat injection combined with the orbicularis oculi muscle flap was carried out to repair the lower eyelid atrophic deformity. Follow up regularly after the operation to observe the occurrence of complications. Six months after the end of treatment, the patient and observer scar assessment scale (POSAS) was used to assess scars, and the doctor-patient comprehensive score was used to assess patient satisfaction.Results:A total of 6 patients with stick-bone scar in the eyelid area were enrolled including 4 males and 2 females, aged 24-53 years old, with an average of 37 years old. The causes of defects included 4 cases of trauma, 2 cases after maxillary osteomyelitis treatment. Duration of disease ranged 1.5-50.0 years, average 14.2 years. Scars were located in the regions of upper eyelid in 4 cases and lower eyelid in 2 cases. Area of depressed region ranged 0.5 cm×2.0 cm-1.5 cm×3.0 cm. After mechanical refinement, the fat texture was more delicate and even. Injection of shuffling fat with the single volume of 0.6 to 1.3 ml was performed 3 to 4 times (average 3.25 times) on the upper eyelid and average 2 times on the lower eyelid, respectively. During the post-operative 6 months, the appearance of all patients was significantly improved, the volume of soft tissues of the eyelid was significantly increased, the pliability and elasticity of the scar tissue was ameliorated, and no complications occurred. The scores of patient scar assessment scale (PSAS) and observer scar assessment scale (OSAS) were (7.0±1.0) and (6.7±1.1), respectively, and the doctor-patient comprehensive score was 4-5 (average 4.5).Conclusions:For upper eyelid, shuffling fat injection has a good therapeutic effect on depressive and atrophic deformity caused by the stick-bone scar by increasing the tissue volume; for lower eyelid, it is necessary to combine the orbicularis oculi myocutaneous flap on the basis of shuffling fat transplantation to further increase the support structure for better appearance.

Neck rejuvenation is warmly concerned day by day. The aesthetic of neck rejuvenation surgery include restoring or creating a clear jawline, ideal cervico-mentalangle, smooth and tight skin and a healthy redistribution of soft tissue volume. Based on the fine anatomy of the neck, this paper analyzes the appearance and pathological features of neck agingand discusses the treatment options for neck rejuvenation, such as injection, photoelectric treatment and surgical treatment.Among them, the surgical treatment includes embedding suspensions, liposuction and chin augmentation, anterior cervical plasty and platysma myoplasty, combined with deep cervical structure treatment for cervical rejuvenation.

Objective:To learn about physicians’ concepts and commonly employed method in hyaluronic acid injection and provide reference data for the standardization of pain management.Methods:This study was a cross-sectional study. Convenient sampling method was used to distribute questionnaires to cosmetic injectors and patients experienced with hyaluronic acid injections to collect data on their views of pain associated with hyaluronic acid injections. The physician portion was collected offline from June 15 to July 20, 2022, and the patient portion was collected from November 14, 2022, to December 6, 2022, via the Questionnaire Star platform. The physician questionnaire consisted of 17 questions, question types included single choice, multiple choice and essay questions. The patient questionnaire consisted of 6 questions, question types included single choice and multiple choice. Relevant data were analyzed using SPSS 22.0 software for descriptive statistics, and data were presented in the form of cases and percentages (%).Results:Sixty-two physician questionnaires and 123 patient questionnaires were collected. 42 (67.74%) physicians observed from their daily practice that more than 50% of their patients were very concerned about pain during injection; 101 (82.11%) patients scored ≥5 out of 10 for concern about impending pain prior to hyaluronic acid filler injection. At the time of treatment, 48 (77.42%) physicians advised patients to choose a lidocaine-containing hyaluronic acid filler for reasons including a significant reduction in injection pain (53 cases, 85.48%) and patient comfort with the treatment experience (59 cases, 95.16%). 60 (48.78%) patients were willing to choose an anesthesia-containing product at the time of injection, but the price of the anesthesia-containing product influenced the patient’ s choice (55 cases 44.72%) .Conclusions:Pain from cosmetic injectable treatments is an important issue to both physicians and patients. Lidocaine-containing hyaluronic acid is recognized by physicians and patients for its analgesic effect and high safety profile. There is no perfect solution for pain in cosmetic injection treatment, and multidisciplinary collaboration may be needed to solve the problem.

Objective:To learn about physicians’ concepts and commonly employed method in hyaluronic acid injection and provide reference data for the standardization of pain management.Methods:This study was a cross-sectional study. Convenient sampling method was used to distribute questionnaires to cosmetic injectors from plastic surgery department of public hospitals or medical beauty institutions and patients experienced with hyaluronic acid injections to collect data on their views of pain associated with hyaluronic acid injections. The physician portion was collected offline from June 15 to July 20, 2022, and the patient portion was collected from November 14 to December 6, 2022, via the Questionnaire Star platform. The physician questionnaire consisted of 17 questions, question types included single choice, multiple choice and essay questions. The patient questionnaire consisted of 6 questions, question types included single choice and multiple choice. Relevant data were analyzed using SPSS 22.0 software for descriptive statistics, and data were presented in the form of cases(%).Results:Sixty-two physician questionnaires and 123 patient questionnaires were collected. 42 (67.74%) physicians observed from their daily practice that more than 50% of their patients were very concerned about pain during injection; 101 (82.11%) patients scored ≥5 out of 10 for concern about impending pain prior to hyaluronic acid filler injection. At the time of treatment, 48 (77.42%) physicians advised patients to choose a lidocaine-containing hyaluronic acid filler for reasons including a significant reduction in injection pain (53 cases, 85.48%) and patient comfort with the treatment experience (59 cases, 95.16%). 60 (48.78%) patients were willing to choose an anesthesia-containing product at the time of injection, but the price of the anesthesia-containing product influenced the patient’s choice (55 cases, 44.72%).Conclusion:Pain from cosmetic injectable treatments is an important issue to both physicians and patients. Lidocaine-containing hyaluronic acid is recognized by physicians and patients for its analgesic effect and high safety profile. There is no perfect solution for pain in cosmetic injection treatment, and multidisciplinary collaboration may be needed to solve the problem.

Objective:To learn about physicians’ concepts and commonly employed method in hyaluronic acid injection and provide reference data for the standardization of pain management.Methods:This study was a cross-sectional study. Convenient sampling method was used to distribute questionnaires to cosmetic injectors and patients experienced with hyaluronic acid injections to collect data on their views of pain associated with hyaluronic acid injections. The physician portion was collected offline from June 15 to July 20, 2022, and the patient portion was collected from November 14, 2022, to December 6, 2022, via the Questionnaire Star platform. The physician questionnaire consisted of 17 questions, question types included single choice, multiple choice and essay questions. The patient questionnaire consisted of 6 questions, question types included single choice and multiple choice. Relevant data were analyzed using SPSS 22.0 software for descriptive statistics, and data were presented in the form of cases and percentages (%).Results:Sixty-two physician questionnaires and 123 patient questionnaires were collected. 42 (67.74%) physicians observed from their daily practice that more than 50% of their patients were very concerned about pain during injection; 101 (82.11%) patients scored ≥5 out of 10 for concern about impending pain prior to hyaluronic acid filler injection. At the time of treatment, 48 (77.42%) physicians advised patients to choose a lidocaine-containing hyaluronic acid filler for reasons including a significant reduction in injection pain (53 cases, 85.48%) and patient comfort with the treatment experience (59 cases, 95.16%). 60 (48.78%) patients were willing to choose an anesthesia-containing product at the time of injection, but the price of the anesthesia-containing product influenced the patient’ s choice (55 cases 44.72%) .Conclusions:Pain from cosmetic injectable treatments is an important issue to both physicians and patients. Lidocaine-containing hyaluronic acid is recognized by physicians and patients for its analgesic effect and high safety profile. There is no perfect solution for pain in cosmetic injection treatment, and multidisciplinary collaboration may be needed to solve the problem.

Objective:To learn about physicians’ concepts and commonly employed method in hyaluronic acid injection and provide reference data for the standardization of pain management.Methods:This study was a cross-sectional study. Convenient sampling method was used to distribute questionnaires to cosmetic injectors from plastic surgery department of public hospitals or medical beauty institutions and patients experienced with hyaluronic acid injections to collect data on their views of pain associated with hyaluronic acid injections. The physician portion was collected offline from June 15 to July 20, 2022, and the patient portion was collected from November 14 to December 6, 2022, via the Questionnaire Star platform. The physician questionnaire consisted of 17 questions, question types included single choice, multiple choice and essay questions. The patient questionnaire consisted of 6 questions, question types included single choice and multiple choice. Relevant data were analyzed using SPSS 22.0 software for descriptive statistics, and data were presented in the form of cases(%).Results:Sixty-two physician questionnaires and 123 patient questionnaires were collected. 42 (67.74%) physicians observed from their daily practice that more than 50% of their patients were very concerned about pain during injection; 101 (82.11%) patients scored ≥5 out of 10 for concern about impending pain prior to hyaluronic acid filler injection. At the time of treatment, 48 (77.42%) physicians advised patients to choose a lidocaine-containing hyaluronic acid filler for reasons including a significant reduction in injection pain (53 cases, 85.48%) and patient comfort with the treatment experience (59 cases, 95.16%). 60 (48.78%) patients were willing to choose an anesthesia-containing product at the time of injection, but the price of the anesthesia-containing product influenced the patient’s choice (55 cases, 44.72%).Conclusion:Pain from cosmetic injectable treatments is an important issue to both physicians and patients. Lidocaine-containing hyaluronic acid is recognized by physicians and patients for its analgesic effect and high safety profile. There is no perfect solution for pain in cosmetic injection treatment, and multidisciplinary collaboration may be needed to solve the problem.