Objective To evaluate the effect of injecting transplantation of autologous fat granules in the treatment of soft tissue depression in face. Methods Autologous subcutaneous fat granules were obtained by liposuction and implanted into the facial sites of soft tissue depression by injection. Results From 1996 to 2002, 56 affected sites were treated, in which 45 sites were given fat granule injection once and 11 sites twice. The volume of fat granules ranged from 1.5ml to 24ml with an average of 8.9ml. Among the 43 sites in 28 cases followed up for more than 6 months, including 8 sites (18.6%) treated twice, 38 ones showed excellent or good augmentation results for 6 months, the percentage being 88.4%. No serious complications occurred. Conclusions Local injecting transplantation of autologous fat granules is effective for correcting the simple soft tissue depression in face. Repeated injections may be needed in some cases. The procedure is simple, safe and minimally invasive.

OBJECTIVETo observe and analyze the pathohistological characteristics of capsules which formed around the mammary prosthesis with different contents. And to provide the selective basis for ideal and safe prosthesis in clinical practice.

METHODS20 specimen of the capsules were taken from 20 cases who receive the operation of prothesis removal for different reasons. HE, Masson and Mallory staining were used to analyse the tissue structure and characteristics under the light microscope.

RESULTSThe common structure including the collagen fibers accumulation, inflammatory cells infiltration and the capillary hyperplasia were found in all specimen. A layer of squamous epithelium-like cell was detected in some specimen. The specific characteristics were also found in different capsules formed around different prosthesis. In the capsules around vegetable oil prosthesis, there was excessive collagen fiber accumulation, and the capsules were much thicker. In the PVP (polyvinylpyrolidone) prosthesis capsules, there was severe inflammatory cell infiltration, and the number of eosinophilic granulocyte increased obviously. In the silicone gel and saline prosthesis capsule, the collagen fibers were well-arranged and the inflammatory cells were much less. Synovial metaplasia was detected in two cases.

CONCLUSION1. The capsules form around the prosthesis in all cases after mammary augmentation. 2. There will be synovial metaplasis in some cases, for vegetable oil prosthesis, the collagen over-accumulated which lead the capsules become thicker and harder. So it is not a kind of ideal mammary prothesis. 4. The severe infiltration of the inflammatory cells especially the large quantity of eosinophilic granulocyte indicate the possibility of the delayed hypersensitive reaction mediated by eosinophilic granulocyte. Cautious attitude should be taken during application.

Adult ; Breast ; pathology ; Breast Implants ; Female ; Humans ; Middle Aged

Objective To evaluate the clinical effect of circumvertical mastopexy with internal shaping using inferior dermal-glandular flap for correction of breast ptosis.Methods From April 2010 to November 2017,33 cases of breast ptosis were treated in our department.The patients required nipple elevation of 3-6 cm and had unpleasing result after circumareolar mastopexy were treated with the technique of circumvertical lift with breast suspension and internal shaping with inferior dermal-glandular flap which pedicle was on the inframammary crease and tack technique for removing excessive skin precisely.Results 33 cases had their drainage tubes removed at the 2～3 days and suture removed at the 12～14 days postoperatively.All had primary healing of incision and no complications such as necrosis of NAC and dehiscence of incision occurred.Elastic bra was asked to wear for three to six months and then stable shape was achieved.Follow-up lasted for 6-60 months.All cases were satisfied with their new breast shape.Conclusions Circumvertical mastopexy with internal shaping using inferior dermal-glandular flap is a simple and effective method with relatively short scar and good shape for correction of the medium grade breast ptosis.

Objective:To investigate the application value and clinical effect of tissue expansion in post-mastectomy breast reconstruction.Methods:From January 2013 to May 2019, 173 patients (38.2±8.0 years old) with body mass index (BMI) of (21.5±2.1) kg/m 2 were treated in Peking University Third Hospital. There were 76 cases on the right side and 97 cases on the left side; 8 cases underwent nipple sparing mastectomy, and 165 cases underwent modified radical mastectomy; 150 cases received chemotherapy and 9 cases received radiotherapy. In the first stage, immediate or delayed chest wall soft tissue expansion was performed. In the second stage, implant replacement, autologous tissue transplantation, or the combination of these two methods was performed to complete the breast reconstruction. All patients were followed up and the clinical effect was evaluated by Harris evaluation method. Results:Among 173 cases, 95 cases were provided immediate reconstruction, and 78 cases were applied delayed reconstruction. The period of tissue expansion was (7.7±3.2) months. During the second stage of reconstruction, implant exchange was conducted in 105 cases, 48 cases received implant exchange with autologous fat injection, 17 cases were performed implant exchange with endoscopy-assisted latissimus dorsi muscle transfer, and 3 cases were applied deep inferior epigastric perforator flap (DIEP) transplantation. The average follow-up time was 12.6 months (3.5-41.0 months). One patient had local tumor recurrence, and the implant was finally removed. The reconstruction effects were evaluated by Harris method, which showed that 23 cases had excellent appearance, 129 cases were good, 13 cases were fair, 7 cases were poor, and 88.4% (152/172) patients were good or above.Conclusions:Tissue expansion plays an important role as a transfer station in post-mastectomy breast reconstruction. In the second stage, the breast reconstruction method can be flexibly selected. Tissue expansion has a wide range of indications, and is especially suitable for immediate post-mastectomy breast reconstruction. Good result can be obtained by using this technique.

Objective:To investigate the application value and clinical effect of tissue expansion in post-mastectomy breast reconstruction.Methods:From January 2013 to May 2019, 173 patients (38.2±8.0 years old) with body mass index (BMI) of (21.5±2.1) kg/m 2 were treated in Peking University Third Hospital. There were 76 cases on the right side and 97 cases on the left side; 8 cases underwent nipple sparing mastectomy, and 165 cases underwent modified radical mastectomy; 150 cases received chemotherapy and 9 cases received radiotherapy. In the first stage, immediate or delayed chest wall soft tissue expansion was performed. In the second stage, implant replacement, autologous tissue transplantation, or the combination of these two methods was performed to complete the breast reconstruction. All patients were followed up and the clinical effect was evaluated by Harris evaluation method. Results:Among 173 cases, 95 cases were provided immediate reconstruction, and 78 cases were applied delayed reconstruction. The period of tissue expansion was (7.7±3.2) months. During the second stage of reconstruction, implant exchange was conducted in 105 cases, 48 cases received implant exchange with autologous fat injection, 17 cases were performed implant exchange with endoscopy-assisted latissimus dorsi muscle transfer, and 3 cases were applied deep inferior epigastric perforator flap (DIEP) transplantation. The average follow-up time was 12.6 months (3.5-41.0 months). One patient had local tumor recurrence, and the implant was finally removed. The reconstruction effects were evaluated by Harris method, which showed that 23 cases had excellent appearance, 129 cases were good, 13 cases were fair, 7 cases were poor, and 88.4% (152/172) patients were good or above.Conclusions:Tissue expansion plays an important role as a transfer station in post-mastectomy breast reconstruction. In the second stage, the breast reconstruction method can be flexibly selected. Tissue expansion has a wide range of indications, and is especially suitable for immediate post-mastectomy breast reconstruction. Good result can be obtained by using this technique.