In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

BACKGROUND: Due to adipose-derived stem cells (ASCs) being easy to obtain, their rapid proliferation rate, and their multidirectional differentiation capabilities, they have been widely used in the field of regenerative medicine. With the progress of decellularized adipose tissue (DAT) and adipose tissue engineering research, the role of DAT in promoting angiogenesis has gradually been emphasized. METHODS: We examined the biological characteristics and biosafety of DAT and evaluated the stem cell maintenance ability and promotion of growth factor secretion through conducting in vitro and in vivo studies. RESULTS: The tested ASCs showed high rat:es of proliferation and adhered well to DAT. The expression levels of essential genes for cell stem maintenance, including OCT4, SOX2, and Nanog were low at 2–24 h and much higher at 48 and 96 h. The Adipogenic expression level of markers for ASCs proliferation including PPARγ, C/EPBα, and LPL increased from 2 to 96 h. Co-culture of ASCs and DAT increased the secretion of local growth factors, such as VEGF, PDGF-bb, bFGF, HGF, EGF, and FDGF-bb, and secretion gradually increased from 0 to 48 h. A model of full-thickness skin defects on the back of nude mice was established, and the co-culture of ASCs and DAT showed the best in vivo treatment effect. CONCLUSION The application of DAT promotes wound healing, and DAT combined with ASCs may be a promising material in adipose tissue engineering and regenerative medicine.

BACKGROUND: Due to adipose-derived stem cells (ASCs) being easy to obtain, their rapid proliferation rate, and their multidirectional differentiation capabilities, they have been widely used in the field of regenerative medicine. With the progress of decellularized adipose tissue (DAT) and adipose tissue engineering research, the role of DAT in promoting angiogenesis has gradually been emphasized. METHODS: We examined the biological characteristics and biosafety of DAT and evaluated the stem cell maintenance ability and promotion of growth factor secretion through conducting in vitro and in vivo studies. RESULTS: The tested ASCs showed high rat:es of proliferation and adhered well to DAT. The expression levels of essential genes for cell stem maintenance, including OCT4, SOX2, and Nanog were low at 2–24 h and much higher at 48 and 96 h. The Adipogenic expression level of markers for ASCs proliferation including PPARγ, C/EPBα, and LPL increased from 2 to 96 h. Co-culture of ASCs and DAT increased the secretion of local growth factors, such as VEGF, PDGF-bb, bFGF, HGF, EGF, and FDGF-bb, and secretion gradually increased from 0 to 48 h. A model of full-thickness skin defects on the back of nude mice was established, and the co-culture of ASCs and DAT showed the best in vivo treatment effect. CONCLUSION The application of DAT promotes wound healing, and DAT combined with ASCs may be a promising material in adipose tissue engineering and regenerative medicine.

Objective:To investigate the efficacy and safety of a simple three-step excision for combined reduction plastic surgery of labia minora clitoral hood complex.Methods:We selected the clinical data of patients with labia minora and clitoral prepuce hypertrophy treated in the Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, from May 2017 to November 2021. All the patients underwent composite labia minora and clitoral hood reduction using a simple three-step excision. In the first step, a longitudinal shuttle incision was designed to remove the redundant lateral prepuce of the clitoris; In the second step, the hypertrophic part of labia minora was removed by wedge resection; The third step was to trim the triangular flap formed by the excess skin at the junction of the labia minora and the clitoral hood, and then complete the incision suture. Patients were asked to return for examinations on days 1, 7, and 10 postoperatively. After that, the patients were followed up in the outpatient department or online, and the satisfaction questionnaires were conducted. The contents included appearance improvement, preoperative symptom improvement, postoperative discomfort symptoms, sexual life quality, partner’s evaluation of surgical effect, and patient’s evaluation of surgical impact.Results:A total of 295 patients were enrolled, with an average age of 29 years, ranged from 9 to 52 years old. Patients were divided into 4 categories according to the surgeries they received, including 21 patients (7.1%) with unilateral labia + unilateral prepuce hypertrophy, 12 patients (4.1%) with unilateral labia + bilateral prepuce hypertrophy, 50 patients (16.9%) with bilateral labia + unilateral prepuce and 212 patients (71.9%) with bilateral labia + bilateral prepuce hypertrophy. The incidence of complications was 3.4%(10/295), hematoma occurred in 8 cases, scar hyperplasia with obvious pain in 1 case, and blood supply disorder in 1 case. After the complementary treatments, all patients recovered well from surgeries. 219 questionnaires were obtained three months after surgeries, and 76 cases were lost to follow-up. The overall satisfaction rate of patients was 94.5%(207/219).Conclusions:The preoperative design of three-step resection is simple, which can safely and effectively carry out composite labia minora and clitoral hood reduction, with less complications, concealed incision, slight scar, and high satisfaction.

Objective:To investigate the efficacy and safety of a simple three-step excision for combined reduction plastic surgery of labia minora clitoral hood complex.Methods:We selected the clinical data of patients with labia minora and clitoral prepuce hypertrophy treated in the Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, from May 2017 to November 2021. All the patients underwent composite labia minora and clitoral hood reduction using a simple three-step excision. In the first step, a longitudinal shuttle incision was designed to remove the redundant lateral prepuce of the clitoris; In the second step, the hypertrophic part of labia minora was removed by wedge resection; The third step was to trim the triangular flap formed by the excess skin at the junction of the labia minora and the clitoral hood, and then complete the incision suture. Patients were asked to return for examinations on days 1, 7, and 10 postoperatively. After that, the patients were followed up in the outpatient department or online, and the satisfaction questionnaires were conducted. The contents included appearance improvement, preoperative symptom improvement, postoperative discomfort symptoms, sexual life quality, partner’s evaluation of surgical effect, and patient’s evaluation of surgical impact.Results:A total of 295 patients were enrolled, with an average age of 29 years, ranged from 9 to 52 years old. Patients were divided into 4 categories according to the surgeries they received, including 21 patients (7.1%) with unilateral labia + unilateral prepuce hypertrophy, 12 patients (4.1%) with unilateral labia + bilateral prepuce hypertrophy, 50 patients (16.9%) with bilateral labia + unilateral prepuce and 212 patients (71.9%) with bilateral labia + bilateral prepuce hypertrophy. The incidence of complications was 3.4%(10/295), hematoma occurred in 8 cases, scar hyperplasia with obvious pain in 1 case, and blood supply disorder in 1 case. After the complementary treatments, all patients recovered well from surgeries. 219 questionnaires were obtained three months after surgeries, and 76 cases were lost to follow-up. The overall satisfaction rate of patients was 94.5%(207/219).Conclusions:The preoperative design of three-step resection is simple, which can safely and effectively carry out composite labia minora and clitoral hood reduction, with less complications, concealed incision, slight scar, and high satisfaction.

Objective:To investigate the efficacy and safety of a simple three-step excision for combined reduction plastic surgery of labia minora clitoral hood complex.Methods:We selected the clinical data of patients with labia minora and clitoral prepuce hypertrophy treated in the Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, from May 2017 to November 2021. All the patients underwent composite labia minora and clitoral hood reduction using a simple three-step excision. In the first step, a longitudinal shuttle incision was designed to remove the redundant lateral prepuce of the clitoris; In the second step, the hypertrophic part of labia minora was removed by wedge resection; The third step was to trim the triangular flap formed by the excess skin at the junction of the labia minora and the clitoral hood, and then complete the incision suture. Patients were asked to return for examinations on days 1, 7, and 10 postoperatively. After that, the patients were followed up in the outpatient department or online, and the satisfaction questionnaires were conducted. The contents included appearance improvement, preoperative symptom improvement, postoperative discomfort symptoms, sexual life quality, partner’s evaluation of surgical effect, and patient’s evaluation of surgical impact.Results:A total of 295 patients were enrolled, with an average age of 29 years, ranged from 9 to 52 years old. Patients were divided into 4 categories according to the surgeries they received, including 21 patients (7.1%) with unilateral labia + unilateral prepuce hypertrophy, 12 patients (4.1%) with unilateral labia + bilateral prepuce hypertrophy, 50 patients (16.9%) with bilateral labia + unilateral prepuce and 212 patients (71.9%) with bilateral labia + bilateral prepuce hypertrophy. The incidence of complications was 3.4%(10/295), hematoma occurred in 8 cases, scar hyperplasia with obvious pain in 1 case, and blood supply disorder in 1 case. After the complementary treatments, all patients recovered well from surgeries. 219 questionnaires were obtained three months after surgeries, and 76 cases were lost to follow-up. The overall satisfaction rate of patients was 94.5%(207/219).Conclusions:The preoperative design of three-step resection is simple, which can safely and effectively carry out composite labia minora and clitoral hood reduction, with less complications, concealed incision, slight scar, and high satisfaction.

Objective:To investigate the efficacy and safety of a simple three-step excision for combined reduction plastic surgery of labia minora clitoral hood complex.Methods:We selected the clinical data of patients with labia minora and clitoral prepuce hypertrophy treated in the Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, from May 2017 to November 2021. All the patients underwent composite labia minora and clitoral hood reduction using a simple three-step excision. In the first step, a longitudinal shuttle incision was designed to remove the redundant lateral prepuce of the clitoris; In the second step, the hypertrophic part of labia minora was removed by wedge resection; The third step was to trim the triangular flap formed by the excess skin at the junction of the labia minora and the clitoral hood, and then complete the incision suture. Patients were asked to return for examinations on days 1, 7, and 10 postoperatively. After that, the patients were followed up in the outpatient department or online, and the satisfaction questionnaires were conducted. The contents included appearance improvement, preoperative symptom improvement, postoperative discomfort symptoms, sexual life quality, partner’s evaluation of surgical effect, and patient’s evaluation of surgical impact.Results:A total of 295 patients were enrolled, with an average age of 29 years, ranged from 9 to 52 years old. Patients were divided into 4 categories according to the surgeries they received, including 21 patients (7.1%) with unilateral labia + unilateral prepuce hypertrophy, 12 patients (4.1%) with unilateral labia + bilateral prepuce hypertrophy, 50 patients (16.9%) with bilateral labia + unilateral prepuce and 212 patients (71.9%) with bilateral labia + bilateral prepuce hypertrophy. The incidence of complications was 3.4%(10/295), hematoma occurred in 8 cases, scar hyperplasia with obvious pain in 1 case, and blood supply disorder in 1 case. After the complementary treatments, all patients recovered well from surgeries. 219 questionnaires were obtained three months after surgeries, and 76 cases were lost to follow-up. The overall satisfaction rate of patients was 94.5%(207/219).Conclusions:The preoperative design of three-step resection is simple, which can safely and effectively carry out composite labia minora and clitoral hood reduction, with less complications, concealed incision, slight scar, and high satisfaction.

Objective:To improve and optimize the modified surgical strategies for patents with Simon Ⅰ and Simon Ⅱ type of gynecomastia, based on their magnetic resonance imaging (MRI) features.Methods:Clinical data of 190 patients aged 12 to 56 years (mean age 26.7±8.6) with gynecomastia who underwent modified surgeries in the Department of Plastic Surgery of Peking Union Medical College Hospital from January 2017 to January 2023 were retrospectively analyzed. The study measured breast MRI images of 44 male patients to calculate the area ratio of the glands on the transverse plane via nipple. This provided insight into the physiological structure and the tissue distribution of gynecomastia for improving the modified surgical strategies. All 190 patients were treated with enhanced liposuction and " Pull-Through and Bottom-Up" techniques. The duration of operation, amount of liposuction and amount of glandular resection, postoperative complications were recorded, and postoperative satisfaction was investigated by questionnaire surveys.Results:MRI images of the 87-side male breast showed that the average area ratio of the glands on the transverse plane via nipple was (10.9±12.5) %. The most prevalent subtype of gynecomastia was branch pattern, accounting for 46.0%. The median surgical duration of 190 patients was 95 (65-210) minutes, the median liposuction volume was 300 (50-1 400) ml, and the median glandular removal was 19.9 (1.5-157.0) g. Eighty-eight patients (46.3%) went through followed up for more than 6 months post-posterative with an overall satisfaction score of 4.68±0.53. Postoperative complications occurred in 19 sides (5.1%), and the reoperation rate was 1.3%.Conclusions:The MRI imaging of gynecomastia shows that the component of patients′ breasts are mainly fat, with a small amount of glandular tissue and the dominant subtype is branch pattern. Enhanced liposuction combined with " Pull-Through and Bottom-Up" stab incision technique can be an effective treatment for Simon grades Ⅰ and Ⅱ gynecomastia. The method results in high patient satisfaction with fewer postoperative complications.

Objective:To evaluate the differences and aesthetic meaning of stable vitiligo treatment in the face and neck region using suction blister transplantation or noncultured autologous suspension of epidermal cells.Methods:Sixty-four stable vitiligo patients (25 males and 39 females with age ranges from 10 to 46 years, average 25 years) in the face and neck region were randomly divided into two groups (32 patients in each group): one group received suction blister transplantation, while other group received noncultured autologous suspension of epidermal cells. Patients′treatment effectiveness, pigmentation and piecing deformity were evaluated in postoperative 3 months and 6 months.Results:In the postoperative 3 months and 6 months, the effectiveness of suction blister transplantation group was 68.75% (22/32) and 90.63% (29/32), respectively, while the effectiveness of noncultured autologous suspension of epidermal cells group was 59.37% (19/32) and 87.50% (28/32), respectively, in which no significant differences were found between two groups ( P>0.05). No obvious pigmentation and piecing deformity were found in noncultured autologous suspension of epidermal cells group, which were much better than the suction blister transplantation group in postoperative 3 months and 6 months. Conclusions:Both suction blister transplantation and noncultured autologous suspension of epidermal cells could bring good treatment effectiveness for patients of stable vitiligo in the face and neck region. Compared with suction blister transplantation, noncultured autologous suspension of epidermal cells could offer better aesthetic appearance.

Objective:To summarize the clinical diagnosis and treatment process of breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) in symptomatic patients with textured breast implants in Peking Union Medical College Hospital in order to provide reference for the management of such patients in China.Methods:From January 2019 to September 2021, 23 symptomatic patients with textured breast implants were admitted to the Peking Union Medical College Hospital, aged 29-52 years, with an average of 36.2 years. All patients agreed to remove the prosthesis by surgery, and accepted cytology, flow cytometry, and immunohistochemical examination of the fluid around the implants and capsule tissue before or during the operation to complete the BIA-ALCL screening process.Results:All 23 patients presented with unilateral periprosthetic fluid accumulation, with fluid volume ranging from 20 to 130 ml, of which 7 cases were combined with periprosthetic contracture. No tumor cells were found in the pathological findings of effusion and the capsule tissue, and the BIA-ALCL pathologic screening results (CD 30 and ALK) were all negative. No bleeding, infection, wound dehiscence and other complications occurred after the operation.Conclusions:A personalized clinical process should be developed for symptomatic patients with textured breast implants. Attention should be paid to imaging and pathological examinations.