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Repair of the deformity of bilateral cleft lip with non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion

Zhiyu JIA ; Yunzhuan ZHAO ; Weili WANG ; Chongbin JIANG ; Pengfei QU ; Yinghuai ZHANG

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):250-252. doi:10.3760/cma.j.issn.1671-0290.2009.04.013

Objective To introduce experiences with non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion for repairing bilateral cleft lips. Methods 29 patients (20 males and 9 females) with bilateral cleft lips underwent operations of non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion. There were 15 bilateral complete cleft lips, 11 bilateral incomplete cleft lips and 3 bilateral mixed cleft lips. The deformity of white lips was reconstructed with traditional non-elongated cheiloplasty. When repairing the vermilion, the rectangular mucomuscular complex flaps which included mucous membrane of vermilion and part of orbicularis oris in double vermilion were designed, and vermilion of fore lip was incised along boundary of wet lip and dry lip. Then rectangular mucomuscular complex flaps of double vermilion were rotated downward and inward to be sewn with fore lip. At the step, the end of orbicularis otis should be sewn widely and fitly in order to form a normal annular structure. Results The wounds of all the patients were healed at one stage. The height and width of patients' upper lips were proper and the center tubercles of the upper lips were obvious. No whistling deformity appeared. Conclusion The method for repairing bilateral cleft lips is simple and reliable. Less tissues could be excised and the satisfactory form and function of nose and lip could be achieved. It is worthy to be applied in clinical practice.

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Combined plastic surgery for inferior facial enlargement

Wenlin YU ; Dong ZENG ; Qin LI ; Yongbo LIU

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):247-249. doi:10.3760/cma.j.issn.1671-0290.2009.04.012

Objective To study the convenient, safe and effective surgical intervention methods for correcting prominent wide lower face. Methods According to the wideness of mandibular angles, single or combined surgical treatments were performed by an intraoral approach under nerve block and local infiltration anesthesia, such as grinding mandibular angles, curved osteotomy of the angles and osteotomy of ascending ramus outer layer, partial masseter muscle resection, partial buccal fat pad removal and liposuction of cheek to reconstruct the whole lower face contour. Resnlts In the 71 cases followed up for 4 to 24 months, 60 cases were excellent, 9 were acceptable and 2 were unsatisfactory. The total satisfactory rate was 97 %. Conclusion According to the characteristics of prominent wide lower face, single or combined surgical treatments are performed to reconstruct the bone and soft tissue of lower face. This operative method is simple, safe and consistent with cosmetic surgery principle with little complications.

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Curved osteotomy combined with sagittal splitting osteotomy of mandibular angle by an intraoral approach for treatment of broad lower face

Guoping WU ; Xiaochuan HE ; Xiaoli JIANG ; Yuegang LI ; Delin XIA ; Li GUO

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):244-246. doi:10.3760/cma.j.issn.1671-0290.2009.04.011

Objective Several surgical procedures are available for treatment the prominent mandibular angle. But in some patients, only one procedure is not likely to obtain satisfactory results. This study was to evaluate the effect of curved osteotomy combined with sagittal splitting osteotomy of the mandibular angle by an intraoral approach for treatment the broad lower face. Methods 21 patients with broad lower face were treated with mandibular angle osteotomy plus mandibular angle splitting osteotomy under general aesthesia by intraoral approach. Changes of the distance between the mandibular angles were observed during follow up phase. Questionnaires were used to assess the patents level of satisfaction after operation. Results All the wounds healed without complications of bleeding and infection. After 7 months to 12 months follow up, the distance between the mandibular angles was effectively reduced, the deformity of broad lower face were improved markedly, the curve of the mandibular angle was smooth and the shape was natural. Conclusion This method is worthy to be applied widely because of the good result with effective reduction of the width of the lower face, smooth and gentle outline of the face.

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Rectification of inverted nipple by double buried purse-ring suture

Weitai JIANG ; Boxi JIANG ; Zhengzheng JIANG

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):232-233. doi:10.3760/cma.j.issn.1671-0290.2009.04.006

Objective To introduce a simple, effective and less wounded approach to rectify an inverted nipple. Methods Patients lian down in a horizontal position, two circles were drawm in diameters of 2.5 cm and 3.5 cm, respectively, in the centre of nipple. Routine disinfection and local anaesthesia were performed, a small incision in 0.3 cm was cut around inner and outer circular arc each, and then # 4 and # 7 threads were buried, respectively, under inner and outer cycles of skin. The inverted nipple was lifted by crossing those two threads, tying # 4 and # 7 thread (not so strong), and finally incisions were sewn by 5.0 thread. 7 days later, stitches were removed but no extrusion done within 3 months after surgery. Results Lactation was normal, and nipple and mammary areola were satisfied by patients. Conclusion The main cause of inverted nipple is imbalance growth for nipple and mammary areola muscle, and lack of tissue to support under nipple. Using double buried purse-ring suture, it is not only strong the nipple root, and block the gap when nipple is retracting, but also make nipple be beautiful and does not affect lactation. It is an easy and useful operation, with less damage to normal tissues and quick recovery.

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Diagnosis and treatment of breast implant rupture

Nan JIANG ; Yuanyuan HAO ; Li SHEN ; Yue WANG ; Yahong XU ; Yan ZHAO ; Hongyan ZHA

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):229-231. doi:10.3760/cma.j.issn.1671-0290.2009.04.005

Objective To study the diagnosis, treatment and prognosis of the rupture of breast implant. Methods Physical examination, X-ray fluoroscopy, high frequency and color the Doppler ultrasonography were helpful to make a clear diagnosis, in exploring and removing the fiber envelope by inframammary or periareolar incision, repairing the anatomy structure of the breasts and performing augmentation mammaplasty again. Results In 32 patients, the breast shape was basically symmetrical, most of the incisions were healed by first intention except 2 cases with complication of subcutaneous fluid collection. A satisfactory therapeautic result could be achieved by taking out the breast implant which was rupture, exploring and removing the fiber envelope, and extending the lacuna. Conclusion A satisfactory therapeautic result can be achieved by extending the lacuna.

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Clinical effects of the implantation of hydroxyapatite orbit after scleral flap

Jixin CAO ; Fengying TANG ; Wenjing LIU ; Cailing BIAN

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):242-243. doi:10.3760/cma.j.issn.1671-0290.2009.04.010

Objective To investigate the clinical outcomes on implantation of hydroxyapatite orbit after scleral flap especially in the cosmetic results. Methods Implant hydroxyapatite orbital after scleral flap for the treatment of all kinds of patients who should be enucleated, including 14 cases of eyeball atrophy, 5 cases of sclerocorneal staphyloma, 3 cases of absolute glaucoma, 3 cases of neovaseular glaucoma and 7 cases of eyeball rupture. Results We observed that the orbit was full and the orbital movement was smooth in all cases. After 3 to 12 months follow-up we found that no hydroxyapatite exposed or moved. Conclusion Good cosmetic results can be achieved by the implantation of hydroxyapatite orbit after scleral flap.

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Augmentation mammaplasty of implant prosthesis immediately after removal of polyacrylamide hydrogel

Haibin WANG ; Shengkang LUO

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):226-228. doi:10.3760/cma.j.issn.1671-0290.2009.04.004

Objective To explore the indication of implant prosthesis immediately after removing polyacrylamide hydrogel for augmentation mammaplasty. Methods MRI and pathologic examinations were made in 226 patients with the postoperative complications of augmentation mammaplasty by injecting polyacrylamide hydrogel and with the specific conditions in operation to analyze the possibility of implant prosthesis while removing polyacrylamide hydrogel. Based on MRI examination, physical examination and specific conditions in operation, we chosen 61 cases who requested for implant prosthesis while removing polyacrylamide hydrogel. Results The patients who did the operation for simply removing polyacrylamide hydrogel recovered well and symptoms such as pain, sclerosis, mass and others disappeared almostly; the patients who did implanting at the same time were satisfied with the breast shape and had no side-effect occured. Conclusion With MRI examination, physical examination and specific conditions in operation, it can achive good effects to do implanting immediately after removing polyacrylamide hydrogel for those suitable and willing to implant prosthesis.

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Isomeric M flap for facial rhombus defect

Hongtai HU ; Dong HAN ; Hao JIANG

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):240-241. doi:10.3760/cma.j.issn.1671-0290.2009.04.009

Objective To explore the possibility of repairing face rhombus defect after resection of pathological tissues on the special regions. Methods After rhombus resection of a pathological tissues on the special regions of the face, using four triangular flaps at the any sides of the defect to stagger suturing each other and to constitute peculiar "M" flap repairing defect in 26 patients (12 males and 14 females). Results The flaps were all survived. No straight line scars were seen at the repairing regions and no scars contraction for the face contour was occurred. Conclusion This is a simple and effective operation procedure that can be used for rhombus defect of the special regions of the face.

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Influencing factors of the survival rate of free autogenous pellet fat graft

Wenge LIU ; Kaiyi ZHANG ; Rong ZHANG ; Lihua LIU

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):237-239. doi:10.3760/cma.j.issn.1671-0290.2009.04.008

Objective To investigate a new technique to increase the survival rate of free autogenous pellet fat graft. Methods Many methods were used to graft free autogenous fat, and the results compared to look for the best method for it. Results After 3 and 6 months, the volume rate in the treatment group and control group were 70%, 60% and 40%, and 30%. The times of fat injection were 2 and 4 . Conclusion Some vasodilators, low negative pressure and plasma can enhance the survival rate of free autogenous pellet fat graft.

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Clinical efficacy and safety of Kecuo Yingtong gel in treatment of acne vulgaris with a detailed staging regimen

Heng CHEN ; Huoda ZHANG ; Hui YU ; Langfeng XU

Chinese Journal of Medical Aesthetics and Cosmetology.2009;15(4):223-225. doi:10.3760/cma.j.issn.1671-0290.2009.04.003

Objective To evaluate the clinical efficacy and safety of Kecuo Yingtong gel with detailed treatment regimen for ache vulgaris by phase. Methods Sixty patients with acne vulgaris of mild to the severity were randomized to receive either detail by phase group (A) or conventional group (B). Group A was treated with Kecuo Yingtong gel topically 1 to 4 times daily according to the severity of the disease. Clinical responses were recorded and photographed weekly in group A, and treatment regimens were adjusted accordingly. Group B only was treated with Kecuo Yingtong gel 2 times daily for 6 to 8 weeks. Results It was shown that cure rates were 66.7% and 36.7% in the groups A and B, respectively. There was no statistical difference between the 2 groups (P<0.05). Only few patients had stimulating symptoms, and severe adverse effects had not been observed. However, incidence of the side effects was higher in group A than group B. Conclusions Kecuo Yingtong gel has been proved to have an excellent response with detailed treatment by phase. Reasonably increasing the daily dosage could improve the cure rates. The cutaneous tolerability of the drug is generally good.

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