Objective:To investigate the clinical efficacy of autologous costal cartilage rhinoplasty combined with costal cartilage block grafting to the alar base in the correction of saddle nose deformity with alar-columellar base depression.Methods:A retrospective analysis was performed on patients who underwent autologous costal cartilage rhinoplasty combined with alar base augmentation at the Department of Plastic Surgery, Zhejiang Provincial People’s Hospital, from January 2022 to December 2023. All patients presented with alar-columellar base depression combined with saddle nose deformity. Through bilateral marginal incisions of the lower lateral cartilage and an inverted V-shaped columellar incision, the 6th costal cartilage near the sternal end was harvested and sculpted into two alar base grafts, one columellar strut graft in an inverted V shape, two septal extension grafts, and one cap graft. On the basis of block costal cartilage grafting to the alar base, a nasal tip support framework and septal extension graft were constructed, combined with implantation of an expanded polytetrafluoroethylene (ePTFE) prosthesis, to correct the aesthetic defects of saddle nose with alar-columellar base depression. Postoperative complications and recovery were recorded. Standardized pre- and 6-month postoperative photographs were analyzed using Adobe Photoshop and Image J to measure nasal base elevation, nasolabial angle, nasofrontal angle, nasal tip angle, nasal tip projection-to-length ratio, and columella-lobule angle. Patient satisfaction was evaluated preoperatively and at 6 months postoperatively using the visual analogue scale (VAS, 0-10 points; higher scores indicate greater satisfaction) and the rhinoplasty outcome evaluation (ROE) questionnaire (total score 0-24; higher scores indicate greater satisfaction). Paired t-tests were used for statistical analysis, with P<0.05 considered statistically significant. Results:A total of 48 patients were enrolled, including 3 males and 45 females, aged from 19 to 37 years (27.3±5.9 years). The postoperative follow-up period ranged from 6 to 12 months. No infections, hemorrhage, or other complications occurred. Swelling subsided substantially within 4-5 weeks postoperatively, and no significant nasal airway obstruction, sensory abnormalities, or olfactory disturbances were observed. Patients were satisfied with their postoperative appearance and outcomes. At 6 months postoperatively, the nasal base elevation was increased compared with preoperative measurements (6.08 ± 0.85) mm. Compared with preoperative values, significant improvements were observed at 6 months postoperatively in nasolabial angle (84.69° ± 4.24° vs. 96.81° ± 5.80°), nasofrontal angle (143.91° ± 3.91° vs. 136.24° ± 2.66°), nasal tip angle (84.13° ± 5.25° vs. 78.20° ± 5.40°), nasal tip projection-to-length ratio (0.45 ± 0.05 vs. 0.53 ± 0.07), columella-lobule angle (49.22° ± 5.29° vs. 44.25° ± 3.52°), VAS score (4.69 ± 0.90 vs. 8.45 ± 0.80), and ROE score (11.99 ± 1.47 vs. 21.50 ± 1.31) (all P<0.05). Conclusion:Autologous costal cartilage rhinoplasty combined with costal cartilage block grafting to the alar base can effectively correct saddle nose deformity with alar-columellar base depression, achieving comprehensive improvement in midfacial aesthetics.

Objective:To explore the accuracy of a self-made color chart to calculate the amount of blood in the liposuction fluid of patients undergoing liposuction surgery.Methods:A retrospective study was conducted on 60 female patients with a median age of 33 (20-50) years who underwent liposuction surgery at Baiyu Medical Beauty Hospital in Milan, Sichuan from December 2022 to December 2023. The self-made color chart consisted of continuous color photos of liposuction bottles contained different amounts of blood, included continuous color charts with fat to water ratios of 3∶1, 2∶1 and 1∶1. The above chart was used to detect the liposuction solution in 60 clinical liposuction patients and to calculate the blood content. At the same time, the above specimens underwent laboratory testing for red blood cell counting. The differences and correlations were compared between two methods for detecting the amount of blood in liposuction solution.Results:The results showed that the blood content of the liposuction solution was (44.3±15.2), (46.9±20.6), (42.9±19.2) ml based on the color chart with a ratio of 3∶1, 2∶1 and 1∶1, respectively. The red blood cell count laboratory test results were (53.6±15.3), (55.2±20.7), (53.5±18.1) ml, respectively, and the differences were statistically significant (all P<0.05). The results of the two methods showed a linear positive correlation ( Y=1.1 X+5.6, R2=0.989, P<0.01). Conclusion:A self-made color chart can be used to quickly and accurately calculate the blood content in liposuction solution.

Objective:To investigate the clinical efficacy of autologous costal cartilage rhinoplasty combined with costal cartilage block grafting to the alar base in the correction of saddle nose deformity with alar-columellar base depression.Methods:A retrospective analysis was performed on patients who underwent autologous costal cartilage rhinoplasty combined with alar base augmentation at the Department of Plastic Surgery, Zhejiang Provincial People’s Hospital, from January 2022 to December 2023. All patients presented with alar-columellar base depression combined with saddle nose deformity. Through bilateral marginal incisions of the lower lateral cartilage and an inverted V-shaped columellar incision, the 6th costal cartilage near the sternal end was harvested and sculpted into two alar base grafts, one columellar strut graft in an inverted V shape, two septal extension grafts, and one cap graft. On the basis of block costal cartilage grafting to the alar base, a nasal tip support framework and septal extension graft were constructed, combined with implantation of an expanded polytetrafluoroethylene (ePTFE) prosthesis, to correct the aesthetic defects of saddle nose with alar-columellar base depression. Postoperative complications and recovery were recorded. Standardized pre- and 6-month postoperative photographs were analyzed using Adobe Photoshop and Image J to measure nasal base elevation, nasolabial angle, nasofrontal angle, nasal tip angle, nasal tip projection-to-length ratio, and columella-lobule angle. Patient satisfaction was evaluated preoperatively and at 6 months postoperatively using the visual analogue scale (VAS, 0-10 points; higher scores indicate greater satisfaction) and the rhinoplasty outcome evaluation (ROE) questionnaire (total score 0-24; higher scores indicate greater satisfaction). Paired t-tests were used for statistical analysis, with P<0.05 considered statistically significant. Results:A total of 48 patients were enrolled, including 3 males and 45 females, aged from 19 to 37 years (27.3±5.9 years). The postoperative follow-up period ranged from 6 to 12 months. No infections, hemorrhage, or other complications occurred. Swelling subsided substantially within 4-5 weeks postoperatively, and no significant nasal airway obstruction, sensory abnormalities, or olfactory disturbances were observed. Patients were satisfied with their postoperative appearance and outcomes. At 6 months postoperatively, the nasal base elevation was increased compared with preoperative measurements (6.08 ± 0.85) mm. Compared with preoperative values, significant improvements were observed at 6 months postoperatively in nasolabial angle (84.69° ± 4.24° vs. 96.81° ± 5.80°), nasofrontal angle (143.91° ± 3.91° vs. 136.24° ± 2.66°), nasal tip angle (84.13° ± 5.25° vs. 78.20° ± 5.40°), nasal tip projection-to-length ratio (0.45 ± 0.05 vs. 0.53 ± 0.07), columella-lobule angle (49.22° ± 5.29° vs. 44.25° ± 3.52°), VAS score (4.69 ± 0.90 vs. 8.45 ± 0.80), and ROE score (11.99 ± 1.47 vs. 21.50 ± 1.31) (all P<0.05). Conclusion:Autologous costal cartilage rhinoplasty combined with costal cartilage block grafting to the alar base can effectively correct saddle nose deformity with alar-columellar base depression, achieving comprehensive improvement in midfacial aesthetics.

Objective:To explore the accuracy of a self-made color chart to calculate the amount of blood in the liposuction fluid of patients undergoing liposuction surgery.Methods:A retrospective study was conducted on 60 female patients with a median age of 33 (20-50) years who underwent liposuction surgery at Baiyu Medical Beauty Hospital in Milan, Sichuan from December 2022 to December 2023. The self-made color chart consisted of continuous color photos of liposuction bottles contained different amounts of blood, included continuous color charts with fat to water ratios of 3∶1, 2∶1 and 1∶1. The above chart was used to detect the liposuction solution in 60 clinical liposuction patients and to calculate the blood content. At the same time, the above specimens underwent laboratory testing for red blood cell counting. The differences and correlations were compared between two methods for detecting the amount of blood in liposuction solution.Results:The results showed that the blood content of the liposuction solution was (44.3±15.2), (46.9±20.6), (42.9±19.2) ml based on the color chart with a ratio of 3∶1, 2∶1 and 1∶1, respectively. The red blood cell count laboratory test results were (53.6±15.3), (55.2±20.7), (53.5±18.1) ml, respectively, and the differences were statistically significant (all P<0.05). The results of the two methods showed a linear positive correlation ( Y=1.1 X+5.6, R2=0.989, P<0.01). Conclusion:A self-made color chart can be used to quickly and accurately calculate the blood content in liposuction solution.

Objective:To explore the benefit finding and influencing factors of primary caregivers of children with cerebral palsy.Methods:This study adopted the method of random sampling, 158 primary caregivers of children with cerebral palsy in the outpatient and inpatient wards of the Children′s Rehabilitation Department of the Second Affiliated Hospital of Wenzhou Medical University from November 2020 to January 2021 were selected as the research objects. The basic data questionnaire, Chinese version of benefit finding scale, simple coping style questionnaire and perceived social support scale were used to do investigation. The influencing factors of benefit finding of main caregivers of children with cerebral palsy were investigated by single factor analysis, Pearson correlation analysis and multiple linear regression analysis.Results:The score of benefit finding of the main caregivers of children with cerebral palsy was (62.4±7.0),which was above the middle level. The years of diagnosis, the payment method of medical expenses, the place of residence and the length of caring for children had a significant impact on the benefit finding of the main caregivers of children with cerebral palsy ( F=3.45, 3.75, 3.97, 6.60, all P<0.05). The main caregivers′ sense of benefit finding was positively correlated with positive coping style, family support, friend support, others′ support and perceived social support ( r=0.43, 0.20, 0.32, 0.24, 0.30, all P<0.05), and negatively correlated with negative coping style ( r=-0.36, P<0.01).The importance of those factors influencing the benefit finding of the main caregivers of children with cerebral palsy was as follows: positive coping style, place of residence and length of caring for children (standardized regression coefficients were 0.33, 0.22, -0.32, all P<0.05). Conclusions:The main caregivers of children with cerebral palsy have a good sense of benefit finding. The main factors affecting the benefit finding of the main caregivers are the children′s residence, the length of care and coping style.

Objective:To investigate the clinical effect of "mutual support" framework in costal cartilage rhinoplasty.Methods:From June 2020 to December 2021, the patients were enrolled and undergone rhinoplasty with bilateral lower lateral cartilage margin incision combined with nasal columnar incision in the Department of Plastic & Reconstructive Surgery of Zhejiang Provincial People’s Hospital. During the operation, the sixth costal cartilage was made into the nasal columella support graft(strut) and the nasal tip graft integrated scaffold, and the septal extension grafts (SEG). The strut and SEG were sutured in the same plane to construct the framework to correct the aesthetic defects of the nose. Abode Photoshop CS 6.0 was used to measure a series of aesthetics index before and 6 months after surgery, including nasofrontal angle, nasorostral angle, nasolabial angle, columella lobular angle, ratio of tip projection to the length of the nose and ratio of the length of the infratip lobule to the length of the nasal columella to evaluate the surgical effect. Visual analogue scale (VAS) and rhinoplasty outcome evaluation (ROE) were used to investigate the patients’ satisfaction. Paired t-test was used for data analysis and P<0.05 was considered statistically significant. Results:A total of 53 patients were enrolled, including 4 males and 49 females, aged from 18 to 45 years (average age: 25.6 years). Forty-nine cases were primary rhinoplasty and 4 cases were secondary rhinoplasty. No short-term complications including hemorrhage and infection occurred in 53 patients. All patients were followed up for 6-12 months. There were statistically significant differences in nasofrontal angle, nasorostral angle, nasolabial angle, columella lobular angle, ratio of tip projection to the length of the nose and ratio of the length of the infratip lobule to the length of the nasal columella( P<0.01), which sugguested that aesthetic defects of the nose were corrected and no obvious deflection and rotation of nasal tip occured. VAS score and ROE score postoperatively were 7.6±0.4 and 21.3±2.1, respectively, which were significantly higher than preoperatively( 6.1±0.5, 10.5±1.6)( P< 0.01). Postoperative satisfaction survey showed that swelling disappeared within 4-6 weeks after surgery, and no obvious ventilatory disorder, paresthesia and hyposmia symptoms occurred. Most patients were satisfied with the aesthetic and functional results. Conclusions:The "mutual support" framework in costal cartilage rhinoplasty can reduce the risk of framework deflection and nasal tip rotation and obtain satisfactory nasal columella shape.

Objective:To investigate the clinical effect of "mutual support" framework in costal cartilage rhinoplasty.Methods:From June 2020 to December 2021, the patients were enrolled and undergone rhinoplasty with bilateral lower lateral cartilage margin incision combined with nasal columnar incision in the Department of Plastic & Reconstructive Surgery of Zhejiang Provincial People’s Hospital. During the operation, the sixth costal cartilage was made into the nasal columella support graft(strut) and the nasal tip graft integrated scaffold, and the septal extension grafts (SEG). The strut and SEG were sutured in the same plane to construct the framework to correct the aesthetic defects of the nose. Abode Photoshop CS 6.0 was used to measure a series of aesthetics index before and 6 months after surgery, including nasofrontal angle, nasorostral angle, nasolabial angle, columella lobular angle, ratio of tip projection to the length of the nose and ratio of the length of the infratip lobule to the length of the nasal columella to evaluate the surgical effect. Visual analogue scale (VAS) and rhinoplasty outcome evaluation (ROE) were used to investigate the patients’ satisfaction. Paired t-test was used for data analysis and P<0.05 was considered statistically significant. Results:A total of 53 patients were enrolled, including 4 males and 49 females, aged from 18 to 45 years (average age: 25.6 years). Forty-nine cases were primary rhinoplasty and 4 cases were secondary rhinoplasty. No short-term complications including hemorrhage and infection occurred in 53 patients. All patients were followed up for 6-12 months. There were statistically significant differences in nasofrontal angle, nasorostral angle, nasolabial angle, columella lobular angle, ratio of tip projection to the length of the nose and ratio of the length of the infratip lobule to the length of the nasal columella( P<0.01), which sugguested that aesthetic defects of the nose were corrected and no obvious deflection and rotation of nasal tip occured. VAS score and ROE score postoperatively were 7.6±0.4 and 21.3±2.1, respectively, which were significantly higher than preoperatively( 6.1±0.5, 10.5±1.6)( P< 0.01). Postoperative satisfaction survey showed that swelling disappeared within 4-6 weeks after surgery, and no obvious ventilatory disorder, paresthesia and hyposmia symptoms occurred. Most patients were satisfied with the aesthetic and functional results. Conclusions:The "mutual support" framework in costal cartilage rhinoplasty can reduce the risk of framework deflection and nasal tip rotation and obtain satisfactory nasal columella shape.

Objective:To figure out the structure and relevant data measurements of zygomatic ligament by cadaver anatomy and review of previous studies.Methods:From July 2018 to January 2020, the zygomatic areas of 20 Chinese frozen fresh cadaver hemifaces were dissected in the Department of Anatomy, Health Science Center of Hangzhou Normal University. Then the structures of zygomatic ligaments were shown. The characters of the ligament and the relationship with adjacent tissue were described and measured. And 16 previous studies were reviewed to get a comprehensive description about the characters of zygomatic ligaments.Results:Zygomatic ligaments were even and dense fibrous tissue structures distributed vertically between the skin and the subcutaneous tissue. Under the SMAS plane, the ligaments divided into two bundles. The origin of major bundle located beyond the origin of the zygomatic major muscle on the periosteum, and the origin of minor bundle located between the origin of the zygomatic minor and major muscle.Conclusions:The anatomy of the zygomatic ligament has a regular pattern, and its anatomical data has certain directive significance for clinical application.

Objective:Facial artery is the main blood supply source of facial soft tissue, which has an important influence on facial plastic surgery and injection procedures. There are many types of facial arteries. They have wide coverage, and travel several layers. In this study, the detailed characteristics of the facial arteries were revealed by cadaver dissection.Methods:In 19 donated fresh cranial (28 sides) specimens, the facial arteries were dissected. And then the type, layer, relationship with nasolabial groove, length, diameter, distance from the oral commissure, branches and submental artery were observed and measured.Results:Facial arteries were found in all cadavers, starting from the external carotid arteries, branching submental arteries below the mandibular margins, ascending to the anterior edge of the masseter muscles, crossing the mandibles and entering the faces. After entering into the faces, the facial arteries branched the submental arteries(100%, 28/28), lower labial arteries (100%, 28/28), upper labial arteries (100%, 28/28), lateral nasal arteries (92.9%, 26/28) and the angular arteries (57.2%, 16/28) throughout the courses. According to the vascular route, the facial artery was classified into four types. In TypesⅠ(8 sides), all branches were included and the angular arteries arose directly from the lower segment of the facial arteries (28.6%). In TypesⅡ(8 sides), all branches were included and the angular arteries were the terminal branches (28.6%). In TypesⅢ(10 sides), angular arteries were absent (35.7%). In Type Ⅳ (2 sides), angular arteries and lateral nasal arteries were absent (7.1%). The lower segment of facial artery coursed under the facial expression muscles, and continued to the middle segment at the point which was (26.0±5.0) mm away from the oral commissure on the lateral side. The layer that the facial artery coursed was varied. It passed through the superficial layer of the facial expression muscles. After passing the horizontal line parallel to the lower margin of nasal sill, the upper segment continued to on the superficial layer of the facial expression muscles. The facial arteries were mostly located medial to the nasolabial fold(24 sides, 85.7%) and occasionally across the nasolabial fold(4 sides, 14.3%). The lengths of the upper, middle and lower segments of facial artery were (26.4±10.9) mm, (29.7±8.4) mm, and(33.5±6.9) mm, respectively. The diameters in starting point of upper, middle and lower sections were(2.45±0.48) mm, (1.85±0.12) mm, and (1.09±0.21) mm, respectively. The facial artery passed lateral to the oral commissure and the distance from the intersection of the horizontal line to the oral commissure was (26.0±5.0) mm. The starting point of the superior labial artery locacted below the horizontal line was (8.0±1.4)mm away from the horizontal line of the oral commissure and(55.0±5.2) mm from the mandibular angle. The starting point of the inferior labial artery located below the horizontal line was (17.1±11.1) mm from the horizontal line of the oral commissure, and the distance from the mandibular angle was (44.2±5.2) mm. The diameter of the submental artery in its starting point was (1.4±0.1) mm. The distance from the starting point of the submental artery to the horizontal line of the oral commissure was (34.9±2.6) mm, and the distance from the mandibular angle was (29.4±5.8) mm. The starting point of the submental artery was (6.4±0.8) mm from the lower margin of the mandible. In the midline of the mandible, the distance between the submental artery and the lower margin of the mandible was (9.0±1.0) mm. In the midsagittal plane, the starting point of the submental artery was(8.4±1.0) mm from the lower margin of the mandible.Conclusions:There were several types of facial arteries and the courses were various, but the way they branched and the layers they coursed had certain rules. Understanding the anatomy of facial arteries is helpful to keep the treatment safe.

Objective:Facial artery is the main blood supply source of facial soft tissue, which has an important influence on facial plastic surgery and injection procedures. There are many types of facial arteries. They have wide coverage, and travel several layers. In this study, the detailed characteristics of the facial arteries were revealed by cadaver dissection.Methods:In 19 donated fresh cranial (28 sides) specimens, the facial arteries were dissected. And then the type, layer, relationship with nasolabial groove, length, diameter, distance from the oral commissure, branches and submental artery were observed and measured.Results:Facial arteries were found in all cadavers, starting from the external carotid arteries, branching submental arteries below the mandibular margins, ascending to the anterior edge of the masseter muscles, crossing the mandibles and entering the faces. After entering into the faces, the facial arteries branched the submental arteries(100%, 28/28), lower labial arteries (100%, 28/28), upper labial arteries (100%, 28/28), lateral nasal arteries (92.9%, 26/28) and the angular arteries (57.2%, 16/28) throughout the courses. According to the vascular route, the facial artery was classified into four types. In TypesⅠ(8 sides), all branches were included and the angular arteries arose directly from the lower segment of the facial arteries (28.6%). In TypesⅡ(8 sides), all branches were included and the angular arteries were the terminal branches (28.6%). In TypesⅢ(10 sides), angular arteries were absent (35.7%). In Type Ⅳ (2 sides), angular arteries and lateral nasal arteries were absent (7.1%). The lower segment of facial artery coursed under the facial expression muscles, and continued to the middle segment at the point which was (26.0±5.0) mm away from the oral commissure on the lateral side. The layer that the facial artery coursed was varied. It passed through the superficial layer of the facial expression muscles. After passing the horizontal line parallel to the lower margin of nasal sill, the upper segment continued to on the superficial layer of the facial expression muscles. The facial arteries were mostly located medial to the nasolabial fold(24 sides, 85.7%) and occasionally across the nasolabial fold(4 sides, 14.3%). The lengths of the upper, middle and lower segments of facial artery were (26.4±10.9) mm, (29.7±8.4) mm, and(33.5±6.9) mm, respectively. The diameters in starting point of upper, middle and lower sections were(2.45±0.48) mm, (1.85±0.12) mm, and (1.09±0.21) mm, respectively. The facial artery passed lateral to the oral commissure and the distance from the intersection of the horizontal line to the oral commissure was (26.0±5.0) mm. The starting point of the superior labial artery locacted below the horizontal line was (8.0±1.4)mm away from the horizontal line of the oral commissure and(55.0±5.2) mm from the mandibular angle. The starting point of the inferior labial artery located below the horizontal line was (17.1±11.1) mm from the horizontal line of the oral commissure, and the distance from the mandibular angle was (44.2±5.2) mm. The diameter of the submental artery in its starting point was (1.4±0.1) mm. The distance from the starting point of the submental artery to the horizontal line of the oral commissure was (34.9±2.6) mm, and the distance from the mandibular angle was (29.4±5.8) mm. The starting point of the submental artery was (6.4±0.8) mm from the lower margin of the mandible. In the midline of the mandible, the distance between the submental artery and the lower margin of the mandible was (9.0±1.0) mm. In the midsagittal plane, the starting point of the submental artery was(8.4±1.0) mm from the lower margin of the mandible.Conclusions:There were several types of facial arteries and the courses were various, but the way they branched and the layers they coursed had certain rules. Understanding the anatomy of facial arteries is helpful to keep the treatment safe.