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 McGregor′s patch surface anatomy parameters and correlation with demographic characteristics.Methods:A retrospective analysis of 134 volunteers [33 males and 101 females, aged (32.9±13.4) years], screened from the hospital information system of Zhejiang Provincial People′s Hospital via a random formula in excel. All subjects were divided into young group (18-40 years) and elderly group (>40 years) according to age; thin group [body mass index (BMI) <18.5 kg/m 2], moderate group (BMI 18.5-24.0 kg/m 2), and obese group (BMI >24.0 kg/m 2) according to BMI. Subjects were photographed under the same standard circumstances, and the rate of McGregor′s patch and its correlation with demographic characteristics were analyzed. The surface anatomy parameters of the McGregor′s patch were also measured. The relationship between associated ligamentous structures and the McGregor′s patch was investigated by fine dissection. Results:The rate of McGregor′s patch was 46.3% (62/134). The rate of McGregor′s patch was 39.4% (13/33) in males and 48.5% (49/101) in females, with no statistically significant difference ( P=0.362). The prevalence of McGregor′s patch was 48.9% (45/92) in the young group and 40.5% (17/42) in the elderly group, with no statistically significant difference ( P=0.364). The prevalence of McGregor′s patch was 51.4% (19/37) in the thin group, 45.9% (34/74) in the moderate group, and 39.1% (9/23) in the obese group, with no statistically significant difference ( P=0.651). The center of the McGregor′s patch was at a distance of (5.7±0.3) cm from the point of the lateral canthal point and (5.1±0.3) cm from the tragion. A detailed autopsy revealed that the zygomatic arch ligament and the occlusal cutaneous ligament appeared at a constant level above and on the deep side of this depression, and the two ligaments had their termination points in the dermis in the area of the depression. Conclusions:The center of the McGregor's patch is（5.7±0.3）cm from lateral canthal point and（5.1±0.3）cm from the tragion. There is no correlation between the rate of McGregor's patch and age or BMI.

Aesthetic injection has become an important treatment item of plastic surgery. Botulinum toxin and dermal fillers are the two major plates of injections. It is clear that the target tissue of botulinum toxin is expression muscles, whereas there are many filling materials to choose from. According to the mechanism, filling materials can be divided into three categories: volume fillers, collagen stimulators, nutritional glossers. The selection of these materials is related to the tissue type of the injection site. This article subdivides facial soft tissues into 5 horizontal layers: skin, subcutaneous fat, superficial muscular aponeurotic system, deep tissue, periosteum or deep fascia, as well as the the vertical ligaments, which compose a three-dimensional structure. The characteristics of these tissue structures are analyzed for selection of filling materials. Particular attention should be paid to the differences between volumetric fillers and collagen stimulators, which have completely different mechanisms of action, indications, and injection technique, with the former being suitable for deep tissues that require volume supplementation, and the latter for all types of tissues that require collagen supplementation. In conclusion, there is a close logical relationship between the choice of injection material and the facial anatomy.

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 McGregor′s patch surface anatomy parameters and correlation with demographic characteristics.Methods:A retrospective analysis of 134 volunteers [33 males and 101 females, aged (32.9±13.4) years], screened from the hospital information system of Zhejiang Provincial People′s Hospital via a random formula in excel. All subjects were divided into young group (18-40 years) and elderly group (>40 years) according to age; thin group [body mass index (BMI) <18.5 kg/m 2], moderate group (BMI 18.5-24.0 kg/m 2), and obese group (BMI >24.0 kg/m 2) according to BMI. Subjects were photographed under the same standard circumstances, and the rate of McGregor′s patch and its correlation with demographic characteristics were analyzed. The surface anatomy parameters of the McGregor′s patch were also measured. The relationship between associated ligamentous structures and the McGregor′s patch was investigated by fine dissection. Results:The rate of McGregor′s patch was 46.3% (62/134). The rate of McGregor′s patch was 39.4% (13/33) in males and 48.5% (49/101) in females, with no statistically significant difference ( P=0.362). The prevalence of McGregor′s patch was 48.9% (45/92) in the young group and 40.5% (17/42) in the elderly group, with no statistically significant difference ( P=0.364). The prevalence of McGregor′s patch was 51.4% (19/37) in the thin group, 45.9% (34/74) in the moderate group, and 39.1% (9/23) in the obese group, with no statistically significant difference ( P=0.651). The center of the McGregor′s patch was at a distance of (5.7±0.3) cm from the point of the lateral canthal point and (5.1±0.3) cm from the tragion. A detailed autopsy revealed that the zygomatic arch ligament and the occlusal cutaneous ligament appeared at a constant level above and on the deep side of this depression, and the two ligaments had their termination points in the dermis in the area of the depression. Conclusions:The center of the McGregor's patch is（5.7±0.3）cm from lateral canthal point and（5.1±0.3）cm from the tragion. There is no correlation between the rate of McGregor's patch and age or BMI.

Aesthetic injection has become an important treatment item of plastic surgery. Botulinum toxin and dermal fillers are the two major plates of injections. It is clear that the target tissue of botulinum toxin is expression muscles, whereas there are many filling materials to choose from. According to the mechanism, filling materials can be divided into three categories: volume fillers, collagen stimulators, nutritional glossers. The selection of these materials is related to the tissue type of the injection site. This article subdivides facial soft tissues into 5 horizontal layers: skin, subcutaneous fat, superficial muscular aponeurotic system, deep tissue, periosteum or deep fascia, as well as the the vertical ligaments, which compose a three-dimensional structure. The characteristics of these tissue structures are analyzed for selection of filling materials. Particular attention should be paid to the differences between volumetric fillers and collagen stimulators, which have completely different mechanisms of action, indications, and injection technique, with the former being suitable for deep tissues that require volume supplementation, and the latter for all types of tissues that require collagen supplementation. In conclusion, there is a close logical relationship between the choice of injection material and the facial anatomy.

Objective:To compare the efficacy of the injection of collagen, hyaluronic acid and their combined application in the treatment of lacrimal depression.Methods:From July 2022 to January 2023, 60 female patients with lacrimal depression, aged 19-49 years with an average age of 33.6 years, were treated by injection in Xi′an Rongyao FRESKIN Medical Cosmetology Clinic. There were 20 cases in the collagen injection group, 20 cases in the hyaluronic acid injection group, and 20 cases in the combined hyaluronic acid and collagen injection group. Preoperative, immediate, 1 month and 6 months after surgery, lacrimal groove deformity rating scale score and patient satisfaction at 1 month and 6 months after surgery were evaluated.Results:One month after operation, the satisfactory rate of patients in collagen group was 90%, that of hyaluronic acid group was 80%, and that of the combined treatment group was 90%. 6 months after operation, the satisfactory rate of patients in the collagen group was 80%, that of hyaluronic acid was 80%, and that of the combined treatment group was 90%. Postoperative follow-up showed no serious complications such as infection, embolism or visual loss in the 3 groups. Pigmentation occurred in 2 cases in the hyaluronic acid group and 1 case in the collagen group. No pigmentation occurred in the combined treatment group. Overall, all the three treatment methods were effective and safe.Conclusions:All three treatment methods can be used to improve lacrimal depression without serious complications.

Objective:To investigate the anatomic mechanism and risk factors of intracranial embolism caused by injection at temporal region.Methods:(1) Latex perfusion was performed on the vessels of 8 cranial specimens. The vessels from the superficial temporal artery to the carotid artery were dissected to measure the length, the diameter of starting point and ending point and the volume of vessels (drainage method). (2) Cranial CT angiography of 20 patients (excluding patients with cervical diseases) were obtained from the database of Zhejiang Provincial People’s Hospital from January 2021 to December 2022. The length, the diameter of starting point and ending point, and the volume of vessels were measured. (3) 5 plastic surgeons used pressure simulation measuring equipment to vigorously press the temporal region of the real skull model according to the clinical practice and maintain 2 s to obtain the maximum pressure value. The additional pressure on the temporal region was obtained by subtracting the common carotid artery base pressure [set at 90, 120, 150 and 200 mmHg (1 mmHg = 0.133 kPa)] from the maximum pressure.Results:(1) 8 arteries were collected from 4 skull specimens. The length of vessels was (169.5±7.2) mm, the diameter of the starting point of vessel was (4.29±0.28) mm, the diameter of the ending point of vessel was (1.31±0.15) mm, and the volume was (1.56±0.21) ml. (2) There were 11 males and 9 females among 20 patients aged 23-53 years. The length of vessels was (172.2±7.6) mm, the diameter of the starting point of vessel was (5.63±0.43) mm, the diameter of the ending point of vessel was (1.77±0.16) mm, and the volume was (1.59±0.23) ml. (3) The mean value of additional pressure generated by local pressure on the temporal region by 5 physicians was (127.2±10.1) mmHg (113.8-138.6 mmHg).Conclusion:When the injection volume into the superficial temporal artery was more than 1.6 ml, the artery was damaged, and the temporal area was pressed strongly (the local pressure was more than 110 mmHg above the basic pressure), the injection material might flow into the intracranial from the junction of the common carotid artery and into the internal carotid artery, which was the possible mechanism of the temporal filling leading to intracranial embolism.