Objective:To compare the clinical effects of the two design schemes of heart-shaped incision and "Mercedes-Benz incision" (three-leaf method) in umbilicoplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent umbilicoplasty during abdominoplasty admitted to the Body Contouring & Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from November 2019 to September 2022. During the umbilicalplasty operation, different patients were treated with either a heart-shaped incision or a "Mercedes-Benz incision" three-flap method. The umbilical cord for infection, hematoma and other complications were observed after surgery; a 5-point Likert scale was used to evaluate the aesthetic effect of the new umbilicus 6 months after surgery(3-15 points, the higher the score, the better the aesthetic effect); the Vancouver scar scale (VSS) was used to score the scar condition 6 months after surgery (0-18 points, the higher the score, the better the scar condition). Postoperatively, patients were surveyed on umbilical shape satisfaction, which was divided into three levels: dissatisfied, relatively satisfied, and very satisfied. Normally distributed measurement data were expressed as Mean±SD, and independent samples t-test was used for comparison between two groups. P<0.05 was considered as a statistically significant difference. Results:A total of 35 patients were enrolled, all of whom were female. Among them, 19 cases underwent heart-shaped incision, and 16 cases underwent umbilicoplasty using "Mercedes-Benz incision". The ages of the two groups were (32.3±2.7) years old and (33.7±2.3) years old respectively. At the 6-month follow-up after surgery, the total aesthetic effect score of the umbilical cord in the heart-shaped incision group was higher than that in the "Mercedes-Benz incision" group [(13.3±0.7) points vs. (12.7±0.5) points, P<0.05]. The VSS score of the heart-shaped incision group was lower than that of the "Mercedes-Benz incision" group [(2.6±0.8) points vs. (3.4±0.9) points, P<0.05]. The results of the satisfaction survey after umbilicoplasty showed that in the heart-shaped incision group, 3 cases were relatively satisfied and 16 cases were very satisfied; in the "Mercedes-Benz incision" group, 2 cases were relatively satisfied and 14 cases were very satisfied. Conclusion:Compared with the classic "Mercedes-Benz incision", the heart-shaped incision design can obtain a better-shaped, more natural new umbilicus and a more invisible scar after umbilicoplasty.

Objective:To compare the clinical effects of the two design schemes of heart-shaped incision and "Mercedes-Benz incision" (three-leaf method) in umbilicoplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent umbilicoplasty during abdominoplasty admitted to the Body Contouring & Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from November 2019 to September 2022. During the umbilicalplasty operation, different patients were treated with either a heart-shaped incision or a "Mercedes-Benz incision" three-flap method. The umbilical cord for infection, hematoma and other complications were observed after surgery; a 5-point Likert scale was used to evaluate the aesthetic effect of the new umbilicus 6 months after surgery(3-15 points, the higher the score, the better the aesthetic effect); the Vancouver scar scale (VSS) was used to score the scar condition 6 months after surgery (0-18 points, the higher the score, the better the scar condition). Postoperatively, patients were surveyed on umbilical shape satisfaction, which was divided into three levels: dissatisfied, relatively satisfied, and very satisfied. Normally distributed measurement data were expressed as Mean±SD, and independent samples t-test was used for comparison between two groups. P<0.05 was considered as a statistically significant difference. Results:A total of 35 patients were enrolled, all of whom were female. Among them, 19 cases underwent heart-shaped incision, and 16 cases underwent umbilicoplasty using "Mercedes-Benz incision". The ages of the two groups were (32.3±2.7) years old and (33.7±2.3) years old respectively. At the 6-month follow-up after surgery, the total aesthetic effect score of the umbilical cord in the heart-shaped incision group was higher than that in the "Mercedes-Benz incision" group [(13.3±0.7) points vs. (12.7±0.5) points, P<0.05]. The VSS score of the heart-shaped incision group was lower than that of the "Mercedes-Benz incision" group [(2.6±0.8) points vs. (3.4±0.9) points, P<0.05]. The results of the satisfaction survey after umbilicoplasty showed that in the heart-shaped incision group, 3 cases were relatively satisfied and 16 cases were very satisfied; in the "Mercedes-Benz incision" group, 2 cases were relatively satisfied and 14 cases were very satisfied. Conclusion:Compared with the classic "Mercedes-Benz incision", the heart-shaped incision design can obtain a better-shaped, more natural new umbilicus and a more invisible scar after umbilicoplasty.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

Objective:To evaluate the clinical efficacy of microfat on neck wrinkles and its structure and viability.Methods:A retrospective analysis was conducted to review the clinical data of 23 patients with neck wrinkles corrected by microfat injection from June 2018 to June 2021 at the Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, aged (38.1±10.7) years old. A blunt cannula with multiple side holes of 0.8 mm was used to obtain fat particles under low negative pressure and to prepare the microfat by washing and soft centrifugation. A 26-gauge sharp needle was used to inject microfat with small amount and at multiple points into the intradermal and subdermal layer where the neck lines were linearly depressed. Regular follow-ups were carried out after the operation, and the efficacy of the operation was evaluated from routine neck examinations, third-party doctor′s grade scoring and patient′s scoring towards satisfaction. To clarify the structure and viability of microfat, scanning electron microscope was used to observe the structure of fat particles, Calcein-AM/propidium iodide (Calcein-AM/PI) staining to detect tissue viability and Musecell counting to count SVF cells.Results:All of the 23 patients successfully completed the operation without complications such as infection and fat liquefaction. After a follow-up of 3 to 30 months, the neck wrinkles were effectively improved. The postoperative grade scores of third-party doctor was significantly reduced ( P<0.05). And the satisfaction of patients was high, with 20 cases (87.0%) satisfied. Scanning electron microscopy showed that the fat granule cells were tightly arranged and the structure remained intact. Calcein-AM/PI staining showed that most cells in the granules survived. The number of viable SVF cells in fat particles was (9.34±2.68)×10 5/ml. Conclusions:Microfat is easy to obtain with high tissue activity, which is suitable for neck wrinkle filling. Good effects can be achieved with high patients′ satisfaction. It is worthy of clinical application.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

Autologous fat grafting has been proved to be effective for both total and adjunctive breast reconstruction, but oncologic safety for breast reconstruction after breast cancer surgery has always been a focus of attention. This review revisted the relevant studies and discussed the risk of breast cancer recurrence after autologous fat grafting on the conditions of different types of breast cancer surgery, timing of autologous fat grafting, pathological classification and various medical treatment. It turned out that autologous fat grafting does not increase the recurrence of breast cancer.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

Autologous fat grafting has been proved to be effective for both total and adjunctive breast reconstruction, but oncologic safety for breast reconstruction after breast cancer surgery has always been a focus of attention. This review revisted the relevant studies and discussed the risk of breast cancer recurrence after autologous fat grafting on the conditions of different types of breast cancer surgery, timing of autologous fat grafting, pathological classification and various medical treatment. It turned out that autologous fat grafting does not increase the recurrence of breast cancer.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

June 5, 2019, a 36-year-old female was diagnosed with septic shock caused by Streptococcus dysgalactiae infection eight hours after liposuction and fat grafting in Plastic Surgery Hospital, Chinese Academy of Medical Sciences. As the symptoms were identified early, the patient received immediate treatment and was transferred to Peking Union Medical College Hospital. After multi-disciplinary coordination of departments of emergency, plastic surgery, and ICU, the septic status was finally resolved and the patient was discharged after a 103-day hospital stay. The authors reviewed the course of the treatment in detail and our experience in dealing with the special kind of toxic septic shock.