1.A comparative study of clinical outcomes between heart-shaped incision and "Mercedes-Benz incision" designs in umbilicoplasty
Sainan WU ; Ji JIN ; Facheng LI
Chinese Journal of Plastic Surgery 2024;40(6):621-625
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.
2.A comparative study of clinical outcomes between heart-shaped incision and "Mercedes-Benz incision" designs in umbilicoplasty
Sainan WU ; Ji JIN ; Facheng LI
Chinese Journal of Plastic Surgery 2024;40(6):621-625
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.
3.Clinical application of microfat in improving neck wrinkles and its biological characteristics
Yuanjing CHEN ; Zhibin YANG ; Yimeng CHAI ; Xuefeng HAN ; Facheng LI
Chinese Journal of Medical Aesthetics and Cosmetology 2023;29(5):369-372
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.
4.Research progress on the mechanism of macrophages in autologous fat transplantation
Chinese Journal of Plastic Surgery 2023;39(1):101-106
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.
5.Research progress on the mechanism of macrophages in autologous fat transplantation
Chinese Journal of Plastic Surgery 2023;39(1):101-106
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.
6.Advances in oncologic safety of autologous fat grafting for breast reconstruction after breast cancer surgery
Chinese Journal of Plastic Surgery 2022;38(3):349-354
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.
7.Research progress on the mechanism of macrophages in autologous fat transplantation
Chinese Journal of Plastic Surgery 2022;38(8):902-907
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.
8.Advances in oncologic safety of autologous fat grafting for breast reconstruction after breast cancer surgery
Chinese Journal of Plastic Surgery 2022;38(3):349-354
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.
9.Research progress on the mechanism of macrophages in autologous fat transplantation
Chinese Journal of Plastic Surgery 2022;38(8):902-907
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.
10.Effects of Enterococcus faecalis supernatants on inflammatory responses of human periodontal ligament cells under pressure
Lei MENG ; Xue LIU ; Lei ZHANG ; Facheng WANG ; Liping YAO ; Xiaoning LI ; Yao LU ; Zhishan LU
Chinese Journal of Stomatology 2021;56(4):335-341
Objective:To study the effect of various concentrations of Enterococcus faecalis (Ef) supernatants on human periodontal ligament cell (hPDLC) and the inflammatory response of hPDLC under static pressure. Methods:The method of methyl thiazolyl tetrazolium (MTT) was used to detect the effect of various concentrations of Ef supernatants on the proliferation of hPDLCs and the flow cytometry was used to detect the expression of Toll-like receptor 2 (TLR-2) on the surface of hPDLC after 24-hour-stimulation of Ef supernatant. Furthermore, the hPDLCs were divided into non inducing group without Ef supernatant and inducing group with 5% Ef supernatant, and hPDLCs in each group were loaded with 0, 49 and 196 Pa static pressures respectively. The expressions of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) mRNA and protein were detected by reverse transcription-PCR (RT-PCR) and enzyme linked immunosorbent assay (ELISA) after 24 hours.Results:MTT results showed that the supernatant of Ef with concentratio n≥5% could significantly inhibit the proliferation activity of hPDLCs at 48 hours of cell culture ( P<0.05). Flow cytometry showed that the positive cell rates of TLR-2 increased with increasing volume fractions of the Ef supernatants. The values were (2.12±0.07)%, (2.41±0.32)%, (2.65±0.27)%, (4.76±0.46)%, (9.91±0.92)% and (12.01±1.35)%, respectively. The differences were statistically significant when the concentrations≥5% ( P<0.05). There were no significant differences in the expressions of IL-1β and TNF-α mRNA between the non inducing group and the control group under the pressure of 49 Pa ( P>0.05). However, there were significant differences in the expressions of IL-1β and TNF-α mRNA between the non inducing group and the control group under the pressure of 196 Pa ( P<0.05), while the expressions of IL-1β and TNF-α in the inducing group were significantly lower than that in the control group under the pressures of 49 and 196 Pa ( P<0.05). Compared with the control group, the mRNA expression was significantly increased ( P<0.05). The result of ELISA was consistent with that of PCR. Conclusions:High concentration of Ef supernatant could inhibit the proliferation of hPDLC. Ef supernatant might promote the expression of TLR-2 on the surface of hPDLC. Excessive mechanical pressure induced the inflammatory response of hPDLC. The presence of inflammatory mediators could lead to the intolerance of hPDLC to pressures and small pressure could aggravate the inflammatory response.

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