BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective:To investigate the consistency of trichoscopic fields in androgenetic alopecia (AGA) patients by using scalp medical pigmentation (SMP) ink as visual marker, as well as the safety and durability.Methods:A retrospective analysis was conducted on patients with AGA who visited the Medical Cosmetology Center, Hangzhou First People’s Hospital, Westlake University School of Medicine from April to August 2024. Trichoscopic images were captured immediately and three months after using SMP ink for visual marker. Each patient’s two trichoscopic images were imported into Photoshop CC 2019 software for processing to obtain the location information of the marker, the distance between the marker center and the image center, and pigments areas. Consistency of markers during repeated trichoscopy was evaluated by comparing distances between pigment center and image center. The difference in distance between the two time points (3-month distance minus immediate-post-marking distance) was defined as "distance difference". Patients were divided into the same-operator group and different-operator group based on whether the two trichoscopy examinations were performed by the same operator. The impact of operator changes on the consistency of markers during repeated trichoscopy was assessed by comparing the "distance difference" between the two groups. Additionally, patients were categorized into single-point, double-point, and triple-point groups according to the number of markers. The influence of marker quantity on consistency of the markers was evaluated by comparing the "distance difference" among these three groups. Pigment spread was assessed by comparing pigment actural area in repeated trichoscopic images. Adverse reactions and ink fading within three months were recorded. Statistical analysis was performed using SPSS 27.0 software.The normal distribution measurement data was expressed as Mean ± SD, and the non-normal distribution measurement data was expressed as M ( Q1, Q3). The Wilcoxon signed-rank test was applied for comparison of the distance between the marker center and the image center in the preceding and subsequent trichoscopic images. Mann-Whitney U test was applied for comparison between the same-operator group and the different-operator group, and the Kruskal-Wallis rank sum test was used for comparison among the single-point, double-point, and triple-point groups. The paired sample t-test was used for comparison of the pigment actural area during repeated measurements. P<0.05 indicated statistically significant differences. Results:A total of 22 male AGA patients (aged 24-43 years) were included, with 46 pigment points marked (8 single-point, 4 double-point, 10 triple-point). Same-operator and different-operator groups comprised of 13 and 9 patients, respectively. No significant difference was found in distances between marker center and image center immediately vs. 3 months post-marking [0.91 (0.62, 1.53) mm vs. 0.83 (0.62, 1.22) mm, Z=-0.83, P=0.408]. Comparisons of the "distance difference" between the same-operator and different-operator groups, and among the single-point, double-point, and triple-point groups, showed no statistically significant differences (all P> 0.05). Pigment areas increased by (0.11±0.12) mm 2 at 3 months ( t=-6.47, P<0.001). All pigments exhibited fading within 3 months but remained identifiable without touch-up. Adverse reactions were minimal: mild puncture-site bleeding was observed, with no pigment-related allergies, foreign-body reactions, or significant scarring. Conclusion:Single-point SMP pigment enables reliable and consistent visualization of trichoscopic measurement points in AGA patients, unaffected by operator changes. The method demonstrates clinical convenience, flexibility, high safety, and long-term durability.

Objective:To evaluate the clinical efficacy of infraorbital rim drilling midface lift combined with composite lower blepharoplasty.Methods:Retrospective analysis of clinical data from the patients who underwent combined midface lift and lower blepharoplasty at Department of Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medical, between January 2022 and February 2024.The infraorbital rim drilling midface lift combined with lower blepharoplasty was performed via a subciliary incision approach. Through a subciliary incision, the herniated orbital fat was excised, followed by fixation of the orbital septum to the infraorbital rim periosteum. Drill holes were created at the medial and lateral infraorbital rim, and arcuate suspension of the midface was performed using 2-0 absorbable sutures (SXPP1A405). Postoperative follow-up assessed midface lifting outcomes and complication rates. The wrinkle severity rating scale (WSRS) was used to grade nasolabial folds pre- and postoperatively (5-point scale: higher scores indicating more pronounced folds). Patient-reported outcomes were assessed using the Face-Q questionnaire, evaluating: (1) overall facial satisfaction, (2) satisfaction with surgical results, and (3) satisfaction with decision (scale 0-100; higher scores indicating greater satisfaction/less decisional regret). Descriptive statistical methods were employed for data analysis.Results:A total of 43 patients were enrolled, comprising 7 males and 36 females, with a mean age of (50.6±12.2) years (range: 32-73 years). Postoperative follow-up averaged (11.9±4.6)months. All patients demonstrated significant improvement in lower eyelid bags, tear trough deformity, midface elevation, and nasolabial folds. Surgical complications included: residual lower eyelid fat ( n=5), intermittent fixation point pain persisting >1 month ( n=4), mild residual tear trough deformity ( n=4), and hematoma ( n=1). Nasolabial fold WSRS scores decreased from ( 3.7±0.9 ) points to(2.9±0.6)points following surgery. In 38 patients, Face-Q scores demonstrated high satisfaction levels: appearance-related satisfaction scored (80.9 ± 10.3)points and satisfaction with decision scored (82.4 ± 8.9)points, indicating favorable patient-reported outcomes. Conclusion:The infraorbital rim drilling-assisted midface lift combined with comprehensive lower blepharoplasty effectively corrects midface ptosis while addressing lower eyelid bags. This technique provides reliable fixation points through drilling, resulting in stable and long-lasting lifting outcomes with high patient satisfaction.

Objective:To investigate the clinical efficacy of hair follicle-bearing microskin transplantation as a novel therapeutic approach for subacute wounds.Methods:A prospective randomized controlled trial was conducted from June to October 2024, involving patients with subacute wounds treated in the Department of Plastic and Reconstructive Surgery, Hand Microsurgery at Ningbo No.6 Hospital, and the Medical Aesthetics Center at Hangzhou First People’s Hospital. Participants were randomly assigned via a random number table into two groups: the observation group received hair follicle-bearing microskin transplantation, while the control group received conventional treatment including debridement, dressing changes, antimicrobial therapy, and local pressure relief. The observation endpoint was set at 6 weeks post-treatment. Outcome measures included time to complete wound healing, wound healing score (comprising five items: wound area, appearance, exudate, signs of infection, and condition of surrounding skin; total score 0-15, with a higher score indicating poorer healing), donor site recovery, adverse reactions, and patient satisfaction [rated on a 4-level scale: very satisfied, satisfied, basically satisfied, dissatisfied; satisfaction rate was calculated as (very satisfied + satisfied) cases/total cases×100%]. Data were analyzed using SPSS 25.0 software, with continuous variables expressed as Mean±SD and compared via t-test; enumeration data were expressed as cases (relative numbers) and analyzed using Fisher’s exact test. P<0.05 was considered statistically significant. Results:Sixteen patients were enrolled (8 per group), including 12 males and 4 females, with a mean age of 46 years (range: 41-71). No significant differences in baseline characteristics (gender, age, wound duration, and wound area) were observed between the two groups (all P>0.05). All procedures in the observation group were completed successfully without intraoperative or short-term postoperative complications. The donor site area was (28.2±11.8) cm 2 (9.0-50.0 cm 2). All wounds in the observation group healed completely within 2-5 weeks post-treatment, with a mean healing time of (26.2±5.0) d. The donor sites healed within two weeks, leaving only pinpoint scars. In contrast, only 4 cases in the control group achieved complete healing within the observation period (6 weeks post-treatment), with a mean healing time of (33.2±5.7) d. The other 4 patients showed no tendency to heal at 6 weeks and progressed to chronic wounds. Before treatment, no significant difference in wound healing scores was found between the two groups (9.6±2.6 vs. 9.1±2.0, t=0.43, P=0.676). At 6 weeks post-treatment, the observation group showed significantly lower wound healing scores than the control group (1.2±1.5 vs. 7.9±3.9, t=-4.48, P=0.001). At 6 weeks post-treatment, patient satisfaction in the observation group was significantly higher than that in the control group (8/8 vs. 4/8, P=0.006). Conclusion:Hair follicle-bearing microskin transplantation demonstrates significant clinical advantages in treating subacute wounds, including accelerated healing, improved aesthetic outcomes, minimal donor site morbidity, and rapid recovery.

Objective:To discuss the clinical effect of the modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures in the treatment of middle and lower facial sagging.Methods:The clinical data of patients with middle and lower facial sagging treated in Hangzhou Yichao Medical Aesthetics Clinic from February 2021 to February 2023 were retrospectively analyzed. The operation was performed using barbed sutures to progressively reduce tension and suspend sutures of the superficial musculoaponeurotic system (SMAS) and the skin and subcutaneous tissue. The skin tissue flap was separated from the superficial layer of SMAS with temporal hairline to peri-auricular incision. Firstly, the sagging SMAS and the zygomatic fat pad were fixed to the deep temporal fascia by purse-string suture with barbed sutures, and then the sagging skin and subcutaneous tissue were progressively fixed to the corresponding SMAS at multiple points to the incision direction to improve the middle and lower facial relaxation and reduce the incision tension as much as possible. The nasolabial groove of the patients was scored (0-4) before surgery and 12 months after surgery to evaluate the surgical effect. The higher the score, the more serious the nasolabial groove depression was. Meanwhile, the postoperative recovery, complications and satisfaction of the patients were observed and followed up. SPSS 26.0 software was used to analyze the data. Preoperative and postoperative nasolabial groove scores were represented by Mean±SD, and paired t-test was used for comparison. P<0.05 was considered statistically significant. Results:A total of 23 patients were included, including 4 males and 19 females. They ranged in age from 42 to 68, with an average age of 54.0. All patients showed varying degrees of middle and lower facial relaxation and nasolabial groove deepening. Nasolabial groove score was (3.6±0.5) points. One patient had mild hematoma on the second day after surgery, which subsided after suction and compression, then the facial swelling basically subsided about 7 days after the operation. After 12-17 months of follow-up (mean 13.2 months), the middle and lower facial relaxation and nasolabial depression of 23 patients were significantly improved. No serious complications such as facial nerve injury occurred in all patients, and postoperative scars were not obvious. The nasolabial groove score at 12 months after the operation was (2.0±0.6) points, which was significantly lower than that before the operation ( t=14.81, P<0.001). The patient satisfaction rate was 95.7%(22/23). Conclusion:The modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures avoids deep dissection, and has simple operation, low complications, fast recovery. The relaxation of middle and lower face can be significantly improved, and the long-term effect is stable.

Objective:To investigate the protocol and clinical efficacy of hair follicle-bearing microskin (HF-MS) transplantation in the treatment of hypertrophic scars.Methods:Prospective randomized controlled trial. From January to November 2024, patients with hypertrophic scars were recruited from the Medical Cosmetic Center of Affiliated Hangzhou First People’s Hospital with Westlake University School of Medicine and the Department of Plastic and Reconstructive Surgery of Ningbo Sixth Hospital. Patients were randomly divided into the observation group and the control group using a random number table. In the observation group, 1.0 mm punch decompression was performed on the hypertrophic scar area, followed by implantation of HF-MS extracted from the scalp donor site using follicular unit excision (FUE) into the decompression pores. The control group underwent only 1.0 mm punch decompression. Vancouver scar scale (VSS) scores (total score 0-15, higher scores indicating more severe scarring) were assessed preoperatively and at 1, 3, and 6 months postoperatively. Efficacy at 6 months, improvement in hypertrophic scar area, hair survival rate (observation group), adverse reactions, and patients’ satisfaction rates were evaluated. Categorical data were expressed as frequency (%) and analyzed using chi-square tests; normally distributed measurement data were expressed as Mean ± SD and analyzed using independent samples t-tests. Results:A total of 50 patients were included (25 per group), with 22 males and 28 females, aged 18-60 years (mean age: 33 years). The effective rate was 92% (23/25) in the observation group and 68% (17/25) in the control group, showing a statistically significant difference ( P<0.05). Preoperative VSS scores did not differ significantly between the observation and control groups [(6.67±3.19) vs. (7.12±2.89), P>0.05]. At 1, 3, and 6 months postoperatively, the observation group had VSS scores of (5.48±2.60), (4.64±2.39), and (3.80±2.10), respectively, compared to (6.36±2.53), (5.84±2.28), and (5.32±2.09) in the control group. The 6-month postoperative VSS scores differed significantly between groups ( P<0.05). Preoperative hypertrophic scar areas showed no significant difference [(5.75±2.83) cm 2 vs. (6.91±3.31) cm 2,P>0.05]. At 6 months postoperatively, the observation group had significantly smaller scar areas than the control group [(3.15±1.55) cm 2 vs. (5.37±2.93) cm 2,P<0.01]. The average hair survival rate in the observation group was 41% at 6 months. Adverse reactions occurred in 3 cases in the observation group (2 skin indurations, 1 hyperpigmentation) and 7 cases in the control group (4 hyperpigmentation, 2 skin atrophy, 1 skin induration). The observation group had a significantly lower adverse reaction rate [12% (3/25) vs. 28% (7/25), P<0.05]. Patient satisfaction rates were 88% (22/25) in the observation group and 64% (16/25) in the control group ( P<0.05). Conclusion:HF-MS transplantation demonstrates definitive clinical efficacy in treating hypertrophic scars, effectively improving scar morphology, clinical symptoms, and patient quality of life.

Objective:To investigate the consistency of trichoscopic fields in androgenetic alopecia (AGA) patients by using scalp medical pigmentation (SMP) ink as visual marker, as well as the safety and durability.Methods:A retrospective analysis was conducted on patients with AGA who visited the Medical Cosmetology Center, Hangzhou First People’s Hospital, Westlake University School of Medicine from April to August 2024. Trichoscopic images were captured immediately and three months after using SMP ink for visual marker. Each patient’s two trichoscopic images were imported into Photoshop CC 2019 software for processing to obtain the location information of the marker, the distance between the marker center and the image center, and pigments areas. Consistency of markers during repeated trichoscopy was evaluated by comparing distances between pigment center and image center. The difference in distance between the two time points (3-month distance minus immediate-post-marking distance) was defined as "distance difference". Patients were divided into the same-operator group and different-operator group based on whether the two trichoscopy examinations were performed by the same operator. The impact of operator changes on the consistency of markers during repeated trichoscopy was assessed by comparing the "distance difference" between the two groups. Additionally, patients were categorized into single-point, double-point, and triple-point groups according to the number of markers. The influence of marker quantity on consistency of the markers was evaluated by comparing the "distance difference" among these three groups. Pigment spread was assessed by comparing pigment actural area in repeated trichoscopic images. Adverse reactions and ink fading within three months were recorded. Statistical analysis was performed using SPSS 27.0 software.The normal distribution measurement data was expressed as Mean ± SD, and the non-normal distribution measurement data was expressed as M ( Q1, Q3). The Wilcoxon signed-rank test was applied for comparison of the distance between the marker center and the image center in the preceding and subsequent trichoscopic images. Mann-Whitney U test was applied for comparison between the same-operator group and the different-operator group, and the Kruskal-Wallis rank sum test was used for comparison among the single-point, double-point, and triple-point groups. The paired sample t-test was used for comparison of the pigment actural area during repeated measurements. P<0.05 indicated statistically significant differences. Results:A total of 22 male AGA patients (aged 24-43 years) were included, with 46 pigment points marked (8 single-point, 4 double-point, 10 triple-point). Same-operator and different-operator groups comprised of 13 and 9 patients, respectively. No significant difference was found in distances between marker center and image center immediately vs. 3 months post-marking [0.91 (0.62, 1.53) mm vs. 0.83 (0.62, 1.22) mm, Z=-0.83, P=0.408]. Comparisons of the "distance difference" between the same-operator and different-operator groups, and among the single-point, double-point, and triple-point groups, showed no statistically significant differences (all P> 0.05). Pigment areas increased by (0.11±0.12) mm 2 at 3 months ( t=-6.47, P<0.001). All pigments exhibited fading within 3 months but remained identifiable without touch-up. Adverse reactions were minimal: mild puncture-site bleeding was observed, with no pigment-related allergies, foreign-body reactions, or significant scarring. Conclusion:Single-point SMP pigment enables reliable and consistent visualization of trichoscopic measurement points in AGA patients, unaffected by operator changes. The method demonstrates clinical convenience, flexibility, high safety, and long-term durability.

Objective:To evaluate the clinical efficacy of infraorbital rim drilling midface lift combined with composite lower blepharoplasty.Methods:Retrospective analysis of clinical data from the patients who underwent combined midface lift and lower blepharoplasty at Department of Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medical, between January 2022 and February 2024.The infraorbital rim drilling midface lift combined with lower blepharoplasty was performed via a subciliary incision approach. Through a subciliary incision, the herniated orbital fat was excised, followed by fixation of the orbital septum to the infraorbital rim periosteum. Drill holes were created at the medial and lateral infraorbital rim, and arcuate suspension of the midface was performed using 2-0 absorbable sutures (SXPP1A405). Postoperative follow-up assessed midface lifting outcomes and complication rates. The wrinkle severity rating scale (WSRS) was used to grade nasolabial folds pre- and postoperatively (5-point scale: higher scores indicating more pronounced folds). Patient-reported outcomes were assessed using the Face-Q questionnaire, evaluating: (1) overall facial satisfaction, (2) satisfaction with surgical results, and (3) satisfaction with decision (scale 0-100; higher scores indicating greater satisfaction/less decisional regret). Descriptive statistical methods were employed for data analysis.Results:A total of 43 patients were enrolled, comprising 7 males and 36 females, with a mean age of (50.6±12.2) years (range: 32-73 years). Postoperative follow-up averaged (11.9±4.6)months. All patients demonstrated significant improvement in lower eyelid bags, tear trough deformity, midface elevation, and nasolabial folds. Surgical complications included: residual lower eyelid fat ( n=5), intermittent fixation point pain persisting >1 month ( n=4), mild residual tear trough deformity ( n=4), and hematoma ( n=1). Nasolabial fold WSRS scores decreased from ( 3.7±0.9 ) points to(2.9±0.6)points following surgery. In 38 patients, Face-Q scores demonstrated high satisfaction levels: appearance-related satisfaction scored (80.9 ± 10.3)points and satisfaction with decision scored (82.4 ± 8.9)points, indicating favorable patient-reported outcomes. Conclusion:The infraorbital rim drilling-assisted midface lift combined with comprehensive lower blepharoplasty effectively corrects midface ptosis while addressing lower eyelid bags. This technique provides reliable fixation points through drilling, resulting in stable and long-lasting lifting outcomes with high patient satisfaction.

Objective:To investigate the clinical efficacy of hair follicle-bearing microskin transplantation as a novel therapeutic approach for subacute wounds.Methods:A prospective randomized controlled trial was conducted from June to October 2024, involving patients with subacute wounds treated in the Department of Plastic and Reconstructive Surgery, Hand Microsurgery at Ningbo No.6 Hospital, and the Medical Aesthetics Center at Hangzhou First People’s Hospital. Participants were randomly assigned via a random number table into two groups: the observation group received hair follicle-bearing microskin transplantation, while the control group received conventional treatment including debridement, dressing changes, antimicrobial therapy, and local pressure relief. The observation endpoint was set at 6 weeks post-treatment. Outcome measures included time to complete wound healing, wound healing score (comprising five items: wound area, appearance, exudate, signs of infection, and condition of surrounding skin; total score 0-15, with a higher score indicating poorer healing), donor site recovery, adverse reactions, and patient satisfaction [rated on a 4-level scale: very satisfied, satisfied, basically satisfied, dissatisfied; satisfaction rate was calculated as (very satisfied + satisfied) cases/total cases×100%]. Data were analyzed using SPSS 25.0 software, with continuous variables expressed as Mean±SD and compared via t-test; enumeration data were expressed as cases (relative numbers) and analyzed using Fisher’s exact test. P<0.05 was considered statistically significant. Results:Sixteen patients were enrolled (8 per group), including 12 males and 4 females, with a mean age of 46 years (range: 41-71). No significant differences in baseline characteristics (gender, age, wound duration, and wound area) were observed between the two groups (all P>0.05). All procedures in the observation group were completed successfully without intraoperative or short-term postoperative complications. The donor site area was (28.2±11.8) cm 2 (9.0-50.0 cm 2). All wounds in the observation group healed completely within 2-5 weeks post-treatment, with a mean healing time of (26.2±5.0) d. The donor sites healed within two weeks, leaving only pinpoint scars. In contrast, only 4 cases in the control group achieved complete healing within the observation period (6 weeks post-treatment), with a mean healing time of (33.2±5.7) d. The other 4 patients showed no tendency to heal at 6 weeks and progressed to chronic wounds. Before treatment, no significant difference in wound healing scores was found between the two groups (9.6±2.6 vs. 9.1±2.0, t=0.43, P=0.676). At 6 weeks post-treatment, the observation group showed significantly lower wound healing scores than the control group (1.2±1.5 vs. 7.9±3.9, t=-4.48, P=0.001). At 6 weeks post-treatment, patient satisfaction in the observation group was significantly higher than that in the control group (8/8 vs. 4/8, P=0.006). Conclusion:Hair follicle-bearing microskin transplantation demonstrates significant clinical advantages in treating subacute wounds, including accelerated healing, improved aesthetic outcomes, minimal donor site morbidity, and rapid recovery.

Objective:To discuss the clinical effect of the modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures in the treatment of middle and lower facial sagging.Methods:The clinical data of patients with middle and lower facial sagging treated in Hangzhou Yichao Medical Aesthetics Clinic from February 2021 to February 2023 were retrospectively analyzed. The operation was performed using barbed sutures to progressively reduce tension and suspend sutures of the superficial musculoaponeurotic system (SMAS) and the skin and subcutaneous tissue. The skin tissue flap was separated from the superficial layer of SMAS with temporal hairline to peri-auricular incision. Firstly, the sagging SMAS and the zygomatic fat pad were fixed to the deep temporal fascia by purse-string suture with barbed sutures, and then the sagging skin and subcutaneous tissue were progressively fixed to the corresponding SMAS at multiple points to the incision direction to improve the middle and lower facial relaxation and reduce the incision tension as much as possible. The nasolabial groove of the patients was scored (0-4) before surgery and 12 months after surgery to evaluate the surgical effect. The higher the score, the more serious the nasolabial groove depression was. Meanwhile, the postoperative recovery, complications and satisfaction of the patients were observed and followed up. SPSS 26.0 software was used to analyze the data. Preoperative and postoperative nasolabial groove scores were represented by Mean±SD, and paired t-test was used for comparison. P<0.05 was considered statistically significant. Results:A total of 23 patients were included, including 4 males and 19 females. They ranged in age from 42 to 68, with an average age of 54.0. All patients showed varying degrees of middle and lower facial relaxation and nasolabial groove deepening. Nasolabial groove score was (3.6±0.5) points. One patient had mild hematoma on the second day after surgery, which subsided after suction and compression, then the facial swelling basically subsided about 7 days after the operation. After 12-17 months of follow-up (mean 13.2 months), the middle and lower facial relaxation and nasolabial depression of 23 patients were significantly improved. No serious complications such as facial nerve injury occurred in all patients, and postoperative scars were not obvious. The nasolabial groove score at 12 months after the operation was (2.0±0.6) points, which was significantly lower than that before the operation ( t=14.81, P<0.001). The patient satisfaction rate was 95.7%(22/23). Conclusion:The modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures avoids deep dissection, and has simple operation, low complications, fast recovery. The relaxation of middle and lower face can be significantly improved, and the long-term effect is stable.