Objective:To explore the precise layered and tension-reducing sutures for skin pigmented mole surgery to promote tissue healing and reduce scar hyperplasia.Methods:From January 2019 to December 2021, the First Department of Surgery of the Civil Aviation General Hospital and Tenth Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences treated 56 patients with skin pigmented moles aged 18-52 years, with an average age of 26 years, including 30 males and 26 females. All patients in this group underwent surgical resection of skin pigmented moles, which reached the subcutaneous fat layer. The dermis and subcutaneous tissue under the skin incision were precisely buried and guided suture by using the middle common hole equal-chord and equal-arc buried guide suture with scale marks on both ends of the needle tip.Results:The incision width of skin tissue defect in this group of patients was less than 30 mm. After the suturing was completed, the tension between the tissues on both sides of the incision and the close-fitting of each layer of tissue on both sides of the incision without dead space were realized immediately. 55 cases achieved primary incision healing. After two years of follow-up observation, there was no scar hyperplasia, and the effect was satisfactory. In only one case, local incision was red and swollen due to suture reaction, and a small amount of scar hyperplasia appeared later.Conclusions:This submerged guided suture method is an effective surgical technique for reducing skin incision scars, and it is more suitable for small incisions with a skin incision length of less than 10 mm, which is difficult to achieve layered suture of the deep tissue of the incision with ordinary suture needles.

Objective:To explore the surgical methods and effects of different types of pudendal thigh flaps in repairing rectovaginal fistula.Methods:From March 1996 to November 2019, totally 18 cases with rectovaginal fistula admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively. The ages of the patients ranged from 17 months to 39 years with an average of 20.8 years. The bilateral pudendal thigh flap based on the anterior cutaneous branches of obturator artery can be used for larger fistula, which is larger than 1 cm in diameter and covered with serious local scars. Smaller fistula with diameter less than 1 cm can be repaired by the unilateral pudendal thigh flap pedicled with lateral branches of posterior labial artery transferred through subcutaneous tunnel. If the local tissue can be closed directly without tension, pudendal thigh fascial flap is inserted between the vaginal and rectal mucosa to act as a waterproof layer.Results:All flaps used in the 18 patients of this group survived postoperatively with fistula closure and donor site healed primarily. The size of the flaps ranged from 4 cm×2 cm to 7 cm×4 cm. The recipient sites including bilateral pudendal thigh island flaps (4 cases), unilateral pudendal thigh flaps (5 cases) and unilateral facial flaps (9 cases). No recurrence was reported during the follow-up period of 6 to 36 months.Conclusions:The application of pudendal thigh flaps can be considered as a safe and reliable procedure for the management of the middle and lower rectovaginal fistula. According to the anatomical characteristics of fistula, we could design rational flaps to meet the functional, morphological and cosmetic demands from the patients.

Female genital plastic surgery is no longer a topic of shame, but rather a fast-growing area of plastic surgery with increasing demand for a variety of procedures that enhance the female body. Female genital plastic surgery includes not only vaginal reconstruction but also external genital reconstruction and rejuvenation. This field applies the core principles of plastic surgery to enhance, reduce, or refashion the various anatomical components of female genitalia, which ultimately improves aesthetics and restores function. The techniques behind vaginal reconstructive surgery have been solidified; the advantages and disadvantages for various surgical approaches are well known. Although major breakthroughs have been limited in recent years, some examples of innovation in vaginal reconstructive surgery include the application of tissue-engineering to support vaginal reconstruction, and development of perforator flap technology, which has increased the range of available donor sites for repair of external genital defects. By contrast, numerous technical gaps still exist in the practice of female genital rejuvenation. Other aspects of female genital rejuvenation outside of surgery are also in need of further development. Non-surgical techniques, such as injection therapy and laser therapy, are flooding into the field. As female genital plastic surgery expands, new challenges have surfaced, including: balancing patient demands against natural aesthetic diversity, lack of high-quality evidence to support practice, inadequate formal training of employees, and variation in operative practice, industry guidelines, and efficacy evaluation standards. Establishment of industry standards is an urgent concern. This process can help standardize operative techniques, provide formal training requirements for practitioners, disseminate successful surgical approaches, and promote evidence-based practice.

Objective:To investigate the method of the complex labia minora and clitoris prepuce hypertrophy and summarize the experience.Methods:From January 2016 to October 2019, a total of 432 patients with complex labia minora and clitoris prepuce hypertrophy in the 10th Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, were selected by classification. The patients were 18-46 years old (average 28 years old). The redundant prepuce of clitoris was repaired to transform the complex labia minora and clitoris prepuce hypertrophy into simple labia minora hypertrophy, and then labiaplasty was performed by edge or wedge resection.Results:A total of 346 cases were followed up for 3-12 months, 86 cases were lost. Hematoma occurred in 2 cases, bilateral asymmetry in 9 cases, irregular edge in 12 cases, and scar hyperplasia in 1 case. After respective treatment and secondary repair, the patients were satisfied. The overall satisfaction rate was 93.6%(324/346).Conclusions:Our method, through the decomposition operation, will change the complex shape into simple labia minora hyperplasia, reduce the difficulty of operation at the same time, which can achieve more satisfactory appearance.

Objective:To explore the surgical methods and effects of different types of pudendal thigh flaps in repairing rectovaginal fistula.Methods:From March 1996 to November 2019, totally 18 cases with rectovaginal fistula admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively. The ages of the patients ranged from 17 months to 39 years with an average of 20.8 years. The bilateral pudendal thigh flap based on the anterior cutaneous branches of obturator artery can be used for larger fistula, which is larger than 1 cm in diameter and covered with serious local scars. Smaller fistula with diameter less than 1 cm can be repaired by the unilateral pudendal thigh flap pedicled with lateral branches of posterior labial artery transferred through subcutaneous tunnel. If the local tissue can be closed directly without tension, pudendal thigh fascial flap is inserted between the vaginal and rectal mucosa to act as a waterproof layer.Results:All flaps used in the 18 patients of this group survived postoperatively with fistula closure and donor site healed primarily. The size of the flaps ranged from 4 cm×2 cm to 7 cm×4 cm. The recipient sites including bilateral pudendal thigh island flaps (4 cases), unilateral pudendal thigh flaps (5 cases) and unilateral facial flaps (9 cases). No recurrence was reported during the follow-up period of 6 to 36 months.Conclusions:The application of pudendal thigh flaps can be considered as a safe and reliable procedure for the management of the middle and lower rectovaginal fistula. According to the anatomical characteristics of fistula, we could design rational flaps to meet the functional, morphological and cosmetic demands from the patients.

Female genital plastic surgery is no longer a topic of shame, but rather a fast-growing area of plastic surgery with increasing demand for a variety of procedures that enhance the female body. Female genital plastic surgery includes not only vaginal reconstruction but also external genital reconstruction and rejuvenation. This field applies the core principles of plastic surgery to enhance, reduce, or refashion the various anatomical components of female genitalia, which ultimately improves aesthetics and restores function. The techniques behind vaginal reconstructive surgery have been solidified; the advantages and disadvantages for various surgical approaches are well known. Although major breakthroughs have been limited in recent years, some examples of innovation in vaginal reconstructive surgery include the application of tissue-engineering to support vaginal reconstruction, and development of perforator flap technology, which has increased the range of available donor sites for repair of external genital defects. By contrast, numerous technical gaps still exist in the practice of female genital rejuvenation. Other aspects of female genital rejuvenation outside of surgery are also in need of further development. Non-surgical techniques, such as injection therapy and laser therapy, are flooding into the field. As female genital plastic surgery expands, new challenges have surfaced, including: balancing patient demands against natural aesthetic diversity, lack of high-quality evidence to support practice, inadequate formal training of employees, and variation in operative practice, industry guidelines, and efficacy evaluation standards. Establishment of industry standards is an urgent concern. This process can help standardize operative techniques, provide formal training requirements for practitioners, disseminate successful surgical approaches, and promote evidence-based practice.

Objective:To investigate the method of the complex labia minora and clitoris prepuce hypertrophy and summarize the experience.Methods:From January 2016 to October 2019, a total of 432 patients with complex labia minora and clitoris prepuce hypertrophy in the 10th Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, were selected by classification. The patients were 18-46 years old (average 28 years old). The redundant prepuce of clitoris was repaired to transform the complex labia minora and clitoris prepuce hypertrophy into simple labia minora hypertrophy, and then labiaplasty was performed by edge or wedge resection.Results:A total of 346 cases were followed up for 3-12 months, 86 cases were lost. Hematoma occurred in 2 cases, bilateral asymmetry in 9 cases, irregular edge in 12 cases, and scar hyperplasia in 1 case. After respective treatment and secondary repair, the patients were satisfied. The overall satisfaction rate was 93.6%(324/346).Conclusions:Our method, through the decomposition operation, will change the complex shape into simple labia minora hyperplasia, reduce the difficulty of operation at the same time, which can achieve more satisfactory appearance.

Objective: To introduce a method to classify the labia minora hypertrophy and to investigate its significance to the selection of surgical method. Methods: From August 2014 to April 2018, 1 058 patients with labia minora hypertrophy were treated in the Plastic Surgery Hospital. According to the hyperplastic degree of the labia minora and praeputium clitoridis, the labia minora hypertrophy was classified to three types, namely simple clitoridis hypertrophy, simple labia minora hypertrophy and mixed type. For patients with simple labia minora hypertrophy, the methods of margin resection, or wedge resection or combination were applied. For patients with simple clitoridis hypertrophy, the reduction of clitoris hood could be performed. For mixed type, firstly the relationship of clitoris hood and labia minor should be recognized, then the appropriate surgical method should be taken. Results: The age of the patients was 18 to 46 years (mean age was 25 years). 83 cases (7.8%) were simple labia minora hypertrophy. 25 cases (2.4%)were simple clitoridis hypertrophy. And 950 cases (89.8%) were mixed type. All the patients received appropriate surgical method to repair the malformation. All the surgeries were successfully performed and the cosmetic results were satisfying. Conclusions As the homologous tissues, whether praeputium clitoridis hypertrophy or labia minora hypertrophy could result poor appearance of female vulva. The concept of holism should be kept in mind when repair surgeries are performed. The labia minora hypertrophy was classified to three types and appreciate surgical methods were applied to repair the hypertrophy. The cosmetic result was satisfying.

Objective: To investigate the clinical outcome of modified peeling method by divisional design in labia minora reduction in the treatment of labial hypertrophy. Methods: From Feb 2015 to Oct 2017, 32 nympha hypertrophy patients underwent labia minora reduction by the modified peeling method with divisional design. The labia minora area was divided into medial and lateral divisions, from which the dermis and subcutaneous tissue were removed asymmetrically. Results: The patients were followed up 1 to 6 months postoperatively. All incisions healed with excellent blood circulation of labia minora, except for 1 case with V-shaped dehiscence. All of the patients were satisfied with the eventual aesthetic appearance and the functional improvement. Conclusions The modified peeling method by divisional design in labia minora reduction is a safe and effective method with many advantages, such as nature contour, wide range of indications, fewer complications, and high satisfaction.

Objective: To collect preliminary data of normal Chinese female genital appearance, to compare the parameters of Han and Uygur nationality, and to present the preliminary data for normal female external genitalia database. Methods: This study design recruited healthy females referred to the out-patient clinic for physical examination from October 2014 to March 2015 in Xinjiang Petroleum Geological Survey Department Staff Hospital. The recruitment was based on rigid inclusion and exclusion criteria. Demographic data consists of nationality, age, height, weight, marital status, gravidity, parity, vaginal delivery, and intercourse frequency. Anthropometric measurements were taken in 234 females of Han group whereas 278 females of Uygur group. For each individual 16 parameters were measured. The external genitalia appearance in Han and Uygur nationality was compared. The significance of variations in age, height, weight, BMI, gravidity, parity, vaginal delivery and intercourse frequency were analyzed. Results: Primary measurements of Han and Uygur nationality are presented as mean (95% confidence interval). There are many differences in female genital appearance between Han and Uygur nationality. Several parameters were statistically associated with age, BMI, gravidity, parity, vaginal delivery and intercourse frequency. The females with complete labial asymmetry account for 5.6%(13/234) and 5.8%(16/278) in Han and Uygur normal adults, respectively. Conclusions This study presented the external genitalia measurements of normal Chinese female adults in Xinjiang, thus providing the preliminary data for normal female external genitalia database. Females of Han and Uygur nationality have multiple differences in external genitalia appearances. The parameters are associated with age, BMI, gravidity, parity, vaginal delivery, and intercourse frequency. The labial asymmetry is a universal phenomenon.