Objective:To investigate the effect of backfilling on the deformity of lacrimal sulcus and blepharobuccal sulcus after special treatment of the fat from orbital septum of the pouch in the lower intra-palpebral approach.Methods:From November 2019 to September 2022, a total of 42 patients (13 males and 29 females) aged 16-47(23.8±6.9) years with orbital septal fat swelling were treated by the surgical department of Beijing Huangsi Medical Cosmetic Clinic after the removal of orbital fat mass by the intraocular pouch approach. With mild, moderate, and severe lacrimal sulci and blepharobuccal depression deformity, the lower eyelid skin was not relaxed. The naturally herniated orbital septal adipose mass was cut off through the lower eyelid conjunctival incision approach, and then granulated into a 1 ml syringe, which was accurately filled into the depressed area of lacrimal sulci and blepharobuccal sulci according to the depressions marked before surgery.Results:The incisions of all 42 patients healed in the first stage without hematoma and infection, and the subcutaneous ecchymosis of 2 cases was observed by local hot compress 48 h later and the ecchymosis subsided 1 week. Follow-up was performed at 1 month, 2 months and 3 months, respectively. Among them, 35 patients underwent the operation of removing the lower eyelid bag and orbital septum cellulite and backfilling to correct the malformation of lacrimal sulci, and the postoperative effect was satisfactory. The symptoms of puffed eye bags, blepharobuccal sulci and lacrimal sulci depression disappeared, and the wound healed in one stage. 7 patients with eye bags accompanied by lacrimal sulci and blepharobuccal sulci were told before surgery that they might need two fat fillings due to insufficient fat content in the orbital septa and slight indentations. One month later, granular fat was taken from the legs to fill the lacrimal sulci and blepharobuccal sulci with satisfactory results.Conclusions:The treatment after the removal of orbital septum cellulite and the correction of lacrimal sulcus and blepharobuccal sulcus deformity are simple and satisfactory, and worthy of clinical application.

Objective:To discuss the effect of bipolar radio frequency (RF) in combination with small incision on lower facial (cheek, chin and neck) shaping and rejuvenation.Methods:From August 2019 to June 2020, 26 patients (aged 35-60 years, with mean 45 years) required for facial rejuvenation and received the fine liposuction in the lower cheek, mandibular margin and submental neck area in Beijing Huangsi Plastic Surgery Hospital. With the help of bipolar RF device - EMBRACE RF (diamond carving), the facetite face and hand radiofrequency were adopted for the subcutaneous tissue to tighten the skin. A concealed small incision was made from the front of the ear to the posterior ear. The superficial layer of the superficial muscular aponeuritic system (SMAS) was stripped, folded, tightened and suspended. The excessive skin was removed while reducing multilayer tension. The incision was cosmetically sutured.Results:All 26 patients had their wounds primary healing, with no complications such as skin necrosis and sensory disorder. All the 24 patients were followed up for 6-12 months. Their scars were concealed and tiny, the skin was tight, the lifting effect was obvious, and the pouch of mouth corners disappeared or alleviated. The contour of the mandibular margin was defined and the mental cervical angle was clear. The shape of the neck was slender and the fat chin was significantly improved. The effect of facial rejuvenation was distinct. Two patients felt it worked but did not achieve the expected results. They were satisfactory after giving the second surgery 6 months later. The satisfactory rate of the first surgery was 92.3% in 24 patients.Conclusions:Bipolar RF in combination with small incision lifting surgery is effective in lower facial (cheek, chin and neck) shaping and rejuvenation. The trauma is little and the wound is recovered fast. The scar is concealed and tiny. It is worthy of clinical application.

Objective:To observe the clinical effect of the improved eyebrow lifting operation through the incision under the eyebrow to improve the upper eyelid skin relaxation and explore its application scope.Methods:From March to October 2019, 32 female patients in the outpatient department of Huangsi Plastic Surgery Hospital underwent the improved eyebrow lifting operation through the incision under the eyebrow.Results:After the improved eyebrow lifting procedure, the blepharoptosis of the upper eyelid in 32 patients was significantly improved, and there was no operative complication, and the eyebrow shape and eyebrow arch fullness were satisfactory.Conclusions:The eyebrow arch is full, and the eyebrow shape and the distance between eyebrow and eye are not changed significantly after the operation.

Objective: To observe the clinical effect of the modified bandaging method for facial rejuvenation with small incision and to explore its applicable scope. Methods: From March to October 2019, 12 people in the outpatient department underwent small incision facial rejuvenation surgery and the improved bandaging method was used. Results: After the small incision facial rejuvenation operation, the relaxation and drooping of the facial tissue in 12 patients were significantly improved without complications, and no cotton pad, bandage and elastic mesh cover were used for fixation. Conclusions This improved bandaging method does not affect daily work and life, and meets the needs of patients with this requirement, and plays a very good role in promoting the small incision facial rejuvenation surgery.

Objective The purpose of this study was to evaluate the efficacy of multipoint transfixion combined with filling of temporal fascia and the lateral orbicularis oculi muscle as an alternative rejuvenation technique on crow's feet wrinkles during face lift.Methods A retrospective review was conducted in 86 patients who underwent crow's feet wrinkles treatment during 2005 and 2009.During operation orbicularis' strength was broken down and blocked when we multi-pointly sutured and fixed the orbicularis oculi and deep tissue,temproal musculofascia was filled on the surface of multi-pointly sutured orbicularis oculi.By postoperative follow-up,complications,aesthetic outcome,and patient's satisfaction were recorded.Results In the group of 86 cases,50 cases were followed up from 3 to 28 months.The effect was lasting obviously and there was no any severe complications,such as hematoma or nerve injury.Patients were satisfied with their results.Among the total,2 patients appeared the temporary movement loss of the eyebrows in one side,but both recovered 3 months later.And 1 case appeared subcutaneous nodular inflammation and recovered after pulling out the suture.Conclusions The authors demonstrate that combination of filling with temporal fascia and the multipoint transfixion of lateral orbicularis oculi muscle is a safe technique,which may be a good alternative for periorbital rejuvenation and help in avoiding lower lid incisions or extensive dissections during face lifting in some cases.

Objective To explore the methods and effects of improving facial appearance on volume defect and aging,and recovery of aesthetic looks by autologous fat granules graft.Methods We designed the filling areas according to gender,age,individual face characteristics and desire of the case before operation.By liposuction technology with low pressure from the trunk,fats were taken with cleaning and purifying.Then pure fats were injected to the marked areas of the face by multi-level and multi-tunnel injection.It was able to supply the facial volume for lost soft tissue,to improve the aging appearance and to achieve smooth facial contour.Results All cases were followed-up for 3 months to 2 years,facial appearances were satisfied or improved,without fat liquefaction,infection,scleroma and other complications.Only a few cases needed complementary transplantation.The overall results were satisfactory.Conclusions Autologous fat granules graft is a safe and effective facial soft tissue filling technology.It can effectively improve facial aging appearance,restore natural,young and beautiful looks,and be worth for clinical application.

ObjectiveTo explore a method for reconstruction of the middle and lower facial tension system for surgical rejuvenation.MethodsFrom 2003 to 2011,257 female patients were treated with this procedure,in which superficial musclo-aponeurotic system (SMAS) of the cheeks were tightened and fixed to the deep temporal fascia and the temporal muscle fascia in muhidirectional and oblique toward the eye and ear rather than just toward the ear through purse string suture method to achieve the goals of facial rejuvenation.ResultsThe follow-up data were obtained in 50 cases,with time range of 3-60 months.Each case was evaluated by both the patient and the surgical team.Excellent or good results were achieved for 255 cases.In all we succeeded in correcting the nasolabial sulcal deformity,and the cheek ptosis,and the contour of the face were more smoothly than that of preoperative appearance.The outlines of lower face became narrow,and thinner than the preoperative.All the patients were without loss of facial identity.Complications occurred occasionally,including the tensional blister on the dermal suture point and local numbness.No incision scar,alopecia and facial nerve injury occurred.Effects of rejuvenation were obvious and natural in 3-6 months after surgery.Especially 12 months after operation the results were the best.ConclusionsThis technique addresses the multiple factors involved in the senescent changes of the midface.Proper patient selection,good aesthetic judgment,and surgical competence are required to restore the midface and lower face tension system reconstruction.This novel approach is safe and effective,and the result is stable and lasting.

Objective To explore the therapeutic effect of infrabrow excision blepharoplasty combined with botulinum toxin A (BTXA) injection on periorbital rejuvenation.Methods A total of 146 females were involved in this study.The incision was designed,hiding at the lower edge of the brow.Eye orbicularis was folded,eyelid lift and some of the skin removed during operation,and simultaneously the shape of eyebrow was better adjusted.After suture cutting,BTXA was injected at the glabella and the lateral of canthus.Results All the 146 cases were followed up for 3 to 12 months.The blepharotosis symptom was improved effectively,the periocular wrinkles were alleviated obviously and no complications occurred in these patients.Conclusions Combining Infrabrow excision blepharoplasty with BTXA injection in periocular treatment is safe,convenient and effective.It is a good clinical approach to make periorbital rejuvenation.

Objective To explore the effective measurements of integrated therapy for the ear keloids in the Oriental. Methods Surgical excision was performed for keloid, and the cut then sutured directly or with flap transfer. At early stage of surgery (within 24 hours), X-ray or electron-ray radiotherapy was used for 3-5 times once daily; and steroids injected after cutting lines at 7th day every two weeks and gradually ended. Results A total of 48 patients were treated, and followed, in which 12 patients were lost of follow-up. The total effective rate was 94. 4 % based on the data of follow-up in 36 patients for 1-3 years. Therefore, the curation rate was 83. 3 % (30 cases) and effective rate 11. 1 % (4 cases). Conclusions Surgical cutting combined with early radiotherapy and steroids injection is the effective integrated therapy for the ear keloids in the Oriental.

Objective To investigate the correlation between human epidermal stem cell (hESCs) and hypertrophic scar or keloid. Methods Improved collagen Ⅳ-coated adhesion methods was used to isolate and culture the epidermal stem cells after neutral protease selectively digested the dermo-epidermal junctions. After the cells were cultured and expanded in vitro, and passage 3 hESCs were induced by different concentrations of TGF-β1 (0.1, 5.0, and 10.0 ng/ml). Morphological fea-tures and identification of these cells were meseasured by HE, Masson, immunohistochemical staining on the days 3 and 7, respectively. Results After induced by TGF-β1 for 3 and 7 days, the morpholo-gy of the epidermal stem cell (hESCs) was changed into fusiform shape, similar to fibroblasts. 70 % ofthe cell which was induced by TGF-β1 were blue stained in the cytoplasm by Masson stain, which is the distinctive method for collagen, suggesting collagen appeared or increased in the cells. The collagen concentrations in supernatants of hESCs were 0.4150±0.0014, 0.3380±0. 0020, and 0.3870±0.0020, much higher than that in control group (0.0780±0.0025) and normal skin fibro-blast group (0.15004±0.0051) (P<0.05). Immunohistochemical staining revealed that positive rates of these cells for anti-vimentin staining were more than (95.00±1.20)% in experiments and (5.70±0.20)% in control group. Conclusion The differentiantion of hESCs induced by TGF-β1 into fibro-blasts indicates that hESCs may play a role in the pathogenesis of hypetrophic scar and keloid.