BackgroundLacking projection nasal tip is a common deformity of Asian nasal. Various nasal tip grafts commonly used generally require the dissecting septal perichondrium, and most of them are autologous cartilage with a non-integrated design. Snake-shaped ePTFE nasal tip graft is an integrated, stable tip graft without any additional assembly and splicing, conforming to the nasal anatomy characteristics of Asian.MethodA retrospective study was performed on Asian patients who underwent rhinoplasty in the nasal tip at Peking University Third Hospital from 2015 to 2022. Nasal tip grafts were categorized into three groups: Snake-shaped ePTFE combined with conchal cartilage (n=15), only costal cartilage (n=25), and only conchal cartilage (n=17). Patients were excluded if their rhinoplasty did not involve a graft above. Visual Analogue Scale, FACE-Q NOSE, FACE-Q NOSRTIL, Nasal Obstruction Symptom Evaluation scale, and Rhinoplasty Outcome Evaluation scale were used to evaluate the preoperative and postoperative results.Results53 cases (93.0 percent) had low nasal dorsum and 46 cases (80.7 percent) had short nose. There was no significant difference in complication rate among the three groups. The difference between preoperative and postoperative scale scores was statistically significant among the three groups (p<0.05). The score improvements including all scales were the highest in the costal cartilage group and lowest in the conchal cartilage group.ConclusionsSnake-shaped ePTFE nasal tip graft can be an effective integrated alternative that provides long-term safety and efficacy compared with traditional autogenous implants (conchal cartilage and costal cartilage).

Purpose:Polyacrylamide hydrogel (PAHG), which had been used widely for breast augmentation, has been banned for more than 15 years. Patients who had been injected PAHG for breast augmentation need evacuation surgery to remove as much as possible. To provide a series of diagnosis and treatment process MRI and intraoperative color Doppler ultrasound are combined for maximal removal of PAHG.Methods:The patients who received evacuation surgery in Peking University Third Hospital from 2010 to 2022 after PAHG injection for breast augmentation were included in this research. MR scanning was performed preoperatively and postoperatively in some of these patients and color Doppler ultrasound was applied to help evacuate PAHG intraoperatively. The mean clearance rate of PAHG was calculated according to the MRI outcomes.Results:Two hundred and 4 patients had received evacuation surgery after PAHG injection for breast augmentation with an average age of 42.8 years and an average body mass index of 21.2 kg/m2. The average PAHG retention time was 13.5 years. Among them, 52 patients underwent pre- and postoperative MRI scanning. The mean three-dimensional (3D) volume of PAHG was 684.8 mL (range, 350.0-1,123.9 mL), and the average residual 3D volume of PAHG was 53.7 mL (range, 12.4-98.3 mL). The mean clearance rate was 92.1%.Conclusion:MRI and intraoperative color Doppler ultrasound can provide effective and precise location information of PAHG for evacuation surgery, which is a reliable method to ensure the maximal removal of PAHG.

BackgroundThe application of nasolabial perforator flap for nasal reconstruction has been reported previously with satisfactory outcomes, but the outcomes and risk factors of postoperative adverse events have been unclear to plastic surgeons.AimsTo statistically analyze the effectiveness of the nasolabial perforator flap in nasal reconstruction and the risk factor of postoperative complications and re-operation.Patients/MethodsThis retrospective study evaluated 58 Chinese patients who underwent nasal reconstruction with the nasolabial perforator flap from 2009 to 2021. The esthetic and blood supply outcomes were measured by plastic surgeons on a 5-point Likert scale. Binary logistic regression was used to determine the risk factors associated with postoperative complications and re-operation.ResultsThe mean age of the cohort was 66.4 +/- 2.0 years. The defect size ranged from 6.5 x 5.5 mm2 to 40 x 70 mm2, and 48.3% of defects covered more than one nasal subunit. Venous congestion occurred in 4.9% of flaps, and the immediate overall postoperative score was 7.72/10. More than one nasal subunit of involvement was the risk factor associated with re-operation (p = 0.004), but no risk factor was associated with complications.ConclusionsThe nasolabial perforator flap is reliable for nasal reconstruction with good esthetic outcomes and fewer complications. However, a large number of involved subunits may lead to multiple surgeries for flap trimming in easterners.

The chin significantly influences facial aesthetics, contributing to the overall balance and harmony of the face. This study aimed to assess the effectiveness of the hyaluronic acid filler Hyamax® Volumizer for chin augmentation and correction of chin retrusion compared to a no-treatment control. Participants aged 18–55 years with mild to moderate chin retrusion were randomized in a 3:1 ratio to receive either the treatment group (n = 150) or control group (n = 50). Evaluations included blinded assessments using the validated Galderma Chin Retrusion Scale, Global Aesthetic Improvement Scale for aesthetic enhancement, and safety follow-up. The Galderma Chin Retrusion Scale responder rate (≥1 grade improvement) was significantly higher for the treatment group (70 www.springer.com/00266 .

目的 探讨基于结构式鼻整形亚单位原理进行自体肋软骨联合膨体聚四氟乙烯(expanded polytetrafluoroethylene,e-PTFE)在单侧唇裂继发鼻畸形整复中的治疗效果.方法 自 2016 年 8 月至 2022 年 12 月,北京大学第三医院成形外科收治25 例单侧唇裂继发鼻畸形患者,采用自体肋软骨联合PTFE矫正单侧唇裂继发鼻畸形.采用Face-Q量表评估患者手术前后鼻部美学的满意度以及鼻塞症状评估(nasal obstruction symptom evaluation,NOSE)量表评估术后鼻塞通气功能情况,同时记录患者术后并发症的发生情况.结果 25 例患者术后切口均一期愈合.术后获随访 3 个月至 6 年,鼻部形态良好,鼻尖及鼻小柱基本居中,鼻背较术前增高,鼻翼塌陷较术前减轻,双侧鼻孔间差异缩小,患侧鼻基底较术前抬高,无感染、鼻中隔偏曲、移植物外露等并发症发生.Face-Q量表评估结果提示,患者术后鼻部美学满意度明显提升;NOSE量表结果表明,患者通气功能在术后得到改善,评分差异具有统计学意义(P<0.05).结论 基于结构式鼻整形亚单位原理采用自体肋软骨联合e-PTFE修复单侧唇裂继发鼻畸形可以获得良好的术后效果.

This article reviewed our experience of Chinese nasal reconstruction over 12 years and evaluated the effect of expanded forehead flap both aesthetically and functionally. The special skin type and other anatomic features of Chinese patients was understood thoroughly during the treatment. This article thus catered for the need of multiracial nasal reconstruction. We analyzed existing clinical data and demonstrated a typical case in detail. The postoperative result supported our strategy which advocated the extensive application of expanded forehead flap, together with flip scar flap as the internal lining. The features of Chinese patients also prompted the use of costal and auricular cartilage. Emerging technology like 3D-printing would benefit nasal reconstruction from more aspects.

Paranasal augmentation has been a popular approach in restoring Asian patients’ lateral profile. Irregular surface in the surgical area emphasizes the importance of morphological evidence for the preoperative evaluation and the design of paranasal implants. We retrospectively collected craniofacial computer tomography scans of patients in the department of plastic surgery from 2020 to 2022. The imaging data were imported to Mimics (version 20.0; Materialize, Leuven, Belgium) for three-dimensional reconstruction. Measurements of osteal nasal base were performed in 3-matics (version 12.0; Materialize). The severity of paranasal concavity was graded by a senior doctor to study the correlation with measured variables. Fifty-seven patients with a median age of 27 years (IQR: 22–33) were included in the study. For design of paranasal implants, the lengths of both lower and lateral edge were measured for reference. In the regression analysis, the alar base-alveolar process angle was significantly associated with the degrees of paranasal concavity (OR = 1.222, p = 0.00001). Morphological data of osteal nasal base were measured and presented in the current study. The analysis supported that alar base-alveolar process angle be used for preoperative grading and evaluation to help guiding treatment decisions. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Objective:To explore the value of tailor-tack technology in vertical mastopexy and to evaluate the clinical effect of vertical mastopexy in correcting breast ptosis.Methods:From April 2010 to August 2020, 47 women aged 18 to 51 years took part in the study, and the tailor-tack technology was used to ensure the amount of redundant skin removal. The patients＇ degree of ptosis was moderate or severe, and the average age was 38.2 years.Results:All the cases had their drainage tube removed 2-3 days after surgery and the wound stitches removed 12-14 days after surgery. All patients had tight and full breasts after surgery. Patients were satisfied with their new breast shapes. After surgery, no patients showed early complications such as necrosis of nipple-areola complex or skin, poor wound healing or abnormal nipple sensation. Follow-up lasted for 6 months to 5 years, and there were no long-term complications such as recurrence of breast ptosis, poor nipple shape, scar flatten and enlargement.Conclusions:Tailor-Tack technology is useful in vertical mastopexy. It can be helpful to evaluate the amount of skin removal, effectively avoiding the situation of insufficient or excessive skin removal. Therefore, this is a desirable clinical skill in mastopexy.

Abstract This article reviewed our experience of Chinese nasal reconstruction over 12 years and evaluated the effect of expanded forehead flap both aesthetically and functionally. The special skin type and other anatomic features of Chinese patients was understood thoroughly during the treatment. This article thus catered for the need of multiracial nasal reconstruction. We analyzed existing clinical data and demonstrated a typical case in detail. The postoperative result supported our strategy which advocated the extensive application of expanded forehead flap, together with flip scar flap as the internal lining. The features of Chinese patients also prompted the use of costal and auricular cartilage. Emerging technology like 3D-printing would benefit nasal reconstruction from more aspects.

作为鼻解剖结构中最重要的亚单位之一,鼻小柱一直是整形外科领域学者、医师的关注重点.鼻小柱的损伤原因包括先天性与后天性两类.因其结构、位置复杂,鼻小柱的修复选择多样,主要包括全厚皮片、复合移植物和皮瓣三类,但目前仍未有一种能够普遍适用的方法,因而对合理修复技术策略的探讨十分必要.笔者通过回顾文献总结了目前各类鼻小柱缺损修复方式的适应证、优劣之处及主要并发症,并在既往学者研究的基础上加以改进,提出一种可能的鼻小柱缺损患者分型及治疗选择系统,以提高临床诊疗效率,帮助实现鼻部美学与功能的良好恢复.

BACKGROUND: As a contour-supporting material, the cartilage has a significant application value in plastic surgery. Since the development of hydrogel scaffolds with sufficient biomechanical strength and high biocompatibility, cell-laden hydrogels have been widely studied for application in cartilage bioengineering. This systematic review summarizes the latest research on engineered cartilage constructed using cell-laden hydrogel scaffolds in plastic surgery. METHODS: A systematic review was performed by searching the PubMed and Web of Science databases using selected keywords and Medical Subject Headings search terms. RESULTS: Forty-two studies were identified based on the search criteria. After full-text screening for inclusion and exclusion criteria, 18 studies were included. Data collected from each study included culturing form, seed cell types and sources, concentration of cells and gels, scaffold materials and bio-printing structures, and biomechanical properties of cartilage constructs. These cell-laden hydrogel scaffolds were reported to show some feasibility of cartilage engineering, including better cell proliferation, enhanced deposition of glycosaminoglycans and collagen type II in the extracellular matrix, and better biomechanical properties close to the natural state. CONCLUSION: Cell-laden hydrogels have been widely used in cartilage bioengineering research. Through 3-dimensional (3D) printing, the cell-laden hydrogel can form a bionic contour structure. Extracellular matrix expression was observed in vivo and in vitro , and the elastic modulus was reported to be similar to that of natural cartilage. The future direction of cartilage tissue engineering in plastic surgery involves the use of novel hydrogel materials and more advanced 3D printing technology combined with biochemistry and biomechanical stimulation.

乳房下垂是相对于挺拔、紧实的乳房形态的衰老表现,与年龄增长、体重骤减、妊娠哺乳、吸烟、隆乳术后延迟效应及发育畸形等因素相关[1,2]. 主要表现为乳头乳晕复合体( nipple-areola complex , NAC)位置的下降、乳房实质组织的下移及皮肤松弛[3]. 下垂的乳房背离女性对年轻化乳房形态的追求. 乳房上提固定术是临床上最主要的下垂矫正方式,是乳房整形中最常见的手术之一[4] ,严重并发症出现较少[ 5 ]. 手术矫正的目的是提高NAC、保持或增大乳房体积并紧致皮肤包被、改善对称性及乳房形态,并使术后效果持久. 乳房下垂的手术方法很多,术式及切口的选择依据下垂程度、皮肤去除量、是否增大乳房体积等因素. 本文就乳房下垂程度分级、乳房下垂矫正手术切口选择、腺体悬吊固定及塑形方法的新进展进行文献总结,为临床应用提供参考.

Epicanthoplasty is the most effective way to treat epicanthus,and it is also a fair choice to improve the eye shape and face shape.There were many different procedures for it,so did the modified ones newly arising in constant.To sort it out,the progress of epicanthus correction surgery was reviewed in this article.

OBJECTIVE To explore the clinical characteristics and the experience of blepharoplasty on mid-dle-aged and elderly people. METHORDS A retrospective study was carried out on 75 cases of blepharoplasty surgery of middle-aged and elderly people. According to different clinical phenotypes,such diverse surgery methods were selected to properly excise the flaccid eyelids,to correct local trichiasis of upper-lid, to strengthen and transfix the orbicularis oculi muscles of lower-lid. RESULTS Successful blepharoplasty surgery on middle-aged and elderly people was realized in 75 cases in 2 years,and the cosmetic effect was satisfactory. CONCLUSIONS The surgery for blepharoplasty of middle-aged and elderly people must correct local abnormal or degenerative status at the same time.

目的 探讨下睑赘皮切除法矫正先天性下睑倒睫的疗效.方法 回顾性病历研究.2010年10月-2012年10月在门诊施行下睑赘皮切除术治疗先天性下睑倒睫患者74例122只眼的手术效果.结果 术后下睑倒睫矫正,局部损伤的角膜上皮24小时内自行愈合.术后随访1年,有4只眼有不同程度(3～4根)倒睫复发,其中2例无刺激症状且未造成角膜损伤未进行处理,另外2例再次手术得以矫正.结论 对于先天性下睑倒睫采用下睑赘皮切除法治疗效果确实.

OBJEVTIVE To evaluate the operation of retrodisplacement of eyelid limbi's anterior layer for treatment of upper eyelid's recurrent trichiasis. METHORDS Made incision along the gray line, split the eyelid margin at a 4~5mm depth and 3~4mm length more than the trichiasis area. The eyelid margin was divided into two layers with the anterior layer(include eyelid skin and orbicularis oculi muscle) and posterior layer(include tarsal plate and conjunctiva). Shift the anterior layer upward to 3~5mm apart from the margin and then fixed it to the surface of the tarsal plate. RESULTS Eighteen cases with 32 eyes were operated and followed-up for 6~12 months. All cases were cured and no secondary ectropion and abnormal position of eyelid. CONCLUSIONS The operation of retrodisplacement of eyelid limbi's anterior layer is an effective method for treatment of upper eyelid's recurrent trichiasis.