Objective:This study aims to investigate the clinical efficacy of targeted injection of stromal vascular fraction (SVF) gel based on the anatomy of the periorbital fat compartment in the treatment of orbital aging with soft tissue loss.Methods:A retrospective cohort study was conducted on 46 patients with periorbital rejuvenation in the Department of Plastic Surgery of the First Affiliated Hospital of Bengbu Medical College from January 2021 to June 2022. The patients included 43 females and 3 males, with age of 27-47 (35.3±3.5) years and body mass index (BMI) of 18.6-24.4 (20.5±1.6) kg/m 2. Periorbital aging was rated as grade 1 in five patients, grade 2 in 17 patients, and grade 3 in 24 patients. Coleman fat and SVF gel were prepared by manual liposuction at low negative pressure in the inner thigh or lower abdomen. According to the different injection materials and methods, the patients were divided into two groups: the observation group (25 patients) and the control group (21 patients). The periorbital depression was filled with fine targeted injection based on the anatomy of the periorbital fat compartment, and that of the control group was filled with Coleman fat. Baseline data such as sex, age, BMI, periorbital aging grade, operation success rate, and postoperative complications were compared between the two groups. The three-dimensional(3D) scanning images of the patient's face before, immediately after, and 3 months after the operation were best fitted by 3D laser scanner. Changes in periorbital volume were analyzed by color scale map. The linear distance between the lacrimal groove point and the periorbital sulcus depression in 38 patients without secondary filling within 1 month after surgery was calculated. The satisfaction of patients was evaluated using a questionnaire 3 months after the operation. Results:No significant differences in sex, aging grade, age, and BMI were found between the two groups (all P values>0.05). All the 46 patients completed the injection and filling treatment, and postoperative complications such as infection, hematoma, fat embolism, induration, and unequal complications were not recorded. Eight patients received secondary filling injection within 1 month after the first injection according to the patient's request and the surgeon's evaluation. Compared with the preoperative 3D deviation color scale map, the periorbital injection area of all patients increased in volume 3 months after the operation. The linear distance showed that the depression of the upper and lower eyelids was significantly improved in the observation group and the control group who received secondary injection 3 months after the operation. However, the improvement values at 3 months after the operation were lower than those immediately after the operation, and the differences were statistically significant ( t=18.76, 20.02, 9.94, 23.63, all P values<0.001). At 3 months after the surgery, the improvement value of orbital eyelid sulcus depression in the observation group (12 patients) was 4.90±0.41 mm, which was higher than that in the control group (10 patients) ([3.81±0.28 mm]). The improvement value of lacrimal sulcus point depression in the observation group (18 patients) was 2.21±0.22 mm, which was higher than that in the control group (14 patients) ([1.81±0.22 mm]), and the differences were statistically significant ( t=7.17, 4.99, all P values <0.001). The satisfaction of the observation group was higher than that of the observation group at 3 months after the surgery, and the difference was not statistically significant between the two groups ( Z=1.30, P=0.194). Conclusion:Based on the anatomy of periorbital fat compartment, fine targeted injection of SVF gel can improve periorbital depression and skin quality better than the traditional Coleman fat injection and has fewer postoperative complications and higher patient satisfaction; hence, the proposed method has higher clinical value in periorbital rejuvenation.

Dermatofibrosarcoma protuberans ( DFSP ) is very rare in clinic, and its diagnosis is not specific. According to the literature domestic and abroad, only 18 cases of patients during gestation period suffered from DFSP have been reported. This paper reported a case from the Department of Plastic Surgery, the First Affiliated Hospital of Bengbu Medical College in April 2022 diagnosed with DFSP during pregnancy.The DFSP showed rapid growth and pain during pregnancy, and stopped rapid growth after delivery. Extensive local resection was performed and the incision margin exceeded 3 cm diameter of the tumor. One-stage skin graft was used to repair the defect. HE staining showed a single spindle cell, arranged in a vortex, with large and dark nuclei. Some nuclei were heteromorphic, and few mitotic figures were observed. Postoperative pathology showed negative margins and basement. Immunohistochemistry showed CD34 (+ + ), Ki-67 (+, 10% ), bcl-2 (-), s-100 (-), SMA (-), CD163 (-), CD68 (-), which were consistent with the diagnosis of DFSP. The pathogenesis of DFSP is not yet clear. As a special population, patients during gestation period need special treatment and diagnosis. Through literature review, this paper summarizes the reports domestic and abroad, and discusses the diagnosis, treatment and prognosis of patients with DFSP during pregnancy.

目的 重建上睑提肌腱膜与眼轮匝肌及皮肤之间的连接,构建先天重睑的生理结构和动力系统,形成重睑.方法 采用切开法重睑成形术,在睑板前筋膜浅面充分分离眶隔和上睑提肌腱膜融合部,至睑板上缘水平,将重睑切口上唇下方的眼轮匝肌与睑板上缘处的上睑提肌腱膜间断缝合,皮肤缝合采用皮肤—眼轮匝肌—皮肤的方式.结果 30例求美者随访6个月,所有求美者术后肿胀时间短,恢复快,闭眼时重睑线不明显,睁眼时弧度流畅、形态自然,动态感十足.结论 重睑成形术中,构建重睑的生理结构和动力系统,可以使重睑手术获得更自然、更可靠的效果.

目的:探讨面横动脉穿支皮瓣在老年颧面部皮肤肿瘤治疗中的应用价值.方法:选取2020年9月-2021年9月就诊于笔者科室的14例颧面部肿瘤患者,收集其基本信息进行回顾性分析.患者肿瘤均行扩大切除,设计以面横动脉穿支为蒂的筋膜皮瓣,作改良V-Y推进,修复切除术后缺损.术后观察皮瓣受、供区外观,并进行相关并发症随访.结果:14例患者皮瓣均存活,患者张口度正常、两侧颧面部对称;术后随访3～12个月,受、供区瘢痕不明显,皮瓣颜色、厚度与周围皮肤无明显差异,患者对功能和外观满意度较高.结论:面横动脉穿支皮瓣在颧弓附近血供较恒定、静脉回流良好、旋转角度灵活,修复后两侧颧部基本对称,在颧面部肿瘤的治疗中具有较高的临床价值.

Autologous cartilage grafts are increasingly used in the treatment of cleft lip nasal deformity, but nasal alar retraction caused by lining defects often occurs after surgery. We designed a new graft to treat unilateral cleft lip nasal deformity while avoiding nasal alar retraction. Nineteen patients in our hospital underwent unilateral cleft lip nasal deformity repair surgery with an auricular cartilage-skin graft. The effect of surgery was evaluated in four aspects: satisfaction with postoperative appearance, nasal aesthetic subunit indices, position of the nasal alar rim and three-dimensional spatial difference. Overall satisfaction with each index was above 90 www.springer.com/00266 .

目的 评估优化脉冲技术(OPT)联合CO2点阵激光对面颈部早期瘢痕干预的临床效果.方法 随机选取自2020年10月至2022年2月就诊于我院的早期面颈部瘢痕的患者96例,随机分成4组,每组24例.4组患者在术后两周分别给予硅凝胶应用、CO2点阵激光+硅凝胶应用、OPT+硅凝胶应用、OPT+CO2点阵激光+硅凝胶应用治疗.除硅凝胶外均给予3次治疗,每次间隔1个月.治疗前、第3次治疗后1个月,分别采用患者评估量表(PSAS),观察者评估量表(OSAS)、新版温哥华瘢痕评估量表(VSS)对患者面颈部瘢痕进行比较分析;记录患者满意度及不良反应.结果 治疗后各组满意率分别为58.33％、83.33％、79.17％、95.83％.治疗后VSS、OSAS、PSAS之间结果差异均有统计学意义(P<0.05)及VSS评分在色泽、血管、柔软度较治疗前差异有统计学意义(P<0.05),治疗中有两例出现水泡、渗出经过及时干预无明显异常.结论 OPT联合低能量CO2点阵激光对面颈部瘢痕早期干预疗效满意且不良反应小,值得临床推广应用.