ObjectiveTo investigate the influence of buried thread nasal augmentation on dorsal soft tissue of nose and revision rhinoplasty. Methods A clinical data of 29 patients requesting revision rhinoplasty after buried thread nasal augmentation, who were admitted between July 2017 and July 2019 and met the selection criteria, was retrospectively analyzed. All patients were female with an average age of 26.8 years (range, 18-43 years). The patiens were admitted to the hospital at 3-48 months after buried thread nasal augmentation (median, 15 months). Among them, there were 18 cases of insufficient nasal tip projection, 22 cases of insufficient nasal root projection, 7 cases of threads ectasia, 5 cases of threads exposure, 3 cases of infection, and 10 cases with two or more conditions. There were 9 cases of combined short nose deformity, 1 case of spherical hypertrophy of the nasal tip, 3 cases of deviation of the nasal columella, 3 cases of excessive width of the nasal base, and 1 case of nasal hump. Three infected patients only underwent threads removal and debridement. The rest patients underwent revision rhinoplasty, and the dorsum of the nose was made with polytetrafluoroethylene expansion; the tip of the nose was reshaped by taking autologous rib cartilage and alar cartilage in 16 cases, and by taking autologous septal cartilage and alar cartilage in another 10 cases. The threads and surrounding tissue specimens removed during operation were subjected to histologic observation. Nasal length and nasal tip projection were measured after revision rhinoplasty and the ratio was calculated to evaluate the nasal morphology; patient satisfaction was evaluated using the Likert 5-grade scale. ResultsPatients were followed up 12-48 months (mean, 18 months). Inflammation was controlled in 3 patients with infections caused by buried thread nasal augmentation. The remaining 26 patients had satisfactory results immediately after revision rhinoplasty. Before revision rhinoplasty and at 7 days and 6 months after revision rhinoplasty, the nasal length was (4.11±0.34), (4.36±0.25), and (4.33±0.22) cm, respectively; the nasal tip projection was (2.34±0.25), (2.81±0.18), and (2.76±0.15) cm, respectively; and the nasal tip projection/nasal length ratio was 0.57±0.08, 0.65±0.05, and 0.64±0.04, respectively. There were significant differences in the nasal length and the nasal tip projection between time points (P<0.05). There was a significant difference in the nasal tip projection/nasal length ratio between pre- and post-operation (P<0.05), but there was no significant difference between 7 days and 6 months after operation (P>0.05). The Likert score for satisfaction ranged from 1.5 to 5.0 (mean, 4.05). During follow-up period of 26 patients, no nasal prosthesis was exposed, and the shape of the nose was stable, and the nasal skin of 5 patients with exposed threads could be seen with different degrees of scarring; there was no infection, cartilage resorption, and no cartilage deformation, displacement, or exposure. Histological observation showed that absorbable threads were not only absorbed after implantation, but also with the prolongation of time, the inflammatory changes in the surrounding tissues caused by decomposition and absorption of the threads showed a gradual aggravation of the first, the heaviest inflammatory reaction in 6 to 12 months, and then gradually reduce the trend. Conclusion After implantation of the absorbable thread into the subcutaneous tissue of the nasal dorsum, the nature of the thread is different from the body’s own tissue, which will affect the soft tissue compliance of the nasal dorsum. The degradation and absorption of the thread will stimulate the infiltration of inflammatory cells and the proliferation of fibroblasts in the surrounding tissue and then form scar tissue, which will affect the design and effect of revision rhinoplasty.
A new type of sillicon rebber, which is a semisolid pairof room temperature vuleanizing silicones,has been used in103cases in plastic surgery, including saddle nose, smallchin,and defect of faicial bone. Satisfactory clinical resultswere achieved in 100 cases. Wound infection occured in2cases and the silicon rubber evacuated. The silicon rubberbody was excised because of infection. No adverse reactionwas observed in 64 follow-up cases.
Objective To summarize the techniques for reconstruction of partial breast defects after breast-conserving surgery in breast cancer. Methods The relevant literatures were reviewed and the oncoplastic techniques and their surgical indications, incision selection, advantages， and disadvantages were summarized. Results Kinds of poor aesthetic outcomes still exist in some patients after breast-conserving surgery due to the breast deformity. How to choose the surgical incision and repair breast defects after tumor resection so as to obtain better cosmetic outcomes is still a focus of breast-conserving surgery. Oncoplastic techniques can not only achieve safe cancer treatments but also have satisfactory aesthetic outcomes. Conclusions Oncoplastic techniques in the breast conservative therapy for early stage breast cancer is a safe and effective procedure， with highly satisfactory cosmetic outcomes in the majority of patients..
【摘要】目的 探討分段整形提縮注射術治療脫肛痔的臨床療效。方法 175例重度環狀痔, 沿肛緣弧形切除結締組織外痔以整形肛門, 再于結扎痔核基底及其上端黏膜下層注射消痔靈注射液,并進行療效觀察。結果 術后肛周水腫(72 h)、疼痛(24及72 h)明顯減少； 術后4周臨床治愈145例,好轉23例,總有效率為96.0%； 所有患者均隨訪3~6個月，未見復發。結論 選擇分段整形提縮注射術既比較徹底地去除了痔核使之不易復發，又整形了肛門，保護其大小和功能, 該術式可成為治療脫肛痔的較理想術式。
Objective To summarize the recent development in the plastic and reconstructive surgery. Methods The related literaturewas reviewed and the main achievements in the field of plastic surgery were summarized. Results Plastic and reconstructive surgery was one ofthe quickly-developed fields in the world medicine, especially aesthetic plastic surgery. Reconstructive plastic surgery and aesthetic plastic surgery would be bined in the future. The “aesthetic hand surgery” was a very important branch of the hand surgery,so not only the function recovery of the hand deformities but also the aesthetic sculpture for the deformed hand should be emphasized. Evaluation on measurement of the facial paralysis reconstruction was a main part of the facial examination. The allotransplantation of the face became more developed. The anatomical research on the cutaneous perforator arteries, vascularisation of the biceps femorismuscle, and the gracilis perforator flap was well performedby the plastic surgeons.
The authors reported nine patients with burn scar contracture of head and face treated by operation. The varieties of operations ineiuded: (1) excision of the scar and primary closure of the wound; (2) excision of the scar and coverage of the wound with split or full thickness skin grafts; (3) excision of the scar and repaired by pedicled flap, and (4) skin expansion by expander, followed by excision the scar and transfer of the "more available skin flap" to the wound. According to certain characteristics of children, the choice of the time for operation, the indications of each methods, and some problems related to operation ahd been discussed.