Abstract:Objective To explore the relationship between the pre-tarsal fat-fascia layer and upper eyelid morphology,guiding bionic natural double eyelid reconstruction surgery.Methods From January to September 2021,Department of Dermatology and Cosme-tology,Changsha County People's Hospital investigated the pre-tarsal fat-fascia layer in single and double eyelids through ultrasound imaging,intraoperative observation,cadaver dissection,and histological analysis.(1)Ultrasound observation:An Aplio ultrasound with an 18 MHz probe was used to examine 58 volunteers(116 eyelids),divided into Group A(congenital single eyelids,58 eyes)and Group B(congenital double eyelids,58 eyes).Ultrasound images were analyzed to observe the pre-tarsal fat-fascia structure.Measurements were taken at three points.Point a:Intersection of the pupillary midline and double eyelid line(7 mm from the eyelid margin in single eyelids).Point b:Midpoint between Point a and the lateral canthus on the double eyelid line.Point c:Midpoint between the double eyelid line and medial canthus.The thickness and layering of the pre-tarsal fat-fascia layer were recorded.(2)Intraoperative observation:86 eyelids(Group A:47 single eyelids;Group B:39 double eyelids)were analyzed during surgery.Structural differences and volume of the pre-tarsal fat-fas-cia layer were measured.(3)Cadaver dissection and histological observation:Six cadaver heads(Group A:3 single eyelids;Group B:3 dou-ble eyelids)were dissected.Gross observation was performed on one side of the bilateral eyelids,and specimens were taken from the other side for HE and Masson staining observation.Results(1)Ultrasound observation:Both groups exhibited a two-layered pre-tarsal fat-fas-cia structure:a superficial loose fat-fascia layer(hypoechoic)and a deep dense fascia layer(hyperechoic).The dense layers of the double eyelid and the single eyelid were closely attached to the surface of the tarsal plate and were very thin,and there is no statistically significant difference(P＞0.05).Thickness of loose fat fascia tissue:In group A,the thickness at Point a was(1.03±0.34)mm,the thickness at Point b was(2.43±0.79)mm,and the thickness at Point c was(2.53±0.49)mm.In group B,the thickness at Point a was(0.88±0.14)mm,the thickness at Point b was(2.06±0.76)mm,and the thickness at Point c was(1.82±0.45)mm.The thickness of the three points in group A was all higher than that in group B(P＜0.001).(2)Intraoperative observation:Both groups showed a layered structure.The loose layer in Group A was thicker and continuous with the retro-orbicularis oculi fat(ROOF),while the dense layer connected to the orbital septum and levator aponeurosis.After removal,the loose layer volume in Group A[0.06(0.04～0.07)ml]exceeded Group B[0.04(0.03～0.05)ml](P＜0.001).(3)Cadaver and histological observations:Gross dissection revealed continuity between the pre-tarsal loose fat-fascia layer and ROOF.HE staining confirmed two layers:a loose layer(fat and sparse connective tissue)and a dense layer(tightly adhering to the tarsal plate).Group A had a thicker loose layer.Masson staining showed the dense layer comprised dense fibrous connective tissue with abundant vasculature,while the loose layer contained fat and minimal fibrous tissue.Conclusion The pre-tarsal fat-fascia layer in single and dou-ble eyelids consists of superficial loose and deep dense layers.The loose layer may critically influence double eyelid formation.Manipulat-ing the pre-tarsal loose fat-fascia layer may aid in shaping a bionic double eyelid.

Abstract:Objective To investigate the efficacy of three-dimensional orbital septal fat flap transposition in the correction of tear trough deformity associated with lower eyelid bags.Methods A retrospective analysis was conducted of 167 patients(334 eyes)with lower eyelid bulging combined with varying degrees of tear trough deformity,who underwent treatment in the Department of Plastic and Aesthetic Surgery,Xiangya Hospital of Central South University,from January 2022 to December 2024.All patients underwent lower eyelid bag cor-rection combined with three-dimensional orbital septal fat flap transposition for tear trough filling.Postoperative follow-up was performed to observe and evaluate surgical outcomes.Results All 167 patients successfully completed the surgery.Subcutaneous nodules in the lower tear trough were palpated in 20 patients(11.98％,20/167),including 3 cases(3.33％,3/90)via transcutaneous approach and 17 cas-es(22.08％,17/77)via transconjunctival approach.All nodules resolved completely within 1 to 2 months of follow-up.No significant or-bital septal fat retraction,incision infection,diplopia,injury to the infraorbital vessels or nerves,contour irregularity,or ectropion was ob-served.Patient self-assessment showed 143 cases satisfied,19 cases basically satisfied,and 5 cases dissatisfied.The global aesthetic im-provement scale(GAIS)scores assessed by attending plastic surgeons averaged(2.71±0.50),including 123 cases scoring 3,40 cases scor-ing 2,and 4 cases scoring 1.Conclusion Three-dimensional orbital septal fat flap transposition for tear trough correction in patients with lower eyelid bags effectively reduces orbital septal fat retraction,demonstrates favorable safety,and is worthy of clinical application and promotion.

Abstract:Objective To compare the therapeutic effects of the"floating bridge"technique and the levator aponeurosis shorten-ing procedure in the correction of mild to moderate ptosis of the upper eyelid.Methods A total of 88 patients(133 eyes)with ptosis ad-mitted to the Department of Plastic and Cosmetic Surgery,Xuzhou First People's Hospital from January 2022 to October 2024 were selected as study subjects.Based on the surgical procedure,the patients were divided into an observation group(67 eyes,treated with the"floating bridge"technique)and a control group(66 eyes,treated with levator aponeurosis shortening procedure).The postoperative marginal reflex distance 1(MRD1)values and complications were compared between the two groups.Results The mean preoperative and postoperative MRD1 values in the observation group were(1.38±0.54)mm and(3.63±0.41)mm,respectively,showing a significant difference(P＜0.001).In the control group,the mean preoperative and postoperative MRD1 values were(1.31±0.50)mm and(3.15±0.31)mm,respectively,also showing a significant difference(P＜0.001).There was no statistical difference in preoperative MRD1 values between the two groups(P=0.398).However,there was a statistically significant difference in postoperative MRD1 values between the two groups(P＜0.001).In the observation group,the incidence of complications was 7.4％,whereas in the control group,the incidence of complications was 19.7％,with a statistically significant difference between the groups(P＜0.05).Conclusion Both the levator aponeurosis shortening surgery and the"floating bridge"technique can improve ptosis.The postoperative effect of the"floating bridge"technique is more stable and lasting,with a lower incidence of complications.

Abstract:Objective To evaluate the clinical efficacy of extracorporeal arterial mechanical perfusion in local drug delivery for reconstructing microcirculation in ischemic limbs to promote wound healing.Methods A retrospective study was conducted on 58 pa-tients with chronic limb-threatening ischemic wounds from January to December 2024.The patients were divided into two groups based on treatment.The patients in observation group received extracorporeal arterial mechanical perfusion of alprostadil(6 h/d for 7 d)with daily wound dressing changes.The patients in control group received continuous intravenous alprostadil infusion(once daily for 7 d)with daily wound dressing changes.Transcutaneous oxygen pressure(TcPO2),skin temperature,and wound area were compared between groups post-treatment.Results The TcPO2 and skin temperature of the affected limbs in both groups were significantly increased compared with those before treatment,and the wound area was smaller than that before treatment(P＜0.05).The observation group exhibited greater im-provements in TcPO2,skin temperature,and wound healing(P＜0.05).Conclusion Extracorporeal arterial mechanical perfusion of al-prostadil can accelerate wound healing by restoring microcirculation in ischemic limbs.

Abstract:The article explores a model for the implementation of teaching surgical days in plastic surgery,based on the cultivation of six core competencies for resident physicians.By analyzing the objectives,overarching principles,selection of surgeries,faculty manage-ment,admission standards for trainees,procedural flow,and risk prevention associated with these surgical teaching days,we have con-structed a comprehensive model tailored to plastic surgery education.This model aims to enhance residents' professional qualities,includ-ing knowledge and skills related to patient care,as well as their communication and collaboration abilities,teaching competence,and ca-pacity for lifelong learning.Simultaneously,it seeks to ensure medical quality and patient safety.It is anticipated that this framework may serve as a template for improving both the effectiveness and substantive aspects of surgical teaching in the field of plastic surgery.

Abstract:Autophagy is a process of cellular degradation and recycling,which plays a crucial role in va rious biological functions including hair growth.It is mainly categorized into three types:Macroautophagy,Chaperone Mediated Autophagy,and Microautophagy,which collectively maintain cellular homeostasis through distinct mechanisms.Previous studies have revealed that autophagy participates in hair growth and the process of alopecia by regulating the hair follicle cycle,influencing the activity of hair follicle stem cells,and modulat-ing the hair follicle microenvironment.In recent years,various therapeutic strategies targeting autophagy in hair growth and alopecia treat-ment have been proposed,including drug interventions,nutritional regulation,and physical stimulation.This review summarizes the re-search progress on the role and mechanisms of autophagy in hair growth and alopecia,with the aim of providing insights for future research and clinical applications.

Abstract:Objective To explore the clinical effect of capsulopalpebral fascia tightening combined with lateral orbicularis oculi suspension in treating recurrence after correction of degenerative lower eyelid entropion.Methods Thirteen patients(21 eyes)with recur-rence after correction of degenerative lower eyelid entropion,who were treated in the Department of Burn and Plastic Surgery,Naval Medi-cal Center of PLA from September 2021 to August 2023,were selected and underwent surgery via the lower eyelid skin approach.During the operation,the capsulopalpebral fascia was exposed,appropriately folded and tightened,and intermittently sutured and fixed to the lower edge of the tarsal plate.Meanwhile,the lateral orbicularis oculi muscle was suspended and fixed to the temporal orbital rim periosteum.A small amount of excess loose skin was removed,and then the incision was sutured.The patients were followed up for 6 to 18 months to e-valuate the surgical efficacy.Results All 13 patients achieved good correction of lower eyelid entropion,and no complications such as ec-tropion or eyelid-globe separation occurred.The therapeutic effect evaluations all met the criterion of cure.Conclusion Capsulopalpebral fascia tightening combined with lateral orbicularis oculi suspension can effectively correct the recurrence after surgery for degenerative lower eyelid entropion.It can not only solve the problem of trichiasis but also meet the patients' cosmetic needs,with significant clinical efficacy.

Abstract:Objective To evaluate the clinical efficacy and safety of transcutaneous approach orbital septal fat repositioning lower blepharoplasty combined with lateral canthoplasty.Methods A retrospective analysis was conducted on 45 patients with lower eyelid bags accompanied by tear trough deformity who underwent correction in the Department of Plastic Surgery at Shenyang Seventh People's Hospital from May 2023 to January 2025.During lower blepharoplasty,dissection was performed along the preseptal space via a subciliary incision without disturbing the periosteum below the orbital rim,preserving its integrity to provide a stable anchoring point for subsequent fixation.The released orbital fat was repositioned and sutured fixedly onto the infraorbital rim periosteum.A lateral canthal extension inci-sion was used to perform lower eyelid composite flap suspension and lateral canthoplasty.Results Postoperative follow-up ranged from 6 to 24 months.The lid-cheek junction was smooth,and the tear trough deformity was significantly improved.Among the 45 patients,42(93.3％)were very satisfied with the outcome,and 3(6.7％)were satisfied.Conclusion Transcutaneous orbital septal fat repositioning blepharoplasty combined with lateral canthoplasty achieves harmonious rejuvenation of the lower eyelid-midface complex through anatom-ical restoration and volumetric redistribution,demonstrating significant clinical value.

Abstract:Injection rhinoplasty effectively addresses aesthetic concerns caused by insufficient nasal tissue volume or suboptimal morphology.With the proliferation of various fillers in the market,reports on related complications have increased.This review summarizes recent research progress in injection rhinoplasty,including common filler types,injection techniques,complications,and prevention/treat-ment strategies,aiming to provide valuable references for the healthy advancement of this field.

Abstract:Objective To systematically evaluate the efficacy and safety of fractional laser and pulsed dye laser(PDL)in the si-multaneous treatment(recombination laser technology)of scars.Methods China National Knowledge Infrastructure(CNKI),Wanfang Medical online,VIP website,PubMed database,Sinomed database,Embase database,and Cochrane Library database were searched from the establishment of the database until March 2025.Relevant clinical studies on the treatment of scars with recombination laser technology were included,and the evaluation indicators mainly included treatment efficacy rate,Vancouver scar scale(VSS),patient and observer scar assessment scale(POSAS),and adverse reaction incidence rate.The efficacy and safety of recombination laser technology in the treatment of scars were systematically evaluated.Results A total of 14 studies were included.(1)Comparing the effective rates of recombination laser technology and fractional laser in scar treatment,the combined treatment group had a higher effective rate[RR(95％CI)=1.33(1.02,1.73),I2=58％,P=0.03].(2)After treating scars with recombination laser technology,the VSS score significantly decreased[SMD(95％CI)=-4.5(-6.07,-2.93),I2=95％,P＜0.00001],and scars improved in pigmentation,vascularity,pliability,and height.(3)After the treatment of scars with recombination laser technology,both the POSAS score of observers[SMD(95％CI)=-11.15(-17.99,-4.31),I2=100％,P=0.001]and the POSAS score of patients[SMD(95％CI)=-11.75(-15.04,-8.46),I2=100％,P＜0.00001]significantly decreased.(4)There was no statistically significant difference in the incidence of adverse reactions to scar treatment by using recombination laser technology and frac-tional laser[RR(95％CI)=0.68(0.20,2.29),I2=0％,P=0.53].(5)Recombination laser treatment for early scars,especially immature scars,can improve the condition of scars.Conclusion Recombination laser technology is safe and effective for treating scars,and is superior to single-type fractional laser therapy.

Abstract:Objective To evaluate the clinical value of corneal bandage lenses in frontalis muscle suspension surgery for pedi-atric congenital ptosis and their impact on therapeutic outcomes.Methods This retrospective study analyzed 100 pediatric patients with congenital ptosis treated at Department of Ophthalmology,Children's Hospital of Hebei Province from May 2022 to December 2024.Among the 50 patients who used corneal bandage lenses,12 experienced≥1 dislocation episode.Participants were stratified into an observation group(corneal bandage lenses users,n=50)and a control group(non-corneal bandage lenses users,n=50).Postoperative outcomes,in-cluding palpebral fissure height,aesthetic scores,and patient satisfaction,were evaluated at 3-month follow-up.Results Frontalis mus-cle suspension surgery significantly improved from preoperative(3.31±0.31)mm to(7.85±0.52)mm,mean improvement:(4.54±0.55)mm(t=82.37,P＜0.0001).No intergroup differences were observed in palpebral fissure height improvement or aesthetic scores(P＞0.05),though both groups demonstrated significant aesthetic improvements versus baseline(P＜0.0001).The effective rates of relief of ocular discomfort in the observation group and the control group were 84％and 70％respectively,with a statistically significant difference(P＜0.05).Weakened frontalis muscle function and refractive errors were identified as high-risk factors for lens dislocation.The increased strength of levator palpebrae superioris muscle was a protective factor to reduce the prolapse of bandage spectacles.Conclusion Frontalis muscle suspen-sion surgery effectively corrects pediatric congenital ptosis.Adjuvant corneal bandage lenses application mitigates postoperative discomfort and prevents exposure keratitis.Dislocation risks correlate with ocular functional status,particularly frontalis muscle dynamics and ambly-opia.Individualized perioperative management is recommended for high-risk patients to optimize corneal bandage lenses retention.

Abstract:Objective To explore a simple and effective surgical technique for repairing iatrogenic lower ectropion caused by cosmetic lateral canthoplasty.Methods From October 2023 to December 2024,18 patients with lower ectropion and lower eyelid conjunc-tival exposure following cosmetic lateral canthoplasty performed at other institutions were treated at the Department of Burn and Plastic Surgery,Naval Medical Center of PLA.All cases were repaired using the lower eyelid anterior and posterior lamellar interdigitating displace-ment technique to restore the morphology and function of the lateral canthus.Results All patients were followed up for 6 to 16 months post-operatively,with an average follow-up time of 9 months.Lower ectropion and conjunctival exposure were completely resolved,and the lower eyelid margin appearance approached normal.Conclusion The lower eyelid anterior and posterior lamellar interdigitating displacement technique is a simple and effective method for repairing lower ectropion and conjunctival exposure following cosmetic lateral canthoplasty.

Abstract:Objective To explore the improvement effect of various types of tear trough deformity treated by transconjunctival or-bital septal fat repositioning using direct fixation with the lifted deep nasolabial fat in soft-tissue space.Methods From August 2019 to June 2025,a retrospective study of 118 patients(236 eyes)who underwent the transconjunctival orbital fat transposition with normal-vision dissection and direct fixation in soft-tissue space for various types of tear trough deformity.The orbital fat was fixed with the lifted deep na-solabial fat.The collected data included age,surgical outcomes,patient satisfaction,and postoperative complications.The types of tear trough deformity were assessed before surgery according to the Turkmani classification system.Results The mean follow-up time was(12.2±4.2)months.There were 32 cases(13.6％)type Ⅰ,18 cases(7.6％)type Ⅱ,96 cases(40.7％)type Ⅲ and 90 cases(38.1％)type Ⅳ.Among all types of tear troughs,85.6％achieved the best result of complete improvement after surgery,13.1％achieved obvious improvement,the smoothness of the lower eyelid-cheek area was significantly better than before surgery,and only 1.3％required re-treat-ment.No serious short-term or long-term complications were observed.Conclusion In the transconjunctival orbital fat transposition,di-rectly fixing the orbital fat with the lifted deep nasolabial fat in soft-tissue space is safe and effective in the treatment of various types of tear trough,and worthy of clinical application.

Abstract:Objective To evaluate the effectiveness of precise mandibular angle osteotomy and chinplasty under the guidance of digital design in lower facial contouring surgery.Methods Fifty-five patients who requested mandibular angle osteotomy or chinplasty for facial contouring from August 2021 to August 2024 were admitted to Department of Plastic and Reconstructive Surgery,Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.With the assistance of digital technology,preoperative and postoperative prediction plans were designed and surgical templates were fabricated.During the operation,precise osteotomy was per-formed under the guidance of metal template.Six-month postoperative follow-up was conducted to assess the effectiveness and safety of the surgery.Effectiveness was evaluated by using three-dimensional CT data to assess the accuracy of osteotomy and the FACE-Q scale to eval-uate patient satisfaction before and after the operation.Safety was evaluated by postoperative healing and complications.Results Fifty-five patients were successfully treated without severe complications.CT measurement data showed that the width of the lower face,mandibular angle,masseter muscle thickness,and mandibular asymmetry were significantly improved.There was no statistically significant difference between the actual surgical error and the preoperative customized plan.FACE-Q scale scores indicated that patients'satisfaction with their appearance increased and their quality of life improved.Conclusion Digital design-assisted lower facial contouring surgery demonstrates high levels of effectiveness and safety.

Abstract:Closed negative pressure drainage technology is an effective method for treating infected wounds.The difficulty of closed fixation mainly lies in special areas,such as the maxillofacial and cervical regions,the top of the head,hands and feet,the perineum,the perianal region,and external fixation bracket wounds.Proper implementation of this technology can effectively reduce wound infection and promote wound healing,improve the clinical efficacy of VSD,and reduce the incidence of complications.This article provides a review of closed negative pressure drainage technology for sealing and fixing wounds in specific locations.

Abstract:Objective To discuss the therapeutic effect of a new skin tension closure device on wound reduction and wound clo-sure.Methods Small Bama pigs were selected for the experiment,and two groups of fusiform wounds were made on both sides of each animal's back.The skin tension control closure device and the control product disposable skin co-attachment device were respectively ap-plied to the skin wounds.The control group was treated with the control product disposable skin pulling device.The wound closure time and wound healing after secondary suture were observed and recorded.The risk of scar formation after wound removal and healing was as-sessed by the Vancouver Scar Assessment Scale.The animal tissues cut at different time points were observed by hematoxylin eosin(HE)staining and Masson staining.The wound data of the experimental group and the control group were statistically compared and analyzed.Results The wound healing rate of the experimental group was higher than that of the control group on the same day.Compared with the control group,the experimental group had more obvious effect of immediate wound tightening,and the average daily wound healing rate of the experimental group was higher than that of the control group.There was a significant difference in the early wound healing rate between the experimental group and the control group.The wound healing rate of the experimental group was faster than that of the control group.The wound healing rate of the experimental group was(90.36±2.60)％and(93.28±2.97)％on the postoperative day and the first postoperative day,respectively,and that of the control group was(74.21±3.58)％and(85.26±6.33)％,respectively.The difference was statistically signifi-cant(P＜0.05).The wound healing rate was(90.36±2.60)％in the experimental group and(74.21±3.58)％in the control group on the day af-ter surgery.During the healing period,both the experimental group and the control group achieved lower scores when the wound was com-pletely closed,and the wound healed well.Both the experimental group and the control group achieved Grade A wound healing with good wound healing and slight skin scar formation inclination.The results of HE and Masson staining were similar between the experimental group and the control group,the scar formation risk was at a low level.Conclusion The pig wound closure experiment confirmed that the new skin tension clamper for the treatment of skin and soft tissue defect wound has definite curative effect,short wound healing time,few complications,simple operation and safe use.

Abstract:Objective To observe the efficacy and cosmetic outcomes of parotid gland tumor resection through a hidden incision for small tumors(less than 2.0 cm).Methods From July 2019 to April 2024,14 patients with parotid gland tumors were treated.The 14 pa-tients underwent regional resection or superficial parotidectomy for parotid tumors using a hidden incision.Results All tumors were com-pletely resected.One patient experienced temporary dysfunction of the mandibular branch of the facial nerve,two patients developed fluid accumulation,and one patient had a small area of necrosis in the ear canal cartilage.All complications healed well after three weeks of dressing changes.After follow-up of 4 to 46 months,there was no tumor recurrence,and the scars were well concealed.Conclusion Re-section of parotid tumors through a hidden incision yields satisfactory therapeutic results and provides an excellent cosmetic outcome.

Abstract:Objective To investigate the clinical efficacy of the stable costal cartilage scaffold complex in the correction of cleft lip nasal deformity.Methods From April 2018 to January 2025,our team performed surgical correction using the stable costal cartilage scaffold complex in 10 patients with cleft lip nasal deformity.Results Postoperative follow-up ranged from 3 to 18 months.All patients demonstrated significant improvements in nasal alar collapse,lateral displacement of the alar base,deviated nasal septum,columellar devi-ation,bilateral nostril asymmetry,and restricted respiratory function on the affected side.Based on follow-up photographs,mild columellar deviation toward the non-affected side was observed at 18 months compared to 6 months postoperatively,likely attributable to prolonged comprehensive biomechanical forces.This deviation was subsequently corrected under local anesthesia using a columellar base skin flap,the patient was satisfied.Other patients expressed satisfaction with the outcomes.Conclusion The stable costal cartilage scaffold complex is an effective and reliable approach for correcting cleft lip nasal deformity,warranting broader clinical application.

Abstract:Objective To observe the clinical effect of concealed incision in repairing secondary nasal deformity caused by uni-lateral cleft lip.Methods A retrospective study reviewed 28 patients with unilateral cleft lip secondary nasal deformity who received con-cealed incision approach treatment at the Deparement of Cleft Lip and Palate of Plastic Surgery Hospital,Chinese Academy of Medical Sci-ences and Peking Union Medical College from August 2022 to October 2024.Nasolabial muscle reconstruction was performed via a con-cealed incision at the alar base.Preoperative and postoperative measurements included the ratios of clefted to non-clefted sides for alar base width,nostril width and height,lateral lip height,columellar deviation,and nostril area.Surgical outcomes were quantitatively assessed through these dimensional ratios.Results A total of 28 patients were included.The follow-up period was 6 to 8 months.The nasal mea-surement data before and after the operation were statistically significant.The concealed incision healed well.All wounds healed in stage Ⅰwithout serious complications.The asymmetry in the size of both nostrils,the collapse of the alar on the split side,the abduction of the alar base,and the deviation of the nasal columella were all significantly improved(P＜0.05).Conclusion For patients with mild white lip scars,con-cealed incision technique safely achieves optimal nasal correction while preserving lip aesthetics.