ObjectiveTo investigate the anatomic features of the perforating branch flap of the medial vastus muscle, so as to provide a new perforating branch flap for repairing the soft tissue defect. MethodsSix fresh donated lower limb specimens underwent an intra-arterial injection of a lead oxide and lactoprene preparation. The integument of the thigh was dissected to observe the origin, course, size, and location of the perforating branch of the medial vastus muscle by angiography and photography. Based on the anatomic study, the free perforating branch flaps of the medial vastus muscle (14 cm × 6 cm to 20 cm × 5 cm) were used to repair skin and soft tissue defects (8 cm × 6 cm to 12 cm × 8 cm) of the feet in 4 patients between June 2009 and August 2011. ResultsThe artery of the medial vastus was sent out constantly from the femoral artery, and then descended in the vastus muscle to lateral patella where it anastomosed with the terminal branches of lateral femoral circumflex artery to form prepatellar vascular network. The artery of the medial vastus sent out 3-5 musculocutaneous perforating branches into the deep fascia and then extended superficially to the overlying skin. Four flaps survived after surgery; wounds at the donor site and recipient site healed by first intention. After follow-up of 6-12 months, the flaps had good appearance and texture. All ankles had normal movement range of plantarflexion and dorsiflexion. ConclusionThe free perforating branch flaps of the medial vastus muscle can be harvested easily, and have the advantage of good texture and abundant donor site.
ObjectiveTo investigate the effectiveness of retro-orbicularis oculi fat resection in Park double eyelid surgery to correct the swollen upper eyelid.MethodsBetween September 2015 and July 2016, partial resection of the retro-orbicularis oculi fat was performed on 32 cases with bilateral swollen upper eyelids in Park double eyelid surgery. There were 10 males and 22 females with an average age of 25 years (range, 19-32 years). The patients had normal function of the levator muscle, and had no history of double eyelid surgery.ResultsAll the incisions healed by first intention. There was no obvious congestion, swelling, levator muscle dysfunction. All patients were followed up 2-14 months, with an average of 10 months. The double eyelid fold was naturally smooth, without depressed scar; blepharochalasis was obviously improved, and the function of upper eyelid levator muscle was normal. All patients were satisfied with the aesthetic effect.ConclusionPark double eyelid surgery and partial resection of retro-orbicularis oculi fat can effectively improve the aesthetic effect in patients with swollen upper eyelid, and can achieve the perfect function and appearance.
Objective To investigate the surgical methods and outcome of reshaping the nose by using autologous cartilage grafting-silicone gel complex combined with trimming the lower lateral cartilages and thinning the superfluous tissue of the tip. Methods Between May 2006 and July 2008, 36 patients with ugly nose shape received open nasal plasty by thinningthe superfluous tissue and trimming the lower lateral cartilages combined with implant of auto-cartilage and silicone gel complex. There were 3 males and 33 females with an average age of 23 years (range, 18-36 years), including 20 cases of hypertrophy and obtuse round of nasal tip, 10 cases of flat of nasal tip, 2 cases of sl ight nostril exposure, and 4 cases of small whole nose with hypertrophy of nasal tip. Among them, 8 cases received 2-time operations. Results All incisions achieved heal ing by first intention. No deformation and compl ication occurred at donor sites of cartilage. The appearance, contour, color, and touch sensation of the nose were satisfactory and no complications of prosthesis exposure and skin redness of the nasal tip occurred. At 3-5 months after operation, the appearance of the nasal tip was satisfactory when part of the soft tissue was absorbed. Thirty-two patients were followed up 3-12 months (6 months on average), who were satisfied with the appearance of nose with good correct rate. Conclusion Nasal plasty by using auto-cartilage grafting and silicone implant combined with trimming the lower lateral cartilages and thinning the superfluous tissue of the tip is an effective method especially for round or bulbous nasal ti p.