Application of Autologous Cartilage Transplantation in the Repair and Reconstruction of Nasal Soft-Tissue Triangle Deformities

Objective: To evaluate the effect of autologous cartilage transplantation in repairing nasal soft-tissue triangle deformities.
Methods: From January 2015 to January 2018, 23 patients underwent the surgery, got part of the costal cartilage, nasal septum cartilage or ear cartilage, An open incision was made along the medial nasal columella and lateral rim of nostril, the cartilage was carved into strips as a graft of the lateral and middle crus of the alar cartilage in order to reconstruct the nasal alar dome and correct the nasal soft-tissue triangle deformities. The costal cartilage or nasal septum cartilage was used as columellar strut. At the same time, a prosthetic or autologous costal cartilage scaffold was placed onto the nasal dorsum, and fascia tissue was placed on the tip of the nose to relieve tensions. The changes of the angle of the medial and lateral crus of the alar cartilage before and after autologous cartilage transplantation and the difference between the greatest distance from the long axis of the nostrils to the alar rim before and after the operation were statistically analyzed. The changes of nasal appearance pre and postoperation were compared. To evaluate the correction effect of nasal soft-tissue triangle deformities, bilateral asymmetry and overall surgical effect. The surgical results were evaluated by comparing the pre- and postoperative images, statistical analysis the difference of alar cartilage angle along inside and outside feet before and after the fornix reconstruction, and evaluate the efficacy satisfaction of repairation for retraction, notching, asymmetries of nasal soft-tissue triangle deformities and overall effect of the rhinoplasty.
Results: The alar cartilage angle of the 23 patients was (50.6±12.4)° preoperative, decreased to(35.0±5.6)° when the nasal dome reconstruction was finished, the difference was statistically significant(P<0.01). The patients were followed up for 6 to 18 months, the noses were with natural appearance and tactile impression, and there were no serious complications. The degree of satisfaction was 87.5%.
Conclusion: Using autologous cartilage to repair the soft-tissue triangle deformities is an ideal surgical method, the nasal morphology can be improved delicately, and the degree of satisfaction is high postoperatively.

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A New Technique of Mastopexy for Mastoptosis: With the Upturned Glandular Flap

A new surgical procedure was introduced for correction of moderate mammary ptosis in this paper. The double-ring incision around areola was taken, tongue-shaped gland flap at the lower part of breast was turned over and filled in the posterior space of breast. The glands at both sides of the lower part were sutured together, and the basal part of the breast was tighten fully. Then, the upper pole gland was sutured by raising so that the nipple-areola complex is fully raised. The breasts were conical through this shaping, thus the correction effect of breast ptosis was satisfactory. This technique is ingenious in design, convenient in operation and exact in curative effect. It can be used as one of the options for mastopexy.

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Distal Foot Reconstruction Using Distally based First Web Flap: A Case Series

Background: The reconstruction of distal foot for various defects or contractures mainly over or near the toes has always been a difficult task. A flap distally based on first web space is dependent upon a perforator arising from the distal communications between the first dorsal and plantar metatarsal arteries, can be used for the coverage of the toe or the distal foot defects.
Method: We had operated 10 patients with toe defects and contractures at the dorsum of the distal foot . Demographic data of the patients were collected and evaluated in terms of age, gender, etiology of injury, site and dimensions of defects, complications, final outcome.
Results: Complications were noted in only two cases in the form of wound infections. Both the cases were managed accordingly.
Conclusion: With our study we concluded that a distally based flap can be reliably raised from the first web space based upon a perforator arising from the distal communication artery between First Dorsal and First Plantar Metatarsal Artery to cover defects in distal foot.

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