The Application Of “v” Knife Combined With Rotary Excision In The Treatment Of Nape-Fat-Pad

Objective To explore the histological characteristics of the nape-fat-pad and the adipose tissue.Meanwhile,to design a minimally invasive,safe and effective surgical method for the treatment of the nape-fat-pad by using the special structural characteristics of the fat pad.Methods The tissue specimens of 20 patients with nape-fat-pad and 20 patients with normal adipose tissue liposuction were collected from the Department of Plastic and Reconstructive Surgery,The Second Affiliated Hospital of South China University,Hunan Province.A total of128 patients with nape-fat-pad in our department from June 2018 to September 2020 were selected for the study.In this marked area,0.2percent Iidocaine with 1:10000 epinephrine was used for local tumescent anesthesia,then a skin incision of about 0.5cm was made directly under the fat pad and/or about 2cm from it.First,use a "V" knife to separate the fat pad at multiple planes and angles,then cut off with a rotary excision and sucked out thoroughly.Second,use a thin liposuction tube to pump the transition area between the nape-fat-pad and normal fat until the transition is natural and smooth.Finally,fix the skin in the separation area with oil nail,apply pressure with "8-form" bandage and sleep on the rice pillow for 1 week after surgery.The appearance of the neck,postoperative complications and patient satisfaction were followed up 3～12 months after the operation.Results Compared with the normal fat area,the nape-fat-pad has more abundant fiber strips,thicker and harder,and compact structure.In this group of 128 patients,the nape-fat-pad was removed at one time through the small incision by "V" knife combined with multiple techniques under excessive swelling anesthesia.128 patients had varying degrees of pain and swelling for 1～2 months after operation,which complete disappearance in about 2 months,7 cases(5.47%)had a sense of subcutaneous cord or induration,and recovered completely in 2～3 months.Subcutaneous effusion was found in 3 patients(2.34%)in the early stage of operation and absorbed about 1 week.6 cases(4.69%)had a slight "sense of step" in the operative and normal fat transition area about1 month after operation,but no further surgical intervention is required.The remaining 122 cases(95.31%)had the nape-fat-pad completely removed,and the neck contour was natural and smooth,and the appearance was beautiful.None of the 128 patients had serious complications such as skin necrosis,fat embolism,and important nerve and blood vessel damage occurred in all the patients 3 to 12 months after the operation.In the patient satisfaction survey,110 patients were satisfied,12 were good,6 were average,and 0 were dissatisfied,the satisfaction rate of the patients was 95.31%.Conclusion The fat pad fiber strip of the neck is thick,hard and compact in structure,which can not be fully removed by conventional operation.The application of “V” knife combined with high-speed rotary excision in the treatment of nape-fat-pad with short operation time,low complication rate,obvious improvement in the appearance of the neck after surgery,and high patient satisfaction.It is worthy of clinical promotion.