Recipient-site Preparation Of Tumescent Anesthesia Expansion Technology Applied In Facial Fat Grafting:a Clinical Application Of Observation

Blackground:Facia]aesthetics focus on three-dimensional facial features and a full cheek,the emergence of fillers to meet our pursuit of young and beautiful.Autologous fat which has been rich in sources,simple for operator,and no rejection,as a natural filler favor by the majority of plastic surgeons and patients in recent years.Autologous fat transplantation(AFT)can be used in cosmetic and reconstruction repair,facial morphology,depression scar deformity,congenital and acquired maxillofacial deformities,breast plastic surgery and so on.However,with the widespread use of fat transplant surgery,clinical complications which have plagued the patient and plastic surgeon,caused by AFT such as induration,calcification,infection,fat liquefaction,hematoma,skin rugged,ptosis and skin numbness.Serious complications caused by vascular embolization lead to eye blindness,acute stroke and skin necrosis and so on.Therefore,the safety is always placed in the most critical position of fat transplant surgery.How to reduce or even eliminate the occurrence of surgical complications become a hotspot in research of plastic surgery.Tumescent anaesthesia as a kind of safe,painless,economical,easy implementation of operation which is first applied in fat gaining,and accumulated lots of experience in clinical.The innovation of this subject lies in the use of tumescent anaesthesia pre-expansion technology in order to transplant fat more safely and effectively.In this study,the clinical analysis and animal experiments were carried out on the swelling and preconditioning of the transplanted area.In this part,the clinical application of autologous fat transplantation was confirmed by the collection of clinical cases after swelling and pre-expansion of autologous fat facial transplantation.Objective:By observing the clinical curative effcetion of recipient-site preparation of tumescent anesthesia expansion technology which use in autologous fat facial transplantation to assess its clinical application value.Methods:From May 2016 to March 2017,22 cases of facial depression due to different causes were treated with autologous fat facial transplantation by recipient-site preparation of tumescent anesthesia expansion technology,and 14 were selected as samples.The age of the patients were between16 to 44 years old,according to the differerce of facial depression tissue,defect site,range,the degree of depression,fat transplantation was 3.9?44ml per time.The high-frequency ultrasound to record the thickness of soft tissue of fixed point and blood flow signal were in recording.To save the information about the patients and to record the follow-up questionnaire.Kruskal-Wallis H was used to test the retention of fat grafts at each time point.However,the relationship between blood flow signals at each time point was tested by variance analysis.The postoperative recovery was observed and the postoperative satisfaction and complication were analyzed.Results:14 cases of the patients who postoperative the depression area improved significantly.Compared with preoperative,,after operation 1 month,3 months and 6 months,the rate of soft tissue thickness change was70.1%(53.85%)?56.4%(51.95%)?and 16.7%(35.8%),The difference between the three groups was statistically significant(H = 1.4×108,P<0.05).The difference between the six groups was statistically significant(F = 3.471,P<0.05).High-frequency ultrasound surgery showed that pre-expansion of autologous fat filling make the fat arranged evenly,patients with local tissue adhesion is well released after pre-expansion.The changes of soft tissue thickness in the transplanted area were gradually stable after the first and second stage.The soft tissue blood flow signals were measured before operation,24 hours,7 days after operation,1 month after operation,3 months after operation and 6 months after operation,the rate of soft tissue blood flow signals change was(3.97±0.84)‰;(2.21±0.55)‰;(6.89±2.39)‰;(14.61±4.66)‰;(9.39±3.94)‰;(15.87±3.02)‰.The area of blood flow signal was significantly increased after transplantation.During the follow-up period,no complications such as swelling,induration and cyst were found in the fat graft area.The clinical satisfaction was high.The 12-hour postoperative pain assessment(digital rating score,NRS)averaged 0.8 points,which was satisfactory for postoperative analgesia.Conclusion:By recipient site expansion Pre-expansion of fat transplantation can be safe and effective use in clinical practice.It is easy to carry out anatomical separation by using the Recipient-site preparation of tumescent anesthesia expansion technology and increase the anesthesia effect,reduce the incidence of intraoperative blood loss and postoperative complications.The acceptance and satisfaction of the patients are high.