| OBJECTIVE:To explore clinical efficacy of autologous adipocyte transplantation combined injection Botulinum toxin A in treating nasolabial groove depression.METHODS:In this group,16 patients received autologous adipocyte transplantation combined with injection of Botulinum toxin A in our hospital due to different degrees of nasolabial groove depression.Injection of Botulinum toxin A:dilated Botulinum toxin A with 0.9%sodium chloride to 2.5ml(4U/0.1ml)and marked injection point on the nasolabial groove before surgery.Injected in superficial muscle and 1-2U on each injection point on the left and right side with equivalent amount in line with status of the subjects.Two weeks later took autologous adipocyte transplantation.Liposuction site:Considering individual status and personal willingness of the subjects,chose sampling sites of adipocyte granules.Generally speaking,the donor site usually took lateral thigh or hypogastric region.16 patients were included in this group with 12 from hypogastric region,3 from outer thigh and 1 from inner thigh.Liposuction method:Tumescent Anesthesia fluid which was configured before surgery was injected into the donor sites and tumescent anaesthesia was taken for the sampling sites.Connected the injector with liposuction needle to manually extract autologous adipocyte granules evenly with low pressure.Washed the extracted adipocyte granules and put into centrifugal machine whose revolving speed was adjusted to 3000r/min.After 3min centrifugation,took the adipocyte granules in the middle for reserve.Adipocyte injection:According to depression situation of patients ' nasolabial groove before operation,injected the autologous granules quantitatively,evenly and with low pressure into depressed sites of nasolabial groove.Routinely took antibiotics for 3 days for infection prevention after surgery,applied Erythromycin Ointment on injection sites and offered pressure dressing for the donor sites while pressure on filling area shall be avoided.RESULTS:Morphology of the patients ' nasoladial groove after surgery was satisfactory with plump outlook,soft feeling on some parts and good texture.And there was no obvious boundary with surrounding tissues.The survival rate of transplanted autologous adipocyte met with expectations.Postoperative morphology was maintained well.The 16 patients suffered from no infection,skin necrosis,vascular thrombosis and other serious complications after surgery.Two patients were dissatisfied due to slight depression after the surgery and one patients were satisfied after one supplementary injection one month later.One patient was reluctant to replenish the injection.Two patients suffered from swelling and cyanoderma of different degree which were recovered after partial cold compress.Regarding satisfaction of the subjects six months after surgery,56.25%were very satisfied,37.50%satisfied and 6.25%unsatisfied,with a 93.75%overall satisfaction.In terms of comments by the operators,68.75%was very effective,25.00%effective and 6.25%void.With respect to assessment by a third party,56.25%was very effective,31.25%effective and 12.50%void.In line with scoring standards of nasolabial groove,average preoperative and postoperative score of the operators were 1.63 ± 0.62 and 0.38 ± 0.50 respectively.Preoperative score by third party and average postoperative score were 1.69 ± 0.70 and 0.50 ± 0.52 respectively.Postoperative score was greatly improved compared with preoperative score and score of the operators and that by third party saw no obvious difference.CONCLUSION:1.Autologous adipocyte transplantation and Botulinum toxin A injection are of minimal trauma,easy to operate,rehabilitate quickly and of reliable shaping effects.2.Autologous adipocyte transplantation combined with injection of Botulinum toxin type A can treat nasolabial groove depression through different mechanisms of action,reduce displacement of filled adipocyte,and accelerate early revascularization. |
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