Analysis of the expression profile of miRNAs related to skin photoaging in the GEO database

Background:Skin aging has recently gained significant attention in both society and skin care research.Understanding the biological processes of photoaging caused by long-term skin exposure to ultraviolet radiation is critical for preventing and treating skin aging.Therefore,it is important to identify genes related to skin photoaging and shed light on their functions.Methods:We used data from the Gene Expression Omnibus(GEO)database and conducted bioinformatics analyses to screen and extract microRNAs(miRNAs)and their downstream target genes related to skin photoaging,and to determine possible biological mechanisms of skin photoaging.Results:A total of 34 differentially expressed miRNAs and their downstream target genes potentially related to the biological process of skin photoaging were identified.Gene Ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed that these target genes were enriched in pathways related to human papillomavirus infection,extracellular matrix(ECM)-receptor signaling,estrogen receptor,skin development,epidermal development,epidermal cell differentiation,keratinocyte differentiation,structural components of the ECM,structural components of the skin epidermis,and others.Conclusion:Based on the GEO database-derived findings,we determined that target genes of two miRNAs,namely miR-4667-5P-KRT79 and miR-139-5P-FOS,play an important role in skin photoaging.These observations could provide theoretical support and guidance for further research on skin aging-related biological processes.

Reconstruction of the thoracic tracheal defects with portions of deepithelialized myocutaneous flaps after resection of a large tumor

Objective： To study the possibility of using portions of deepithelialized myocutaneous flaps to the reconstruction of thoracic tracheal defects after resection of a large tumor. Methods： From June 2007 to June 2012, five cases of defects of the thoracic trachea were reconstructed by applying portions of deepithelialized myocutaneous flaps. The patients were 27-61 years old with 4 male cases and 1 female. The cervical trachea ranged in diameter from 4-8.5 cm with circumferences of approximately 1/3-2/5 of the bronchial circumference. Results： M1 five patients with thoracic tracheal defects after resection of a large tumor were cured of portions of deepithelialized myocutaneous flaps, with no tracheal stricture remaining and vomica successfully eliminated. During the first 1 to 3 months after the operation, bronchoscopy showed that the tracheal lumens were smooth, and the visible skin of the musculocutaneous flaps became gray and exhibited a small amount of white discharge. Conclusions： Despite this being a small series and short follow-up, this thoracic tracheal reconstruction with portions of deepithelialized myocutaneous flaps shows encouraging preliminary results and could be an alternative to other methods for the treatment of carefully selected patients with thoracic tracheal defects.

Recovery of sympathetic nerve function after lumbar sympathectomy is slower in the hind limbs than in the torso

Local sympathetic denervation by surgical sympathectomy is used in the treatment of lower limb ulcers and ischemia,but the restoration of cutaneous sympathetic nerve functions is less clear.This study aims to explore the recovery of cutaneous sympathetic functions after bilateral L2-4 sympathectomy.The skin temperature of the left feet,using a point monitoring thermometer,increased intraoperatively after sympathectomy.The cytoplasm of sympathetic neurons contained tyrosine hydroxylase and dopamineβ-hydroxylase,visualized by immunofluorescence,indicated the accuracy of sympathectomy.Iodine starch test results suggested that the sweating function of the hind feet plantar skin decreased 2 and 7 weeks after lumbar sympathectomy but had recovered by 3 months.Immunofluorescence and western blot assay results revealed that norepinephrine and dopamineβ-hydroxylase expression in the skin from the sacrococcygeal region and hind feet decreased in the sympathectomized group at 2 weeks.Transmission electron microscopy results showed that perinuclear space and axon demyelination in sympathetic cells in the L5 sympathetic trunks were found in the sympathectomized group 3 months after sympathectomy.Although sympathetic denervation occurred in the sacrococcygeal region and hind feet skin 2 weeks after lumbar sympathectomy,the skin functions recovered gradually over 7 weeks to 3 months.In conclusion,sympathetic functional recovery may account for the recurrence of hyperhidrosis after sympathectomy and the normalization of sympathetic nerve trunks after incomplete injury.The recovery of sympathetic nerve function was slower in the limbs than in the torso after bilateral L（2-4） sympathectomy.

The therapeutic effect of expanded scalp flaps pedicled with the superficial temporal vessel for the reconstruction of the large facial skin scar

Objective To investigate the therapeutic effect of expanded scalp flaps pedicled with superficial temporal vessel in the repair of facial skin scars.Methods From May 2017 to October 2018,4 patients with facial skin scars were treated with expanded scalp flaps pedicled with superficial temporal vessels and laser hair removal.All patients were followed up for at least 6 to 12 months.Results The flaps of all 4 patients survived well,and the color,texture and thickness of the flaps matched well with the surrounding skin tissue.Conclusion Expanded scalp flaps pedicled with superficial temporal vessel is a good option for repairing facial skin scars,which is worthy of clinical application.

Dynamic changes of autophagy during hypertrophic scar formation and the role of autophagy intervention

Background:The role of autophagy in the formation of hypertrophic scars(HS)remains unclear.This study aimed to explore the role and potential mechanism of autophagy during the development of HS.Methods:RNA and protein expression levels of Beclin-1,p62,and LC3II in normal skin tissues and HS specimens from different patients were examined.Autophagy inducers and inhibitors were used to cure established HS in rabbit ears,and the expression of Beclin-1,p62,and LC3II at the RNA and protein level was determined.Lastly,the effects of autophagy inducers and inhibitors on HS development were analyzed.Results:Compared to normal skin tissues,the expression of LC3II and Beclin-1 was higher(P<0.05),while that of p62 was lower(P<0.05)in HS tissues.In addition,the LC3II/LC3I ratio was increased during HS formation,and the altered expression of the three proteins stabilized after one year.Administration of autophagy inducers enhanced the formation of HS as well as the expression levels of LC3II and Beclin-1 but decreased p62 expression.Meanwhile,administration of autophagy inhibitors increased the expression of LC3II,Beclin-1,and p62,along with reduced HS formation.Conclusion:Autophagic activity increased during HS initiation and subsequent stabilization.In addition,autophagy inhibitors were able to inhibit HS formation by suppressing autophagy,whereas autophagy inducers promoted scar hyperplasia by enhancing autophagy。

Change in self-image pressure level before and after autologous fat breast augmentation and its effect on social adaptability

BACKGROUND There is an increasingly strong demand for appearance and physical beauty in social life,marriage,and other aspects with the development of society and the improvement of material living standards.An increasing number of people have improved their appearance and physical shape through aesthetic plastic surgery.The female breast plays a significant role in physical beauty,and droopy or atrophied breasts can frequently lead to psychological inferiority and lack of confidence in women.This,in turn,can affect their mental health and quality of life.AIM To analyze preoperative and postoperative self-image pressure-level changes of autologous fat breast augmentation patients and their impact on social adaptability.METHODS We selected 160 patients who underwent autologous fat breast augmentation at the First Affiliated Hospital of Xinxiang Medical University from January 2020 to December 2022 using random sampling method.The general information,selfimage pressure level,and social adaptability of the patients were investigated using a basic information survey,body image self-assessment scale,and social adaptability scale.The self-image pressure-level changes and their effects on the social adaptability of patients before and after autologous fat breast augmentation were analyzed.RESULTS We collected 142 valid questionnaires.The single-factor analysis results showed no statistically significant difference in the self-image pressure level and social adaptability score of patients with different ages,marital status,and monthly income.However,there were significant differences in social adaptability among patients with different education levels and employment statuses.The correlation analysis results revealed a significant correlation between the self-image pressure level and social adaptability score before and after surgery.Multiple factors analysis results showed that the degree of concern caused by appearance in selfimage pressure,the degree of possible behavioral intervention,the related distress caused by body image,and the influence of body image on social life influenced the social adaptability of autologous fat breast augmentation patients.CONCLUSION The self-image pressure on autologous fat breast augmentation patients is inversely proportional to their social adaptability.

Evaluation of sensory function and recovery after replantation of fingertips at ZoneⅠin children

Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function af- ter replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July 2014 to January 2016. Variations in the extent of damage, with the residual vessels or nerves in some fingers being too short or even missing, prevented tension-free suture repair in some patients. Thus, re- pair of four of the nine fingertips included arteriovenous anastomosis, the remaining five undergoing arterial anastomosis during replanta- tion of the amputated fingers. Three patients underwent nerve repair, whereas the remaining six cases did not. Fingertip replantations were successful in all eight patients. Compared with the patients without vascular anastomosis, no obvious atrophy was visible in the fingertips of patients who did undergo vascular anastomosis during replantation and their sensory function did recover. Fingertip replantation pro- vides good sensory function and cosmetic outcomes when good artery and vein anastomoses have been created, even when digital nerves have not been repaired.

Factors Influencing the Emergency Medical Service Response Time for Cardiovascular Disease in Guangzhou, China

While emergency medical service (EMS) response time (ERT) is a major factor associated with the survival of patients with cardiovascular disease (CVD), relatively few studies have explored the factors associated with ERT. This study aimed to assess the current status of ERT and to identify the factors affecting ERT in patients with CVD in China. Between January 1, 2011 and December 31, 2015, EMS responses to CVD incidents in Guangzhou, China, were examined. The primary outcome was ERT, defined as the time from receipt of an emergency call to the arrival of paramedics on the scene. Factors associated with ERT were evaluated by multivariable logistic regression. A total of 44 383 CVD incidents were analysed. The median ERT was 12.58 min (interquartile range=9.98-15.67). Among the risk factors, distance (OR=13.73, 95% CI=11.76- 16.04), level of hospital (OR=1.57, 95% CI=1.40-1.75), and site of the incident (OR=1.53, 95% CI=1.38-1.69) were the top three significant factors affecting the ERT. Our results suggest that greater attention should be given to factors affecting the ERT. It is essential to make continuous efforts to promote the development of effective interventions to reduce the response time.

NONLINEAR SPECTRAL IMAGING OF ELASTIC CARTILAGE IN RABBIT EARS

Elastic cartilage in the rabbit external ear is an important animal model with attractive potential value for researching the physiological and pathological states of cartilages especially during wound healing.In this work,nonlinear optical microscopy based on two-photon excited fluor-escence and second harmonic generation were employed for imaging and quantifying the intact elastic cartilage.The morphology and distribution of main components in elastic carti lage incuding cartilage cells,collagen and elastic fibers were clearly observed from the high-resolution two-di mensional nonlinear optical images.The areas of cell nuclei,a parameter related to the pathological changes of nornal or abnormal elastic cartilage,can be easily quantifed.Moreover,the three-dimensional structure of chondrocytes and matrix were displayed by constructing threedimensional image of cartilage tissue.At last,the enmission spectra from cartilage were obtained and analyzed.We found that the different ratio of collagen over elastic fibens can be used to locate the observed position in the elastic cartilage.The redox ratio based on the ratio of nicotinamide adenine dimucleotide(NADH)over flavin adenine dinucleotide(FAD)fuorescence can also be calculated to analyze the metabolic state of chondrocytes in different regions.Our results demonstrated that this technique has the potential to provide more accurate and comprehensive information for the physiological states of elastic cartilage.

Comprehensive pathogenesis and clinical therapy in striae distensae: An overview and current perspective

The pathogenesis of striae distensae(SD) is complicated and has not yet been fully elucidated. Hormonal changes,overstretched skin, and structural and functional changes in the skin may be crucial factors in the development of SD. Therapy aims to stimulate dermal collagen synthesis and improve skin texture. Mainstream treatments include topical medications, chemical peeling, laser and radiofrequency therapy, microdermabrasion, microneedle therapy, and filler injection therapy. In the present review, we summarize current perspectives on the pathogenesis and clinical therapy of SD.

Double Forehead Expanded Flaps for Reconstruction of Total Nasal Defect: A Case Report

Objective To introduce a method for total nasal defect reconstruction with a double forehead expanded flap.Case presentation A 55-year-old man underwent three-stage total nasal reconstruction for a complete nasal defect due to electrical injury.The skin expander was implanted during the 1st stage.Total nasal reconstruction was performed with double expanded forehead flap transfer during the 2nd stage.The unilateral forehead flap was used for lining and the contralateral forehead flap,together with the autologous cartilage and titanium mesh framework,were used for skin replacement.The forehead donor defect was covered with a skin graft.Pedicle division and inset were performed in the 3rd stage.Results There was no flap loss,infection,hematoma,rhinostenosis,or implant exposure over the 2-year follow-up,and satisfactory aesthetic results were achieved.Conclusion The double forehead expanded flap method is useful for the reconstruction of large composite nasal defects in patients who are not suitable for nasolabial flaps and those who may not tolerate free tissue transfer.The operation has fewer complications and is uncomplicated.

Clinical Observation of Botulinum Toxin Type A Combined with Nanofat in Facial Rejuvenation Treatment

Objective:To investigate the efficacy of botulinum toxin type A combined with nanofat in the treatment of facial rejuvenation.Methods:from January 2020 to January 2021,20 patients with facial wrinkles in our hospital(The First Affiliated Hospital of Dalian Medical University)were treated with botulinum toxin type A combined with nanofat,and the effect,duration and complications were observed.Results:After 1,3 and 6 months of injection,the effective rates were 90%,75%and 40%,respectively;there was no occurrence of postoperative infection,fat mass,granuloma,and other adverse reactions.Conclusion:Botulinum toxin type A combined with nanofat filling has a clear therapeutic effect in the facial rejuvenation treatment,and can improve the skin texture while improving wrinkles,which is worthy of further popularization and application in clinic.

Pilomatrixoma causing irreversible peripheral eyebrow shedding:A case report

Pilomatrixomas are benign tumors derived from hair stromal cells;however,their exact etiology is unknown.A 31-year-old woman presented with a subcutaneous mass located precisely above the left eyebrow,with shedding of eyebrow hair around the mass,and the shedding area gradually expanded.Surgical removal of the mass failed to prevent eyebrow loss,and the entire left eyebrow shed 6 months postoperatively.Pathology and histology of the biopsy specimen revealed a pilomatrixoma comprising basaloid cells and ghost cells,with basaloid cells expressing high bcl-2 levels.Instead of apoptosis,the emergence and growth of pilomatrixoma-induced microinflammation around the hair follicles of the eyebrow may lead to eyebrow loss.

Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly： Systematic Review and Meta-analysis of Short- and Long-term Effectiveness

Background：There is conflicting evidence as to whether the femoral head should be preserved or replaced in elderly patients with displaced intracapsular femoral neck fractures.In this article,we performed a systematic review and meta-analysis to compare the short-and long-term effectiveness of arthroplasty （AR） and internal fixation （IF）.Methods：PubMed,Embase,and the Cochrane Library were searched systematically up to January 2016.All randomized controlled trials directly comparing the effectiveness of AR and IF for displaced intracapsular fracture were retrieved with no limitation on language or publication year.Results：In total,eight prospective randomized studies involving 2206 patients were included.The results of our study showed that patients in the AR group reported significantly lower complication （risk ratio：0.56,95% confidence interval [CI] =0.38-0.80）,re-operation （risk ratio：0.17,95% CI =0.13-0.22）,revision rates （risk ratio：0.11,95% CI：0.08-0.16）,and better function compared with their IF counterparts,and they were less likely to suffer postoperative pain.No statistically significant differences for the rates of mortality,infection,and/or deep vein thrombosis between AR and IF were found.Conclusions：Based on our analysis,we recommend that AR should be used as the primary treatment for displaced intracapsular femoral neck fractures in the elderly.However,IF may be appropriate for those who are very frail.

Construction and identification of an RNA interference lentivirus vector targeting the Ras homology C gene of melanoma cells

Background Melanoma has the highest mortality among all superficial malignant tumors.The poor prognosis is due to its high metastasis rate and the lack of therapeutic targets.As a molecular switch that controls tumor metastasis,Ras homology C （RhoC） has been correlated with tumor progression,especially tumor invasion and metastasis.However,little research has been done about the effects of RNA interference （RNAi） targeting RhoC on the invasion and metastasis of melanoma.In this study,we constructed an RNAi lentivirus vector targeting the RhoC gene of melanoma cells and identified its silencing effects on the RhoC gene.Methods Based on the RhoC gene encoding information,three pGPU6/GFP/Neo-short hairpin （shRNA） plasmids were constructed.After detecting their silencing effects on the RhoC gene of A375 cells,the most effective pGPU6/GFP/ Neo-shRNA plasmid was packed with lentivirus to construct the recombinant pLenti6.3-EGFP-453 targeting RhoC.The lentivirus vector was used to infect A375 cells,and then the expression of RhoC mRNA and protein were determined with real-time PCR and Western blotting.Results The plasmids pGPU6/GFP/Neo-shRNA 336,pGPU6/GFP/Neo-shRNA 453,and pGPU6/GFP/Neo-shRNA 680 were constructed.After they were transfected into A375 cells,the expressions of RhoC mRNA and protein were 1.47±0.26,1.13±0.16,1.39±0.11 and 70.98±9.21,50.67±6.06,65.77±4.06,respectively.pGPU6/GFP/Neo-shRNA 453 was the most effective sequence,and was used to successfully construct the pLenti6.3-EGFP-453 lentiviral vector targeting RhoC.pLenti6.3-EGFP-453 was used to infect A375 cells.The expression of RhoC mRNA and protein were 1.05±0.05 and 62.04±15.86 in the lentivirus group,4.21±0.24 and 220.86±24.07 in the negative lentivirus control group,and 4.63±0.32 and 257.39±12.30 in the normal control group respectively with the difference between the lentivirus group and the control groups being statistically significant （P ＜0.05）.Conclusion The successfully constructed pLenti6.3-EGFP-453 vector targeting the RhoC can effectively infect human melanoma A375 cells in vitro,and significantly inhibit the RhoC mRNA and protein expression.

Controlled release of transforming growth factor-beta receptor kinase inhibitor from thermosensitive Chitosan-based hydrogel Application for prevention of capsular contracture

Background Capsular contracture has become the most common complication associated with breast implant.Transforming growth factor-beta （TGF-β） is well known for a prominent role in fibrotic diseases.Due to the critical role of TGF-β in pathogenesis of capsular formation,we utilized thermosensitive C/GP hydrogel to controlled release of TGF-β receptor kinase inhibitor （SD208） and investigated their effects on capsular contracture.Methods In vitro degradation and drug release of C/GP hydrogel were performed.Twenty-four rabbits underwent subpanniculus implantation with 30 ml smooth silicone implants and were randomly divided into four groups as fellows：Group 1 received saline solution;Group 2 received SD208;Group 3 received SD208-C/GP;Group 4 received C/GP.At 8 weeks,the samples of capsular tissues were analyzed by hematoxylin and eosin and immunohistological staining.The mRNA expression of collagen Ⅲ and TGF-β1 was detected by RT-PCR assay.Results C/GP hydrogel could be applied as an ideal drug delivery vehicle which supported the controlled release of SD208.SD208-C/GP treatment showed a significant reduction in capsule thickness with fewer vessels.The histological findings confirmed that the lower amounts of inflammatory cells and fibroblasts infiltrate in SD208-C/GP group.In contrast,typical capsules with more vessel predominance were developed in control group.We did not observe the same inhibitory effect of SD208 or C/GP treatment on capsular contracture.Moreover,SD208-C/GP therapy yielded an evident down-regulation of collagen Ⅲ and TGF-β1 mRNA expression.Conclusions This study demonstrated that controlled release of TGF-β receptor kinase inhibitor from thermosensitive C/GP hydrogel could significantly prevent capsule formation after mammary implants.

Various changes in cryopreserved acellular nerve allografts at-80°C

The experimental design evaluated histological,mechanical,and biological properties of allogeneic decellularized nerves after cryopreservation in a multi-angle,multi-directional manner to provide evidence for long-term preservation.Acellular nerve allografts from human and rats were cryopreserved in a cryoprotectant（10% fetal bovine serum,10% dimethyl sulfoxide,and 5% sucrose in RPMI1640 medium） at-80°C for 1 year,followed by thawing at 40°C or 37°C for 8 minutes.The breaking force of acellular nerve allografts was measured using a tensile test.Cell survival was determined using L-929 cell suspensions.Acellular nerve allografts were transplanted into a rat model with loss of a 15-mm segment of the left sciatic nerve.Immunohistochemistry staining was used to measure neurofilament 200 expression.Hematoxylin-eosin staining was utilized to detect relative muscle area in gastrocnemius muscle.Electron microscopy was applied to observe changes in allograft ultrastructure.There was no obvious change in morphological appearance or ultrastructure,breaking force,or cytotoxicity of human acellular nerve allografts after cryopreservation at-80°C.Moreover,there was no remarkable change in neurofilament 200 expression,myelin sheath thickness,or muscle atrophy when fresh or cryopreserved rat acellular nerve allografts were applied to repair nerve injury in rats.These results suggest that cryopreservation can greatly extend the storage duration of acellular nerve tissue allografts without concomitant alteration of the physiochemical and biological properties of the engineered tissue to be used for transplantation.

Long-term complications after liquid silicone injection:A case report and literature review

Liquid silicone injection for cosmetic purposes has a long and notorious history.However,reports of delayed and extensive lesions are rare.Here,we report a case of long-term complications after the use of liquid silicone materials for the correction of facial deformities.In this case,the complications of foreign body granulomas and unique silicone nodules lasting for more than 10 years were reported.Liquid silicone injection can induce delayed adverse reactions,which are difficult to treat.This case presents the successful surgical treatment of a mass injection of liquid silicone.The focus of treatment should be to remove the injected material and degenerated tissue as much as possible while protecting normal tissue and its function.Through open reconstructive surgery with an appropriate incision,postoperative scars can be hidden.Consequently,both functional and aesthetic outcomes can be achieved.

Three-Dimensional M-Shaped Resection for Nasal Alar Hypertrophy in Asian Patients

Background Nasal alarplasty is an important component of esthetic rhinoplasty in Asians.The two main surgical techniques that correct alar hypertrophy by reducing the height or length often leave external scars and are associated with a high relapse rate.Methods We developed a new technique,called three-dimensional(3D)M-shaped resection,which corrects both the nasal alar height and length and simultaneously minimizes external scarring.We performed this procedure from January 2013 to September 2016 in 49 consecutive female patients diagnosed with saddle nose and nasal alar hypertrophy.Their mean age was 28.6(range,18–40)years.All patients had previously undergone simple rhinoplasty.Nasal alar length and height,nostril length and width,and maximal nose width were analyzed preoperatively and postoperatively from photographs.Results After a mean of 9(range,3–24)months of follow-up,surgery was considered successful in 46 women(94%)with good cosmetic effects.In three patients,nasal alar hypertrophy recurred(6 months postoperatively).There were no early complications such as hematomas,infections,skin or mucosal necrosis,or wound dehiscence.The mean reductions postoperatively were 1.7 mm and 0.9 mm for nasal alar length and height,respectively,1.6 mm for both nostril length and width,and 3.5 mm for nose width.Conclusion The 3D M-shaped resection for nasal alar hypertrophy effectively reduced hypertrophy in 94%of patients for up to 24 months,producing minimal external scars and good cosmetic effects.It is a simple and convenient technique that is an effective and safe option for nasal alarplasty.

Laser-assisted Liposuction Combined with Masseter Dissection for Mid-Lower Facial Recontouring

Background Asian women usually view the oval face,with a beautiful curve and clear outline,as elegant.The fat and bloated mid-lower face,with an undefined outline,takes away from what they perceive to be a beautiful appearance.Not only a bone but also soft tissue determine the shape of the mid-lower face.In this article,we introduce a modified surgical method of soft tissue for mid-lower facial recontouring,which can improve the fat and undefined outline of the mid-lower face caused by benign masseter muscle hypertrophy and reduce subcutaneous fat accumulation at the same time.The operative technique is simple and effective with few complications.Methods The surgical treatment of 36 patients who met the adaptation criteria was carried out by laser-assisted liposuction combined with masseter muscle dissection.All patients were followed up postoperatively,and the surgical efficacy was evaluated on the basis of:the comparison of facial contours of patients before and after surgery,the change of masseter muscle thickness detected by B-ultrasound imaging,the satisfaction of patients with postoperative facial contour improvement,and the incidence of complications.Results Between March 1,2018,and August 31,2019,36 patients with indications underwent this procedure.The follow-up lasted 6 to 12 months postoperatively and demonstrated that all patients were satisfied with the postoperative results,of which 33 cases(91.7%)were very satisfied,and 3 cases(8.3%)were satisfied with the treatment and had obvious improvement of the appearance of their mid-lower face.Preoperatively,the average mandibular bigonial breadth was 138.6±8.3 mm,and the average thickness of the masseter muscle was 13.9±0.8 mm;the postoperative breadth was 123.3±7.7 mm,and the thickness was 10.1±0.2 mm.The average reduction of the lower face width and masseter thickness were 15.2±2.1 mm and 3.8±0.1 mm,respectively.No complications occurred among the 36 patients.Conclusion The described method makes a great improvement in reshaping the outline of the mid-lower face,improves the fat and unclear outline of the mid-lower face caused by masseter muscle hypertrophy,and reduces subcutaneous fat accumulation.The procedure is easy to perform and is minimally traumatic,allowing for a quick recovery with few complications.These advantages along with the patients'overall satisfaction with the results make it worthy of clinical application.