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OBJECTIVE To investigate the clinical features, diagnosis, and treatment of nontuberculous mycobacterial infections after minimally invasive plastic surgery and cosmetic surgery, and to provide reference data for the management of affected patients. METHOD We retrospectively analyzed 12 cases of nontuberculous mycobacterial infection after minimally invasive plastic surgery and cosmetic surgery in our department from January 2014 to December 2020. The case data included baseline characteristics, morbidity, chronology of patient symptoms, diagnostic results, and treatment outcomes. Disease characteristics were summarized and objectively analyzed. RESULTS The 12 patients infected with nontuberculous mycobacteria after plastic surgery and cosmetic surgery received small incision or minimally invasive surgery. The onset time was 5-30 days after surgery, the clinical manifestations were non-specific, and ordinary antibiotics are ineffective. CONCLUSIONS Small incisions or minimally invasive plastic surgery and cosmetic surgery have hidden dangers of nontuberculous mycobacterial infection, and the detection and diagnosis are difficult, and the treatment time is long, which requires attention.

OBJECTIVE Double blepharoplasty or double eyelid surgery is a common plastic surgery in Asians. Our study aimed to evaluate the advantages and disadvantages of the minimally invasive 3-point subcutaneous tunnel double eyelid surgical technique relative to other commonly used approaches. METHOD The study compared 852 single eyelid patients electing 1 of 3 double eyelid surgical options; minimally invasive 3-point subcutaneous tunnel, minimally invasive 3-point embedding, or incision double eyelid surgery. Evaluation criteria included postoperative swelling, hyperemia, pain, scarring, single eyelid recurrence, and patient satisfaction after 2 years. RESULTS All surgical methods effectively achieved double eyelids. Directly after the procedure, the minimally invasive 3-point embedding method produced the mildest degree of swelling and congestion, followed by the 3-point subcutaneous tunnel method and then the incision method (F = 523.908, P = 0.000). The incision method also resulted in more serious postoperative pain, whereas the other 2 methods were equivalent (F = 83.117, P = 0.000). Patients in the incision group had the most severe scars compared with the other 2 groups with milder scarring (F = 882.102, P = 0.000). The minimally invasive 3-point embedding method group had the highest single eyelid recurrence rate (5.88%), whereas the recurrence rates for the other 2 methods were less than 1%. Patients satisfaction after 2 years was highest in the minimally invasive 3-point subcutaneous tunneling method, followed by the 3-point embedding method and lastly the incision method (F = 25.931, P = 0.00). CONCLUSIONS Minimally invasive 3-point subcutaneous tunnel double eyelid surgery has advantages over other techniques, and its clinical application is worth promoting for suitable patients.

Objective To investigate the relationship among natural aging of epidermal cells, epigenetics, and SPRY1 methylation mechanism. Methods Immunohistochemistry, reverse transcription-PCR (RT-PCR), and Western blot were used to detect the expression of DNA methyltransferase 1 (DNMT1) and Sprouty1 (SPRY1) in skin epithelial cells from different age groups. An aging model of HaCaT cells was constructed. In HaCaT cells and their aging groups, DNMT1 and SPRY1 expression were detected by RT-PCR and WB. SPRY1 methylation status in epidermal cells from different age groups and HaCaT cells were detected by Methylation-Specific PCR (MS-PCR). Results The expression of DNMT1 and SPRY1 in skin epithelial cells from natural aging groups decreased with age; there was no significant difference in the expression of DNMT1 in HaCaT cells and the different age groups. The expression of SPRY1 in HaCaT cells was lower than it was in the aging groups. The methylation status of SPRY1 gradually decreased as the age of skin epidermal cells increased, while the methylation status of SPRY1 was not different between HaCaT cells and the aging group. Conclusion DNMT1 is involved in the regulation of natural aging of skin epidermal cells but has a nominal role in our induced aging model. SPRY1 is involved in natural aging and induced aging of skin epidermal cells. The regulation of SPRY1 methylation is involved in the natural senescence of skin epidermal cells, while the induced aging of epidermal cells is nominally involved in the mechanism of SPRY1 methylation.

Objective To explore an optimal surgical approach for different types of labia minora hypertrophy and to design a better personalized surgical treatment plan for patients. Methods Forty-five patients with labia minora treated in our department from January 2014 to January 2019 were the study participants. Depending upon the appearance of the labia minora, they were divided into length labia minora hypertrophy, width labia minora hypertrophy, overall labia minora hypertrophy, and labia hypertrophy combined with clitoris foreskin. By combining the characteristics of the patient's labia minora hypertrophy and the aesthetic requirements for postoperative appearance, we designed a personalized treatment plan for each group of patients. The surgical approaches include upper pedicle flap wedge resection, upper and lower pedicle flap similar to wedge resection, lower pedicle flap pedicle wedge resection, and labia minora combined with clitoris foreskin surgery. We followed up the postoperative results, recovery, and complication rates for a period of 3 months. Results All patients who underwent surgery had good wound healing. The labia minora had good bilateral symmetry, moderate size, and desired appearance. The scar of the surgical incision was also not obvious. The postoperative labia minora felt normal without any serious complications. Overall, the treatment effect was satisfactory. Conclusion There are many surgical methods for the reduction in the labia minora. Our findings suggest that in order to achieve better results, a personalized surgical plan should be designed considering the patient's unique type of hypertrophy and the individual aesthetic requirements. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This study aimed to investigate the expression and significance of DNA methyltransferase 1 (DNMT1) in pathologic scar fibroblasts, as well as the influence of methylase inhibitor, 5-aza-2-deoxycytidine, on pathological scars.Samples of 31 keloids, 20 hypertrophic scars, and 25 normal skins were taken to test the expression rate of DNMT1 by immunohistochemistry. Primary fibroblasts were cultured with the monoplast method. Samples were categorized into the keloid group (K group), 5-aza-2-deoxycytidine keloid intervention group (K+ group), normal skin group (N group), hypertrophic scar group (H group), and 5-aza-2-deoxycytidine hypertrophic scar intervention group (H+ group). The expressions of DNMT1, transforming growth factor-β (TGF-β), and Smad7 mRNA in each group were detected with realtime polymerase chain reaction. The effect of 5-aza-2-deoxycytidine on the cell cycle and apoptosis of pathologic scar fibroblasts were analyzed with flow cytometry.The expression rate of DNMT1 was 100% in keloid fibroblasts, 90% in hyperplastic scar fibroblasts, and 8% in normal skin fibroblasts. After the intervention with 5-aza-2-deoxycytidine in the K+ group, the expression of DNMT1 and TGF-β1 mRNA was lower, Smad7 mRNA was elevated in pathological scar fibroblasts, the flow cytometry showed the proportion of cells in G0/G1 phase were increased, and the proportion of apoptosis cells were also increased, with similar changes in the cells in the H and H+ groups.DNMT1 may play a vital role on the generation of pathological scars. Methylaze inhibitors 5-aza-2-deoxycytidine may influence the related cytokines of pathological scars, inhibit proliferation, and promote apoptosis of pathological scar fibroblasts. The generation of pathological scars may be related with methylation of certain genes. 5-aza-2-deoxycytidine be a new choice for the treatment of pathological scars.