Background: Fat grafting is a standard method for soft augmentation. However, occasionally Mycobacterium abscessus infection can be seen secondary to fat grafting. The aim of this study was to report experience with and propose standard treatment. Patients and Methods: From 2006 to 2018, 12 women who had received fat grafting for facial soft augmentation in different Chinese private clinics were reviewed. Results: The patients presented with local swelling and skin ulceration. They patients received primary infusion of antibiotic agents; however, the results were poor. After being admitted to our hospital, cultures were taken and sent to the specialized examination center. Mycobacterium abscessus was diagnosed in all of the patients. According to drug sensitivity results, targeted antibiotic agent treatment was implemented for 12 months. Local proper conservative debridement was conducted as needed. When the patients were discharged from the hospital, they were advised to continual oral medication for six months. After three to nine years of follow-up, no recurrence was found. On the basis of this, a corresponding standard treatment was proposed. Conclusions: Mycobacterium abscessus infection after fat grafting should be diagnosed and treated accurately. Our experience and proposed treatment may be beneficial.

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The technique of TSDO is effective, minimally invasive, and aesthetically optimal for early correction of midfacial hypoplasia of the growing children, and the technique of ODO can be used successfully for hypoplastic midface of the adults. The most postoperative retrusion appeared in the first 6 months, and no statistically significant retrusion occurred in growing patients.

The surgical treatment for giant neurofibromatosis-1 (NF-1) requires comprehensive measures. Presently, there is no systematic description of surgical treatment. Because of its high level of risk, we want to share our clinical experience. From 2011 to 2014, patients (n = 8, 5 female and 3 male patients, aging from 31 to 45 years-old) were included in the study. The tumours were located on the trunk (n = 5) or face (n = 3). In addition to routine examination, blood storage was also prepared. Preoperative consultation from related departments was critical at first. Related artery embolisation was also carried out. In the operation, we checked thromboelastography, based on which reasonable blood component transfusion was implemented. Autologous blood transfusion was also ready. An instrument of copper needle or ring ligation was used to reduce haemorrhage before the surgery. Protruding or drooping portions of the tumours were excised. A pressurised bandage was applied when the surgery was completed. After the surgery, besides the routine monitoring of vital signs, re-haemorrhage should be detected in time. Then, we should decide whether blood transfusion or surgery was required again. Expanders were implanted in one female patient with facial injuries before removing the tumour. Then, expanded flaps were applied to repair the secondary wound. According to the above clinical route, after an average of 1-year follow-up, no patients died, and other unforeseen events did not occur. Wounds healed well in all patients. The tumor was excised as much as possible. No facial nerve paralysis occurred in the facial sites. Expanded flaps necrosis WAS not encountered. It is essential to design the educational clinical route for treating NF-1 when a giant protruding tumour is advised to be excised, which can minimise the risk of surgery and assure us of the maximum range of resection.