Nasal bone fractures are the most common type of facial fractures. Previous studies have shown that most nasal fractures involve the septum, which can provide an obstacle to the successful reduction of nasal bone fractures. In particular, septal fractures in combination with simple nasal bone fractures are usually unrecognized and untreated at the time of injury. Furthermore, systemized treatment protocols and diagnostic tools for septal fractures in the case of simple nasal bone fracture have not previously been presented. In this study, the clinical findings of septal fractures in cases of simple nasal bone fracture were correlated with symptoms, signs, and computed tomography findings and assessed statistically. The patterns of septal fractures in simple nasal bone fractures were assessed by direct vision via hemitransfixion incision. Of the 52 patients with simple nasal bone fracture who presented over a 3-year period and were included in this study, 10 were female and 42 were male, with an average age of 33.8 years (age range, 18 to 61 years). Fifty of these patients (96.2 percent) showed septal fractures, and septoplasty or submucosal resection was performed on 41 patients (78.8 percent) who manifested severe septal fractures of perioperative septal grade 3 or higher. Closed reduction of the nasal bone fracture only was performed on the remaining 11 patients. Among the signs evident at physical examination, mucosal tearing was found to be statistically significant for septal fracture. Computed tomography was found to be very helpful in diagnosing septal fracture but could not predict its severity accurately (Spearman correlation coefficient between computed tomography septal grading and perioperative septal grading, 33.5 percent). Therefore, computed tomography could not be used as a definitive diagnostic modality for septal fractures in terms of deciding whether septoplasty or submucous resection was needed. It is evident that septal fractures are frequent in simple nasal bone fractures that are not combined with other facial bone fractures. This study confirms that there are differences between radiologic findings and perioperative findings. To reduce the incidence of posttraumatic nasal deformity, meticulous physical examinations with subsequent septoplasty or submucosal resection are needed in the treatment of simple nasal bone fracture.

Although many studies have suggested that human adipose tissue contains pluripotent stem cells, a few reports are available on stromal vascular fraction (SVF). In the present study, we evaluated the bone formation capacities of SVF. We implanted uncultured freshly isolated adipose-derived stem cells combined with demineralized bone matrix (DBM) to induce bone regeneration in a critically sized rat calvarial defect model. We used DBM (DBX(®)) and/or poly(70L-lactide-co-30DL-lactide) copolymer PLA as a scaffold. Fifty white rats were randomized to 5 different groups (n=10): (1) control, (2) DBM, (3) DBM + SVF, (4) DBM + PLA, and (5) DBM + PLA + SVF groups. After acquiring SVF, an 8-mm critically sized calvarial defect was made in each rat. Specimens were harvested at 8 weeks postimplantation and evaluated radiographically and histologically. New bone formation was qualified by hematoxylin and eosin staining and anti-osteocalcin antibody (OC4-30) immunostaining of calvarial sections. Amounts of mineralization were determined by radiodensitometric analysis. In gross appearance, the DBM + SVF and DBM + PLA + SVF groups showed more abundant bone formation than the other groups. Radiodensitometric evaluations revealed that significant intergroup differences were observed according to the Kruskal-Wallis (rank) test (P=0.030<0.05). The 5 groups show different amounts of filling of bone defects (control: 13.48%; DBM: 39.94%; DBM + SVF: 57.69%; DBM + PLA: 24.86%; DBM + PLA + SVF: 42.75%). Histological evaluation revealed that there was abundant new bone formation in the DBM + SVF and DBM + PLA + SVF groups. It was found that undifferentiated adipose-derived stem cells in the form of SVF induced new bone formation in rat calvarial defects. Accordingly, SVF offers a practical, promising candidate for regenerative tissue engineering or cell-based therapy.

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The authors insist that facial analysis should take into consideration racial, ethnic, and gender differences. The BAPA approach is a new practical and simple method for photogrammetric facial analysis. Using the authors' method, more advanced and automated computer systems for analyzing human faces may be developed.

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Mesotherapy is not an effective alternative treatment modality for body contouring.

Introduction: Human adipose tissue contains pluripotent stem cells that are similar to bone marrow-derived stem cells. The present study examined whether osteogenic induced adipose-derived stem cells (ASCs) could enhance the osteogenic capacity of demineralized bone matrix and accelerate bone formation in a rat critically-sized calvarial defect model. Materials and Methods:Forty Sprague-Dawley rats were divided randomly into four groups containing 10 rats per each group (Control, 0.05 cc fibrin glue (25 mg/ml) and 0.05 cc thrombin (130 U/ml); DBX, control + 0.2 g DBX ® ; ASC, DBX + 1 x 10 5 ASCs/g; iASC, DBX + 1 x 10 5 osteogenic-induced ASCs/g). After osteogenic differentiation of ASCs, alkaline phosphatase and von Kossa staining were performed each week to determine the extent of differentiation and mineralization. An 8-mm critical size circular defect was made in the calvarial bone of each rat. The specimens were harvested 8 weeks after implantation, and radiographic and histological evaluations were carried out. New bone formation was quantified by radiodensitometric analysis of the calvarial sections. Statistical analysis was accomplished using a Mann-Whitney test and Kruskal-Wallis test at a significance level of P<0.05.Results: Alkaline phosphatase and von Kossa staining showed that the osteogenic-induced ASCs yielded higher osteogenic differentiation at 3 weeks. The calvarial defect was filled more in the iASC group compared to the other groups, as demonstrated by the gross appearance of the specimen and radiologic evaluation. The mean radiodensity of the control, DBX, ASC, and iASC group was 16.78%, 39.94%, 25.58%, and 51.31%, respectively, and these were significantly different (P=0.034). Histomorphological evaluation confirmed that new bone formation was accelerated and enhanced by the osteogenic-induced ASCs.Conclusions: ASCs produced greater osteogenic differentiation at 3 weeks. Osteogenic regeneration was accelerated and enhanced in vivo with the osteogenic-induced ASCs, compared to undifferentiated ASCs. Osteogenic-induced ASCs are an excellent and promising candidate for regenerative medicine and tissue engineering application.

To evaluate outcomes of aesthetic facial plastic surgery objectively the authors developed a photogrammetric profile analysis method, which they call "balanced angular profile analysis" (BAPA). To develop standards and ways to determine the conformation of various soft tissue segments analytically, 19 mean angular values acquired from the photographs of 71 famous female models (53 Eastern models and 18 Western models) were standardized to provide reference data (recommended aesthetic mean angles [RAMA]), which contain some of the common features and differences between ethnic groups and races. On the basis of the data prepared from angular profile analyses of these photographs, the authors apply their developed method in a practical way to the pre- and postoperative photographs of patients. By using the data provided by BAPA, the clinician can identify delicate profile problems correctly, perform appropriate aesthetic operations, and thus produce better aesthetic results. The authors' harmonized and balanced angular profile analysis can provide surgeons with a way of determining the conformational problems associated with various soft tissue segments of the face. It also offers aesthetic plastic surgeons reference information concerning the creation of an attractive face during the first patient consultation. The authors hope that their straightforward method of profile analysis will provide facial plastic surgeons with a simple tool for profile analysis and surgical planning designed to create an attractive face.