Abstract:
:Dimpling of the skin of the thighs and buttocks is commonly referred to as cellulite, and it afflicts women much more frequently than men. Whereas many therapies that presume cellulite is caused by an abnormality of adipose tissue have gained recent popularity, the basic pathophysiology of cellulite has not been clearly identified. Theoretically, cellulite could reflect differences in adipose tissue biochemistry or connective tissue structure of affected versus unaffected individuals and/or of affected versus unaffected regions within an individual. We report here on direct experimental examination of these possibilities. Seven healthy adult subjects (five women, two men; four affected, three unaffected) underwent sonography of the thigh, measurement of regional in vivo subcutaneous adipose tissue metabolism (catecholaminergic responsiveness and blood flow) by microdialysis probe studies of the abdomen and the thigh, and full-thickness wedge biopsy of the thigh under local anesthesia. The presence of cellulite was defined as evidence of dimpling of the skin of the posterolateral thigh when the subject stood with the affected leg flexed to 90 degrees at the hip and knee. Any continuous area of skin at least 3 cm in diameter in which no dimpling was evident was designated as "unaffected." In all affected individuals, studies were performed to include both affected and unaffected areas of the thigh. In vitro pathologic examination of wedge biopsies and in vivo sonographic examination of the thigh both showed a diffuse pattern of extrusion of underlying adipose tissue into the reticular dermis in affected, but not unaffected, individuals. In vitro and in vivo studies also demonstrated that women had a diffuse pattern of irregular and discontinuous connective tissue immediately below the dermis, but this same layer of connective tissue was smooth and continuous in men. This connective tissue layer was more irregular and discontinuous in affected versus unaffected individuals. No significant differences were noted in subcutaneous adipose tissue morphology, lipolytic responsiveness, or regional blood flow between affected and unaffected sites within individuals. There is a sexual dimorphism in the structural characteristics of subdermal connective tissue that predisposes women to develop the irregular extrusion of adipose tissue into the dermis, which characterizes cellulite. These gender-related differences are diffuse and not localized only to affected areas. There is no evidence of any primary role for adipose tissue physiology, blood flow, or biochemistry in the etiology of cellulite, although the connective tissue of the female thigh is structured to accentuate differences in small subdermal adipose tissue depots.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Rosenbaum M,Prieto V,Hellmer J,Boschmann M,Krueger J,Leibel RL,Ship AGdoi
10.1097/00006534-199806000-00025subject
Has Abstractpub_date
1998-06-01 00:00:00pages
1934-9issue
7eissn
0032-1052issn
1529-4242journal_volume
101pub_type
杂志文章abstract:BACKGROUND:Recent studies have demonstrated low levels of National Institutes of Health funding for surgical research. The authors compared the funding in plastic surgery with the funding for other surgical specialties. METHODS:A query of National Institutes of Health grants awarded to departments of surgical specialt...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003866
更新日期:2017-12-01 00:00:00
abstract::The ability of immature animals and newborns to orchestrate successful calvarial reossification is well described. This capacity is markedly attenuated in mature animals and in humans greater than 2 years of age. Previous studies have implicated the dura mater as critical to successful calvarial reossification. The au...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Fat grafting may be beneficial in prosthetic reconstruction of irradiated tissues, but there is a paucity of data on the complication rates associated with this clinical scenario. METHODS:All consecutive patients who had undergone fat grafting and prosthetic reconstruction from 2010 to 2013 were enrolled. V...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002916
更新日期:2017-01-01 00:00:00
abstract::Breast implant rupture is an important complication of augmented and reconstructed breasts. Although several techniques such as mammography, xeromammography, ultrasound, thermography, and computed tomographic (CT) scanning have been proven to be useful to detect implant rupture, they have several disadvantages and lac...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199309001-00018
更新日期:1993-09-01 00:00:00
abstract::Although surgical release and reconstruction have been used extensively to treat severe postburn knee flexion contractures, the degree of correction is sometimes unsatisfactory, and the procedure is not exempt from significant complications. Based on the principle of slow, gradual external fixation distraction, we hav...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199304001-00036
更新日期:1993-04-01 00:00:00
abstract::The purpose of this study was to develop a methodology to quantify osseous, ocular, and periocular fat changes caused by correction of orbital hypertelorism to test the hypothesis that there is a quantitatively predictable relationship between the movement of the osseous orbit and that of the ocular globe. A retrospec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Complete or incomplete cleft lip may include a contralateral lesser form of incomplete cleft lip to give rise to an asymmetrical bilateral cleft lip deformity. The principle of simultaneous bilateral cleft repair remains an area of contention with regard to asymmetrical cases, including a lesser form deformi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182402f50
更新日期:2012-03-01 00:00:00
abstract::The Internet was evaluated as a source of information for the layperson on the topic of breast augmentation. Three commonly used search engines (Excite, AOL, and Yahoo) were employed using the term "breast augmentation." These sites were then evaluated by each of three experienced plastic surgeons for their quality an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200101000-00028
更新日期:2001-01-01 00:00:00
abstract::During the past 18 months, 60 tissue expanders were utilized in the reconstruction of 42 children with burn alopecia of the scalp not amenable to a single excision and primary closure at the Shriners Burns Institute in Galveston, Texas. The children were grouped according to the degree of alopecia. All patients with d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198804000-00005
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the factors associated with primary and secondary amputation in patients with limb-threatening trauma to the upper extremity, describe the incidence of these injuries, and describe the procedures involved in the treatment of these difficult injuries. METHODS:A retrospecti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000006644
更新日期:2020-04-01 00:00:00
abstract::Spontaneous "overnight" deflation of inflatable prostheses is rather uncommon, but we have had a 5.7% incidence of it in a 24-month period in which we used implants with a suturable tab and fastened them to the subjacent fascia. At exploration we found these tabs had torn the bag of the implant, usually at the vulcani...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197909000-00004
更新日期:1979-09-01 00:00:00
abstract::Advancements in modern robotic technology have led to the development of highly sophisticated upper extremity prosthetic limbs. High-fidelity volitional control of these devices is dependent on the critical interface between the patient and the mechanical prosthesis. Recent innovations in prosthetic interfaces have fo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3182a97e5f
更新日期:2013-12-01 00:00:00
abstract::Bacterial colonization of mammary implants is a prelude to clinical infection and has been implicated in the etiology of capsular contracture. Antimicrobial impregnation of a variety of medical devices with the combination of minocycline and rifampin has recently emerged as a potentially effective method for preventin...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200204010-00022
更新日期:2002-04-01 00:00:00
abstract::In the vast majority of burned patients, the injury is limited to the skin and superficial subcutaneous tissue, and the vasculature of the deeper fascia is spared. This fact encouraged me to design a flap in which the burned scar tissue is employed. The island fasciocutaneous flap is based only on the proximal septocu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199709001-00014
更新日期:1997-09-01 00:00:00
abstract::We present a case of occupation-related carcinoma of the scrotum (chimney sweeper's disease) in a black man. The history of this disease is outlined. ...
journal_title:Plastic and reconstructive surgery
pub_type: 历史文章,杂志文章
doi:
更新日期:1978-02-01 00:00:00
abstract::The concept and technique of the use of resorbable synthetic material for nasal spreader grafts are presented. The material is felt to be particularly useful in revision rhinoplasty, in which the likelihood of internal valve collapse is high and the septum (the most common source of material for spreader grafts) often...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Posttraumatic facial paralysis is a disabling condition. Current surgical management by faciofacial nerve suture provides limited recovery. To improve the outcome, the authors evaluated an add-on strategy based on a syngeneic transplantation of nasal olfactory stem cells in a rat model of facial nerve injury...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007367
更新日期:2020-12-01 00:00:00
abstract::We describe 3 patients with the Pierre Robin Syndrome who developed severe problems of airway obstruction after having the cleft palate closed and a pharyngeal flap done simultaneously. We now believe that, even at a later age, pharyngeal flaps should be done in these patients only after a most careful assessment of t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197608000-00007
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:The conchal cartilage is favored in nasal tip surgery, but is limited in dorsal augmentation. The authors evaluated diced conchal cartilage with perichondrial attachment in augmentation of the nasal dorsum, radix, and/or tip. METHODS:The medical records of 37 patients who underwent rhinoplasty using diced c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001227
更新日期:2015-06-01 00:00:00
abstract::Fibrin glue was applied at the anastomotic site of the vein graft that was placed in rat femoral artery defects by the telescoping anastomotic technique at both proximal and distal anastomoses. All 35 vein grafts thus placed were patent, yielding a statistically higher patency rate than those placed in the same femora...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199511000-00026
更新日期:1995-11-01 00:00:00
abstract::Correcting facial asymmetry is a difficult problem for plastic surgeons. From 1991 to 1996, the authors treated 53 cases of mandibular angle resection, 13 of which were of patients with an asymmetrical lower face. On the basis of these experiences, the authors highlight two important points in dealing with the asymmet...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Nipple-sparing mastectomy with immediate prosthetic reconstruction is routinely performed because of excellent aesthetic results and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, caused by...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003627
更新日期:2017-09-01 00:00:00
abstract::Virtual surgical planning and computer-aided design and computer-aided modeling are promising technologies with a growing trend in contemporary head and neck reconstruction. Segmental mandibular reconstruction with the osteoseptocutaneous fibula flap is one of the fields in which these technologies are increasingly us...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000479998.49928.71
更新日期:2016-03-01 00:00:00
abstract::The use of the island rotation flap for the repair of small and medium-sized partial-thickness defects of the nasal tip and soft triangle has led to extremely favorable aesthetic results far superior to that of full-thickness skin grafts. The color and thickness match have been excellent, and the complication rate was...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-199612000-00030
更新日期:1996-12-01 00:00:00
abstract::Clinical application of composite tissue allograft transplants opened discussion on the restoration of facial deformities by allotransplantation. The authors introduce a hemifacial allograft transplant model to investigate the rationale for the development of functional tolerance across the major histocompatibility co...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000142414.92308.ab
更新日期:2004-12-01 00:00:00
abstract::A case of a rare variation of the vascular pedicle of the latissimus dorsi musculocutaneous flap is described. Its main vascular pedicle was the circumflex scapular vessel. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199112000-00021
更新日期:1991-12-01 00:00:00
abstract::The extensor digitorum brevis muscle flap, which has already been suggested as a local flap for the foot, has been applied by us in 2 cases with excellent results. This flap, as with other muscle flaps, provides an excellent bed for the skin graft. Furthermore, because of its width, it allows for covering an area of s...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198506000-00024
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:Both one- and two-stage approaches have been widely used for patients with asymmetric bilateral cleft lip. There are insufficient long-term outcome data for comparison of these two methods. The purpose of this retrospective study was to compare the clinical outcome over the past 20 years. METHODS:The senior...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004327
更新日期:2018-05-01 00:00:00
abstract::EXECUTIVE SUMMARY: 1. Foot infections in patients with diabetes cause substantial morbidity and frequent visits to health care professionals and may lead to amputation of a lower extremity. 2. Diabetic foot infections require attention to local (foot) and systemic (metabolic) issues and coordinated management, prefera...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000222737.09322.77
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Recent literature has focused on the advantages and disadvantages of using acellular dermal matrix in breast reconstruction. Many of the reported data are from low level-of-evidence studies, leaving many questions incompletely answered. The present randomized trial provides high-level data on the incidence a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000000809
更新日期:2015-01-01 00:00:00