Nerve dysfunction and alterations in genetic material are important factors in hyperhidrosis. In recent years, numerous clinical trials have confirmed the effectiveness and safety of botulinum toxin type A as a neurotoxin and cytotoxin in the treatment of axillary hyperhidrosis. This article describes the pathogenesis of hyperhidrosis and the application and mechanism research progress of botulinum toxin type A in the treatment of axillary hyperhidrosis, hoping to provide a basis for basic studies and clinical treatment related to axillary hyperhidrosis and botulinum toxin type A.

Objective:To identify potential therapeutic targets for the treatment of hair color and hair shaft abnormalities, providing novel insights and approaches for managing related conditions.Methods:Using the pQTL data from large-scale proteomics studies, a two-sample Mendelian randomization (TwoSampleMR) was conducted to preliminarily identify potential drug therapeutic targets. Subsequently, sensitivity analysis was performed to evaluate potential confounding factors such as heterogeneity and horizontal pleiotropy, and a leave-one-out sensitivity analysis was conducted by eliminating each single nucleotide polymorphism (SNP) one by one. Finally, co-localization analysis was carried out to explore whether there are shared genetic variants between the identified plasma proteins and traits.Results:The proteomic data used in this study included 4, 907 pQTLs, while the genetic data related to hair pigmentation and shaft abnormalities comprised 124 cases and 432, 686 controls. After Mendelian randomization screening, six candidate protein genes were identified: HLA-DQA2, CTSB, KIR2DS2, SVEP1, HOMER2, and HOMER1. Sensitivity analyses revealed no evidence of heterogeneity or horizontal pleiotropy among these proteins. Leave-one-out sensitivity analysis indicated that no single SNP significantly influenced the overall result. Notably, HOMER2 was supported by colocalization analysis with strong evidence, suggesting its potential role in regulating genetic mechanisms underlying hair pigmentation and shaft health.Conclusions:This study identified six potential therapeutic targets for hair pigmentation and shaft abnormalities, with HOMER2 showing stronger evidence. These findings provide novel directions for the treatment of hair color and hair shaft abnormalities.

Migraine disorders, a common disabling headache condition, is the second largest contributor to global neurological disability-adjusted life-years. Since 2000, migraine surgery has been pioneered and elaborated by plastic surgeons. For certain patients, migraine episodes are associated with "trigger sites" caused by compression of the peripheral nerves in the head and neck region. Botulinum toxin type A injections or nerve blocks, clinical manifestations and image studies can help confirm the trigger sites. Surgical deactivation of the trigger sites can effectively alleviate or eliminate migraine disorders, with the optimal result incorporated with experience and principles of plastic and cosmetic surgery.

Radiation-induced skin injury can occur following multiple radiotherapy treatments or nuclear accidents, significantly impacting patients’ quality of life. Radiation-induced skin ulcers often fail to heal and currently lack effective treatment options. Previous studies have demonstrated that cellular senescence is a critical factor contributing to the impaired healing of these ulcers. This article reviews the occurrence and progression of radiation-induced skin damage, the role of cellular senescence in wound healing, potential mechanisms and related biomarkers, and explores the significance of removing senescent cells in alleviating radiation-induced skin damage. It is hoped that this review will provide new insights for the treatment of radiation-induced skin injuries.

Rhytidectomy, as the most effective method for improving facial aging at present, precisely restores the position of facial anatomical structures. However, for facial aging accompanied by soft tissue or bone atrophy, the improvement effect of rhytidectomy alone is inadequate, and simultaneous restoration of facial volume is required to achieve better facial rejuvenation results. Therefore, rhytidectomy combined with fat grafting has received increasing attention in facial rejuvenation in recent years. This paper reviewed the research progress of facial rhytidectomy, fat grafting, and their combined approaches.

Inverted nipple is a common type of breast deformity in women, which not only affects appearance and function, but may also seriously damage the physical and mental health of female patients. The reports on its prevalence vary, roughly ranging from 3.0% to 23.0%. Currently, conservative treatment or minimally invasive surgery are feasible options for mild patients. However, moderate to severe patients usually require surgical correction. Given that surgery may cause loss of breastfeeding function and sensory ability, in recent years, many scholars have been committed to improving existing technologies or proposing innovative method . These method tailor treatment plans for patients based on factors such as the severity of their condition, age, and the need for breastfeeding, thereby achieving significant therapeutic effects. This article reviews the general situation of the field at home and abroad over the past 40 years and the common treatment method and progress of inverted nipples.

Abdominoplasty is one of the most widely performed plastic surgeries globally, with steadily increasing cases in China. Stress urinary incontinence is one important characteristic of pelvic organ prolapse, significantly impacting patients’ quality of life and contributing to increased healthcare burdens on society. This review tries to explore the impact of abdominoplasty on stress urinary incontinence in females and provides more information on their relationship.

Aesthetic injection has become an important treatment item of plastic surgery. Botulinum toxin and dermal fillers are the two major plates of injections. It is clear that the target tissue of botulinum toxin is expression muscles, whereas there are many filling materials to choose from. According to the mechanism, filling materials can be divided into three categories: volume fillers, collagen stimulators, nutritional glossers. The selection of these materials is related to the tissue type of the injection site. This article subdivides facial soft tissues into 5 horizontal layers: skin, subcutaneous fat, superficial muscular aponeurotic system, deep tissue, periosteum or deep fascia, as well as the the vertical ligaments, which compose a three-dimensional structure. The characteristics of these tissue structures are analyzed for selection of filling materials. Particular attention should be paid to the differences between volumetric fillers and collagen stimulators, which have completely different mechanisms of action, indications, and injection technique, with the former being suitable for deep tissues that require volume supplementation, and the latter for all types of tissues that require collagen supplementation. In conclusion, there is a close logical relationship between the choice of injection material and the facial anatomy.

Objective:To summarize the experience of repairing partial areolar necrosis following reduction mammaplasty.Methods:A retrospective analysis was conducted on clinical data from patients who experienced partial areola necrosis after reduction mammaplasty. These patients were treated or consulted at the Department of Plastic Surgery, Zhongshan Hospital, Fudan University, between January 2017 and February 2023. Preoperatively, daily dressing changes were performed on the necrotic areola wounds until the boundaries of necrosis were clearly defined. Debridement and repair were then carried out by resecting bilateral breast glandular tissue through the original incision to reduce breast volume, followed by narrowing the areola radius. If no areola defect remained after narrowing, direct suturing was performed; if defects persisted, the resected normal areola skin was used for grafting. Postoperative follow-up was conducted to observe areola recovery and complications. At the 6-month postoperative mark, patient satisfaction was evaluated using a 5-level scale (very satisfied, satisfied, neutral, dissatisfied, very dissatisfied). An experienced plastic physician, not involved in the surgery, assessed areolar outcomes based on four criteria: color, softness, shape, and scarring, with each criterion scored from 1 to 4 (higher scores indicating better outcomes).Results:Eight female patients (9 necrotic areolas) were included in the study, with a mean age of (31.8±5.4) years and a mean body mass index of (24.1±1.8) kg/m 2. Among the 9 necrotic areolas, 3 had defect areas greater than 50% of the total areola area, while 6 had defects less than 50%. Direct suturing after areola narrowing was performed in 3 areolas, while free areola skin grafting was used in 6 areolas. Postoperatively, 2 cases exhibited mild epidermal erosion at the graft site, which improved with dressing changes. No complications such as infection, bleeding, hematoma, or seroma occurred. At the 6-month follow-up, all 8 patients demonstrated good wound healing, and all 9 areolas survived. The areolas exhibited consistent shape and color bilaterally, without significant pigmentation changes, depigmentation, or irregular shapes. In the 6 grafted areolas, the grafted skin color closely matched the surrounding native areola tissue, with no obvious demarcation or scar hyperplasia. Patient satisfaction was rated as very satisfied in 3 cases and satisfied in 5 cases. According to the physician’s evaluation, the scores for color, softness, shape, and scarring were (3.7±0.5), (3.8±0.4), (3.3±0.7) and (3.2±0.7) points, respectively. Conclusion:Partial areola necrosis following reduction mammaplasty can be effectively repaired by further reducing breast volume and narrowing the areola for direct suturing or by grafting excess areola skin to the defect site. A satisfactory appearance can be achieved after surgery.

Objective:To discuss the clinical effect of the modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures in the treatment of middle and lower facial sagging.Methods:The clinical data of patients with middle and lower facial sagging treated in Hangzhou Yichao Medical Aesthetics Clinic from February 2021 to February 2023 were retrospectively analyzed. The operation was performed using barbed sutures to progressively reduce tension and suspend sutures of the superficial musculoaponeurotic system (SMAS) and the skin and subcutaneous tissue. The skin tissue flap was separated from the superficial layer of SMAS with temporal hairline to peri-auricular incision. Firstly, the sagging SMAS and the zygomatic fat pad were fixed to the deep temporal fascia by purse-string suture with barbed sutures, and then the sagging skin and subcutaneous tissue were progressively fixed to the corresponding SMAS at multiple points to the incision direction to improve the middle and lower facial relaxation and reduce the incision tension as much as possible. The nasolabial groove of the patients was scored (0-4) before surgery and 12 months after surgery to evaluate the surgical effect. The higher the score, the more serious the nasolabial groove depression was. Meanwhile, the postoperative recovery, complications and satisfaction of the patients were observed and followed up. SPSS 26.0 software was used to analyze the data. Preoperative and postoperative nasolabial groove scores were represented by Mean±SD, and paired t-test was used for comparison. P<0.05 was considered statistically significant. Results:A total of 23 patients were included, including 4 males and 19 females. They ranged in age from 42 to 68, with an average age of 54.0. All patients showed varying degrees of middle and lower facial relaxation and nasolabial groove deepening. Nasolabial groove score was (3.6±0.5) points. One patient had mild hematoma on the second day after surgery, which subsided after suction and compression, then the facial swelling basically subsided about 7 days after the operation. After 12-17 months of follow-up (mean 13.2 months), the middle and lower facial relaxation and nasolabial depression of 23 patients were significantly improved. No serious complications such as facial nerve injury occurred in all patients, and postoperative scars were not obvious. The nasolabial groove score at 12 months after the operation was (2.0±0.6) points, which was significantly lower than that before the operation ( t=14.81, P<0.001). The patient satisfaction rate was 95.7%(22/23). Conclusion:The modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures avoids deep dissection, and has simple operation, low complications, fast recovery. The relaxation of middle and lower face can be significantly improved, and the long-term effect is stable.