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.

Objective:To investigate the efficacy of microneedling combined with topical 5% minoxidil tincture in the treatment of male androgenetic alopecia (AGA).Methods:This study was a prospective study. Male patients with newly diagnosed androgenetic alopecia at the Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital Westlake University School of Medicine, from April 2022 to April 2024 were selected. Age and BASP score were used as matching variables, and every 3 cases were matched as a group. In the study group, 1.0 mm microneedle combined with topical 5% minoxidil tincture was used for 2-3 times of acupuncture operation in the hair loss area, and then about 1 ml of 5% minoxidil tincture was applied to the scalp to promote absorption. From the second day, about 1 ml of 5% minoxidil tincture was evenly sprayed on the hair roots of the scalp in the hair loss area and massaged until absorption, once in the morning and evening every day. Control group 1 was evenly sprayed with 5% minoxidil tincture on the hair roots of the alopecia area, once a day in the morning and evening, about 1 ml each time. Patients in control group 2 received oral finasteride 1 mg once daily. The three groups were treated for 13 weeks, and adverse reactions were recorded during the treatment. Before and immediately after 13 weeks of treatment, the final hair density, velus hair density, hair follicle density, hair shaft average diameter, single hair follicle density and double hair follicle density of the three groups were measured by dermoscopy. Paired sample t-test was used for statistical analysis. After 13 weeks of treatment, the above measurement indexes of study group, control group 1 and control group 2 were analyzed by LSD multiple comparison method. Results:A total of 99 male patients were enrolled, with 33 in the study group [mean age: (31.6 ± 5.8) years, range: 18-45], 33 in control group 1[mean age: (31.7 ± 5.6) years, range: 20-44], and 33 in control group 2 [mean age: (32.2 ± 5.4 )years, range: 19-45].In the study group, three patients experienced transient pain in the treated areas during and after microneedling, which resolved spontaneously within two hours. Two patients developed scalp flaking three days post-treatment, which improved with increased washing frequency and targeted shampoo selection. No significant adverse reactions were observed in control groups 1 and 2.After 13 weeks of treatment, significant increases were observed in the study group compared to baseline for terminal hair density [(104.5 ± 29.6) hairs/cm 2 vs. (72.5 ± 27.9) hairs/cm 2], mean hair shaft diameter [(53.6 ± 11.4) μm vs. (45.7 ± 12.9) μm], follicular unit density [(71.4 ± 18.5) units/cm 2 vs. (57.8 ± 17.4) units/cm 2], and single-hair follicular unit density [(46.7 ± 11.1) units/cm 2 vs. (31.4 ± 12.3) units/cm 2], all with statistically significant differences ( P < 0.05). Control group 1 also showed significant increases in terminal hair density [(87.3 ± 24.5) hairs/cm 2 vs. (70.7 ± 26.0) hairs/cm 2], vellus hair density [(55.3 ± 13.9) hairs/cm 2 vs. (30.2 ± 8.8) hairs/cm 2], follicular unit density [(58.9 ± 17.1) units/cm 2 vs. (52.6 ± 15.5) units/cm 2], mean hair shaft diameter [(52.8 ± 15.7) μm vs. (50.1 ± 16.0) μm], and single-hair follicular unit density [(40.1 ± 11.1) units/cm 2 vs. (34.2 ± 12.0) units/cm 2], all with statistically significant differences ( P < 0.05).Control group 2 showed significant improvements in terminal hair density [(106.3 ± 22.5) hairs/cm 2 vs. (73.7 ± 26.9) hairs/cm 2], follicular unit density [(68.4 ± 18.1) units/cm 2 vs. (53.7 ± 15.4) units/cm 2], mean hair shaft diameter [(57.9 ± 16.2) μm vs. (50.6 ± 15.7) μm], single-hair follicular unit density [(48.1 ± 11.5) units/cm 2 vs. (34.2 ± 12.6) units/cm 2], and double-hair follicular unit density [(23.5 ± 6.4) units/cm 2 vs. (17.2 ± 6.8) units/cm 2], all with statistically significant differences ( P < 0.05). When comparing post-treatment outcomes, the study group exhibited significantly higher terminal hair density, vellus hair density, mean hair shaft diameter, follicular unit density, and single-hair follicular unit density than control group 1, while vellus hair density was significantly lower ( P < 0.05). The study group and control group 2 showed no statistically significant differences in most parameters except for double-hair follicular unit density, which was significantly lower in the study group ( P< 0.05). Conclusion:Microneedling combined with topical 5% minoxidil tincture is an effective treatment for male androgenetic alopecia, demonstrating significant improvements in hair density, follicular unit density, and hair shaft thickness.

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.

Objective:To investigate the efficacy of microneedling combined with topical 5% minoxidil tincture in the treatment of male androgenetic alopecia (AGA).Methods:This study was a prospective study. Male patients with newly diagnosed androgenetic alopecia at the Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital Westlake University School of Medicine, from April 2022 to April 2024 were selected. Age and BASP score were used as matching variables, and every 3 cases were matched as a group. In the study group, 1.0 mm microneedle combined with topical 5% minoxidil tincture was used for 2-3 times of acupuncture operation in the hair loss area, and then about 1 ml of 5% minoxidil tincture was applied to the scalp to promote absorption. From the second day, about 1 ml of 5% minoxidil tincture was evenly sprayed on the hair roots of the scalp in the hair loss area and massaged until absorption, once in the morning and evening every day. Control group 1 was evenly sprayed with 5% minoxidil tincture on the hair roots of the alopecia area, once a day in the morning and evening, about 1 ml each time. Patients in control group 2 received oral finasteride 1 mg once daily. The three groups were treated for 13 weeks, and adverse reactions were recorded during the treatment. Before and immediately after 13 weeks of treatment, the final hair density, velus hair density, hair follicle density, hair shaft average diameter, single hair follicle density and double hair follicle density of the three groups were measured by dermoscopy. Paired sample t-test was used for statistical analysis. After 13 weeks of treatment, the above measurement indexes of study group, control group 1 and control group 2 were analyzed by LSD multiple comparison method. Results:A total of 99 male patients were enrolled, with 33 in the study group [mean age: (31.6 ± 5.8) years, range: 18-45], 33 in control group 1[mean age: (31.7 ± 5.6) years, range: 20-44], and 33 in control group 2 [mean age: (32.2 ± 5.4 )years, range: 19-45].In the study group, three patients experienced transient pain in the treated areas during and after microneedling, which resolved spontaneously within two hours. Two patients developed scalp flaking three days post-treatment, which improved with increased washing frequency and targeted shampoo selection. No significant adverse reactions were observed in control groups 1 and 2.After 13 weeks of treatment, significant increases were observed in the study group compared to baseline for terminal hair density [(104.5 ± 29.6) hairs/cm 2 vs. (72.5 ± 27.9) hairs/cm 2], mean hair shaft diameter [(53.6 ± 11.4) μm vs. (45.7 ± 12.9) μm], follicular unit density [(71.4 ± 18.5) units/cm 2 vs. (57.8 ± 17.4) units/cm 2], and single-hair follicular unit density [(46.7 ± 11.1) units/cm 2 vs. (31.4 ± 12.3) units/cm 2], all with statistically significant differences ( P < 0.05). Control group 1 also showed significant increases in terminal hair density [(87.3 ± 24.5) hairs/cm 2 vs. (70.7 ± 26.0) hairs/cm 2], vellus hair density [(55.3 ± 13.9) hairs/cm 2 vs. (30.2 ± 8.8) hairs/cm 2], follicular unit density [(58.9 ± 17.1) units/cm 2 vs. (52.6 ± 15.5) units/cm 2], mean hair shaft diameter [(52.8 ± 15.7) μm vs. (50.1 ± 16.0) μm], and single-hair follicular unit density [(40.1 ± 11.1) units/cm 2 vs. (34.2 ± 12.0) units/cm 2], all with statistically significant differences ( P < 0.05).Control group 2 showed significant improvements in terminal hair density [(106.3 ± 22.5) hairs/cm 2 vs. (73.7 ± 26.9) hairs/cm 2], follicular unit density [(68.4 ± 18.1) units/cm 2 vs. (53.7 ± 15.4) units/cm 2], mean hair shaft diameter [(57.9 ± 16.2) μm vs. (50.6 ± 15.7) μm], single-hair follicular unit density [(48.1 ± 11.5) units/cm 2 vs. (34.2 ± 12.6) units/cm 2], and double-hair follicular unit density [(23.5 ± 6.4) units/cm 2 vs. (17.2 ± 6.8) units/cm 2], all with statistically significant differences ( P < 0.05). When comparing post-treatment outcomes, the study group exhibited significantly higher terminal hair density, vellus hair density, mean hair shaft diameter, follicular unit density, and single-hair follicular unit density than control group 1, while vellus hair density was significantly lower ( P < 0.05). The study group and control group 2 showed no statistically significant differences in most parameters except for double-hair follicular unit density, which was significantly lower in the study group ( P< 0.05). Conclusion:Microneedling combined with topical 5% minoxidil tincture is an effective treatment for male androgenetic alopecia, demonstrating significant improvements in hair density, follicular unit density, and hair shaft thickness.

In order to promote the development of hair transplantation, particularly the establishment of standards, the Hair Transplantation Expert Group of Plastic and Aesthetic National Medical Quality Control Center invited experts in the field of hair transplantation across China and formed a draft of the Expert Consensus on Standard Terminology for Hair Transplantation based on the collation of relevant literature and monographs. By combining Delphi methodology and consensus meetings, the expert group conducted several rounds of consultations on issues such as follicular unit anatomy, harvesting, dissection, and implantation, ultimately presenting 54 terminologies. This consensus considers the original Chinese and English meanings as well as the professional characteristics of terms used in hair transplantation, highlights the unique features and advantages of hair transplantation, and preserves its essence while promoting innovation, with the hope of providing valuable reference for clinical researchers engaged in hair transplantation both domestically and internationally, and better facilitating the standardization and advancement of the field.

In order to promote the development of hair transplantation, particularly the establishment of standards, the Hair Transplantation Expert Group of Plastic and Aesthetic National Medical Quality Control Center invited experts in the field of hair transplantation across China and formed a draft of the Expert Consensus on Standard Terminology for Hair Transplantation based on the collation of relevant literature and monographs. By combining Delphi methodology and consensus meetings, the expert group conducted several rounds of consultations on issues such as follicular unit anatomy, harvesting, dissection, and implantation, ultimately presenting 54 terminologies. This consensus considers the original Chinese and English meanings as well as the professional characteristics of terms used in hair transplantation, highlights the unique features and advantages of hair transplantation, and preserves its essence while promoting innovation, with the hope of providing valuable reference for clinical researchers engaged in hair transplantation both domestically and internationally, and better facilitating the standardization and advancement of the field.

Objective:To explore the applicability of the distance between facial marks classification in evaluating the severity of androgenic alopecia in men.Methods:From June to December 2019, the male Chinese with diagnosis of androgenic alopecia were evaluated in the specific clinic of alopecia of Hangzhou First People’s Hospital according to the distance between facial marks and BASP(basic and specific) classification. The classification based on the distance between facial marks measures the distance from the facial marks of the anterior hairline to the horizontal line of the eyebrow and the longest radius of hair loss in the hair rotation center, the hair recession of the patient’s forehead (F), temporal (M) and vertex (V) parts. The hair loss in each region is rated as 0-3 grade from light to heavy, and the final hair loss grading is expressed as FnMnVn, such as F1M2V0. The highest grade of hair loss in F, M and V is the overall grade of hair loss. SPSS 25.0 software was used to statistically analyze the general data of patients, and Kappa test was used to evaluate the consistency between the results of the distance classification and BASP classification. The repeatability of the distance classification was tested by the repetition rate of three hair loss specialists. When two or more specialists gave the same evaluation among the three hair loss specialists, the result was regarded as the standard result. The ease of use of the distance between facial marks classification was tested by the consistency rate between the grading results of two temporary trained general doctors and the standard results.Results:A total of 150 male patients, aged (32.8±7.9) years (19-58 years), were included, of which 99 patients were 24-35 years old, accounting for 66.00%. It can be observed that the onset age was earlier. As assessed in this classification, the patients who participated in the study were graded as mild in 65 cases(43.33%), severe in 58 cases(38.67%), and moderate, which was consistency with the results obtained by BASP classification ( κ=0.573, P<0.001). Three experienced alopecia specialists evaluated 150 patients through the distance between facial marks. The results showed that the repetition rates of frontal, temporal and parietal classification results were 98.00%(147/150), 97.33%(146/150) and 96.00%(144/150), respectively. The repetition rate of the final alopecia classification was 92.00%(138/150), and the repetition rate of the overall alopecia classification was 98.00%(147/150). The consistency rate between the overall alopecia classification results of two temporary trained general doctors and the standard results was 95.92%(141/147) and 96.60%(142/147), respectively, and the consistency rate of the other results was higher than 90.00% except for one general doctor who was 89.86%(124/138) in the final classification. Conclusion:The distance between facial marks classification is a comparatively accurate and easy-to-learn grading method designed for Chinese male androgenic hair loss patients based on objective measurement data.

Objective:To explore the precise layered and tension-reducing sutures for skin pigmented mole surgery to promote tissue healing and reduce scar hyperplasia.Methods:From January 2019 to December 2021, the First Department of Surgery of the Civil Aviation General Hospital and Tenth Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences treated 56 patients with skin pigmented moles aged 18-52 years, with an average age of 26 years, including 30 males and 26 females. All patients in this group underwent surgical resection of skin pigmented moles, which reached the subcutaneous fat layer. The dermis and subcutaneous tissue under the skin incision were precisely buried and guided suture by using the middle common hole equal-chord and equal-arc buried guide suture with scale marks on both ends of the needle tip.Results:The incision width of skin tissue defect in this group of patients was less than 30 mm. After the suturing was completed, the tension between the tissues on both sides of the incision and the close-fitting of each layer of tissue on both sides of the incision without dead space were realized immediately. 55 cases achieved primary incision healing. After two years of follow-up observation, there was no scar hyperplasia, and the effect was satisfactory. In only one case, local incision was red and swollen due to suture reaction, and a small amount of scar hyperplasia appeared later.Conclusions:This submerged guided suture method is an effective surgical technique for reducing skin incision scars, and it is more suitable for small incisions with a skin incision length of less than 10 mm, which is difficult to achieve layered suture of the deep tissue of the incision with ordinary suture needles.

Objective:To explore the applicability of the distance between facial marks classification in evaluating the severity of androgenic alopecia in men.Methods:From June to December 2019, the male Chinese with diagnosis of androgenic alopecia were evaluated in the specific clinic of alopecia of Hangzhou First People’s Hospital according to the distance between facial marks and BASP(basic and specific) classification. The classification based on the distance between facial marks measures the distance from the facial marks of the anterior hairline to the horizontal line of the eyebrow and the longest radius of hair loss in the hair rotation center, the hair recession of the patient’s forehead (F), temporal (M) and vertex (V) parts. The hair loss in each region is rated as 0-3 grade from light to heavy, and the final hair loss grading is expressed as FnMnVn, such as F1M2V0. The highest grade of hair loss in F, M and V is the overall grade of hair loss. SPSS 25.0 software was used to statistically analyze the general data of patients, and Kappa test was used to evaluate the consistency between the results of the distance classification and BASP classification. The repeatability of the distance classification was tested by the repetition rate of three hair loss specialists. When two or more specialists gave the same evaluation among the three hair loss specialists, the result was regarded as the standard result. The ease of use of the distance between facial marks classification was tested by the consistency rate between the grading results of two temporary trained general doctors and the standard results.Results:A total of 150 male patients, aged (32.8±7.9) years (19-58 years), were included, of which 99 patients were 24-35 years old, accounting for 66.00%. It can be observed that the onset age was earlier. As assessed in this classification, the patients who participated in the study were graded as mild in 65 cases(43.33%), severe in 58 cases(38.67%), and moderate, which was consistency with the results obtained by BASP classification ( κ=0.573, P<0.001). Three experienced alopecia specialists evaluated 150 patients through the distance between facial marks. The results showed that the repetition rates of frontal, temporal and parietal classification results were 98.00%(147/150), 97.33%(146/150) and 96.00%(144/150), respectively. The repetition rate of the final alopecia classification was 92.00%(138/150), and the repetition rate of the overall alopecia classification was 98.00%(147/150). The consistency rate between the overall alopecia classification results of two temporary trained general doctors and the standard results was 95.92%(141/147) and 96.60%(142/147), respectively, and the consistency rate of the other results was higher than 90.00% except for one general doctor who was 89.86%(124/138) in the final classification. Conclusion:The distance between facial marks classification is a comparatively accurate and easy-to-learn grading method designed for Chinese male androgenic hair loss patients based on objective measurement data.

Background::Non-smokers account for a large proportion of lung cancer patients, especially in Asia, but the attention paid to them is limited compared with smokers. In non-smokers, males display a risk for lung cancer incidence distinct from the females—even after excluding the influence of smoking; but the knowledge regarding the factors causing the difference is sparse. Based on a large multicenter prospective cancer screening cohort in China, we aimed to elucidate the interpretable sex differences caused by known factors and provide clues for primary and secondary prevention.Methods::Risk factors including demographic characteristics, lifestyle factors, family history of cancer, and baseline comorbidity were obtained from 796,283 Chinese non-smoking participants by the baseline risk assessment completed in 2013 to 2018. Cox regression analysis was performed to assess the sex difference in the risk of lung cancer, and the hazard ratios (HRs) that were adjusted for different known factors were calculated and compared to determine the proportion of excess risk and to explain the existing risk factors.Results::With a median follow-up of 4.80 years, 3351 subjects who were diagnosed with lung cancer were selected in the analysis. The lung cancer risk of males was significantly higher than that of females; the HRs in all male non-smokers were 1.29 (95% confidence interval [CI]: 1.20-1.38) after adjusting for the age and 1.38 (95% CI: 1.28-1.50) after adjusting for all factors, which suggested that known factors could not explain the sex difference in the risk of lung cancer in non-smokers. Known factors were 7% (|1.29-1.38|/1.29) more harmful in women than in men. For adenocarcinoma, women showed excess risk higher than men, contrary to squamous cell carcinoma; after adjusting for all factors, 47% ([1.30-1.16]/[1.30-1]) and 4% ([7.02-6.75]/[7.02-1])) of the excess risk was explainable in adenocarcinoma and squamous cell carcinoma. The main causes of gender differences in lung cancer risk were lifestyle factors, baseline comorbidity, and family history.Conclusions::Significant gender differences in the risk of lung cancer were discovered in China non-smokers. Existing risk factors did not explain the excess lung cancer risk of all non-smoking men, and the internal causes for the excess risk still need to be explored; most known risk factors were more harmful to non-smoking women; further exploring the causes of the sex difference would help to improve the prevention and screening programs and protect the non-smoking males from lung cancers.