OBJECTIVE: To review recent advances in the application of hair transplantation in wound healing and scar repair in special areas. METHODS: An extensive review of the literature on the application of hair transplantation in wound healing and scar repair in special areas was conducted, focusing on cellular functions, molecular mechanisms, and clinical applications. RESULTS: Hair transplantation has been shown to effectively promote wound healing and scar repair in special areas. The underlying mechanisms are complex, but current understanding emphasizes a strong association with hair follicle-associated stem cells (including epidermal stem cells, dermal papilla cells, dermal sheath cells, etc). CONCLUSION The application of hair transplantation in wound healing and scar repair in special areas remains in its early stages. Further investigation into its mechanisms of action is essential, and randomized controlled trials are needed to establish its efficacy.
Humans ; Wound Healing/physiology* ; Cicatrix/therapy* ; Hair/transplantation* ; Hair Follicle/transplantation*

Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical intervention remains the most effective therapeutic approach for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive procedures combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Objective:To investigate the consistency of trichoscopic fields in androgenetic alopecia (AGA) patients by using scalp medical pigmentation (SMP) ink as visual marker, as well as the safety and durability.Methods:A retrospective analysis was conducted on patients with AGA who visited the Medical Cosmetology Center, Hangzhou First People’s Hospital, Westlake University School of Medicine from April to August 2024. Trichoscopic images were captured immediately and three months after using SMP ink for visual marker. Each patient’s two trichoscopic images were imported into Photoshop CC 2019 software for processing to obtain the location information of the marker, the distance between the marker center and the image center, and pigments areas. Consistency of markers during repeated trichoscopy was evaluated by comparing distances between pigment center and image center. The difference in distance between the two time points (3-month distance minus immediate-post-marking distance) was defined as "distance difference". Patients were divided into the same-operator group and different-operator group based on whether the two trichoscopy examinations were performed by the same operator. The impact of operator changes on the consistency of markers during repeated trichoscopy was assessed by comparing the "distance difference" between the two groups. Additionally, patients were categorized into single-point, double-point, and triple-point groups according to the number of markers. The influence of marker quantity on consistency of the markers was evaluated by comparing the "distance difference" among these three groups. Pigment spread was assessed by comparing pigment actural area in repeated trichoscopic images. Adverse reactions and ink fading within three months were recorded. Statistical analysis was performed using SPSS 27.0 software.The normal distribution measurement data was expressed as Mean ± SD, and the non-normal distribution measurement data was expressed as M ( Q1, Q3). The Wilcoxon signed-rank test was applied for comparison of the distance between the marker center and the image center in the preceding and subsequent trichoscopic images. Mann-Whitney U test was applied for comparison between the same-operator group and the different-operator group, and the Kruskal-Wallis rank sum test was used for comparison among the single-point, double-point, and triple-point groups. The paired sample t-test was used for comparison of the pigment actural area during repeated measurements. P<0.05 indicated statistically significant differences. Results:A total of 22 male AGA patients (aged 24-43 years) were included, with 46 pigment points marked (8 single-point, 4 double-point, 10 triple-point). Same-operator and different-operator groups comprised of 13 and 9 patients, respectively. No significant difference was found in distances between marker center and image center immediately vs. 3 months post-marking [0.91 (0.62, 1.53) mm vs. 0.83 (0.62, 1.22) mm, Z=-0.83, P=0.408]. Comparisons of the "distance difference" between the same-operator and different-operator groups, and among the single-point, double-point, and triple-point groups, showed no statistically significant differences (all P> 0.05). Pigment areas increased by (0.11±0.12) mm 2 at 3 months ( t=-6.47, P<0.001). All pigments exhibited fading within 3 months but remained identifiable without touch-up. Adverse reactions were minimal: mild puncture-site bleeding was observed, with no pigment-related allergies, foreign-body reactions, or significant scarring. Conclusion:Single-point SMP pigment enables reliable and consistent visualization of trichoscopic measurement points in AGA patients, unaffected by operator changes. The method demonstrates clinical convenience, flexibility, high safety, and long-term durability.

Objective:To evaluate the clinical efficacy of infraorbital rim drilling midface lift combined with composite lower blepharoplasty.Methods:Retrospective analysis of clinical data from the patients who underwent combined midface lift and lower blepharoplasty at Department of Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medical, between January 2022 and February 2024.The infraorbital rim drilling midface lift combined with lower blepharoplasty was performed via a subciliary incision approach. Through a subciliary incision, the herniated orbital fat was excised, followed by fixation of the orbital septum to the infraorbital rim periosteum. Drill holes were created at the medial and lateral infraorbital rim, and arcuate suspension of the midface was performed using 2-0 absorbable sutures (SXPP1A405). Postoperative follow-up assessed midface lifting outcomes and complication rates. The wrinkle severity rating scale (WSRS) was used to grade nasolabial folds pre- and postoperatively (5-point scale: higher scores indicating more pronounced folds). Patient-reported outcomes were assessed using the Face-Q questionnaire, evaluating: (1) overall facial satisfaction, (2) satisfaction with surgical results, and (3) satisfaction with decision (scale 0-100; higher scores indicating greater satisfaction/less decisional regret). Descriptive statistical methods were employed for data analysis.Results:A total of 43 patients were enrolled, comprising 7 males and 36 females, with a mean age of (50.6±12.2) years (range: 32-73 years). Postoperative follow-up averaged (11.9±4.6)months. All patients demonstrated significant improvement in lower eyelid bags, tear trough deformity, midface elevation, and nasolabial folds. Surgical complications included: residual lower eyelid fat ( n=5), intermittent fixation point pain persisting >1 month ( n=4), mild residual tear trough deformity ( n=4), and hematoma ( n=1). Nasolabial fold WSRS scores decreased from ( 3.7±0.9 ) points to(2.9±0.6)points following surgery. In 38 patients, Face-Q scores demonstrated high satisfaction levels: appearance-related satisfaction scored (80.9 ± 10.3)points and satisfaction with decision scored (82.4 ± 8.9)points, indicating favorable patient-reported outcomes. Conclusion:The infraorbital rim drilling-assisted midface lift combined with comprehensive lower blepharoplasty effectively corrects midface ptosis while addressing lower eyelid bags. This technique provides reliable fixation points through drilling, resulting in stable and long-lasting lifting outcomes with high patient satisfaction.

Objective:To investigate the protocol and clinical efficacy of hair follicle-bearing microskin (HF-MS) transplantation in the treatment of hypertrophic scars.Methods:Prospective randomized controlled trial. From January to November 2024, patients with hypertrophic scars were recruited from the Medical Cosmetic Center of Affiliated Hangzhou First People’s Hospital with Westlake University School of Medicine and the Department of Plastic and Reconstructive Surgery of Ningbo Sixth Hospital. Patients were randomly divided into the observation group and the control group using a random number table. In the observation group, 1.0 mm punch decompression was performed on the hypertrophic scar area, followed by implantation of HF-MS extracted from the scalp donor site using follicular unit excision (FUE) into the decompression pores. The control group underwent only 1.0 mm punch decompression. Vancouver scar scale (VSS) scores (total score 0-15, higher scores indicating more severe scarring) were assessed preoperatively and at 1, 3, and 6 months postoperatively. Efficacy at 6 months, improvement in hypertrophic scar area, hair survival rate (observation group), adverse reactions, and patients’ satisfaction rates were evaluated. Categorical data were expressed as frequency (%) and analyzed using chi-square tests; normally distributed measurement data were expressed as Mean ± SD and analyzed using independent samples t-tests. Results:A total of 50 patients were included (25 per group), with 22 males and 28 females, aged 18-60 years (mean age: 33 years). The effective rate was 92% (23/25) in the observation group and 68% (17/25) in the control group, showing a statistically significant difference ( P<0.05). Preoperative VSS scores did not differ significantly between the observation and control groups [(6.67±3.19) vs. (7.12±2.89), P>0.05]. At 1, 3, and 6 months postoperatively, the observation group had VSS scores of (5.48±2.60), (4.64±2.39), and (3.80±2.10), respectively, compared to (6.36±2.53), (5.84±2.28), and (5.32±2.09) in the control group. The 6-month postoperative VSS scores differed significantly between groups ( P<0.05). Preoperative hypertrophic scar areas showed no significant difference [(5.75±2.83) cm 2 vs. (6.91±3.31) cm 2,P>0.05]. At 6 months postoperatively, the observation group had significantly smaller scar areas than the control group [(3.15±1.55) cm 2 vs. (5.37±2.93) cm 2,P<0.01]. The average hair survival rate in the observation group was 41% at 6 months. Adverse reactions occurred in 3 cases in the observation group (2 skin indurations, 1 hyperpigmentation) and 7 cases in the control group (4 hyperpigmentation, 2 skin atrophy, 1 skin induration). The observation group had a significantly lower adverse reaction rate [12% (3/25) vs. 28% (7/25), P<0.05]. Patient satisfaction rates were 88% (22/25) in the observation group and 64% (16/25) in the control group ( P<0.05). Conclusion:HF-MS transplantation demonstrates definitive clinical efficacy in treating hypertrophic scars, effectively improving scar morphology, clinical symptoms, and patient quality of life.

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.

Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical intervention remains the most effective therapeutic approach for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive procedures combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Objective:To investigate the consistency of trichoscopic fields in androgenetic alopecia (AGA) patients by using scalp medical pigmentation (SMP) ink as visual marker, as well as the safety and durability.Methods:A retrospective analysis was conducted on patients with AGA who visited the Medical Cosmetology Center, Hangzhou First People’s Hospital, Westlake University School of Medicine from April to August 2024. Trichoscopic images were captured immediately and three months after using SMP ink for visual marker. Each patient’s two trichoscopic images were imported into Photoshop CC 2019 software for processing to obtain the location information of the marker, the distance between the marker center and the image center, and pigments areas. Consistency of markers during repeated trichoscopy was evaluated by comparing distances between pigment center and image center. The difference in distance between the two time points (3-month distance minus immediate-post-marking distance) was defined as "distance difference". Patients were divided into the same-operator group and different-operator group based on whether the two trichoscopy examinations were performed by the same operator. The impact of operator changes on the consistency of markers during repeated trichoscopy was assessed by comparing the "distance difference" between the two groups. Additionally, patients were categorized into single-point, double-point, and triple-point groups according to the number of markers. The influence of marker quantity on consistency of the markers was evaluated by comparing the "distance difference" among these three groups. Pigment spread was assessed by comparing pigment actural area in repeated trichoscopic images. Adverse reactions and ink fading within three months were recorded. Statistical analysis was performed using SPSS 27.0 software.The normal distribution measurement data was expressed as Mean ± SD, and the non-normal distribution measurement data was expressed as M ( Q1, Q3). The Wilcoxon signed-rank test was applied for comparison of the distance between the marker center and the image center in the preceding and subsequent trichoscopic images. Mann-Whitney U test was applied for comparison between the same-operator group and the different-operator group, and the Kruskal-Wallis rank sum test was used for comparison among the single-point, double-point, and triple-point groups. The paired sample t-test was used for comparison of the pigment actural area during repeated measurements. P<0.05 indicated statistically significant differences. Results:A total of 22 male AGA patients (aged 24-43 years) were included, with 46 pigment points marked (8 single-point, 4 double-point, 10 triple-point). Same-operator and different-operator groups comprised of 13 and 9 patients, respectively. No significant difference was found in distances between marker center and image center immediately vs. 3 months post-marking [0.91 (0.62, 1.53) mm vs. 0.83 (0.62, 1.22) mm, Z=-0.83, P=0.408]. Comparisons of the "distance difference" between the same-operator and different-operator groups, and among the single-point, double-point, and triple-point groups, showed no statistically significant differences (all P> 0.05). Pigment areas increased by (0.11±0.12) mm 2 at 3 months ( t=-6.47, P<0.001). All pigments exhibited fading within 3 months but remained identifiable without touch-up. Adverse reactions were minimal: mild puncture-site bleeding was observed, with no pigment-related allergies, foreign-body reactions, or significant scarring. Conclusion:Single-point SMP pigment enables reliable and consistent visualization of trichoscopic measurement points in AGA patients, unaffected by operator changes. The method demonstrates clinical convenience, flexibility, high safety, and long-term durability.

Objective:To evaluate the clinical efficacy of infraorbital rim drilling midface lift combined with composite lower blepharoplasty.Methods:Retrospective analysis of clinical data from the patients who underwent combined midface lift and lower blepharoplasty at Department of Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medical, between January 2022 and February 2024.The infraorbital rim drilling midface lift combined with lower blepharoplasty was performed via a subciliary incision approach. Through a subciliary incision, the herniated orbital fat was excised, followed by fixation of the orbital septum to the infraorbital rim periosteum. Drill holes were created at the medial and lateral infraorbital rim, and arcuate suspension of the midface was performed using 2-0 absorbable sutures (SXPP1A405). Postoperative follow-up assessed midface lifting outcomes and complication rates. The wrinkle severity rating scale (WSRS) was used to grade nasolabial folds pre- and postoperatively (5-point scale: higher scores indicating more pronounced folds). Patient-reported outcomes were assessed using the Face-Q questionnaire, evaluating: (1) overall facial satisfaction, (2) satisfaction with surgical results, and (3) satisfaction with decision (scale 0-100; higher scores indicating greater satisfaction/less decisional regret). Descriptive statistical methods were employed for data analysis.Results:A total of 43 patients were enrolled, comprising 7 males and 36 females, with a mean age of (50.6±12.2) years (range: 32-73 years). Postoperative follow-up averaged (11.9±4.6)months. All patients demonstrated significant improvement in lower eyelid bags, tear trough deformity, midface elevation, and nasolabial folds. Surgical complications included: residual lower eyelid fat ( n=5), intermittent fixation point pain persisting >1 month ( n=4), mild residual tear trough deformity ( n=4), and hematoma ( n=1). Nasolabial fold WSRS scores decreased from ( 3.7±0.9 ) points to(2.9±0.6)points following surgery. In 38 patients, Face-Q scores demonstrated high satisfaction levels: appearance-related satisfaction scored (80.9 ± 10.3)points and satisfaction with decision scored (82.4 ± 8.9)points, indicating favorable patient-reported outcomes. Conclusion:The infraorbital rim drilling-assisted midface lift combined with comprehensive lower blepharoplasty effectively corrects midface ptosis while addressing lower eyelid bags. This technique provides reliable fixation points through drilling, resulting in stable and long-lasting lifting outcomes with high patient satisfaction.

Objective:To investigate the protocol and clinical efficacy of hair follicle-bearing microskin (HF-MS) transplantation in the treatment of hypertrophic scars.Methods:Prospective randomized controlled trial. From January to November 2024, patients with hypertrophic scars were recruited from the Medical Cosmetic Center of Affiliated Hangzhou First People’s Hospital with Westlake University School of Medicine and the Department of Plastic and Reconstructive Surgery of Ningbo Sixth Hospital. Patients were randomly divided into the observation group and the control group using a random number table. In the observation group, 1.0 mm punch decompression was performed on the hypertrophic scar area, followed by implantation of HF-MS extracted from the scalp donor site using follicular unit excision (FUE) into the decompression pores. The control group underwent only 1.0 mm punch decompression. Vancouver scar scale (VSS) scores (total score 0-15, higher scores indicating more severe scarring) were assessed preoperatively and at 1, 3, and 6 months postoperatively. Efficacy at 6 months, improvement in hypertrophic scar area, hair survival rate (observation group), adverse reactions, and patients’ satisfaction rates were evaluated. Categorical data were expressed as frequency (%) and analyzed using chi-square tests; normally distributed measurement data were expressed as Mean ± SD and analyzed using independent samples t-tests. Results:A total of 50 patients were included (25 per group), with 22 males and 28 females, aged 18-60 years (mean age: 33 years). The effective rate was 92% (23/25) in the observation group and 68% (17/25) in the control group, showing a statistically significant difference ( P<0.05). Preoperative VSS scores did not differ significantly between the observation and control groups [(6.67±3.19) vs. (7.12±2.89), P>0.05]. At 1, 3, and 6 months postoperatively, the observation group had VSS scores of (5.48±2.60), (4.64±2.39), and (3.80±2.10), respectively, compared to (6.36±2.53), (5.84±2.28), and (5.32±2.09) in the control group. The 6-month postoperative VSS scores differed significantly between groups ( P<0.05). Preoperative hypertrophic scar areas showed no significant difference [(5.75±2.83) cm 2 vs. (6.91±3.31) cm 2,P>0.05]. At 6 months postoperatively, the observation group had significantly smaller scar areas than the control group [(3.15±1.55) cm 2 vs. (5.37±2.93) cm 2,P<0.01]. The average hair survival rate in the observation group was 41% at 6 months. Adverse reactions occurred in 3 cases in the observation group (2 skin indurations, 1 hyperpigmentation) and 7 cases in the control group (4 hyperpigmentation, 2 skin atrophy, 1 skin induration). The observation group had a significantly lower adverse reaction rate [12% (3/25) vs. 28% (7/25), P<0.05]. Patient satisfaction rates were 88% (22/25) in the observation group and 64% (16/25) in the control group ( P<0.05). Conclusion:HF-MS transplantation demonstrates definitive clinical efficacy in treating hypertrophic scars, effectively improving scar morphology, clinical symptoms, and patient quality of life.