Dermatologic Surgery最新文献

Background: Hair has long held cultural and psychosocial significance, symbolizing health, status, and identity. Hair loss impacts quality of life, self-esteem, and psychological well-being. While treatments like minoxidil and finasteride exist, they often yield limited results. Hair transplantation (HT), first demonstrated by Johann Friedrich Dieffenbach in 1822, has evolved into the most effective hair restoration method. Since its inception in 1975, Dermatologic Surgery has been a main source for groundbreaking publications from major players in the field, while also playing a pivotal role in documenting the history of HT.

Objective: This mini review examines the historical evolution of HT techniques over the past 200 years, highlighting their advantages and limitations.

Materials and methods: A literature search was conducted using PubMed and Google Scholar with the term "hair transplantation techniques." Relevant sources were reviewed to extract information on technique development and historical origins.

Results: Key pioneers such as Dieffenbach, Menahem Hodara, and Shoji Okuda laid the groundwork for modern HT. Milestones include punch grafting, follicular unit transplantation (FUT), and follicular unit extraction (FUE). FUT emphasized natural follicular grouping, while FUE introduced minimally invasive methods with faster recovery and better aesthetics. Recent advancements include robotic-assisted procedures and bioengineered follicles, reflecting a shift toward precision and patient-centered care.

Conclusion: The continuous evolution of HT techniques underscores its position as the most effective method for hair restoration, particularly in androgenetic alopecia cases.

Background: Facial aging, marked by skin laxity, wrinkling, and dyspigmentation, remains a common aesthetic concern. Few studies have investigated combination approaches to treat these concomitant components of aging.

Objective: To investigate the effect of combining monopolar radiofrequency with fractional nonablative diode laser treatments to improve skin laxity, wrinkling, and dyspigmentation.

Methods and materials: A prospective, single-arm study enrolled 20 females with mild to moderate facial skin laxity and photoaging. Subjects underwent a sequence of one monopolar radiofrequency treatment (Thermage FLX, Solta, Bausch Medica, Bothell, WA) followed by 4 fractional 1440-/1927-nm nonablative diode laser treatments (Clear + Brilliant Touch, Solta, Bausch Medica). Assessments included clinical evaluations, blinded photographic assessments, and patient satisfaction scores.

Results: At the 6-month follow-up, a significant improvement was observed in Skin Laxity Grading Scale and Glogau Classification of Photoaging scale scores (1.65 ± 0.49-1.30 ± 0.47, p = .039, and 1.85 ± 0.36-1.35 ± 0.49, p = .00082, respectively). Blinded reviewers correctly identified 67% of post-treatment photographs, and 77% of participants were considered responders. No serious adverse events occurred.

Conclusion: Monopolar radiofrequency combined with fractional diode led to significant efficacy, suggesting a safe and promising strategy for addressing facial skin laxity, wrinkles, and dyspigmentation.

Background: Poly-l-lactic acid (PLLA-SCA) can be used to improve the aesthetics of the temporal fossae but is usually only deposited within the visible area of the temporal hollows. However, extending the treatment area posterior to the hairline may provide a greater lifting effect.

Objectives: Assess the efficacy and safety of 2 techniques (traditional vs extended) of injecting PLLA-SCA for aesthetic improvement of the temporal fossae.

Materials and methods: A prospective, randomized-controlled clinical trial was conducted. Twenty-four subjects were randomized in a 1-to-1 ratio to the traditional or extended injection technique. Subjects received 3 treatments (Baseline, Week 7, Week 14) and were evaluated for follow-up at Weeks 20, 26, and 38. Assessments included the Global Aesthetic Improvement Scale (GAIS), Temple Volume Deficit Scale (TVDS), lifting and volumizing effects, subject satisfaction, and adverse events.

Results: A greater facial lifting effect (p < .001) and mean decrease in TVDS scores were observed with the extended injection technique. Regardless of injection technique, all subjects were at least improved on the GAIS at Week 38, and there was a low frequency of adverse events.

Conclusion: Poly-l-lactic acid is a safe and effective treatment for improving the aesthetic appearance of the temporal fossae. Outcomes can be maximized using an extended injection technique.

Background: Hair follicle (HF) transplantation, especially through follicular unit excision (FUE), is renowned for treating androgenetic alopecia. Recent advancements have expanded its use in dermatology and plastic surgery.

Objective: This review explores FUE's broader applications beyond hair restoration, including its efficacy in treating chronic ulcers, axillary hyperhidrosis, bromhidrosis, vitiligo, and scar remodeling.

Methods: A comprehensive literature review was conducted using key medical databases, focusing on clinical research such as randomized controlled trials, retrospective studies, case series, and reports, while excluding review articles and commentaries.

Results: Hair follicle transplantation using the FUE technique has shown significant promise in enhancing healing in chronic ulcers and difficult to heal wounds, with cases demonstrating complete wound healing across various ulcer types. The method of sweat gland removal using FUE micropunches substantially reduced sweating and malodor in patients with axillary hyperhidrosis and bromhidrosis. In vitiligo treatment, FUE combined with other therapies showed promising repigmentation results.

Conclusion: Follicular unit excision emerges as a versatile surgical technique demonstrating potential in various conditions beyond alopecia. The minimal complications associated with FUE across various applications highlight its safety profile. Its expanding scope in medical applications calls for further research and clinical trials to optimize its use and understand its full therapeutic potential.