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Hypertrophic scar (HS) is a chronic inflammatory skin disorder characterized by excessive deposition of extracellular matrix, and the mechanisms underlying their formation remain poorly understood. We analysed scRNA‐seq data from samples of normal skin and HS. Using the hdWGCNA method, key gene modules of fibroblasts in HS were identified. Non‐negative matrix factorization was employed to perform subtype analysis of HS patients using these gene modules. Multiple machine learning algorithms were applied to screen and validate accurate gene signatures for identifying and predicting HS, and a convolutional neural network (CNN) based on deep learning was established and validated. Quantitative reverse transcription‐polymerase chain reaction and western blotting were performed to measure mRNA and protein expression. Immunofluorescence was used for gene localization analysis, and biological features were assessed through CCK8 and wound healing assay. Single‐cell sequencing revealed distinct subpopulations of fibroblasts in HS. HdWGCNA identified key gene characteristics of this population, and pseudotime analysis was conducted to investigate gene variation during fibroblast differentiation. By employing various machine learning algorithms, the gene range was narrowed down to three key genes. A CNN was trained using the expression of these key genes and immune cell infiltration, enabling diagnosis and prediction of HS. Functional experiments demonstrated that THBS2 is associated with fibroblast proliferation and migration in HS and affects the formation and development of HS through the TGFβ1/P‐Smad2/3 pathway. Our study identifies unique fibroblast subpopulations closely associated with HS and provides biomarkers for the diagnosis and treatment of HS. [ABSTRACT FROM AUTHOR]

Background: Hypertrophic scar (HS) is caused by the abnormal proliferation of fibroblasts and excessive deposition of extracellular matrix (ECM). Emerging evidence demonstrates that c‐Maf positive M2 macrophages were mainly located in the hypertrophic scar tissues of proliferative phase. But whether c‐Maf positive M2 macrophages can promote hypertrophic scar formation through modulating hypertrophic scar fibroblasts remains elusive. Aims: The aim of this study is to investigate the effects of c‐Maf positive M2 macrophages on the biological behaviors and functions of hypertrophic scar fibroblasts and the potential mechanism. Methods: HE and Masson trichrome staining were used to examine the histological features of human hypertrophic scar. Immunofluorescence staining was employed to label and quantify the c‐Maf+/CD68+ M2 macrophages. CCK8, wound healing, and transwell assays were utilized to test the effects of c‐Maf overexpressed M2 macrophages or the cell culture supernatants on the proliferation and migration of hypertrophic scar derived fibroblasts (HFBs) and normal skin derived fibroblasts (NFBs). Western blot and qPCR were harnessed to test the expressions of COL1, COL3, and α‐SMA in the co‐cultivated fibroblasts and TGF‐β1 in the c‐Maf overexpressed M2 macrophages. Results: Increased number of c‐Maf+/CD68+ M2 macrophages were found in HS in contrast to the normal skin (NS). Elevated proliferation and migration were observed in the HFBs or NFBs co‐cultured with c‐Maf overexpressed macrophages or the cell culture supernatants. A higher mRNA and protein expressions of COL1, COL3, and α‐SMA were recorded in the HFBs co‐cultured with c‐Maf overexpressed macrophages or treated with its culture supernatants. In addition, augmented mRNA and protein expressions of TGF‐β1 were also investigated in the c‐Maf overexpressed macrophages. Conclusion: c‐Maf positive macrophages promote hypertrophic scar formation through regulating HFBs proliferation, migration, and ECM deposition via the secreted TGF‐β1. [ABSTRACT FROM AUTHOR]

Background Fat grafting is an effective procedure for breast augmentation, but the variations in this technique result in unpredictable fat retention. Therefore, animal models are needed to simulate the operation and the optimal layer for fat retention. Objectives An autologous fat grafting murine model for breast augmentation was built to detect a new layer for fat grafting in the chest. Methods The left side of the female rat inguinal fat flap was harvested, dissected into small pieces, and autotransplanted into 3 different layers of the breast. Retention rate and hematoxylin and eosin (H&E) staining were measured at 1, 4, 8 12, and 16 weeks. Immunofluorescence staining was utilized to detect adipocytes and endothelial cells, and immunohistochemistry was conducted to evaluate the expression of integrins β1 and α6. Results The volume of fat grafts slightly grew in the intramuscular and submuscular layers at Week 4. Retention rates in the subcutaneous layer and submuscular layer were significantly higher than the intramuscular layer at Week 16. H&E staining showed that oil cysts existed in the subcutaneous layer throughout the 16 weeks. At the terminal time point, well-vascularized mature adipose structures were observed in intramuscular and submuscular layers, with smaller adipocytes in intramuscular layers. Immunohistochemistry analysis showed that integrin β1 was identically expressed in every adipocyte in all the layers, whereas integrin α6 selectively expressed in bigger adipocytes in the intramuscular layer. The expression intensities of integrin β1 and α6 were significantly higher in the intramuscular layer than in the subcutaneous and submuscular layers. Conclusions The angiogenic and moderate mechanical environment makes the submuscular layer the optimal layer for fat retention. [ABSTRACT FROM AUTHOR]

Background Dorsal augmentation with costal cartilage is generally used for aesthetic rhinoplasty. However, the tendency of costal cartilage to warp may jeopardize the aesthetic outcome. Objectives The aim of this study was to describe a new "Z" technique to overcome the warping of costal cartilage after implantation and to evaluate the efficacy of this technique in vitro. Methods A total of 31 pairs of porcine costal cartilage grafts (40 mm × 10 mm × 5 mm) were obtained and kept in Dulbecco's Modified Eagle Medium (Sigma-Aldrich, St. Louis, MO) to maintain cell viability. Paired grafts were obtained and randomly allocated for preparation by the accordion technique and the "Z" technique. Standardized photographs (obtained immediately after operation and at 4 weeks) were used for warping analysis. Biomechanical testing was performed to measure the graft's capacity to resist deformation by an external force. Results Cell viability of the grafts at 4 weeks was comparably good in the accordion group and the Z group (61.88% ± 4.47% vs 67.48% ± 7.03%, P = 0.55). Warping angle was comparable between the 2 groups (P > 0.01). The capacity to resist external force was significantly better in the Z group; the force needed to cause deformation was 3.98 ± 1.04 N in the Z group vs 1.61 ± 0.47 N in the accordion group in lateral view (P < 0.0001), and 1.33 ± 0.41 N vs 0.96 ± 0.24 N, respectively, in frontal view (P = 0.0013). Conclusions The "Z" technique appears to be a simple and effective method to minimize the tendency of costal cartilage to warp after implantation. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Method Result Conclusion Public health and social measures (PHSMs) are considered the most effective approaches for controlling epidemic diseases. This study aimed to explore variations in the time‐dependent characteristics of and public preferences for cosmetic treatments during and after the implementation of PHSMs during the COVID‐19 pandemic.Medical records from six medical institutions were extracted retrospectively. Time–series analyses were conducted to reveal the variations in characteristics in volume and proportion of cosmetic treatments according to PHSMs. A cross‐sectional study was conducted with online questionnaire designed for the general population during and after the implementation of PHSMs.A total of 141 033 records were included in this retrospective study. The implementation of PHSMs led to extremely low treatment volumes; compared with the increases in private hospitals, the treatment volumes in public hospitals exhibited earlier and more significant increases, even higher than pre‐PHSM levels (p < 0.05), which mainly contributed to the increase in plastic surgery volumes during and after the implementation of PHSMs. The differences in the anxiety state, self‐perceived appearance, and cosmetic treatment intentions of the participants were illustrated during and after PHSMs. We further demonstrated the participants' decisions on cosmetic treatments after the implementation of PHSMs during the COVID‐19 pandemic.The immediate effects and aftereffects of PHSMs on cosmetic treatments were different in public and private hospitals. Furthermore, as PHSMs guided the adjustment of cosmetic treatments in the post‐COVID‐19 era, the intention to undergo cosmetic treatment during PHSMs was associated with the anxiety states and preferences of the population. [ABSTRACT FROM AUTHOR]

Background Objective Method Results Conclusion Eyebrows play a crucial role in the human body. While Follicular Unit Extraction (FUE) is a widely utilized and highly effective treatment for typical eyebrow deficiencies, it may not yield satisfactory outcomes for patients with post‐traumatic eyebrow scars and defects.A prospective comparative clinical study was conducted to explore the treatment outcomes of post‐traumatic eyebrow scars accompanied by defects using a combination of ablative fractional CO2 laser therapy with FUE.Between January 2019 and January 2023, we enrolled 30 patients with post‐traumatic eyebrow scars and accompanying eyebrow defects, randomly assigning them to experimental and control groups. Patients in the control group received FUE treatment exclusively, whereas patients in the experimental group underwent CO2 fractional laser therapy on the eyebrow scars prior to FUE treatment. Alongside the patients' baseline data and the quantity of transplanted follicular units during surgery, we will compare the follicular survival rates between the two groups at 6 and 12 months post‐treatment.Prior to FUE, there were no notable variances in baseline data between the two‐patient groups. At 6 and 12 months postoperatively, the follicular survival rate in the experimental group was significantly higher compared to the control group. Additionally, patients in the control group were more prone to experiencing postoperative asymmetry between their eyebrows and developing curly hair.For patients with post‐traumatic eyebrow scars accompanied by eyebrow defects, we applied ablative fractional CO2 laser therapy in combination with FUE treatment. This approach not only resulted in a higher follicular survival rate postoperatively but also led to the achievement of a well‐defined eyebrow shape. [ABSTRACT FROM AUTHOR]

Cosmetic periorbital and eyelid surgery is a commonly performed procedure in facial plastic surgery. Understanding the biomechanics of periorbital anatomy and its role in aesthetic surgery is essential for achieving optimal outcomes. This review explores the biomechanical processes involved in periorbital age changes and analyzes the impact of cosmetic surgery approaches on these processes. By maintaining the initial mechanical equilibrium of the brows, eyelids, septal fat, and blepharoplasty folds, periorbital and eyelid cosmetic surgery can effectively rejuvenate the appearance. Disruption of this equilibrium can lead to the migration of anatomic components, resulting in signs of aging. Surgeons, by applying biomechanical concepts, can tailor the forces exerted upon the different structures to manifest the patient's aesthetic aspirations. The key to success in periorbital and eyelid cosmetic surgery lies in re-establishing a dynamic mechanical equilibrium within the periorbital framework., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

This paper presents the findings of an observational study involving 38 patients to evaluate the application of a surgical technique utilizing an autologous costal cartilage scaffold for correcting nasal tip and alar asymmetry in unilateral cleft lip-nasal deformity. Nasal septum extension spreader grafts (SEG) and warped alar batten grafts, both made from autologous costal cartilage, were utilized in open rhinoplasty procedures. The warped alar batten graft was fixed to the caudal end of the SEG, with the lower lateral cartilage on the cleft side suspended to the free part of the newly created warped alar batten graft to lift the collapsed nasal alar further. Measurements of nasal tip height, nostril height, and the intersection angle of the nasal sill and alar (α) were taken before and after surgery, comparing the ratios between the normal and cleft sides. Patients were followed up for 2.5 to 5.5 years, with all cases showing successful healing and no complications. Postoperative improvements in nasal tip and nostril asymmetries were significant, with statistically significant changes observed in nasal tip height, nostril height, and the intersection angle of nasal sill and alar (α) (P<0.05). The combined use of SEG and warped alar batten graft, both crafted from autologous costal cartilage, effectively corrected nasal tip and alar asymmetry in adult cleft lip nasal deformity cases., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Background: Reconstruction of composite scalp and skull defects is a great challenge for plastic surgeons, and this study aimed to report the therapeutic regimen of using free ALT flaps with fascia lata and vastus lateralis muscle to cover scalp and cranial defects., Methods: A retrospective analysis was performed including 10 patients with composite scalp and skull defects who were treated with a free ALT flap with fascia lata and vastus lateralis muscle from January 2012 to June 2020. All patients underwent a 1-stage operation and were followed up for 1 year with clinical data including sex, age, etiology, skull defect area, scalp defect area, flap area, dura mater involvement, recipient vessel, donor site repair, lumbar cistern drainage, and complications., Results: All flaps survived well, 2 patients developed complications, one had cerebrospinal fluid leakage, and another experienced partial skin graft necrosis; All patients were satisfied with both the appearance and functional outcomes of the procedure., Conclusion: Free tissue transplantation is an effective method for large defects of the scalp and skull. The combination of a free ALT flap with fascia lata and vastus lateralis muscle, which has a long pedicle, convenient flap designs, less donor-site morbidity, and effective prevention of cerebrospinal fluid leakage, is an ideal choice to repair the composite scalp and cranial defects in stage 1., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)